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Exam (elaborations)

Midterm Pack – NR566 Advanced Pharm Test (Updated 2025)

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Midterm Pack – NR566 Advanced Pharm Test (Updated 2025)

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1. A client is prescribed loratadine for seasonal allergies.
What is
A. key difference from diphenhydramine?
A. Loratadine causes more drowsiness
B. Loratadine causes GI upset
C. Loratadine is non-sedating
D. Loratadine is only available IV
Answer: C
Rationale: Second-generation antihistamines like loratadine
are
non-sedating.

2. A nurse is caring for a client prescribed lisinopril. Which
lab
result should the nurse report to the provider?
A. Sodium 138 mEq/L
B. Potassium 5.8 mEq/L
C. Hemoglobin 14 g/dL
D. BUN 18 mg/dL
Answer: B
Rationale: Lisinopril, an ACE inhibitor, can cause
hyperkalemia. A
potassium level of 5.8 is elevated and should be reported.

3. A client with COPD is on prednisone. Which instruction
is
appropriate?
A. Stop taking it once symptoms resolve
B. Take on an empty stomach
C. Report black tarry stools
D. Avoid potassium-rich foods
Answer: C
Rationale: Corticosteroids increase the risk for GI bleeding
and
ulcers. Tarry stools may indicate bleeding.

4. A client with herpes simplex is prescribed acyclovir.
What is the
most important teaching?
A. "Take on an empty stomach."
B. "Drink plenty of fluids."
C. "Discontinue when symptoms improve."
D. "Expect yellowing of the eyes."
Answer: B
Rationale: Acyclovir can cause nephrotoxicity. Hydration is
essential to reduce the risk.

5. A client taking phenytoin shows swollen, bleeding gums.

, What
should the nurse recommend?
A. Discontinue the drug
B. Increase fluid intake
C. Practice good oral hygiene
D. Reduce dietary sugar
Answer: C
Rationale: Gingival hyperplasia is a known side effect.
Encourage
oral care, not discontinuation.

6. A client receiving methotrexate for cancer reports
mouth
sores. What is the nurse's best response?
A. “This is a normal side effect.”
B. “Increase intake of spicy food.”
C. “Use a soft toothbrush and rinse with saline.”
D. “Chew gum frequently.”
Answer: C
Rationale: Mouth sores (stomatitis) are common. Gentle oral
care
is essential to prevent infection and discomfort.

7. A client prescribed clopidogrel should avoid which overthe
counter medication?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Guaifenesin
Answer: B
Rationale: NSAIDs like ibuprofen increase bleeding risk
when
combined with antiplatelet agents like clopidogrel.

8. A client is taking diphenhydramine. Which side effect is
most
likely?
A. Hypertension
B. Drowsiness
C. Diarrhea
D. Insomnia
Answer: B
Rationale: First-generation antihistamines like
diphenhydramine
cause sedation and drowsiness.

9. A client started on fluoxetine 5 days ago reports
increased
energy and planning their funeral. What should the nurse
do?

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May 14, 2025
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