Pharmacology Practice Quiz Questions and Answers Graded A

Pharmacology Practice Quiz Questions and Answers Graded A Following the administration of sublingual nitroglycerin to a client experiencing an acute anginal attack, which assessment finding indicates to the nurse that the desired effect has been achieved? A) Client states chest pain is relieved. B) Client's pulse decreases from 120 to 90. C) Client's systolic blood pressure decreases from 180 to 90. D) Client's SaO2 level increases from 92% to 96%. - ANS- Client states chest pain is relieved. Rationale: Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and reduces chest pain (A). (B and D) would also occur if the angina was relieved, but are not as significant as the client's subjective report of decreased pain. (C) may indicate a reduction in pain, or a potentially serious side effect of the medication. Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription for warfarin Coumadin. In conducting discharge teaching, the nurse advises the client to have which diagnostic test monitored regularly after discharge? A) Perfusion scan. B) Prothrombin Time (PT/INR). C) Activated partial thromboplastin (APTT). D) Serum Coumadin level (SCL). - ANS- Prothrombin Time (PT/INR) Rationale: When used for a client with pulmonary embolus, the therapeutic goal for warfarin therapy is a PT 1½ to 2½ times greater than the control, or an INR of 2 to 3 (B). A perfusion might be performed to monitor lung function, but not monthly (A). APTT is monitored for the client receiving heparin therapy (C). A blood level for Coumadin cannot be measured (D). A healthcare provider prescribes cephalexin monohydrate Keflex for a client with a postoperative infection. It is most important for the nurse to assess for what additional drug allergy before administering this prescription? A) Penicillins. B) Aminoglycosides. C) Erythromycins. D) Sulfonamides. - ANS- Penicillin Rationale: Cross-allergies exist between penicillins (A) and cephalosporins, such as cephalexin monohydrate (Keflex), so checking for penicillin allergy is a wise precaution before administering this drug. A client is admitted to the coronary care unit with a medical diagnosis of acute myocardial infarction. Which medication prescription decreases both preload and afterload? A) Nitroglycerin. B) Propranolol (Inderal). C) Morphine. D) Captopril (Capoten). - ANS- Nitroglycerin Rationale: Nitroglycerin (A) is a nitrate that causes peripheral vasodilation and decreases contractility, thereby decreasing both preload and afterload. (B) is a beta adrenergic blocker that decreases both heart rate and contractility, but only decreases afterload. Morphine (C) decreases myocardial oxygen consumption and preload. Capoten (D) is an angiotensin converting enzyme (ACE) inhibitor that acts to prevents vasoconstriction, thereby decreasing blood pressure and afterload. Which dosing schedule should the nurse teach the client to observe for a controlled-release oxycodone prescription? A) As needed. B) Every 12 hours. C) Every 24 hours. D) Every 4 to 6 hours. - ANS- Every 12 hours Rationale: A controlled-release oxycodone provides long-acting analgesia to relieve moderate to severe pain, so a dosing schedule of every 12 hours (B) provides the best around-the-clock pain management. Controlled-release oxycodone is not prescribed for breakthrough pain on a PRN or as needed schedule (A). (C) is inadequate for continuous pain management. Using a schedule of every 4 to 6 hours (D) may jeopardize patient safety due to cumulative effects. A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the nurse to obtain the trough level? A) Sixty minutes after the antibiotic dose is administered. B) Immediately before the next antibiotic dose is given. C) When the next blood glucose level is to be checked. D) Thirty minutes before the next antibiotic dose is given. - ANS- Immediately before the next antibiotic dose is given Rationale: Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose is given (B). (A, C, and D) do not describe the optimum time for obtaining a trough level of an antibiotic. After abdominal surgery, a male client is prescribed low molecular weight heparin LMWH. During administration of the medication, the client asks the nurse why he is receiving this medication. Which is the best response for the nurse to provide? A) This medication is a blood thinner given to prevent blood clot formation. B) This medication enhances antibiotics to prevent infection. C) This medication dissolves any clots that develop in the legs. D) This abdominal injection assists in the healing of the abdominal wound. - ANS- This medication is a blood thinner given to prevent blood clot formation Rationale: Unfractionated heparin or low molecular weight heparin (LMWH) is an anticoagulant that inhibits thrombin-mediated conversion of fibrinogen to fibrin and is given prophylactically to prevent postoperative venous thrombosis (A) or to treat pulmonary embolism or deep vein thrombosis following knee and abdominal surgeries. Heparin does not dissolve clots but prevents clot extension or further clot formation (C). The anticoagulant heparin does not prevent infection (B) or influence operative wound healing (D). A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the nurse should indicate that the desired outcome of the medication is being achieved? A) Decreased blood pressure. B) Lessening of tremors. C) Increased salivation. D) Increased attention span. - ANS- Lessening of tremors Rationale: Sinemet increases the amount of levodopa to the CNS (dopamine to the brain). Increased amounts of dopamine improve the symptoms of Parkinson's, such as involuntary movements, resting tremors (B), shuffling gait, etc. (A) is a side effect of Sinemet. Decreased drooling would be a desired effect, not (C). Sinemet does not affect (D). A client is receiving metoprolol Lopressor SR. What assessment is most important for the nurse to obtain? A) Temperature. B) Lung sounds. C) Blood pressure. D) Urinary output. - ANS- Blood pressure Rationale: It is most important to monitor the blood pressure (C) of clients taking this medication because Lopressor is an antianginal, antiarrhythmic, antihypertensive agent. While (A and B) are important data to obtain on any client, they are not as important for a client receiving Lopressor as (C). Intake and output ratios and daily weights should be monitored while taking Lopressor to assess for signs and symptoms of congestive heart failure, but (D) alone does not have the importance of (C). The nurse is assessing a client who is experiencing anaphylaxis from an insect sting. Which prescription should the nurse prepare to administer this client? A) Dopamine B) Ephedrine C) Epinephrine D) Diphenhydramine. - ANS- Epinephrine Rationale: Epinephrine (C) is an adrenergic agent that stimulate beta receptors to increase cardiac automaticity in cardiac arrest and relax bronchospasms in anaphylaxis. Dopamine (A) is a vasopressor used to treat clients with shock. Ephedrine (B) causes peripheral vasoconstriction and is used in the treatment of nasal congestion. Diphenhydramine (D) is an antihistamine decongestant used in the treatment of mild allergic reactions and motion sickness. A medication that is classified as a beta-1 agonist is most commonly prescribed for a client with which condition? A) Glaucoma B) Hypertension C) Heart Failure D) Asthma - ANS- Heart failure Rationale: Beta-1 agonists improve cardiac output by increasing the heart rate and blood pressure and are indicated in heart failure (C), shock, atrioventricular block dysrhythmias, and cardiac arrest. Glaucoma (A) is managed using adrenergic agents and beta-adrenergic blocking agents. Beta-1 blocking agents are used in the management of hypertension (B). Medications that stimulate beta-2 receptors in the bronchi are effective for bronchoconstriction in respiratory disorders, such as asthma (D).