PHARMACOLOGY MIDTERM EXAM. 2023
1. A nurse is caring for a 4-year-old child who is resistant to taking medication.
Which of the following strategies should the nurse use to elicit the child’s
cooperation?
a. Offer the child a choice of taking the medication with juice or water
b. Tell the child it is candy
c. Hide the medications in a large dish of ice cream
d. Tell the child he will have a shot instead
Rationale : Providing choices and involving the child in the decision-making process can help
increase cooperation. Offering the medication with juice or water gives the child a sense of
control and may make the experience more positive.
2. A nurse is caring for a client who has difficulty swallowing medications and is
prescribed enteric-coated aspirin PO once daily. The client asks if the medication
can be crushed to make it easier to swallow. Which of the following responses
should the nurse provide?
a. "Crushing the medication might cause you to have a stomach ache or indigestion.
b. "Crushing the medication is a good idea, and I can mix it in some ice cream for you.
c. "Crushing the medication would release all the medication at once, rather than over time."
d. "Crushing is unsafe, as it destroys the ingredients in the medication."
Rationale : c. "Crushing the medication would release all the medication at once, rather than
over time."Enteric-coated medications are designed to dissolve in the small intestine, providing
a delayed release of the medication. Crushing the medication would disrupt the coating,
causing it to dissolve in the stomach and potentially leading to rapid absorption and adverse
effects. Therefore, it's important to advise against crushing enteric-coated medications.
1
,3. A nurse is caring for a client who has congestive heart failure and is taking
digoxin daily.The client refused breakfast and is complaining of nausea and
weakness. Which of the following actions should the nurse take first?
a. A. Check the client's vital signs.
b. Request a dietitian consult.
c. Suggest that the client rests before eating the meal.
d. Request an order for an antiemetic.
Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. Assess
for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication
and call the provider if the client's heart rate is less than 60 bpm
4. A nurse is caring for a client who has thrombophlebitis and is receiving
heparin by continuous IV infusion. The client asks the nurse how long it will take
for the heparin to dissolve the clot. Which of the following responses should the
nurse give?
a. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
b. "Pharmacist is the person to answer that question."
c. "Heparin does not dissolve clots. It stops new clots from forming."
d. "The oral medication you will take after this IV will dissolve the clot.
i. Rationale: This statement accurately answers the client's question.
5. A nurse is caring for a client who has bipolar disorder and has been taking
lithium for 1 year. Before administering the medication, the nurse should check to
see that which of the following tests have been completed?
a. Thyroid hormone assay
b. Liver function tests:
c. Erythrocyte sedimentation rate
d. Brain natriuretic peptide
2
, Rationale : Regular monitoring of thyroid function is essential for clients taking lithium, as
lithium can affect thyroid hormone levels. The thyroid hormone assay helps assess the thyroid
function and allows healthcare providers to make adjustments to the medication or provide
additional treatment if needed. Both hypothyroidism and hyperthyroidism can occur as side
effects of long-term lithium use.
6. A nurse is providing discharge teaching to a client who has asthma and new
prescriptions for cromolyn and albuterol, both by nebulizer. Which of the
following statements by the client indicates an understanding of the teaching?
a. “If my breathing begins to feel tight, I will use the cromolyn immediately.”
b. “I will be sure to take the albuterol before taking the cromolyn.”
c. “I will use both medications immediately after exercising.”
d. “I will administer the medications 10 minutes apart.”
Rationale: The client should always use the bronchodilator (albuterol)prior to using the
leukotriene modifier (cromolyn). Using the bronchodilator first allows the airways to be
opened, ensuring that themaximum dose of medication will get to the client's lungs.
7. A nurse is completing a medication history for a client who reports using
over-the counter calcium carbonate antacid. Which of the following
recommendations should the nurse make about taking this medication?
a. Decrease bulk in the diet to counteract the adverse effect of diarrhea.
b. Take medication with dairy products to increase absorption.
c. Reduce sodium intake.
d. Drink a glass of water after taking the medication.
Rationale : i. Calcium carbonate is a dietary supplement used when the amount of
calcium taken in the diet is not enough. Calcium carbonate may also be used as an
antacid to relieve heartburn, acid indigestion, and stomach upset. The client should drink
a full glass of water after taking an antacid to enhance its effectiveness.
8. Anurse is caring for a client who has deep vein thrombosis and has been on
heparin continuous infusion for 5 days. The provider prescribes warfarin PO
3
1. A nurse is caring for a 4-year-old child who is resistant to taking medication.
Which of the following strategies should the nurse use to elicit the child’s
cooperation?
a. Offer the child a choice of taking the medication with juice or water
b. Tell the child it is candy
c. Hide the medications in a large dish of ice cream
d. Tell the child he will have a shot instead
Rationale : Providing choices and involving the child in the decision-making process can help
increase cooperation. Offering the medication with juice or water gives the child a sense of
control and may make the experience more positive.
2. A nurse is caring for a client who has difficulty swallowing medications and is
prescribed enteric-coated aspirin PO once daily. The client asks if the medication
can be crushed to make it easier to swallow. Which of the following responses
should the nurse provide?
a. "Crushing the medication might cause you to have a stomach ache or indigestion.
b. "Crushing the medication is a good idea, and I can mix it in some ice cream for you.
c. "Crushing the medication would release all the medication at once, rather than over time."
d. "Crushing is unsafe, as it destroys the ingredients in the medication."
Rationale : c. "Crushing the medication would release all the medication at once, rather than
over time."Enteric-coated medications are designed to dissolve in the small intestine, providing
a delayed release of the medication. Crushing the medication would disrupt the coating,
causing it to dissolve in the stomach and potentially leading to rapid absorption and adverse
effects. Therefore, it's important to advise against crushing enteric-coated medications.
1
,3. A nurse is caring for a client who has congestive heart failure and is taking
digoxin daily.The client refused breakfast and is complaining of nausea and
weakness. Which of the following actions should the nurse take first?
a. A. Check the client's vital signs.
b. Request a dietitian consult.
c. Suggest that the client rests before eating the meal.
d. Request an order for an antiemetic.
Rationale: It is possible that the client's nausea is secondary to digoxin toxicity. Assess
for bradycardia, a symptom of digoxin toxicity. The nurse should withhold the medication
and call the provider if the client's heart rate is less than 60 bpm
4. A nurse is caring for a client who has thrombophlebitis and is receiving
heparin by continuous IV infusion. The client asks the nurse how long it will take
for the heparin to dissolve the clot. Which of the following responses should the
nurse give?
a. "It usually takes heparin at least 2 to 3 days to reach a therapeutic blood level."
b. "Pharmacist is the person to answer that question."
c. "Heparin does not dissolve clots. It stops new clots from forming."
d. "The oral medication you will take after this IV will dissolve the clot.
i. Rationale: This statement accurately answers the client's question.
5. A nurse is caring for a client who has bipolar disorder and has been taking
lithium for 1 year. Before administering the medication, the nurse should check to
see that which of the following tests have been completed?
a. Thyroid hormone assay
b. Liver function tests:
c. Erythrocyte sedimentation rate
d. Brain natriuretic peptide
2
, Rationale : Regular monitoring of thyroid function is essential for clients taking lithium, as
lithium can affect thyroid hormone levels. The thyroid hormone assay helps assess the thyroid
function and allows healthcare providers to make adjustments to the medication or provide
additional treatment if needed. Both hypothyroidism and hyperthyroidism can occur as side
effects of long-term lithium use.
6. A nurse is providing discharge teaching to a client who has asthma and new
prescriptions for cromolyn and albuterol, both by nebulizer. Which of the
following statements by the client indicates an understanding of the teaching?
a. “If my breathing begins to feel tight, I will use the cromolyn immediately.”
b. “I will be sure to take the albuterol before taking the cromolyn.”
c. “I will use both medications immediately after exercising.”
d. “I will administer the medications 10 minutes apart.”
Rationale: The client should always use the bronchodilator (albuterol)prior to using the
leukotriene modifier (cromolyn). Using the bronchodilator first allows the airways to be
opened, ensuring that themaximum dose of medication will get to the client's lungs.
7. A nurse is completing a medication history for a client who reports using
over-the counter calcium carbonate antacid. Which of the following
recommendations should the nurse make about taking this medication?
a. Decrease bulk in the diet to counteract the adverse effect of diarrhea.
b. Take medication with dairy products to increase absorption.
c. Reduce sodium intake.
d. Drink a glass of water after taking the medication.
Rationale : i. Calcium carbonate is a dietary supplement used when the amount of
calcium taken in the diet is not enough. Calcium carbonate may also be used as an
antacid to relieve heartburn, acid indigestion, and stomach upset. The client should drink
a full glass of water after taking an antacid to enhance its effectiveness.
8. Anurse is caring for a client who has deep vein thrombosis and has been on
heparin continuous infusion for 5 days. The provider prescribes warfarin PO
3
