Pharm quiz
assignment answers
1. ID: 311018725
Which route should the nurse clarify with the healthcare provider
prior to administering a drug with a high first-pass effect?
A. Intravenous.
B. Buccal.
C. Sublingual.
D. Oral. Correct
The first-pass effect occurs when hepatic metabolism decreases
the bioavailability of a drug. Oral (A) forms of medications are
processed through the GI tract, absorbed through the small
intestines, and undergo the first-pass effect in the liver before
the drug reaches the intended site of action. (B, C, and D)
Awarded
bypass 5.0
the points metabolism
hepatic out of 5.0 possible
and arepoints.
not affected by the first-
2. ID: 310951980
A client calls the clinic and states that she forgot to take her oral contraceptives for the past
two days. Which instruction is best for the nurse to provide to this client?
A. Quit the pills for this cycle, use an alternate method of contraception, and
resume pills on the fifth day of menstruation.
B. Take 4 pills now and use an alternate method of contraception for the
rest of this cycle.
C. Take 2 pills a day for 2 days and use an alternate method of
contraception for 7 days. Correct
D. Take one extra pill per day for the rest of this cycle, then resume taking
pills as usual next cycle.
If two pills are missed the client should implement (A). If three
pills are missed, the client should implement (B). The woman
who misses three or more days also has the option of stopping
the pills in this cycle pack and starting a new pack on the same
day. A backup method of contraception should be used for 7
days. (C and D) provide incorrect instructions.
3. ID: 310944033
The healthcare provider prescribes a medication for an older
adult client who is complaining of insomnia, and instructs the
client to return in two weeks. The nurse should question which
prescription?
A. Temazepam (Restoril) 7.5 milligrams orally at bedtime.
B. Eszopiclone (Lunesta) 10 milligrams orally at bedtime. Correct
C. Ramelteon (Rozerem) 8 milligrams orally at bedtime.
D. Zolpidem (Ambien) 10 milligrams orally at bedtime.
, The dosage range for eszopiclone (Lunesta) is 1 to 3 milligrams
daily at bedtime, so the dosage for (B) is too high. (A, C, and D)
are within a safe dosage range and are not contraindicated for
use in the elderly.
4. ID: 310946610
A client with chronic kidney disease (CKD) and severe anemia
refuses blood transfusions. The healthcare provider prescribes
epoetin alfa. Which action should the nurse explain to the client
about the medication's therapeutic response?
A. Stimulates erythropoiesis in the bone marrow to
increase circulating erythrocytes. Correct
B. Accelerates neutrophil production, maturation, and activation.
C. Increases production and maturation of
granulocytes and macrophages.
D. Activates the immune system with development of T
and B cells and natural killer cells.
Epoetin alfa is a biological response modifier that is used to
stimulate the formation of red blood cells (C). (A) describes
agents, such as filgrastim, used to decrease the risk for infection
in clients with chemotherapy-induced neutropenia.
Immunomodulators, a subtype of biologic response modifiers,
such as interferon, provide a specified action in the immune
system (B) used in chemotherapeutic protocols. (D) specifies the
therapeutic response of agents, such as sargramostim, which
also inhibits neutrophil migration and is primarily used to
accelerate myeloid recovery during bone marrow
5. ID: 311002959
Which statement by a client warrants further instruction by the
nurse about the changing insulin needs of a diabetic client
during pregnancy?
A. I will increase my insulin dosage by 5 units each
month during the first trimester.Correct
B. Breastfeeding will decrease my insulin needs to
lower than my prepregnancy levels.
C. Insulin dosage will likely need to be increased during
the second and third trimesters. Incorrect
D. Episodes of hypoglycemia are more likely to occur
during the first 3 months.
Insulin needs during pregnancy are determined individually
according to the client's glucose levels. Insulin needs in the
first trimester may actually decrease, so (B) indicates the need
for reteaching. (A, C, and D) are correct statements. (A) helps
explains why insulin needs may actually decrease in the first
, Insulin resistance begins as early as 14- to 16-weeks gestation (C) and continues to rise until it
stabilizes during the last few weeks of pregnancy. Insulin needs after birth are lower once the
placenta is delivered and the source of insulin resistance is gone. Breastfeeding (D) lowers circulating
blood glucose.
6. ID: 310965985
A client receives a new prescription for ciprofloxacin (Cipro), a synthetic quinolone. When
teaching about this drug, which information in the client's history requires special emphasis
by the nurse?
A. Snacks on dairy products such as yogurt or ice cream.
B. Works twenty hours a week as a lifeguard at the local pool. Correct
C. Previously had a mild allergic reaction to a cephalosporin.
D. Consumes alcoholic drinks occasionally on the weekends.
Cipro can cause both dizziness and photosensitivity. Since the
client works as a lifeguard outdoors (D), measures related to
these adverse effects should be addressed. Dairy products (A) do
not impact the effectiveness of Cipro. There is no cross-
sensitivity between quinolones and cephalosporins (B). Although
avoiding alcohol consumption is commonly recommended with
many prescription drugs, (C) does not affect the actions of Cipro.
7. ID: 310944037
Which common side effect should the nurse alert a female client about when
medroxyprogesterone (Depo-Provera) is prescribed?
A. Leg or calf pain. Incorrect
B. Jaundice during the first 3 weeks of administration.
C. Headaches or visual changes.
D. Vaginal bleeding after discontinuing the medication. Correct
Approximately 3 to 7 days after the last cyclic dose of
medroxyprogesterone, a female client may experience
withdrawal vaginal bleeding (C). (A, B, and D) are not common
side effects of hormonal therapy and may indicate a serious
adverse reaction.
8. ID: 310993907
When assessing a client prior to the administration of digoxin
(Lanoxin), which data is most important for the nurse to
consider?
A. Bilateral lower extremity dependent rubor.
B. Presence of a grade 2 murmur.
C. Nailbed capillary refill of 5 seconds.
D. Irregular apical pulse with a rate of 87. Correct
The action of digoxin is to slow the heart rate and strengthen
the force of contraction, so it is essential for the nurse to ensure
that the apical pulse (C) is within determined parameters prior
to administration. (A, B, and D) are unlikely to influence the
nurse's decision regarding the administration of digoxin.
assignment answers
1. ID: 311018725
Which route should the nurse clarify with the healthcare provider
prior to administering a drug with a high first-pass effect?
A. Intravenous.
B. Buccal.
C. Sublingual.
D. Oral. Correct
The first-pass effect occurs when hepatic metabolism decreases
the bioavailability of a drug. Oral (A) forms of medications are
processed through the GI tract, absorbed through the small
intestines, and undergo the first-pass effect in the liver before
the drug reaches the intended site of action. (B, C, and D)
Awarded
bypass 5.0
the points metabolism
hepatic out of 5.0 possible
and arepoints.
not affected by the first-
2. ID: 310951980
A client calls the clinic and states that she forgot to take her oral contraceptives for the past
two days. Which instruction is best for the nurse to provide to this client?
A. Quit the pills for this cycle, use an alternate method of contraception, and
resume pills on the fifth day of menstruation.
B. Take 4 pills now and use an alternate method of contraception for the
rest of this cycle.
C. Take 2 pills a day for 2 days and use an alternate method of
contraception for 7 days. Correct
D. Take one extra pill per day for the rest of this cycle, then resume taking
pills as usual next cycle.
If two pills are missed the client should implement (A). If three
pills are missed, the client should implement (B). The woman
who misses three or more days also has the option of stopping
the pills in this cycle pack and starting a new pack on the same
day. A backup method of contraception should be used for 7
days. (C and D) provide incorrect instructions.
3. ID: 310944033
The healthcare provider prescribes a medication for an older
adult client who is complaining of insomnia, and instructs the
client to return in two weeks. The nurse should question which
prescription?
A. Temazepam (Restoril) 7.5 milligrams orally at bedtime.
B. Eszopiclone (Lunesta) 10 milligrams orally at bedtime. Correct
C. Ramelteon (Rozerem) 8 milligrams orally at bedtime.
D. Zolpidem (Ambien) 10 milligrams orally at bedtime.
, The dosage range for eszopiclone (Lunesta) is 1 to 3 milligrams
daily at bedtime, so the dosage for (B) is too high. (A, C, and D)
are within a safe dosage range and are not contraindicated for
use in the elderly.
4. ID: 310946610
A client with chronic kidney disease (CKD) and severe anemia
refuses blood transfusions. The healthcare provider prescribes
epoetin alfa. Which action should the nurse explain to the client
about the medication's therapeutic response?
A. Stimulates erythropoiesis in the bone marrow to
increase circulating erythrocytes. Correct
B. Accelerates neutrophil production, maturation, and activation.
C. Increases production and maturation of
granulocytes and macrophages.
D. Activates the immune system with development of T
and B cells and natural killer cells.
Epoetin alfa is a biological response modifier that is used to
stimulate the formation of red blood cells (C). (A) describes
agents, such as filgrastim, used to decrease the risk for infection
in clients with chemotherapy-induced neutropenia.
Immunomodulators, a subtype of biologic response modifiers,
such as interferon, provide a specified action in the immune
system (B) used in chemotherapeutic protocols. (D) specifies the
therapeutic response of agents, such as sargramostim, which
also inhibits neutrophil migration and is primarily used to
accelerate myeloid recovery during bone marrow
5. ID: 311002959
Which statement by a client warrants further instruction by the
nurse about the changing insulin needs of a diabetic client
during pregnancy?
A. I will increase my insulin dosage by 5 units each
month during the first trimester.Correct
B. Breastfeeding will decrease my insulin needs to
lower than my prepregnancy levels.
C. Insulin dosage will likely need to be increased during
the second and third trimesters. Incorrect
D. Episodes of hypoglycemia are more likely to occur
during the first 3 months.
Insulin needs during pregnancy are determined individually
according to the client's glucose levels. Insulin needs in the
first trimester may actually decrease, so (B) indicates the need
for reteaching. (A, C, and D) are correct statements. (A) helps
explains why insulin needs may actually decrease in the first
, Insulin resistance begins as early as 14- to 16-weeks gestation (C) and continues to rise until it
stabilizes during the last few weeks of pregnancy. Insulin needs after birth are lower once the
placenta is delivered and the source of insulin resistance is gone. Breastfeeding (D) lowers circulating
blood glucose.
6. ID: 310965985
A client receives a new prescription for ciprofloxacin (Cipro), a synthetic quinolone. When
teaching about this drug, which information in the client's history requires special emphasis
by the nurse?
A. Snacks on dairy products such as yogurt or ice cream.
B. Works twenty hours a week as a lifeguard at the local pool. Correct
C. Previously had a mild allergic reaction to a cephalosporin.
D. Consumes alcoholic drinks occasionally on the weekends.
Cipro can cause both dizziness and photosensitivity. Since the
client works as a lifeguard outdoors (D), measures related to
these adverse effects should be addressed. Dairy products (A) do
not impact the effectiveness of Cipro. There is no cross-
sensitivity between quinolones and cephalosporins (B). Although
avoiding alcohol consumption is commonly recommended with
many prescription drugs, (C) does not affect the actions of Cipro.
7. ID: 310944037
Which common side effect should the nurse alert a female client about when
medroxyprogesterone (Depo-Provera) is prescribed?
A. Leg or calf pain. Incorrect
B. Jaundice during the first 3 weeks of administration.
C. Headaches or visual changes.
D. Vaginal bleeding after discontinuing the medication. Correct
Approximately 3 to 7 days after the last cyclic dose of
medroxyprogesterone, a female client may experience
withdrawal vaginal bleeding (C). (A, B, and D) are not common
side effects of hormonal therapy and may indicate a serious
adverse reaction.
8. ID: 310993907
When assessing a client prior to the administration of digoxin
(Lanoxin), which data is most important for the nurse to
consider?
A. Bilateral lower extremity dependent rubor.
B. Presence of a grade 2 murmur.
C. Nailbed capillary refill of 5 seconds.
D. Irregular apical pulse with a rate of 87. Correct
The action of digoxin is to slow the heart rate and strengthen
the force of contraction, so it is essential for the nurse to ensure
that the apical pulse (C) is within determined parameters prior
to administration. (A, B, and D) are unlikely to influence the
nurse's decision regarding the administration of digoxin.
