NSG 304 Pharmacology Comprehensive Midterm Exam 2025

Asthma is treated according to severity. For quick relief of a single asthmatic symptom a(n) _________ drug is recommended. a. oral beta1 and beta2 antagonist b. inhaled glucocorticoid c. short-acting inhaled beta2 agonist d. theophylline preparation - Correct Ans-c. short-acting inhaled beta2 agonist The advantage of using a glucocorticoid inhaler instead of an oral glucocorticoid is that it: a. increases the risk for adrenal suppression b. minimizes the risk for adrenal suppression c. increases the need for more oral glucocorticoid d. necessitates less glucocorticoid - Correct Ans-b. minimizes the risk for adrenal suppression A client who uses an inhaler is taught the strategies to prevent Candida infections. Which of the following would the nurse include in the instructions? a. soak the spacer in alcohol between uses b. do not use a spacer c. rinse the mouth with water after each use d. use antifungal agent such as fluconazole (Diflucan) prophylactically - Correct Ans-c. rinse the mouth with water after each use Albuterol (Proventil), a beta2 adrenergic agonist and a sympathomimetic, is an effective drug to control asthma. The action of a beta2 adrenergic is to: a. decrease mucus production b. enhance bronchodilation c. promote bronchoconstriction d. promote bronchospasm - Correct Ans-b. enhance bronchodilation A patient has been admitted to the hospital with acute asthma and has had nausea and vomiting. The drug history reveals that the patient has been taking theophylline (Elixophyllin) for 3 weeks. Prior to the administration of theophylline, the nurse should check the orders for a. renal function tests NSG 304 NSG 304 b. a plasma drug level c. a basal metabolic panel (BMP) d. a complete blood count (CBC) - Correct Ans-b. a plasma drug level A nurse counsels a patient using two different types of asthma inhalers: a short acting beta2 agonist and a corticosteroid. When the patient questions the purpose of the steroid inhaler, the nurse's best response would be that glucocorticoids a. work rapidly in acute attacks b. are used as prophylaxis for chronic asthma c. help prevent respiratory infections d. are used only when exposed to environmental allergens - Correct Ans-b. are used as prophylaxis for chronic asthma While caring for a patient with cirrhosis or hepatitis, the nurse knows that abnormalities in which phase of pharmacokinetics may occur? a. Absorption b. Distribution c. Metabolism d. Excretion - Correct Ans-c. Metabolism A patient has an order for tetracycline antibiotic and has been instructed to avoid taking the medication with foods, beverages, or drug that contains calcium, iron, or magnesium. The patient takes the antibiotic along with a daily multivitamin, not realizing that the vitamin contains iron. What effect may this have on the tetracycline? a. Absorption b. Distribution c. Metabolism d. Excretion - Correct Ans-a. Absorption The nurse looks up butorphanol (Stadol) in a drug reference guide prior to administering the drug and notes that it is a partial agonist. What does this term tell the nurse about the drug? a. it is a drug that produces the same type of response as the endogenous substance b. it is a drug that will occupy a receptor and prevent the endogenous chemical from acting c. it is a drug that cause unpredictable and unexplained drug reactions d. it is a drug that produces a weaker, or less efficacious, response than an agonist drug - Correct Ans-d. it is a drug that produces a weaker, or less efficacious, response than an agonist drug The nurse reads that the drug to be given to the patient has a "narrow therapeutic index". The nurse knows that this means that the drug has what properties? NSG 304 NSG 304 a. it has a narrow range of effectiveness and may not give this patient the desired therapeutic response b. it has a narrow safety margin and even a small increase in dose may produce adverse or toxic effects c. it has a narrow range of conditions or diseases that the drug will be expected to treat successfully d. it has a narrow segment of the population for whom the drug will work as desired - Correct Ans-b. it has a narrow safety margin and even a small increase in dose may produce adverse or toxic effects A nurse is reviewing a patient's health record and notes a new prescription by the provider to verify the trough level of the patient's medication. Which of the following actions should the nurse take? a. have a blood specimen obtained immediately prior to the next dose of medication b. verify that the patient has been on the medication for 24 hours before ordering a blood specimen c. ask the patient to provide a urine specimen after the next dose of medication d. begin administering the medication, and obtain a blood specimen - Correct Ans-a. have a blood specimen obtained immediately prior to the next dose of medication The nursing instructor is teaching student nurses about how the media effective does (ED50) of a medication is related to clinical practice. Which statement reflects the correct understanding by the student? a. about 50% of patients will experience severe side effects from the drug b. about 50% of patients will not experience any effect from the drug c. some patients will respond differently, depending on their ethnic background d. some clients will require more or less than average dose of the drug - Correct Ans-d. some clients will require more or less than average dose of the drug A patient is prescribed phenobarbital sodium (Luminal) for a seizure disorder. The medication has a long half-life of 4 days. Based on this half-life, the medication will most likely be prescribed _____ a. once a day b. twice a day c. three times a day d. four times a day - Correct Ans-a. once a day A patient has a history of cardiac problems is admitted to a telemetry unit. The prescriber orders azithromycin antibiotic at a high dose for one day, followed by a lower dose thereafter. What is the nurse's best action? NSG 304 NSG 304 a. delay administration of the drug in order to discuss the prescription with the pharmacist b. question the prescriber about the two doses, recognizing that a potentially hazardous situation exists c. administer the drug per the prescription, recognizing that a loading dose, followed by a maintenance dose, is being given d. in the interest of patient advocacy, seek a second prescriber's opinion before carrying out the prescription - Correct Ans-c. administer the drug per the prescription, recognizing that a loading dose, followed by a maintenance dose, is being given A patient has been receiving an antibiotic with a narrow therapeutic index for 10 days. Upon assessment, the nurse suspects that the patient may be experiencing toxicity. The nurse's priority action would be to a. call the prescriber and have the antibiotic changed b. suspect an allergic reaction and administer a prn antihistamine c. ask the prescriber to order a plasma drug level d. set up oxygen and obtain an order for an antagonist - Correct Ans-c. ask the prescriber to order a plasma drug level The nurse is caring for a patient who is to recieve a beta1 selective blocker, which assessment finding must the nurse address before the medication can be administered? a. blood pressure of 140/80 mm Hg b. respiratory rate of 18 breaths per minute c. creatinine of 1.2 mg/dL d. heart rate of 45 beats per minute - Correct Ans-d. heart rate of 45 beats per minute A nurse is discussing the functions of the sympathetic nervous system with a group of nursing students. Which statement made by one of the students indicates a need for further teaching? a. the sympathetic nervous system regulates the digestive functions of the body b. the sympathetic nervous system regulates the cardiovascular system c. the sympathetic nervous system implements the fight or flight response d. the sympathetic nervous system regulates body temperature - Correct Ans-a. the sympathetic nervous system regulates the digestive functions of the body The prescriber has written an order for a muscarinic agonist. For which patient would a muscarinic agonist be indicated? a. a patient with urinary retention b. a patient who suffers from intestinal obstruction c. a patient with a heart rate of 60 beats per minute NSG 304 NSG 304 d. a patient who experiences orthostatic hypotension - Correct Ans-a. a patient with urinary retention A nurse is providing education to the other nurses on the unit on how to differentiate between a myasthenic crisis and a cholinergic crisis. To show that they understand the difference, the nurse could state that they should a. ask the patient about occupation and family history b. assess serum levels of the cholinesterase inhibitors c. assess the patient for muscle weakness d. administer edrophonium (Tensilon) and monitor the response - Correct Ans-d. administer edrophonium (Tensilon) and monitor the response A nurse is providing patient education to patients who experience seizures and their families. To evaluate their understanding, the nurse asks the group several questions about medications. Which statement from the group best demonstrates an understanding of antiepileptic medication therapy? a. all seizure medications can be monitored by drug levels present in the urine b. maintenance of a seizure frequency calendar is essential c. the monitoring period is 10 days for most patients d. patients can safely drive during monitoring period - Correct Ans-b. maintenance of a seizure frequency calendar is essential A nurse is completing a discharge plan for a 24 year old woman who has been prescribed an antiepileptic drug. What is the priority for teaching the patient about the drug? a. if you stop taking the medication all of a sudden, an unpleasant, acute withdrawal syndrome is likely to occur b. you may stop taking the drug when you have had no seizures for 1 full year c. lets talk about what kind of contraception you plan to use while you are taking this medication d. i know it's depressing to have to take a drug for the rest of your life, but you absolutely may not ever stop taking it - Correct Ans-c. lets talk about what kind of contraception you plan to use while you are taking this medication A nurse caring for a patient with a history of recurrent seizures that involved LOC, urinary incontinence, and postictal confusion for 2 days. Based on results from an electroencephalogram recording, the nurse recognizes this finding as a generalized onset seizure and anticipates that the prescriber will order which medication? a. Phenytoin (Dilantin) b. Gabapentin (Neurontin) c. Carbamazepine (Tegretol) d. Valporic acid (Depakote) - Correct Ans-d. Valporic acid (Depakote