NR 293 ATI Pharmacology Final Review_2020 – Chamberlain
College of Nursing
1) A nurse is assessing a client who is taking levothyroxine. The nurse should recognize
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
an increase
b) Increase in the T4.
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
, i) Rationale: If the dose of this medication has been adequate, the nurse should see
an increase
b) Increase in the T4.
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) Guaifenesin
i) Drowsiness and dizziness
c) Prednisone
i) With glucose intolerance and hyperglycemia, the patient might require
an increased dosage of hypoglycemic med.
d) Atorvastatin
i) Thyroid function tests.
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
,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 of 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.
6) A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The
client tells the nurse she is experiencing flank pain. Which of the following adverse effects
should the nurse suspect?
a) Renal stones
7) A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve.
Whi h f th f ll i l b t l h ld th it f th ti ff t
, 6) A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The
client tells the nurse she is experiencing flank pain. Which of the following adverse effects
should the nurse suspect?
a) Renal stones
7) A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve.
Which of the following laboratory values should the nurse monitor for a therapeutic effect
of warfarin?
a) Hemoglobin
b) Prothrombin time (PT)
i) Rationale: This test is used to monitor warfarin therapy. For a client
receiving full anticoagulant therapy, should typically be
approximately two to three times the normal value, depending on the
indication for therapeutic anticoagulation.
c) Bleeding time
d) Activated partial thromboplastin time (aPTT)
8) A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The
client states, "I don't need this medication. I am not constipated." The nurse should explain
that in clients who have cirrhosis, lactulose is used to decrease levels of which of the
following components in the bloodstream?
a) Glucose
b) Ammonia
i) Rationale: Lactulose, a disaccharide, is a sugar that works as an osmotic
diuretic. It prevents the absorption of ammonia in the colon.
Accumulation of ammonia in the bloodstream, which occurs in
pathologic conditions ofthe liver, such as cirrhosis, may affect the
central nervous system, causing hepatic encephalopathy or coma.
c) Potassium
d) Bicarbonate
9) A nurse is educating a group of clients about the contraindications of warfarin therapy.
Which of the following statements should the nurse include in the teaching?
a) "Clients who have glaucoma should not take warfarin."
b) "Clients who have rheumatoid arthritis should not take warfarin."
c) "Clients who are pregnant should not take warfarin."
i) Rationale: Warfarin therapy is contraindicated in the pregnant client
College of Nursing
1) A nurse is assessing a client who is taking levothyroxine. The nurse should recognize
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
an increase
b) Increase in the T4.
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
, i) Rationale: If the dose of this medication has been adequate, the nurse should see
an increase
b) Increase in the T4.
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) Guaifenesin
i) Drowsiness and dizziness
c) Prednisone
i) With glucose intolerance and hyperglycemia, the patient might require
an increased dosage of hypoglycemic med.
d) Atorvastatin
i) Thyroid function tests.
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
,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 of 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.
6) A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The
client tells the nurse she is experiencing flank pain. Which of the following adverse effects
should the nurse suspect?
a) Renal stones
7) A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve.
Whi h f th f ll i l b t l h ld th it f th ti ff t
, 6) A nurse is talking to a client who is taking a calcium supplement for osteoporosis. The
client tells the nurse she is experiencing flank pain. Which of the following adverse effects
should the nurse suspect?
a) Renal stones
7) A nurse is caring for a client who is prescribed warfarin therapy for an artificial heart valve.
Which of the following laboratory values should the nurse monitor for a therapeutic effect
of warfarin?
a) Hemoglobin
b) Prothrombin time (PT)
i) Rationale: This test is used to monitor warfarin therapy. For a client
receiving full anticoagulant therapy, should typically be
approximately two to three times the normal value, depending on the
indication for therapeutic anticoagulation.
c) Bleeding time
d) Activated partial thromboplastin time (aPTT)
8) A nurse is preparing to administer a dose of lactulose to a client who has cirrhosis. The
client states, "I don't need this medication. I am not constipated." The nurse should explain
that in clients who have cirrhosis, lactulose is used to decrease levels of which of the
following components in the bloodstream?
a) Glucose
b) Ammonia
i) Rationale: Lactulose, a disaccharide, is a sugar that works as an osmotic
diuretic. It prevents the absorption of ammonia in the colon.
Accumulation of ammonia in the bloodstream, which occurs in
pathologic conditions ofthe liver, such as cirrhosis, may affect the
central nervous system, causing hepatic encephalopathy or coma.
c) Potassium
d) Bicarbonate
9) A nurse is educating a group of clients about the contraindications of warfarin therapy.
Which of the following statements should the nurse include in the teaching?
a) "Clients who have glaucoma should not take warfarin."
b) "Clients who have rheumatoid arthritis should not take warfarin."
c) "Clients who are pregnant should not take warfarin."
i) Rationale: Warfarin therapy is contraindicated in the pregnant client
