Pharmacology and Medication Management
UPDATED ACTUAL Exam Questions and
CORRECT Answers
The nurse is instructing a client who will be discharged on anticoagulant therapy. What is the
most important instruction for this nurse to include?
a. Do not shave with an electric razor.
b. Take ibuprofen or aspirin for pain.
c. Take the anticoagulant at the same time each day.
d. Eat green, leafy vegetables and salad daily. - CORRECT ANSWER - c. Take the
anticoagulant at the same time each day.
Explanation:
It is important to take the anticoagulant at the same time each day to maintain an adequate blood
level. An electric razor reduces the risk of cutting the skin. Avoid the use of standard razors.
Avoid taking aspirin or ibuprofen because these drugs decrease clotting time. Eating a large
amount of green, leafy vegetables that contain vitamin K will increase clotting time, thus
requiring more anticoagulants.
The nurse makes initial rounds for the clients. Five medications are scheduled for administration
at the same time to five different clients. Which medication should the nurse administer first after
initial rounds?
a. a maintenance dose of digoxin to the client with congestive heart failure
b. morphine sulfate to a client with a myocardial infarction reporting chest pain
c. naproxen to the client with rheumatoid arthritis
d. ondansetron to a diabetic client reporting nausea - CORRECT ANSWER - b. morphine
sulfate to a client with a myocardial infarction reporting chest pain
Explanation:
,Morphine sulfate relieves pain which immediately decreases myocardial oxygen demand and
decreases preload and afterload pressure. The digoxin is a maintenance dose and does not elicit
an immediate reaction. Though administration of naproxen and ondansetron are next in the order
of urgency, they are not the priority.
Five days after running out of medication, a client taking clonazepam tells the nurse, "I know I
shouldn't have just stopped the drug like that, but I'm OK." What is the nurse's most appropriate
response?
a. "Let's monitor you for problems, in case something else happens."
b. "You could go through withdrawal symptoms for up to two weeks."
c. "You have handled your anxiety, and now you know how to cope with stress."
d. "If you're fine now, chances are you won't experience withdrawal symptoms." - CORRECT
ANSWER - b. "You could go through withdrawal symptoms for up to two weeks."
Explanation:
Withdrawal symptoms can appear after one or two weeks because the benzodiazepine has a long
half-life. Looking for another problem unrelated to withdrawal isn't the nurse's best strategy. The
act of discontinuing an antianxiety medication doesn't indicate that a client has learned to cope
with stress. Every client taking medication needs to be monitored for withdrawal symptoms
when the medication is abruptly stopped.
A client, diagnosed with asthma, is experiencing an anaphylactic reaction to a medication. After
administering initial emergency care, the nurse would
a. administer beta-adrenergic blockers.
b. administer bronchodilators.
c. obtain serum electrolyte levels.
d. have the client lie flat in the bed. - CORRECT ANSWER - b. administer
bronchodilators.
Explanation:
,Bronchodilators will open the client's airway and improve oxygenation status. Beta-adrenergic
blockers aren't indicated in the management of asthma because they may cause bronchospasm.
Obtaining laboratory values wouldn't be done during an emergency, and having the client lie flat
in bed could impede their ability to breathe.
A client calls the clinic worried about experiencing new symptoms after taking antipsychotic
medicine. The client reports persistent, uncontrollable restlessness of the limbs and head despite
improvement in psychotic symptoms. What is the most appropriate intervention by the nurse?
a. Inform the client to ignore these symptoms because they will go away.
b. Advise the client to experiment with different dosages to see how that feels.
c. Tell the client to go to the emergency room if blurred vision or fever develops.
d. Direct the client to see the provider for medication to address these side effects. - CORRECT
ANSWER - Explanation:
Symptoms of tardive dyskinesia include tongue protrusion, lip smacking, chewing, blinking,
grimacing, choreiform movements of limbs and trunk, and foot tapping. Primary prevention of
tardive dyskinesia is achieved by using the lowest effective dose of a neuroleptic for the shortest
time. However, with diseases of chronic psychosis such as schizophrenia, this strategy must be
balanced with the fact that increased dosages are more beneficial in preventing recurrence of
psychosis. If tardive dyskinesia is diagnosed, the causative drug should be discontinued. Blurred
vision is a common adverse reaction of antipsychotic drugs and usually disappears after a few
weeks of therapy. Restlessness is associated with akathisia. Sudden fever is a symptom of a
malignant neurological disorder. The prescribing provider will make appropriate changes to meet
the client's need. Clients should not ignore such symptoms, or adjust their own medication
dosage.
A client with a history of schizophrenia presents to the emergency department accompanied by
police officers after assaulting a neighbor. The client is agitated and combative and cannot be
reoriented. What prescribed medication should the nurse prioritize administering to the client?
a. diphenhydramine
b. paroxetine
c. haloperidol
d. fluoxetine - CORRECT ANSWER - c. haloperidol
, Explanation:
Haloperidol is the drug of choice to treat symptoms of acute psychosis. Diphenhydramine may
be indicated in conjunction with other medications for its sedating effect, but is not a primary
drug of choice. Paroxetine and fluoxetine are antidepressant medications and not indicated to
treat acute psychosis.
Which physical assessment data would alert the nurse to a possible mild toxic reaction in a client
receiving lithium?
a. vomiting and diarrhea
b. hypotension
c. seizures
d. increased appetite - CORRECT ANSWER - a. vomiting and diarrhea
Explanation:
Vomiting and diarrhea are signs of mild to moderate lithium toxicity. Hypotension and seizures
occur with moderate to severe toxic reactions. Anorexia occurs with mild toxic reactions.
A client has been prescribed neomycin and polymyxin B sulfates and hydrocortisone otic
suspension, two drops in the right ear. What action is most important for the nurse take when
instilling the medication?
a. Verify the proper client and route.
b. Warm the solution to prevent dizziness.
c. Hold an emesis basin under the client's ear.
d. Position the client in the semi-Fowler's position. - CORRECT ANSWER - a. Verify the
proper client and route.
Explanation:
UPDATED ACTUAL Exam Questions and
CORRECT Answers
The nurse is instructing a client who will be discharged on anticoagulant therapy. What is the
most important instruction for this nurse to include?
a. Do not shave with an electric razor.
b. Take ibuprofen or aspirin for pain.
c. Take the anticoagulant at the same time each day.
d. Eat green, leafy vegetables and salad daily. - CORRECT ANSWER - c. Take the
anticoagulant at the same time each day.
Explanation:
It is important to take the anticoagulant at the same time each day to maintain an adequate blood
level. An electric razor reduces the risk of cutting the skin. Avoid the use of standard razors.
Avoid taking aspirin or ibuprofen because these drugs decrease clotting time. Eating a large
amount of green, leafy vegetables that contain vitamin K will increase clotting time, thus
requiring more anticoagulants.
The nurse makes initial rounds for the clients. Five medications are scheduled for administration
at the same time to five different clients. Which medication should the nurse administer first after
initial rounds?
a. a maintenance dose of digoxin to the client with congestive heart failure
b. morphine sulfate to a client with a myocardial infarction reporting chest pain
c. naproxen to the client with rheumatoid arthritis
d. ondansetron to a diabetic client reporting nausea - CORRECT ANSWER - b. morphine
sulfate to a client with a myocardial infarction reporting chest pain
Explanation:
,Morphine sulfate relieves pain which immediately decreases myocardial oxygen demand and
decreases preload and afterload pressure. The digoxin is a maintenance dose and does not elicit
an immediate reaction. Though administration of naproxen and ondansetron are next in the order
of urgency, they are not the priority.
Five days after running out of medication, a client taking clonazepam tells the nurse, "I know I
shouldn't have just stopped the drug like that, but I'm OK." What is the nurse's most appropriate
response?
a. "Let's monitor you for problems, in case something else happens."
b. "You could go through withdrawal symptoms for up to two weeks."
c. "You have handled your anxiety, and now you know how to cope with stress."
d. "If you're fine now, chances are you won't experience withdrawal symptoms." - CORRECT
ANSWER - b. "You could go through withdrawal symptoms for up to two weeks."
Explanation:
Withdrawal symptoms can appear after one or two weeks because the benzodiazepine has a long
half-life. Looking for another problem unrelated to withdrawal isn't the nurse's best strategy. The
act of discontinuing an antianxiety medication doesn't indicate that a client has learned to cope
with stress. Every client taking medication needs to be monitored for withdrawal symptoms
when the medication is abruptly stopped.
A client, diagnosed with asthma, is experiencing an anaphylactic reaction to a medication. After
administering initial emergency care, the nurse would
a. administer beta-adrenergic blockers.
b. administer bronchodilators.
c. obtain serum electrolyte levels.
d. have the client lie flat in the bed. - CORRECT ANSWER - b. administer
bronchodilators.
Explanation:
,Bronchodilators will open the client's airway and improve oxygenation status. Beta-adrenergic
blockers aren't indicated in the management of asthma because they may cause bronchospasm.
Obtaining laboratory values wouldn't be done during an emergency, and having the client lie flat
in bed could impede their ability to breathe.
A client calls the clinic worried about experiencing new symptoms after taking antipsychotic
medicine. The client reports persistent, uncontrollable restlessness of the limbs and head despite
improvement in psychotic symptoms. What is the most appropriate intervention by the nurse?
a. Inform the client to ignore these symptoms because they will go away.
b. Advise the client to experiment with different dosages to see how that feels.
c. Tell the client to go to the emergency room if blurred vision or fever develops.
d. Direct the client to see the provider for medication to address these side effects. - CORRECT
ANSWER - Explanation:
Symptoms of tardive dyskinesia include tongue protrusion, lip smacking, chewing, blinking,
grimacing, choreiform movements of limbs and trunk, and foot tapping. Primary prevention of
tardive dyskinesia is achieved by using the lowest effective dose of a neuroleptic for the shortest
time. However, with diseases of chronic psychosis such as schizophrenia, this strategy must be
balanced with the fact that increased dosages are more beneficial in preventing recurrence of
psychosis. If tardive dyskinesia is diagnosed, the causative drug should be discontinued. Blurred
vision is a common adverse reaction of antipsychotic drugs and usually disappears after a few
weeks of therapy. Restlessness is associated with akathisia. Sudden fever is a symptom of a
malignant neurological disorder. The prescribing provider will make appropriate changes to meet
the client's need. Clients should not ignore such symptoms, or adjust their own medication
dosage.
A client with a history of schizophrenia presents to the emergency department accompanied by
police officers after assaulting a neighbor. The client is agitated and combative and cannot be
reoriented. What prescribed medication should the nurse prioritize administering to the client?
a. diphenhydramine
b. paroxetine
c. haloperidol
d. fluoxetine - CORRECT ANSWER - c. haloperidol
, Explanation:
Haloperidol is the drug of choice to treat symptoms of acute psychosis. Diphenhydramine may
be indicated in conjunction with other medications for its sedating effect, but is not a primary
drug of choice. Paroxetine and fluoxetine are antidepressant medications and not indicated to
treat acute psychosis.
Which physical assessment data would alert the nurse to a possible mild toxic reaction in a client
receiving lithium?
a. vomiting and diarrhea
b. hypotension
c. seizures
d. increased appetite - CORRECT ANSWER - a. vomiting and diarrhea
Explanation:
Vomiting and diarrhea are signs of mild to moderate lithium toxicity. Hypotension and seizures
occur with moderate to severe toxic reactions. Anorexia occurs with mild toxic reactions.
A client has been prescribed neomycin and polymyxin B sulfates and hydrocortisone otic
suspension, two drops in the right ear. What action is most important for the nurse take when
instilling the medication?
a. Verify the proper client and route.
b. Warm the solution to prevent dizziness.
c. Hold an emesis basin under the client's ear.
d. Position the client in the semi-Fowler's position. - CORRECT ANSWER - a. Verify the
proper client and route.
Explanation:
