Pharmacology 2022
1. A nurse is caring for a client who is taking phenytoin. For
which of the following adverse effects should the nurse monitor
and report to the provider?
a. Cognitive impairment
b. Tachycardia +.
c. Elevated blood pressure
d. Tinnitus
Rationale: Pharmacology 7.0 Chapter 13 page 96:
phenytoin (Dilantin, Phenytek) : Classification: antiarrhythmics,
anticonvulsants. Pharmacologic: Hydantoins. Pregnancy category: D.
Indications: treatment/prevention of tonic-clonic (grand mal) seizures
and complex partial seizures via enhancing inhibitory effects of GABA
and decreases neuron firing. Also used as an antiarrhythmic,
particularly for ventricular arrhythmias associated with digoxin toxicity
& prolonged QT interval. Adverse effects: CNS effects (nystagmus,
sedation, ataxia, double vision, cognitive impairment) notify providers
if these occur, Gingival hyperplasia (softening and overgrowth of gum
tissue, tenderness, and bleeding gums; maintain good oral hygiene),
Skin rash (stop med if this occurs), Cardiovascular effects
(dysrhythmias, hypotension), Endocrine and other effects (coarsening
of focal features, hirsutism, and interference with vitamin D
metabolism), and Interfering with vitamin K-dependent clotting factors
causing bleeding in newborns.
,2. MISSING
3. MISSING
4. A nurse is teaching a client who has a history of acute myocardial
infarction about taking metoprolol to treat angina. Which of the
following instructions should the nurse include?
Stop taking the medication if you become dizzy - NEVER
a.
EVER discontinue abruptly without consulting your provider
b. Check your pulse rate daily - can cause bradycardia. So, you
withhold the meds if HR is under 50. Also, can cause orthostatic
hypo, and MASK hypoglycemic effects of insulin.
c. Expect to see an increase in your urinary output
d. Call your provider if you lose more than 1 pound per week
Rationale: Pharmacology 7.0 Chapter 20 page 158:
Metoprolol (Betaloc, Lopressor): Classification: antianginals,
antihypertensives. Pharmacological: Beta adrenergic blockers
(sympatholytics), cardioselective. Indication: blocks stimulation of
beta1 (myocardial)-adrenergic receptors. Decreases BP, HR, and
frequency of attacks of angina pectoris. Adverse effects: bradycardia
(monitor pulse, if below 50 BPM, hold med), decreased cardiac output,
AV block, orthostatic hypotension, and rebound myocardium
excitation.
5. A nurse is caring for a client who develops an anaphylactic reaction
to IV antibiotic administration. After assessing the client’s
respiratory status and stopping the medication infusion, which of the
, following actions should the nurse take next?
A. Elevate the client’s legs and feet
B. Administer epinephrine IM
C. Replace the solution with 0.9 % sodium chloride
D. Give diphenhydramine IM
Rationale Pharmacology 7.0 Chapter 5 page 36:
Anaphylactic reaction: a life threatening, immediate allergic reaction
that causes respiratory distress, severe bronchospasm, laryngeal edema,
a quick drop in blood pressure, as well as cardiovascular collapse.
Treat with epinephrine, bronchodilators, and antihistamines. Provide
respiratory support, and inform the provider.
A nurse is assessing a client who is receiving via continuous IV
6.
infusion for labor augmentation. The nurse notes six contractions in
a 10-minute period with a nonreassuring FHR. Which of the
following actions should the nurse take first?
a. Administer Terbutaline 0.25 mg subcutaneously
b. Discontinue the oxytocin IV infusion
c. Turn the client on the left side
d. Apply oxygen at 10 L / min via face mask Rationale:
Pharmacology 7.0 Chapter 32 page 253:
Oxytocin (Pitocin): hormone, oxytocics, pregnancy category X.
Uterine stimulants increase the strength, frequency, and length of
uterine contractions. (contractions lasting longer than 60 secs, and
occurring more frequently than every 2 to 3 min, stop the infusion, and
notify the provider.
Practice question from RN Pharmacology Practice Questions A: the
priority question is for the nurse to place the client in lateral position.
7. A nurse is administering Lactated Ringer solution at 100ml/hr. The
drop factor of the manual IV tubing is 15 gtt/ml. The nurse should
set the manual IV infusion to deliver how many drops per minute?
Round the answer to the nearest whole number? mL/ min x drop
factor (gtt/min)
1 hr. = 60 min
100 mL/60 min x 15 gtt/mL = 25 gtt/min
8.A client who has active tuberculosis and is taking rifampin reports
that this urine and sweat have developed a red orange tinge. Which
of the following actions should the nurse take? page 376
Adverse effects: Hepatotoxic sxs (jaundice, anorexia,
fatigue, nausea vomiting, Metabolizes, warfarin, HIV
, drugs. and PO contraceptives NI: give it 1 or 2 hours
before or after meals.
a. Prepare the client for dialysis - no need to, orange pee is
expected
b. Instruct the client to increase the fluid intake
c. Check the client’s liver function tests results
d. Document this as an expected finding - Rationale:
Pharmacology 7.0 Chapter 47 page 376:
Rifampin: Broad spectrum antibiotic for gram-positive and gram-
negative bacteria. Is given in combination with at least one other
antituberculosis medication to help prevent antibiotic resistance.
Inform clients of expected orange color of urine, saliva, sweat & tears.
Adverse effects: hepatotoxicity (jaundice, anorexia, and fatigue), mild
GI discomfort, and pseudomembranous colitis. Contraindicated in
clients who have liver dysfunction.
9. A nurse is teaching a client about self-administration of enoxaparin .
Which of the following instructions should the nurse include? (Select
all that apply)
a. Grasp the skin between the thumb and forefinger, while
injecting the medication (SQ)
b. Alternate the injection sites between the side of the abdomen
Expel the air bubble from the prefilled syringe (do not expel
c.
the bubble)
d. Massage the insertion site after injecting the medication (do not
rub)
e. Insert the entire length of the needle into the skin during
injection
Rationale: pg. 324 pharm ATI enoxaparin (Lovenox) low molecular
heparin prevent clotting by activating antithrombin and indirectly
inactivating both thrombin and factor x. inhibits fibrin formation.
Normal aPTT levels are 60-80 seconds.
10. A nurse is caring for a client who is receiving warfarin to treat atrial
fibrillation. Which of the following laboratory lab values should the
nurse identify as the outside the expected range for this client?
A. aPTT 36 seconds 35 - 45 seconds
B. Hgb 15.2 g/dl 12- 16
C. Hct 43 % 35- 45
D. INR 4.5 normal is 2-3 seconds PT levels normal is 18-24
seconds.
1. A nurse is caring for a client who is taking phenytoin. For
which of the following adverse effects should the nurse monitor
and report to the provider?
a. Cognitive impairment
b. Tachycardia +.
c. Elevated blood pressure
d. Tinnitus
Rationale: Pharmacology 7.0 Chapter 13 page 96:
phenytoin (Dilantin, Phenytek) : Classification: antiarrhythmics,
anticonvulsants. Pharmacologic: Hydantoins. Pregnancy category: D.
Indications: treatment/prevention of tonic-clonic (grand mal) seizures
and complex partial seizures via enhancing inhibitory effects of GABA
and decreases neuron firing. Also used as an antiarrhythmic,
particularly for ventricular arrhythmias associated with digoxin toxicity
& prolonged QT interval. Adverse effects: CNS effects (nystagmus,
sedation, ataxia, double vision, cognitive impairment) notify providers
if these occur, Gingival hyperplasia (softening and overgrowth of gum
tissue, tenderness, and bleeding gums; maintain good oral hygiene),
Skin rash (stop med if this occurs), Cardiovascular effects
(dysrhythmias, hypotension), Endocrine and other effects (coarsening
of focal features, hirsutism, and interference with vitamin D
metabolism), and Interfering with vitamin K-dependent clotting factors
causing bleeding in newborns.
,2. MISSING
3. MISSING
4. A nurse is teaching a client who has a history of acute myocardial
infarction about taking metoprolol to treat angina. Which of the
following instructions should the nurse include?
Stop taking the medication if you become dizzy - NEVER
a.
EVER discontinue abruptly without consulting your provider
b. Check your pulse rate daily - can cause bradycardia. So, you
withhold the meds if HR is under 50. Also, can cause orthostatic
hypo, and MASK hypoglycemic effects of insulin.
c. Expect to see an increase in your urinary output
d. Call your provider if you lose more than 1 pound per week
Rationale: Pharmacology 7.0 Chapter 20 page 158:
Metoprolol (Betaloc, Lopressor): Classification: antianginals,
antihypertensives. Pharmacological: Beta adrenergic blockers
(sympatholytics), cardioselective. Indication: blocks stimulation of
beta1 (myocardial)-adrenergic receptors. Decreases BP, HR, and
frequency of attacks of angina pectoris. Adverse effects: bradycardia
(monitor pulse, if below 50 BPM, hold med), decreased cardiac output,
AV block, orthostatic hypotension, and rebound myocardium
excitation.
5. A nurse is caring for a client who develops an anaphylactic reaction
to IV antibiotic administration. After assessing the client’s
respiratory status and stopping the medication infusion, which of the
, following actions should the nurse take next?
A. Elevate the client’s legs and feet
B. Administer epinephrine IM
C. Replace the solution with 0.9 % sodium chloride
D. Give diphenhydramine IM
Rationale Pharmacology 7.0 Chapter 5 page 36:
Anaphylactic reaction: a life threatening, immediate allergic reaction
that causes respiratory distress, severe bronchospasm, laryngeal edema,
a quick drop in blood pressure, as well as cardiovascular collapse.
Treat with epinephrine, bronchodilators, and antihistamines. Provide
respiratory support, and inform the provider.
A nurse is assessing a client who is receiving via continuous IV
6.
infusion for labor augmentation. The nurse notes six contractions in
a 10-minute period with a nonreassuring FHR. Which of the
following actions should the nurse take first?
a. Administer Terbutaline 0.25 mg subcutaneously
b. Discontinue the oxytocin IV infusion
c. Turn the client on the left side
d. Apply oxygen at 10 L / min via face mask Rationale:
Pharmacology 7.0 Chapter 32 page 253:
Oxytocin (Pitocin): hormone, oxytocics, pregnancy category X.
Uterine stimulants increase the strength, frequency, and length of
uterine contractions. (contractions lasting longer than 60 secs, and
occurring more frequently than every 2 to 3 min, stop the infusion, and
notify the provider.
Practice question from RN Pharmacology Practice Questions A: the
priority question is for the nurse to place the client in lateral position.
7. A nurse is administering Lactated Ringer solution at 100ml/hr. The
drop factor of the manual IV tubing is 15 gtt/ml. The nurse should
set the manual IV infusion to deliver how many drops per minute?
Round the answer to the nearest whole number? mL/ min x drop
factor (gtt/min)
1 hr. = 60 min
100 mL/60 min x 15 gtt/mL = 25 gtt/min
8.A client who has active tuberculosis and is taking rifampin reports
that this urine and sweat have developed a red orange tinge. Which
of the following actions should the nurse take? page 376
Adverse effects: Hepatotoxic sxs (jaundice, anorexia,
fatigue, nausea vomiting, Metabolizes, warfarin, HIV
, drugs. and PO contraceptives NI: give it 1 or 2 hours
before or after meals.
a. Prepare the client for dialysis - no need to, orange pee is
expected
b. Instruct the client to increase the fluid intake
c. Check the client’s liver function tests results
d. Document this as an expected finding - Rationale:
Pharmacology 7.0 Chapter 47 page 376:
Rifampin: Broad spectrum antibiotic for gram-positive and gram-
negative bacteria. Is given in combination with at least one other
antituberculosis medication to help prevent antibiotic resistance.
Inform clients of expected orange color of urine, saliva, sweat & tears.
Adverse effects: hepatotoxicity (jaundice, anorexia, and fatigue), mild
GI discomfort, and pseudomembranous colitis. Contraindicated in
clients who have liver dysfunction.
9. A nurse is teaching a client about self-administration of enoxaparin .
Which of the following instructions should the nurse include? (Select
all that apply)
a. Grasp the skin between the thumb and forefinger, while
injecting the medication (SQ)
b. Alternate the injection sites between the side of the abdomen
Expel the air bubble from the prefilled syringe (do not expel
c.
the bubble)
d. Massage the insertion site after injecting the medication (do not
rub)
e. Insert the entire length of the needle into the skin during
injection
Rationale: pg. 324 pharm ATI enoxaparin (Lovenox) low molecular
heparin prevent clotting by activating antithrombin and indirectly
inactivating both thrombin and factor x. inhibits fibrin formation.
Normal aPTT levels are 60-80 seconds.
10. A nurse is caring for a client who is receiving warfarin to treat atrial
fibrillation. Which of the following laboratory lab values should the
nurse identify as the outside the expected range for this client?
A. aPTT 36 seconds 35 - 45 seconds
B. Hgb 15.2 g/dl 12- 16
C. Hct 43 % 35- 45
D. INR 4.5 normal is 2-3 seconds PT levels normal is 18-24
seconds.
