NUR2474 Pharmacology Final Exam Questions With 100% Correct Answers 2025

NUR2474 Pharmacology Final Exam Questions With 100% Correct Answers 2025 1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first? a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin. b. The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin) c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) - ANSWER-a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin. *low/normal BGL and insulin will continue to drop glucose level. At risk for hypoglycemia. .2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a. No insulin should be administered. b. NPH c. 70/30 mix d. Lispro (Humalog) - ANSWER-d. Lispro (Humalog) *high blood sugar needs rapid acting insulin. .3. A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule? a. Before each meal and before bed b. In the morning for a fasting level and at 4 PM for the peak level c. Six or seven times a day d. Three times a day, along with urine glucose testing - ANSWER-c. Six or seven times a day *pregnancy can effect glucose levels. Frequent monitoring required. .4. An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response? a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." b. "At this level, you probably have diabetes. You will need an oral glucose tolerance test this week." c. "This level is conclusive evidence that you have diabetes." d. "This level is conclusive evidence that you do not have diabetes." - ANSWER-a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." *could be a normal level without fasting and does not mean diabetes unless it was high for a fasting blood glucose level. .5. Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug? a. Approximately 15 to 30 minutes before each meal b. In the morning and at 4 PM c. Once daily at bedtime d. After meals and at bedtime - ANSWER-c. Once daily at bedtime *goodnight glargine .6. A patient with type 1 diabetes who takes insulin reports taking propranolol for hypertension. Why is the nurse concerned? a. The beta blocker can cause insulin resistance. b. Using the two agents together increases the risk of ketoacidosis. c. Propranolol increases insulin requirements because of receptor blocking. d. The beta blocker can mask the symptoms of hypoglycemia. - ANSWER-d. The beta blocker can mask the symptoms of hypoglycemia. *beta blockers block adrenaline which signals the liver to release glucose in the blood when glucose is low to avoid hypoglycemia. .7. Which statement is correct about the contrast between a carbose and miglitol? a. Miglitol has not been associated with hepatic dysfunction. b. With miglitol, sucrose can be used to treat hypoglycemia. c. Miglitol is less effective in African Americans. d. Miglitol has no gastrointestinal side effects. - ANSWER-a. Miglitol has not been associated with hepatic dysfunction. *key difference is that acarbose has been associated with rare cases of hepatic dysfunction .8. A nurse counsels a patient with diabetes who is starting therapy with an alpha- glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.) a. Hypoglycemia b. Flatulence c. Elevated iron levels in the blood d. Fluid retention e. Diarrhea - ANSWER-b. Flatulence e. Diarrhea *due to build up of gasses (flatulence) from to undigested carbohydrates reaching the colon and causing an osmotic effect (diarrhea) .9. The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence. b. Neuropsychologic deficits in the fetus can occur if the condition is not treated. c. No danger to the fetus exists until the third trimester. d. Treatment is required only if the patient is experiencing symptoms. - ANSWER-b. Neuropsychologic deficits in the fetus can occur if the condition is not treated. *Thyroid hormones are crucial for the normal development of the fetal brain and nervous system and must be treated in pregnancy. .10. A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching? a. "I should not take heartburn medication without consulting my provider." b. "I should report insomnia, tremors, and an increased heart rate to my provider." c. "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid." d."If I take calcium supplements, I may need to decrease my dose of Synthroid." - ANSWER-d."If I take calcium supplements, I may need to decrease my dose of Synthroid." *this statement is incorrect since calcium interferes with the absorption of Synthroid, it may need to be increased not decreased. .11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug? a. Beta blocker b. Increased dose of PO levothyroxine c. Intravenous levothyroxine d. Methimazole (Tapazole) - ANSWER-c. Intravenous levothyroxine *IV allows for a more rapid correction of thyroid hormone levels especially hypothyroidism with symptoms of myxedema coma or severe hypothyroidism. This is considered a medical emergency. .12. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The nurse will notify the provider to discuss _____ the _____ dose. a. reducing levothyroxine b. reducing warfarin c. increasing levothyroxine d. increasing warfarin - ANSWER-b. reducing warfarin *Levothyroxine (Synthroid) can potentially increase the effects of warfarin, leading to an increased risk of bleeding. .13. An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine (Levothroid) 100 mcg/day PO. What will the nurse do? a. Administer the medication as ordered. b. Contact the provider to discuss giving the levothyroxine IV. c. Request an order to give desiccated thyroid (Armour Thyroid). d. Suggest that the provider lower the dose. - ANSWER-d. Suggest that the provider lower the dose. *normal TSH is 0.4-4. .14. A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine (Synthroid). The child comes to the clinic for a well-child check up. The nurse will expect the provider to: a. change the dose of levothyroxine to 6 mcg/kg/day. b. discontinue the drug if the child's physical and mental development is normal. c. increase the dose to accommodate the child's increased growth. d. stop the drug for 4 weeks and check the child's TSH level. - ANSWER-a. change the dose of levothyroxine to 6 mcg/kg/day. *after 1 year of age, the organs are developed and higher does is no longer needed. .15. A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action? a. Apply warm packs to the arm, and infuse the medication at a slower rate. b. Continue the infusion while elevating the arm. c. Select an alternate intravenous site and administer the infusion more slowly. d. Request central venous access. - ANSWER-c. Select an alternate intravenous site and administer the infusion more slowly. *infiltration .16. A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? a."Cephalosporins are assigned to generations based on their relative costs to administer." b. "Cephalosporins have increased activity against gram-negative bacteria with each generation. c. "First-generation cephalosporins have better penetration of the cerebrospinal fluid."d. "Later generations of cephalosporins have lower resistance to destruction by beta- lactamases." - ANSWER-b. "Cephalosporins have increased activity against gram-negative bacteria with each generation. *this statement reflects the general trend seen in cephalosporins .17. A provider has ordered ceftriaxone 4 gm once daily for a patient with renal impairment. What will the nurse do? a. Administer the medication as prescribed. b. Contact the provider to ask about giving the drug in divided doses. c. Discuss increasing the interval between doses with the provider. d. Discuss reducing the dose with the provider. - ANSWER-a. Administer the medication as prescribed. *? .18. A patient will be discharged home to complete treatment with intravenous cefotetan with the assistance of a home nurse. The home care nurse will include which instruction when teaching the patient about this drug treatment? a. Abstain from alcohol consumption during therapy. b. Avoid dairy products while taking this drug. c. Take an antihistamine if a rash occurs. d. Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain. - ANSWER-a. Abstain from alcohol consumption during therapy. *consuming alcohol while on this medication can lead to a disulfiram-like reaction with symptoms such as flushing, headache, nausea, vomiting, and an increased heart rate .19. The nurse is caring for a patient who is receiving vancomycin (Vancocin). The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: a. allergic reaction. b. red man syndrome. c. rhabdomyolysis. d. Stevens-Johnson syndrome. - ANSWER-b. red man syndrome. *associated with the rapid infusion of vancomycin .20. A patient is to undergo orthopedic surgery, and the prescriber will order a cephalosporin to be given preoperatively as prophylaxis against infection. The nurse expects the provider to order which cephalosporin? a. First-generation cephalosporin b. Second-generation cephalosporin c. Third-generation cephalosporin d. Fourth-generation cephalosporin - ANSWER-a. First-generation cephalosporin *due to its efficacy against common skin flora and lower risk of broad-spectrum resistance. .21. A patient receiving a cephalosporin develops a secondary intestinal infection caused by Clostridium difficile. What is an appropriate treatment for this patient? a. Adding an antibiotic, such as vancomycin (Vancocin), to the patient's regimen b. Discontinuing the cephalosporin and beginning metronidazole (Flagyl) c. Discontinuing all antibiotics and providing fluid replacement d. Increasing the dose of the cephalosporin and providing isolation measures - ANSWER-b. Discontinuing the cephalosporin and beginning metronidazole (Flagyl) *treatment involves discontinuing the inciting antibiotic and initiating specific therapy against C. difficile. .22. Besides the cost of administering a given drug, which are considerations when a provider selects a cephalosporin to treat an infection? (Select all that apply.) a. Adverse effects b. Antimicrobial spectrum c. Brand name d. Manufacturer e. Pharmacokinetics - ANSWER-a. Adverse effects b. Antimicrobial spectrum e. Pharmacokinetics *brand names and manufacturers will change over time, but the adverse effects, antimicrobial spectrum, and pharmacokinetics are considerations for infection treatment. .23. A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do? a. Make sure to administer the drugs at different times using different IV tubing. b. Suggest giving larger doses of piperacillin and discontinuing the amikacin. c. Suggest that a fixed-dose combination of piperacillin and tazobactam (Zosyn) be used. d. Watch the patient closely for allergic reactions, because this risk is increased with this combination. - ANSWER-a. Make sure to administer the drugs at different times using different IV tubing. *they should be administered separately to prevent any potential incompatibilities or interactions. .24. A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: a. disinhibit transpeptidases. b. disrupt bacterial cell wall synthesis. c. inhibit autolysins. d. inhibit host cell wall function. - ANSWER-b. disrupt bacterial cell wall synthesis. *Penicillins (PCNs) are antibiotics that work by disrupting bacterial cell wall synthesis. .25. A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history, the nurse learns that the patient experienced a rash when given amoxicillin (Amoxil) as a child 20 years earlier. What will the nurse do? a. Ask the provider to order a cephalosporin. b. Reassure the patient that allergic responses diminish over time. c. Request an order for a skin test to assess the current risk. d. Suggest using a desensitization schedule to administer the drug. - ANSWER-c. Request an order for a skin test to assess the current risk. *It helps determine whether a patient has developed an allergic sensitivity to penicillin over time or if the previous reaction was an isolated incident. .26. A patient with no known drug allergies is receiving amoxicillin (Amoxil) PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/58 mm Hg. What will the nurse do?