Global Insights: Module 8 Exam on Pharmacology &
Parenteral Therapies - A+ Graded Questions from
Renowned Sources with Detailed Explanations and
Answers
A nurse has taught a client taking a methylxanthine bronchodilator about beverages that
must be avoided. Which beverage choices by the client indicate to the nurse that the client
needs further education? Select all that apply. - CORRECT ANS- -A. Cocoa
B. Coffee
E. Chocolate milk.
Rationale: Cola, coffee, and chocolate contain xanthine and should therefore be avoided
by the client taking a methylxanthine bronchodilator, because they will enhance the effects
of the medication, increasing the likelihood of cardiovascular and central nervous system
side effects. Lemonade and orange juice are acceptable choices.
Erythromycin is prescribed for a client with a respiratory tract infection. The nurse provides
instructions to the client regarding the administration of the oral medication and tells the
client to take the medication: - CORRECT ANS- -c. On an empty stomach.
Rationale: Oral erythromycin should be taken on an empty stomach with a full glass of
water. Some preparations may be administered with food if gastrointestinal upset occurs,
but it is best to administer the drug on an empty stomach.
A home health nurse provides instructions to a client who is taking allopurinol (Zyloprim)
for the treatment of gout. The nurse should tell the client to: - CORRECT ANS- -B. Drink at
least 8 glasses of fluid every day.
Rationale: Clients taking allopurinol are encouraged to drink 3000 mL/day of fluid.
Allopurinol is to be given with or immediately after meals or milk. If a rash, irritation of the
,eyes, or swelling of the lips or mouth develops, the client should contact the physician,
because this development may indicate hypersensitivity.
A client with tuberculosis is being started on isoniazid (INH), and the nurse stresses the
importance of returning to the clinic for follow-up blood testing. Which blood test will be
performed?
Blood urea nitrogen
Serum creatinine
Liver enzymes
Red blood cell count - CORRECT ANS- -A. Liver enzymes.
Rationale: INH therapy can increase hepatic enzymes and cause hepatitis. Therefore the
client's liver enzymes are assessed when therapy is initiated and during the first 3 months
of therapy. Monitoring may be continued further in the client who is older than 50 or abuses
alcohol. The other options are not specifically related to the use of this medication.
Fluoxetine hydrochloride (Prozac) is prescribed for a client, and the nurse provides
instruction regarding the use of the medication. The nurse tells the client that it is best to
take the medication:
At lunchtime
With the evening meal
In the morning
Midafternoon, with an antacid - CORRECT ANS- -B. In the morning.
Rationale: Fluoxetine hydrochloride (Prozac) is a selective serotonin reuptake inhibitor that
elicits an antidepressant response. It is best administered in the early morning, and there is
no need to coordinate the dose with a meal. (If the medication causes lightheadedness or
,dizziness, the healthcare provider may advise the client to take it at bedtime.) The other
options are incorrect.
A nurse is providing instruction to a client who is taking codeine sulfate for severe back
pain. The nurse should tell the client to: - CORRECT ANS- -B. Maintain a high-fiber diet.
Rationale: Codeine sulfate can cause constipation. The client is instructed to increase fluid
intake and maintain a high-fiber diet to help prevent constipation. The other options are
incorrect because they do not address the side effects associated with the use of this
medication. Although lightheadedness may occur with the use of this medication, all
exercise is not avoided; in fact, the client should ambulate frequently.
A nurse hangs a 500-mL bag of intravenous (IV) fluid for an assigned client. One hour later
the client complains of chest tightness, is dyspneic and apprehensive, and has an irregular
pulse. The IV bag has 100 mL remaining. Which of the following actions should the nurse
take first? - CORRECT ANS- -C. Shutting off the IV infusion.
Rationale: The client's symptoms are indicative of speed shock, which results from the
rapid infusion of drugs or a bolus infusion. In this case, the nurse would note that 400 mL
has infused over 60 minutes. The first action on the part of the nurse is shutting off the IV
infusion. Other actions may follow in rapid sequence: The nurse may elevate the head of
the bed to aid the client's breathing and then immediately notify the healthcare provider.
Slowing the infusion rate is inappropriate because the client will continue to receive fluid.
The IV does not need to be removed. It may be needed to manage the complication.
A physician prescribes 1000 mL of normal saline 0.45% for infusion over 8 hours. The drop
factor is 10 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round
your answer to the nearest whole number). - CORRECT ANS- -21.
A client taking metronidazole (Flagyl) for the treatment of trichomoniasis vaginalis calls the
clinic nurse to express concern because her urine has turned dark. The nurse should tell
the client: - CORRECT ANS- -D.That darkening of the urine is a harmless side effect.
, Rationale: Metronidazole can produce a variety of untoward effects, but they rarely require
termination of treatment. Harmless darkening of the urine may occur, and the client should
be forewarned of this effect. The nurse would not instruct the client to discontinue the
medication. It is not necessary that the client see the physician. Increasing fluid intake is a
good health measure but will not prevent this expected side effect.
A client who has undergone adrenalectomy is prescribed prednisone. Which of the
following findings indicates that the client is experiencing an adverse effect of the
medication? - CORRECT ANS- -B. Tarry stools.
Rationale: Glucocorticoids increase gastric secretion, which may result in the
development of peptic ulcers and gastrointestinal bleeding. Corticosteroids increase
blood glucose. Dry mouth and hypotension are not side effects of corticosteroid therapy.
At 1600 the nurse checks a client's parenteral nutrition (PN) infusion bag and finds 1100 mL
remaining in the 3000-mL bag. The solution is running at a rate of 100 mL/hr. The bag was
hung the previous day at 1800. The nurse plans to change the infusion bag and tubing this
evening at: - CORRECT ANS- -B. 1800.
Rationale: The PN solution should be changed every 24 hours as a means of helping
prevent infection. Infection is also prevented with the use of aseptic technique during bag
and tubing changes. Most agencies recommend that tubing be changed every 24 hours
along with the PN infusion bag. Specific agency policies should always be followed. The
nurse should also use a filter when administering PN in accordance with hospital protocol.
Therefore the remaining options are incorrect.
Carbamazepine (Tegretol) is prescribed for a client with trigeminal neuralgia. Which of the
following side effects does the nurse instruct the client to report to the physician? Select all
that apply. - CORRECT ANS- -A.Fever
D. Sore throat
E. Mouth sores.
Parenteral Therapies - A+ Graded Questions from
Renowned Sources with Detailed Explanations and
Answers
A nurse has taught a client taking a methylxanthine bronchodilator about beverages that
must be avoided. Which beverage choices by the client indicate to the nurse that the client
needs further education? Select all that apply. - CORRECT ANS- -A. Cocoa
B. Coffee
E. Chocolate milk.
Rationale: Cola, coffee, and chocolate contain xanthine and should therefore be avoided
by the client taking a methylxanthine bronchodilator, because they will enhance the effects
of the medication, increasing the likelihood of cardiovascular and central nervous system
side effects. Lemonade and orange juice are acceptable choices.
Erythromycin is prescribed for a client with a respiratory tract infection. The nurse provides
instructions to the client regarding the administration of the oral medication and tells the
client to take the medication: - CORRECT ANS- -c. On an empty stomach.
Rationale: Oral erythromycin should be taken on an empty stomach with a full glass of
water. Some preparations may be administered with food if gastrointestinal upset occurs,
but it is best to administer the drug on an empty stomach.
A home health nurse provides instructions to a client who is taking allopurinol (Zyloprim)
for the treatment of gout. The nurse should tell the client to: - CORRECT ANS- -B. Drink at
least 8 glasses of fluid every day.
Rationale: Clients taking allopurinol are encouraged to drink 3000 mL/day of fluid.
Allopurinol is to be given with or immediately after meals or milk. If a rash, irritation of the
,eyes, or swelling of the lips or mouth develops, the client should contact the physician,
because this development may indicate hypersensitivity.
A client with tuberculosis is being started on isoniazid (INH), and the nurse stresses the
importance of returning to the clinic for follow-up blood testing. Which blood test will be
performed?
Blood urea nitrogen
Serum creatinine
Liver enzymes
Red blood cell count - CORRECT ANS- -A. Liver enzymes.
Rationale: INH therapy can increase hepatic enzymes and cause hepatitis. Therefore the
client's liver enzymes are assessed when therapy is initiated and during the first 3 months
of therapy. Monitoring may be continued further in the client who is older than 50 or abuses
alcohol. The other options are not specifically related to the use of this medication.
Fluoxetine hydrochloride (Prozac) is prescribed for a client, and the nurse provides
instruction regarding the use of the medication. The nurse tells the client that it is best to
take the medication:
At lunchtime
With the evening meal
In the morning
Midafternoon, with an antacid - CORRECT ANS- -B. In the morning.
Rationale: Fluoxetine hydrochloride (Prozac) is a selective serotonin reuptake inhibitor that
elicits an antidepressant response. It is best administered in the early morning, and there is
no need to coordinate the dose with a meal. (If the medication causes lightheadedness or
,dizziness, the healthcare provider may advise the client to take it at bedtime.) The other
options are incorrect.
A nurse is providing instruction to a client who is taking codeine sulfate for severe back
pain. The nurse should tell the client to: - CORRECT ANS- -B. Maintain a high-fiber diet.
Rationale: Codeine sulfate can cause constipation. The client is instructed to increase fluid
intake and maintain a high-fiber diet to help prevent constipation. The other options are
incorrect because they do not address the side effects associated with the use of this
medication. Although lightheadedness may occur with the use of this medication, all
exercise is not avoided; in fact, the client should ambulate frequently.
A nurse hangs a 500-mL bag of intravenous (IV) fluid for an assigned client. One hour later
the client complains of chest tightness, is dyspneic and apprehensive, and has an irregular
pulse. The IV bag has 100 mL remaining. Which of the following actions should the nurse
take first? - CORRECT ANS- -C. Shutting off the IV infusion.
Rationale: The client's symptoms are indicative of speed shock, which results from the
rapid infusion of drugs or a bolus infusion. In this case, the nurse would note that 400 mL
has infused over 60 minutes. The first action on the part of the nurse is shutting off the IV
infusion. Other actions may follow in rapid sequence: The nurse may elevate the head of
the bed to aid the client's breathing and then immediately notify the healthcare provider.
Slowing the infusion rate is inappropriate because the client will continue to receive fluid.
The IV does not need to be removed. It may be needed to manage the complication.
A physician prescribes 1000 mL of normal saline 0.45% for infusion over 8 hours. The drop
factor is 10 gtt/mL. At how many drops per minute does the nurse set the flow rate? (Round
your answer to the nearest whole number). - CORRECT ANS- -21.
A client taking metronidazole (Flagyl) for the treatment of trichomoniasis vaginalis calls the
clinic nurse to express concern because her urine has turned dark. The nurse should tell
the client: - CORRECT ANS- -D.That darkening of the urine is a harmless side effect.
, Rationale: Metronidazole can produce a variety of untoward effects, but they rarely require
termination of treatment. Harmless darkening of the urine may occur, and the client should
be forewarned of this effect. The nurse would not instruct the client to discontinue the
medication. It is not necessary that the client see the physician. Increasing fluid intake is a
good health measure but will not prevent this expected side effect.
A client who has undergone adrenalectomy is prescribed prednisone. Which of the
following findings indicates that the client is experiencing an adverse effect of the
medication? - CORRECT ANS- -B. Tarry stools.
Rationale: Glucocorticoids increase gastric secretion, which may result in the
development of peptic ulcers and gastrointestinal bleeding. Corticosteroids increase
blood glucose. Dry mouth and hypotension are not side effects of corticosteroid therapy.
At 1600 the nurse checks a client's parenteral nutrition (PN) infusion bag and finds 1100 mL
remaining in the 3000-mL bag. The solution is running at a rate of 100 mL/hr. The bag was
hung the previous day at 1800. The nurse plans to change the infusion bag and tubing this
evening at: - CORRECT ANS- -B. 1800.
Rationale: The PN solution should be changed every 24 hours as a means of helping
prevent infection. Infection is also prevented with the use of aseptic technique during bag
and tubing changes. Most agencies recommend that tubing be changed every 24 hours
along with the PN infusion bag. Specific agency policies should always be followed. The
nurse should also use a filter when administering PN in accordance with hospital protocol.
Therefore the remaining options are incorrect.
Carbamazepine (Tegretol) is prescribed for a client with trigeminal neuralgia. Which of the
following side effects does the nurse instruct the client to report to the physician? Select all
that apply. - CORRECT ANS- -A.Fever
D. Sore throat
E. Mouth sores.
