1
RN VATI PHARMACOLOGYEXAM TEST
QUESTIONS AND ANSWERS
(VERIFIED ANSWERS)
.
A nurse receives a verbal prescription from the provider for hydrochlorothiazide
25 mg by mouth daily for a client who has hypertension. Which of the following
indicates how the nurse should transcribe the prescription in the client's medical
record?
a. Hydrochlorothiazide 25.0 mg orally q.d.
b. Hydrochlorothiazide 25 mg PO daily
c. HCTZ 25.0 mg by mouth daily
d. HCTZ 25 mg PO OD
Hydrochlorothiazide 25 mg PO daily
The nurse should transcribe the provider's prescription by spelling out the name of the
medication, recording the dosage as a whole number, and spelling out the word "daily."
The abbreviation PO is acceptable for use to indicate the route by mouth.
The nurse should not transcribe a trailing zero after a decimal point because if the
decimal point is not seen, it could be mistaken as 250 mg. The abbreviation q.d. is not
acceptable because it could be mistaken for q.i.d. The nurse should write out the word
"daily."The nurse should not transcribe the medication name abbreviated as HCTZ,
because it could be mistaken for hydrocortisone. The nurse should not place a trailing
zero after a decimal point because if the decimal point is not seen, it could be mistaken
as 250 mg.The nurse should not transcribe the medication name abbreviated as HCTZ,
because it could be mistaken for hydrocortisone. The abbreviation OD is not acceptable
for use because it could be mistaken for "right eye." The nurse should write out the word
"daily."
A nurse is planning care for a client who is taking tamoxifen for treatment of
breast cancer. Which of the following interventions should the nurse include in
the plan? SATA
a. Monitor the client's calcium level
b. Monitor the client for pulmonary embolus
c. Advise the client of the potential for menstrual irregularities
d. Advise the client of the potential for peripheral neuropathy
e. Advise the client of the potential for hot flashes
Monitor the clients calcium level, monitor the client for pulmonary embolus, advise the
client for potential menstrual irregularities, advise the client of potential for hot flashes
,2
Monitor the client's calcium level is correct. Tamoxifen increases the risk for
hypercalcemia. The nurse should monitor the client's pulse and blood pressure, which
are increased in mild hypercalcemia and decreased in severe or prolonged
hypercalcemia. Other manifestations include cyanosis, pallor, muscle weakness, and
decreased deep tendon reflexes. Monitor the client for pulmonary embolus is correct.
Tamoxifen increases the risk for pulmonary embolus. The nurse should instruct the
client to report any chest pain or difficulty breathing. Advise the client of the potential for
menstrual irregularities is correct. Tamoxifen can cause menstrual irregularities, pain,
and bleeding. Therefore, the nurse should instruct the client to notify the provider.
Advise the client of the potential for peripheral neuropathy is incorrect. The nurse does
not need to instruct the client to monitor for potential peripheral neuropathy because
tamoxifen does not cause numbness and tingling of the extremities. Advise the client of
the potential for hot flashes is correct. Hot flashes are a common occurrence in clients
taking tamoxifen. The nurse should inform the client that hot flashes are reversible with
discontinuation of the medication.
A nurse is caring for a client who is receiving meperidine. Which of the following
is the nurse's priority assessment before administering the medication?
a. urinary retention
b. vomiting
c. respiratory rate
d. level of consciousness
Respiratory Rate
When using the airway, breathing, and circulation (ABC) approach to client care, the
nurse should determine that the priority assessment is to check the client's respiratory
rate. Opioid therapy can result in respiratory depression, which can lead to respiratory
arrest. The nurse should withhold the opioid medication and notify the provider if the
client's respiratory rate is below 12/min.
Meperidine is an opioid analgesic that can cause urinary retention, although to a lesser
degree than other opioids. The nurse should monitor the client's intake and output,
palpate the bladder or perform a bladder scan, and notify the provider of any voiding
difficulties or bladder distention; however, another assessment is the nurse's
priority.Meperidine stimulates the chemoreceptor trigger zone of the medulla, which
results in nausea and vomiting. The nurse should assess the client for nausea prior to
administering meperidine, pretreat for nausea, and encourage the client to remain in a
supine position to minimize the medication's emetic effects; however, another
assessment is the nurse's priority.Meperidine is an opioid analgesic that can cause
somnolence and mental clouding. The nurse should assess the client's level of
consciousness and ensure the client's safety prior to administering meperidine;
however, another assessment is the nurse's priority.
,3
A nurse is reviewing the laboratory results for a client who is taking warfarin
following orthopedic surgery. Which of the following results should the nurse
report to the provider? a. PT 12.5 seconds
b. aPTT 36 seconds
c. PTT 65 seconds
d. INR 5.2
INR 5.2
A client who is taking warfarin following an orthopedic surgery should have a therapeutic
INR between 2 to 3. The nurse should identify an INR greater than 5 as a critical value.
Therefore, the nurse should report this laboratory value to the provider to have the
client's warfarin dosage adjusted.
A PT of 12.5 seconds is within the expected reference range of 11 to 12.5 seconds. The
nurse should expect the client who is taking coumadin to have a prolonged PT. An aPTT
of 36 seconds is within the expected reference range of 30 to 40 seconds. The aPTT is
used to monitor clients who are receiving heparin therapy. A PTT of 65 seconds is within
the expected reference range of 60 to 70 seconds. This test is used to monitor clients
who are receiving heparin therapy.
INR 5.2
A nurse is preparing to administer medications to a client. The client tells the
nurse, "I will take the pills but not that liquid medication." Which of the following
actions should the nurse take?
a. Document the reason for the missed dose of medication in the nurse's notes.
b. Ask an assistive personnel (AP) to ensure the client drinks the medication after
breakfast.
c. Notify the pharmacist that the client is refusing to take the medication.
d. Mix the medication in juice on the client's breakfast tray.
Document the reason for the missed dose of medication in the nurse's notes
It is the responsibility of the nurse to respect the client's right to refuse to take a
medication and to document the reason a medication dose is not administered. This
should include the client's refusal to take the medication.
Medication administration, regardless of the route, is not within the range of function for
an AP. The client refused the medication so the nurse should not ask someone else to
administer it at a later time. The nurse should notify the client's provider of the refusal;
however, it is not necessary to notify the pharmacist. The nurse should respect the
client's right to refuse to take the medication. The nurse cannot force the client to take
any medication against their will, which includes mixing the medication in the client's
juice without their knowledge.
, 4
A nurse is assessing a client who is receiving androgen therapy to treat
endometriosis. The nurse should monitor the client for which of the following
adverse effects?
a. weight loss
b. hypotension
c. muscle hypertrophy
d. edema
Edema
Androgens treat endometriosis and fibrocystic breast disease, and can cause fluid
retention; therefore, androgen therapy should be used cautiously with clients who have
existing cardiac or renal impairment. The nurse should monitor the client for edema and
instruct the client to measure weight daily.
Androgen therapy can cause weight gain, not weight loss. Androgen therapy can also
cause nausea, vomiting, and constipation. Cardiovascular adverse effects of androgen
therapy include hypertension, myocardial infarction, tachycardia, and palpitations.
Anabolic steroids, such as oxymetholone, have muscle-building properties; however,
androgen therapy does not cause hypertrophy of the muscles. Androgens can, however,
cause muscle cramps and spasms.
A nurse is providing teaching to an adolescent who has a prescription for
cromolyn for the management of asthma. Which of the following statements
by the adolescent indicates an understanding of the teaching?
0 "I'll use this medication every day. even when l have no symptoms."
0 "I should use this medication as soon as I feel like I am going to start to
wheeze."
0 "I'll be sure to call the doctor ifl don't feel better in a week."
0 "When I know I'm going to play softball, I'll use the medication 2 hours before I
start."
"I'll use this medication every day. even when l have no symptoms."
Cromolyn is a mast cell stabilizer that prevents exacerbations of chronic asthma. The
adolescent should take it routinely, usually three or four times per day.
Cromolyn is a prophylactic medication. It is not useful for treating an acute asthma
attack. The adolescent should use a short-acting bronchodilator such as albuterol to
treat an acute attack. Cromolyn requires regular use over a period of several weeks
before achieving its full therapeutic effects. Although the adolescent might have relief
RN VATI PHARMACOLOGYEXAM TEST
QUESTIONS AND ANSWERS
(VERIFIED ANSWERS)
.
A nurse receives a verbal prescription from the provider for hydrochlorothiazide
25 mg by mouth daily for a client who has hypertension. Which of the following
indicates how the nurse should transcribe the prescription in the client's medical
record?
a. Hydrochlorothiazide 25.0 mg orally q.d.
b. Hydrochlorothiazide 25 mg PO daily
c. HCTZ 25.0 mg by mouth daily
d. HCTZ 25 mg PO OD
Hydrochlorothiazide 25 mg PO daily
The nurse should transcribe the provider's prescription by spelling out the name of the
medication, recording the dosage as a whole number, and spelling out the word "daily."
The abbreviation PO is acceptable for use to indicate the route by mouth.
The nurse should not transcribe a trailing zero after a decimal point because if the
decimal point is not seen, it could be mistaken as 250 mg. The abbreviation q.d. is not
acceptable because it could be mistaken for q.i.d. The nurse should write out the word
"daily."The nurse should not transcribe the medication name abbreviated as HCTZ,
because it could be mistaken for hydrocortisone. The nurse should not place a trailing
zero after a decimal point because if the decimal point is not seen, it could be mistaken
as 250 mg.The nurse should not transcribe the medication name abbreviated as HCTZ,
because it could be mistaken for hydrocortisone. The abbreviation OD is not acceptable
for use because it could be mistaken for "right eye." The nurse should write out the word
"daily."
A nurse is planning care for a client who is taking tamoxifen for treatment of
breast cancer. Which of the following interventions should the nurse include in
the plan? SATA
a. Monitor the client's calcium level
b. Monitor the client for pulmonary embolus
c. Advise the client of the potential for menstrual irregularities
d. Advise the client of the potential for peripheral neuropathy
e. Advise the client of the potential for hot flashes
Monitor the clients calcium level, monitor the client for pulmonary embolus, advise the
client for potential menstrual irregularities, advise the client of potential for hot flashes
,2
Monitor the client's calcium level is correct. Tamoxifen increases the risk for
hypercalcemia. The nurse should monitor the client's pulse and blood pressure, which
are increased in mild hypercalcemia and decreased in severe or prolonged
hypercalcemia. Other manifestations include cyanosis, pallor, muscle weakness, and
decreased deep tendon reflexes. Monitor the client for pulmonary embolus is correct.
Tamoxifen increases the risk for pulmonary embolus. The nurse should instruct the
client to report any chest pain or difficulty breathing. Advise the client of the potential for
menstrual irregularities is correct. Tamoxifen can cause menstrual irregularities, pain,
and bleeding. Therefore, the nurse should instruct the client to notify the provider.
Advise the client of the potential for peripheral neuropathy is incorrect. The nurse does
not need to instruct the client to monitor for potential peripheral neuropathy because
tamoxifen does not cause numbness and tingling of the extremities. Advise the client of
the potential for hot flashes is correct. Hot flashes are a common occurrence in clients
taking tamoxifen. The nurse should inform the client that hot flashes are reversible with
discontinuation of the medication.
A nurse is caring for a client who is receiving meperidine. Which of the following
is the nurse's priority assessment before administering the medication?
a. urinary retention
b. vomiting
c. respiratory rate
d. level of consciousness
Respiratory Rate
When using the airway, breathing, and circulation (ABC) approach to client care, the
nurse should determine that the priority assessment is to check the client's respiratory
rate. Opioid therapy can result in respiratory depression, which can lead to respiratory
arrest. The nurse should withhold the opioid medication and notify the provider if the
client's respiratory rate is below 12/min.
Meperidine is an opioid analgesic that can cause urinary retention, although to a lesser
degree than other opioids. The nurse should monitor the client's intake and output,
palpate the bladder or perform a bladder scan, and notify the provider of any voiding
difficulties or bladder distention; however, another assessment is the nurse's
priority.Meperidine stimulates the chemoreceptor trigger zone of the medulla, which
results in nausea and vomiting. The nurse should assess the client for nausea prior to
administering meperidine, pretreat for nausea, and encourage the client to remain in a
supine position to minimize the medication's emetic effects; however, another
assessment is the nurse's priority.Meperidine is an opioid analgesic that can cause
somnolence and mental clouding. The nurse should assess the client's level of
consciousness and ensure the client's safety prior to administering meperidine;
however, another assessment is the nurse's priority.
,3
A nurse is reviewing the laboratory results for a client who is taking warfarin
following orthopedic surgery. Which of the following results should the nurse
report to the provider? a. PT 12.5 seconds
b. aPTT 36 seconds
c. PTT 65 seconds
d. INR 5.2
INR 5.2
A client who is taking warfarin following an orthopedic surgery should have a therapeutic
INR between 2 to 3. The nurse should identify an INR greater than 5 as a critical value.
Therefore, the nurse should report this laboratory value to the provider to have the
client's warfarin dosage adjusted.
A PT of 12.5 seconds is within the expected reference range of 11 to 12.5 seconds. The
nurse should expect the client who is taking coumadin to have a prolonged PT. An aPTT
of 36 seconds is within the expected reference range of 30 to 40 seconds. The aPTT is
used to monitor clients who are receiving heparin therapy. A PTT of 65 seconds is within
the expected reference range of 60 to 70 seconds. This test is used to monitor clients
who are receiving heparin therapy.
INR 5.2
A nurse is preparing to administer medications to a client. The client tells the
nurse, "I will take the pills but not that liquid medication." Which of the following
actions should the nurse take?
a. Document the reason for the missed dose of medication in the nurse's notes.
b. Ask an assistive personnel (AP) to ensure the client drinks the medication after
breakfast.
c. Notify the pharmacist that the client is refusing to take the medication.
d. Mix the medication in juice on the client's breakfast tray.
Document the reason for the missed dose of medication in the nurse's notes
It is the responsibility of the nurse to respect the client's right to refuse to take a
medication and to document the reason a medication dose is not administered. This
should include the client's refusal to take the medication.
Medication administration, regardless of the route, is not within the range of function for
an AP. The client refused the medication so the nurse should not ask someone else to
administer it at a later time. The nurse should notify the client's provider of the refusal;
however, it is not necessary to notify the pharmacist. The nurse should respect the
client's right to refuse to take the medication. The nurse cannot force the client to take
any medication against their will, which includes mixing the medication in the client's
juice without their knowledge.
, 4
A nurse is assessing a client who is receiving androgen therapy to treat
endometriosis. The nurse should monitor the client for which of the following
adverse effects?
a. weight loss
b. hypotension
c. muscle hypertrophy
d. edema
Edema
Androgens treat endometriosis and fibrocystic breast disease, and can cause fluid
retention; therefore, androgen therapy should be used cautiously with clients who have
existing cardiac or renal impairment. The nurse should monitor the client for edema and
instruct the client to measure weight daily.
Androgen therapy can cause weight gain, not weight loss. Androgen therapy can also
cause nausea, vomiting, and constipation. Cardiovascular adverse effects of androgen
therapy include hypertension, myocardial infarction, tachycardia, and palpitations.
Anabolic steroids, such as oxymetholone, have muscle-building properties; however,
androgen therapy does not cause hypertrophy of the muscles. Androgens can, however,
cause muscle cramps and spasms.
A nurse is providing teaching to an adolescent who has a prescription for
cromolyn for the management of asthma. Which of the following statements
by the adolescent indicates an understanding of the teaching?
0 "I'll use this medication every day. even when l have no symptoms."
0 "I should use this medication as soon as I feel like I am going to start to
wheeze."
0 "I'll be sure to call the doctor ifl don't feel better in a week."
0 "When I know I'm going to play softball, I'll use the medication 2 hours before I
start."
"I'll use this medication every day. even when l have no symptoms."
Cromolyn is a mast cell stabilizer that prevents exacerbations of chronic asthma. The
adolescent should take it routinely, usually three or four times per day.
Cromolyn is a prophylactic medication. It is not useful for treating an acute asthma
attack. The adolescent should use a short-acting bronchodilator such as albuterol to
treat an acute attack. Cromolyn requires regular use over a period of several weeks
before achieving its full therapeutic effects. Although the adolescent might have relief
