AS
N316B – Pharmacology Midterm: A+ Graded Term
Exam with Verified Answers
Questions and Mark scheme
Version: Final 1.1
,Question 11
A client is started on long-term corticosteroid therapy for an autoimmune disorder. Which statement by the client
indicates the need for more teaching by the nurse?
Question 11 Answer Choices
A"For 1 week each month I will stop taking the medication."
"For 1 week each month I will stop taking the medication."
B"I will keep a record of my weight each week."
"I will keep a record of my weight each week."
C"The medication needs to be taken with food."
"The medication needs to be taken with food."
D"I will be sure to eat foods that are high in potassium."
"I will be sure to eat foods that are high in potassium."
Question Explanation - ✔✔Rationale
Corticosteroids should never be stopped abruptly, they should always be weaned. To suddenly stop this medication may
result in a sudden drop in the blood pressure from a loss in fluid volume associated with adrenal crisis. Clients should be
warned not to abruptly stop taking the medication. Corticosteroids can lower the amount of potassium in the body so
the client should eat more potassium rich foods. Weight gain is an expected effect of corticosteroid therapy. Clients
should regularly keep track of their weight. Generally, corticosteroid medications are taken with breakfast.
Question 8
The nurse is caring for a client who is receiving a continuous intravenous heparin infusion. The client's most recent
activated partial thromboplastin time (aPTT) is 120 seconds. Which medication should the nurse plan to administer?
Question 8 Answer Choices
AProtamine
Protamine
BNaloxone
Naloxone
CVitamin K
Vitamin K
DEnoxaparin
Enoxaparin
Question Explanation - ✔✔Rationale
,The client's aPTT is much higher than the typical desired therapeutic range of 1.5-2.5 the control value and places the
client at great risk for uncontrolled bleeding. Protamine sulfate is the medication used to reverse the effects of heparin;
it is a heparin antagonist. Neutralization of heparin occurs immediately and lasts for 2 hours, after which additional
protamine may be needed. Protamine is administered by slow IV injection (no faster than 20 mg/ min or 50 mg in 10
minutes). Dosage is based on the fact that 1 mg of protamine will inactivate approx. 100 units of heparin. Vitamin K is
used to reverse the effects of warfarin. Naloxone is used to reverse the effects of opioids. Enoxaparin is another
anticoagulant (low molecular weight heparin).
Question 3
A nurse is teaching a client with asthma about the correct use of the fluticasone inhaler. Which statement, if made by
the client, would indicate that the teaching was effective?
Question 3 Answer Choices
A"The inhaler can be used when I feel short of breath."
"The inhaler can be used when I feel short of breath."
B"If I forget a dose, I will double the next dose."
"If I forget a dose, I will double the next dose."
C"I should rinse my mouth after using the inhaler."
"I should rinse my mouth after using the inhaler."
D"I should not use a spacer with my inhaler."
"I should not use a spacer with my inhaler."
Question Explanation - ✔✔Rationale
Fluticasone is an inhaled corticosteroid used to prevent asthma attacks. After using the inhaler, the client should rinse
away any residue in the mouth to reduce the risk of an oral fungal infection. Fluticasone is not a bronchodilator and
should not be used as needed for shortness of breath. The client should not double the dose of this medication and
should use a spacer with this inhaler.
Question 1
The nurse is teaching a client diagnosed with asthma about the medication albuterol. Which statement by the nurse
demonstrates appropriate teaching?
Question 1 Answer Choices
A"Call your doctor's office if you need to use the drug more often."
"Call your doctor's office if you need to use the drug more often."
B"Use this medication at bedtime to promote rest."
"Use this medication at bedtime to promote rest."
C"Use this medication after other asthma inhalers."
, "Use this medication after other asthma inhalers."
D"Discontinue the inhaler if you feel dizzy."
"Discontinue the inhaler if you feel dizzy."
Question Explanation - ✔✔Rationale
Albuterol is a bronchodilator used for the relief of bronchospasm. It is considered a rescue medication for a client during
an asthmatic attack. If the client notices the need to use the inhaler more frequently, the health care provider (HCP)
should be notified. The client may need to seek emergency medical care, as the medication is no longer effective. In
addition, clients should not exceed the recommended dosage, as adverse effects may occur. Be sure the client
understands how to correctly use this medication. The client may experience side effects of dizziness, headache, nausea,
vomiting, rapid heart rate, anxiety, sweating, flushing and insomnia. Using albuterol at bedtime may lead to insomnia.
Albuterol should be used before all other inhalers, as it dilates the bronchi or bronchioles and allows more of the other
medication to reach the lower respiratory tract. It would not be appropriate to suddenly discontinue taking a
bronchodilator.
Question 3
The nurse is reviewing the prothrombin time results for a client who is taking warfarin. The nurse notes the value is 20
seconds. What is an appropriate nursing action?
Question 3 Answer Choices
ARecognize that this is a therapeutic level.
Recognize that this is a therapeutic level.
BAssess for bleeding gums or IV sites.
Assess for bleeding gums or IV sites.
CNotify the primary health care provider immediately.
Notify the primary health care provider immediately.
DObserve the client for hematoma development.
Observe the client for hematoma development.
Question Explanation - ✔✔Rationale
For the client on warfarin therapy, this prothrombin level is within the therapeutic range. Therapeutic levels for warfarin
are usually one and a half to two times the normal level.
Question 4
A nurse is reviewing the INR results for caring for a client who had a cerebral vascular accident and is receiving
prescribed warfarin. The nurse notes the INR is 5.2. Which finding requires priority follow-up?
Question 4 Answer Choices
N316B – Pharmacology Midterm: A+ Graded Term
Exam with Verified Answers
Questions and Mark scheme
Version: Final 1.1
,Question 11
A client is started on long-term corticosteroid therapy for an autoimmune disorder. Which statement by the client
indicates the need for more teaching by the nurse?
Question 11 Answer Choices
A"For 1 week each month I will stop taking the medication."
"For 1 week each month I will stop taking the medication."
B"I will keep a record of my weight each week."
"I will keep a record of my weight each week."
C"The medication needs to be taken with food."
"The medication needs to be taken with food."
D"I will be sure to eat foods that are high in potassium."
"I will be sure to eat foods that are high in potassium."
Question Explanation - ✔✔Rationale
Corticosteroids should never be stopped abruptly, they should always be weaned. To suddenly stop this medication may
result in a sudden drop in the blood pressure from a loss in fluid volume associated with adrenal crisis. Clients should be
warned not to abruptly stop taking the medication. Corticosteroids can lower the amount of potassium in the body so
the client should eat more potassium rich foods. Weight gain is an expected effect of corticosteroid therapy. Clients
should regularly keep track of their weight. Generally, corticosteroid medications are taken with breakfast.
Question 8
The nurse is caring for a client who is receiving a continuous intravenous heparin infusion. The client's most recent
activated partial thromboplastin time (aPTT) is 120 seconds. Which medication should the nurse plan to administer?
Question 8 Answer Choices
AProtamine
Protamine
BNaloxone
Naloxone
CVitamin K
Vitamin K
DEnoxaparin
Enoxaparin
Question Explanation - ✔✔Rationale
,The client's aPTT is much higher than the typical desired therapeutic range of 1.5-2.5 the control value and places the
client at great risk for uncontrolled bleeding. Protamine sulfate is the medication used to reverse the effects of heparin;
it is a heparin antagonist. Neutralization of heparin occurs immediately and lasts for 2 hours, after which additional
protamine may be needed. Protamine is administered by slow IV injection (no faster than 20 mg/ min or 50 mg in 10
minutes). Dosage is based on the fact that 1 mg of protamine will inactivate approx. 100 units of heparin. Vitamin K is
used to reverse the effects of warfarin. Naloxone is used to reverse the effects of opioids. Enoxaparin is another
anticoagulant (low molecular weight heparin).
Question 3
A nurse is teaching a client with asthma about the correct use of the fluticasone inhaler. Which statement, if made by
the client, would indicate that the teaching was effective?
Question 3 Answer Choices
A"The inhaler can be used when I feel short of breath."
"The inhaler can be used when I feel short of breath."
B"If I forget a dose, I will double the next dose."
"If I forget a dose, I will double the next dose."
C"I should rinse my mouth after using the inhaler."
"I should rinse my mouth after using the inhaler."
D"I should not use a spacer with my inhaler."
"I should not use a spacer with my inhaler."
Question Explanation - ✔✔Rationale
Fluticasone is an inhaled corticosteroid used to prevent asthma attacks. After using the inhaler, the client should rinse
away any residue in the mouth to reduce the risk of an oral fungal infection. Fluticasone is not a bronchodilator and
should not be used as needed for shortness of breath. The client should not double the dose of this medication and
should use a spacer with this inhaler.
Question 1
The nurse is teaching a client diagnosed with asthma about the medication albuterol. Which statement by the nurse
demonstrates appropriate teaching?
Question 1 Answer Choices
A"Call your doctor's office if you need to use the drug more often."
"Call your doctor's office if you need to use the drug more often."
B"Use this medication at bedtime to promote rest."
"Use this medication at bedtime to promote rest."
C"Use this medication after other asthma inhalers."
, "Use this medication after other asthma inhalers."
D"Discontinue the inhaler if you feel dizzy."
"Discontinue the inhaler if you feel dizzy."
Question Explanation - ✔✔Rationale
Albuterol is a bronchodilator used for the relief of bronchospasm. It is considered a rescue medication for a client during
an asthmatic attack. If the client notices the need to use the inhaler more frequently, the health care provider (HCP)
should be notified. The client may need to seek emergency medical care, as the medication is no longer effective. In
addition, clients should not exceed the recommended dosage, as adverse effects may occur. Be sure the client
understands how to correctly use this medication. The client may experience side effects of dizziness, headache, nausea,
vomiting, rapid heart rate, anxiety, sweating, flushing and insomnia. Using albuterol at bedtime may lead to insomnia.
Albuterol should be used before all other inhalers, as it dilates the bronchi or bronchioles and allows more of the other
medication to reach the lower respiratory tract. It would not be appropriate to suddenly discontinue taking a
bronchodilator.
Question 3
The nurse is reviewing the prothrombin time results for a client who is taking warfarin. The nurse notes the value is 20
seconds. What is an appropriate nursing action?
Question 3 Answer Choices
ARecognize that this is a therapeutic level.
Recognize that this is a therapeutic level.
BAssess for bleeding gums or IV sites.
Assess for bleeding gums or IV sites.
CNotify the primary health care provider immediately.
Notify the primary health care provider immediately.
DObserve the client for hematoma development.
Observe the client for hematoma development.
Question Explanation - ✔✔Rationale
For the client on warfarin therapy, this prothrombin level is within the therapeutic range. Therapeutic levels for warfarin
are usually one and a half to two times the normal level.
Question 4
A nurse is reviewing the INR results for caring for a client who had a cerebral vascular accident and is receiving
prescribed warfarin. The nurse notes the INR is 5.2. Which finding requires priority follow-up?
Question 4 Answer Choices
