pharm 2 exam review questions complete solution with rationales
1. A nurse is teaching a client who has a new prescription for ferrous sulfate. Which of the following
statements by the client indicates need for additional teaching?
INCORRECT
A. "I will expect the color of my urine to be amber."
Rationale: The color of the urine is an indication of how concentrated or diluted the urine is and may
be affected by food and medications; however, ferrous sulfate does not affect the color of the urine.
B. "I should not expect any changes in color of stools."
Rationale: Ferrous sulfate is an iron supplement used to treat clients who have iron deficiency
anemia. An expected adverse effect of this medication is black, tarry stools.
INCORRECT
C. "I should expect increased bruising."
Rationale: Ferrous sulfate does not impact clotting factors or platelets, so the client should not expect
increased bruising.
INCORRECT
D. "I will not get as many infections."
Rationale: Ferrous sulfate will not impact white blood cells, so the client does not have any added
protection from infection while taking this medication.
2. A nurse is preparing to initiate a transfusion of packed RBC for a client who has anemia. Which of
the following describes the correct actions for to nurse take?
INCORRECT
A. Leave the client 5 min after beginning the transfusion.
Rationale: The nurse should remain with the client for 15 to 30 min after the start of the transfusion
to monitor for a reaction, which usually occurs during the first 50 mL of the transfusion.
B. Infuse the transfusion over 2-4 hours.
Rationale: The transfusion should infuse in 2 to 4 hr to prevent fluid overload.
INCORRECT
C. Check the client's vital signs every 15 minutes during the transfusion.
Rationale: The nurse should check the client's vital signs every 15 min at the start of the transfusion,
then every 1 hr to monitor for a transfusion reaction.
INCORRECT
D. Flush the blood tubing with dextrose 5% in water.
Rationale: The nurse should flush the blood tubing with 0.9% sodium chloride to prevent hemolysis
of the blood.
,pharm 2 exam review questions complete solution with rationales
3. When providing teaching a client who reports taking gingko biloba, what adverse effects would be
important for the nurse to include?
INCORRECT
A. Bad breath
Rationale: Bad breath is not an expected adverse effect of gingko biloba.
INCORRECT
B. Decreased alertness
Rationale: Decreased alertness is not an expected adverse effect of ginkgo biloba; however, ginkgo
biloba can cause headache, dizziness, and vertigo.
C. May notice increased bleeding.
Rationale: Gingko biloba is an herbal medication used by clients to improve age-related memory loss
as well as to decrease leg pain in clients with peripheral arterial disease (PAD). Although gingko
biloba is generally well-tolerated, it may suppress coagulation. There have been reports of
spontaneous bleeding in clients taking this herbal medication. Clients should be instructed to
discontinue use and report increased bleeding, such as nosebleeds, bleeding gums, any cuts that do not
stop bleeding, to their provider.
INCORRECT
D. Breast enlargement
Rationale: Breast enlargement is not an expected adverse effect of ginkgo biloba.
4. The nurse is providing teaching to a client recently prescribed ferrous sulfate tablets twice daily for
iron-deficiency anemia. The nurse includes instructions to take the medication between meals. Which
of the following should be discussed?
INCORRECT
A) "Taking the medication between meals will help you avoid becoming constipated."
Answer Rationale:
Taking the medication with food can reduce the GI symptoms associated with it. However, taking the
medication between meals maximizes absorption.
B) "Taking the medication between meals will help you absorb the medication more efficiently."
Answer Rationale:
Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron
supplements between meals helps to increase the bioavailability of the iron.
INCORRECT
C) "Taking the medication with food increases the risk of esophagitis."
Answer Rationale:
,pharm 2 exam review questions complete solution with rationales
Reclining immediately after taking ferrous sulfate may lead to esophageal corrosion. Clients should
remain upright for 15-30 min following administering.
INCORRECT
D) "The medication can cause nausea if taken with food."
Answer Rationale:
Taking ferrous sulfate with food can reduce the GI symptoms associated with it. However, taking the
medication between meals maximizes absorption.
5. A nurse is planning a menu for a client who has folic acid deficiency anemia. The nurse is aware of
the need for additional teaching when the client states which of the following foods are high in
folate?
ANSWERS – Select All That Apply.
INCORRECT
A) ½ cup of asparagus
Answer Rationale:
A half cup of asparagus contains 132 mcg of folate.
CORRECT
B) ¼ cup of olives
Answer Rationale:
Olives are not a source folic acid.
CORRECT
C) 4 slices of roast beef
Answer Rationale:
Roast beef is not a source of folic acid.
INCORRECT
D) 1 cup part-skim mozzarella cheese
Answer Rationale:
A cup of part-skim mozzarella cheese contains 36 mcg of folic acid.
6. When teaching a client with chronic kidney disease about the new prescription for epoetin
, pharm 2 exam review questions complete solution with rationales
alfa. Which of the following dietary supplements should be included in the daily regimen?
INCORRECT
A) Sodium
Answer Rationale:
The client who has chronic kidney disease is at risk for hypernatremia and should eat a low-sodium
diet.
B) Iron
Answer Rationale:
Epoetin alfa is a synthetic form of erythropoietin, a substance produced by the kidneys that stimulates
the bone marrow to produce red blood cells. Increased iron is needed for the production of
hemoglobin and red blood cells by the bone marrow.
INCORRECT
C) Protein
Answer Rationale:
The client who has chronic kidney disease is at risk for uremia and should eat a low-protein diet.
INCORRECT
D) Potassium
Answer Rationale:
The client who has chronic kidney disease is at risk for hyperkalemia and should eat a low-potassium
diet.
7. When teaching a client about chronic renal disease and therapy with epoetin alfa. What laboratory
results indicate correct therapeutic effect of the medication?
ANSWERS - Multiple Choice
CORRECT
A) The hematocrit (Hct)
Answer Rationale:
Epoetin alfa is an antianemic medication that is indicated in the treatment of clients who have anemia
due to reduced production of endogenous erythropoietin, which may occur in clients who have end-
stage renal disease or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is
enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct.
INCORRECT
B) The leukocyte count
1. A nurse is teaching a client who has a new prescription for ferrous sulfate. Which of the following
statements by the client indicates need for additional teaching?
INCORRECT
A. "I will expect the color of my urine to be amber."
Rationale: The color of the urine is an indication of how concentrated or diluted the urine is and may
be affected by food and medications; however, ferrous sulfate does not affect the color of the urine.
B. "I should not expect any changes in color of stools."
Rationale: Ferrous sulfate is an iron supplement used to treat clients who have iron deficiency
anemia. An expected adverse effect of this medication is black, tarry stools.
INCORRECT
C. "I should expect increased bruising."
Rationale: Ferrous sulfate does not impact clotting factors or platelets, so the client should not expect
increased bruising.
INCORRECT
D. "I will not get as many infections."
Rationale: Ferrous sulfate will not impact white blood cells, so the client does not have any added
protection from infection while taking this medication.
2. A nurse is preparing to initiate a transfusion of packed RBC for a client who has anemia. Which of
the following describes the correct actions for to nurse take?
INCORRECT
A. Leave the client 5 min after beginning the transfusion.
Rationale: The nurse should remain with the client for 15 to 30 min after the start of the transfusion
to monitor for a reaction, which usually occurs during the first 50 mL of the transfusion.
B. Infuse the transfusion over 2-4 hours.
Rationale: The transfusion should infuse in 2 to 4 hr to prevent fluid overload.
INCORRECT
C. Check the client's vital signs every 15 minutes during the transfusion.
Rationale: The nurse should check the client's vital signs every 15 min at the start of the transfusion,
then every 1 hr to monitor for a transfusion reaction.
INCORRECT
D. Flush the blood tubing with dextrose 5% in water.
Rationale: The nurse should flush the blood tubing with 0.9% sodium chloride to prevent hemolysis
of the blood.
,pharm 2 exam review questions complete solution with rationales
3. When providing teaching a client who reports taking gingko biloba, what adverse effects would be
important for the nurse to include?
INCORRECT
A. Bad breath
Rationale: Bad breath is not an expected adverse effect of gingko biloba.
INCORRECT
B. Decreased alertness
Rationale: Decreased alertness is not an expected adverse effect of ginkgo biloba; however, ginkgo
biloba can cause headache, dizziness, and vertigo.
C. May notice increased bleeding.
Rationale: Gingko biloba is an herbal medication used by clients to improve age-related memory loss
as well as to decrease leg pain in clients with peripheral arterial disease (PAD). Although gingko
biloba is generally well-tolerated, it may suppress coagulation. There have been reports of
spontaneous bleeding in clients taking this herbal medication. Clients should be instructed to
discontinue use and report increased bleeding, such as nosebleeds, bleeding gums, any cuts that do not
stop bleeding, to their provider.
INCORRECT
D. Breast enlargement
Rationale: Breast enlargement is not an expected adverse effect of ginkgo biloba.
4. The nurse is providing teaching to a client recently prescribed ferrous sulfate tablets twice daily for
iron-deficiency anemia. The nurse includes instructions to take the medication between meals. Which
of the following should be discussed?
INCORRECT
A) "Taking the medication between meals will help you avoid becoming constipated."
Answer Rationale:
Taking the medication with food can reduce the GI symptoms associated with it. However, taking the
medication between meals maximizes absorption.
B) "Taking the medication between meals will help you absorb the medication more efficiently."
Answer Rationale:
Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron
supplements between meals helps to increase the bioavailability of the iron.
INCORRECT
C) "Taking the medication with food increases the risk of esophagitis."
Answer Rationale:
,pharm 2 exam review questions complete solution with rationales
Reclining immediately after taking ferrous sulfate may lead to esophageal corrosion. Clients should
remain upright for 15-30 min following administering.
INCORRECT
D) "The medication can cause nausea if taken with food."
Answer Rationale:
Taking ferrous sulfate with food can reduce the GI symptoms associated with it. However, taking the
medication between meals maximizes absorption.
5. A nurse is planning a menu for a client who has folic acid deficiency anemia. The nurse is aware of
the need for additional teaching when the client states which of the following foods are high in
folate?
ANSWERS – Select All That Apply.
INCORRECT
A) ½ cup of asparagus
Answer Rationale:
A half cup of asparagus contains 132 mcg of folate.
CORRECT
B) ¼ cup of olives
Answer Rationale:
Olives are not a source folic acid.
CORRECT
C) 4 slices of roast beef
Answer Rationale:
Roast beef is not a source of folic acid.
INCORRECT
D) 1 cup part-skim mozzarella cheese
Answer Rationale:
A cup of part-skim mozzarella cheese contains 36 mcg of folic acid.
6. When teaching a client with chronic kidney disease about the new prescription for epoetin
, pharm 2 exam review questions complete solution with rationales
alfa. Which of the following dietary supplements should be included in the daily regimen?
INCORRECT
A) Sodium
Answer Rationale:
The client who has chronic kidney disease is at risk for hypernatremia and should eat a low-sodium
diet.
B) Iron
Answer Rationale:
Epoetin alfa is a synthetic form of erythropoietin, a substance produced by the kidneys that stimulates
the bone marrow to produce red blood cells. Increased iron is needed for the production of
hemoglobin and red blood cells by the bone marrow.
INCORRECT
C) Protein
Answer Rationale:
The client who has chronic kidney disease is at risk for uremia and should eat a low-protein diet.
INCORRECT
D) Potassium
Answer Rationale:
The client who has chronic kidney disease is at risk for hyperkalemia and should eat a low-potassium
diet.
7. When teaching a client about chronic renal disease and therapy with epoetin alfa. What laboratory
results indicate correct therapeutic effect of the medication?
ANSWERS - Multiple Choice
CORRECT
A) The hematocrit (Hct)
Answer Rationale:
Epoetin alfa is an antianemic medication that is indicated in the treatment of clients who have anemia
due to reduced production of endogenous erythropoietin, which may occur in clients who have end-
stage renal disease or myelosuppression from chemotherapy. The therapeutic effect of epoetin alfa is
enhanced red blood cell production, which is reflected in an increased RBC, Hgb, and Hct.
INCORRECT
B) The leukocyte count
