Pharmacology Rationales
The nurse is preparing to administer haloperidol to a client. The nurse understands that
this medication is prescribed to treat which of the following?
A. dementia
B. schizophrenia
C. major depressive disorder
D. bipolar disorder correct answers Choice B is correct: Haloperidol is a typical (first-
generation) antipsychotic that is indicated for schizophrenia. Typical antipsychotics,
such as haloperidol, may raise the client's risk for extrapyramidal symptoms (EPS).
The nurse is caring for a client who is prescribed enoxaparin. Which laboratory value
should the nurse monitor?
A. Platelet count
B. Activated Partial Thromboplastin Time (aPTT)
C. International Normalized Ratio (INR)
D. Troponin correct answers Choice A is correct: Enoxaparin is a low molecular weight-
based heparin (LMWH). One of the adverse events of enoxaparin is heparin-induced
thrombocytopenia (HIT). This severe condition results in a 50% or more decrease in the
platelet count while also causing thrombosis. Therefore, it is reasonable to monitor the
platelet count after initiating enoxaparin.
The nurse is caring for a client who is receiving prescribed dicyclomine. Which of the
following client findings would indicate a therapeutic response?
A. Decreased abdominal cramping
B. Absence of nausea and vomiting
C. Decreased urinary retention
D. Less burning with urination correct answers Choice A is correct. Dicyclomine is an
antispasmodic agent used in the treatment of irritable bowel syndrome (IBS). This may
provide the client with relief from the spasms and cramping associated with IBS.
A 16-year-old female client was recently diagnosed with Graves' disease and
subsequently admitted. Which of the following orders, if written by the health care
provider (HCP), should the nurse question?
A. Atenolol
B. Propylthiouracil
C. Radioactive iodine (I-131)
D. Methimazole correct answers Choice C is correct. The nurse should question the
health care provider's (HCP) order written for radioactive iodine (I-131) for this 16-year-
old female client, as this client is of childbearing potential, and there is no evidence that
the provider concurrently ordered a beta-hCG test. A client of "childbearing potential" is
defined as any biological female who has begun menstruation and is capable of
conception (typically, female clients between 12 years to 50 years). When given
,radioactive iodine (also referred to as RAI), RAI is taken up by the thyroid, destroying
thyroid tissue. Radioactive iodine is highly effective and is the treatment of choice for
Graves' disease in nearly all clients except pregnant clients, breastfeeding clients, or
clients who hope to become pregnant within the next 12 months. Iodine, including
radioactive isotopes, is readily transferred across the placenta, thus affecting the
developing thyroid gland of a developing fetus. Therefore, in any female of childbearing
potential, the American Thyroid Association recommends obtaining a beta-hCG test
within 72 hours before RAI therapy initiation to rule out pregnancy. As such, the nurse
should question the health care provider's (HCP) order for radioactive iodine (I-131) in
this 16-year-old female client, as this client is of childbearing potential.
The emergency department (ED) nurse cares for a client receiving prescribed warfarin
and reports dizziness, black tarry stools, and bloody gums. The international normalized
ratio (INR) returns at 5 (0.9-1.2 seconds). The nurse anticipates the primary healthcare
provider (PHCP) will prescribe which blood product?
A. Packed red blood cells (PRBCs)
B. Platelets
C. Granulocytes
D. Fresh frozen plasma (FFP) correct answers Choice D is correct. FFP would be
prescribed because this client is experiencing bleeding related to the prescribed
warfarin. The client's INR is grossly elevated (therapeutic for VTE prophylaxis is 2-3),
and FFP includes the Vitamin K-dependent clotting factors (factors II, VII, IX, X, proteins
C, and S) that need to be replaced to stop the bleeding. Vitamin K may be prescribed,
but the efficacy takes six to eight hours. FFP can treat the bleeding almost immediately.
While reviewing the side effects of adjuvant analgesic medications, the nurse
understands which of the following drugs is accurately paired with its most serious
adverse side effect?
A. Acetaminophen: Gastrointestinal tract bleeding
B. Ibuprofen: Hepatic failure
C. Clonidine: Renal failure
D. Aspirin: Anaphylaxis correct answers Choice D is correct. The most severe adverse
effect of aspirin is an anaphylactic shock, which is life-threatening. Other side effects of
aspirin include gastrointestinal ulcerations and hemolytic anemia.
A client diagnosed with acute gastroenteritis is prescribed a 40 mEq potassium chloride
capsule for hypokalemia. Which action should the nurse take when administering this
medication?
A. Open the capsule and sprinkle on a spoonful of applesauce
B. Instruct the client to chew the capsule
C. Give separate from other medications
D. Give the medication two hours before meals correct answers Choice A is correct.
Potassium supplements can be distasteful, even in capsule form. To improve
palatability, the nurse may sprinkle the contents of the potassium capsule on apple
sauce, and the client can then swallow it. This also should be used for those who have
difficulty swallowing. The client must not chew on a capsule or tablet.
, The nurse cares for a client with a potassium of 3.2 mEq/L (3.5-5 mEq/L). Which of the
following medications may cause this abnormality?
A. spironolactone
B. triamterene
C. prednisone
D. lisinopril correct answers Choice C is correct. Prednisone is a corticosteroid that
increases aldosterone and is responsible for sodium retention and the elimination of
potassium. Therefore, a client's potassium level will decrease while taking this
medication. If a client is taking prednisone, the recommendation is that they reduce
dietary sodium and increase dietary potassium.
The nurse observes a newly hired nurse caring for a client prescribed a unit of packed
red blood cells. It would require immediate intervention if the nurse observes the newly
hired nurse
A. spikes the unit of blood with Y-type blood tubing.
B. verifies the client's name, date of birth, blood compatibility, and expiration date with
another nurse.
C. instructs the unlicensed assistive personnel (UAP) to obtain pre-transfusion vital
signs.
D. remains with the client for the first 15-30 minutes to observe for a febrile reaction.
correct answers Choice D is correct. Observing a client at the start of the blood
transfusion is to quickly assess a potentially fatal hemolytic / ABO incompatibility
reaction - not a febrile reaction. A hemolytic reaction would manifest as lower back or
chest pain, apprehension, and dyspnea. A febrile reaction would not manifest as quickly
as a hemolytic reaction. Therefore, this action requires follow-up.
The nurse is reviewing the client's serum digoxin level resulting in 2.5 ng/mL (3.2
nmol/L). The nurse should initially
A. Notify the primary health care provider (PHCP) regarding this laboratory result.
B. Review the client's medical record for the most recent pulse rate.
C. Record this laboratory value as within the therapeutic range.
D. Administer the next dose of digoxin as prescribed. correct answers Choice A is
correct. The therapeutic range for digoxin is 0.5 to 2.0 ng/mL [0.64 to 2.6 nmol/L]).
Levels greater than 2.2 ng/mL (2.8 nmol/L) indicate toxicity. The client's most recent
digoxin level of 2.5 ng/mL indicates toxicity. The nurse's initial response should be to
notify the client's healthcare provider (HCP) of this laboratory value. Following the
notification, the nurse should document the notification.
The nurse is caring for a three-year-old with congestive heart failure receiving digoxin.
The nurse recognizes which of the following manifestation is an early sign of digitalis
toxicity?
A. Dizziness
B. Tachycardia
C. Vomiting
The nurse is preparing to administer haloperidol to a client. The nurse understands that
this medication is prescribed to treat which of the following?
A. dementia
B. schizophrenia
C. major depressive disorder
D. bipolar disorder correct answers Choice B is correct: Haloperidol is a typical (first-
generation) antipsychotic that is indicated for schizophrenia. Typical antipsychotics,
such as haloperidol, may raise the client's risk for extrapyramidal symptoms (EPS).
The nurse is caring for a client who is prescribed enoxaparin. Which laboratory value
should the nurse monitor?
A. Platelet count
B. Activated Partial Thromboplastin Time (aPTT)
C. International Normalized Ratio (INR)
D. Troponin correct answers Choice A is correct: Enoxaparin is a low molecular weight-
based heparin (LMWH). One of the adverse events of enoxaparin is heparin-induced
thrombocytopenia (HIT). This severe condition results in a 50% or more decrease in the
platelet count while also causing thrombosis. Therefore, it is reasonable to monitor the
platelet count after initiating enoxaparin.
The nurse is caring for a client who is receiving prescribed dicyclomine. Which of the
following client findings would indicate a therapeutic response?
A. Decreased abdominal cramping
B. Absence of nausea and vomiting
C. Decreased urinary retention
D. Less burning with urination correct answers Choice A is correct. Dicyclomine is an
antispasmodic agent used in the treatment of irritable bowel syndrome (IBS). This may
provide the client with relief from the spasms and cramping associated with IBS.
A 16-year-old female client was recently diagnosed with Graves' disease and
subsequently admitted. Which of the following orders, if written by the health care
provider (HCP), should the nurse question?
A. Atenolol
B. Propylthiouracil
C. Radioactive iodine (I-131)
D. Methimazole correct answers Choice C is correct. The nurse should question the
health care provider's (HCP) order written for radioactive iodine (I-131) for this 16-year-
old female client, as this client is of childbearing potential, and there is no evidence that
the provider concurrently ordered a beta-hCG test. A client of "childbearing potential" is
defined as any biological female who has begun menstruation and is capable of
conception (typically, female clients between 12 years to 50 years). When given
,radioactive iodine (also referred to as RAI), RAI is taken up by the thyroid, destroying
thyroid tissue. Radioactive iodine is highly effective and is the treatment of choice for
Graves' disease in nearly all clients except pregnant clients, breastfeeding clients, or
clients who hope to become pregnant within the next 12 months. Iodine, including
radioactive isotopes, is readily transferred across the placenta, thus affecting the
developing thyroid gland of a developing fetus. Therefore, in any female of childbearing
potential, the American Thyroid Association recommends obtaining a beta-hCG test
within 72 hours before RAI therapy initiation to rule out pregnancy. As such, the nurse
should question the health care provider's (HCP) order for radioactive iodine (I-131) in
this 16-year-old female client, as this client is of childbearing potential.
The emergency department (ED) nurse cares for a client receiving prescribed warfarin
and reports dizziness, black tarry stools, and bloody gums. The international normalized
ratio (INR) returns at 5 (0.9-1.2 seconds). The nurse anticipates the primary healthcare
provider (PHCP) will prescribe which blood product?
A. Packed red blood cells (PRBCs)
B. Platelets
C. Granulocytes
D. Fresh frozen plasma (FFP) correct answers Choice D is correct. FFP would be
prescribed because this client is experiencing bleeding related to the prescribed
warfarin. The client's INR is grossly elevated (therapeutic for VTE prophylaxis is 2-3),
and FFP includes the Vitamin K-dependent clotting factors (factors II, VII, IX, X, proteins
C, and S) that need to be replaced to stop the bleeding. Vitamin K may be prescribed,
but the efficacy takes six to eight hours. FFP can treat the bleeding almost immediately.
While reviewing the side effects of adjuvant analgesic medications, the nurse
understands which of the following drugs is accurately paired with its most serious
adverse side effect?
A. Acetaminophen: Gastrointestinal tract bleeding
B. Ibuprofen: Hepatic failure
C. Clonidine: Renal failure
D. Aspirin: Anaphylaxis correct answers Choice D is correct. The most severe adverse
effect of aspirin is an anaphylactic shock, which is life-threatening. Other side effects of
aspirin include gastrointestinal ulcerations and hemolytic anemia.
A client diagnosed with acute gastroenteritis is prescribed a 40 mEq potassium chloride
capsule for hypokalemia. Which action should the nurse take when administering this
medication?
A. Open the capsule and sprinkle on a spoonful of applesauce
B. Instruct the client to chew the capsule
C. Give separate from other medications
D. Give the medication two hours before meals correct answers Choice A is correct.
Potassium supplements can be distasteful, even in capsule form. To improve
palatability, the nurse may sprinkle the contents of the potassium capsule on apple
sauce, and the client can then swallow it. This also should be used for those who have
difficulty swallowing. The client must not chew on a capsule or tablet.
, The nurse cares for a client with a potassium of 3.2 mEq/L (3.5-5 mEq/L). Which of the
following medications may cause this abnormality?
A. spironolactone
B. triamterene
C. prednisone
D. lisinopril correct answers Choice C is correct. Prednisone is a corticosteroid that
increases aldosterone and is responsible for sodium retention and the elimination of
potassium. Therefore, a client's potassium level will decrease while taking this
medication. If a client is taking prednisone, the recommendation is that they reduce
dietary sodium and increase dietary potassium.
The nurse observes a newly hired nurse caring for a client prescribed a unit of packed
red blood cells. It would require immediate intervention if the nurse observes the newly
hired nurse
A. spikes the unit of blood with Y-type blood tubing.
B. verifies the client's name, date of birth, blood compatibility, and expiration date with
another nurse.
C. instructs the unlicensed assistive personnel (UAP) to obtain pre-transfusion vital
signs.
D. remains with the client for the first 15-30 minutes to observe for a febrile reaction.
correct answers Choice D is correct. Observing a client at the start of the blood
transfusion is to quickly assess a potentially fatal hemolytic / ABO incompatibility
reaction - not a febrile reaction. A hemolytic reaction would manifest as lower back or
chest pain, apprehension, and dyspnea. A febrile reaction would not manifest as quickly
as a hemolytic reaction. Therefore, this action requires follow-up.
The nurse is reviewing the client's serum digoxin level resulting in 2.5 ng/mL (3.2
nmol/L). The nurse should initially
A. Notify the primary health care provider (PHCP) regarding this laboratory result.
B. Review the client's medical record for the most recent pulse rate.
C. Record this laboratory value as within the therapeutic range.
D. Administer the next dose of digoxin as prescribed. correct answers Choice A is
correct. The therapeutic range for digoxin is 0.5 to 2.0 ng/mL [0.64 to 2.6 nmol/L]).
Levels greater than 2.2 ng/mL (2.8 nmol/L) indicate toxicity. The client's most recent
digoxin level of 2.5 ng/mL indicates toxicity. The nurse's initial response should be to
notify the client's healthcare provider (HCP) of this laboratory value. Following the
notification, the nurse should document the notification.
The nurse is caring for a three-year-old with congestive heart failure receiving digoxin.
The nurse recognizes which of the following manifestation is an early sign of digitalis
toxicity?
A. Dizziness
B. Tachycardia
C. Vomiting
