50 item Pharmacology Exam
Source: Saunders Q&A Review 3rd edition
1. A client with myasthenia gravis reports the occurrence of difficulty
chewing. The physician prescribes pyridostigmine bromide (Mestinon)
to increase muscle strength for this activity. The nurse instructs the
client to take the medication at what time, in relation to meals?
a. after dinner daily when most fatigued
b. before breakfast daily
c. as soon as arising in the morning
d. thirty minutes before each meal
Pyridostigmine is a cholinergic medication used to increase muscle strength
for the client with myasthenia gravis. For the client who has difficulty
chewing, the medication should be administered 30 minutes before meals to
enhance the client’s ability to eat.
2. A client is advised to take senna (Senokot) for the treatment of
constipation asks the nurse how this medication works. The nurse
responds knowing that it:
a. accumulates water in the stool and increases peristalsis
b. stimulates the vagus nerve
c. coats the bowel wall
d. adds fiber and bulk to the stool
Senna works by changing the transport of water and electrolytes in the large
intestine, which causes the accumulation of water in the mass of stool and
increased peristalsis.
3. A client is receiving heparin sodium by continuous intravenous
infusion. The nurse monitors the client for which adverse effect of this
therapy?
a. decreased blood pressure
b. increased pulse rate
c. ecchymoses
d. tinnitus
Heparin sodium is an anticoagulant. The client who receives heparin sodium
is at risk for bleeding. The nurse monitors for signs of bleeding, which
includes bleeding from the gums, ecchymoses on the skin, cloudy or pink-
tinged urine, tarry stools, and body fluids that test positive for occult blood.
4. A client is being treated for acute congestive heart failure (CHF) and
the client’s vital signs are as follows: BP 85/50 mm Hg; pulse, 96
, bpm; respirations, 26 cpm. The physician prescribes digoxin (Lanoxin).
To evaluate a therapeutic effectiveness of this medication, the nurse
would expect which of the following changes in the client’s vital signs?
a. BP 85/50 mm Hg, pulse 60 bpm, respirations 26 cpm
b. BP 98/60 mm Hg, pulse 80 bpm, respirations 24 cpm
c. BP 130/70 mm Hg, pulse 104 bpm, respirations 20 cpm
d. BP 110/40 mm Hg, 110 bpm, respirations 20 cpm
The main function of digoxin is inotropic. It produces increased myocardial
contractility that is associated with an increased cardiac output. This causes a
rise in the BP in a client with CHF. Digoxin also has a negative chronotropic
effect (decreases heart rate) and will therefore cause a slowing of the heart
rate. As cardiac output improves, there should be an improvement in
respirations as well.
5. Diazepam (Valium) is prescribed for a client with anxiety. The nurse
instructs the client to expect which side effect?
a. incoordination
b. cough
c. tinnitus
d. hypertension
Valium, a benzodiazepine, can cause motor incoordination and ataxia and
safety precautions should be instituted for clients taking this medication.
6. A client receives oxytocin (Pitocin) to induce labor. During the
administration of the oxytocin, it is most important for the nurse to
monitor:
a. urinary output
b. fetal heart rate
c. central venous pressure
d. maternal blood glucose
Pitocin produces uterine contractions. Uterine contractions can cause fetal
anoxia. The nurse monitors the fetal heart rate and notifies the physician of
any significant changes.
7. A clinic nurse is performing assessment on a client who is being seen
in the clinic for the first time. When asking about the client’s
medication history, the client tells the nurse that he takes nateglinide
(Starlix). The nurse then questions the client about the presence of
which disorder that is treated with this medication?
a. hypothyroidism
b. insomnia
, c. type 2 diabetes mellitus
d. renal failure
Nateglinide (Starlix) is an antidiabetic medication used to treat type 2
diabetes mellitus in clients whose disease cannot be adequately controlled
with diet and exercise. It stimulates the release of insulin from beta cells of
the pancreas by depolarizing beta cells, leading to an opening of calcium
channels. Resulting calcium influx induces insulin secretion.
8. A client who is taking rifampin (Rifadin) as part of the medication
regimen for the treatment of tuberculosis calls the clinic nurse and
reports that her urine is a red-orange color. The nurse tells the client
to:
a. come to the clinic to provide a urine sample
b. stop the medication until further instructions are given by the
physician
c. take the medication dose with an antacid to prevent this adverse
effect
d. expect a red-orange color in urine, feces, sweat, sputum,
and tears as a harmless side effect
Rifampin (Rifadin) is an antitubercular medication used in conjunction with at
least one other antitubercular agent for initial treatment or retreatment of
tuberculosis. Urine, feces, sputum, sweat, and tears may become red-orange
in color. The client should also be told that soft contact lenses may become
permanently stained as a result of this harmless side effect. There is no
useful reason for the client to provide a urine sample. The client is not told to
stop a medication. Antacids are not usually taken with a medication because
of interactive effects.
9. A nurse is caring for a client with a tracheostomy that has been
diagnosed with a respiratory infection. The client is receiving
vancomycin hydrochloride (Vancocin) 500 mg intravenously every 12
hours. Which of the following would indicate to the nurse that the
client is experiencing an adverse effect of the medication?
a. decreased hearing acuity
b. photophobia
c. hypotension
d. bradycardia
Vancomycin hydrochloride (Vancocin) is an antibiotic. Adverse and toxic
effects include nephrotoxicity characterized by a change in the amount or
frequency of urination, anorexia, nausea, vomiting, and increased thirst;
ototoxicity characterized by hearing loss due to damage to the auditory
branch of the eight cranial nerve; and red-neck syndrome from too rapid
injection of the medication characterized by chills, fever, fast heartbeat,
Source: Saunders Q&A Review 3rd edition
1. A client with myasthenia gravis reports the occurrence of difficulty
chewing. The physician prescribes pyridostigmine bromide (Mestinon)
to increase muscle strength for this activity. The nurse instructs the
client to take the medication at what time, in relation to meals?
a. after dinner daily when most fatigued
b. before breakfast daily
c. as soon as arising in the morning
d. thirty minutes before each meal
Pyridostigmine is a cholinergic medication used to increase muscle strength
for the client with myasthenia gravis. For the client who has difficulty
chewing, the medication should be administered 30 minutes before meals to
enhance the client’s ability to eat.
2. A client is advised to take senna (Senokot) for the treatment of
constipation asks the nurse how this medication works. The nurse
responds knowing that it:
a. accumulates water in the stool and increases peristalsis
b. stimulates the vagus nerve
c. coats the bowel wall
d. adds fiber and bulk to the stool
Senna works by changing the transport of water and electrolytes in the large
intestine, which causes the accumulation of water in the mass of stool and
increased peristalsis.
3. A client is receiving heparin sodium by continuous intravenous
infusion. The nurse monitors the client for which adverse effect of this
therapy?
a. decreased blood pressure
b. increased pulse rate
c. ecchymoses
d. tinnitus
Heparin sodium is an anticoagulant. The client who receives heparin sodium
is at risk for bleeding. The nurse monitors for signs of bleeding, which
includes bleeding from the gums, ecchymoses on the skin, cloudy or pink-
tinged urine, tarry stools, and body fluids that test positive for occult blood.
4. A client is being treated for acute congestive heart failure (CHF) and
the client’s vital signs are as follows: BP 85/50 mm Hg; pulse, 96
, bpm; respirations, 26 cpm. The physician prescribes digoxin (Lanoxin).
To evaluate a therapeutic effectiveness of this medication, the nurse
would expect which of the following changes in the client’s vital signs?
a. BP 85/50 mm Hg, pulse 60 bpm, respirations 26 cpm
b. BP 98/60 mm Hg, pulse 80 bpm, respirations 24 cpm
c. BP 130/70 mm Hg, pulse 104 bpm, respirations 20 cpm
d. BP 110/40 mm Hg, 110 bpm, respirations 20 cpm
The main function of digoxin is inotropic. It produces increased myocardial
contractility that is associated with an increased cardiac output. This causes a
rise in the BP in a client with CHF. Digoxin also has a negative chronotropic
effect (decreases heart rate) and will therefore cause a slowing of the heart
rate. As cardiac output improves, there should be an improvement in
respirations as well.
5. Diazepam (Valium) is prescribed for a client with anxiety. The nurse
instructs the client to expect which side effect?
a. incoordination
b. cough
c. tinnitus
d. hypertension
Valium, a benzodiazepine, can cause motor incoordination and ataxia and
safety precautions should be instituted for clients taking this medication.
6. A client receives oxytocin (Pitocin) to induce labor. During the
administration of the oxytocin, it is most important for the nurse to
monitor:
a. urinary output
b. fetal heart rate
c. central venous pressure
d. maternal blood glucose
Pitocin produces uterine contractions. Uterine contractions can cause fetal
anoxia. The nurse monitors the fetal heart rate and notifies the physician of
any significant changes.
7. A clinic nurse is performing assessment on a client who is being seen
in the clinic for the first time. When asking about the client’s
medication history, the client tells the nurse that he takes nateglinide
(Starlix). The nurse then questions the client about the presence of
which disorder that is treated with this medication?
a. hypothyroidism
b. insomnia
, c. type 2 diabetes mellitus
d. renal failure
Nateglinide (Starlix) is an antidiabetic medication used to treat type 2
diabetes mellitus in clients whose disease cannot be adequately controlled
with diet and exercise. It stimulates the release of insulin from beta cells of
the pancreas by depolarizing beta cells, leading to an opening of calcium
channels. Resulting calcium influx induces insulin secretion.
8. A client who is taking rifampin (Rifadin) as part of the medication
regimen for the treatment of tuberculosis calls the clinic nurse and
reports that her urine is a red-orange color. The nurse tells the client
to:
a. come to the clinic to provide a urine sample
b. stop the medication until further instructions are given by the
physician
c. take the medication dose with an antacid to prevent this adverse
effect
d. expect a red-orange color in urine, feces, sweat, sputum,
and tears as a harmless side effect
Rifampin (Rifadin) is an antitubercular medication used in conjunction with at
least one other antitubercular agent for initial treatment or retreatment of
tuberculosis. Urine, feces, sputum, sweat, and tears may become red-orange
in color. The client should also be told that soft contact lenses may become
permanently stained as a result of this harmless side effect. There is no
useful reason for the client to provide a urine sample. The client is not told to
stop a medication. Antacids are not usually taken with a medication because
of interactive effects.
9. A nurse is caring for a client with a tracheostomy that has been
diagnosed with a respiratory infection. The client is receiving
vancomycin hydrochloride (Vancocin) 500 mg intravenously every 12
hours. Which of the following would indicate to the nurse that the
client is experiencing an adverse effect of the medication?
a. decreased hearing acuity
b. photophobia
c. hypotension
d. bradycardia
Vancomycin hydrochloride (Vancocin) is an antibiotic. Adverse and toxic
effects include nephrotoxicity characterized by a change in the amount or
frequency of urination, anorexia, nausea, vomiting, and increased thirst;
ototoxicity characterized by hearing loss due to damage to the auditory
branch of the eight cranial nerve; and red-neck syndrome from too rapid
injection of the medication characterized by chills, fever, fast heartbeat,
