RN Pharmacology Online Practice 2023
A
A nurse is caring for a client who is to receive treatment for opiod use disorder. Which of
the following medications should the nurse expect to administer?
A. Bupropion
B. Disulfiram
C. Modafinil
D. Methadone - answersD. Methadone
Rationale:
The nurse should expect to administer methadone for treatment of opioid use disorder.
Methadone can be administered for withdrawal and to assist with maintenance and
suppressive therapy.
The nurse should administer modafinil to assist with the fatigue and prolonged sleep
from methamphetamine withdrawal.
The nurse should administer disulfiram as an aversion therapy to assist with maintaining
abstinence from alcohol.
The nurse should administer bupropion to assist the client with smoking cessation.
A nurse is caring for a client on a medical-surgical unit.
Nurses' Notes:
Yesterday:Client was admitted 1 week ago with a Crohn's disease exacerbation. A
central venous access device (CVAD) was placed in the client's right subclavian vein.
Total parental nutrition (TPN) and lipids initiated 3 days ago. The client is NPO. The
client reports abdominal pain as 5 on a scale of 0 to 10. Bowel sounds are hyperactive
and lower right quadrant is tender to palpation.
,Today:The 24-hr bag of TPN infusion was complete 1 hr ago, pharmacy notified and
waiting for a new bag. CVAD dressing is clean, dry, and intact. CVAD is difficult to flush.
The client reports abdominal pain as 4 on a scale of 0 to 10 and chills.
Vital Signs:
Yesterday:
Oral temperature 36.6° C (97.9° F)
Pulse 80/min
Respiratory rate 16/min
Blood pressure 105/78 mm Hg
Oxygen saturation 99% on room air
Today:
Oral temperature 37.4° C (99.4° F)
Pu - answersThe nurse should first address the client's Glucose level, followed by the
client's CVAD.
Rationale:
When analyzing cues, the nurse should identify that the client is developing
hypoglycemia and experiencing a complication with the central venous line (CVL).
Hypoglycemia can occur if the TPN is stopped abruptly. A CVAD can become occluded
or infected. Findings of a CVL complication can include difficulty flushing, pain while
flushing, fever, or chills.
A nurse is preparing to administer hydrochlorothiazide (HCTZ) to a client. Which of the
following actions should the nurse take prior to administering the medication?
A. Ask the client to drink 8 oz of water.
B. Review the client's most recent Hgb level.
C. Obtain the client's blood pressure.
D. Determine if the client is allergic to NSAIDs. - answersC. Obtain the client's blood
pressure.
Rationale:
HCTZ is a thiazide diuretic administered to promote urine output and reduce blood
pressure and edema. The nurse should obtain the client's blood pressure prior to
administration of the medication.
HCTZ is a thiazide diuretic administered to promote urine output and reduce blood
pressure and edema. The client does not need to drink 8 oz of water prior to taking the
medication.
HCTZ does not affect Hgb levels. The nurse should monitor the client's electrolytes,
especially potassium, before and periodically while the client is taking this medication.
The nurse should assess the client for an allergy to sulfonamides due to the potential of
cross-sensitivity with HCTZ. NSAIDs can decrease the effectiveness of HCTZ.
,A nurse is planning care for a client who is receiving mannitol via continuous IV infusion.
Which of the following adverse effects should the nurse monitor the client for?
A. Weight loss
B. Increased intraocular pressure
C. Auditory hallucinations
D. Bibasilar crackles - answersD. Bibasilar crackles
Rationale:
Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema.
Therefore, the nurse should recognize lung crackles as an indicator of a potential
complication and stop the infusion.
Mannitol is an osmotic diuretic used to promote diuresis, decrease intracranial pressure,
and improve renal function. An expected therapeutic effect of mannitol is weight loss
resulting from diuresis.
An indication for the use of mannitol is increased intraocular pressure. Mannitol
decreases the intraocular pressure by creating an osmotic gradient between the
intraocular fluid and the plasma.
Mannitol has several neurologic adverse effects, including increased intracranial
pressure, seizures, confusion, and headaches. However, it does not cause auditory
hallucinations.
A nurse is caring for a client who is taking nitroglycerin for angina and reports feeling
faint when standing up. Which of the following actions should the nurse take?
A. Inform the client that feeling faint is caused by rapid constriction of the blood vessels
in the legs.
B. Assist the client into bed, elevate the lower extremities, and check their blood
pressure.
C. Request a prescription for dobutamine from the client's provider.
D. Check the client's blood pressure while they're still standing. - answersB. Assist the
client into bed, elevate the lower extremities, and check their blood pressure.
Rationale:
The nurse should first assist the client into bed to prevent injuries from a fall. The nurse
should elevate the client's legs on pillows to enhance venous return from the lower
extremities. The nurse should then check the client's blood pressure.
Orthostatic, or postural, hypotension is caused by vasodilation of the blood vessels of
the lower extremities, which allows pooling of blood. This pooling leads to
manifestations such as dizziness, light headedness, or feeling faint. Nitroglycerin
causes vasodilation.
, Dobutamine is an adrenergic agonist medication used in the treatment of heart failure or
cardiogenic shock. It is not used in the treatment of orthostatic hypotension.
To assess for orthostatic hypotension, the nurse should have the client lie supine for at
least 5 minutes, then check their blood pressure. The nurse should then have the client
sit up and recheck the blood pressure. Last, the client should stand up and the nurse
should measure the blood pressure.
A nurse is preparing medication instructions for a client who is receiving end-of-life care
and their family. The client has a prescription for fentanyl patches. Which of the
following information regarding the manifestations and use of fentanyl should the nurse
include in the instructions?
A. Respiratory depression as a result of fentanyl use will cause a need for an at-home
nefazodone prescription.
B. Removing the patch will immediately reverse any adverse effects of fentanyl.
C. An increase in urinary output should be expected.
D. Taking a stool softener daily will be needed. - answersD. Taking a stool softener
daily will be needed.
Rationale:
Constipation is an adverse effect of opioid use. Stool softeners can decrease the
severity of this adverse effect.
Urinary retention is an adverse effect of opioids, including fentanyl.
After removing the patch, the effects will persist for several hours due to the absorption
of the residual medication on the skin.
Naloxone may be prescribed for the reversal of severe respiratory depression, not
nefazodone, an atypical antidepressant.
A nurse is providing teaching to a client who has a gastric ulcer and a new prescription
for famotidine.
Which of the following instructions should the nurse include?
A. "Take the medication on an empty stomach for full effectiveness."
B. "You may discontinue this medication when stomach discomfort subsides."
C. "Report yellowing of the skin."
D. "You will be taking this medication for 2 weeks." - answersC. "Report yellowing of the
skin."
Rationale:
Famotidine can be hepatotoxic and cause jaundice. The nurse should instruct the client
to monitor for and report yellowing of the skin or eyes to the provider.
The client can take famotidine with or without food because food does not affect the
medication's effectiveness.
A
A nurse is caring for a client who is to receive treatment for opiod use disorder. Which of
the following medications should the nurse expect to administer?
A. Bupropion
B. Disulfiram
C. Modafinil
D. Methadone - answersD. Methadone
Rationale:
The nurse should expect to administer methadone for treatment of opioid use disorder.
Methadone can be administered for withdrawal and to assist with maintenance and
suppressive therapy.
The nurse should administer modafinil to assist with the fatigue and prolonged sleep
from methamphetamine withdrawal.
The nurse should administer disulfiram as an aversion therapy to assist with maintaining
abstinence from alcohol.
The nurse should administer bupropion to assist the client with smoking cessation.
A nurse is caring for a client on a medical-surgical unit.
Nurses' Notes:
Yesterday:Client was admitted 1 week ago with a Crohn's disease exacerbation. A
central venous access device (CVAD) was placed in the client's right subclavian vein.
Total parental nutrition (TPN) and lipids initiated 3 days ago. The client is NPO. The
client reports abdominal pain as 5 on a scale of 0 to 10. Bowel sounds are hyperactive
and lower right quadrant is tender to palpation.
,Today:The 24-hr bag of TPN infusion was complete 1 hr ago, pharmacy notified and
waiting for a new bag. CVAD dressing is clean, dry, and intact. CVAD is difficult to flush.
The client reports abdominal pain as 4 on a scale of 0 to 10 and chills.
Vital Signs:
Yesterday:
Oral temperature 36.6° C (97.9° F)
Pulse 80/min
Respiratory rate 16/min
Blood pressure 105/78 mm Hg
Oxygen saturation 99% on room air
Today:
Oral temperature 37.4° C (99.4° F)
Pu - answersThe nurse should first address the client's Glucose level, followed by the
client's CVAD.
Rationale:
When analyzing cues, the nurse should identify that the client is developing
hypoglycemia and experiencing a complication with the central venous line (CVL).
Hypoglycemia can occur if the TPN is stopped abruptly. A CVAD can become occluded
or infected. Findings of a CVL complication can include difficulty flushing, pain while
flushing, fever, or chills.
A nurse is preparing to administer hydrochlorothiazide (HCTZ) to a client. Which of the
following actions should the nurse take prior to administering the medication?
A. Ask the client to drink 8 oz of water.
B. Review the client's most recent Hgb level.
C. Obtain the client's blood pressure.
D. Determine if the client is allergic to NSAIDs. - answersC. Obtain the client's blood
pressure.
Rationale:
HCTZ is a thiazide diuretic administered to promote urine output and reduce blood
pressure and edema. The nurse should obtain the client's blood pressure prior to
administration of the medication.
HCTZ is a thiazide diuretic administered to promote urine output and reduce blood
pressure and edema. The client does not need to drink 8 oz of water prior to taking the
medication.
HCTZ does not affect Hgb levels. The nurse should monitor the client's electrolytes,
especially potassium, before and periodically while the client is taking this medication.
The nurse should assess the client for an allergy to sulfonamides due to the potential of
cross-sensitivity with HCTZ. NSAIDs can decrease the effectiveness of HCTZ.
,A nurse is planning care for a client who is receiving mannitol via continuous IV infusion.
Which of the following adverse effects should the nurse monitor the client for?
A. Weight loss
B. Increased intraocular pressure
C. Auditory hallucinations
D. Bibasilar crackles - answersD. Bibasilar crackles
Rationale:
Mannitol, an osmotic diuretic, can precipitate heart failure and pulmonary edema.
Therefore, the nurse should recognize lung crackles as an indicator of a potential
complication and stop the infusion.
Mannitol is an osmotic diuretic used to promote diuresis, decrease intracranial pressure,
and improve renal function. An expected therapeutic effect of mannitol is weight loss
resulting from diuresis.
An indication for the use of mannitol is increased intraocular pressure. Mannitol
decreases the intraocular pressure by creating an osmotic gradient between the
intraocular fluid and the plasma.
Mannitol has several neurologic adverse effects, including increased intracranial
pressure, seizures, confusion, and headaches. However, it does not cause auditory
hallucinations.
A nurse is caring for a client who is taking nitroglycerin for angina and reports feeling
faint when standing up. Which of the following actions should the nurse take?
A. Inform the client that feeling faint is caused by rapid constriction of the blood vessels
in the legs.
B. Assist the client into bed, elevate the lower extremities, and check their blood
pressure.
C. Request a prescription for dobutamine from the client's provider.
D. Check the client's blood pressure while they're still standing. - answersB. Assist the
client into bed, elevate the lower extremities, and check their blood pressure.
Rationale:
The nurse should first assist the client into bed to prevent injuries from a fall. The nurse
should elevate the client's legs on pillows to enhance venous return from the lower
extremities. The nurse should then check the client's blood pressure.
Orthostatic, or postural, hypotension is caused by vasodilation of the blood vessels of
the lower extremities, which allows pooling of blood. This pooling leads to
manifestations such as dizziness, light headedness, or feeling faint. Nitroglycerin
causes vasodilation.
, Dobutamine is an adrenergic agonist medication used in the treatment of heart failure or
cardiogenic shock. It is not used in the treatment of orthostatic hypotension.
To assess for orthostatic hypotension, the nurse should have the client lie supine for at
least 5 minutes, then check their blood pressure. The nurse should then have the client
sit up and recheck the blood pressure. Last, the client should stand up and the nurse
should measure the blood pressure.
A nurse is preparing medication instructions for a client who is receiving end-of-life care
and their family. The client has a prescription for fentanyl patches. Which of the
following information regarding the manifestations and use of fentanyl should the nurse
include in the instructions?
A. Respiratory depression as a result of fentanyl use will cause a need for an at-home
nefazodone prescription.
B. Removing the patch will immediately reverse any adverse effects of fentanyl.
C. An increase in urinary output should be expected.
D. Taking a stool softener daily will be needed. - answersD. Taking a stool softener
daily will be needed.
Rationale:
Constipation is an adverse effect of opioid use. Stool softeners can decrease the
severity of this adverse effect.
Urinary retention is an adverse effect of opioids, including fentanyl.
After removing the patch, the effects will persist for several hours due to the absorption
of the residual medication on the skin.
Naloxone may be prescribed for the reversal of severe respiratory depression, not
nefazodone, an atypical antidepressant.
A nurse is providing teaching to a client who has a gastric ulcer and a new prescription
for famotidine.
Which of the following instructions should the nurse include?
A. "Take the medication on an empty stomach for full effectiveness."
B. "You may discontinue this medication when stomach discomfort subsides."
C. "Report yellowing of the skin."
D. "You will be taking this medication for 2 weeks." - answersC. "Report yellowing of the
skin."
Rationale:
Famotidine can be hepatotoxic and cause jaundice. The nurse should instruct the client
to monitor for and report yellowing of the skin or eyes to the provider.
The client can take famotidine with or without food because food does not affect the
medication's effectiveness.
