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Exam (elaborations)

NU641 Advanced Clinical Pharm – All-in-One Study Guide 2024–25

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NU641 Advanced Clinical Pharm – All-in-One Study Guide 2024–25

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1. A nurse is teaching a client how to apply clotrimazole
vaginal
cream. What instruction is correct?
A. Use during menstruation
B. Stop once symptoms go away
C. Use applicator at bedtime
D. Use with a tampon
Answer: C
Rationale: For maximum effect, apply at bedtime using the
applicator. Avoid tampons during treatment.

2. 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.

3. 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.

4. A nurse is educating a client on atorvastatin. What side
effect
should the client report immediately?
A. Headache
B. Muscle pain
C. Drowsiness
D. Constipation
Answer: B
Rationale: Myopathy can occur with statins and may
progress to
rhabdomyolysis. Report muscle pain immediately.

5. A client taking warfarin has an INR of 4.2. Which action

, should
the nurse take?
A. Administer the next dose of warfarin
B. Hold the dose and notify the provider
C. Give vitamin K IV immediately
D. Prepare for platelet transfusion
Answer: B
Rationale: An INR >3.0 indicates increased bleeding risk.
The
nurse should hold the medication and notify the provider.

6. A client is prescribed exenatide. What is a common side
effect?
A. Hyperglycemia
B. Constipation
C. Nausea
D. Tachycardia
Answer: C
Rationale: Exenatide can cause nausea, especially when
initiating
therapy. It’s an injectable incretin mimetic.

7. A client with hypothyroidism takes levothyroxine. Which
statement indicates effective therapy?
A. “I feel cold all the time.”
B. “My heart rate is slower than usual.”
C. “I have more energy now.”
D. “I’m gaining weight quickly.”
Answer: C
Rationale: Increased energy suggests improved thyroid
function.

8. A client asks about insulin glargine (Lantus). What is the
correct response?
A. “It works immediately.”
B. “It peaks in 4 hours.”
C. “It has no peak and lasts 24 hours.”
D. “It must be mixed with regular insulin.”
Answer: C
Rationale: Glargine is a long-acting insulin with no
pronounced
peak, providing steady glucose control.

9. What lab value should be monitored in a client receiving
propylthiouracil (PTU)?
A. Glucose
B. TSH and T3/T4
C. Calcium
D. Sodium
Answer: B

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