ATI NCLEX PHARMACOLOGY ASSESSMENT 1
A nurse is teaching a client who will start using transdermal fentanyl. Which of the
following statements should the nurse identify as an indication that the client
understands the teaching
A. "I can use an electric blanket while in bed"
B. "I will replace the patch every day"
C. "I should apply the patch to my upper thigh"
D. "I can take an oral analgesic for breakthrough pain" - Answers- D
Fentanyl is a transdermal opioid agonist for managing persistent, moderate to severe
chronic pain. It takes up to 24 hr after the client applies the patch for medication levels
to reach their peak. Use short acting analgesics to treat acute or breakthrough pain
--
A, heat causes an increase in the release of the medication from the patch, as well as
vasodilation, which can increase the absorption of the medication
B, the patch releases the med steadily over 72 hrs, but some times they can change it
every 48 hr
C, apply the patch to the skin of the upper torso for optimal absorption
A nurse is teaching a client who has a new prescription for levodopa- carbidopa. Which
of the following instructions should the nurse include in the teaching
A. Report muscle twitching to your provider
B. Reduce your daily fluid intake
C. Take the medication with a high protein meal
D. Discontinue the medication if your urine turns a dark color - Answers- A
Levodopa carbidopa can cause dyskinesias with toxicity and to report muscle twitching,
tremors, and spastic winking
--
B, reducing fluid intake can increase risk of orthostatic hypotension. Drink at least 2-3 L
of fluid daily
C, protein reduces the absorption of levodopa carbidopa
D, urine and sweat can become dark in color, but this is harmless
A nurse is caring for a client who has primary hypothyroidism and has been taking
levothyroxine for 8 weeks. The current thyroid stimulating hormone (TSH) level is 5.2
microunits/mL. The nurse should expect which of the following prescriptions regarding
the client's medication?
,A. Decrease in the dosage
B. Discontinue the medication
C. Increase in the dosage
D. Maintain the current dosage - Answers- C
A TSH of 5.2 is above the expected reference range, which indicates the thyroid
hormone level is not adequate (so the TSH is trying to increase to compensate and
release more thyroid hormone). Increase the dosage to achieve a therapeutic TSH,
undergo lab testing in 6-8 weeks after dosage increase to reassess the TSH level
A nurse is assessing a client who is taking esomeprazole. Which of the following
statements by the client should the nurse identify as an indication that the medication is
having an effective therapeutic response?
A. "My headaches are gone"
B. "My mouth isn't so dry anymore"
C. "The burning in my throat is gone"
D. "I have regular bowel movements" - Answers- C
Esomeprazole is a proton pump inhibitor and works in the parietal cells of the stomach
by inhibiting the proton pump enzyme that generates gastric acid secretion. It treats
ulcers, duodenal ulcers, and GERD. Heartburn is a common manifestation of GERD, so
the absence of burning is an indication that the med is working
--
A, headaches are an adverse effect of esomeprazole
B, dry mouth is an adverse effect of esomeprazole
D, constipation and diarrhea are an adverse effect of esomeprazole
A nurse is assessing a client for pain who is 4 hr postoperative following surgery and
still experiencing the effects of anesthesia. Which of the following findings should the
nurse identify as an indication that the client might be experiencing pain and requires
pain medication
A. Reduced blood glucose
B. Pupil constriction
C. Diaphoresis
D. Facial flushing - Answers- C
A client in pain can be come diaphroetic in an attempt to keep the body temperature
under control during stress
--
A, blood glucose can increase in a client who has pain as the body attempts to make
more energy available
, B, pupils can dilate in a client who has pain to help improve vision
D, a client in pain can become pale as the body shifts blood to the central circulation
and away from the peripheral circulation
A nurse is providing discharge teaching to a client who has a new prescription for
transdermal nitroglycerin. Which of the following statements should the nurse identify as
an indication that the client understands the instructions
A. "I will apply the patch to the same location each time"
B. "I should leave the patch in place until it is time for my next dose"
C. "I might feel lightheaded when I get out of bed"
D. "I will call the doctor if I develop headaches when I use the patches" - Answers- C
Nitroglycerin patches can cause orthostatic hypotension, these effects increase with
alcohol consumption. Rise slowly and rest feet on the floor for a few minutes before
standing up. Do not use with erectile dysfunction meds because the interaction can
cause severe hypotension
--
A, rotate sites of application to reduce skin irritation and enhance the absorption
B, pt needs 10-12 hr of "nitrate-free" time. Apply the patch at the same time each day
and remove the patch about 12 hr later, this helps decrease nitrate dependence and
ensures that the med's vasodilation effects remain in place
D, headache is a common adverse effect, especially at the start of therapy, Take over
the counter analgesic when necessary
A nurse is assessing a client who has chronic pain disorder and is requesting pain
medication. Which of the following findings should the nurse identify as the most reliable
indicator of the client's pain
A. The client's behavior
B. Changes in the client's vital signs
C. The client's facial expression
D. The client's verbal report - Answers- D
The nurse should ask the client about the location, quality, and intensity of the pain
A nurse is assessing a client who is dehydrated. Which of the following findings is an
indication of hypokalemia
A. Muscle weakness
B. Hyperactive bowel sounds
C. Positive Chvostek's sign
D. Red tongue - Answers- A
A nurse is teaching a client who will start using transdermal fentanyl. Which of the
following statements should the nurse identify as an indication that the client
understands the teaching
A. "I can use an electric blanket while in bed"
B. "I will replace the patch every day"
C. "I should apply the patch to my upper thigh"
D. "I can take an oral analgesic for breakthrough pain" - Answers- D
Fentanyl is a transdermal opioid agonist for managing persistent, moderate to severe
chronic pain. It takes up to 24 hr after the client applies the patch for medication levels
to reach their peak. Use short acting analgesics to treat acute or breakthrough pain
--
A, heat causes an increase in the release of the medication from the patch, as well as
vasodilation, which can increase the absorption of the medication
B, the patch releases the med steadily over 72 hrs, but some times they can change it
every 48 hr
C, apply the patch to the skin of the upper torso for optimal absorption
A nurse is teaching a client who has a new prescription for levodopa- carbidopa. Which
of the following instructions should the nurse include in the teaching
A. Report muscle twitching to your provider
B. Reduce your daily fluid intake
C. Take the medication with a high protein meal
D. Discontinue the medication if your urine turns a dark color - Answers- A
Levodopa carbidopa can cause dyskinesias with toxicity and to report muscle twitching,
tremors, and spastic winking
--
B, reducing fluid intake can increase risk of orthostatic hypotension. Drink at least 2-3 L
of fluid daily
C, protein reduces the absorption of levodopa carbidopa
D, urine and sweat can become dark in color, but this is harmless
A nurse is caring for a client who has primary hypothyroidism and has been taking
levothyroxine for 8 weeks. The current thyroid stimulating hormone (TSH) level is 5.2
microunits/mL. The nurse should expect which of the following prescriptions regarding
the client's medication?
,A. Decrease in the dosage
B. Discontinue the medication
C. Increase in the dosage
D. Maintain the current dosage - Answers- C
A TSH of 5.2 is above the expected reference range, which indicates the thyroid
hormone level is not adequate (so the TSH is trying to increase to compensate and
release more thyroid hormone). Increase the dosage to achieve a therapeutic TSH,
undergo lab testing in 6-8 weeks after dosage increase to reassess the TSH level
A nurse is assessing a client who is taking esomeprazole. Which of the following
statements by the client should the nurse identify as an indication that the medication is
having an effective therapeutic response?
A. "My headaches are gone"
B. "My mouth isn't so dry anymore"
C. "The burning in my throat is gone"
D. "I have regular bowel movements" - Answers- C
Esomeprazole is a proton pump inhibitor and works in the parietal cells of the stomach
by inhibiting the proton pump enzyme that generates gastric acid secretion. It treats
ulcers, duodenal ulcers, and GERD. Heartburn is a common manifestation of GERD, so
the absence of burning is an indication that the med is working
--
A, headaches are an adverse effect of esomeprazole
B, dry mouth is an adverse effect of esomeprazole
D, constipation and diarrhea are an adverse effect of esomeprazole
A nurse is assessing a client for pain who is 4 hr postoperative following surgery and
still experiencing the effects of anesthesia. Which of the following findings should the
nurse identify as an indication that the client might be experiencing pain and requires
pain medication
A. Reduced blood glucose
B. Pupil constriction
C. Diaphoresis
D. Facial flushing - Answers- C
A client in pain can be come diaphroetic in an attempt to keep the body temperature
under control during stress
--
A, blood glucose can increase in a client who has pain as the body attempts to make
more energy available
, B, pupils can dilate in a client who has pain to help improve vision
D, a client in pain can become pale as the body shifts blood to the central circulation
and away from the peripheral circulation
A nurse is providing discharge teaching to a client who has a new prescription for
transdermal nitroglycerin. Which of the following statements should the nurse identify as
an indication that the client understands the instructions
A. "I will apply the patch to the same location each time"
B. "I should leave the patch in place until it is time for my next dose"
C. "I might feel lightheaded when I get out of bed"
D. "I will call the doctor if I develop headaches when I use the patches" - Answers- C
Nitroglycerin patches can cause orthostatic hypotension, these effects increase with
alcohol consumption. Rise slowly and rest feet on the floor for a few minutes before
standing up. Do not use with erectile dysfunction meds because the interaction can
cause severe hypotension
--
A, rotate sites of application to reduce skin irritation and enhance the absorption
B, pt needs 10-12 hr of "nitrate-free" time. Apply the patch at the same time each day
and remove the patch about 12 hr later, this helps decrease nitrate dependence and
ensures that the med's vasodilation effects remain in place
D, headache is a common adverse effect, especially at the start of therapy, Take over
the counter analgesic when necessary
A nurse is assessing a client who has chronic pain disorder and is requesting pain
medication. Which of the following findings should the nurse identify as the most reliable
indicator of the client's pain
A. The client's behavior
B. Changes in the client's vital signs
C. The client's facial expression
D. The client's verbal report - Answers- D
The nurse should ask the client about the location, quality, and intensity of the pain
A nurse is assessing a client who is dehydrated. Which of the following findings is an
indication of hypokalemia
A. Muscle weakness
B. Hyperactive bowel sounds
C. Positive Chvostek's sign
D. Red tongue - Answers- A
