Pharmacology Assessment A compilation. Questions, Answers, Reason
Pharm A
1. A nurse is caring for a client who has multiple sclerosis and has a new prescription for
baclofen. Which of the following findings indicates to the nurse that the medication is having
a therapeutic effect?
A) Decreased muscle spasticity
The nurse should identify that baclofen is an antispasmodic that decreases muscle spasticity
in a client who has multiple sclerosis.
B) Increased urinary output
Urinary frequency is an adverse effect of baclofen rather than a therapeutic effect.
C) Increased mental alertness
Baclofen is an antispasmodic that can cause CNS adverse effects, such as drowsiness,
fatigue, and confusion, and does not produce an increase in the client's mental alertness as
a therapeutic effect.
D) Decreased heart rate
Baclofen is an antispasmodic and does not decrease the client's heart rate as a therapeutic
effect.
2. A nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the
following findings reported by the client should indicate to the nurse that the medication is
having a therapeutic effect?
A) Passage of a soft, formed stool daily
Passing a soft, formed stool is not an indication the medication is having a therapeutic effect.
Ferrous sulfate can cause constipation.
B) Decreased number of viral illnesses
A decreased number of viral illnesses is not an indication the ferrous sulfate is having a
therapeutic effect.
C) Improved ability to fall asleep
An improved ability to fall asleep is not an indication the ferrous sulfate is having a
therapeutic effect.
D) Increased tolerance to exercise
The client who takes ferrous sulfate, which is used to treat iron-deficiency anemia, can have
fatigue and shortness of breath due to a low hemoglobin level. An increased tolerance to
exercise is an indication the ferrous sulfate is having a therapeutic effect. Increased
tolerance to exercise occurs when the hemoglobin level increases, allowing more oxygen to
be carried to the vital organs and tissue.
3. A nurse is collecting data from a client who is asking about taking celecoxib for treatment of
joint pain. The nurse should identify that which of the following findings is a contraindication
to receiving celecoxib?
A) Hyperglycemia
Celecoxib is not contraindicated for a client who has hyperglycemia.
B) Allergy to penicillin
Celecoxib can cause hypersensitivity reactions in clients who are allergic to sulfonamides or
salicylates rather than penicillin.
C) History of myocardial infarction
, Celecoxib increases the risk of myocardial infarction caused by increased vasoconstriction
and unimpeded platelet aggregation. It is contraindicated for a client who has a history of
myocardial infarction or heart disease.
D) Peptic ulcer disease
Celecoxib should be used with caution for clients who have peptic ulcer disease; however, it
is not contraindicated.
4. A client comes to an urgent care clinic and announces with great enthusiasm, "I am an
expert at all things medical as they apply to me, and I require zolpidem." The client's pupils
are dilated, along with an elevated heart rate and blood pressure level. The nurse should
suspect intoxication with which of the following substances?
A) Alcohol
The client who has alcohol intoxication typically has slurred speech, drowsiness, impaired
judgment, irritability, and decreased blood pressure.
B) Cocaine
The client who has cocaine intoxication typically has tachycardia, elevated blood pressure,
dilated pupils, and displays delusions. This client's behavior and physiological data indicate
cocaine intoxication.
C) Barbiturates
The client who has barbiturate toxicity typically has respiratory depression, constricted
pupils, drowsiness, impaired judgment, irritability, and decreased blood pressure.
D) Heroin
The client who has heroin toxicity typically has slurred speech, drowsiness, constricted
pupils, and decreased blood pressure
5. A nurse is planning to administer metoprolol to a client who has heart failure and a heart rate
of 48/min. Which of the following actions should the nurse take?
A) Ambulate the client before administering the medication.
A client who has a heart rate of 50/min or below can become hypotensive. Therefore,
ambulating can increase the client's risk of falling. However, the nurse should not administer
this medication because of the client's bradycardia.
B) Give the medication when the client has an empty stomach.
The nurse should administer the medication to the client with meals or immediately after
meals. This medication can mask manifestations of hypoglycemia if the client has diabetes.
C) Administer one-half of the client's prescribed dose.
The nurse should notify the provider of the client's heart rate to determine when to administer
the next dose or if a decrease in the dosage is needed.
D) Withhold the client's medication.
The nurse should withhold the metoprolol when the client's heart rate is 50/min or less and
notify the provider.
6. A nurse is caring for a client who is receiving 0.9% sodium
chloride 1,000 mL to infuse over 8 hr. The drop factor on the
manual IV tubing is 15 gtt/mL. The nurse should ensure that the
manual infusion is set to deliver how many gtt/min? (Round the
answer to the nearest whole number. Use a leading zero if it
applies. Do not use a trailing zero.)
, Ans: Step 1: What is the unit of measurement the nurse should calculate? gtt/min
Step 2: What is the quantity of the drop factor that is available ? 15 gtt/mL
Step 3: What is the volume the nurse should infuse? 1,000 mL
Step 4: What is the total infusion time? 8 hr
Step 5: Should the nurse convert the units of measurement? Yes (hr does not equal min)
1 hr/min = 8 hr/ 60 min
X = 480 min
Step 6: Set up an equation and solve for X.
Volume (mL)/Time (min) x drop factor (gtt/mL) = X
1,000 mL/480 min x 15 gtt/mL = X gtt/min
X = 31.25
Step 7: Round if necessary. 31.25 = 31 gtt/min
Step 8: Reassess to determine whether the amount to administer makes sense. If the
prescription reads 0.9% sodium chloride 1,000 mL IV to infuse over 8 hr, the drop factor on
the manual IV tubing is 15 gtt/mL, it makes sense to administer 31 gtt/min. The nurse should
set the manual IV infusion to deliver 0.9% sodium chloride 1,000 mL IV at 31 gtt /min over 8
hr.
7. A nurse is reinforcing teaching with a client following placement of a cast for a fractured
ankle. The client is to take oxycodone for pain management. The nurse should instruct the
client that which of the following over-the-counter medications is contraindicated while taking
oxycodone?
A) Docusate sodium
Use of oxycodone can result in constipation. The client can take a stool softener, such as
docusate sodium, to manage this adverse effect.
B) Ranitidine
There are no known interactions between oxycodone and ranitidine and no indication for the
client to avoid the use of ranitidine while taking oxycodone.
C) Diphenhydramine
Both diphenhydramine, an antihistamine, and oxycodone, an opioid analgesic, can cause
CNS depression. Therefore, when a client uses the two medications together, the client is at
increased risk for sedation, respiratory depression, and injury.
D) Ibuprofen
Clients who have a musculoskeletal injury will benefit from using ibuprofen, an NSAID, in
conjunction with an opioid analgesic.
8. A nurse is reviewing the laboratory results of a client who takes insulin for the management
of diabetes mellitus. Which of the following findings should indicate to the nurse the
medication is effective?
A) Fasting blood glucose 260 mg/dL
The expected reference range for a fasting blood glucose level is 70 to 110 mg/dL. The
nurse should identify that a client who has a fasting blood glucose level of 260 mg/dL is
hyperglycemic and does not indicate effective management of diabetes mellitus.
B) HbA1c 9.2%
The expected reference range for HbA1c is 5.5% to 7%. The nurse should identify that a
client who has an HbA1c of 9.2% has poor diabetic control and does not indicate effective
management of diabetes mellitus.
C) Fasting blood glucose 100 mg/dL
The expected reference range for a fasting blood glucose level is 70 to 110 mg/dL. The
Pharm A
1. A nurse is caring for a client who has multiple sclerosis and has a new prescription for
baclofen. Which of the following findings indicates to the nurse that the medication is having
a therapeutic effect?
A) Decreased muscle spasticity
The nurse should identify that baclofen is an antispasmodic that decreases muscle spasticity
in a client who has multiple sclerosis.
B) Increased urinary output
Urinary frequency is an adverse effect of baclofen rather than a therapeutic effect.
C) Increased mental alertness
Baclofen is an antispasmodic that can cause CNS adverse effects, such as drowsiness,
fatigue, and confusion, and does not produce an increase in the client's mental alertness as
a therapeutic effect.
D) Decreased heart rate
Baclofen is an antispasmodic and does not decrease the client's heart rate as a therapeutic
effect.
2. A nurse is collecting data from a client who is taking ferrous sulfate orally. Which of the
following findings reported by the client should indicate to the nurse that the medication is
having a therapeutic effect?
A) Passage of a soft, formed stool daily
Passing a soft, formed stool is not an indication the medication is having a therapeutic effect.
Ferrous sulfate can cause constipation.
B) Decreased number of viral illnesses
A decreased number of viral illnesses is not an indication the ferrous sulfate is having a
therapeutic effect.
C) Improved ability to fall asleep
An improved ability to fall asleep is not an indication the ferrous sulfate is having a
therapeutic effect.
D) Increased tolerance to exercise
The client who takes ferrous sulfate, which is used to treat iron-deficiency anemia, can have
fatigue and shortness of breath due to a low hemoglobin level. An increased tolerance to
exercise is an indication the ferrous sulfate is having a therapeutic effect. Increased
tolerance to exercise occurs when the hemoglobin level increases, allowing more oxygen to
be carried to the vital organs and tissue.
3. A nurse is collecting data from a client who is asking about taking celecoxib for treatment of
joint pain. The nurse should identify that which of the following findings is a contraindication
to receiving celecoxib?
A) Hyperglycemia
Celecoxib is not contraindicated for a client who has hyperglycemia.
B) Allergy to penicillin
Celecoxib can cause hypersensitivity reactions in clients who are allergic to sulfonamides or
salicylates rather than penicillin.
C) History of myocardial infarction
, Celecoxib increases the risk of myocardial infarction caused by increased vasoconstriction
and unimpeded platelet aggregation. It is contraindicated for a client who has a history of
myocardial infarction or heart disease.
D) Peptic ulcer disease
Celecoxib should be used with caution for clients who have peptic ulcer disease; however, it
is not contraindicated.
4. A client comes to an urgent care clinic and announces with great enthusiasm, "I am an
expert at all things medical as they apply to me, and I require zolpidem." The client's pupils
are dilated, along with an elevated heart rate and blood pressure level. The nurse should
suspect intoxication with which of the following substances?
A) Alcohol
The client who has alcohol intoxication typically has slurred speech, drowsiness, impaired
judgment, irritability, and decreased blood pressure.
B) Cocaine
The client who has cocaine intoxication typically has tachycardia, elevated blood pressure,
dilated pupils, and displays delusions. This client's behavior and physiological data indicate
cocaine intoxication.
C) Barbiturates
The client who has barbiturate toxicity typically has respiratory depression, constricted
pupils, drowsiness, impaired judgment, irritability, and decreased blood pressure.
D) Heroin
The client who has heroin toxicity typically has slurred speech, drowsiness, constricted
pupils, and decreased blood pressure
5. A nurse is planning to administer metoprolol to a client who has heart failure and a heart rate
of 48/min. Which of the following actions should the nurse take?
A) Ambulate the client before administering the medication.
A client who has a heart rate of 50/min or below can become hypotensive. Therefore,
ambulating can increase the client's risk of falling. However, the nurse should not administer
this medication because of the client's bradycardia.
B) Give the medication when the client has an empty stomach.
The nurse should administer the medication to the client with meals or immediately after
meals. This medication can mask manifestations of hypoglycemia if the client has diabetes.
C) Administer one-half of the client's prescribed dose.
The nurse should notify the provider of the client's heart rate to determine when to administer
the next dose or if a decrease in the dosage is needed.
D) Withhold the client's medication.
The nurse should withhold the metoprolol when the client's heart rate is 50/min or less and
notify the provider.
6. A nurse is caring for a client who is receiving 0.9% sodium
chloride 1,000 mL to infuse over 8 hr. The drop factor on the
manual IV tubing is 15 gtt/mL. The nurse should ensure that the
manual infusion is set to deliver how many gtt/min? (Round the
answer to the nearest whole number. Use a leading zero if it
applies. Do not use a trailing zero.)
, Ans: Step 1: What is the unit of measurement the nurse should calculate? gtt/min
Step 2: What is the quantity of the drop factor that is available ? 15 gtt/mL
Step 3: What is the volume the nurse should infuse? 1,000 mL
Step 4: What is the total infusion time? 8 hr
Step 5: Should the nurse convert the units of measurement? Yes (hr does not equal min)
1 hr/min = 8 hr/ 60 min
X = 480 min
Step 6: Set up an equation and solve for X.
Volume (mL)/Time (min) x drop factor (gtt/mL) = X
1,000 mL/480 min x 15 gtt/mL = X gtt/min
X = 31.25
Step 7: Round if necessary. 31.25 = 31 gtt/min
Step 8: Reassess to determine whether the amount to administer makes sense. If the
prescription reads 0.9% sodium chloride 1,000 mL IV to infuse over 8 hr, the drop factor on
the manual IV tubing is 15 gtt/mL, it makes sense to administer 31 gtt/min. The nurse should
set the manual IV infusion to deliver 0.9% sodium chloride 1,000 mL IV at 31 gtt /min over 8
hr.
7. A nurse is reinforcing teaching with a client following placement of a cast for a fractured
ankle. The client is to take oxycodone for pain management. The nurse should instruct the
client that which of the following over-the-counter medications is contraindicated while taking
oxycodone?
A) Docusate sodium
Use of oxycodone can result in constipation. The client can take a stool softener, such as
docusate sodium, to manage this adverse effect.
B) Ranitidine
There are no known interactions between oxycodone and ranitidine and no indication for the
client to avoid the use of ranitidine while taking oxycodone.
C) Diphenhydramine
Both diphenhydramine, an antihistamine, and oxycodone, an opioid analgesic, can cause
CNS depression. Therefore, when a client uses the two medications together, the client is at
increased risk for sedation, respiratory depression, and injury.
D) Ibuprofen
Clients who have a musculoskeletal injury will benefit from using ibuprofen, an NSAID, in
conjunction with an opioid analgesic.
8. A nurse is reviewing the laboratory results of a client who takes insulin for the management
of diabetes mellitus. Which of the following findings should indicate to the nurse the
medication is effective?
A) Fasting blood glucose 260 mg/dL
The expected reference range for a fasting blood glucose level is 70 to 110 mg/dL. The
nurse should identify that a client who has a fasting blood glucose level of 260 mg/dL is
hyperglycemic and does not indicate effective management of diabetes mellitus.
B) HbA1c 9.2%
The expected reference range for HbA1c is 5.5% to 7%. The nurse should identify that a
client who has an HbA1c of 9.2% has poor diabetic control and does not indicate effective
management of diabetes mellitus.
C) Fasting blood glucose 100 mg/dL
The expected reference range for a fasting blood glucose level is 70 to 110 mg/dL. The
