PN Pharmacology Online Practice 2014 B
1. A nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain.
What is a contraindication to receiving celecoxib? History of myocardial infarction or heart disease
Rationale: Celecoxib increases the risk of MI because of increased vasoconstriction and platelet
aggregation.
2. A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium.
What instructions should the nurse include in the teaching? Maintain a consistent sodium intake
Rationale: The client should not take lithium on an empty stomach, this will help reduce GI upset.
Hypothyroidism and polyuria might occur while taking lithium. The client should maintain a consistent sodium
intake while taking lithium. Decreased serum sodium levels cause lithium excretion to decline which can lead to
toxicity
3. A nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. What action
should the nurse take to counteract the adverse affects of this medicine? Help the client to apply sunblock before
going outside.
Rationale: Chlorpromazine increases skin sensitivity to ultraviolet light and to the risk of sunburn.
Applying sunblock will counteract this adverse affect. This drug also causes constipation, excessive sweating.
The client should also take with food or fluid to minimize GI upset.
4. A nurse is collecting data from a client who has been taking levodova/carbidopa. What finding should
indicate to the nurse that the medication is effective? The client is able to wash his face
Rationale: Levodopa works by activating dopamine receptors, restoring nerve transmission for clients
who have Parkinson's disease. Carbidopa enhances these effects by inhibiting the breakdown of levodopa in the
intestine and periphery. This allows the client to move freely and resume ADL's
5. A nurse is caring for a client who is receiving methylprednisolone sodium succinate. What laboratory
values should the nurse plan to monitor? White blood cells, Serum Potassium, Blood glucose
Rationale: methylprednisolone sodium succinate can increase the clients risk for infection (WBC)
methylprednisolone sodium succinate can cause hypokalemia along with fluid and sodium retention (K)
methylprednisolone sodium succinate can cause increased blood glucose levels (blood glucose)
6. A nurse is reinforcing teaching with a client who has a prescription for ciproflaxcin. What instructions
should the nurse include in the teaching? The client should drink 8 full glasses of water per day
Rationale: The nurse should instruct the client to drink plenty of water while taking this medication.
This will keep the client hydrated and prevent crystalluria of the urine. The client should also decrease exposure
to sunlight, avoid taking this medication with milk because calcium levels inhibit the absorption of this
medication.
7. A nurse is collecting data from a client who has a prescription for tobramycin. What findings should the
nurse immediately report to the provider? Oliguria
Rationale: Oliguria indicates the client is at greatest risk for nephrotoxicity. Therefore, this is a priority
that should be reported immediately.
8. A nurse is caring for a client who is having an acute asthma attack. What medication should the nurse
administer first? Albuterol
Rationale: Albuterol is a short-acting beta2 agonist with rapid onset. Therefore, the nurse should
administer albuterol to treat acute asthma. The nurse should administer prednisone, a glucocorticoid, after the
clients acute attack resolves. The client can take oral prednisone for 10 days following an acute attack to
decrease inflammation
9. The nurse is reinforcing teaching with a client who has a new prescription for theophylline. What should
the nurse instruct the client that is an expected outcome of this medication? Dilates bronchioles
Rationale: Theophylline is a bronchodilator, which affects smooth muscle relaxation leading to opened
airways
This study source was downloaded by 100000852681095 from CourseHero.com on 03-06-2023 17:29:05 GMT -06:00
https://www.coursehero.com/file/20900948/PN-Pharmacology-Online-Practice-2014-B-Review/
, 10. A nurse is reinforcing teaching with a client who is to start therapy with nitroglycerin transdermal patch.
Give a statement that the client would say to indicate an understanding of the use of this patch? "While using the
patch, I will be careful when rising from a chair"
Rationale: Nitroglycerin can cause orthostatic hypotension, which causes dizziness. The client should
also apply the patch each morning but should remove it after 12-14 hours and allow for 10-12 hours without any
medication. This will prevent the client from developing tolerance to this medication. The client should rotate the
site to avoid skin irritations. The client should use rapid onset, short acting nitroglycerin to treat acute angina.
11. The nurse is caring for a client who has chronic renal failure and has been receiving epoetin alfa for 2
weeks. What would indicate to the nurse that the medication is having the desired therapeutic effect? Hemoglobin
rises 0.5 g/dL
Rationale: Initial effects occur within the first 2 weeks of therapy. Hemoglobin reaches target levels (10-
12 g/dL) in 2-3 months
12. A nurse is reviewing the medication administration record for a client who has a history of Stevens-
Johnson syndrome when taking sulfamethoxazole-trimethoprim. What medication should the nurse withhold to
prevent an allergic reaction? Furosemide
Rationale: The client who has a history of Steven-Johnson syndrome when taking sulfonamides is at
risk for an allergic reaction to furosemide because the two medications are chemically related
13. A client is visiting her provider to follow-up on routine laboratory work related to warfarin therapy for
mitral valve replacement. The clients current INR is 5.0. What question should the nurse ask based on the clients
INR results? "Have you noticed any bruising"
Rationale: An INR expected range is 2.0-3.0. The clients current INR is above the expected range
which places the client at an increased risk for bleeding.
14. A nurse is monitoring a client who is to start therapy with spironolactone. What serum laboratory result
should the nurse report to the provider? Increased levels of Potassium
Rationale: Increased levels of potassium places the client at risk for muscle weakness, nausea, vomiting
and cardiac dysrhythmias and should be reported. Sodium range: 135-145, chloride range: 96-106 Magnesium
range: 1.5-2.5
15. A nurse is preparing to instill antibiotic ear drops for a client who has otitis externa. What actions
should the nurse take? Wiggle the earlobe after instilling the ear drops
Rationale: Wiggling the earlobe can help the ear drops move down the clients external auditory canal
16.A nurse is reinforcing teaching with a client who is to start therapy with metronidazole for a urinary tract
infection. What should the nurse include in the teaching? " Your urine may become reddish brown"
Rationale: The nurse should warn the client that urine may turn dark or reddish brown. The medication
can be kept at room temperature. Instruct client to finish the full course of treatment even if symptoms have
disappeared.
17. A nurse is reinforcing teaching about comfort measures with the parent of a 10 year old child who has a
viral infection. The nurse should plan to tell the parent that aspirin is contraindicated because of the risk for what
condition? Reyes Syndrome
Rationale: Aspirin is contraindicated for children and adolescents who have a viral illness because it is
associated with the development of Reyes Syndrome.
18. A nurse is caring for a client who is prescribed disulfiram and consumed alcohol 12 hours ago. What
adverse reaction is the priority finding to report to the provider? Respiratory Depression!
Rationale: Respiratory depression is a potentionally dangerous event and should be reported
immediately.
This study source was downloaded by 100000852681095 from CourseHero.com on 03-06-2023 17:29:05 GMT -06:00
https://www.coursehero.com/file/20900948/PN-Pharmacology-Online-Practice-2014-B-Review/
1. A nurse is collecting data from a client who is asking about taking celecoxib for treatment of joint pain.
What is a contraindication to receiving celecoxib? History of myocardial infarction or heart disease
Rationale: Celecoxib increases the risk of MI because of increased vasoconstriction and platelet
aggregation.
2. A nurse is reinforcing teaching with a client who has bipolar disorder and a new prescription for lithium.
What instructions should the nurse include in the teaching? Maintain a consistent sodium intake
Rationale: The client should not take lithium on an empty stomach, this will help reduce GI upset.
Hypothyroidism and polyuria might occur while taking lithium. The client should maintain a consistent sodium
intake while taking lithium. Decreased serum sodium levels cause lithium excretion to decline which can lead to
toxicity
3. A nurse is caring for a client who has a history of psychosis and is taking chlorpromazine. What action
should the nurse take to counteract the adverse affects of this medicine? Help the client to apply sunblock before
going outside.
Rationale: Chlorpromazine increases skin sensitivity to ultraviolet light and to the risk of sunburn.
Applying sunblock will counteract this adverse affect. This drug also causes constipation, excessive sweating.
The client should also take with food or fluid to minimize GI upset.
4. A nurse is collecting data from a client who has been taking levodova/carbidopa. What finding should
indicate to the nurse that the medication is effective? The client is able to wash his face
Rationale: Levodopa works by activating dopamine receptors, restoring nerve transmission for clients
who have Parkinson's disease. Carbidopa enhances these effects by inhibiting the breakdown of levodopa in the
intestine and periphery. This allows the client to move freely and resume ADL's
5. A nurse is caring for a client who is receiving methylprednisolone sodium succinate. What laboratory
values should the nurse plan to monitor? White blood cells, Serum Potassium, Blood glucose
Rationale: methylprednisolone sodium succinate can increase the clients risk for infection (WBC)
methylprednisolone sodium succinate can cause hypokalemia along with fluid and sodium retention (K)
methylprednisolone sodium succinate can cause increased blood glucose levels (blood glucose)
6. A nurse is reinforcing teaching with a client who has a prescription for ciproflaxcin. What instructions
should the nurse include in the teaching? The client should drink 8 full glasses of water per day
Rationale: The nurse should instruct the client to drink plenty of water while taking this medication.
This will keep the client hydrated and prevent crystalluria of the urine. The client should also decrease exposure
to sunlight, avoid taking this medication with milk because calcium levels inhibit the absorption of this
medication.
7. A nurse is collecting data from a client who has a prescription for tobramycin. What findings should the
nurse immediately report to the provider? Oliguria
Rationale: Oliguria indicates the client is at greatest risk for nephrotoxicity. Therefore, this is a priority
that should be reported immediately.
8. A nurse is caring for a client who is having an acute asthma attack. What medication should the nurse
administer first? Albuterol
Rationale: Albuterol is a short-acting beta2 agonist with rapid onset. Therefore, the nurse should
administer albuterol to treat acute asthma. The nurse should administer prednisone, a glucocorticoid, after the
clients acute attack resolves. The client can take oral prednisone for 10 days following an acute attack to
decrease inflammation
9. The nurse is reinforcing teaching with a client who has a new prescription for theophylline. What should
the nurse instruct the client that is an expected outcome of this medication? Dilates bronchioles
Rationale: Theophylline is a bronchodilator, which affects smooth muscle relaxation leading to opened
airways
This study source was downloaded by 100000852681095 from CourseHero.com on 03-06-2023 17:29:05 GMT -06:00
https://www.coursehero.com/file/20900948/PN-Pharmacology-Online-Practice-2014-B-Review/
, 10. A nurse is reinforcing teaching with a client who is to start therapy with nitroglycerin transdermal patch.
Give a statement that the client would say to indicate an understanding of the use of this patch? "While using the
patch, I will be careful when rising from a chair"
Rationale: Nitroglycerin can cause orthostatic hypotension, which causes dizziness. The client should
also apply the patch each morning but should remove it after 12-14 hours and allow for 10-12 hours without any
medication. This will prevent the client from developing tolerance to this medication. The client should rotate the
site to avoid skin irritations. The client should use rapid onset, short acting nitroglycerin to treat acute angina.
11. The nurse is caring for a client who has chronic renal failure and has been receiving epoetin alfa for 2
weeks. What would indicate to the nurse that the medication is having the desired therapeutic effect? Hemoglobin
rises 0.5 g/dL
Rationale: Initial effects occur within the first 2 weeks of therapy. Hemoglobin reaches target levels (10-
12 g/dL) in 2-3 months
12. A nurse is reviewing the medication administration record for a client who has a history of Stevens-
Johnson syndrome when taking sulfamethoxazole-trimethoprim. What medication should the nurse withhold to
prevent an allergic reaction? Furosemide
Rationale: The client who has a history of Steven-Johnson syndrome when taking sulfonamides is at
risk for an allergic reaction to furosemide because the two medications are chemically related
13. A client is visiting her provider to follow-up on routine laboratory work related to warfarin therapy for
mitral valve replacement. The clients current INR is 5.0. What question should the nurse ask based on the clients
INR results? "Have you noticed any bruising"
Rationale: An INR expected range is 2.0-3.0. The clients current INR is above the expected range
which places the client at an increased risk for bleeding.
14. A nurse is monitoring a client who is to start therapy with spironolactone. What serum laboratory result
should the nurse report to the provider? Increased levels of Potassium
Rationale: Increased levels of potassium places the client at risk for muscle weakness, nausea, vomiting
and cardiac dysrhythmias and should be reported. Sodium range: 135-145, chloride range: 96-106 Magnesium
range: 1.5-2.5
15. A nurse is preparing to instill antibiotic ear drops for a client who has otitis externa. What actions
should the nurse take? Wiggle the earlobe after instilling the ear drops
Rationale: Wiggling the earlobe can help the ear drops move down the clients external auditory canal
16.A nurse is reinforcing teaching with a client who is to start therapy with metronidazole for a urinary tract
infection. What should the nurse include in the teaching? " Your urine may become reddish brown"
Rationale: The nurse should warn the client that urine may turn dark or reddish brown. The medication
can be kept at room temperature. Instruct client to finish the full course of treatment even if symptoms have
disappeared.
17. A nurse is reinforcing teaching about comfort measures with the parent of a 10 year old child who has a
viral infection. The nurse should plan to tell the parent that aspirin is contraindicated because of the risk for what
condition? Reyes Syndrome
Rationale: Aspirin is contraindicated for children and adolescents who have a viral illness because it is
associated with the development of Reyes Syndrome.
18. A nurse is caring for a client who is prescribed disulfiram and consumed alcohol 12 hours ago. What
adverse reaction is the priority finding to report to the provider? Respiratory Depression!
Rationale: Respiratory depression is a potentionally dangerous event and should be reported
immediately.
This study source was downloaded by 100000852681095 from CourseHero.com on 03-06-2023 17:29:05 GMT -06:00
https://www.coursehero.com/file/20900948/PN-Pharmacology-Online-Practice-2014-B-Review/
