BSN HESI 315 Pharmacology Practice Exam Version 4 (New 2026/ 2027 Update) Q&A |100% Correct| Grade A-Nightingale

BSN HESI 315 Pharmacology Practice Exam Version 4 (New 2026/ 2027 Update) Q&A |100% Correct| Grade A-Nightingale Q. A 38-year-old gravida 2 para 2 is diagnosed with bacterial vaginosis 9-months postpartum. A prescription is written for metronidazole. Which information is most important for the nurse to obtain from the client before initiating treatment? ANSWER Sexual history. Use of oral contraceptives. Method of infant feeding. Possibility of pregnancy. Method of infant feeding. Q. What teaching should the nurse provide a client who has received a new prescription for sildenafil? (Select all that apply.) Frequent use can lead to the development of hypertension. Most effective if taken after at least 6 hours of REM sleep. Take within 30 to 60 minutes of sexual stimulation. Report rebound priapism that occurs for 4 hours or more. Can cause facial flushing and headache. ANSWER Take within 30 to 60 minutes of sexual stimulation. Report rebound priapism that occurs for 4 hours or more. Can cause facial flushing and headache. Q. A client with chronic schizophrenia illness is admitted after taking risperidone 10 mg/day for three months. The nurse implements a daily assessment using the "Abnormal Involuntary Movement Scale" (AIMS). Which findings should the nurse report to the healthcare provider? Cogwheel rigidity. Drowsiness and dizziness. Tremors and muscle twitching. Dry mouth, constipation, and blurred vision. ANSWER Tremors and muscle twitching. Q. Miotic drug therapy for the treatment of glaucoma is based chiefly upon which physiologic action? Enhancing aqueous humor outflow. Inhibiting aqueous humor production. Maintaining intraocular pressure. Preventing extraocular infection. ANSWER Enhancing aqueous humor outflow. Q. A client with depression receives a prescription for amitriptyline. Which instruction should the nurse include in the client's teaching? Do not ingest foods with tyramine. Avoid the consumption of alcohol. Obtain daily blood pressure readings. Take with a glass of orange juice. ANSWER Avoid the consumption of alcohol. Q. A client receives a prescription for sulfamethoxazole-trimethoprim for a urinary tract infection (UTI). Which instruction should the nurse provide the client? Ingest food prior to taking the antibiotic. Drink at least 8 glasses of water a day. Take the medication with grapefruit juice. Avoid prolonged exposure to sunlight. ANSWER Drink at least 8 glasses of water a day. Q. The nurse reviews the new prescription, phenelzine, a monoamine oxidase inhibitor (MAOI), for a client on the psychiatric unit with depression. Which information is most important for the nurse to assess? Consumption of any alcohol or tyramine-rich foods. Complaints of nausea or vomiting. Therapeutic serum drug levels. Blood pressure and pulse prior to taking each dose. ANSWER Consumption of any alcohol or tyramine-rich foods. Q. A school-aged child is taking methylphenidate hydrochloride for the treatment of attention-deficit hyperactivity disorder (ADHD). The mother tells the nurse that she gives the medication at bedtime so it is "working" during school the next morning. Which modification to the administration plan should the nurse recommend to this mother? Continue administering the medication dose at bedtime. Give the medication when the child arrives at school. Take the medication with meals. Administer at least six hours before bedtime. ANSWER Administer at least six hours before bedtime. Q. A client receives a new prescription for pentazocine, a mixed opioid agonist-antagonist after an opioid agonist is discontinued. Which is the advantage for the client when the new prescription is implemented? Tolerance does not occur. Less agitation is experienced. The analgesic ceiling is higher. Used to decrease substance use disorder. ANSWER Used to decrease substance use disorder. Q. A client who is receiving chemotherapy is prescribed ondansetron. Which side effect should the nurse include in the teaching plan? Headache. Dry mouth. Impaired taste. Blurred vision. ANSWER Headache Q. The therapeutic effect of insulin in treating type 1 diabetes mellitus is based on which physiologic action? Facilitates transport of glucose into the cells. Stimulates function of beta cells in the pancreas. Increases intracellular receptor site sensitivity. Delays carbohydrate digestion and absorption. ANSWER Facilitates transport of glucose into the cells. Q. The healthcare provider prescribes oral antifungal therapy for a client with onychomycosis. Which information should the nurse tell the client? A single dose of the oral antifungal agent is usually sufficient to treat the infection. The infection is difficult to eradicate and requires prolonged therapy for 3 to 6 months. Complete eradication is important because of the risk of a systemic infection. Prolonged therapy provides no benefit and increases the risk of adverse effects. ANSWER The infection is difficult to eradicate and requires prolonged therapy for 3 to 6 months. Q. A client receives a new prescription for an angiotensin-converting enzyme (ACE) inhibitor. Which client history contraindicates its use? Asthma. Heart failure. Renal artery stenosis. Coronary artery disease. ANSWER Renal artery stenosis Q. An older client is taking warfarin sodium PO 2.5 mg twice a day. Which laboratory value should the nurse identify as a therapeutic response of the medication? INR of 2 to 3. PT of 4 seconds. PTT of 20 seconds. aPTT of 3 times normal. ANSWER INR of 2 to 3 Q. Which findings should the nurse identify in an adult client with possible chronic salicylate intoxication? Tinnitus and hearing loss. Photosensitivity and nervousness. Acute gastrointestinal bleeding and anorexia. Hyperventilation and central nervous system effects. ANSWER Tinnitus and hearing loss (sxs of salicylate poisoning) Q. While reviewing the client's electronic medical record (EMR), the nurse assesses a client who is at risk for a possible interaction with an over-the-counter (OTC) decongestant. Which client health history should the nurse report to the healthcare provider concerning the OTC medication? (Select all that apply). Type I diabetes mellitus (DM). Closed angle glaucoma. Chronic hypertension. Rheumatoid arthritis. Crohn's disease. ANSWER Closed-angle glaucoma Chronic hypertension Q. A client at 30 weeks gestation is in preterm labor. The healthcare provider prescribes two 12-mg doses of betamethasone intramuscularly every 12 hours. The client asks the nurse why she is receiving betamethasone. Which information should the nurse use to explain the action of the medication? Suppresses uterine contractions. Stimulates fetal surfactant production. Reduces maternal and fetal tachycardia associated with terbutaline administration. Maintains adequate maternal respiratory effort and ventilation with magnesium administration. ANSWER Stimulates fetal surfactant production. (Bethamethasone is a corticosteroid used in preterm labor) Q. Which statement by a client warrants further instruction by the nurse about the changing insulin needs of a diabetic client during pregnancy? "Episodes of hypoglycemia are more likely to occur during the first 3 months." "I will increase my insulin dosage by 5 units each month during the first trimester." "Insulin dosage will likely need to be increased during the second and third trimesters." "Breastfeeding will decrease my insulin needs to lower than my prepregnancy levels." ANSWER "I will increase my insulin dosage by 5 units each month during the first trimester." Q. A client is taking cyclosporine for renal allograft rejection prevention. After 9 months of drug therapy, the nurse reviews laboratory data and notes that the blood urea nitrogen level is 36 mg/dl. What additional finding should the nurse identify? Hypotension. White blood cell count 10,000. Creatinine 2.8 mg/dl (0.25 mmol/L). Anaphylactic reaction. ANSWER Creatinine 2.8 mg/dl (0.25 mmol/L). (normal range 0.6-1.2 mg/dl.) Q. A pediatric client who has been diagnosed with partial seizures receives a prescription for topiramate. Which information should the nurse provide to the child's parents? Do not crush the tablet prior to administration. Give the medication with 8 oz of orange juice. Avoid prolonged exposure to direct sunlight. Administer the tablet an hour before meals. Submit ANSWER Do not crush the tablet prior to administration. Q. A client diagnosed with multiple sclerosis is experiencing profound weakness, blurry vision, and shooting pains in both legs. Which medication is considered the best course of treatment for the nurse to administer? High dose methylprednisolone intravenously. Baclofen three times a day. Broad spectrum antibiotic coverage orally. Immunomodulatory drug therapy periodically. ANSWER High dose methylprednisolone intravenously. (for acute relapses in MS) A client receives a prescription for esomeprazole for heartburn. Which finding in the client's history should the nurse report to the healthcare provider before administering the prescription? Eats spicy food three times a week. History of deep vein thrombosis. Drinks 2 alcoholic beverages on weekends. Family history of diabetes mellitus. History of deep vein thrombosis. (this is a PPI, has been associated with an increased risk of blood clots.) A client who takes a statin and gemfibrozil for hyperlipidemia reports the onset of muscle pain and weakness. Which additional assessment is most important for the nurse to obtain? Serum liver enzymes. T3 and T4 blood levels. Bowel function. Peripheral sensation. Serum liver enzymes. A client asks the nurse to explain the meaning of a narrow therapeutic index of a medication. Which information should the nurse use to answer the question? The onset of action for the medication occurs very quickly. A small margin exists between safe and toxic plasma levels. Bioavailability is significantly reduced by the first-pass effect. Minimum dosage is needed for the medication to be effective. A small margin exists between safe and toxic plasma levels. (the difference between the dose that produces a therapeutic effect and the dose that causes toxicity is minimal) A client who uses ipratropium reports having nausea, blurred vision, headaches, and insomnia after using the inhaler. Which action should the nurse implement first? Withhold medication and report symptoms and vital signs to the healthcare provider. Give PRN medication for nausea and vomiting and evaluate client in 30 minutes. Reassure client that the ipratropium given will alleviate the symptoms. Delay administration of ipratropium until next maintenance medication is scheduled. Withhold medication and report symptoms and vital signs to the healthcare provider. Which is the expected outcome of esomeprazole when prescribed for a client with gastroesophageal reflux disease (GERD)? Promotion of rapid tissue healing. Increased gastric emptying. Improved esophageal peristalsis. Neutralization of gastric secretions. Promotion of rapid tissue healing. A client with chronic gouty arthritis takes allopurinol and experiences an acute attack of gouty arthritis. The healthcare provider prescribes concurrent low-dose colchicine. Which information should the nurse provide the client that best explains the action of the colchicine? Acts like aspirin to relieve pain. Facilitates the excretion of uric acid. Reduces inflammation at the affected site. Prevents formation of uric acid crystals. Reduces inflammation at the affected site. (Inhibits the inflammatory response to the presence of urate crystals in the joints) A client is taking danazol for endometriosis and calls the clinic nurse to complain of a dark, swollen, and painful leg. Which instructions should the nurse provide the client? Wear support stockings. Elevate both legs and apply heat. Proceed to the closest emergency room. Walk for 20 to 30 minutes to reduce muscle cramps. Proceed to the closest emergency room. (possible DVT) Which action should the nurse implement to provide analgesic titration for a client in pain? Teach the client to increase the time range between doses of pain medication. Monitor the effects of continuous intravenous infusion of narcotic analgesics. Plan with the client how to use a specific total dose of analgesic over a 24-hour period. Determine the optimal analgesic dosage required that causes the least side effects. Submit Determine the optimal analgesic dosage required that causes the least side effects. A resident of a long-term care facility is taking lithium carbonate to treat bipolar disorder. Which instruction should the nurse provide to this client's caregivers? Offer the morning dose of the medicine before breakfast. Have the client chew the pill if it is difficult to swallow. Encourage high energy fluid intake by providing sports drinks or sodas. Report symptoms of hypothyroidism such as fatigue and constipation. Report symptoms of hypothyroidism such as fatigue and constipation. (lithium carbonate can lead to hypothyroidism as a side effect) 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? Take 2 pills a day for 2 days and use an alternate method of contraception for 7 days. Quit the pills for this cycle, use an alternate method of contraception, and resume pills on the fifth day of menstruation. Take one extra pill per day for the rest of this cycle, then resume taking pills as usual next cycle. Take 4 pills now and use an alternate method of contraception for the rest of this cycle. Submit Take 2 pills a day for 2 days and use an alternate method of contraception for 7 days. Which common side effect should the nurse alert a female client about when medroxyprogesterone is prescribed? Leg or calf pain. Headaches or visual changes. Vaginal bleeding after discontinuing the medication. Jaundice during the first 3 weeks of administration. Vaginal bleeding after discontinuing the medication. (Approximately 3 to 7 days after the last cyclic dose of medroxyprogesterone, a female client may experience withdrawal vaginal bleeding.) A male client with meningitis is prescribed cefotaxime IV and asks the nurse why he cannot receive an oral drug, such as cefaclor or cefadroxil, that he has taken before for infections. How should the nurse respond when considering the actions of cephalosporins? Cefazolin is another IV antibiotic that can be prescribed. Cefaclor is a good alternative to suggest to the healthcare provider. Cefadroxil is usually prescribed when the IV is discontinued. Cefotaxime provides therapeutic CNS concentrations. Submit Cefotaxime provides therapeutic CNS concentrations. (IV administration of these antibiotics is the preferred route of administration due to oral administration medication levels tend to be too low to be effective in comparison to parental administration.) A client who was recently diagnosed with myasthenia gravis receives a prescription for pyridostigmine, a cholinergic agent. Which information should the nurse instruct the client to implement when taking this medication? Always take with meals to avoid gastrointestinal distress. Plan the doses close together for maximal therapeutic effect. To report muscle weakness or bradycardia. Avoid dairy products two hours before and after taking medications. To report muscle weakness or bradycardia. (could indicate cholinergic crisis or underdosing.) Which drug of choice is indicated for acute ventricular dysrhythmias associated with myocardial infarction? Diltiazem. Bretylium. Amiodarone. Adenosine. Submit Amiodarone. (amiodarone is the drug of choice for acute ventricular dysrhythmias associated with myocardial infarction.) A client is diagnosed with peptic ulcer disease and receives a prescription for esomeprazole 20 mg capsule daily. When providing this client with discharge teaching, the nurse should include which instruction? Drink fluids between meals to relieve gastric distress. Monitor for an increase in blood pressure during therapy. Dissolve capsule contents in fruit juice for easier ingestion. Take at same time each day one hour before eating a meal. Take at same time each day one hour before eating a meal. A male client who is in the terminal stage of cancer is cared for at home by his family and receives a prescription for morphine at a rate to control intractable pain. When the hospice nurse visits, the client awakens, moans in severe pain, and asks for an increase in the morphine dosage. After determining the client's respirations are 10 per minute, what is the best action for the nurse to implement? Titrate the morphine dose upward until the client has adequate pain relief. Suggest to the family that they can also give the client ibuprofen, a non-narcotic analgesic. Hold additional morphine until the client's respirations are at least 16 per minute. Inform the client that an increased dose of morphine increases side effects without additional pain control. Titrate the morphine dose upward until the client has adequate pain relief. A client with pneumonia receives a prescription for tetracycline. Which precaution should the nurse include in this client's teaching? Take the medication with a glass of orange juice. Avoid over-the-counter medications containing alcohol. Avoid dairy products for 2 hours after taking the medication. Do not use teeth whitening agents during the treatment regimen. Avoid dairy products for 2 hours after taking the medication. (Dairy products should not be ingested until at least 2 hours after taking tetracycline because the calcium from the dairy binds with tetracycline and decreases the medication's absorption.) An emergency department triage nurse is interviewing a female client who has a history of epilepsy with tonic-clonic seizures controlled by phenytoin. Which information is most significant in planning this client's care? She has missed 2 menstrual periods. She has had no dental care for several years. She ran out of her medication 4 days ago. She has smoked 3 packs of cigarettes a day for 10 years. She ran out of her medication 4 days ago. (Crucial, stopping this med abruptly can lead to increased seizure frequency.) The nurse should expect the healthcare provider to prescribe which treatment regimen for a client with a peptic ulcer caused by Helicobacter pylori ? (Select all that apply.) Clarithromycin. Sulfisoxazole. Misoprostol. Omeprazole. Metronidazole. Sucralfate. Clarithromycin Omeprazole Metronidazole (Recommended medical treatment for Helicobacter pylori includes the use of at least 2 different antibiotics and a proton pump inhibitor to decrease the incidence of antibiotic resistance.) The nurse receives a unit of blood from the blood bank for a postoperative client who is currently in the X-ray department. Which action should the nurse implement? Return the blood to the blood bank for refrigeration within 30 minutes. Hang the blood transfusion as soon as the client returns to the unit. Store the blood bag in the nursing unit's refrigerator until the client returns. Take the unit of blood to the X-ray department to initiate the transfusion. Return the blood to the blood bank for refrigeration within 30 minutes. The nurse administers the initial dose of a fentanyl transdermal patch to a client with chronic pain. When monitoring the client an hour later, which assessment is most important for the nurse to obtain? Level of consciousness. Moistness of mucosa. Bowel sound activity. Numeric pain scale. Numeric pain scale. When prescribed for a client with hepatic encephalopathy, which is the therapeutic action of lactulose? Lowers the pH of the colon. Softens the stool. Increases glucose absorption. Stimulates peristalsis. Lowers the pH of the colon. What pathophysiological action supports the expected outcome for a client with chronic cancer pain who is treated with imipramine, a tricyclic antidepressant? Increases pain threshold by stimulating opiate receptors in the CNS to release of endogenous enkephalins. Decreases perception of pain by blocking opiate receptors in the brain and descending inhibitory nerves. Decreases transmission of pain impulses by altering serotonin and norepinephrine activity at nerve synapses. Increases pain tolerance through relief of depression by increasing the amounts of norepinephrine in the brain. Decreases transmission of pain impulses by altering serotonin and norepinephrine activity at nerve synapses. (Tricyclic antidepressants reduce neuropathic pain due to cancer invasion by blocking the reuptake of serotonin and norepinephrine in the CNS) The healthcare provider prescribes pyridostigmine bromide tablets for a client with myasthenia gravis (MG). Which instruction should the nurse provide this client? Increase activity in the afternoon when the medication is most effective. That the medication is not a cure, but it does relieve symptoms. Use a PRN dose for increasing muscular weakness or fasciculations. Give the client a dietary guide that describes low-protein foods. That the medication is not a cure, but it does relieve symptoms. Which is the effect of beta-blocking agents when used for the treatment of glaucoma? Inhibiting aqueous humor production. Enhancing aqueous humor outflow. Increasing intraocular pressure. Preventing extraocular infection. Inhibiting aqueous humor production. (Beta-blockers are used to inhibit aqueous humor production, and the goal is to reduce intraocular pressure.) A client is beginning therapy with montelukast PO 10 mg once a day in the evening. The client asks the nurse, "When should I begin to feel better?" How should the nurse respond? Immediately. Peak is 3-4 hours with duration of 24 hours. In about 12 hours. 30 minutes to 1 hour. Peak is 3-4 hours with duration of 24 hours. A client who has Trichomonas vaginalis receives a prescription for metronidazole. Which instruction should the nurse provide during client education? Do not ingest with dairy products. Notify the clinic if the urine changes color. Obtain liver function tests every 3 months. Avoid over-the-counter antitussives. Avoid over-the-counter antitussives. A client is admitted for atrial fibrillation, and the healthcare provider prescribes disopyramide. After explaining the action of this antidysrhythmic agent, which complaint should the nurse instruct the client to report? Joint pain. Dizziness or muscle weakness. Daily weight gain of 2 pounds. Dry mouth. Daily weight gain of 2 pounds. (fluid retention r/t poor cardia output.) A healthcare provider prescribes cefadroxil for a client with a postoperative infection. It is most important for the nurse to assess for which additional drug allergy before administering this prescription? Penicillin's. Aminoglycosides. Erythromycins. Sulfonamides. Penicillin's. (Cross-allergies exist between penicillins and cephalosporins, such as cefadroxil, so checking for penicillin allergy is a wise precaution before administering this drug.) A client with chronic pancreatitis receives a new prescription for pancrelipase. Which instruction is most important for the nurse to include in this client's teaching? Avoid prolonged exposure to direct sunlight. Stay away from products containing alcohol. Ingest 8 oz of grapefruit juice with the medication. Take the medication when consuming food. Take the medication when consuming food. (pancrelipase needs to be taken with meals or snacks to help with the digestion of food properly.) The nurse should withhold which medication if a client reports nausea, vomiting, and diarrhea? Colchicine. Erythromycin. Naproxen. Labetolol. Colchicine. (Associated with GI side effects, N/V/D can indicate toxicity.) The mother of a newborn asks the nurse why her infant needs the vitamin K injection. Which information should the nurse provide? Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract. Oral vitamin K impedes the synthesis of clotting factors in the liver. The maternal diet is often deficient in vitamin K, so the infant is also deficient in the vitamin. The synthesis of vitamin K is inadequate for 3 to 4 months in the newborn. Bacteria that synthesize vitamin K are not present in the newborn's intestinal tract. A client who is diagnosed with methicillin-resistant Staphylococcus aureus receives a prescription for vancomycin. Which assessment should the nurse perform to identify a potential adverse effect? Whisper test. Romberg test. Tactile discrimination. Skin turgor. Whisper test. (Assesses hearing acuity and is related to potential ototoxicity. Vanco can cause damage to the inner ear.) A client is receiving fentanyl via an epidural infusion. Which side effect should the nurse anticipate in the first 24 hours of epidural analgesia? Headache. Agitation. Urinary retention. Abdominal cramping and diarrhea. Urinary retention. The nurse should instruct a client to avoid which product while taking carisoprodol for muscle spasms? Aspirin products. Antacids. Alcoholic beverages. Dairy products. Alcoholic beverages. Which route should the nurse clarify with the healthcare provider prior to administering a drug with a high first-pass effect? Oral. Buccal. Sublingual. Intravenous. Oral. (The first-pass effect occurs when hepatic metabolism decreases the bioavailability of a drug. Oral forms of medications are processed through the GI tract, absorbed through the small intestines, and undergo the first-pass effect in the liver in which some of the active ingredients are removed from the drug before it reaches the intended site of action.) Which side effects should the nurse monitor for a client who is receiving dexamethasone following neurosurgery? (Select all that apply.) Mood swings. Decreased appetite. Increased weight gain. Serum glucose level of 65 mg/dl. Delayed incisional wound healing. Serum hemoglobin level of 9 mg/dl. Mood swings Increased weight gain Delayed incisional wound healing Serum hemoglobin level of 9mg/dl. The nurse is providing medication teaching for a client who has recently received a prescription for clozapine. Which instruction should be included in this client's teaching plan? Avoid prolonged sun exposure. Rise slowly from a lying position. Do not eat any aged cheese. Take as needed for anxiety. Rise slowly from a lying position. (can cause orthostatic hypotension) When assessing a client prior to the administration of digoxin, which data is most important for the nurse to consider? Presence of a grade 2 murmur. Nailbed capillary refill of 5 seconds. Irregular apical pulse with a rate of 87. Bilateral lower extremity dependent rubor. Irregular apical pulse with a rate of 87. (AP must be 60 for adults and 90 for infants) The healthcare provider discontinues prednisone, a glucocorticoid, for a client with chronic obstructive pulmonary disease. Which instructions should the nurse give the client about the regimen to follow? Life-long treatment is common for chronic disease. The drug should be stopped immediately if no longer needed. The dose must be tapered over the course of 7 to 10 days. Another glucocorticoid should be used to prevent cross-tolerance. The dose must be tapered over the course of 7 to 10 days. The healthcare provider has prescribed digoxin for a client who has been taking furosemide for six months. What laboratory serum levels should the nurse review before administering the digoxin? Calcium. Magnesium. Potassium Furosemide. Potassium. (furosemide can cause hyperkalemia) The healthcare provider prescribes 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? Zolpidem 10 milligrams orally at bedtime. Eszopiclone 10 milligrams orally at bedtime. Temazepam 7.5 milligrams orally at bedtime. Ramelteon 8 milligrams orally at bedtime. Eszopiclone 10 milligrams orally at bedtime. (The dose of this med is usually started off at 1mg at bedtime and max 3mg.) Based on the blood culture and sensitivity results, the healthcare provider prescribes an IV aminoglycoside antibiotic and discontinues the current prescription for another broad-spectrum antibiotic. The medication administration record indicates that the client received the broad-spectrum antibiotic two hours ago. Which action should the nurse implement? Obtain peak and trough serum levels so the aminoglycoside antibiotic can be initiated. Administer the initial dose of the aminoglycoside antibiotic as soon as possible. Withhold antibiotic administration until the healthcare provider clarifies the prescriptions. Schedule the initial dose of the aminoglycoside antibiotic for the following day. Administer the initial dose of the aminoglycoside antibiotic as soon as possible. (most effective treatment) A client receives a new prescription for nitroglycerin tablets. Which instruction should the nurse include in this client's teaching? Take the medication at least an hour before every meal. Monitor your pulse for 60 seconds before administration. Place under the tongue as needed every 5 minutes up to 3 times. Resume normal activities after chest pain relief is obtained. Place under the tongue as needed every 5 minutes up to 3 times. A female client receives a prescription for cefadroxil for a urinary tract infection. The client informs the nurse that she is currently taking oral contraceptives (OCP). Which information is important for the nurse to share with the client? The antibiotic may be less effective while taking OCP. The medication combination potentiates the risk of adverse reactions. Avoid prolonged sun exposure while taking the antibiotic. Use an additional form of contraception until your menstrual cycle. Use an additional form of contraception until your menstrual cycle. A 48-year-old client is experiencing a severe anaphylactic reaction to an injection of contrast media. Which pharmacologic agent is of greatest use in this situation? Dopamine. Loratadine. Nitroprusside. Epinephrine. Epinephrine. The nurse is administering haloperidol 0.5 mg IM PRN to a client for the first time. What side effects should the nurse assess the client for during the initial dose? Bradykinesia. Dystonia. Somatization. Akathisia. Dystonia. A client receives a new prescription for ciprofloxacin, a synthetic quinolone. When teaching about this drug, which information in the client's history requires special emphasis by the nurse? Snacks on dairy products such as yogurt or ice cream. Previously had a mild allergic reaction to a cephalosporin. Consumes alcoholic drinks occasionally on the weekends. Works twenty hours a week as a lifeguard at the local pool. Works twenty hours a week as a lifeguard at the local pool. (can cause photosensitivity) A client is taking sulfisoxazole for a urinary tract infection (UTI) and complains of nausea and gastric upset since starting the medication. Which additional adverse reaction should the nurse instruct the client to report? Rash. Diarrhea. Hematuria. Muscle cramping. Rash. A client with Paget's disease is started on calcitonin 500 mcg subcutaneously daily. During the initial treatment, which is the priority nursing action? Assess the injection site for inflammation. Evaluate the client's level of pain. Monitor the client's alkaline phosphatase levels. Observe the client for signs of hypersensitivity. Observe the client for signs of hypersensitivity. A client with rheumatoid arthritis is receiving a prescription for minocycline. Which side effect is most important for the nurse to instruct the client to report? Loss of balance and dizziness. Nausea and vomiting. Headache and mouth sores. Abdominal pain and diarrhea. Loss of balance and dizziness. (can cause damage to inner ear, would be dizzy and unable to balance.) The nurse is caring for a client who has taken atenolol for 2 years . The healthcare provider recently changed the medication to enalapril to manage the client's blood pressure. Which instruction should the nurse provide the client regarding the new medication? Rise slowly when getting out of the bed or chair. 3 multiple choice options A female client calls the clinic and inquires about a possible reaction after taking amoxicillin for 5 days. She reports having vaginal discomfort, itching and white discharge. The nurse should discuss which action with the client? Consult with a healthcare provider about another treatment for this effect. 3 multiple choice options NGN- The nurse is making rounds on a group of clients when one begins exhibiting symptoms of an acute asthma attack. The nurse administers a PRN prescription for a short- acting Beta- 2 receptor agonist. Which client responses should the nurse expect? SATA Rapid resolution of wheezing Improved pulse oximetry values 3 multiple choice options A client prescribed atenolol has a blood pressure of 120/68 mmhg, sinus bradycardia with a rate of 58 bpm , and a PR interval of 0.24. Which action should the nurse take? Give the medication as prescribed and continue to monitor the client. 3 multiple choice options The nurse is preparing the 0900 dose of losartan (Cozaar), an ARB, for a client with hypertension and heart failure. The nurse notes the serum potassium is 5.9 mEq/L. Which action should the nurse take first? Withhold the scheduled dose. 3 multiple choice options NGN- A client with acute status asthmatics is prescribed a series of medication. Salmeterol (Serevent Diskus) Albuterol (Proventil) puffs Gentamicin (Garamycin) IM Prednisone (Deltasone) orally Question: In which order should the nurse administer these medications? 1) Albuterol (Proventil) 2) Salmeterol (Serevent diskus) 3) Prednisone( Deltasone) Orally 4) Gentamicin (Garamycin) IM A client is given a prescription for scopolamine patch to prevent motion sickness while on a cruise. Which information should the nurse provide? Apply the patch at the least 4 hours prior to departure 3 multiple choice options A client with giardiasis is prescribed metronidazole (Flagyl) 2 grams PO. Which information should the nurse include? Take the medication with food. 3 multiple choice options A female client with rheumatoid arthritis takes ibuprofen 600 mg PO four times a day. To prevent GI bleeding, misoprostol (Cytotec) 100 mcg PO is prescribed. Which teaching is most important? Use contraception during intercourse. 3 multiple choice options A client with osteoarthritis get a new prescription for celecoxib (Celebrex). The client has a sulfa allergy. Which action is most important before administering? Notify the healthcare provider. 3 multiple choice options A client with a new onset SVT is prescribed digoxin. For which lab result should the nurse contact the HCP immediately? K+ = 3.1 mEq/L 3 multiple choice options The nurse is transcribing a new prescription for spironolactone (aldactone) in a client take an ACE inhibitor. Which action should the nurse implement? Verify both prescriptions with the HCP 3 multiple choice options A client has a tumor-induced spinal cord compression. Which medication should the nurse anticipate for the best palliative treatment? Dexamethasone 3 multiple choice options The nurse prepares an education session for a client taking long-term opioids for cancer pain. Which common side effect should the nurse include strategies to prevent? Constipation 3 multiple choice options A client is prescribed controlled-release oxycodone. Which dosing schedule is best? Every 12 hours 3 multiple choice options Which client is at highest risk of complication during opioid analgesic use? Young adult with Inflammatory bowel disease 3 multiple choice options Which medications should the nurse caution the client about taking while on an opioid analgesic? Benzodiazepines 3 multiple choice options A client is prescribed dobutamine 1 mcg/kg/min via IV infusion. Which client condition would benefit most from dobutamine? Heart failure 3 multiple choice options A client is experiencing anaphylaxis from an insect sting. Which medication should be administered? Epinephrine 3 multiple choice options The HCP prescribes a beta 1-agonist. For which diagnosis should the nurse anticipate its use? Heart failure 3 multiple choice options An older client with decreased lean body mass is admitted. Which pharmacokinetic process is primarily affected and impacts dosing? Distribution 3 multiple choice options A category x drug is prescribed for a young adult female. Which is most important? Use a reliable form of birth control. 3 multiple choice options A client is discharged on an antibiotic with a dosage " three times higher" than in the the hospital. Which route should the nurse anticipate for the greatest first-pass effect? Oral 3 multiple choice options The HCP prescribes naproxen twice daily for osteoarthritis. After three weeks the client says it " isn't effective". Which nurse response is best? "Another NSAID may be indicated " 3 multiple choice options After abdominal surgery, a client prescribed low molecular weight heparin (LMWH). The client asks why. Which is the best nurse response? "The medication prevents blood clot formation" 3 multiple choice options A client with heart failure is prescribed spironolactone. Which diet modification is most important? Refrain from eating foods high in potassium. 3 multiple choice options A client receiving IV doxorubicin complains of pain at the IV site, and the nurse notes edema there . Which intervention is most important? Discontinue the IV fluids. 3 multiple choice options A client with acute myocardial infarction is admitted. Which medication lessens cardiac workload by decreasing preload and afterload? Nitroglycerin 3 multiple choice options NGN- A female client who just received oral metronidazole (Flagyl) for trichomonas vaginalis asks for instructions. Which statements should the nurse include? SATA Increase fluid intake, especially cranberry juice Avoid drinking alcohol while taking this medication Use condoms until treatment is complete Ensure all sexual partners are treated as well 3 multiple choice options A client with hyperlipidemia receives niacin (Niaspan). Which teaching is most important? Expected duration of flushing 3 multiple choice options The nurse is planning discharge instructions for client on cyclosporine post-liver transplant. Which adverse reaction should be reported immediately? Hand tremors 3 multiple choice options A client has been taking oral hydromorphone every 4 hours at home. Post-surgery, the provider prescribes hydromorphone IV and butorphanol IV PRN every 4 hours. If the client request pain medication and the last dose of IV hydromorphone was 4 hours ago, which intervention should the nurse implement? Administer on IV hydromorphone. 3 multiple choice options Which data change suggests the ARB valsartan is achieving its desired effect? BP reduced 160/90 - 130/80 3 multiple choice options A client with coronary artery disease on digoxin receives a new prescription for atorvastatin. Two weeks later , which finding needs immediate intervention? Vomiting 3 multiple choice options Isosorbide dinitrate is prescribed for a client with angina . Which instruction should the nurse include? Do not get up quickly; always rise slowly. 3 multiple choice options The nurse reviews admission prescriptions for a client with myxedema. Which order requires clarification? Pentobarbital sodium for sleep. 3 multiple choice options A client is prescribed propranolol. Which symptoms should be reported immediately? Wheezing, hypotension, AV block 3 multiple choice options A client asks " is glipizide (Glucotrol) an oral insulin? " Which response by the nurse is correct? " No, it is not an oral insulin and can be used only if so beta cell function is present" 3 multiple choice options Which intervention is most important when caring for a client receiving the antimetabolite cystosine arabinoside (ARa-C)? Inspect the oral mucosa for ulcerations. 3 multiple choice options A 43 year -old female client is prescribed thyroid replacement hormone post-thyrodiectomy. Which adverse effects warrant immediate reporting? Tachycardia and chest pain 3 multiple choice options A client taking albuterol tablets report nausea nightly with the 9 pm dose. Which action can reduce this side effect? Give the dose with a snack. 3 multiple choice options NGN(Peak and Trough Measurement) A client receiving antibiotic therapy, has peak and trough levels ordered. When should the nurse obtain the trough? Immediately before the next dose. 3 multiple choice options A client is prescribed ampicillin for sinus infection. Which symptom requires notifying the HCP immediately? Rash 3 multiple choice options A client states, " I'm allergic to penicillin." The nurse should ask about a related allergy to: Cephalosporins 3 multiple choice options A client with Parkinson's previously on TID levodopa is switched to sustained- release levodopa/carbidopa BID, with the last dose of plain levodopa at 0800. Which instruction is correct? "Begin the evening, but do not take any more plain levodopa." 3 multiple choice options A client with possible myasthenia gravis is to receive IV edrophonium (Tensilon). Which outcome is expected? Decreased muscle weakness 3 multiple choice options The provider prescribes naloxone (Narcan) for a client in the ER. Which data indicates naloxone was effective? Respiratory rate is 16 breaths/ min 3 multiple choice options A PCA order for morphine 1 mg IV/ hr basal + 1mg IV q 15 mins PRN, total max 5 mg/hr. Which is the highest priority before initiating PCA? Assess the client's respiratory rate and depth. 3 multiple choice options An 88 year-old on high-dose aspirin for arthritis complains of ringing in the ears. Which action is priority? Notify the HCP immediately. 3 multiple choice options Which antidiarrheal must be used cautiously in clients taking high-dose aspirin? Bismuth subsalicylate (Pepto-Bismol) 3 multiple choice options Assessing an adolescent who overdosed on acetaminophen, it is most important to assess for pain in which area? Abdomen 3 multiple choice options A client's isosorbide dinitrate is increased from 40 mg to 60 mg PO daily. The client reports headache before the next dose. Which action is best? Give 60 mg and PRN acetaminophen. 3 multiple choice options A client has morphine 2.5 mg IV q6h and ketorolac 30 mg IV q6h. Which action is correct? Give both as prescribed. 3 multiple choice options A client is receiving methlyprednisolone 40 mg IV daily. Which lab should the nurse monitor most closely? Serum glucose 3 multiple choice options A client has a clonidine 0.1 mg/ 24 hr transdermal patch. Which finding indicates the desired effect? BP from 180/120 to 140/70 3 multiple choice options A client on atorvastin (Lipitor) for a month calls complaining of leg muscle pain and weakness. Which statement is correct? " Make an appointment; muscle pain may be serious" 3 multiple choice options Which nursing diagnosis is important for a client or irbesartan (Avapro) an ARB? Risk of Injury 3 multiple choice options A client on a continuous IV of dopamine plus 50 ml/hr NA shows UO of 20 ml/hr x2 hours. Which intervention first? Notify the provider of decreased UO. 3 multiple choice options Which action is most important before giving the antiarrhythmic adenosine? Apply continuous cardiac monitoring. 3 multiple choice options A client with a dysrhythmia is prescribed procainamide in four divided doses over 24 hours. Which schedule is best? Every 6 hours The nurse administers metoprolol to a client. Which assessment is most important? blood pressure 3 multiple choice options A client with osteoporosis on alendronate (Fosamax) has completed teaching. Which morning schedule indicates understanding? Take med, remain upright, walk, then eat in 30 mins 3 multiple choice options A post- op client on meperidine 35 mg/ hr IV for four days becomes restless, irritable, and hallucinates. Which action is first? Decrease the meperidine infusion. 3 multiple choice options A client discharging on warfarin post-pulmonary embolism should have which test monthly? Prothrombin time (PT) 3 multiple choice options A client with Parkinson's on carbidopa-levodopa. which observation shows the drug is effective? Lessening of tremors 3 multiple choice options A client with hyperthyroidism on propylthiouracil (PTU) asks, "How does it work?" Best response? It inhibits the synthesis of T3 and T4 3 multiple choice options A client with heart failure is discharged on captopril (Capoten). Which problem should be reported immediately? Dizziness 3 multiple choice options After sublingual nitroglycerin for acute angina, which finding indicates desired effect? A client states chest pain is relieved 3 multiple choice options The HCP prescribes digoxin for a client with heart failure. Which intervention is essential prior to administration? Assess serum potassium 3 multiple choice options Evaluating lactulose (cephulac) effects, which outcome indicates the drug is working? Two or three soft stools per day 3 multiple choice options A client is prescribed aluminum hydroxide for PUD. Which statement indicates correct understanding? It helps maintain a gastric PH of 3.5 or above 3 multiple choice options A male client using long-term opioid pain management for chronic back pain asks why it's not as effective as before. Best nurse response? "Pharmacodynamic tolerance requires increased drug levels to achieve the same effect." 3 multiple choice options Discharge instructions for a client on a hepatotoxic antibiotic. Which teaching is most important? Avoid alcohol or acetaminophen. 3 multiple choice options A client with mild Parkinsonism is started amantadine (Symmetrel). Which statement best describes its actions? It increases dopamine in the CNS 3 multiple choice options A female client on long-term corticosteroids takes her dose at bedtime with crackers/milk. Which is best nurse response? Taking medication in the morning is preferred. 3 multiple choice options A female client with myasthenia gravis taking a cholinesterase inhibitor asks how to handle her fatigue/dysphagia. Which is corrrect? Develop a plan to self- adjust the dose in response to symptoms. 3 multiple choice options A female client on minocycline (Minocin) for acne is taught about the drug. Which statement should be included? "Oral contraceptives may not be effective." 3 multiple choice options A client with trichomoniasis is given metronidazole (Flagyl). Which teaching is most important? Avoid alcohol consumption. 3 multiple choice options The nurse evaluates a client's understanding of lovastatin (Mevacor). Which statement shows a need for further teaching? "I will take it every day before breakfast." 3 multiple choice options An older client post-colon resection is receiving a constant dose of hydromorphone PCA. Which finding is most significant and requires intervention? Respirations decrease to 14/ min 3 multiple choice options A client receives a daily antihypertensive. Which action is most important prior to administration? Obtain the client's blood pressure. 3 multiple choice options Which newly admitted client is at greatest risk for adverse medication reactions? 75 year-old female with liver disease 3 multiple choice options NGN- A client post-hip replacement is prescribed enoxaprin ( Lovenox) 30 mg/ 0.3 ml "IV" every 12 hours. Before first dose, which is most important? Contact HCP to clarify route. 3 multiple choice options The nurse prepares a care plan for a client on methylprednisolone (Solu-Medrol). Which nursing diagnosis reflects a problem with this med? Risk for infection 3 multiple choice options A client notes their oral opioid dose at discharge is higher than the IV dose in the hospital. Which explanation is best? "Oral drugs are not 100% absorbed; a higher dose is needed." 3 multiple choice options Calculation- Amoxicillin 500 mg PO q8h is prescribed. Available: 125 mg/5ml. How many ml per dose? 20 mL Minocycline (Minocin) 50 mg PO q8h is prescribed. Which teaching points should be included? Report vaginal itching/discharge Protect skin from UV exposure Avoid driving until response is known Use a non hormonal contraceptive if sexually active. 3 multiple choice options Carbamazepine (Tegretol) is ordered for a child with poorly controlled tonic clonic seizures. The nurse explains weekly blood tests are needed. Which complication do these labs assess? Myelosuppression 3 multiple choice options A 67 year old is discharged on digoxin 0.25 mg daily. Which instruction should be in the teaching plan? "Record your radial pulse daily." 3 multiple choice options A pediatric client is discharged with multiple prescriptions. Which info is most helpful for parents to manage these regimens? Maintain a drug administration record 3 multiple choice options A hypertensive client on hydrochlorothiazide (HCTZ) should report which symptoms? Fatigue, muscle weakness 3 multiple choice options A client with ulcerative colitis is discharged on sulfasalazine (Azulfidine). Which teaching is most important? Drink eight glasses of fluid daily 3 multiple choice options Which parameter is most important before giving SQ heparin? aPTT 3 multiple choice options A client with myasthenia gravis (MG) is on pyridostigmine bromide (Mestinon). Which intervention is highest priority? Assess respiratory status frequently 3 multiple choice options Planning peak and trough levels for gentamicin, when should the nurse obtain peak? 30 minutes after dose infusion 3 multiple choice options A client on continuous IV heparin is hemorrhaging. Which medication reverses heparin? Protamine sulfate 3 multiple choice options A client with ALL starts chemotherapy today. The HCP prescribes ondansetron IV 30 minutes before cisplatin. the rationale? Eliminate, reduce nausea and vomiting 3 multiple choice options A client is prescribed cisplatin (Plattinol) in D5 1/2 NS with mannitol's effectiveness? Urine output 3 multiple choice options Which factor is most important to ensure compliance when teaching a client about a drug regimen? Client education 3 multiple choice options A client with acute MI is to receive altep;ase (Activase). Which explanation is correct ? It's a clot buster that dissolves clots in the coronary artery. 3 multiple choice options See 10 more You can also click the terms or definitions to blur or reveal them Review with an activity