PHARM 2 EXAM REVIEW QUESTIONS AND ANSWERS 2021/2022

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 AND ANSWERS 2021/2022 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: 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 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 endstage 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 Answer Rationale: Epoetin alfa does not affect the leukocyte, or WBC, count. INCORRECT C) The platelet count Answer Rationale: An increase in platelets is not the therapeutic or desired effect of epoetin alfa. INCORRECT D) The erythrocyte sedimentation rate (ESR) Answer Rationale: Epoetin alfa does not affect the ESR, which is a measurement of inflammation. 8. Which of the following foods is a reliable source of Vitamin B12 for a pregnant client who states she is vegan? ANSWERS - Multiple Choice INCORRECT A) Tempeh Answer Rationale: Tempeh and other fermented foods contain a form of vitamin B12 that the body cannot use; therefore, it is an unreliable source of vitamin B12. INCORRECT B) Algae Answer Rationale: Algae and other fermented foods contain a form of vitamin B12 that the body cannot use; therefore, it is an unreliable source of vitamin B12. INCORRECT C) Sea vegetables Answer Rationale: Sea vegetables can provide a source of iodine to a client who is vegan; however, it is an unreliable source of vitamin B12. D) Sunflower Seeds Answer Rationale: Sunflower seeds is fortified with vitamin B12 and is a reliable source of vitamin B12. 9. When instructing a client about Vitamin D, what information should be included as a trigger for formation of the vitamin in the body? INCORRECT A) Calcium Answer Rationale: Calcium does not trigger the formation of vitamin D in the body. CORRECT B) Exposure to sunlight Answer Rationale: Exposure to sunlight triggers the formation of vitamin D in the body. INCORRECT C) Vitamin A depletion Answer Rationale: Vitamin A depletion does not trigger the formation of vitamin D in the body. INCORRECT D) Weight-bearing exercise Answer Rationale: Weight-bearing exercises do not trigger the formation of vitamin D in the body. 10. When teaching a client about sources of Vitamin C, which of the following should be included? (Select all that apply.) ANSWERS - Multiple Response A) Green pepper B) Orange C) Milk D) Yogurt E) Cabbage Answer Rationale: Green pepper is a correct response. Green peppers are a source of vitamin C and should be included as a source of vitamin C. Orange is a correct response. Oranges are a good source of vitamin C and should be included as a source of vitamin C