gt BANK/ATI PHARMACOLOGY EXAM 245 QUESTIONS gt gt gt gt
WITH CORRECT ANSWERS AND gt gt gt gt
RATIONALE/A+GRADED/ VERIFIED gt gt gt
1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium
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level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the
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client?
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1. Calcium chloride gt
2. Calcium gluconate gt
3. Calcitonin (Miacalcin) gt
4. Large doses of vitamin D gt gt gt gt
3.Calcitonin (Miacalcin)
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Rationale:
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The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hyperkalemia.
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Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which
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occurs as a result of acute hypocalcaemia. In hyperkalemia, large doses of vitamin D need to be
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avoided.
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Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and
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lowering the serum calcium concentration.
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2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The
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nurse instructs the mother to administer the iron with which best food item?
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1. Milk
2. Water
3. Apple juice gt
4. Orange juice gt
4. Orange
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juice
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Rational
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e:
Vitamin C increases the absorption of iron by the body. The mother should be instructed to
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administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may
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affect absorption of the iron. Water will not assist in absorption. Orange juice contains a
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greater amount of vitamin C than apple juice.
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3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the gt gt gt gt gt gt gt gt gt gt gt gt gt gt gt
client, knowing that which of the following would indicate the presence of systemic toxicity
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from this medication?
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1. Tinnitus
2. Diarrhea
3. Constipation
, 4. Decreased respirations gt
1. Tinnitu
s
Rational
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e:
Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result.
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Symptoms
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include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and
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diarrhea are not associated with salicylism.
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4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen.
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The nurse reminds the children that chemical sunscreens are most effective when applied:
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1. Immediately before swimming gt gt
2. 15 minutes before exposure to the sun
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3. Immediately before exposure to the sun gt gt gt gt gt
4. At least 30 minutes before exposure to the sun
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At least 30 minutes before exposure to the
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sun
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Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so
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that they can penetrate the skin. All sunscreens should be reapplied after swimming or
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sweating.
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5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When
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applying the medication, the client complains of local discomfort and burning. Which of the
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following is the most appropriate nursing action?
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1. Notifying the registered nurse gt gt gt
2. Discontinuing the medication gt gt
3. Informing the client that this is normal gt gt gt gt gt gt
4. Applying a thinner film than prescribed to the burn site gt gt gt gt gt gt gt gt gt
2. Informing the client that this is gt gt gt gt gt
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Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms and is
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used to treat burns to reduce bacteria present in avascular tissues. The client should be
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informed that the medication will cause local discomfort and burning and that this is a
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normal reaction; therefore options 1, 2, and 4 are incorrect
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6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to the site
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of injury. The nurse monitors the client, knowing that which of the following indicates that a
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systemic effect has occurred?
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1. Hyperventilation
2. Elevated blood pressure gt gt
3. Local pain at the burn site gt gt gt gt gt
4. Local rash at the burn site gt gt gt gt gt
,1. Hyperventilatio
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Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion of acid,
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thereby causing acidosis. Clients receiving this treatment should be monitored for signs of
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an acid-base imbalance (hyperventilation). If this occurs, the medication should be
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discontinued for 1 to 2 days. Options 3 and 4 describe local rather than systemic effects. An
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elevated blood pressure may be expected from the pain that occurs with a burn injury.
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7.) Isotretinoin is prescribed for a client with severe acne. Before the administration of this gt gt gt gt gt gt gt gt gt gt gt gt gt
medication, the nurse anticipates that which laboratory test will be prescribed?
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1. Platelet count gt
2. Triglyceride level gt
3. Complete blood count gt gt
4. White blood cell count gt gt gt
2. Triglyceride
level
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Rationale:
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Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be measured
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before treatment and periodically thereafter until the effect on the triglycerides has been
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evaluated. Options 1, 3, and 4 do not need to be monitored specifically during this treatment.
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8.) A client with severe acne is seen in the clinic and the health care provider (HCP) prescribes
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isotretinoin. The nurse reviews the client's medication record and would contact the (HCP) if the
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client is taking which medication?
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1. Vitamin A gt
2. Digoxin (Lanoxin) gt
3. Furosemide (Lasix) gt
4. Phenytoin (Dilantin) gt
1. Vitamin
A
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Rationale:
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Isotretinoin is a metabolite of vitamin A and can produce generalized intensification of
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isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A supplements
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should be discontinued before isotretinoin therapy. Options 2, 3, and 4 are not
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contraindicated with the use of isotretinoin.
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9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse would monitor
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for the potential for increased systemic absorption of the medication if the medication were being
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applied to which of the following body areas?
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1. Back
2. Axilla
3. Soles of the feet gt gt gt
4. Palms of the hands gt gt gt
2. Axil
la
, Rational
gt
e:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is higher
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from regions where the skin is especially permeable (scalp, axilla, face, eyelids, neck,
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perineum, genitalia), and lower from regions in which permeability is poor (back, palms,
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soles).
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10.) The clinic nurse is performing an admission assessment on a client. The nurse notes that the
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client is taking azelaic acid (Azelex). Because of the medication prescription, the nurse would
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suspect that the client is being treated for:
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1. Acne
2. Eczema
3. Hair loss gt
4. Herpes simplex gt
1. Acne
Rational
gt
e:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid appears to
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work by suppressing the growth of Propionibacterium acnes and decreasing the proliferation
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of keratinocytes. Options 2, 3, and 4 are incorrect.
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W
11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the client with a
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partial- thickness burn, which has cultured positive for gram-negative bacteria. The nurse is
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reinforcing information to the client about the medication. Which statement made by the client
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indicates a lack of understanding about the treatments?
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1. "The medication is an antibacterial."
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2. "The medication will help heal the burn."
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3. "The medication will permanently stain my skin."
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4. "The medication should be applied directly to the wound."
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3. "The medication will permanently stain
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my skin."
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Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of activity against
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gram- negative bacteria, gram-positive bacteria, and yeast. It is applied directly to the wound
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to assist in healing. It does not stain the skin.
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12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an antineoplastic
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medication. During the infusion, the client complains of pain at the insertion site. During an
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inspection of the site, the nurse notes redness and swelling and that the rate of infusion of the
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medication has slowed. The nurse should take which appropriate action?
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1. Notify the registered nurse. gt gt gt
2. Administer pain medication to reduce the discomfort. gt gt gt gt gt gt
3. Apply ice and maintain the infusion rate, as prescribed.
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4. Elevate the extremity of the IV site, and slow the infusion.
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1. Notifythe gt