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Pharmacology Exam 2 NCLEX

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Nursing Quiz on Pharmacology Exam 2 NCLEX, created by Megan Czap on 20/06/2017.
Megan Czap
Quiz by Megan Czap, updated more than 1 year ago
Megan Czap
Created by Megan Czap over 7 years ago
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Resource summary

Question 1

Question
The nurse is assessing the patient's knowledge regarding drug therapy prescribed for the treatment of hypertension. Which statement by the patient indicates the need for further teaching by the nurse?
Answer
  • "I will wear a medical alert bracelet."
  • "I will move slowly from a sitting to standing position."
  • "Blood pressure drugs can cause changes in sexual functioning."
  • "When my blood pressure is over 140/90, I will take my medication."

Question 2

Question
The nurse understands a patient who is treated for hypertension may be switched to an angiotensin receptor blocker (ARB) because of which angiotensin-converting enzyme (ACE) inhibitor adverse effect?
Answer
  • Fatigue
  • Hypokalemia
  • Orthostatic hypotension
  • Dry, nonproductive cough

Question 3

Question
Which medication should the nurse question if prescribed together with ACE inhibitors?
Answer
  • Furosemide (Lasix)
  • Morphine
  • Docusate sodium (Colace)
  • Potassium chloride (K-Dur)

Question 4

Question
Before administering eplerenone (Inspra) to a patient, what is the priority nursing action?
Answer
  • Auscultate heart sounds.
  • Check serum electrolytes.
  • Assess level of consciousness.
  • Obtain serum thiocyanate level.

Question 5

Question
To prevent cerebral artery spasms after a subarachnoid hemorrhage, the nurse anticipates administering which calcium channel blocker?
Answer
  • Verapamil (Calan)
  • Diltiazem (Cardizem)
  • Amlodipine (Norvasc)
  • Nimodipine (Nimotop)

Question 6

Question
The nurse should question a prescription for a calcium channel blocker in a patient with which condition?
Answer
  • Dysrhythmia
  • Hypotension
  • Angina pectoris
  • Increased intracranial pressure

Question 7

Question
During discharge teaching, which statement by the nurse would be MOST appropriate for a patient prescribed a transdermal clonidine (Catapres)?
Answer
  • “Occasional drooling is a common adverse effect of this medication.”
  • “Prolonged sitting or standing does not cause hypotension symptoms.”
  • “Your blood pressure should be checked by your health care provider two to three times a week.”
  • “The patch should be applied to a nonhairy site, and you should not suddenly stop using this drug.”

Question 8

Question
The nurse is conducting a community education program. When explaining different medication regimens to treat hypertension, it would be accurate to state that African Americans probably respond best to which combination of medications?
Answer
  • ACE inhibitors and diuretics
  • Diuretics and calcium channel blockers
  • Diuretics and beta blockers
  • ACE inhibitors and beta blockers

Question 9

Question
What is the classification of carvedilol (Coreg)?
Answer
  • Beta blocker
  • Alpha2 blocker
  • Dual-action alpha1 and beta receptor blocker
  • ACE inhibitor

Question 10

Question
When administering nitroprusside (Nipride) by continuous intravenous infusion, the nurse monitors for which symptom of drug toxicity?
Answer
  • Fever
  • Wheezing
  • Hypotension
  • Hyperglycemia

Question 11

Question
A patient who is prescribed tamsulosin (Flomax) does not have a history of hypertension. The nurse knows this medication is also used for what condition?
Answer
  • Migraine headache
  • Pulmonary emboli
  • Subarachnoid hemorrhage
  • Benign prostatic hyperplasia (BPH)

Question 12

Question
ACE inhibitors and ARBs both work to decrease blood pressure by which action?
Answer
  • Prevent aldosterone secretion
  • Increase the breakdown of bradykinin
  • Enhance sodium and water resorption
  • Prevent the formation of angiotensin II

Question 13

Question
When teaching a patient about a new prescription for carvedilol (Coreg), the nurse explains that this medication reduces blood pressure by which action? (Select all that apply.)
Answer
  • Relaxes muscle tone
  • Decreases heart rate
  • Peripheral vasodilation
  • Increases urine output
  • Promotes excretion of sodium

Question 14

Question
Which instruction should be included in the discharge teaching for a patient with a transdermal nitroglycerin (Nitro-Dur) patch?
Answer
  • “If you get chest pain, apply a second patch next to the first patch.”
  • “If you get a headache, remove the patch for 4 hours and then reapply.”
  • “Make sure to rub a lotion or cream on the skin before putting on a new patch.”
  • “Apply the patch to a hairless, nonirritated area of the chest, upper arm, back or shoulder.”

Question 15

Question
The patient states to the nurse, “My friend said nitroglycerin relieves angina pain by reducing preload. What is preload?” Which statement by the nurse explains preload to this patient?
Answer
  • “It is the blood return to the heart.”
  • “It is the oxygen demand of the heart.”
  • “It is the pressure against which the heart must pump.”
  • “It is dilation of arteries and veins throughout the body.”

Question 16

Question
Which statement by the patient demonstrates a need for further education regarding nitroglycerin (Nitrostat) sublingual tablets?
Answer
  • “I should keep my nitroglycerin in a cool, dry place.”
  • "I can take up to four tablets at 5-minute intervals for chest pain.”
  • “If I get a headache, I should keep taking my nitroglycerin and use Tylenol to relieve my headache.”
  • "I should change positions slowly to avoid getting dizzy from the drug’s effect on my blood pressure.”

Question 17

Question
Calcium channel blockers reduce myocardial oxygen demand by decreasing afterload. How would the nurse explain afterload to the patient?
Answer
  • It is the contractility of the heart muscle.
  • It is the total volume of blood in the heart.
  • It is the force against which the heart must pump.
  • It is the pressure within the four chambers of the heart.

Question 18

Question
Which dosage form of nitroglycerin has the longest duration of action?
Answer
  • Sublingual tablet
  • Transdermal patch
  • Intravenous (IV) infusion
  • Immediate-release tablet

Question 19

Question
To prevent the development of tolerance to nitroglycerin (Nitro-Bid) transdermal patch, the nurse instructs the patient to perform which action?
Answer
  • Apply a new nitroglycerin patch every other day.
  • Use the nitroglycerin patch for acute episodes of angina only.
  • Apply the nitroglycerin patch in the morning and remove it at night for 8 hours.
  • Switch to sublingual nitroglycerin when the systolic blood pressure is greater than 140 mm Hg.

Question 20

Question
Before administering isosorbide mononitrate (Imdur) sustained-release tablet to a patient, what is the priority nursing intervention?
Answer
  • Obtain a blood pressure reading.
  • Remind the patient to take the tablet before meals.
  • Emphasize that the patient should swallow the tablet whole.
  • Advise the patient that Tylenol is used to treat headache.

Question 21

Question
The patient asks the nurse, “How should sublingual nitroglycerin be stored when I travel?” What is the nurse’s best response?
Answer
  • “You can protect it from heat by placing the bottle in an ice chest.”
  • “It’s best to keep it in its original container away from heat and light.”
  • “You can put a few tablets in a resealable bag and carry it in your pocket.”
  • “Keep it in the glove compartment of your car to prevent exposure to heat.”

Question 22

Question
The nurse is teaching treatment of acute chest pain for a patient prescribed nitroglycerin (Nitrostat) sublingual tablets. Which instructions should the nurse include?
Answer
  • Take five tablets every 3 minutes for chest pain.
  • Sit or lie down before taking medication.
  • Chew or swallow the tablet for the quickest effect.
  • Keep the tablets locked in a safe place until you need them.

Question 23

Question
The nurse is providing discharge teaching for a patient with a new prescription for nitroglycerin (Nitrostat) sublingual tablets. Which statement by the patient indicates an understanding of the nurse’s discharge instructions about this medication?
Answer
  • “My nitroglycerin tablets are not affected by cold or heat.”
  • “I can take some aspirin if I get a headache related to nitroglycerin.”
  • “I will keep my nitroglycerin tablets in their original glass container.”
  • “I will need to refill my prescription when I feel burning under my tongue.”

Question 24

Question
A patient who is taking nitroglycerin (Nitrostat) sublingual tablets is complaining of flushing and headaches. What is the nurse’s best response?
Answer
  • “Put a cold wet washcloth or use an icepack on your forehead and lie down in a quiet place.”
  • “Stop taking the nitroglycerin because you are experiencing an allergic reaction to the medication.”
  • “These are the most common adverse effects of nitroglycerin. They should subside with continued use of nitroglycerin.”
  • “Immediately notify your health care provider because these symptoms are not related to the sublingual nitroglycerin.”

Question 25

Question
When applying nitroglycerin (Nitro-Bid) ointment, the nurse should perform which action?
Answer
  • Massage and then gently rub the ointment into the skin.
  • Apply the ointment to a nonhairy part of the upper torso.
  • Apply a thick layer of ointment on the nitroglycerin paper.
  • Use the fingers to spread the ointment evenly over a 3-inch area.

Question 26

Question
A patient receiving IV nitroglycerin at 20 mcg/min complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg, heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. What is the nurse’s best action?
Answer
  • Assess the patient’s lung sounds.
  • Decrease the IV nitroglycerin by 10 mcg/min.
  • Increase the IV nitroglycerin by 10 mcg/min.
  • Recheck the patient’s vital signs in 1 hour.

Question 27

Question
It is MOST important for the nurse to instruct a patient prescribed nitroglycerin to avoid which substance?
Answer
  • Antacids
  • Grapefruit juice
  • Erectile dysfunction drugs
  • Potassium-sparing diuretics

Question 28

Question
When caring for a patient with angina pectoris, the nurse would question a prescription for a noncardioselective beta blocker in a patient with which preexisting condition?
Answer
  • Hypertension
  • Atrial fibrillation
  • Bronchial asthma
  • Myocardial infarction

Question 29

Question
The nurse understands that a patient receiving nitroglycerin should be monitored for which common adverse effects associated with this medication? (Select all that apply.)
Answer
  • Flushing
  • Headache
  • Dizziness
  • Hypotension
  • Blurred vision

Question 30

Question
For a patient receiving IV nitroglycerin (Tridil), what are the priority nursing interventions? (Select all that apply.)
Answer
  • Check the heart rate.
  • Monitor blood pressure.
  • Auscultate lung sounds.
  • Measure intake and output.
  • Assess for worsening chest pain.

Question 31

Question
The nurse is preparing to administer digoxin (Lanoxin) 0.25mg intravenous push to a patient. Which is an expected patient outcome related to the administration of digoxin?
Answer
  • Low serum potassium
  • Reduction in urine output
  • Decrease in the heart rate
  • Increase in blood pressure

Question 32

Question
The patient’s serum digoxin level is 0.4 ng/mL. How does the nurse interpret this laboratory value result for digoxin?
Answer
  • Normal therapeutic level
  • A toxic serum blood level
  • Above the therapeutic level
  • Below the therapeutic level

Question 33

Question
A patient prescribed digoxin (Lanoxin) 0.25 mg and furosemide (Lasix) 40 mg for the treatment of systolic heart failure states, “I am starting to see yellow halos around lights.” Which action will the nurse take?
Answer
  • Perform a visual acuity test on each eye.
  • Document the finding and reassess in 1 hour.
  • Assess for other symptoms of digoxin toxicity.
  • Prepare to administer digoxin immune fab (Digifab).

Question 34

Question
A patient weighing 44 lb is prescribed a digoxin (Lanoxin) loading dose of 0.03 mg/kg to be administered in three divided doses. How much will the nurse administer in each dose?
Answer
  • 0.2 mg
  • 0.3 mg
  • 0.4 mg
  • 0.6 mg

Question 35

Question
Which are therapeutic effects of digoxin (Lanoxin)?
Answer
  • Positive inotropic, positive chronotropic, and negative dromotropic
  • Positive inotropic, negative chronotropic, and positive dromotropic
  • Positive inotropic, negative chronotropic, and negative dromotropic
  • Negative inotropic, negative chronotropic, and negative dromotropic

Question 36

Question
Phosphodiesterase inhibitors (PDIs) have an added advantage in treating heart failure. These drugs cause a positive inotropic effect and what other effect?
Answer
  • Vasodilation
  • Bronchodilation
  • Vasoconstriction
  • Platelet inhibition

Question 37

Question
The nurse reviews an adult patient’s laboratory values and notes a digoxin level of 11 ng/mL and a serum potassium level of 6.2 mEq/L. The nurse would notify the health care provider and anticipate which medication will be prescribed to administer?
Answer
  • Sodium polystyrene sulfonate (Kayexalate)
  • Atropine
  • Epinephrine (Adrenalin)
  • Digoxin immune Fab

Question 38

Question
The nurse would question the use of milrinone (Primacor) in a patient with which condition?
Answer
  • Acute renal failure
  • Aortic regurgitation
  • Systolic heart failure
  • Mitral valve prolapse

Question 39

Question
When teaching a patient regarding the administration of digoxin (Lanoxin), the nurse instructs the patient not to take this medication with which food?
Answer
  • Bananas
  • Wheat bran
  • French toast
  • Scrambled eggs

Question 40

Question
For a patient receiving a positive inotropic drug, which nursing assessments should be performed? (Select all that apply.)
Answer
  • Check apical pulse.
  • Obtain daily weights.
  • Auscultate lung sounds.
  • Monitor serum electrolytes.
  • Review red blood cell count.

Question 41

Question
A patient is receiving lidocaine (Xylocaine) by continuous intravenous (IV) infusion. The nurse understands this medication is prescribed for what condition?
Answer
  • Atrial fibrillation
  • Sinus bradycardia
  • First-degree heart block
  • Ventricular dysrhythmias

Question 42

Question
The nurse is reviewing the protocol for administration of IV adenosine (Adenocard). What is the MOST important nursing intervention to remember when giving this medication?
Answer
  • Administer it as a fast IV push.
  • Assess for burning sensation at the IV site.
  • Monitor the infusion site for hematoma.
  • Flush the IV catheter with normal saline.

Question 43

Question
To prevent the occurrence of cinchonism in a patient prescribed quinidine (Quindex), which instruction is MOST important for the nurse to provide for this patient?
Answer
  • Avoid drinking grapefruit juice.
  • Remind the patient to change positions slowly.
  • Advise the patient to wear sunscreen every day.
  • Increase dietary intake of potassium.

Question 44

Question
The nurse understands adenosine (Adenocard) is used to treat which condition?
Answer
  • Atrial flutter
  • Atrial fibrillation
  • Second-degree atrioventricular block
  • Paroxysmal supraventricular tachycardia (PSVT)

Question 45

Question
Sodium channel blockers are considered which class of antidysrhythmic drugs?
Answer
  • Class I
  • Class II
  • Class III
  • Class IV

Question 46

Question
The patient is prescribed ibutilide (Corvert), a class III antiarrhythmic drug. The nurse understands this drug has been prescribed for which reason?
Answer
  • Conversion of life-threatening ventricular dysrhythmias
  • Conversion of recent-onset atrial fibrillation and flutter
  • Treatment of dysrhythmias in patients with acute renal failure
  • Treatment of PSVT

Question 47

Question
Before administering a dose of an antidysrhythmic drug to a patient, what is the priority nursing assessment?
Answer
  • Check apical pulse and blood pressure.
  • Measure urine output and specific gravity.
  • Obtain temperature and pulse oximetry on room air.
  • Evaluate peripheral pulses and level of consciousness.

Question 48

Question
Which drug class is used to treat both hypertension and antidysrhythmias?
Answer
  • Sodium channel blockers
  • Calcium channel blockers
  • Direct-acting vasodilators
  • Alpha-adrenergic-blocking

Question 49

Question
Calcium channel blockers have which pharmacodynamic effect?
Answer
  • Positive inotropic
  • Positive chronotropic
  • Coronary vasodilation
  • Shortened refractory period

Question 50

Question
The nurse is caring for a patient prescribed amiodarone (Cordarone). The nurse knows the MOST serious adverse effect of this medication can occur in which body system?
Answer
  • Nervous
  • Immune
  • Respiratory
  • Gastrointestinal

Question 51

Question
For patients prescribed amiodarone (Cordarone), the nurse should monitor for which potential adverse effects of this drug? (Select all that apply.)
Answer
  • Diarrhea
  • Visual halos
  • Hypothyroidism
  • Photosensitivity
  • Overgrowth of gum tissue
  • Blue gray skin discoloration

Question 52

Question
Epinephrine, as an adrenergic (sympathomimetic) drug, produces which therapeutic effect?
Answer
  • Urinary retention
  • Bronchial constriction
  • Decreased intestinal motility
  • Increased heart rate and contractility

Question 53

Question
The health care provider has prescribed dopamine (Intropin) to treat the patient’s hypovolemic shock secondary to severe blood loss. For the medication to be effective, the health care provider must also prescribe which treatment?
Answer
  • Temporary pacing
  • Fluid replacement
  • Induced hypothermia
  • Beta-stimulating drugs

Question 54

Question
A patient weighing 176 lb is to receive a dopamine (Intropin) continuous intravenous (IV) infusion at 5 mcg/kg/min. The solution strength available is dopamine 400 mg in 500 mL D5W. The nurse will infuse the medication at which rate?
Answer
  • 20 mL/hr
  • 30 mL/hr
  • 40 mL/hr
  • 50 mL/hr

Question 55

Question
When assessing for cardiovascular effects of an adrenergic (sympathomimetic) drug, the nurse understands that these drugs produce which effect on the heart?
Answer
  • A positive inotropic, positive chronotropic, and positive dromotropic effect
  • A negative inotropic, positive chronotropic, and positive dromotropic effect
  • A positive inotropic, negative chronotropic, and negative dromotropic effect
  • A negative inotropic, negative chronotropic, and negative dromotropic effect

Question 56

Question
A hypertensive crisis may occur if adrenergic (sympathomimetic) drugs are given along with which of the following drug classes?
Answer
  • Beta blockers
  • Alpha1 blockers
  • Direct renin inhibitors
  • Monoamine oxidase inhibitors (MAOIs)

Question 57

Question
The nurse assesses the patient’s IV site, and it has infiltrated during the infusion of dopamine (Intropin). The nurse will prepare which medication to treat this infiltration?
Answer
  • Naloxone (Narcan)
  • Lidocaine (Xylocaine)
  • Nitroprusside (Nipride)
  • Phentolamine (Regitine)

Question 58

Question
A patient using Afrin nasal spray complains of worsening cold symptoms and tells the nurse, “I don’t understand why this is not working. I am using it almost every 3 hours.” The nurse’s response is based on knowledge of which drug information?
Answer
  • Afrin nasal spray may be minimally effective to relieve the nasal congestion.
  • The medication needs to be used every 30 minutes for maximum effectiveness.
  • The patient is experiencing rebound congestion related to excessive use of the medication.
  • Adrenergic decongestants should only be used prophylactically, not to treat acute congestion.

Question 59

Question
Nonselective beta blockers may be used to treat hypertension and what other condition?
Answer
  • Heart failure
  • Heart block
  • Supraventricular dysrhythmias
  • Chronic obstructive pulmonary disease (COPD)

Question 60

Question
The nurse knows which drug is an example of a cardioselective beta blocker?
Answer
  • Sotalol (Betapace)
  • Atenolol (Tenormin)
  • Propranolol (Inderal)
  • Labetalol (Normodyne)

Question 61

Question
When teaching a patient about beta blockers such as atenolol (Tenormin) and metoprolol (Lopressor), it is important for the nurse to instruct the patient about which drug information?
Answer
  • Alcohol intake is encouraged for its vasodilating effects.
  • Abrupt medication withdrawal may lead to a rebound hypertension.
  • Hot baths and showers will help increase the therapeutic effects of this drug.
  • These medications may be taken with antacids to minimize gastrointestinal distress.

Question 62

Question
Which is the pharmacological action of propranolol (Inderal)?
Answer
  • Beta1-adrenergic antagonist
  • Beta2-adrenergic antagonist
  • Selective alpha-adrenergic antagonist
  • Nonselective beta-adrenergic antagonist

Question 63

Question
During assessment of a patient diagnosed with pheochromocytoma, the nurse auscultates a blood pressure of 210/110 mm Hg. The nurse would expect to administer which medication?
Answer
  • Verapamil (Calan)
  • Nadolol (Corgard)
  • Dobutamine (Dobutrex)
  • Phentolamine (Regitine)

Question 64

Question
The nurse understands beta blockers produce which cardiovascular effects?
Answer
  • Positive inotropic, positive chronotropic, and positive dromotropic
  • Negative inotropic, positive chronotropic, and positive dromotropic
  • Positive inotropic, negative chronotropic, and negative dromotropic
  • Negative inotropic, negative chronotropic, and negative dromotropic

Question 65

Question
What is the priority nursing diagnosis for a patient prescribed metoprolol (Lopressor)?
Answer
  • Risk for injury related to possible adverse effects of the adrenergic blockers
  • Acute confusion related to adverse central nervous system effects of the drug
  • Risk for decreased cardiac tissue perfusion related to effects of medication
  • Deficient knowledge related to lack of information about the therapeutic regimen

Question 66

Question
When performing discharge instructions to a patient prescribed metoprolol (Lopressor), which statement by the nurse is correct?
Answer
  • “If you become dizzy, do not take your medication for 2 days and then restart on the third day.”
  • “This medication may make you fatigued; increasing caffeine in your diet may help alleviate this problem.”
  • “If you take your pulse and it is less than 60 beats/min, hold your medicine and call your health care provider for instructions.”
  • “Increase your intake of green leafy vegetables to prevent bleeding problems that can be caused by this medication.”

Question 67

Question
The nurse is caring for a patient with a history of angina and hypertension who is diagnosed with moderate heart failure. The patient’s current medication regimen includes digoxin (Lanoxin), furosemide (Lasix), and quinapril (Accupril). Which medication would be most beneficial for the health care provider to add to this patient’s treatment plan?
Answer
  • Carvedilol (Coreg)
  • Sotalol (Betapace)
  • Esmolol (Brevibloc)
  • Propranolol (Inderal)

Question 68

Question
Cholinergic (parasympathomimetic) drugs have which therapeutic effect?
Answer
  • Pupil dilation
  • Urinary retention
  • Blood vessel vasoconstriction
  • Increased gastrointestinal (GI) motility

Question 69

Question
Cholinergic (parasympathomimetic) drugs are indicated for which situation?
Answer
  • To treat a postoperative patient who has bradycardia
  • To lower intraocular pressure in patients with glaucoma
  • To manage patients with excessive salivation and sweating
  • For conditions in which the patient has frequent urination

Question 70

Question
The nurse is performing postoperative teaching for a patient prescribed bethanechol (Urecholine). The patient is prescribed this drug for the treatment of which condition?
Answer
  • Urinary atony
  • Ischemic colitis
  • Respiratory atelectasis
  • Orthostatic hypotension

Question 71

Question
What is an adverse effect of bethanechol (Urecholine)?
Answer
  • Headache
  • Tachypnea
  • Constipation
  • Hypertension

Question 72

Question
The nurse administering donepezil (Aricept) to a patient with Alzheimer’s disease understands this drug has which expected therapeutic action?
Answer
  • Relief of anxiety and restless behavior of the patient
  • Helps control associated urinary and fecal incontinence
  • Blocks the effect of norepinephrine at the presynaptic cell membrane
  • Increases levels of acetylcholine in the brain by blocking its breakdown

Question 73

Question
When providing teaching to a patient diagnosed with myasthenia gravis, which instruction regarding the administration of physostigmine (Antilirium) is MOST appropriate?
Answer
  • Instruct the patient to take the medication 30 minutes before meals.
  • Tell the patient to increase fluid and fiber in the diet to prevent constipation.
  • Inform the patient that common adverse effects include tachycardia and hypertension.
  • Explain that if a dose is missed, the patient should double the next dose to prevent withdrawal.

Question 74

Question
The health care provider prescribes donepezil (Aricept) for a patient. The patient states to the nurse, “I have no idea why I take this medication.” The nurse knows the administration of donepezil (Aricept) is MOST commonly associated with what condition?
Answer
  • Bladder retention
  • Urinary retention
  • Parkinson’s disease
  • Alzheimer’s disease

Question 75

Question
The nurse caring for an adult patient with symptomatic bradycardia prepares to administer which recommended dose of intravenous (IV) atropine?
Answer
  • 2 mg
  • 0.3 mg
  • 0.5 mg
  • 1.25 mg

Question 76

Question
An adult patient presents to the emergency department with insecticide poisoning. The nurse prepares to administer which dose of IV atropine?
Answer
  • 0.3 mg
  • 0.5 mg
  • 2 mg
  • 4 mg

Question 77

Question
The nurse monitors a patient prescribed tolterodine (Detrol) for which therapeutic effect?
Answer
  • Absence of salivation
  • Increase in heart rate
  • Decrease in urinary frequency
  • Reduction in gastrointestinal (GI) motility

Question 78

Question
The nurse monitors a patient prescribed dicyclomine (Bentyl) for which therapeutic effect?
Answer
  • Decrease in sweating
  • Dilation of the pupils
  • Reduction in urinary frequency
  • Decrease in GI motility

Question 79

Question
What would be a priority nursing diagnosis for a patient receiving anticholinergic (parasympatholytic) drugs?
Answer
  • Risk for injury related to excessive central nervous system stimulation
  • Impaired gas exchange related to thickened respiratory secretions
  • Urinary retention related to loss of bladder tone
  • Deficient knowledge related to pharmacologic regimen

Question 80

Question
Which would be the most appropriate application time for a patient prescribed a scopolamine (Transderm Scop) transdermal medication patch for motion sickness?
Answer
  • Just before bedtime
  • Every 4 hours as needed
  • 4 to 5 hours before travel
  • At the first sign of motion sickness

Question 81

Question
After administering oxybutynin (Ditropan) to a patient with spina bifida, the nurse is monitoring the patient for therapeutic effects. Which assessment finding indicates the therapeutic effect of this drug?
Answer
  • Increase in heart rate
  • Decrease in urinary frequency
  • Absence of muscle rigidity and tremors
  • Sudden urge to have a bowel movement

Question 82

Question
The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin (Hemochron)?
Answer
  • Prothrombin time (PT)
  • Blood urea nitrogen
  • Complete blood count
  • Activated partial thromboplastin time (aPTT)

Question 83

Question
The nurse is caring for a patient admitted with gastrointestinal bleeding who is anticoagulated with warfarin (Coumadin). Which medication should the nurse anticipate administering?
Answer
  • Vitamin E
  • Vitamin K (Phytonadione)
  • Protamine (Protamine sulfate)
  • Calcium gluconate

Question 84

Question
The nurse notes a patient’s international normalized ratio (INR) value of 2.5. What is the meaning of this reported value?
Answer
  • The patient’s warfarin dose is within the therapeutic range.
  • The patient needs the subcutaneous heparin dose increased.
  • The patient is not receiving enough warfarin for a therapeutic effect.
  • The patient is receiving too much heparin and is at risk for bleeding.

Question 85

Question
The nurse is giving discharge instructions to a patient prescribed warfarin (Coumadin) for atrial fibrillation. Which statement by the patient indicates a need for further instruction from the nurse?
Answer
  • “I will take my medication in the early evening each day.”
  • “I will increase the dark green leafy vegetables in my diet.”
  • “I will contact my health care provider if I develop excessive bruising.”
  • “I will avoid activities that have a risk for injury such as contact sports.”

Question 86

Question
Which medication is an antiplatelet drug?
Answer
  • Clopidogrel (Plavix)
  • Alteplase (Activase)
  • Heparin (Hemochron)
  • Enoxaparin (Lovenox)

Question 87

Question
The nurse is preparing a patient with acute chest pain for an emergency angioplasty. The nurse would anticipate administering which medication to prevent platelet aggregation?
Answer
  • Warfarin (Coumadin)
  • Tirofiban (Aggrastat)
  • Aminocaproic acid (Amicar)
  • Protamine (Protamine sulfate)

Question 88

Question
Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This medication is in which drug class?
Answer
  • Thrombolytic drug
  • Oral anticoagulant
  • Glycoprotein IIb/IIIa inhibitor
  • Low-molecular-weight heparin

Question 89

Question
The patient asks the nurse, “What is the difference between dalteparin (Fragmin) and heparin?” What is the nurse’s best response?
Answer
  • “There is really no difference, but dalteparin is preferred because it is less expensive.”
  • “I’m not really sure why some health care providers choose dalteparin and some heparin.”
  • “The only difference is that the heparin dosage calculation is based on the patient’s weight.”
  • “Dalteparin is a low-molecular-weight heparin that has a more predictable anticoagulant effect.”

Question 90

Question
Before emergency surgery, the nurse would anticipate administering which medication to a patient receiving heparin?
Answer
  • Vitamin K (Phytonadione)
  • Vitamin E
  • Phenytoin (Dilantin)
  • Protamine (Protamine sulfate)

Question 91

Question
A patient who is prescribed an anticoagulant requests an aspirin (acetylsalicylic acid) for headache relief. What is the nurse’s best action?
Answer
  • Inform the patient of potential drug interactions with anticoagulants.
  • Explain that a common initial adverse effect is a headache for this drug.
  • Explain that acetylsalicylic acid is contraindicated and administer ibuprofen.
  • Administer 650 mg of acetylsalicylic acid and reassess pain in 30 minutes.

Question 92

Question
A patient is prescribed oral anticoagulant therapy while still receiving IV heparin infusion. The patient is concerned about risk for bleeding. What is the nurse’s best response?
Answer
  • “Bleeding is a common adverse effect of taking warfarin. If bleeding occurs, your health care provider will prescribe an injection of medication to stop the bleeding.”
  • “Because you are now getting out of bed and walking around, you have a higher risk of blood clot formation and therefore need to be on both medications.”
  • “Because of your mechanical valve replacement, it is especially important for you to be fully anticoagulated, and the heparin and warfarin together are more effective than one alone.”
  • “It usually takes 4 to 5 days to achieve a full therapeutic effect for warfarin, so the heparin infusion is continued to help prevent blood clots until the warfarin reaches its therapeutic effect.”

Question 93

Question
The nurse determines the patient has a good understanding of the discharge instructions regarding warfarin (Coumadin) with which patient statement?
Answer
  • “I should keep taking ibuprofen for my arthritis.”
  • “I should use a soft toothbrush for dental hygiene.”
  • “I should decrease the dose if I start bruising easily.”
  • “I will double my dose if I forget to take it the day before.”

Question 94

Question
While observing a patient self-administer enoxaparin (Lovenox), the nurse identifies the need for further teaching when the patient performs which self-injection action?
Answer
  • Does not aspirate before injecting the medication
  • Massages the site after administration of the medication
  • Administers the medication into subcutaneous (fatty) tissue
  • Injects the medication greater than 2 inches away from the umbilicus

Question 95

Question
The nurse recognizes that the patient understands the teaching about warfarin (Coumadin) when the patient verbalizes an increased risk of bleeding with concurrent use of which herbal product? (Select all that apply.)
Answer
  • Garlic
  • Ginkgo
  • Dong quai
  • Glucosamine
  • St. John’s wort

Question 96

Question
The nurse provides discharge instructions to a patient prescribed cholestyramine (Questran). Which statement by the patient indicates teaching was effective for this drug?
Answer
  • “I will increase fiber in my diet and drink more fluids.”
  • “I will notify my health care provider if I have muscle pain.”
  • “I will take Questran 1 hour before my other medications.”
  • “This drug can cause flushing, itching and gastrointestinal upset.”

Question 97

Question
To decrease the skin flushing adverse effect reaction of niacin (nicotinic acid), which action should the nurse take?
Answer
  • Administer niacin with a liquid antacid.
  • Give niacin with all other morning medications.
  • Apply cold compresses to the head and neck.
  • Administer aspirin 30 minutes before each dose.

Question 98

Question
Hydroxymethylglutaryl–coenzyme A (HMG–CoA) reductase inhibitors (statins) are generally administered at which time of day?
Answer
  • Morning
  • Evening
  • Afternoon
  • 12:00 noon

Question 99

Question
Which discharge instruction should the nurse include for a patient prescribed an antilipemic medication?
Answer
  • “Stop taking the medication if it causes nausea and vomiting.”
  • “Continue your exercise program and maintain a low-fat diet.”
  • “It is important to take a double dose to make up for a missed dose.”
  • “Lifestyle changes are no longer necessary when taking this medication.”

Question 100

Question
What is the mechanism of action of ezetimibe (Zetia)?
Answer
  • Inhibits the biosynthesis of cholesterol in the liver.
  • Decreases the adhesion of cholesterol in the arteries.
  • Inhibits absorption of dietary and biliary cholesterol in the small intestine.
  • Binds to bile acids in the intestine, inhibiting its reabsorption into the blood.

Question 101

Question
Which statement by the nurse explains to the patient the action of cholestyramine (Questran) to decrease blood lipid levels?
Answer
  • Inhibits absorption of dietary cholesterol in the small and large intestine.
  • Stimulates the biliary system to increase excretion of dietary cholesterol.
  • Binds to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces.
  • Inhibits lipolysis in adipose tissue and decreases the hepatic synthesis of triglycerides in the liver.

Question 102

Question
Which statement by the patient indicates a need for further instruction about colestipol (Colestid) from the nurse?
Answer
  • “The potential adverse effects of this drug are rash and itching.”
  • “I might need to take fat-soluble vitamins to supplement my diet.”
  • “I will mix and stir the powder thoroughly with at least 1 to 2 oz of fluid.”
  • “I should take this medication 1 hour after or 4 hours before my other medications.”

Question 103

Question
By which action does atorvastatin (Lipitor) decrease lipid levels?
Answer
  • Stimulating the gallbladder and biliary system to increase excretion of dietary cholesterol
  • Binding to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces
  • Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver
  • Decreasing the amount of triglycerides produced by the liver and increasing the removal of triglycerides by the liver

Question 104

Question
To assess for a potentially serious adverse effect to HMG-CoA reductase inhibitors, the nurse should monitor which laboratory results?
Answer
  • Serum electrolytes
  • Urine specific gravity
  • Liver function studies
  • Complete blood count

Question 105

Question
The nurse is providing discharge teaching for a patient about potential serious adverse effects to simvastatin (Zocor). Which symptom may indicate the patient is experiencing a serious adverse effect to this medication?
Answer
  • Itching
  • Headache
  • Muscle pain
  • Weight loss

Question 106

Question
The nurse would question a prescription for simvastatin (Zocor) in a patient with which condition?
Answer
  • Diabetes
  • Leukemia
  • Heart failure
  • Hepatic disease

Question 107

Question
A patient with elevated triglyceride levels unresponsive to HMG-CoA reductase inhibitors will most likely be prescribed which drug?
Answer
  • Gemfibrozil (Lopid)
  • Cholestyramine (Questran)
  • Colestipol (Colestid)
  • Simvastatin (Zocor)

Question 108

Question
The nurse would question a prescription for colesevelam (Welchol) in a patient with which condition?
Answer
  • Glaucoma
  • Renal disease
  • Hepatic disease
  • Bowel obstruction

Question 109

Question
The nurse will assess a patient receiving gemfibrozil (Lopid) and warfarin (Coumadin) for the increased risk of which adverse effect?
Answer
  • Clotting
  • Bleeding
  • Vitamin K toxicity
  • Deep vein thrombosis

Question 110

Question
For a patient prescribed hydrochlorothiazide (HydroDIURIL), the nurse should closely monitor which laboratory test value?
Answer
  • Sodium
  • Glucose
  • Calcium
  • Chloride

Question 111

Question
The nurse is providing education to a patient prescribed spironolactone (Aldactone) and furosemide (Lasix). What information does the nurse explain to the patient?
Answer
  • Using two drugs increases blood osmolality and the glomerular filtration rate.
  • This combination promotes diuresis but decreases the risk of low levels of potassium.
  • The lowest dose of two different types of diuretics are more effective than a large dose of one type.
  • This combination maintains water balance to protect against dehydration and electrolyte imbalance.

Question 112

Question
Which laboratory test result is a common adverse effect of furosemide (Lasix)?
Answer
  • Hypokalemia
  • Hypernatremia
  • Hyperchloremia
  • Hypophosphatemia

Question 113

Question
Why does the health care provider prescribe furosemide (Lasix) 40 mg twice a day by mouth for a patient with a history of renal insufficiency?
Answer
  • Furosemide is effective in treating patients with hypoaldosteronism.
  • Furosemide helps the kidney with reabsorption of sodium and water.
  • Furosemide has an antagonist effect to prevent respiratory alkalosis.
  • Furosemide is effective in treating patients with impaired kidney function

Question 114

Question
The nurse would question the use of mannitol (Osmitrol) for which patient condition?
Answer
  • Increased intraocular pressure
  • Oliguria from acute renal failure
  • Cerebral edema from head trauma
  • Anuria related to end-stage kidney disease

Question 115

Question
When preparing to administer intravenous furosemide (Lasix) to a patient with renal dysfunction, the nurse will administer the medication no faster than which rate?
Answer
  • 2 mg/min
  • 4 mg/min
  • 6 mg/min
  • 8 mg/min

Question 116

Question
A patient asks the nurse about using potassium supplements while taking spironolactone (Aldactone). What is the nurse’s best response?
Answer
  • “I will call your health care provider and discuss your concern.”
  • I would recommend that you take two multivitamins every day.”
  • “This diuretic is potassium sparing, so there is no need for extra potassium.”
  • “You will need to take potassium supplements for the medication to be effective.”

Question 117

Question
To treat a patient diagnosed with primary hyperaldosteronism, the nurse would expect to administer which diuretic?
Answer
  • Furosemide (Lasix)
  • Acetazolamide (Diamox)
  • Spironolactone (Aldactone)
  • Hydrochlorothiazide (HydroDIURIL)

Question 118

Question
To treat a patient with pulmonary edema, the nurse prepares to administer which diuretic to this patient?
Answer
  • Furosemide (Lasix)
  • Amiloride (Midamor)
  • Triamterene (Dyrenium)
  • Spironolactone (Aldactone)

Question 119

Question
To evaluate the therapeutic effects of mannitol (Osmitrol), the nurse should monitor the patient for which clinical finding?
Answer
  • Increase in urine osmolality
  • Decrease in serum osmolality
  • Decrease in intracranial pressure
  • Increase in cerebral blood volume

Question 120

Question
When assessing a patient taking triamterene (Dyrenium), the nurse would monitor for which possible adverse effect?
Answer
  • Hypokalemia
  • Hyperkalemia
  • Hypoglycemia
  • Hypernatremia

Question 121

Question
When teaching a patient about symptoms of hypokalemia, the nurse will instruct the patient to notify the health care provider if which symptom occurs?
Answer
  • Diaphoresis
  • Constipation
  • Blurred vision
  • Muscle weakness

Question 122

Question
A patient prescribed spironolactone (Aldactone) asks the nurse to assist with food choices that are low in potassium. The nurse would recommend which food choices? (Select all that apply.)
Answer
  • Apples
  • Bananas
  • Pineapple
  • Lean meat
  • Winter squash

Question 123

Question
Acetazolamide (Diamox) is used to treat which conditions? (Select all that apply.)
Answer
  • Dry eye syndrome
  • Cardiac dysrhythmias
  • High-altitude sickness
  • Open-angle glaucoma
  • Edema associated with heart failure

Question 124

Question
Potassium-sparing diuretics may cause which common adverse reactions? (Select all that apply.)
Answer
  • Dizziness
  • Headache
  • Hyperkalemia
  • Mental confusion
  • Muscle weakness
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