InsomniaInsomnia
NR 293 ATI Pharmacology Final Review Chamberlain
College of Nursing
1) A nurse is assessing a client who is taking levothyroxine. The nurse should recognize
that which of the following findings is a manifestation of levothyroxine overdose?
a) Insomnia
i) Rationale: Levothyroxine overdose will result in manifestations
of hyperthyroidism, which include Insomnia, tachycardia, and
hyperthermia.
b) Constipation
i) Rationale: Constipation is a manifestation of hypothyroidism and indicates
an inadequate dose of levothyroxine.
c) Drowsiness
i) Rationale: Drowsiness is a manifestation of hypothyroidism and indicates
an inadequate dose of levothyroxine.
d) Hypoactive deep-tendon reflexes
i) Rationale: Hypoactive deep-tendon reflexes are manifestations of hypothyroidism
and indicate an inadequate dose of levothyroxine.
2) A nurse is reviewing the medical record of a client who has been on levothyroxine for
several months. Which of the following findings indicates a therapeutic response to
the medication?
a) Decrease in level of thyroxine (T4)
i) Rationale: If the dose of this medication has been adequate, the nurse should see
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an increase in the T4.
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b) Increase in weight
i) Rationale: If the dose of this medication has been adequate, the nurse should see
a decrease in weight, as hypothyroidism causes a decrease in metabolism with
weight gain.
c) Increase in hr of sleep per night
i) Rationale: If the dose of this medication has been adequate, the nurse should see
a decrease in the hr of sleep per night, as hypothyroidism causes sluggishness with
increased hr of sleep.
d) Decrease in level of thyroid stimulating hormone (TSH).
i) Rationale: In hypothyroidism, the nonfunctioning thyroid gland is
unable to respond to the TSH, and no endogenous thyroid hormones
are released. This results in an elevation of the TSH level as the anterior
pituitary continues to release the TSH to stimulate the thyroid gland.
Administration of exogenous thyroid hormones, such as levothyroxine,
turns off this feedback loop, which results in a decreased level of TSH.
3) A nurse is reviewing the medication list for a client who has a new diagnosis of type 2
diabetes mellitus. The nurse should recognize which of the following medications can
cause glucose intolerance?
a) Ranitidine
i) Serum creatinine levels
b) Guafenesin
i) Drowsiness and dizziness
c) Prednisone
i) Glucose intolerance and hyperglycemia, patient might require
increased dosage of hypoglycemic med.
d) Atorvastatin
i) Thyroid function tests.
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4) A nurse is caring for a client receiving mydriatic eye drops. Which of the following
clinical manifestations indicates to the nurse that the client has developed a systemic
anticholinergic effect?
a) Seizures
b) Tachypnea
c) Constipation
i) Mydriatic eye drops can cause systemic anticholinergic effects such
as constipation, dry mouth, photophobia, and tachycardia.
d) Hypothermia
5) A nurse is caring for a client who has heart failure and is receiving IV furosemide. The
nurse should monitor the client for which of the following electrolyte imbalances?
a) Hypernatremia
i) Rationale: The nurse should monitor the client who is receiving IV furosemide for
hyponatremia.
b) Hyperuricemia
i) Rationale: The nurse should monitor the client who is receiving IV furosemide
for hyperuricemia. The nurse should instruct the client to notify the provider for
any tenderness or swelling of the joints.
c) Hypercalcemia
i) Rationale: The nurse should monitor the client who is receiving IV furosemide
for hypocalcemia.
d) Hyperchloremia
i) Rationale: The nurse should monitor the client who is receiving IV furosemide
for hypochloremia.
Page 4 of 68
NR 293 ATI Pharmacology Final Review Chamberlain
College of Nursing
1) A nurse is assessing a client who is taking levothyroxine. The nurse should recognize
that which of the following findings is a manifestation of levothyroxine overdose?
a) Insomnia
i) Rationale: Levothyroxine overdose will result in manifestations
of hyperthyroidism, which include Insomnia, tachycardia, and
hyperthermia.
b) Constipation
i) Rationale: Constipation is a manifestation of hypothyroidism and indicates
an inadequate dose of levothyroxine.
c) Drowsiness
i) Rationale: Drowsiness is a manifestation of hypothyroidism and indicates
an inadequate dose of levothyroxine.
d) Hypoactive deep-tendon reflexes
i) Rationale: Hypoactive deep-tendon reflexes are manifestations of hypothyroidism
and indicate an inadequate dose of levothyroxine.
2) A nurse is reviewing the medical record of a client who has been on levothyroxine for
several months. Which of the following findings indicates a therapeutic response to
the medication?
a) Decrease in level of thyroxine (T4)
i) Rationale: If the dose of this medication has been adequate, the nurse should see
Page 1 of 68
, InsomniaInsomnia
an increase in the T4.
Page 2 of 68
, InsomniaInsomnia 3
b) Increase in weight
i) Rationale: If the dose of this medication has been adequate, the nurse should see
a decrease in weight, as hypothyroidism causes a decrease in metabolism with
weight gain.
c) Increase in hr of sleep per night
i) Rationale: If the dose of this medication has been adequate, the nurse should see
a decrease in the hr of sleep per night, as hypothyroidism causes sluggishness with
increased hr of sleep.
d) Decrease in level of thyroid stimulating hormone (TSH).
i) Rationale: In hypothyroidism, the nonfunctioning thyroid gland is
unable to respond to the TSH, and no endogenous thyroid hormones
are released. This results in an elevation of the TSH level as the anterior
pituitary continues to release the TSH to stimulate the thyroid gland.
Administration of exogenous thyroid hormones, such as levothyroxine,
turns off this feedback loop, which results in a decreased level of TSH.
3) A nurse is reviewing the medication list for a client who has a new diagnosis of type 2
diabetes mellitus. The nurse should recognize which of the following medications can
cause glucose intolerance?
a) Ranitidine
i) Serum creatinine levels
b) Guafenesin
i) Drowsiness and dizziness
c) Prednisone
i) Glucose intolerance and hyperglycemia, patient might require
increased dosage of hypoglycemic med.
d) Atorvastatin
i) Thyroid function tests.
Page 3 of 68
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4) A nurse is caring for a client receiving mydriatic eye drops. Which of the following
clinical manifestations indicates to the nurse that the client has developed a systemic
anticholinergic effect?
a) Seizures
b) Tachypnea
c) Constipation
i) Mydriatic eye drops can cause systemic anticholinergic effects such
as constipation, dry mouth, photophobia, and tachycardia.
d) Hypothermia
5) A nurse is caring for a client who has heart failure and is receiving IV furosemide. The
nurse should monitor the client for which of the following electrolyte imbalances?
a) Hypernatremia
i) Rationale: The nurse should monitor the client who is receiving IV furosemide for
hyponatremia.
b) Hyperuricemia
i) Rationale: The nurse should monitor the client who is receiving IV furosemide
for hyperuricemia. The nurse should instruct the client to notify the provider for
any tenderness or swelling of the joints.
c) Hypercalcemia
i) Rationale: The nurse should monitor the client who is receiving IV furosemide
for hypocalcemia.
d) Hyperchloremia
i) Rationale: The nurse should monitor the client who is receiving IV furosemide
for hypochloremia.
Page 4 of 68
