Pharm Capstone Exam Questions
A nurse is caring for a client who is taking sumatriptan for migraine headaches and reports a positive
pregnancy test. Which of the following responses should the nurse make? - ANS "You should discuss
with your provider other migraine medications that may be safer during pregnancy."
Sumatriptan is a migraine abortive medication that acts by causing vasoconstriction of cranial arteries.
Sumatriptan is a category C medication in pregnancy. Therefore, the client should discuss the use of the
medication during pregnancy with her provider.
A nurse is collecting data from a client who has been taking esomeprazole for several months. Which of
the following client statements should the nurse identify as indicating effectiveness of the medication? -
ANS "I don't have pain in my stomach anymore."
Esomeprazole is a proton pump inhibitor that treats gastric ulcers, duodenal ulcers, and
gastroesophageal reflux disease. Therefore, this statement indicates the medication is improving the
client's condition.
A nurse is reinforcing discharge teaching with a client who has pulmonary tuberculosis and is to start
taking rifampin. Which of the following information should the nurse include? - ANS Urine and other
secretions will turn orange.
Rifampin will turn the urine and other secretions a harmless reddish-orange color. This includes sputum,
tears, and sweat.
A nurse is reinforcing teaching with a group of nurses about the administration of nitroglycerin. Which
of the following routes of administration provides the most rapid onset for the client? - ANS Sublingual
The client who receives sublingual nitroglycerin will have an onset of 1 to 3 min. Therefore, the nurse
should use this route for nitroglycerin administration for the most rapid onset for the client. Absorption
through the sublingual route is brisk because the medication goes through the oral mucosa directly into
the bloodstream.
A nurse is caring for a client who has asthma. The client asks the nurse how albuterol helps his
breathing. Which of the following information should the nurse include in the response? - ANS The
medication will prevent wheezing.
,The medication will open the airways.
The medication will decrease coughing episodes.
The medication will prevent wheezing is correct. Albuterol may be used to prevent or treat wheezing by
promoting bronchodilation and relieving bronchospasm.
The medication will open the airways is correct. Albuterol promotes bronchodilation. The primary
purpose is to provide rapid relief of bronchoconstriction, thus opening the airway and improving
oxygenation
The medication will decrease coughing episodes is correct. Coughing is often an early indicator of
bronchospasm. Albuterol provides a rapid response to reduce bronchoconstriction, which will decrease
coughing.
A nurse is caring for an older adult client who has a new prescription for spironolactone. Which of the
following laboratory values should the nurse monitor for this client? - ANS Potassium
Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. The nurse should plan to
monitor potassium levels while the client takes this medication. Spironolactone may be discontinued if
the serum potassium level is above 5 mEq/L.
A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for
prednisone. Which of the following statements indicates an understanding of the teaching? - ANS "I
should expect to feel hungrier while on this medication."
Prednisone causes an increase in appetite.
A nurse is caring for a client who is receiving warfarin therapy to prevent a deep vein thrombosis. Which
of the following medications should the nurse have available in the event of an overdose? - ANS Vitamin
K
,The nurse should have available vitamin K available to reverse the effects of warfarin in the event of an
overdose.
A nurse is reinforcing teaching with a female client who has rheumatoid arthritis and a prescription for
methotrexate. Which of the following information should the nurse include in the teaching? - ANS Drink
10 to 12 glasses of water per day to mediate renal toxicity
Methotrexate can cause renal toxicity. Adequate hydration promotes its excretion and helps prevent
this adverse effect.
A nurse is preparing to administer ceftriaxone 3 mL intramuscularly to an adult client. Which of the
following actions should the nurse plan to take? - ANS Locate the ventrogluteal site.
When administering ceftriaxone intramuscularly, it should be injected deeply into a large muscle. The
ventrogluteal site is preferred when more than 1 mL of medication is to be injected. This site contains no
large nerves or blood vessels and has less subcutaneous fat than other parts of the buttock area.
A nurse is reinforcing discharge instructions for a client who has asthma and is about to start using
beclomethasone MDI. for which of the following findings should the nurse instruct the client to monitor
and report to the provider as an adverse effect of the medication? - ANS White coating in the mouth
related to candidias
Beclomethasone, an inhaled glucocorticoid, might cause oropharyngeal candidiasis. The client should
gargle after each use, use a spacer to reduce the amount of the medication in the mouth and throat, and
report any white patches inside the mouth or on the tongue.
A nurse is caring for a client who is postoperative and receiving fentanyl via patient controlled analgesia.
The client has a prescription for naloxone. The nurse understands that the purpose of naloxone is which
of the following? - ANS Block the effects of opioids on the central nervous system
Naloxone is a narcotic antagonist that combines competitively with opiate receptors and blocks or
reverses the action of narcotic analgesics. By blocking the effects of narcotics on the central nervous
system (CNS), it prevents CNS and respiratory depression.
, A nurse is reinforcing teaching with a client who has a new prescription for codeine. Which of the
following information should the nurse include in the teaching? - ANS Change positions slowly.
Codeine is an opioid analgesic that causes CNS depression and orthostatic hypotension. The client
should change positions slowly to avoid the risk of falls.
A nurse is caring for a client whose serum potassium level is 5.3 mEq/L. The nurse should anticipate a
prescription for which of the following medications? - ANS Sodium polystyrene (tx hyperkalemia)
In addition to calcium gluconate, glucose and insulin, sodium polystyrene is administered orally or
rectally to absorb excess potassium.
Potassium chloride tx? - hypokalemia
A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client who
has diabetes. Identify the steps the nurse should take when preparing the two insulins. - ANS Using
evidence-based practice, the first action the nurse should take is to draw up 20 units of air into the
syringe, inject 20 units of air into the NPH insulin vial, and then withdraw the needle, which will facilitate
drawing up the insulin. Next the nurse should draw up 10 units of air into the syringe and then inject 10
units of air into the regular insulin vial. The nurse should next withdraw 10 units of regular insulin into
the syringe and withdraw the needle. The nurse should then reinsert the needle into the NPH insulin vial
and withdraw 20 units of NPH, which will minimize mixing any of the NPH insulin with the regular
insulin.
A nurse is planning to instill ear drops to a toddler and must straighten the ear canal by pulling the
auricle of the ear. The nurse should plan to pull the auricle in which of the following directions? - ANS
Down and backward
The nurse should pull the auricle down and backward. This is the correct technique used for infants and
children under 3 years of age.
A nurse is caring for a client who is taking sumatriptan for migraine headaches and reports a positive
pregnancy test. Which of the following responses should the nurse make? - ANS "You should discuss
with your provider other migraine medications that may be safer during pregnancy."
Sumatriptan is a migraine abortive medication that acts by causing vasoconstriction of cranial arteries.
Sumatriptan is a category C medication in pregnancy. Therefore, the client should discuss the use of the
medication during pregnancy with her provider.
A nurse is collecting data from a client who has been taking esomeprazole for several months. Which of
the following client statements should the nurse identify as indicating effectiveness of the medication? -
ANS "I don't have pain in my stomach anymore."
Esomeprazole is a proton pump inhibitor that treats gastric ulcers, duodenal ulcers, and
gastroesophageal reflux disease. Therefore, this statement indicates the medication is improving the
client's condition.
A nurse is reinforcing discharge teaching with a client who has pulmonary tuberculosis and is to start
taking rifampin. Which of the following information should the nurse include? - ANS Urine and other
secretions will turn orange.
Rifampin will turn the urine and other secretions a harmless reddish-orange color. This includes sputum,
tears, and sweat.
A nurse is reinforcing teaching with a group of nurses about the administration of nitroglycerin. Which
of the following routes of administration provides the most rapid onset for the client? - ANS Sublingual
The client who receives sublingual nitroglycerin will have an onset of 1 to 3 min. Therefore, the nurse
should use this route for nitroglycerin administration for the most rapid onset for the client. Absorption
through the sublingual route is brisk because the medication goes through the oral mucosa directly into
the bloodstream.
A nurse is caring for a client who has asthma. The client asks the nurse how albuterol helps his
breathing. Which of the following information should the nurse include in the response? - ANS The
medication will prevent wheezing.
,The medication will open the airways.
The medication will decrease coughing episodes.
The medication will prevent wheezing is correct. Albuterol may be used to prevent or treat wheezing by
promoting bronchodilation and relieving bronchospasm.
The medication will open the airways is correct. Albuterol promotes bronchodilation. The primary
purpose is to provide rapid relief of bronchoconstriction, thus opening the airway and improving
oxygenation
The medication will decrease coughing episodes is correct. Coughing is often an early indicator of
bronchospasm. Albuterol provides a rapid response to reduce bronchoconstriction, which will decrease
coughing.
A nurse is caring for an older adult client who has a new prescription for spironolactone. Which of the
following laboratory values should the nurse monitor for this client? - ANS Potassium
Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia. The nurse should plan to
monitor potassium levels while the client takes this medication. Spironolactone may be discontinued if
the serum potassium level is above 5 mEq/L.
A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for
prednisone. Which of the following statements indicates an understanding of the teaching? - ANS "I
should expect to feel hungrier while on this medication."
Prednisone causes an increase in appetite.
A nurse is caring for a client who is receiving warfarin therapy to prevent a deep vein thrombosis. Which
of the following medications should the nurse have available in the event of an overdose? - ANS Vitamin
K
,The nurse should have available vitamin K available to reverse the effects of warfarin in the event of an
overdose.
A nurse is reinforcing teaching with a female client who has rheumatoid arthritis and a prescription for
methotrexate. Which of the following information should the nurse include in the teaching? - ANS Drink
10 to 12 glasses of water per day to mediate renal toxicity
Methotrexate can cause renal toxicity. Adequate hydration promotes its excretion and helps prevent
this adverse effect.
A nurse is preparing to administer ceftriaxone 3 mL intramuscularly to an adult client. Which of the
following actions should the nurse plan to take? - ANS Locate the ventrogluteal site.
When administering ceftriaxone intramuscularly, it should be injected deeply into a large muscle. The
ventrogluteal site is preferred when more than 1 mL of medication is to be injected. This site contains no
large nerves or blood vessels and has less subcutaneous fat than other parts of the buttock area.
A nurse is reinforcing discharge instructions for a client who has asthma and is about to start using
beclomethasone MDI. for which of the following findings should the nurse instruct the client to monitor
and report to the provider as an adverse effect of the medication? - ANS White coating in the mouth
related to candidias
Beclomethasone, an inhaled glucocorticoid, might cause oropharyngeal candidiasis. The client should
gargle after each use, use a spacer to reduce the amount of the medication in the mouth and throat, and
report any white patches inside the mouth or on the tongue.
A nurse is caring for a client who is postoperative and receiving fentanyl via patient controlled analgesia.
The client has a prescription for naloxone. The nurse understands that the purpose of naloxone is which
of the following? - ANS Block the effects of opioids on the central nervous system
Naloxone is a narcotic antagonist that combines competitively with opiate receptors and blocks or
reverses the action of narcotic analgesics. By blocking the effects of narcotics on the central nervous
system (CNS), it prevents CNS and respiratory depression.
, A nurse is reinforcing teaching with a client who has a new prescription for codeine. Which of the
following information should the nurse include in the teaching? - ANS Change positions slowly.
Codeine is an opioid analgesic that causes CNS depression and orthostatic hypotension. The client
should change positions slowly to avoid the risk of falls.
A nurse is caring for a client whose serum potassium level is 5.3 mEq/L. The nurse should anticipate a
prescription for which of the following medications? - ANS Sodium polystyrene (tx hyperkalemia)
In addition to calcium gluconate, glucose and insulin, sodium polystyrene is administered orally or
rectally to absorb excess potassium.
Potassium chloride tx? - hypokalemia
A nurse is preparing to administer 10 units of regular insulin and 20 units of NPH insulin to a client who
has diabetes. Identify the steps the nurse should take when preparing the two insulins. - ANS Using
evidence-based practice, the first action the nurse should take is to draw up 20 units of air into the
syringe, inject 20 units of air into the NPH insulin vial, and then withdraw the needle, which will facilitate
drawing up the insulin. Next the nurse should draw up 10 units of air into the syringe and then inject 10
units of air into the regular insulin vial. The nurse should next withdraw 10 units of regular insulin into
the syringe and withdraw the needle. The nurse should then reinsert the needle into the NPH insulin vial
and withdraw 20 units of NPH, which will minimize mixing any of the NPH insulin with the regular
insulin.
A nurse is planning to instill ear drops to a toddler and must straighten the ear canal by pulling the
auricle of the ear. The nurse should plan to pull the auricle in which of the following directions? - ANS
Down and backward
The nurse should pull the auricle down and backward. This is the correct technique used for infants and
children under 3 years of age.
