Pharmacology Final Exam Lecture Questions & Answers.
Which is the correct action when the nurse is administering sucralfate? (select all that apply)
A. Giving the drug with meals
B. Giving the drug on an empty stomach
C. Instructing patient to restrict fluids
D. Waiting 30 minutes before administering other drugs
E. Giving other drugs 2 hours before giving the sucralfate
B, E
In reviewing the various types of anti-nausea medications, the nurse recognizes that prokinetic
drugs are also used for which condition(s)? (select all that apply)
A. Motion Sickness
B. Vertigo
C. Gastroesophageal reflux
D. Delayed gastric emptying
E. GI obstruction
C, D
A patient calls the clinic because she realized she missed one dose of an oral contraceptive.
Which statement from the nurse is appropriate? (select all that apply)
A. Go ahead and take the missed dose now, along with today's dose
B. Don't worry, you are still protected from pregnancy
,C. Please come to the clinic for a reevaluation of your therapy
D. Wait 7 days and then start a new pack of pills
E. You will need to use a backup form of contraception concurrently for 7 days
A, E
A patient is recovering from an appendectomy. She also has asthma and allergies to shellfish
and iodine. To manage her postoperative pain, the physician has prescribed patient-controlled
analgesia (PCA) with hydromorphone (Dilaudid). Which vital sign is of greatest concern?
A.Pulse
B.Blood pressure
C.Temperature
D.Respirations
D. Respirations
This patient has a history of asthma and allergies, and she will be receiving a drug that can
depress respirations.
A patient who has metastasized bone cancer has been on transdermal fentanyl patches for pain
management for 3 months. He has been hospitalized for tests and has told the nurse that his
pain is becoming "unbearable." The nurse is reluctant to give him the ordered pain medication
because the nurse does not want the patient to get addicted to the medication. What do the
nurse's actions reflect?
A.Appropriate concern for the patient's best welfare
B.Appropriate caution for a patient who is already on a long-term opioid
,C.An uncaring attitude toward the patient
D.A failure to manage the patient's pain properly
D
Patients with severe pain, including metastatic pain or bone pain, may need higher and higher
doses of analgesics. The nurse is responsible for ensuring that the patient experiences adequate
pain relief.
A patient with a history of heavy alcohol use needs a medication for pain. The recommended
maximum daily dose of acetaminophen for this patient would be
A.1000 mg.
B.2000 mg.
C.3000 mg.
D.4000 mg.
B
Chronic heavy alcohol abusers may be at increased risk of liver toxicity from excessive
acetaminophen use. For this reason, a maximum daily dose of 2000 mg is generally
recommended for these persons.
Case Study #1
You are the home health nurse assigned to care for a patient who is in the terminal phases of
breast cancer. Mrs. D. is 48 years of age and underwent bilateral mastectomy 4 years ago. She
had lymph node involvement at the time of surgery, and recently has been diagnosed with
metastasis to the bone. She has been taking one 5 mg tablet of oxycodone every 4-6 hours for
pain as needed. She is not sleeping through the night and is now complaining of increasing pain
, to the point that her quality of life has decreased significantly. She wants to stay at home during
the terminal phases of her illness but needs to have adequate and safe pain control. Her
husband of 18 years is very supportive. They have no children. They are both college graduates
and have medical insurance.
1a. Mrs. D's recent increase in pain has been attributed to bone metastasis in the area of the
lumbar spine. At this time, the oxycodone is not beneficial, and you as the home health care
nurse need to advocate for Mrs. D. to receive adequate pain relief.
Mrs. D. visits her physician and receives a different opioid medication that is given around the
clock, plus an additional medication to help with any breakthrough pain.
1b. What type of drug is given for breakthrough pain?
Generally, the drug used to manage breakthrough pain is a short-acting form of the longer-
acting opioid being given. For example, an immediate-release morphine will be used for
breakthrough pain while sustained-release morphine used for round-the-clock pain relief
1c. After 1 week, Mr. D. finds Mrs. D. awake but lethargic, and speaking with slurred words.
What do you think has happened? What should Mr. D. do?
It is possible that she has received too much opioid medication and is oversedated. Any changes
in mental status will have to be evaluated immediately to rule out other causes that may not be
related to the medications. Mr. D. needs to notify her physician immediately, and, if necessary,
take Mrs. D. to the emergency department, especially if she shows difficulty breathing. The
opioid drug dosage will have to be adjusted.
1d. Mrs. D is taken to the emergency department and is treated for oversedation. Her physician
is contacted, and the medication doses are adjusted to a lower dose. How can this problem be
prevented in the future?
Which is the correct action when the nurse is administering sucralfate? (select all that apply)
A. Giving the drug with meals
B. Giving the drug on an empty stomach
C. Instructing patient to restrict fluids
D. Waiting 30 minutes before administering other drugs
E. Giving other drugs 2 hours before giving the sucralfate
B, E
In reviewing the various types of anti-nausea medications, the nurse recognizes that prokinetic
drugs are also used for which condition(s)? (select all that apply)
A. Motion Sickness
B. Vertigo
C. Gastroesophageal reflux
D. Delayed gastric emptying
E. GI obstruction
C, D
A patient calls the clinic because she realized she missed one dose of an oral contraceptive.
Which statement from the nurse is appropriate? (select all that apply)
A. Go ahead and take the missed dose now, along with today's dose
B. Don't worry, you are still protected from pregnancy
,C. Please come to the clinic for a reevaluation of your therapy
D. Wait 7 days and then start a new pack of pills
E. You will need to use a backup form of contraception concurrently for 7 days
A, E
A patient is recovering from an appendectomy. She also has asthma and allergies to shellfish
and iodine. To manage her postoperative pain, the physician has prescribed patient-controlled
analgesia (PCA) with hydromorphone (Dilaudid). Which vital sign is of greatest concern?
A.Pulse
B.Blood pressure
C.Temperature
D.Respirations
D. Respirations
This patient has a history of asthma and allergies, and she will be receiving a drug that can
depress respirations.
A patient who has metastasized bone cancer has been on transdermal fentanyl patches for pain
management for 3 months. He has been hospitalized for tests and has told the nurse that his
pain is becoming "unbearable." The nurse is reluctant to give him the ordered pain medication
because the nurse does not want the patient to get addicted to the medication. What do the
nurse's actions reflect?
A.Appropriate concern for the patient's best welfare
B.Appropriate caution for a patient who is already on a long-term opioid
,C.An uncaring attitude toward the patient
D.A failure to manage the patient's pain properly
D
Patients with severe pain, including metastatic pain or bone pain, may need higher and higher
doses of analgesics. The nurse is responsible for ensuring that the patient experiences adequate
pain relief.
A patient with a history of heavy alcohol use needs a medication for pain. The recommended
maximum daily dose of acetaminophen for this patient would be
A.1000 mg.
B.2000 mg.
C.3000 mg.
D.4000 mg.
B
Chronic heavy alcohol abusers may be at increased risk of liver toxicity from excessive
acetaminophen use. For this reason, a maximum daily dose of 2000 mg is generally
recommended for these persons.
Case Study #1
You are the home health nurse assigned to care for a patient who is in the terminal phases of
breast cancer. Mrs. D. is 48 years of age and underwent bilateral mastectomy 4 years ago. She
had lymph node involvement at the time of surgery, and recently has been diagnosed with
metastasis to the bone. She has been taking one 5 mg tablet of oxycodone every 4-6 hours for
pain as needed. She is not sleeping through the night and is now complaining of increasing pain
, to the point that her quality of life has decreased significantly. She wants to stay at home during
the terminal phases of her illness but needs to have adequate and safe pain control. Her
husband of 18 years is very supportive. They have no children. They are both college graduates
and have medical insurance.
1a. Mrs. D's recent increase in pain has been attributed to bone metastasis in the area of the
lumbar spine. At this time, the oxycodone is not beneficial, and you as the home health care
nurse need to advocate for Mrs. D. to receive adequate pain relief.
Mrs. D. visits her physician and receives a different opioid medication that is given around the
clock, plus an additional medication to help with any breakthrough pain.
1b. What type of drug is given for breakthrough pain?
Generally, the drug used to manage breakthrough pain is a short-acting form of the longer-
acting opioid being given. For example, an immediate-release morphine will be used for
breakthrough pain while sustained-release morphine used for round-the-clock pain relief
1c. After 1 week, Mr. D. finds Mrs. D. awake but lethargic, and speaking with slurred words.
What do you think has happened? What should Mr. D. do?
It is possible that she has received too much opioid medication and is oversedated. Any changes
in mental status will have to be evaluated immediately to rule out other causes that may not be
related to the medications. Mr. D. needs to notify her physician immediately, and, if necessary,
take Mrs. D. to the emergency department, especially if she shows difficulty breathing. The
opioid drug dosage will have to be adjusted.
1d. Mrs. D is taken to the emergency department and is treated for oversedation. Her physician
is contacted, and the medication doses are adjusted to a lower dose. How can this problem be
prevented in the future?
