Pharm Final Exam
The nurse is teaching a student about the administration of opioid analgesics. Which statement
by the student nurse indicates a need for further teaching?
a. I will contact the prescriber if the patient's condition declines after receiving pain medication.
b. To maximize analgesic effects, opioid analgesics are given when the pain has reached its
peak.
c. Oral doses of opioid analgesics may be given with food to minimize GI upset.
d. I will assess the patient's respiratory rate and bowel sounds before administering the
morphine dose as ordered. - ANSB
Rationale: "Opioids or any analgesic must be given before the pain reaches its peak to help
maximize the effectiveness of the opioid or other analgesic." (Lilley, p. 157). The statement in
answer B is inaccurate and therefore indicates the need for further teaching. All of the other
answers are accurate and do not require further teaching.
True or False.
Morphine is seven times more potent than hydromorphone (Dilaudid) - ANSFalse
Rationale: "Hydromorphone (Dilaudid) is seven times more potent than morphine." (Lilley, p.
143).
Which statement given by the patient demonstrates a need for further teaching by the nurse
regarding the use of antacids?
a. Antacids increase the secretion of bicarbonate from the glands in the stomach.
b. Antacids neutralize stomach acid.
c. Antacids promote gastric mucosal defensive mechanisms.
d. Antacids decrease the responsiveness of parietal cells and increase the pH in the stomach. -
ANSD
Rationale: "Antacids work by neutralizing gastric acidity, promoting gastric mucosal defensive
mechanisms, and stimulate the secretion of mucus, prostaglandins, and bicarbonate from the
cells inside the gastric glands" (Lilley, 2562). Therefore the answer is D. "H2 receptor
antagonists make the parietal cell less responsive. The effect of these drugs is reduced
hydrogen ion secretion from the parietal cells, which results in an increase in the pH of the
stomach" (Lilley, 2570).
When the nurse is administering Lansoprazole (Prevacid) which action by the nurse is correct?
a. The nurse will administer Lansoprazole along with Tums.
,b. The capsule of Lansoprazole can be opened and mixed with water and put in an NGT.
c. The nurse will clarify the order with the HCP when Lansoprazole comes as a capsule.
d. The nurse will administer Lansoprazole during the meal. - ANSB
Rationale: "The capsules can be opened and mixed (not crushed with apple juice for
administration via NG tube" (Lilley, 2578). "A is wrong because antacids should be given within
1-2 hours of other medications, because antacids may impair absorption of other oral
medications" (Lilley, 2587). C is wrong because the capsule can be open and mixed (Lilley,
2578). "D is wrong because PPIs are to be taken before meals" (Lilley, 2590).
A client with history of opioid abuse is hospitalized for surgery. The nurse enters the room to find
the client unresponsive, and has pinpoint pupils. Which prescribed medication should be
administered?
a. Diazepam (Valium)
b. Naloxone (Narcan)
c. Clonidine(Catapres)
d. Methadone(Dolophine) - ANSB
Rationale: "Based on client's assessment, it is indicative of opioid overdose, naloxone (opioid
antagonist) should be given to prevent the client from going into respiratory arrest." (p. 275)
True or False.
A patient who is taking Disulfiram (Antabuse) has consumed half of a beer. As a result of the
mechanism of action of the medication he is taking, the patient should expect to experience
copious vomiting. - ANSTrue
Rationale: "Disulfiram alters the metabolism of alcohol, which produces adverse effects within
5-10 minutes after alcohol consumption, these effects include copious vomiting, throbbing in the
head and neck, diaphoresis and blurred vision. As little as 7ml of alcohol will cause mild
symptoms in a sensitive person and the effects last from 30 minutes to several hours. (p. 278)"
During preoperative care, the nurse applies a scopolamine patch to prevent postoperative
nausea and vomiting. Which of the following demonstrates incorrect nursing care?
a. The nurse applies the patch behind the patient's ear.
b. The nurse takes off the transdermal patch 72 hours after application and documents the
removal.
c. The nurse applies a barrier cream to the skin before putting on the patch to prevent skin
irritation.
d. If the patch falls off, the nurse washes off the residual drug and applies a new patch. - ANSC
Rationale: Scopolamine patches should be applied to dry, clean skin behind the ear (p. 819).
, True or False.
Extrapyramidal reactions, such as tardive dyskinesia, is an adverse side effect of taking
metoclopramide. - ANSTrue
Rationale: Particularly in young adults, extrapyramidal reactions can occur with making
prokinetic medications like metoclopramide because these drugs can enhance involuntary
muscle movements. Long-term use of metoclopramide has been associated with the
development of tardive dyskinesia (p. 816, 819).
A patient who has been taking antihypertensive drugs for a few months complains of having a
persistent dry cough. The nurse knows that this cough is an adverse effect of which class of
antihypertensive drugs?
a. Beta blockers
b. Angiotensin-converting enzyme (ACE) inhibitors
c. Angiotensin II receptor blockers (ARBs)
d. Calcium channel blockers - ANSB
Rationale: ACE inhibitors cause a characteristic dry, nonproductive cough that reverses when
therapy is stopped. The other drug classes do not cause this cough (p. 340).
A pregnant woman is experience hypertension. The nurse knows that which drug is commonly
used for a pregnant patient who is experiencing hypertension?
a. Mannitol (Osmitrol)
b. Enalapril (Vasotec)
c. Hydrochlorothiazide (HydroDIURIL)
d. Methyldopa (Aldomet) - ANSD
Rationale: Methyldopa is used in the treatment of hypertension during pregnancy. The other
drug options are incorrect (p.338).
The nurse will give an intravenous dose of phenytoin (Dilantin). Which statement is correct
when administering phenytoin (Dilantin)?
a. Mix the drug with normal saline and give it as a slow IV push.
b. Give the dose only IV infusion.
c. Mix the drug with D5W and give it as a slow IV infusion.
d. Give the drug undiluted and don't have to use a filter to draw the drug. - ANSA
Rationale: phenytoin is "very irritating to veins when injected and must be given by slow
intravenous (IV) push (not exceeding 50 mg/min in adults) directly into a large vein through a
The nurse is teaching a student about the administration of opioid analgesics. Which statement
by the student nurse indicates a need for further teaching?
a. I will contact the prescriber if the patient's condition declines after receiving pain medication.
b. To maximize analgesic effects, opioid analgesics are given when the pain has reached its
peak.
c. Oral doses of opioid analgesics may be given with food to minimize GI upset.
d. I will assess the patient's respiratory rate and bowel sounds before administering the
morphine dose as ordered. - ANSB
Rationale: "Opioids or any analgesic must be given before the pain reaches its peak to help
maximize the effectiveness of the opioid or other analgesic." (Lilley, p. 157). The statement in
answer B is inaccurate and therefore indicates the need for further teaching. All of the other
answers are accurate and do not require further teaching.
True or False.
Morphine is seven times more potent than hydromorphone (Dilaudid) - ANSFalse
Rationale: "Hydromorphone (Dilaudid) is seven times more potent than morphine." (Lilley, p.
143).
Which statement given by the patient demonstrates a need for further teaching by the nurse
regarding the use of antacids?
a. Antacids increase the secretion of bicarbonate from the glands in the stomach.
b. Antacids neutralize stomach acid.
c. Antacids promote gastric mucosal defensive mechanisms.
d. Antacids decrease the responsiveness of parietal cells and increase the pH in the stomach. -
ANSD
Rationale: "Antacids work by neutralizing gastric acidity, promoting gastric mucosal defensive
mechanisms, and stimulate the secretion of mucus, prostaglandins, and bicarbonate from the
cells inside the gastric glands" (Lilley, 2562). Therefore the answer is D. "H2 receptor
antagonists make the parietal cell less responsive. The effect of these drugs is reduced
hydrogen ion secretion from the parietal cells, which results in an increase in the pH of the
stomach" (Lilley, 2570).
When the nurse is administering Lansoprazole (Prevacid) which action by the nurse is correct?
a. The nurse will administer Lansoprazole along with Tums.
,b. The capsule of Lansoprazole can be opened and mixed with water and put in an NGT.
c. The nurse will clarify the order with the HCP when Lansoprazole comes as a capsule.
d. The nurse will administer Lansoprazole during the meal. - ANSB
Rationale: "The capsules can be opened and mixed (not crushed with apple juice for
administration via NG tube" (Lilley, 2578). "A is wrong because antacids should be given within
1-2 hours of other medications, because antacids may impair absorption of other oral
medications" (Lilley, 2587). C is wrong because the capsule can be open and mixed (Lilley,
2578). "D is wrong because PPIs are to be taken before meals" (Lilley, 2590).
A client with history of opioid abuse is hospitalized for surgery. The nurse enters the room to find
the client unresponsive, and has pinpoint pupils. Which prescribed medication should be
administered?
a. Diazepam (Valium)
b. Naloxone (Narcan)
c. Clonidine(Catapres)
d. Methadone(Dolophine) - ANSB
Rationale: "Based on client's assessment, it is indicative of opioid overdose, naloxone (opioid
antagonist) should be given to prevent the client from going into respiratory arrest." (p. 275)
True or False.
A patient who is taking Disulfiram (Antabuse) has consumed half of a beer. As a result of the
mechanism of action of the medication he is taking, the patient should expect to experience
copious vomiting. - ANSTrue
Rationale: "Disulfiram alters the metabolism of alcohol, which produces adverse effects within
5-10 minutes after alcohol consumption, these effects include copious vomiting, throbbing in the
head and neck, diaphoresis and blurred vision. As little as 7ml of alcohol will cause mild
symptoms in a sensitive person and the effects last from 30 minutes to several hours. (p. 278)"
During preoperative care, the nurse applies a scopolamine patch to prevent postoperative
nausea and vomiting. Which of the following demonstrates incorrect nursing care?
a. The nurse applies the patch behind the patient's ear.
b. The nurse takes off the transdermal patch 72 hours after application and documents the
removal.
c. The nurse applies a barrier cream to the skin before putting on the patch to prevent skin
irritation.
d. If the patch falls off, the nurse washes off the residual drug and applies a new patch. - ANSC
Rationale: Scopolamine patches should be applied to dry, clean skin behind the ear (p. 819).
, True or False.
Extrapyramidal reactions, such as tardive dyskinesia, is an adverse side effect of taking
metoclopramide. - ANSTrue
Rationale: Particularly in young adults, extrapyramidal reactions can occur with making
prokinetic medications like metoclopramide because these drugs can enhance involuntary
muscle movements. Long-term use of metoclopramide has been associated with the
development of tardive dyskinesia (p. 816, 819).
A patient who has been taking antihypertensive drugs for a few months complains of having a
persistent dry cough. The nurse knows that this cough is an adverse effect of which class of
antihypertensive drugs?
a. Beta blockers
b. Angiotensin-converting enzyme (ACE) inhibitors
c. Angiotensin II receptor blockers (ARBs)
d. Calcium channel blockers - ANSB
Rationale: ACE inhibitors cause a characteristic dry, nonproductive cough that reverses when
therapy is stopped. The other drug classes do not cause this cough (p. 340).
A pregnant woman is experience hypertension. The nurse knows that which drug is commonly
used for a pregnant patient who is experiencing hypertension?
a. Mannitol (Osmitrol)
b. Enalapril (Vasotec)
c. Hydrochlorothiazide (HydroDIURIL)
d. Methyldopa (Aldomet) - ANSD
Rationale: Methyldopa is used in the treatment of hypertension during pregnancy. The other
drug options are incorrect (p.338).
The nurse will give an intravenous dose of phenytoin (Dilantin). Which statement is correct
when administering phenytoin (Dilantin)?
a. Mix the drug with normal saline and give it as a slow IV push.
b. Give the dose only IV infusion.
c. Mix the drug with D5W and give it as a slow IV infusion.
d. Give the drug undiluted and don't have to use a filter to draw the drug. - ANSA
Rationale: phenytoin is "very irritating to veins when injected and must be given by slow
intravenous (IV) push (not exceeding 50 mg/min in adults) directly into a large vein through a
