NURSING PHARMACOLOGY 1 c. Complaints of pain at the site of
infusion.
A 2-year-old child is receiving temporary
d. A rash on the client’s extremities.
total parenteral nutrition (TPN) through a
central venous line. This is the first day of Nurse Celine is caring for a client with
TPN therapy. Although all of the following clinical depression who is receiving an
nursing actions must be included in the plan MAO inhibitor. When providing instructions
of care of this child, which one would be a about precautions with this medication, the
priority at this time? nurse should instruct the client to:
a. Use aseptic technique during a. Avoid chocolate and cheese.
dressing changes. b. Take frequent naps.
b. Maintain central line catheter c. Take the medication with milk.
integrity. d. Avoid walking without assistance.
c. Monitor serum glucose levels.
While providing home care to a client with
d. Check results of liver function tests.
congestive heart failure, the nurse is asked
Nurse Jamie is administering the initial total how long diuretics must be taken.
parenteral nutrition solution to a client. The best response to this client should be:
Which of the following assessments requires
a. “As you urinate more, you will need
the nurse’s immediate attention?
less medication to control fluid.”
a. Temperature of 37.5 degrees Celsius. b. “You will have to take this
b. Urine output of 300 cc in 4 hours. medication for about a year.”
c. Poor skin turgor. c. “The medication must be continued
d. Blood glucose of 350 mg/dl. so the fluid problem is controlled.”
d. “Please talk to your physician about
Nurse Susan administered intravenous
medications and treatments.”
gamma globulin to an 18 month-old child
with AIDS. The parent asks why this George, age 8, is admitted with rheumatic
medication is being given. What is the fever. Which clinical finding indicates to the
nurse’s best response? nurse that George needs to continue taking
the salicylates he had received at home?
a. “It will slow down the replication of
the virus.” a. Chorea
b. “This medication will improve your b. Polyarthritis
child’s overall health status.” c. Subcutaneous nodules
c. “This medication is used to prevent d. Erythema marginatum
bacterial infections.”
An order is written to start an IV on a 74-
d. “It will increase the effectiveness of
year-old client who is getting ready to go to
the other medications your child
the operating room for a total hip
receives.”
replacement. What gauge of catheter
When caring for a client with total parenteral would best meet the needs of this client?
nutrition (TPN), what is the most important
a. 18
action on the part of the nurse?
b. 20
a. Record the number of stools per day. c. 21 butterfly
b. Maintain strict intake and output d. 25
records.
A client with an acute exacerbation of
c. Sterile technique for dressing change
rheumatoid arthritis is admitted to the
at IV site.
hospital for treatment. Which drug, used to
d. Monitor for cardiac arrhythmias.
treat clients with rheumatoid arthritis, has
The nurse is administering an intravenous both an anti-inflammatory and
vesicant chemotherapeutic agent to a client. immunosuppressive effect?
,Which of the following is least likely to a. “Are you sure all this insulin won’t
influence the potential for a client to comply hurt my baby?”
with lithium therapy after discharge? b. “I’ll probably need my daily insulin
dose raised.”
a. The impact of lithium on the client’s
c. “I will continue to take my regular
energy level and lifestyle.
dose of insulin.”
b. The need for consistent blood level
d. “These finger sticks make my hand
monitoring.
sore. Can I do them less frequently?”
c. The potential side effects of lithium.
d. What the client’s friends think of his Mrs. Johanson’s physician has prescribed
need to take medication. tetracycline 500 mg po q6h. While assessing
Mrs. Johanson’s nursing history for
A male patient is to receive a percutaneously
allergies, the nurse notes that Mrs.
inserted central catheter (PICC). He asks the
Johanson’s is also taking oral
nurse whether the insertion will hurt. How
contraceptives. What is the most appropriate
will the nurse reply?
initial nursing intervention?
a. “You will have general anesthesia so
a. Administer the dose of tetracycline.
you won’t feel anything.”
b. Notify the physician that Mrs.
b. “It will be inserted rapidly, and any
Johanson is taking oral
discomfort is fleeting.”
contraceptives.
c. “The insertion site will be
c. Tell Mrs. Johanson, she should stop
anesthetized. Threading the catheter
taking oral contraceptives since they
through the vein is not painful.”
are inactivated by tetracycline.
d. “You will receive sedation prior to
d. Tell Mrs. Johanson, to use another
the procedure.”
form of birth control for at least two
The nurse is caring for an elderly client who months.
has been diagnosed as having sundown
An adult client’s insulin dosage is 10 units
syndrome. He is alert and oriented during
of regular insulin and 15 units of NPH
the day but becomes disoriented and
insulin in the morning. The client should be
disruptive around dinnertime. He is
taught to expect the first insulin peak:
hospitalized for evaluation. The nurse asks
the client and his family to list all of the a. As soon as food is ingested.
medications, prescription and b. In two to four hours.
nonprescription, he is currently taking. What c. In six hours.
is the primary reason for this action? d. In ten to twelve hours.
a. Multiple medications can lead to An adult is hospitalized for treatment of
dementia. deep electrical burns. Burn wound sepsis
develops and mafenide acetate 10%
b. The medications can provide clues
(Sulfamylon) is ordered BID. While
regarding his medical background.
applying the Sulfamylon to the wound, it is
c. Ability to recall medications is a good important for the nurse to prepare the client
assessment of the client’s level of for expected responses to the topical
orientation. application, which include:
d. Medications taken by a client are part of a. Severe burning pain for a few
every nursing assessment. minutes following application.
b. Possible severe metabolic alkalosis
A 25-year-old woman is in her fifth month with continued use.
of pregnancy. She has been taking 20 units c. Black discoloration of everything
of NPH insulin for diabetes mellitus daily that comes in contact with this drug.
for six years. Her diabetes has been well d. Chilling due to evaporation of
controlled with this dosage. She has been
, primary reason for giving Lugol’s solution c. Theophylline toxicity
preoperatively is to: d. Ineffective theophylline
a. Decrease the risk of agranulocytosis The client at highest risk for nephrotoxicity
postoperatively. with aminoglycoside use is a:
b. Prevent tetany while the client is
a. Male with a creatinine of 1.7 and
under general anesthesia.
BUN of 52 on a 10-day regimen.
c. Reduce the size and vascularity of
b. Female with BUN of 12 and
the thyroid and prevent hemorrhage.
creatinine of 0.8
d. Potentiate the effect of the other
c. Female with past history of cystitis
preoperative medication so less
on 5 days of therapy.
medicine can be given while the
d. Male with history of kidney stones
client is under anesthesia.
on 8 days of therapy.
A two-year-old child with congestive heart
When assessing clients for evidence of a
failure has been receiving digoxin for one
penicillin allergy, which of the following
week. The nurse needs to recognize that an
symptoms may not be considered to be a
early sign of digitalis toxicity is:
true hypersensitivity reaction?
a. Bradypnea
a. Wheezing
b. Failure to thrive
b. Nausea
c. Tachycardia
c. Urticaria
d. Vomiting
d. Angioneurotic edema
Mr. Bates is admitted to the surgical ICU
All of the following symptoms are evidence
following left adrenalectomy. He is sleepy
of a superinfection except:
but easily aroused. An IV containing
hydrocortisone is running. The nurse a. White oral plaques
planning care for Mr. Bates knows it is b. Creamy vaginal discharge
essential to include which of the following c. Skin rash
nursing interventions at this time? d. Darkened tongue
a. Monitor blood glucose levels every Which of the following statements
shift to detect the development of is true when educating clients about
hypo- or hyperglycemia. penicillin therapy?
b. Keep flat on back with minimal
movement to reduce the risk of a. The client must take the medication
hemorrhage following surgery. at evenly spaced intervals.
c. Administer hydrocortisone until vital b. The client may save leftover
signs stabilize, then discontinue the medication for a future illness.
IV. c. If signs of an allergic reaction,
d. Teach Mr. Bates how to care for his
continue the medication and notify
the physician.
wound since he is at high risk for
developing postoperative infection. d. Clients taking oral contraceptives
must be cautioned to use an alternate
Corinne is experiencing diarrhea after form of birth control while being
consuming her prescribed antibiotics for the treated with penicillin.
whole week. This is because:
Antonietta is taking antitubercular,
a. The drugs render food indigestible. the most common adverse effect she may be
b. Gastric flora is disturbed. experiencing is:
c. Fluid is added into the intestine.
d. Normal intestinal bacteria are a. Red-orange discoloration of urine
destroyed. b. Hypersensitivity
c. Hepatotoxicity
infusion.
A 2-year-old child is receiving temporary
d. A rash on the client’s extremities.
total parenteral nutrition (TPN) through a
central venous line. This is the first day of Nurse Celine is caring for a client with
TPN therapy. Although all of the following clinical depression who is receiving an
nursing actions must be included in the plan MAO inhibitor. When providing instructions
of care of this child, which one would be a about precautions with this medication, the
priority at this time? nurse should instruct the client to:
a. Use aseptic technique during a. Avoid chocolate and cheese.
dressing changes. b. Take frequent naps.
b. Maintain central line catheter c. Take the medication with milk.
integrity. d. Avoid walking without assistance.
c. Monitor serum glucose levels.
While providing home care to a client with
d. Check results of liver function tests.
congestive heart failure, the nurse is asked
Nurse Jamie is administering the initial total how long diuretics must be taken.
parenteral nutrition solution to a client. The best response to this client should be:
Which of the following assessments requires
a. “As you urinate more, you will need
the nurse’s immediate attention?
less medication to control fluid.”
a. Temperature of 37.5 degrees Celsius. b. “You will have to take this
b. Urine output of 300 cc in 4 hours. medication for about a year.”
c. Poor skin turgor. c. “The medication must be continued
d. Blood glucose of 350 mg/dl. so the fluid problem is controlled.”
d. “Please talk to your physician about
Nurse Susan administered intravenous
medications and treatments.”
gamma globulin to an 18 month-old child
with AIDS. The parent asks why this George, age 8, is admitted with rheumatic
medication is being given. What is the fever. Which clinical finding indicates to the
nurse’s best response? nurse that George needs to continue taking
the salicylates he had received at home?
a. “It will slow down the replication of
the virus.” a. Chorea
b. “This medication will improve your b. Polyarthritis
child’s overall health status.” c. Subcutaneous nodules
c. “This medication is used to prevent d. Erythema marginatum
bacterial infections.”
An order is written to start an IV on a 74-
d. “It will increase the effectiveness of
year-old client who is getting ready to go to
the other medications your child
the operating room for a total hip
receives.”
replacement. What gauge of catheter
When caring for a client with total parenteral would best meet the needs of this client?
nutrition (TPN), what is the most important
a. 18
action on the part of the nurse?
b. 20
a. Record the number of stools per day. c. 21 butterfly
b. Maintain strict intake and output d. 25
records.
A client with an acute exacerbation of
c. Sterile technique for dressing change
rheumatoid arthritis is admitted to the
at IV site.
hospital for treatment. Which drug, used to
d. Monitor for cardiac arrhythmias.
treat clients with rheumatoid arthritis, has
The nurse is administering an intravenous both an anti-inflammatory and
vesicant chemotherapeutic agent to a client. immunosuppressive effect?
,Which of the following is least likely to a. “Are you sure all this insulin won’t
influence the potential for a client to comply hurt my baby?”
with lithium therapy after discharge? b. “I’ll probably need my daily insulin
dose raised.”
a. The impact of lithium on the client’s
c. “I will continue to take my regular
energy level and lifestyle.
dose of insulin.”
b. The need for consistent blood level
d. “These finger sticks make my hand
monitoring.
sore. Can I do them less frequently?”
c. The potential side effects of lithium.
d. What the client’s friends think of his Mrs. Johanson’s physician has prescribed
need to take medication. tetracycline 500 mg po q6h. While assessing
Mrs. Johanson’s nursing history for
A male patient is to receive a percutaneously
allergies, the nurse notes that Mrs.
inserted central catheter (PICC). He asks the
Johanson’s is also taking oral
nurse whether the insertion will hurt. How
contraceptives. What is the most appropriate
will the nurse reply?
initial nursing intervention?
a. “You will have general anesthesia so
a. Administer the dose of tetracycline.
you won’t feel anything.”
b. Notify the physician that Mrs.
b. “It will be inserted rapidly, and any
Johanson is taking oral
discomfort is fleeting.”
contraceptives.
c. “The insertion site will be
c. Tell Mrs. Johanson, she should stop
anesthetized. Threading the catheter
taking oral contraceptives since they
through the vein is not painful.”
are inactivated by tetracycline.
d. “You will receive sedation prior to
d. Tell Mrs. Johanson, to use another
the procedure.”
form of birth control for at least two
The nurse is caring for an elderly client who months.
has been diagnosed as having sundown
An adult client’s insulin dosage is 10 units
syndrome. He is alert and oriented during
of regular insulin and 15 units of NPH
the day but becomes disoriented and
insulin in the morning. The client should be
disruptive around dinnertime. He is
taught to expect the first insulin peak:
hospitalized for evaluation. The nurse asks
the client and his family to list all of the a. As soon as food is ingested.
medications, prescription and b. In two to four hours.
nonprescription, he is currently taking. What c. In six hours.
is the primary reason for this action? d. In ten to twelve hours.
a. Multiple medications can lead to An adult is hospitalized for treatment of
dementia. deep electrical burns. Burn wound sepsis
develops and mafenide acetate 10%
b. The medications can provide clues
(Sulfamylon) is ordered BID. While
regarding his medical background.
applying the Sulfamylon to the wound, it is
c. Ability to recall medications is a good important for the nurse to prepare the client
assessment of the client’s level of for expected responses to the topical
orientation. application, which include:
d. Medications taken by a client are part of a. Severe burning pain for a few
every nursing assessment. minutes following application.
b. Possible severe metabolic alkalosis
A 25-year-old woman is in her fifth month with continued use.
of pregnancy. She has been taking 20 units c. Black discoloration of everything
of NPH insulin for diabetes mellitus daily that comes in contact with this drug.
for six years. Her diabetes has been well d. Chilling due to evaporation of
controlled with this dosage. She has been
, primary reason for giving Lugol’s solution c. Theophylline toxicity
preoperatively is to: d. Ineffective theophylline
a. Decrease the risk of agranulocytosis The client at highest risk for nephrotoxicity
postoperatively. with aminoglycoside use is a:
b. Prevent tetany while the client is
a. Male with a creatinine of 1.7 and
under general anesthesia.
BUN of 52 on a 10-day regimen.
c. Reduce the size and vascularity of
b. Female with BUN of 12 and
the thyroid and prevent hemorrhage.
creatinine of 0.8
d. Potentiate the effect of the other
c. Female with past history of cystitis
preoperative medication so less
on 5 days of therapy.
medicine can be given while the
d. Male with history of kidney stones
client is under anesthesia.
on 8 days of therapy.
A two-year-old child with congestive heart
When assessing clients for evidence of a
failure has been receiving digoxin for one
penicillin allergy, which of the following
week. The nurse needs to recognize that an
symptoms may not be considered to be a
early sign of digitalis toxicity is:
true hypersensitivity reaction?
a. Bradypnea
a. Wheezing
b. Failure to thrive
b. Nausea
c. Tachycardia
c. Urticaria
d. Vomiting
d. Angioneurotic edema
Mr. Bates is admitted to the surgical ICU
All of the following symptoms are evidence
following left adrenalectomy. He is sleepy
of a superinfection except:
but easily aroused. An IV containing
hydrocortisone is running. The nurse a. White oral plaques
planning care for Mr. Bates knows it is b. Creamy vaginal discharge
essential to include which of the following c. Skin rash
nursing interventions at this time? d. Darkened tongue
a. Monitor blood glucose levels every Which of the following statements
shift to detect the development of is true when educating clients about
hypo- or hyperglycemia. penicillin therapy?
b. Keep flat on back with minimal
movement to reduce the risk of a. The client must take the medication
hemorrhage following surgery. at evenly spaced intervals.
c. Administer hydrocortisone until vital b. The client may save leftover
signs stabilize, then discontinue the medication for a future illness.
IV. c. If signs of an allergic reaction,
d. Teach Mr. Bates how to care for his
continue the medication and notify
the physician.
wound since he is at high risk for
developing postoperative infection. d. Clients taking oral contraceptives
must be cautioned to use an alternate
Corinne is experiencing diarrhea after form of birth control while being
consuming her prescribed antibiotics for the treated with penicillin.
whole week. This is because:
Antonietta is taking antitubercular,
a. The drugs render food indigestible. the most common adverse effect she may be
b. Gastric flora is disturbed. experiencing is:
c. Fluid is added into the intestine.
d. Normal intestinal bacteria are a. Red-orange discoloration of urine
destroyed. b. Hypersensitivity
c. Hepatotoxicity
