NURS 6521 Advanced Pharmacology
Final Exam
A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is
appropriate for the infant's age and weight, the nurse administers a narcotic analgesic intravenously.
When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths/minute and a
heart rate of 110 beats/minute. The infant is asleep in the parent's arms and does not awaken when
vital signs are assessed. The nurse understands that these findings are the result of: *** immaturity of
the blood-brain barrier in the infant.
A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The drug may be
dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse
discuss with the child's provider? *** 500 mg/5 mL to 375 mg PO twice daily
Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not
recommended for infants. Which response by the nurse is correct? *** "Infants are more susceptible to
central nervous system effects than are adults."
A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking
a medication history, the nurse will ask about which group of medications? *** Tetracyclines
An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant's parents
ask the nurse about using a topical antihistamine. What should the nurse tell them? *** Applying an
antihistamine to the skin can cause toxicity in this age group.
An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the
medication information and learns that the drug is excreted by the kidneys. When giving the medication,
the nurse will assess the infant for: *** signs of drug toxicity.
A pediatric nurse is teaching nursing students to calculate medication doses for children using a formula
based on body surface area. Which statement by a nursing student indicates understanding of the
teaching? *** "This formula helps approximate the first dose; other doses should be based on clinical
observations."
,A pediatric nurse is teaching nursing students about medication administration in children. Which
statement by a student indicates an understanding of the teaching? *** "Drugs effective in adults may
not work in children, even if the dose is proportional for weight and size."
A nurse is teaching nursing students about pediatric medication administration. What will the nurse
include when discussing pediatric drug research? *** Studies showed a significant percentage of
unanticipated and potentially lethal side effects in children.
A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic
metabolism. The nurse expects the prescriber to: *** order a dose that is lower than an adult dose.
The parents of a child with asthma ask the nurse why their child can not use oral corticosteroids more
often, because they are so effective. The nurse will offer which information that is true for children? ***
Chronic steroid use can inhibit growth.
A patient with schizophrenia receives a dose of risperidone [Risperdal Consta] IM. The nurse teaching
this patient about this medication will make which statement? *** "You will need to take an oral
antipsychotic drug for 3 weeks."
A patient with schizophrenia shows suicidal behaviors, and the provider orders clozapine [Clozaril]. The
nurse teaches the family about the medication and its side effects. Which statement by a family member
indicates a need for further teaching about this drug? *** "If the ANC is less than 3000, the drug will be
discontinued permanently."
A patient in whom drug therapy has failed several times in the past is readmitted to a hospital to begin
therapy for schizophrenia. What will the nurse do to help improve adherence? *** Teach the patient
about drug side effects and how to manage them.
A nurse provides teaching for a patient about to begin taking an FGA drug for schizophrenia. Which
statement by the patient indicates a need for further teaching about side effects of these drugs? ***
"Dry mouth and constipation are uncommon with this medication."
,A patient taking an FGA medication develops severe parkinsonism and is treated with amantadine
[Symmetrel]. The amantadine is withdrawn 2 months later, and the parkinsonism returns. The nurse will
expect the provider to: *** try a second-generation antipsychotic (SGA).
What are negative symptoms of schizophrenia? Select all that apply. *** Poor judgment
Poor self-care
Poverty of speech
A patient is taking an FGA for schizophrenia. The nurse notes that the patient has trouble speaking and
chewing and observes slow, wormlike-movements of the patient's tongue. The nurse recognizes which
adverse effect in this patient? *** Tardive dyskinesia
A nurse and a nursing student are discussing the plan of care for a patient with schizophrenia. The
patient, who has been taking a high-potency FGA for 2 months, has become restless and constantly
needs to be in motion. Which statement by the student indicates a need for further education? ***
"Because this may be an exacerbation of psychosis, the provider may increase the dose of the FGA."
A patient who is taking a first-generation antipsychotic (FGA) drug for schizophrenia comes to the clinic
for evaluation. The nurse observes that the patient has a shuffling gait and mild tremors. The nurse will
ask the patient's provider about which course of action? *** Giving an anticholinergic medication
A patient with schizophrenia has been taking an oral FGA for 1 week. The patient has been taking the
drug daily in two divided doses. The individual complains of daytime drowsiness. The patient's family
reports a decrease in the person's hostility and anxiety but states that the patient remains antisocial
with disordered thinking. What will the nurse tell the patient and the family? *** Some symptoms take
months to improve.
A patient with schizophrenia has been taking an antipsychotic drug for several days. The nurse enters
the patient's room to administer a dose of haloperidol [Haldol] and finds the patient having facial
spasms. The patient's head is thrust back, and the patient is unable to speak. What will the nurse do?
*** Request an order to give diphenhydramine.
, A parent reports being afraid that a child may have schizophrenia because of disorganized speech and
asocial behaviors. The nurse will tell this parent that which of the following must also be present to
make a diagnosis? Select all that apply. *** A decrease in self-care, job, or school function
A 1-month duration of active phase symptoms
Continuous signs of disturbance for longer than 6 months
Which side effects are more common in second-generation antipsychotic medications than in first-
generation antipsychotic medications? Select all that apply. *** Agranulocytosis
Anticholinergic effects
Metabolism by CYP3A4
A nurse in a mental health hospital finds a patient with schizophrenia who takes haloperidol [Haldol]
lying rigid in bed with a temperature of 41.3°C. A cardiac monitor shows cardiac dysrhythmias. What will
be included in the treatment of this patient? Select all that apply. *** Dantrolene
Intravenous fluids
Withdrawal of haloperidol
A patient who has diabetes mellitus is diagnosed with schizophrenia and the provider orders
thioridazine. The patient asks the nurse why the provider has not ordered olanzapine [Zyprexa], which
the patient has seen advertised on television. Which response by the nurse is the most important reason
that this patient is not receiving olanzapine? *** "Olanzapine causes more metabolic side effects than
thioridazine."
A patient who has been taking a monoamine oxidase inhibitor (MAOI) for depression for several months
tells the provider that the medication has not helped with symptoms. The provider plans to switch the
patient to an SSRI. The nurse will teach this patient to: *** stop taking the MAOI 2 weeks before starting
the SSRI.
A young adult patient has been taking an antidepressant medication for several weeks and reports
having increased thoughts of suicide. The nurse questions further and learns that the patient has
Final Exam
A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is
appropriate for the infant's age and weight, the nurse administers a narcotic analgesic intravenously.
When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths/minute and a
heart rate of 110 beats/minute. The infant is asleep in the parent's arms and does not awaken when
vital signs are assessed. The nurse understands that these findings are the result of: *** immaturity of
the blood-brain barrier in the infant.
A child will receive 750 mg of an antibiotic for 10 days. The child attends day care. The drug may be
dosed in several ways and is available in two concentrations. Which dosing regimen will the nurse
discuss with the child's provider? *** 500 mg/5 mL to 375 mg PO twice daily
Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not
recommended for infants. Which response by the nurse is correct? *** "Infants are more susceptible to
central nervous system effects than are adults."
A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking
a medication history, the nurse will ask about which group of medications? *** Tetracyclines
An infant has allergies and often develops a pruritic rash when exposed to allergens. The infant's parents
ask the nurse about using a topical antihistamine. What should the nurse tell them? *** Applying an
antihistamine to the skin can cause toxicity in this age group.
An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the
medication information and learns that the drug is excreted by the kidneys. When giving the medication,
the nurse will assess the infant for: *** signs of drug toxicity.
A pediatric nurse is teaching nursing students to calculate medication doses for children using a formula
based on body surface area. Which statement by a nursing student indicates understanding of the
teaching? *** "This formula helps approximate the first dose; other doses should be based on clinical
observations."
,A pediatric nurse is teaching nursing students about medication administration in children. Which
statement by a student indicates an understanding of the teaching? *** "Drugs effective in adults may
not work in children, even if the dose is proportional for weight and size."
A nurse is teaching nursing students about pediatric medication administration. What will the nurse
include when discussing pediatric drug research? *** Studies showed a significant percentage of
unanticipated and potentially lethal side effects in children.
A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic
metabolism. The nurse expects the prescriber to: *** order a dose that is lower than an adult dose.
The parents of a child with asthma ask the nurse why their child can not use oral corticosteroids more
often, because they are so effective. The nurse will offer which information that is true for children? ***
Chronic steroid use can inhibit growth.
A patient with schizophrenia receives a dose of risperidone [Risperdal Consta] IM. The nurse teaching
this patient about this medication will make which statement? *** "You will need to take an oral
antipsychotic drug for 3 weeks."
A patient with schizophrenia shows suicidal behaviors, and the provider orders clozapine [Clozaril]. The
nurse teaches the family about the medication and its side effects. Which statement by a family member
indicates a need for further teaching about this drug? *** "If the ANC is less than 3000, the drug will be
discontinued permanently."
A patient in whom drug therapy has failed several times in the past is readmitted to a hospital to begin
therapy for schizophrenia. What will the nurse do to help improve adherence? *** Teach the patient
about drug side effects and how to manage them.
A nurse provides teaching for a patient about to begin taking an FGA drug for schizophrenia. Which
statement by the patient indicates a need for further teaching about side effects of these drugs? ***
"Dry mouth and constipation are uncommon with this medication."
,A patient taking an FGA medication develops severe parkinsonism and is treated with amantadine
[Symmetrel]. The amantadine is withdrawn 2 months later, and the parkinsonism returns. The nurse will
expect the provider to: *** try a second-generation antipsychotic (SGA).
What are negative symptoms of schizophrenia? Select all that apply. *** Poor judgment
Poor self-care
Poverty of speech
A patient is taking an FGA for schizophrenia. The nurse notes that the patient has trouble speaking and
chewing and observes slow, wormlike-movements of the patient's tongue. The nurse recognizes which
adverse effect in this patient? *** Tardive dyskinesia
A nurse and a nursing student are discussing the plan of care for a patient with schizophrenia. The
patient, who has been taking a high-potency FGA for 2 months, has become restless and constantly
needs to be in motion. Which statement by the student indicates a need for further education? ***
"Because this may be an exacerbation of psychosis, the provider may increase the dose of the FGA."
A patient who is taking a first-generation antipsychotic (FGA) drug for schizophrenia comes to the clinic
for evaluation. The nurse observes that the patient has a shuffling gait and mild tremors. The nurse will
ask the patient's provider about which course of action? *** Giving an anticholinergic medication
A patient with schizophrenia has been taking an oral FGA for 1 week. The patient has been taking the
drug daily in two divided doses. The individual complains of daytime drowsiness. The patient's family
reports a decrease in the person's hostility and anxiety but states that the patient remains antisocial
with disordered thinking. What will the nurse tell the patient and the family? *** Some symptoms take
months to improve.
A patient with schizophrenia has been taking an antipsychotic drug for several days. The nurse enters
the patient's room to administer a dose of haloperidol [Haldol] and finds the patient having facial
spasms. The patient's head is thrust back, and the patient is unable to speak. What will the nurse do?
*** Request an order to give diphenhydramine.
, A parent reports being afraid that a child may have schizophrenia because of disorganized speech and
asocial behaviors. The nurse will tell this parent that which of the following must also be present to
make a diagnosis? Select all that apply. *** A decrease in self-care, job, or school function
A 1-month duration of active phase symptoms
Continuous signs of disturbance for longer than 6 months
Which side effects are more common in second-generation antipsychotic medications than in first-
generation antipsychotic medications? Select all that apply. *** Agranulocytosis
Anticholinergic effects
Metabolism by CYP3A4
A nurse in a mental health hospital finds a patient with schizophrenia who takes haloperidol [Haldol]
lying rigid in bed with a temperature of 41.3°C. A cardiac monitor shows cardiac dysrhythmias. What will
be included in the treatment of this patient? Select all that apply. *** Dantrolene
Intravenous fluids
Withdrawal of haloperidol
A patient who has diabetes mellitus is diagnosed with schizophrenia and the provider orders
thioridazine. The patient asks the nurse why the provider has not ordered olanzapine [Zyprexa], which
the patient has seen advertised on television. Which response by the nurse is the most important reason
that this patient is not receiving olanzapine? *** "Olanzapine causes more metabolic side effects than
thioridazine."
A patient who has been taking a monoamine oxidase inhibitor (MAOI) for depression for several months
tells the provider that the medication has not helped with symptoms. The provider plans to switch the
patient to an SSRI. The nurse will teach this patient to: *** stop taking the MAOI 2 weeks before starting
the SSRI.
A young adult patient has been taking an antidepressant medication for several weeks and reports
having increased thoughts of suicide. The nurse questions further and learns that the patient has
