NR293/ NR 293 (2023/ 2024 Update) Pharmacology for Nursing Practice Exam| 100% Correct Questions and Verified Answers - Chamberlain

Exam 2: NR293/ NR 293 (2023/ 2024 Update) Pharmacology for Nursing Practice Exam| 100% Correct Questions and Verified Answers - ChamberlainQUESTION A nurse is caring for a client who has a new prescription for valproic acid. The nurse should instruct the client that while taking this medication he will need to have which of the following laboratory tests completed periodically? SATA a. thrombocyte count b. hematocrit c. amylase d. liver function tests e. potassium Answer: a. thrombocyte count c. amylase d. liver function tests QUESTION A nurse is preparing a teaching plan for a female client who has bipolar disorder and a new prescription for carbamazepine. Which of the following instructions shoudl the nurse include in the teaching? a. this medication can safely be taken during pregnancy b. eliminate grapefruit juice from your diet c. you will need to have a complete blood count and carbamazepine levels drawn periodically d. notify your provider if you develop a rash e. avoid driving for the first few days after starting this medication. Answer: b. eliminate grapefruit juice from your diet c. you will need to have a complete blood count and carbamazepine levels drawn periodically d. notify your provider if you develop a rash e. avoid driving for the first few days after starting this medication.QUESTION A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which for the following information should the nurse include in the teaching? a. increases the risk for seizure activity b. provides a form of aversion therapy c. decreases cravings d. results in mild hypertension Answer: c. decreases cravings QUESTION A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which fo the following medications should the charge nurse include in the discussion? a. Lorazepam b. Diazepam c. Disulfiram D. Naltrexone E. Acamprosate Answer: a. Lorazepam b. Diazepam benzodiazepines are used during alcohol withdrawal to decrease anxiety and reduce the risk for seizures. QUESTION A nurse is providing teaching to a client who has a new prescription for clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects? a. diarrhea b. dry mouth c. insomnia d. hypertensionAnswer: b. dry mouth QUESTION A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid use and has a prescription for clonidine. Which of the following actions should the nurse identify as the priority? a. administer the clonidine on the prescribed schedule. b. provide ice chips at the client's bedside c. educate the client on the effects of clonidine d. obtain baseline vital signs Answer: d. obtain baseline vital signs QUESTION A nurse in the post-anesthesia recovery unit is caring for a client who received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should anticipate a prescription for which of the following medications? a. neostigmine b. naloxone c. dantrolene d. vecuronium Answer: a. neostigmine QUESTION A nurse is teaching a client who has a new prescription for levodopa/carbidopa for Parkinson's. Which of the following instructions should the nurse include? a. increase intake of protein-rich foods. b. expect muscle twitching to occur. c. take this medication with food. d. anticipate relief of manifestations in 24 hours.Answer: c. take this medication with food. QUESTION A nurse in the PACU is caring for a client who is experiencing malignant hyperthermia. Which of the following actions should the nurse take? SATA a. place a cooling blanket on the client. b. administer oxygen at 100%. c Administer iced 0.9% sodium chloride d. administer potassium chloride IV e. monitor core body temperature Answer: a. place a cooling blanket on the client. b. administer oxygen at 100%. c Administer iced 0.9% sodium chloride e. monitor core body temperature QUESTION A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is oversedated. Which of the following medications should the nurse anticipate administering to this client? a. ketamine b. naltrexone c. flumazenil d. fluvoxamine Answer: C. Flumazenil QUESTION A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include? a. rinse your mouth after each use of this medication. b. limit fluid intake while taking this medication. c. increase your intake of vitamin B12 while taking this medication. d. you can take the medication as needed.Answer: a. rinse your mouth after each use of this medication. QUESTION A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. Which of the folllowing instructions should the nurse include in the teaching? a. take albuterol at the same time each day b. administer the albuterol inhaler prior to using the beclomethasone inhaler c. use the beclomethasone if experiencing an acute episode. d. avoid shaking the beclomethasone before use. Answer: b. administer the albuterol inhaler prior to using the beclomethasone inhaler QUESTION A nurse is providing instructions to the parent of an adolescent client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include? a. you can take this medication to abort an acute asthma attack. b. tremors are an adverse effect of this medication. c. prolonged used of this medication can cause hyperglycemia. d. this medication can slow skeletal growth rate. Answer: b. tremors are an adverse effect of this medication. QUESTION A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following adverse effects of this medication. a. weight gain b. nervousness c. bradycardia d. constipationAnswer: a. weight gain QUESTION A nurse is planning care for a client who is receiving furosemide IV for peripheral edema. Which of the following interventions should the nurse include in the plan of care? SATA a. assess for tinnitus b. report urine output of 50 mL/hr c. monitor serum potassium levels d. elevate the head of the bed slowly before ambulation e. recommend eating a banana daily Answer: a. assess for tinnitus c. monitor serum potassium levels d. elevate the head of the bed slowly before ambulation e. recommend eating a banana daily QUESTION A nurse is providing information to a client who has a new prescription for hydrochlorothiazide. Which of the following information should the nurse include? a. take the medication with food. b. plan to take the medication at bedtime. c. expect increased swelling of the ankles. d. fluid intake should be limited in the morning. Answer: a. take the medication with food. QUESTION A nurse is monitoring a client who is receiving spironolactone. Which of the following findings should the nurse report to the provider? a. serum sodium at 144 b. urine output 120 mL in 4 hr c. serum potassium at 5.2 d. blood pressure 140/90Answer: c. serum potassium at 5.2 QUESTION A nurse in a provider's office is monitoring serum electrolytes for four older adult clients who take digoxin. Which of the following electrolyte values increases a client's risk for digoxin toxicity? a. calcium 9.2 mg/dL b. calcium 10.3 mg/dL c. potassium 3.4 mEq/L d. potassium 3.8 mEq/L Answer: c. potassium 3.4 mEq/L QUESTION A nurse caring for an older adult client who has a new prescription for digoxin and takes multiple other medications. The nurse shoudl recognize that concurrent use of which of the following medications places the client at risk for digoxin toxicity? a. phenytoin b. verapamil c. warfarin d. aluminum hydroxide Answer: b. verapamil QUESTION A nurse is providing teaching to a client who has a new prescription for digoxin. The nurse should instruct the client to monitor and report which of the following adverse effects that is a manifestation of digoxin toxicity? SATA a. fatigue b. constipation c. anorexia d. rashe. diplopia Answer: a. fatigue c. anorexia e. diplopia QUESTION A nurse is teaching a client who has angina pectoris and is learning how to treat acute anginal attacks. The client asks, "What is my next step if I take one tablet, wait 5 minutes, but still have anginal pain?" Which of the following responses should the nurse make? a. Take two more sublingual tablets at the same time. b. Call the emergency response team. c. Take a sustained-release nitroglycerin capsule. d. Wait another 5 minutes then take a second sublingual tablet. Answer: b. Call the emergency response team. QUESTION A nurse is teaching a client who has a new prescription for nitroglycerin transdermal patch for angina pectoris. Which of the following instructions should the nurse include? a. remove the patch each evening b. cut each patch in half if angina attacks are under control c. take off the nitroglycerin patch for 30 min if a headache occurs. d. apply a new patch every 48 hours. Answer: a. remove the patch each evening QUESTION A nurse is preparing to administer propranolol to a client who has a dysrhythmia. Which of the following actions should the nurse plan to take? a. hold propranolol for an apical pulse greater than 100/min. b. administer propranolol to increase the client's blood pressure. c. assist the client when she sits up or stands after taking this medicationd. check for hypokalemia frequently due to the risk of propranolol toxicity. Answer: c. assist the client when she sits up or stands after taking this medication QUESTION A nurse is caring for a hospitalized client who is receiving IV heparin for a DVT. The client begins vomiting blood. After the heparin has been stopped, which of the following medications should the nurse prepare to administer? a. vitamin K b. atropine c. protamine d. calcium gluconate Answer: c. protamine QUESTION A nurse is monitoring a client who is receiving epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication? SATA a. leukocytosis b. hypertension c. edema d. blurred vision e. headache Answer: b. hypertension e. headache QUESTION A nurse is assessing a client who is taking digoxin to treat heart failure. Which of the following findings is a manifestation of digoxin toxicity? a. bruising b. report of metallic tastec. muscle pain d. report of anorexia Answer: d. report of anorexia QUESTION first line of defense for congestive heart failure, fluid retention will show here first report weight gain with CHF Answer: Dailiy weights QUESTION A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity due to an overdose. Which of the following actions is the nurse's priority? a. administer flumazenil b. identify the client's level of orientation c. infuse IV fluids d. prepare the client for gastric lavage Answer: b. identify the client's level of orientation First is to assess the client QUESTION A nurse is teaching a client who ha sa new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicates understanding of the teaching? a. I should take the medication on an empty stomach. b. I will follow a low-sodium diet while taking this medication. c. I need to discontinue this medication slowly. d. I should not crush this medication before swallowing Answer:c. I need to discontinue this medication slowly. QUESTION A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include? A. Take this medication on an empty stomach. B. expect optimal therapeutic effects with 24 hours. C. Take this medication when needed for anxiety. D. This medication has a low risk for dependency. Answer: D. This medication has a low risk for dependency. QUESTION A nurse is teaching a client who has OCD and has a new prescription for paroxetine. Which of the following instructions should the nurse include? A. It can take several weeks before you feel like the medication is helping. B. Take the medication just before bedtime to promote sleep. C. You should take the medication when needed for obsessive urges. D. Monitor for weight gain while taking this medication. Answer: A. It can take several weeks before you feel like the medication is helping. QUESTION A nurse is caring for a client who takes paroxetine to treat PTSD and reports that he grinds his teeth during the night. The nurse should identify which of the following interventions o manage bruxism? A. concurrent administration of buspirone. B. Administration of a different SSRI C. use of a mouth guard D. changing to a different class of antidepressant medication E. increasing the dose of paroxetine Answer: A. concurrent administration of buspirone.C. use of a mouth guard D. changing to a different class of antidepressant medication QUESTION A nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression. Which of the following indicates that the client has developed an adverse effect of this medication? a. orthostatic hypotension b. hearing loss c. gastrointestinal bleeding d. weight loss Answer: a. orthostatic hypotension QUESTION A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. which of the following should the nurse include in the teaching? SATA a. expect therapeutic effects in 24-48 hours b. discontinue the medication after a week of improved mood. c. change positions slowly to minimize dizziness d. decrease dietary fiber intake to control diarrhea e. chew sugarless gum to prevent dry mouth Answer: c. change positions slowly to minimize dizziness e. chew sugarless gum to prevent dry mouth QUESTION A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for PTSD. Which of the following statements should the nurse include in the teaching? A. You may have a decreased desire for intimacy while taking this medication. B. you should take this medication at bedtime to help promote sleep. C. You will have fewer urinary adverse effects if you urinate just before taking this medication. D. You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication.Answer: A. You may have a decreased desire for intimacy while taking this medication. QUESTION A nurse is caring for a client who has depression and a new prescription for venlafaxine. For which of the following adverse effects should the nurse monitor this client? SATA a. cough b. dizziness c. decreased libido d. alopecia e. hypotension Answer: a. cough b. dizziness c. decreased libido QUESTION A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome? a. bruising b. fever c. abdominal pain d. rash Answer: b. fever QUESTION A nurse is reviewing laboratory findings and notes that a client's plasma lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse? a. perform immediate gastric lavage b. prepare the client for hemodialysis c. administer an additional oral dose of lithium d. request a stat repeat of the lab testAnswer: a. perform immediate gastric lavage QUESTION A nurse is caring for a client who has a new prescription for lithium carbonate. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following? a. avoid the use of acetaminophen for headaches. b. restrict intake of foods rich in sodium c. decrease fluid intake to less than 1,500 mL daily d. limit aerobic activity in hot weather Answer: d. limit aerobic activity in hot weather QUESTION A nurse is assessing a client who takes lithium carbonate for the treatment of bipolar disorder. The nurse should recognize which of the following findings as a possible indication of toxicity to this medication? a. severe hypertension b. coarse tremors c. constipation d. muscle spasms Answer: b. coarse tremors QUESTION Opioid analgesic Decreases respiratory depression, slows GI motility, constipation, do not give if patient has paralytic ileus Antidote: Naloxone Answer:Morphine QUESTION A genetically linked major adverse reaction to general anesthesia characterized by a rapid rise in body temp, tachycardia, tachypnea, and sweating. Answer: Malignant Hyperthermia QUESTION analgesic hard on liver, alcoholics have 2000 mg max elevated AST and ALT indicate liver damage Answer: Acetaminophen (Tylenol) QUESTION antipsychotic causes extrapyramidal side effects antihistamines (Cogentin) reduces or eliminates side effects Answer: Chlorpromazine (Thorazine) QUESTION Tx: Parkinson's, Thorazine side effects Class: anticholinergic side effects: TACHYCARDIA, blurred vision, dry eyes Answer: Benztropine (Cogentin)QUESTION Benzodiazepine sedative, hypnotic anxiolytics side effects: dizziness, should not drive afterwards, increases fall risk Answer: Alprazolam/Xanax QUESTION Anticonvulsant flush with saline only only in IV push, never infusion Need very good oral care - can cause gingival hyperplasia Lifetime use required Answer: Phenytoin/Dilantin QUESTION Narrow therapeutic range of 0.6-1.2 mmol/L Toxic is 1.5 mmol/L Requires stable sodium level to reduce change of toxicity Requires appropriate hydration (not over or under) Answer: Lithium QUESTION Require continued periodic assessment of suicidality Answer: AntidepressantsQUESTION many interactions avoid tyramine (wine, aged cheese/meats, etc). Answer: MAOI QUESTION EMERGENCY - most life threatening substance withdrawal Can potentially be treated outpatient but still need to be monitored** * Tremulousness * Seizure (first 48 hrs) * Hallucinations * DTs (after 72 hrs) Benzodiazepines (Ativan/Valium) will take edge off Answer: ETOH withdrawal QUESTION opiate antagonist, reverses opioid induced respiratory depression Answer: Naloxone (Narcan) QUESTION Clinical use: Parkinson's disease Replaces/replenishes missing dopamine stores Toxicity: arrhythmias from increased peripheral formation of catecholamines; long term use may → dyskinesia following administration w/ akinesia between doses ("on-off" phenomenon) Answer: Levodopa (Carbidopa)QUESTION Benzodiazepine antidote Answer: Flumazenil (Romazicon) QUESTION Muscle paralysis in surgery or mechanical ventilation. Selective for motor (vs. autonomic) nicotinic receptor. MUST HAVE ARTIFICIAL VENTILATION Answer: Neuromuscular blocking drugs QUESTION Anticoagulant Dietary concern: green, leafy vegetables (interferes) Target INR range: 2-3.5 Antidote: Vitamin K Not okay for pregnancy Takes 3-5 days to achieve therapeutic range Interactions: St. John's wort, anise, arnica, chamomile, clove, dong quai, fenugreek, feverfew, garlic, ginger, ginkgo biloba, panax ginseng, licorice, foods high in VitaminK Answer: Warfarin (Coumadin) QUESTION Anticoagulant Antidote: protamine safe for pregnancy Target aPPT: (30-45 sec) x 1.5 (65 ok)Answer: Heparin QUESTION 150,000 to 450,000 Answer: Platelet Labs QUESTION percentage of blood volume occupied by red blood cells Male: 40-52 Female: 35-47 Answer: Hematocrit QUESTION white blood cell 4,000 to 10,000 normal Answer: WBC QUESTION Normal range: 30-45 sec Answer: aPTTQUESTION Normal range 1-2 (x1.5 on blood thinners) Answer: INR QUESTION low molecular weight heparin cannot give w/ indwelling epidural catheter More predictable anticoagulant response Frequent laboratory monitoring of bleeding times using tests such as aPTT not needed Answer: Lovenox (enoxaparin) QUESTION stimulates RBC production given for anemia Answer: epoetin QUESTION xanthine derivative side effect: irritability, edgy Answer: Theophylline (Theodur) QUESTION Used to thin secretions to cough upAnswer: Expectorant (general) QUESTION a severe, life-threatening asthma attack that is refractory to usual treatment and places the patient at risk for developing respiratory failure. Give fast-acting rescue inhaler Answer: Status Asthmaticus QUESTION Bronchodilator Use before second medication (i.e. steroid) Answer: Albuterol QUESTION mast cell stabilizer; used for asthma before exercise prophylactically is allergen is causative agent, MDI; maximal effects may take several weeks before clinical response; NSAID that inhibits the IgE mediated release of antiflammatory mediators from mast cells; not used to tx acute bronchospasm Answer: Cromolyn QUESTION 1. shake gently before using 2. remove cap and inspect mouthpiece to ensure no foreign objects in mouthpiece 3. hold inhaler upright and grasp w/ thumb and first two fingers 4. Tilt head back slightly 5. (if no spacer) hold 1" - 2" away from mouth6. exhale completely, then press down to release medication 7. breathe in slowly and deeply for 5 seconds 8. hold breath for 10 seconds and exhale slowly through nose or pursed lips Answer: MDI steps QUESTION Cholestyramine (Questran) All drugs must be taken at least 1 hour before or 4-6 hours after admin of bile acid sequestrants High doses of bile acid sequestrant decrease absorption of A, D, E, K vitamins (fat-soluble) Answer: Bile Acid Sequestrants QUESTION fluticasone/salmeterol glucocorticoid inhalers can lead to fungal infections (candidiasis) of oral mucosa and cavity -- rinse after use hoarseness, throat irritation, dry mouth decreased wound healing compromised immune system Answer: Advair QUESTION Corticosteroid inhaler teach good oral care yeast infection in mouth must rinse after use Answer: BeclomethasoneQUESTION Antiplatelet keeps platelets from aggregating, specifically in stents Answer: Clopidogrel (Plavix) QUESTION bile acid sequestrate for cholesterol All drugs must be taken at least 1 hour before or 4-6 hours after admin of bile acid sequestrants Answer: Colesevelam (Whelcol) QUESTION Do not break or crush - coating is to protect intestine from upset Answer: Enteric Coated QUESTION cardiac stimulant and diuretic Toxicity: green/yellow halows around light, early sign is GI upset (n/v/d), bradycardia, headache, dizziness, confusion, visual disturbances narrow therapeutic window Therapeutic levels: 0.5-2 ng/mL Atrial fibrillation needs 2 Answer: Digoxin (Lanoxin)QUESTION Beta adrenergic blocker monitor/educate for possible postural hypotension or orthostatic hypotension from suddenly having "normal" blood pressure Answer: Propranolol (Inderal) QUESTION Take pill, wait 5 min. If pain persists, call 911, take 2nd pill If pain persists, take 3rd after 5 minutes Answer: nitroglycerin QUESTION diuretic; treats hypertension, heart failure loop diuretic concern for hypokalemia Answer: Furosemide (Lasix) QUESTION Osmotic diuretic used short term for reduction of intracranial pressure or to promote excretion of renal toxins. Tox: expansion of extracellular fluid volume with resulting hyponatremia, headache, nausea. With excessive use, dehydration and hypernatremia. Answer: MannitolQUESTION potassium sparing diuretic aldosterone antagonist interacts with anti hypertensives and ACE inhibitors avoid high salt foods, no potassium supplements Answer: Spironolactone (Aldactone) QUESTION First drug approved for a specific ethnic group, namely African Americans, who typically don't respond to single drug therapy Answer: hydralazine/isosorbide dinitrate (BiDil) QUESTION anti-hypertensive, ACE inhibitor given to diabetics because it is protective of kidneys used for diabetic nephropathy Answer: Lisinopril (Prinivil, Zestril) QUESTION Topical anesthetic Also used for treatment of dysrhythmias via IV pump, particularly ventricular dysrhythmias Answer: Lidocaine