Pharmacology NCLEX Questions

An 86-year-old patient is being discharged to home on digitalis therapy and has very little information regarding the medication. Which statement best reflects a realistic outcome of patient teaching activities? a. The patient and patient's daughter will state the proper way to take the drug. b. The nurse will provide teaching about the drug's adverse effects. c. The patient will state all the symptoms of digitalis toxicity. d. The patient will call the prescriber if adverse effects occur. a. The patient and patient's daughter will state the proper way to take the drug. A patient has a new prescription for a blood pressure medication that may cause him to feel dizzy during the first few days of therapy. Which is the best nursing diagnosis for this situation? a. Activity intolerance b. Risk for injury c. Disturbed body image d. Self-care deficit b. Risk for injury A patient's chart includes an order that reads as follows: "Lanoxin 250 mcg once daily at 0900." Which action by the nurse is correct? a. The nurse gives the drug via the transdermal route. b. The nurse gives the drug orally. c. The nurse gives the drug intravenously. d. The nurse contacts the prescriber to clarify the dosage route. d. The nurse contacts the prescriber to clarify the dosage route. A 77-year-old man who has been diagnosed with an upper respiratory tract infection tells the nurse that he is allergic to penicillin. Which is the most appropriate response by the nurse? a. "that's to be expected--lots of people are allergic to penicillin." b. "This allergy is not of major concern because the drug is given so commonly." c. "What type of reaction did you have when you took penicillin?" d. "Drug allergies don't usually occur in older individuals because they have built up resistance." c. "What type of reaction did you have when you took penicillin?" The nurse is compiling a drug history for a patient. Which question from the nurse will obtain the most information from the patient? a. "Do you depend on sleeping pills to get to sleep?" b. "Do you have a family history of heart disease?" c. "When you have pain, what do you do to relieve it?" d. "What childhood diseases did you have?" c. "When you have pain, what do you do to relieve it?" The nurse is preparing a care plan for a patient who has been newly diagnosed with type 2 diabetes mellitus. Put into correct order the steps of the nursing process, with 1 being the first step and 5 being the last step. a. Implementation b. Planning c. Assessment d. Evaluation e. Nursing diagnoses 4, 3, 1, 5, 2 The nurse is reviewing new medication orders that have been written for a newly admitted patient. The nurse will need to clarify which orders? Select all that apply. a. Metformin (Glucophage) 1000 mg PO twice a day b. Sitagliptin (Januvia) 50 mg daily c. Simvastatin (Zocor) 20 mg PO every evening d. Irbesartan (Avapro) 300 mg PO once a day e. Docusate (Colace) as needed for constipation b. Sitagliptin (Januvia) 50 mg daily e. Docusate (Colace) as needed for constipation An elderly woman took a prescription medicine to help her to sleep; however, she felt restless all night and did not sleep at all. The nurse recognizes that this woman has experienced which type of reaction or effect? a. Allergic reaction b. Idiosyncratic reaction c. Mutagenic effect d. Synergistic effect b. Idiosyncratic reaction While caring for a patient with cirrhosis or hepatitis, the nurse knows that abnormalities in which phase of pharmacokinetics may occur? a. Absorption b. Distribution c. Metabolism d. Excretion c. Metabolism A patient who has advanced cancer is receiving opioid medications around the clock to "keep him comfortable" as he nears the end of his life. Which term best describes this type of therapy? a. Palliative therapy b. Maintenance therapy c. Supportive therapy d. Supplemental therapy a. Palliative therapy The nurse is giving medications to a patient in heart failure. The intravenous route is chosen instead of the intramuscular route. The nurse knows that the factor that most influences the decision about which route to use is the patient's a. altered biliary function. b. increased glomerular filtration. c. reduced liver metabolism. d. diminished circulation. d. diminished circulation. A patient has just received a prescription for an enteric-coated stool softener. When teaching the patient, the nurse should include which statement? a. "Take the tablet with 2 to 3 ounces of orange juice." b. "Avoid taking all other medications with any enteric-coated tablet." c. "Crush the tablet before swallowing if you have problems with swallowing." d. "Be sure to swallow the tablet whole without chewing it." d. "Be sure to swallow the tablet whole without chewing it." Each statement describes a phase of pharmacokinetics. Put the statements in order, with 1 indicating the phase that occurs first and 4 indicating the phase that occurs last. a. Enzymes in the liver transform the drug into an inactive metabolite. b. Drug metabolites are secreted through passive glomerular filtration into the renal tubules. c. A drug binds to the plasma protein albumin and circulates through the body. d. A drug moves from the intestinal lumen into the mesenteric blood system. 3,4,2,1 A drug that delivers 500 mg has a half-life of 4 hours. How many milligrams of drug will remain in the body after 1 half-life? 250 mg The nurse is reviewing factors that influence pharmacokinetics in the neonatal patient. Which factor puts the neonatal patient at risk with regard to drug therapy? a. Immature renal system b. Hyperperistalsis in the GI tract c. Irregular temperature regulation d. Smaller circulatory capacity a. Immature renal system The physiologic differences in the pediatric patient compared with the adult patient affect the amount of drug needed to produce a therapeutic effect. The nurse is aware that one of the main differences is that infants have a. increased protein in circulation. b. fat composition lower than 0.001% c. more muscular body composition. d. water composition of approximately 75% d. water composition of approximately 75% While teaching a 76-year-old patient about the adverse effects of his medications, the nurse encourages him to keep a journal of the adverse effects he experiences. This intervention is important for the elderly patient because of which alterations in pharmacokinetics? a. Increased renal excretion of protein-bound drugs b. More alkaline gastric pH, resulting in more adverse effects c. Decreased blood flow to the liver, resulting in altered metabolism d. Less adipose tissue to store fat-soluble drugs c. Decreased blood flow to the liver, resulting in altered metabolism When the nurse is reviewing a list of medications taken by an 88-year-old patient, the patient says, "I get dizzy when I stand up." She also states that she has nearly fainted "a time or two" in the afternoons. Her systolic blood pressure drops 15 points when she stands up. Which type of medication may be responsible for these effects? a. NSAIDS b. Cardiac glycosides c. Anticoagulants d. Antihypertensives d. Antihypertensives A pregnant patient who is at 32 weeks' gestation has a cold and calls the office to ask about taking an over-the-counter medication that is rated as pregnancy category A. Which answer by the nurse is correct? a. "This drug causes problems in the human fetus, so you should not take this medication." b. "This drug may cause problems in the human fetus, but nothing has been proven in clinical trials. It is best not to take this medication." c. "This drug has not caused problems in animals, but no testing has been done in humans. It is probably safe to take." d. "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it." d. "Studies indicate that there is no risk to the human fetus, so it is okay to take this medication as directed if you need it." The nurse is preparing to administer an injection to a preschool-age child. Which approaches are appropriate for this age group? (Select all that apply.) a. Explain to the child in advance about the injection. b. Provide a brief, concrete explanation about the injection. c. Encourage participation in the procedure. d. Make use of magical thinking. e. Provide comfort measures after the injection. B, D, E The nurse is preparing to give an oral dose of acetaminophen (Tylenol) to a child who weighs 12 kg. The dose is 15 mg/kg. How many milligrams will the nurse administer for this dose? 180 mg A patient is undergoing major surgery and asks the nurse about a living will. He states, "I don't want anybody making decisions for me. And I don't want to prolong my life." The patient is demonstrating a. autonomy b. beneficence c. justice d. veracity a. autonomy When caring for an elderly Chinese patient, the nurse recognizes that which of these cultural issues may influence the care of this patient? a. Radiographs are seen as a break in the soul's integrity. b. Hospital diets are interpreted as being healing and healthful. c. The use of heat may be an important practice for this patient. d. Being hospitalized is a source of peace and socialization for this culture. c. The use of heat may be an important practice for this patient. A patient is being counseled for possible participation in a clinical trial for a new medication. After the patient meets with the physician, the nurse is asked to obtain the patient's signature on the consent forms. The nurse knows that this "informed consent" indicates which of the following? a. Once therapy has begun, the patient cannot withdraw from the clinical trial. b. The patient has been informed of all potential hazards and benefits of the therapy. c. The patient has received only the information that will help to make the clinical trial a success. d. No matter what happens, the patient will not be able to sue the researchers for damages. b. The patient has been informed of all potential hazards and benefits of the therapy. A new drug has been approved for use and the drug manufacturer has made it available for sale. During the first 6 months, the FDA receives reports of severe adverse effects that were not discovered during the testing and considers withdrawing the drug. This illustrates which phase of investigational studies? a. Phase I b. Phase II c. Phase III d. Phase IV d. Phase IV A patient of Japanese decent describes a family trait that manifests frequently: She says that members of her family often have "strong reactions" after taking certain medications, but her white friends have no problems with the same dosages of the same drugs. The nurse recognizes that, because of this trait, which statement applies? a. She may need lower dosages of the medications prescribed. b. She may need higher dosages of the medications prescribed. c. She should not receive these medications because of potential problems with metabolism. d. These situations vary greatly, and her accounts may not indicate a valid cause for concern. a. She may need lower dosages of the medications prescribed. When evaluating polymorphism and medication administration, the nurse considers which factors? (Select all that apply.) a. Nutritional status b. Drug route c. Patient's ethnicity d. Cultural beliefs e. Patient's age A, C, D, E