NURS 8024 PHARM FINAL EXAM NEWEST TEST BANK
COMPLETE 500 QUESTIONS AND CORRECT DETAILED
ANSWERS
Potassium chloride intravenously is prescribed for a client with hypokalemia. Which
actions should the nurse take to plan for preparation and administration of the
potassium? Select all that apply.
1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
3. Prepare the medication for bolus administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the
solution. - ANSWER: 1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the
solution.
Rationale:
Potassium chloride administered intravenously must always be diluted in IV fluid and
infused via an infusion pump. Potassium chloride is never given by bolus (IV push).
Giving potassium chloride by IV push can result in cardiac arrest. The nurse should
ensure that the potassium is diluted in the appropriate amount of diluent or fluid.
The IV bag containing the potassium chloride should always be labeled with the
volume of potassium it contains. The IV site is monitored closely because potassium
chloride is irritating to the veins and there is risk of phlebitis. In addition, the nurse
should monitor for infiltration. The nurse monitors urinary output during
administration and contacts the health care provider if the urinary output is less than
30 mL/hour.
A client with atrial fibrillation is receiving a continuous heparin infusion at 1000
units/hour. The nurse determines that the client is receiving the therapeutic effect
based on which results?
1. Prothrombin time of 12.5 seconds
2. Activated partial thromboplastin time of 60 seconds
3. Activated partial thromboplastin time of 28 seconds
4. Activated partial thromboplastin time longer than 120 seconds - ANSWER: 2.
Activated partial thromboplastin time of 60 seconds
Rationale:
,Common laboratory ranges for activated partial thromboplastin time (aPTT) are 30
to 40 seconds. Because the aPTT should be 1.5 to 2.5 times the normal value, the
client's aPTT would be considered therapeutic if it was 60 seconds. Prothrombin time
assesses response to warfarin therapy.
The nurse provides discharge instructions to a client who is taking warfarin sodium.
Which statement, by the client, reflects the need for further teaching?
1. "I will avoid alcohol consumption."
2. "I will take my pills every day at the same time."
3. "I have already called my family to pick up a MedicAlert bracelet."
4. "I will take coated aspirin for my headaches because it will coat my stomach." -
ANSWER: 4. "I will take coated aspirin for my headaches because it will coat my
stomach."
Rationale:
Aspirin-containing products need to be avoided when a client is taking this
medication. Alcohol consumption should be avoided by a client taking warfarin
sodium. Taking the prescribed medication at the same time each day increases client
compliance. The MedicAlert bracelet provides health care personnel with emergency
information.
A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3
mmol/L) and is complaining of anorexia. The health care provider prescribes a serum
digoxin level to be done. The nurse checks the results and should expect to note
which level that is outside of the therapeutic range?
1. 0.3 ng/mL
2. 0.5 ng/mL
3. 0.8 ng/mL
4. 1.0 ng/mL - ANSWER: 4. 1.0 ng/mL
Rationale:
The optimal therapeutic range for digoxin is 0.5 to 0.8 ng/mL. If the client is
experiencing symptoms such as anorexia and is experiencing hypokalemia as
evidenced by a low potassium level, digoxin toxicity is a concern. Therefore, option 4
is correct because it is outside of the therapeutic level and an elevated level.
A client is being treated with procainamide for a cardiac dysrhythmia. Following
intravenous administration of the medication, the client complains of dizziness.
What intervention should the nurse take first?
1. Measure the heart rate on the rhythm strip.
2. Administer prescribed nitroglycerin tablets.
3. Obtain a 12-lead electrocardiogram immediately.
4. Auscultate the client's apical pulse and obtain a blood pressure. - ANSWER: 4.
Auscultate the client's apical pulse and obtain a blood pressure.
,Rationale:
Signs of toxicity from procainamide include confusion, dizziness, drowsiness,
decreased urination, nausea, vomiting, and tachydysrhythmias. If the client
complains of dizziness, the nurse should assess the vital signs first. Although
measuring the heart rate on the rhythm strip and obtaining a 12-lead
electrocardiogram may be interventions, these would be done after the vital signs
are taken. Nitroglycerin is a vasodilator and will lower the blood pressure.
The nurse is monitoring a client who is taking propranolol. Which assessment finding
indicates a potential adverse complication associated with this medication?
1. The development of complaints of insomnia
2. The development of audible expiratory wheezes
3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of
138/72 mm Hg after 2 doses of the medication
4. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of
72 beats/minute after 2 doses of the medication - ANSWER: 2. The development of
audible expiratory wheezes
Rationale:
Audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm.
Beta blockers may induce this reaction, particularly in clients with chronic
obstructive pulmonary disease or asthma. Normal decreases in blood pressure and
heart rate are expected. Insomnia is a frequent mild side effect and should be
monitored.
A client with a clot in the right atrium is receiving a heparin sodium infusion at 1000
units/hour and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory
results are as follows: activated partial thromboplastin time (aPTT), 32 seconds;
international normalized ratio (INR), 1.3. The nurse should take which action based
on the client's laboratory results?
1. Collaborate with the health care provider (HCP) to discontinue the heparin
infusion and administer the warfarin sodium as prescribed.
2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion
and administer the warfarin sodium as prescribed.
3. Collaborate with the HCP to withhold the warfarin sodium since the client is
receiving a heparin infusion and the aPTT is within the therapeutic range.
4. Collaborate with the HCP to continue the heparin infusion at the same rate and to
discuss use of dabigatran etexilate in place - ANSWER: 2. Collaborate with the HCP to
obtain a prescription to increase the heparin infusion and administer the warfarin
sodium as prescribed.
Rationale:
When a client is receiving warfarin for clot prevention due to atrial fibrillation, an INR
of 2 to 3 is appropriate for most clients. Until the INR has achieved a therapeutic
, range, the client should be maintained on a continuous heparin infusion with the
aPTT ranging between 60 and 80 seconds. Therefore, the nurse should collaborate
with the HCP to obtain a prescription to increase the heparin infusion and to
administer the warfarin as prescribed.
A client is diagnosed with an ST segment elevation myocardial infarction (STEMI) and
is receiving a tissue plasminogen activator, alteplase. Which action is a priority
nursing intervention?
1. Monitor for kidney failure.
2. Monitor psychosocial status.
3. Monitor for signs of bleeding.
4. Have heparin sodium available. - ANSWER: 3. Monitor for signs of bleeding.
Rationale:
Tissue plasminogen activator is a thrombolytic. Hemorrhage is a complication of any
type of thrombolytic medication. The client is monitored for bleeding. Monitoring for
renal failure and monitoring the client's psychosocial status are important but are
not the most critical interventions. Heparin may be administered after thrombolytic
therapy, but the question is not asking about follow-up medications.
The nurse is planning to administer hydrochlorothiazide to a client. The nurse should
monitor for which adverse effects related to the administration of this medication?
1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
3. Hypokalemia, hyperglycemia, sulfa allergy
4. Hyperkalemia, hypoglycemia, penicillin allergy - ANSWER: 3. Hypokalemia,
hyperglycemia, sulfa allergy
Rationale:
Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a
client with a sulfa allergy is at risk for an allergic reaction. Also, clients are at risk for
hypokalemia, hyperglycemia, hypercalcemia, hyperlipidemia, and hyperuricemia.
The home health care nurse is visiting a client with elevated triglyceride levels and a
serum cholesterol level of 398 mg/dL (10 mmol/L). The client is taking
cholestyramine and the nurse teaches the client about the medication. Which
statement, by the client, indicates the need for further teaching?
1. "Constipation and bloating might be a problem."
2. "I'll continue to watch my diet and reduce my fats."
3. "Walking a mile each day will help the whole process."
4. "I'll continue my nicotinic acid from the health food store." - ANSWER: 4. "I'll
continue my nicotinic acid from the health food store."
Rationale:
COMPLETE 500 QUESTIONS AND CORRECT DETAILED
ANSWERS
Potassium chloride intravenously is prescribed for a client with hypokalemia. Which
actions should the nurse take to plan for preparation and administration of the
potassium? Select all that apply.
1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
3. Prepare the medication for bolus administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the
solution. - ANSWER: 1. Obtain an intravenous (IV) infusion pump.
2. Monitor urine output during administration.
4. Monitor the IV site for signs of infiltration or phlebitis.
5. Ensure that the medication is diluted in the appropriate volume of fluid.
6. Ensure that the bag is labeled so that it reads the volume of potassium in the
solution.
Rationale:
Potassium chloride administered intravenously must always be diluted in IV fluid and
infused via an infusion pump. Potassium chloride is never given by bolus (IV push).
Giving potassium chloride by IV push can result in cardiac arrest. The nurse should
ensure that the potassium is diluted in the appropriate amount of diluent or fluid.
The IV bag containing the potassium chloride should always be labeled with the
volume of potassium it contains. The IV site is monitored closely because potassium
chloride is irritating to the veins and there is risk of phlebitis. In addition, the nurse
should monitor for infiltration. The nurse monitors urinary output during
administration and contacts the health care provider if the urinary output is less than
30 mL/hour.
A client with atrial fibrillation is receiving a continuous heparin infusion at 1000
units/hour. The nurse determines that the client is receiving the therapeutic effect
based on which results?
1. Prothrombin time of 12.5 seconds
2. Activated partial thromboplastin time of 60 seconds
3. Activated partial thromboplastin time of 28 seconds
4. Activated partial thromboplastin time longer than 120 seconds - ANSWER: 2.
Activated partial thromboplastin time of 60 seconds
Rationale:
,Common laboratory ranges for activated partial thromboplastin time (aPTT) are 30
to 40 seconds. Because the aPTT should be 1.5 to 2.5 times the normal value, the
client's aPTT would be considered therapeutic if it was 60 seconds. Prothrombin time
assesses response to warfarin therapy.
The nurse provides discharge instructions to a client who is taking warfarin sodium.
Which statement, by the client, reflects the need for further teaching?
1. "I will avoid alcohol consumption."
2. "I will take my pills every day at the same time."
3. "I have already called my family to pick up a MedicAlert bracelet."
4. "I will take coated aspirin for my headaches because it will coat my stomach." -
ANSWER: 4. "I will take coated aspirin for my headaches because it will coat my
stomach."
Rationale:
Aspirin-containing products need to be avoided when a client is taking this
medication. Alcohol consumption should be avoided by a client taking warfarin
sodium. Taking the prescribed medication at the same time each day increases client
compliance. The MedicAlert bracelet provides health care personnel with emergency
information.
A client who is receiving digoxin daily has a serum potassium level of 3 mEq/L (3
mmol/L) and is complaining of anorexia. The health care provider prescribes a serum
digoxin level to be done. The nurse checks the results and should expect to note
which level that is outside of the therapeutic range?
1. 0.3 ng/mL
2. 0.5 ng/mL
3. 0.8 ng/mL
4. 1.0 ng/mL - ANSWER: 4. 1.0 ng/mL
Rationale:
The optimal therapeutic range for digoxin is 0.5 to 0.8 ng/mL. If the client is
experiencing symptoms such as anorexia and is experiencing hypokalemia as
evidenced by a low potassium level, digoxin toxicity is a concern. Therefore, option 4
is correct because it is outside of the therapeutic level and an elevated level.
A client is being treated with procainamide for a cardiac dysrhythmia. Following
intravenous administration of the medication, the client complains of dizziness.
What intervention should the nurse take first?
1. Measure the heart rate on the rhythm strip.
2. Administer prescribed nitroglycerin tablets.
3. Obtain a 12-lead electrocardiogram immediately.
4. Auscultate the client's apical pulse and obtain a blood pressure. - ANSWER: 4.
Auscultate the client's apical pulse and obtain a blood pressure.
,Rationale:
Signs of toxicity from procainamide include confusion, dizziness, drowsiness,
decreased urination, nausea, vomiting, and tachydysrhythmias. If the client
complains of dizziness, the nurse should assess the vital signs first. Although
measuring the heart rate on the rhythm strip and obtaining a 12-lead
electrocardiogram may be interventions, these would be done after the vital signs
are taken. Nitroglycerin is a vasodilator and will lower the blood pressure.
The nurse is monitoring a client who is taking propranolol. Which assessment finding
indicates a potential adverse complication associated with this medication?
1. The development of complaints of insomnia
2. The development of audible expiratory wheezes
3. A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of
138/72 mm Hg after 2 doses of the medication
4. A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of
72 beats/minute after 2 doses of the medication - ANSWER: 2. The development of
audible expiratory wheezes
Rationale:
Audible expiratory wheezes may indicate a serious adverse reaction, bronchospasm.
Beta blockers may induce this reaction, particularly in clients with chronic
obstructive pulmonary disease or asthma. Normal decreases in blood pressure and
heart rate are expected. Insomnia is a frequent mild side effect and should be
monitored.
A client with a clot in the right atrium is receiving a heparin sodium infusion at 1000
units/hour and warfarin sodium 7.5 mg at 5:00 p.m. daily. The morning laboratory
results are as follows: activated partial thromboplastin time (aPTT), 32 seconds;
international normalized ratio (INR), 1.3. The nurse should take which action based
on the client's laboratory results?
1. Collaborate with the health care provider (HCP) to discontinue the heparin
infusion and administer the warfarin sodium as prescribed.
2. Collaborate with the HCP to obtain a prescription to increase the heparin infusion
and administer the warfarin sodium as prescribed.
3. Collaborate with the HCP to withhold the warfarin sodium since the client is
receiving a heparin infusion and the aPTT is within the therapeutic range.
4. Collaborate with the HCP to continue the heparin infusion at the same rate and to
discuss use of dabigatran etexilate in place - ANSWER: 2. Collaborate with the HCP to
obtain a prescription to increase the heparin infusion and administer the warfarin
sodium as prescribed.
Rationale:
When a client is receiving warfarin for clot prevention due to atrial fibrillation, an INR
of 2 to 3 is appropriate for most clients. Until the INR has achieved a therapeutic
, range, the client should be maintained on a continuous heparin infusion with the
aPTT ranging between 60 and 80 seconds. Therefore, the nurse should collaborate
with the HCP to obtain a prescription to increase the heparin infusion and to
administer the warfarin as prescribed.
A client is diagnosed with an ST segment elevation myocardial infarction (STEMI) and
is receiving a tissue plasminogen activator, alteplase. Which action is a priority
nursing intervention?
1. Monitor for kidney failure.
2. Monitor psychosocial status.
3. Monitor for signs of bleeding.
4. Have heparin sodium available. - ANSWER: 3. Monitor for signs of bleeding.
Rationale:
Tissue plasminogen activator is a thrombolytic. Hemorrhage is a complication of any
type of thrombolytic medication. The client is monitored for bleeding. Monitoring for
renal failure and monitoring the client's psychosocial status are important but are
not the most critical interventions. Heparin may be administered after thrombolytic
therapy, but the question is not asking about follow-up medications.
The nurse is planning to administer hydrochlorothiazide to a client. The nurse should
monitor for which adverse effects related to the administration of this medication?
1. Hypouricemia, hyperkalemia
2. Increased risk of osteoporosis
3. Hypokalemia, hyperglycemia, sulfa allergy
4. Hyperkalemia, hypoglycemia, penicillin allergy - ANSWER: 3. Hypokalemia,
hyperglycemia, sulfa allergy
Rationale:
Thiazide diuretics such as hydrochlorothiazide are sulfa-based medications, and a
client with a sulfa allergy is at risk for an allergic reaction. Also, clients are at risk for
hypokalemia, hyperglycemia, hypercalcemia, hyperlipidemia, and hyperuricemia.
The home health care nurse is visiting a client with elevated triglyceride levels and a
serum cholesterol level of 398 mg/dL (10 mmol/L). The client is taking
cholestyramine and the nurse teaches the client about the medication. Which
statement, by the client, indicates the need for further teaching?
1. "Constipation and bloating might be a problem."
2. "I'll continue to watch my diet and reduce my fats."
3. "Walking a mile each day will help the whole process."
4. "I'll continue my nicotinic acid from the health food store." - ANSWER: 4. "I'll
continue my nicotinic acid from the health food store."
Rationale:
