PN PHARM
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the
nurse would indicate that the desired outcome of the medication is being achieved?
Lessening of tremors
A client is prescribed a peak and trough level test for the antibiotic vancomycin (Vancocin). What time
should the specimen be collected to obtain the trough serum drug concentration?
Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose
is given
A 67-year-old client is discharged from the hospital with a prescription for digoxin (Lanoxin) 0.25 mg
daily. Which instruction should the practical nurse (PN) reinforce?
Monitoring the pulse rate for 1 minute is very important when taking digoxin (Lanoxin). The client
should be further instructed to report pulse rates lower than 60, greater than 110 beats/min, or
irregular, and to withhold the dosage until consulting with the health care provider in such cases.
Which instruction should the practical nurse (PN) reinforce when teaching a client who is receiving
phenytoin (Dilantin) for seizure control?
Brushing and flossing the teeth daily prevents gingival hyperplasia (gum disease) that is common with
long-term phenytoin (Dilantin)
The nurse reviews medications at discharge with a client who suffers from severe anxiety disorder.
Which statement made by the client indicates an understanding of the medication phenobarbital
(Luminal)?
Phenobarbital (Luminal) should be taken at the same time every day to maintain blood levels and
enhance compliance. Because of the sedative effects, it is best to take it before bedtime
The H2 receptor blocker famotidine (Pepcid) is prescribed for a client who has been taking antacids for
chronic gastritis. Which client statement indicates to the practical nurse (PN) that teaching was effective
regarding concurrent use of these medications?
When taken at the same time, antacids block the absorption of H2 receptor blockers
A healthy 58-year-old client asks the practical nurse (PN) about taking the pneumococcal vaccine
(Pneumovax). Which statement should the PN offer to the client that provides the most accurate
information about this vaccine?
The immunization is administered once to older adults or persons with a history of chronic illness.
In planning care for a client diagnosed with bacterial pneumonia, which intervention should the practical
nurse implement?
Obtain the sputum specimen before administering prescribed antibiotics.
Phenytoin (Dilantin) is prescribed for a client who has a seizure disorder. Which statement by the client
indicates to the practical nurse that the instruction about this drug has been effective?
, "I know that I should never stop taking this medication abruptly." Abruptly discontinuing the medication
can precipitate seizures.
A female client who started taking an oral sulfonamide for a urinary tract infection the previous day
reports to the nurse that the medication is causing slight anorexia. She also states that she continues to
experience urinary frequency, so she takes the medication with a small sip of cranberry juice and limits
her fluid intake. What information should the practical nurse provide?
The PN should emphasize the need to take sulfonamides with a full glass of water and to increase fluid
intake to prevent crystalluria.
A 74-year-old female client asks the practical nurse (PN) if she should get a flu shot. Which response
should the PN provide?
"Yes. Normal aging decreases your immunity, making you more susceptible to contagious diseases such
as the flu."
A client with angina pectoris is instructed to take sublingual nitroglycerin tablets PRN for chest pain.
Which information should the practical nurse (PN) reinforce with this client?
Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest
A health care provider prescribes cefadroxil (Duricef) for a client with a postoperative infection. It is
most important for the practical nurse (PN) to consider that a cross allergy is possible with what drug
allergy?
Cross allergies exist between penicillins and cephalosporins such as cefadroxil (Duricef), so checking for
penicillin allergy is a wise precaution before administering this drug.
A 75-year-old male client taking hydrochlorothiazide (HCTZ) is admitted to the hospital having
"palpitations" and "skipped heart beats." What is the most likely cause of these symptoms given the
client's medication history?
The nurse should be alert for symptoms related to hypokalemia in clients taking thiazide diuretics.
Which outcome(s) should the practical nurse (PN) expect a client to have who is receiving pregabalin
(Lyrica)? (Select all that apply.)
A decrease in joint pain resulting from osteoarthritis
Improved range of motion during physical therapy exercises
Amitriptyline hydrochloride (Elavil) is prescribed for an adult female client who is clinically depressed.
Five days after beginning the drug, the client is admitted to the hospital because of suicide ideation. She
tells the practical nurse (PN) that the drug is not working because she is not feeling any better. Which
explanation should the PN provide?
"It takes 2 to 4 weeks for antidepressant medications to become effective."
A first-day postoperative client vomits 30 minutes after receiving an IV dose of hydromorphone
(Dilaudid). What initial intervention is best for the practical nurse (PN) to implement?
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which observation by the
nurse would indicate that the desired outcome of the medication is being achieved?
Lessening of tremors
A client is prescribed a peak and trough level test for the antibiotic vancomycin (Vancocin). What time
should the specimen be collected to obtain the trough serum drug concentration?
Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose
is given
A 67-year-old client is discharged from the hospital with a prescription for digoxin (Lanoxin) 0.25 mg
daily. Which instruction should the practical nurse (PN) reinforce?
Monitoring the pulse rate for 1 minute is very important when taking digoxin (Lanoxin). The client
should be further instructed to report pulse rates lower than 60, greater than 110 beats/min, or
irregular, and to withhold the dosage until consulting with the health care provider in such cases.
Which instruction should the practical nurse (PN) reinforce when teaching a client who is receiving
phenytoin (Dilantin) for seizure control?
Brushing and flossing the teeth daily prevents gingival hyperplasia (gum disease) that is common with
long-term phenytoin (Dilantin)
The nurse reviews medications at discharge with a client who suffers from severe anxiety disorder.
Which statement made by the client indicates an understanding of the medication phenobarbital
(Luminal)?
Phenobarbital (Luminal) should be taken at the same time every day to maintain blood levels and
enhance compliance. Because of the sedative effects, it is best to take it before bedtime
The H2 receptor blocker famotidine (Pepcid) is prescribed for a client who has been taking antacids for
chronic gastritis. Which client statement indicates to the practical nurse (PN) that teaching was effective
regarding concurrent use of these medications?
When taken at the same time, antacids block the absorption of H2 receptor blockers
A healthy 58-year-old client asks the practical nurse (PN) about taking the pneumococcal vaccine
(Pneumovax). Which statement should the PN offer to the client that provides the most accurate
information about this vaccine?
The immunization is administered once to older adults or persons with a history of chronic illness.
In planning care for a client diagnosed with bacterial pneumonia, which intervention should the practical
nurse implement?
Obtain the sputum specimen before administering prescribed antibiotics.
Phenytoin (Dilantin) is prescribed for a client who has a seizure disorder. Which statement by the client
indicates to the practical nurse that the instruction about this drug has been effective?
, "I know that I should never stop taking this medication abruptly." Abruptly discontinuing the medication
can precipitate seizures.
A female client who started taking an oral sulfonamide for a urinary tract infection the previous day
reports to the nurse that the medication is causing slight anorexia. She also states that she continues to
experience urinary frequency, so she takes the medication with a small sip of cranberry juice and limits
her fluid intake. What information should the practical nurse provide?
The PN should emphasize the need to take sulfonamides with a full glass of water and to increase fluid
intake to prevent crystalluria.
A 74-year-old female client asks the practical nurse (PN) if she should get a flu shot. Which response
should the PN provide?
"Yes. Normal aging decreases your immunity, making you more susceptible to contagious diseases such
as the flu."
A client with angina pectoris is instructed to take sublingual nitroglycerin tablets PRN for chest pain.
Which information should the practical nurse (PN) reinforce with this client?
Nitroglycerin tablets should be taken at the onset of angina, and the client should stop activity and rest
A health care provider prescribes cefadroxil (Duricef) for a client with a postoperative infection. It is
most important for the practical nurse (PN) to consider that a cross allergy is possible with what drug
allergy?
Cross allergies exist between penicillins and cephalosporins such as cefadroxil (Duricef), so checking for
penicillin allergy is a wise precaution before administering this drug.
A 75-year-old male client taking hydrochlorothiazide (HCTZ) is admitted to the hospital having
"palpitations" and "skipped heart beats." What is the most likely cause of these symptoms given the
client's medication history?
The nurse should be alert for symptoms related to hypokalemia in clients taking thiazide diuretics.
Which outcome(s) should the practical nurse (PN) expect a client to have who is receiving pregabalin
(Lyrica)? (Select all that apply.)
A decrease in joint pain resulting from osteoarthritis
Improved range of motion during physical therapy exercises
Amitriptyline hydrochloride (Elavil) is prescribed for an adult female client who is clinically depressed.
Five days after beginning the drug, the client is admitted to the hospital because of suicide ideation. She
tells the practical nurse (PN) that the drug is not working because she is not feeling any better. Which
explanation should the PN provide?
"It takes 2 to 4 weeks for antidepressant medications to become effective."
A first-day postoperative client vomits 30 minutes after receiving an IV dose of hydromorphone
(Dilaudid). What initial intervention is best for the practical nurse (PN) to implement?
