Learning system Pharmacology final Quiz
A nurse is assessing a client who reports using several herbal and vitamin supplements daily, including
saw palmetto. The nurse should recognize that saw palmetto is a supplement used by clients to elicit
which of the following therapeutic effects?
Urinary health promotion
Rationale: Saw palmetto is used primarily for manifestations related to prostatic conditions, such as benign
prostatic hypertrophy (BPH). Its effectiveness has not been scientifically proven, however. The nurse should
teach the client to check with the provider about interactions between saw palmetto and other medications.
A nurse is preparing a discharge teaching plan for a 6-year-old client who has asthma and several
prescription medications using metered dose inhalers (MDIs). Which of the following interventions
should the nurse include in the plan?
Add a spacer to each MDI.
Rationale: MDIs are difficult to use correctly and, even when properly used, only a portion of the medication is
delivered to the lungs. A spacer applied to an MDI can make up for lack of hand-lung coordination by increasing
the amount of medication delivered to the lungs.
A nurse is providing teaching to a client who has postmenopausal osteoporosis and a new prescription for
intranasal calcitonin-salmon. Which of the following statements by the client indicates an understanding
of the teaching?
"I will need to depress the side arms to activate the pump."
Rationale: The nurse should instruct the client to activate the pump on the initial use by holding the bottle
upright and depressing the two white side arms toward the bottle six times.
A nurse in an outpatient facility is assessing a client who is prescribed furosemide 40 mg daily but the
client reports she has been taking extra doses to promote weight loss. Which of the following findings
should indicate to the nurse that the client is dehydrated?
Urine specific gravity 1.035
Rationale: Oliguria, increased urine concentration, and an increase in urine specific gravity greater than 1.030
are expected findings in clients who are dehydrated.
A nurse is providing teaching to a client who is to start taking hydrochlorothiazide for hypertension. The
nurse instructs the client to eat foods rich in potassium. Which of the following statements by the client
indicates an understanding of the teaching?
"This medication can cause a loss of potassium."
Rationale: Hydrochlorothiazide can result in hypokalemia caused by excessive potassium excretion by the
kidneys. The client should supplement his diet with potassium-rich foods to avoid the occurrence of
hypokalemia. Foods that are high in potassium include bananas, raisins, baked potatoes, pumpkins, and milk.
A home health nurse is visiting an older adult client who has Alzheimer’s disease. His caregiver tells the
nurse she has been administering prescribed lorazepam, 1 mg three times per day, to the client for
restlessness and anxiety during the past few days. For which of the following adverse effects should the
nurse assess the client?
Sedation
Rationale: Lorazepam is a benzodiazepine with anti-anxiety and sedative effects. Older adult clients,
especially, are at risk for central nervous system depression even with low doses of benzodiazepines. Clients
who are 50 years or older can have a more profound and prolonged sedation than younger clients.
A nurse is providing discharge teaching to a client who had a kidney transplant and has a prescription
for oral cyclosporine. Which of the following statements by the client indicates an understanding of the
teaching?
"I am likely to develop higher blood pressure while taking this medication."
Rationale: Half the clients who take cyclosporine develop a 10% to 15% increase in blood pressure and might
need to start antihypertensive therapy.
A nurse is caring for a client who is in preterm labor and has a new prescription for nifedipine. The client
states she is concerned because her father takes nifedipine for his angina pectoris. The nurse should
explain to the client that nifedipine works for clients who are pregnant by which of the following
mechanisms?
It inhibits uterine contractions by blocking entry of calcium into uterine cells.
Rationale: Nifedipine, a calcium channel blocker, causes uterine relaxation by blocking the flow of calcium to
the myometrial cells of the uterus.
A nurse is administering adenosine via IV bolus for a client who has developed paroxysmal atrial
tachycardia. For which of the following findings should the nurse assess the client during administration
of adenosine?
Dyspnea
Rationale: Dyspnea can occur during administration of adenosine due to bronchoconstriction. Since adenosine
has a very short half-life of about 10 seconds, this effect should be short-lived.
A nurse is administering oral hydroxyzine to a client. Which of the following adverse effects should the
nurse instruct the client to expect?
Dry mouth
Rationale: Hydroxyzine has anticholinergic properties. Dry mouth is a common adverse effect of this
medication. The nurse should instruct the client to take sips of water or suck hard candies to minimize this
effect.
A nurse is planning discharge teaching for a client who has major depressive disorder and a new
prescription for phenelzine. Which of the following foods should the nurse include in the plan as safe for
the client to consume while taking phenelzine?
Broiled beef steak
Rationale: Phenelzine, an MAOI, is an antidepressant. This medication interacts with a variety of foods to
produce a hypertensive crisis. Beef steak and other meats that are fresh do not interact with phenelzine and are
safe to consume.
A nurse is caring for a client who has heart failure and is taking oral furosemide 40 mg daily. For which
of the following adverse effects should the client be taught to monitor and notify the provider if it occurs?
Tinnitus
Rationale: Loop diuretics, such as furosemide, can cause ototoxicity. The client should be taught to notify the
provider if tinnitus, a full feeling in the ears, or hearing loss occurs.
A nurse is planning to administer diphenhydramine 50 mg via IV bolus to a client who is having an
allergic reaction. The client has an IV infusion containing a medication that is incompatible with
diphenhydramine in solution. Which of the following actions should the nurse take?
Aspirate to check for IV patency before administering the diphenhydramine.
Rationale: It is important to confirm IV patency prior to administering an IV bolus. Some medications cause
severe tissue damage when inadvertently administered into tissue rather than into a vein.
A nurse is caring for a client who has congestive heart failure and is taking digoxin. The client reports
nausea and refuses to eat breakfast. Which of the following actions should the nurse take first?
Check the client’s apical pulse.
Rationale: Nausea, anorexia, fatigue, visual effects, and cardiac dysrhythmias, often caused by a slow pulse
rate, are possible findings in digoxin toxicity. Caring for this client requires application of the nursing process
priority- setting framework. The nurse can use the nursing process to plan client care and prioritize nursing
actions. Each step of the nursing process builds on the previous step, beginning with assessment. Before the
nurse can formulate a plan of action, implement a nursing intervention, or notify the provider about a change in
the client’s
status, she must first collect adequate data from the client. Assessing will provide the nurse with knowledge to
make an appropriate decision.
A nurse is caring for a client who has a positive tuberculin skin test and is beginning a prescription for
isoniazid. The nurse should teach the client that which of the following laboratory values should be
monitored while taking isoniazid?
Aspartate aminotransferase (AST)
Rationale: Isoniazid can be toxic to the liver. Therefore, it is important to monitor liver enzymes, such as AST,
during therapy with isoniazid. In addition, the nurse should instruct the client to notify the provider of jaundice,
nausea, dark-colored urine or other findings indicating hepatitis.
A nurse is preparing a discharge teaching plan for a client who is to begin long-term oral prednisone for
asthma. Which of the following instructions should the nurse include in the plan?
Schedule the medication on alternate days to decrease adverse effects
Rationale: Some of the adverse effects caused by long-term glucocorticoid therapy, such as suppression of the
adrenal gland, can be avoided by using alternate-day therapy.
A nurse is caring for a client who has alcohol use disorder and is admitted with lower extremity fractures
following a motor-vehicle crash. A few hours after admission, the client develops restlessness and
tremors. Which of the following medications should the nurse anticipate administering to the client first?
Chlordiazepoxide
Rationale: Chlordiazepoxide, a long-acting oral benzodiazepine, is a first-line medication to use for a client
who is experiencing manifestations of acute alcohol withdrawal. For clients who are nauseated or vomiting,
another benzodiazepine, such as lorazepam, can be administered via IV. The nurse should apply the acute
versus chronic priority-setting framework when caring for this client. Using this framework, acute needs
(manifestations of acute alcohol withdrawal) are typically the priority need because they pose more of a threat
to the client. Because chronic needs usually develop over a period of time, the client has more of an opportunity
to adapt to the alteration in health.
A nurse is caring for a client and realizes after administering the 0900 medications that she administered
digoxin 0.25 mg PO to the client instead of the prescribed digoxin 0.125 mg PO. Which of the following
actions should the nurse take first?
Assess the client's apical pulse
Rationale: Caring for this client requires application of the nursing process priority-setting framework. The
nurse can use the nursing process to plan client care and prioritize nursing actions. Each step of the nursing
process builds on the previous step, beginning with assessment. Before the nurse can formulate a plan of action,
implement a nursing intervention, or notify a provider about a change in the client's status, she must first collect
adequate data from the client. Assessing will provide the nurse with knowledge to make an appropriate
decision. Therefore, the first action the nurse should take is to assess the client.
A nurse is planning to administer diltiazem via IV bolus to a client who has atrial fibrillation. When
assessing the client, the nurse should recognize that which of the following findings is a contraindication
to administration of diltiazem?
Hypotension
Rationale: Diltiazem can be a treatment option for essential hypertension. This medication will lower blood
pressure and is contraindicated for a client who is hypertensive. The nurse should teach the client to selfmonitor blood pressure and keep a record of the readings.
A nurse is caring for a client who was brought to the emergency department by friends who report the
client has overdosed on heroin. Which of the following findings should the nurse expect to assess?
Pinpoint pupils
Rationale: Pinpoint pupils are an expected finding in opioid toxicity. Increased pupil size is seen in opioid
withdrawal.
A nurse is providing teaching to a client who has hypertension and a new prescription for oral clonidine.
Which of the following instructions should the nurse include in the teaching?
Avoid driving until the client’s reaction to the medication is known.
Rationale: Clonidine can cause drowsiness, weakness, sedation, and other CNS effects. Until the client’s
response to the medication is known, the nurse should instruct the client to avoid driving or handling other
potentially hazardous equipment. Over time, these effects are likely to decrease.
A nurse is assessing a client who has hypothyroidism and takes levothyroxine. Which of the following
findings should alert the nurse that the client is experiencing acute levothyroxine overdose?
Tremor
Rationale: Tremor and anxiety are expected findings in acute levothyroxine overdose. These findings are
similar to those seen in hyperthyroidism.
A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent client who has
type 1 diabetes mellitus. The nurse should anticipate onset of action of the insulin at which of the
following times?
0745
Rationale: Insulin glulisine has a very short onset of action of 15 min. The nurse should expect the onset of
action around 0745 and ensure the client eats breakfast immediately following administration of the insulin
A nurse is providing discharge teaching to a client who has been hospitalized for major depressive
disorder and has a prescription for amitriptyline. Which of the following statements by the client
indicates an understanding of the teaching?
"I will move slowly when I stand up because amitriptyline can cause my blood pressure to decrease."
Rationale: Amitriptyline can cause orthostatic hypotension. The nurse should instruct the client to take
precautions to prevent injury due to falls while taking amitriptyline.
A hospice nurse is caring for a client who has cancer and is taking naproxen 250 mg 3 times daily PO and
gabapentin 1,800 mg three times daily PO to manage pain. The client tells the nurse, "I’m having pain
that keeps me from doing what I’d like most of the time." Which of the following additions should the
nurse anticipate to the client’s medication regimen?
Oral oxycodone
Rationale: The client’s current pain regimen consists of a nonopioid analgesic, naproxen, and an adjuvant
medication for neuropathic pain, gabapentin. According to the WHO analgesic ladder for cancer pain
management, the next addition to the pain regimen is an opioid for moderate pain. Oxycodone is an oral opioid
that relieves moderate to moderately severe pain; therefore, it is an appropriate choice to add to the client’s pain
regimen.
A nurse is teaching a client who has type 2 diabetes mellitus and a new prescription for metformin.
Which of the following adverse effects of metformin should the nurse instruct the client to watch for and
report to the provider?
Myalgia
Rationale: Myalgia, malaise, somnolence, and hyperventilation are manifestations of lactic acidosis, which
rarely occur while taking metformin due to blockage of lactic acid oxidation. The nurse should instruct the
client to report these findings promptly to the provider.
A nurse is preparing to administer oxytocin to a client who is at 41 weeks of gestation and is experiencing
ineffective labor. Which of the following actions should the nurse plan to take?
Increase the dose of oxytocin to obtain uterine contractions that occur every 2 to 3 min
Rationale: Effective uterine contractions should occur every 2 to 3 min
A nurse is planning care for a female client who has severe irritable bowel syndrome with diarrhea (IBSD) and a new prescription for alosetron. Which of the following interventions should the nurse include in
the plan of care?
The client must sign an agreement with the provider before beginning alosetron.
Rationale: Alosetron has potentially fatal adverse effects associated with constipation and bowel obstruction.
The FDA has allowed alosetron to be placed on the market only if clients sign and adhere to a risk management
program, which includes signing a client-provider agreement before starting alosetron.
A nurse is providing teaching to the parents of a school-age child who has asthma about medications for
bronchospasm. Which of the following inhaled medications should the nurse instruct the parents to use to
relieve an acute asthma attack?
Albuterol
Rationale: Albuterol is a short-acting beta2-adrenergic agonist that is used to provide immediate relief for an
acute asthma attack. One or two puffs every 4 to 6 hr PRN is the usual prescribed dose for a school-age child. If
higher or more frequent doses are needed, the provider should evaluate the client for worsening asthma.
A nurse is providing discharge teaching to a client who has angina pectoris and a new prescription for
verapamil. The client tells the nurse, "My brother takes verapamil for high blood pressure. Do you think
the provider made a mistake? Which of the following responses should the nurse make?
"Verapamil is used to treat both high blood pressure and angina."
Rationale: Verapamil is a calcium channel blocker that is used for both hypertension and anginal pain because
of its ability to dilate arteries and decrease afterload.
A nurse is providing discharge teaching to a client who had a bleeding duodenal ulcer and is prescribed
omeprazole. Which of the following statements should the nurse include in the teaching?
"You should take this medication before breakfast every day."
Rationale: Clients who have active duodenal ulcer or gastric reflux disease should take omeprazole once daily
before a meal (usually breakfast) because the medication is less effective when taken with food.
A nurse is monitoring laboratory values for a male client who has leukemia and is receiving weekly
chemotherapy with methotrexate via IV infusion. Which of the following laboratory values should the
nurse report to the provider?
Platelets 78,000/mm3
Rationale: The nurse should monitor the platelet count of a client who is taking methotrexate because the
medication can cause thrombocytopenia. This client’s platelet count is very low and puts the client at risk for
severe bleeding. The nurse should report this finding promptly to the provider.
A nurse is preparing to administer iron dextran IV to a client. Which of the following actions should the
nurse plan to take?
Administer a small test dose before giving the full dose.
Rationale: A serious adverse effect of iron dextran is anaphylaxis caused by hypersensitivity to the medication.
It is recommended that a small test dose be administered over 5 min before giving the full dose. The client
should be monitored carefully for an allergic reaction during and for a period of time following the test dose.
A nurse is providing discharge teaching to a client who has heart failure and a prescription for digoxin
0.125 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the client
indicates an understanding of the teaching?
"I will eat fruits and vegetables that have high potassium content every day."
Rationale: Hypokalemia is an adverse effect of diuretic therapy. Because the client is taking digoxin, it is
important to maintain the potassium level between 3.5 to 5.0 mg/dL to avoid digoxin toxicity.
A nurse is planning to administer epoetin alfa to a client who has chronic kidney failure. Which of the
following data should the nurse plan to review prior to administration of this medication?
Blood pressure
Rationale: Epoetin alfa often causes hypertension, which can lead to stroke or other cardiovascular
complications. The nurse should monitor the client’s blood pressure and notify the provider about increases.
The client who receives epoetin alfa frequently requires concurrent use of antihypertensive medication.
A nurse is administering ciprofloxacin and phenazopyridine to a client who has a severe urinary tract
infection (UTI). The client asks why both medications are needed. Which of the following responses
should the nurse make?
"Ciprofloxacin hydrochloride treats the infection, and the phenazopyridine treats pain."
Rationale: Ciprofloxacin hydrochloride is a broad-spectrum quinolone antibiotic and phenazopyridine is a
bladder analgesic/anesthetic that relieves burning and pain in the bladder mucosa caused by bladder spasm and
inflammation.
A nurse is providing discharge teaching about lithium toxicity to a client who has a new prescription for
lithium. Which of the following statements by the client indicates an understanding of the teaching?
"I can develop lithium toxicity if I experience vomiting or diarrhea."
Rationale: Vomiting or diarrhea can cause electrolyte imbalances. If serum sodium decreases, lithium is
retained by the kidneys and the risk for lithium toxicity increases.
A nurse is providing teaching to a client who has hypertension and type 1 diabetes mellitus and a new
prescription for metoprolol. Which of the following statements by the client indicates an understanding
of the teaching?
"I might have difficulty recognizing when my blood sugar is low."
Rationale: Metoprolol, a beta-adrenergic blocker, is used to treat hypertension. Because it decreases heart rate,
this common manifestation of hypoglycemia can be masked and hypoglycemia might become more difficult to
recognize. The client should be taught to recognize hypoglycemia by other manifestations, such as hunger,
nausea, and sweating.
A nurse is assessing a client who takes oral theophylline for relief of chronic bronchitis. The nurse should
recognize that which of the following findings indicates toxicity to theophylline?
Tremors
Rationale: Theophylline is a xanthine derivative bronchodilator. An early manifestation of toxicity is CNS
stimulation, often seen as tremors. Seizures can occur if blood levels continue to rise.
A nurse is providing teaching to a client who has heart failure and is taking spironolactone. Which of the
following statements by the client indicates an understanding of the teaching?
"I will watch for increased breast tissue growth while taking this medication."
Rationale: Spironolactone, which is derived from steroids, can cause adverse endocrine effects, such as
gynecomastia, impotence in men and irregular menses and hirsutism in women. The nurse should instruct the
client that these changes can occur.
A nurse is providing discharge teaching to a client who has venous thrombosis and a prescription for
warfarin. Which of the following instructions should the nurse include in the teaching?
Carry a medic alert ID card.
Rationale: A client who is taking warfarin is at increased risk for bleeding. In the case of an emergency, it is
important that any medical personnel are aware of the client's medication history.
A nurse is preparing to administer Chlorothiazide 20 mg/kg/day PO divided equally and administered
twice daily for a toddler who weighs 28.6 lb. The amount available is Chlorothiazide oral suspension 250
mg/5ml. how many ml should the nurse administer per dose?
2.6 ml
A nurse is preparing to administer ampicillin 500 mg in 50 ml of dextrose 5% in water [D5W] to infuse
over 15 minutes. The drop factor of the manual IV tubing is 10 gtt./ml. The nurse should set the manual
IV infusion to deliver how many gtt./min?
33 gtt/min
A nurse is teaching a client who has chronic stable angina pectoris and a prescription for sublingual
nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the client to use if he
experiences chest pain?
Stop activity, place a tablet under the tongue, wait 5 minutes, call 911 if the pain is not relieved
A nurse is preparing to administer ampicillin 50 mg/kg/day PO divided into 4 equal doses for a toddler
who weighs 33 lbs. available is ampicillin 125 mg/5ml oral solution. How many ml should the nurse
administer per dose?
7.5 ml
A nurse is preparing to administer codeine 30 mg PO every 4 hr. PRN to a client for pain. The amount
available is codeine oral solution 15 mg/5 ml. How many ml should the nurse plan to administer per
does?
10 ml
A nurse is preparing to administer heparin 900 units/hr. via IV infusion. The amount available is heparin
25, 000 units in 500 mL 5% dextrose in water. The nurse should set the IV pump to deliver how many
mL/hr.?
18 ml/hr
A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over 2 hr. to a client
who is dehydrated. The nurse should set the IV pump to deliver how many ml/hr.?
500 ml/hr
A nurse is preparing to administer dextrose 5& in 0.45% sodium chloride 400 ml IV to an older adult
client over 8 hr. The nurse should set the IV pump to deliver how many ml/hr.?
50 ml/hr
A nurse is preparing to administer Digoxin 0.2 mg via IV bolus to a client. The amount available is
Digoxin 0.25 mg/1ml. How many ml should the nurse administer?
0.8 ml