Pharmacology Made Incredibly Easy
5th Edition
• Author(s)Cherie R. Rebar; Nicole M.
Heimgartner; Carolyn Gersch
NCLEX-RN Pharmacology Practice
Questions
Introduction to Pharmacology
,Test Bank
Question 1
Clinical Scenario
A 68-year-old client is admitted for postoperative pain. During
medication reconciliation, the client reports taking
hydrocodone/acetaminophen as prescribed and an over-the-counter
“cold and flu” product for congestion. The medication list shows
acetaminophen 650 mg every 6 hours as needed. The client has no
known drug allergies and a history of fatty liver disease.
Question Stem
Which action should the nurse take before administering the prescribed
acetaminophen?
A. Administer the acetaminophen because the medications have
different indications.
,B. Verify whether the cold and flu product also contains
acetaminophen.
C. Administer the acetaminophen with food to prevent liver injury.
D. Substitute ibuprofen without notifying the provider.
Correct Answer: B. Verify whether the cold and flu product also
contains acetaminophen.
Detailed Rationale
The correct answer is B because medication reconciliation must identify
duplicate active ingredients before a medication is administered. Many
combination prescription and over-the-counter products contain
acetaminophen. Taking multiple acetaminophen-containing products
can unintentionally increase the total daily dose and increase the risk of
serious liver injury. FDA guidance specifically advises patients to check
whether other medicines contain acetaminophen and warns about
severe liver damage when excessive amounts are taken.
Option A is incorrect because different therapeutic purposes do not
eliminate duplicate dosing of the same active ingredient. Option C is
incorrect because taking acetaminophen with food does not prevent
dose-related hepatotoxicity. Option D is unsafe because changing
analgesics is not an independent nursing decision without an
appropriate order or clinical assessment.
The nurse should review the complete medication list, determine the
total acetaminophen exposure from all sources, assess hepatic history,
and clarify the regimen when necessary. This illustrates why medication
reconciliation is an active safety process rather than simply comparing
medication lists.
, Learning Objective
After completing this question, the learner should be able to:
• Identify duplicate active ingredients during medication
reconciliation.
• Recognize the risk of acetaminophen-related hepatotoxicity.
• Apply medication-safety principles before administering
analgesics.
Medication Safety Focus: Medication reconciliation
Question 2
Clinical Scenario
A 54-year-old client with type 1 diabetes is prescribed insulin lispro 6
units subcutaneously before meals. The client's capillary blood glucose
is 58 mg/dL (3.2 mmol/L), and breakfast has been delayed because the
client is scheduled for an imaging study. The client is awake,
diaphoretic, and able to swallow.
Question Stem
Which action should the nurse take first?
A. Administer the scheduled insulin and recheck glucose in 30 minutes.
B. Hold the insulin lispro and treat the hypoglycemia according to
protocol.
C. Administer the insulin after the imaging study.
D. Give the insulin with a carbohydrate-containing meal when the client
returns.
5th Edition
• Author(s)Cherie R. Rebar; Nicole M.
Heimgartner; Carolyn Gersch
NCLEX-RN Pharmacology Practice
Questions
Introduction to Pharmacology
,Test Bank
Question 1
Clinical Scenario
A 68-year-old client is admitted for postoperative pain. During
medication reconciliation, the client reports taking
hydrocodone/acetaminophen as prescribed and an over-the-counter
“cold and flu” product for congestion. The medication list shows
acetaminophen 650 mg every 6 hours as needed. The client has no
known drug allergies and a history of fatty liver disease.
Question Stem
Which action should the nurse take before administering the prescribed
acetaminophen?
A. Administer the acetaminophen because the medications have
different indications.
,B. Verify whether the cold and flu product also contains
acetaminophen.
C. Administer the acetaminophen with food to prevent liver injury.
D. Substitute ibuprofen without notifying the provider.
Correct Answer: B. Verify whether the cold and flu product also
contains acetaminophen.
Detailed Rationale
The correct answer is B because medication reconciliation must identify
duplicate active ingredients before a medication is administered. Many
combination prescription and over-the-counter products contain
acetaminophen. Taking multiple acetaminophen-containing products
can unintentionally increase the total daily dose and increase the risk of
serious liver injury. FDA guidance specifically advises patients to check
whether other medicines contain acetaminophen and warns about
severe liver damage when excessive amounts are taken.
Option A is incorrect because different therapeutic purposes do not
eliminate duplicate dosing of the same active ingredient. Option C is
incorrect because taking acetaminophen with food does not prevent
dose-related hepatotoxicity. Option D is unsafe because changing
analgesics is not an independent nursing decision without an
appropriate order or clinical assessment.
The nurse should review the complete medication list, determine the
total acetaminophen exposure from all sources, assess hepatic history,
and clarify the regimen when necessary. This illustrates why medication
reconciliation is an active safety process rather than simply comparing
medication lists.
, Learning Objective
After completing this question, the learner should be able to:
• Identify duplicate active ingredients during medication
reconciliation.
• Recognize the risk of acetaminophen-related hepatotoxicity.
• Apply medication-safety principles before administering
analgesics.
Medication Safety Focus: Medication reconciliation
Question 2
Clinical Scenario
A 54-year-old client with type 1 diabetes is prescribed insulin lispro 6
units subcutaneously before meals. The client's capillary blood glucose
is 58 mg/dL (3.2 mmol/L), and breakfast has been delayed because the
client is scheduled for an imaging study. The client is awake,
diaphoretic, and able to swallow.
Question Stem
Which action should the nurse take first?
A. Administer the scheduled insulin and recheck glucose in 30 minutes.
B. Hold the insulin lispro and treat the hypoglycemia according to
protocol.
C. Administer the insulin after the imaging study.
D. Give the insulin with a carbohydrate-containing meal when the client
returns.
