NUR 2474 PHARMACOLOGY FINAL EXAM
CORRECT QUESTIONS & ANSWERS A+ GRAD
(RAMUSSEN COLLEGE)
The nurse working on a high-acuity medical-surgical unit is prioritizing care for four clients
who were just admitted. Which client should the nurse assess first?
a.The NPO client with a blood glucose level of 80 mg/dL who just received 20 units of 70/30
Novolin insulin
b.The client with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin)
c.The client with a blood pressure of 136/92 mm Hg who complains of having a headache
d.The client with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin)
A client with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale
and are ordered before a meal and at bedtime. The client's blood sugar level is 317 mg/dL.
Which formulation of insulin should the nurse prepare to administer?
a.No insulin should be
administered.
b.NPH
c.70/30 mix
d.Lispro (Humalog)
A client with type 1 diabetes recently became pregnant. The nurse plans a blood glucose
testing schedule for her. What is the recommended monitoring schedule?
a.Before each meal and before bed
b.In the morning for a fasting level and at 4 PM for the peak level
c.Six or seven times a day
d.Three times a day, along with urine glucose testing
An adolescent client recently attended a health fair and had a serum glucose test. The client
telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?"
What is the nurse's most accurate response?
,• "Unless you were fasting for longer than 8 hours, this does not necessarily mean you
havediabetes."
• "At this level, you probably have diabetes. You will need an oral glucose tolerance test
thisweek."
• "This level is conclusive evidence that you have diabetes."
• "This level is conclusive evidence that you do not have diabetes."
Insulin glargine is prescribed for a hospitalized client who is diabetic. When will the nurse
administer this drug?
a.Approximately 15 to 30 minutes before each meal
b.In the morning and at 4 PM
c.Once daily at bedtime
d.After meals and at bedtime
A client with type 1 diabetes who takes insulin reports taking propranolol for hypertension.
Why is the nurse concerned?
a.The beta blocker can cause insulin resistance.
b.Using the two agents together increases the risk of ketoacidosis.
c.Propranolol increases insulin requirements because of receptor blocking.
d.The beta blocker can mask the symptoms of hypoglycemia.
Which statement is correct about the contrast between acarbose and miglitol?
• Miglitol has not been associated with hepatic dysfunction.
• With miglitol, sucrose can be used to treat hypoglycemia.
• Miglitol is less effective in African Americans.
• Miglitol has no gastrointestinal side effects.
A nurse counsels a client with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The client should be educated about the potential for which
adverse reactions?(Select all that apply.)
a.Hypoglycemia
b.Flatulence
c.Elevated iron levels in the
blood
d.Fluid retention
• Diarrhea
,The nurse is caring for a pregnant client recently diagnosed with hypothyroidism. The client
tells the nurse she does not want to take medications while she is pregnant. What will the
nurse explain to this client?
a.Hypothyroidism is a normal effect of pregnancy and usually is of no
consequence.
b.Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c.No danger to the fetus exists until the third trimester.
d.Treatment is required only if the client is experiencing symptoms.
A nurse is teaching a client who has been diagnosed with hypothyroidism about levothyroxine
(Synthroid). Which statement by the client indicates a need for further teaching?
• "I should not take heartburn medication without consulting my provider."
• "I should report insomnia, tremors, and an increased heart rate to my provider."
• "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."
• "If I take calcium supplements, I may need to decrease my dose of Synthroid."
A client with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses
the client at the beginning of the shift and notes a heart rate of 62 beats per minute and a
temperature of 97.2° F. The client is lethargic and difficult to arouse. The nurse will contact
the provider to request an order for which drug?
a.Beta blocker
b.Increased dose of PO
levothyroxine
c.Intravenous levothyroxine
d.Methimazole (Tapazole)
A client is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse
learns that the client also takes warfarin (Coumadin). The nurse will notify the provider to
discuss the dose.
a.reducing levothyroxine
b.reducing warfarin
c.increasing levothyroxine
d.increasing warfarin
, An older adult client is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL,
and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine (Levothroid) 100
mcg/day PO. What will the nurse do?
a.Administer the medication as ordered.
b.Contact the provider to discuss giving the levothyroxine IV.
c.Request an order to give desiccated thyroid (Armour Thyroid).
d.Suggest that the provider lower the dose.
A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine
(Synthroid).The child comes to the clinic for a well-child check up. The nurse will expect the
provider to:
a.change the dose of levothyroxine to 6 mcg/kg/day.
b.discontinue the drug if the child's physical and mental development is normal.
c.increase the dose to accommodate the child's increased growth.
d.stop the drug for 4 weeks and check the child's TSH level.
A client who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of
pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion
site and along the vein. What is the nurse's priority action?
a.Apply warm packs to the arm, and infuse the medication at a slower
rate.
b.Continue the infusion while elevating the arm.
c.Select an alternate intravenous site and administer the infusion more slowly.
d.Request central venous access.
A nurse is teaching a nursing student what is meant by "generations" of cephalosporins.
Whichstatement by the student indicates understanding of the teaching?
a."Cephalosporins are assigned to generations based on their relative costs to administer."
b."Cephalosporins have increased activity against gram-negative bacteria with each
generation."
c."First-generation cephalosporins have better penetration of the cerebrospinal fluid."
d."Later generations of cephalosporins have lower resistance to destruction by beta-
lactamases."
CORRECT QUESTIONS & ANSWERS A+ GRAD
(RAMUSSEN COLLEGE)
The nurse working on a high-acuity medical-surgical unit is prioritizing care for four clients
who were just admitted. Which client should the nurse assess first?
a.The NPO client with a blood glucose level of 80 mg/dL who just received 20 units of 70/30
Novolin insulin
b.The client with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin)
c.The client with a blood pressure of 136/92 mm Hg who complains of having a headache
d.The client with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin)
A client with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale
and are ordered before a meal and at bedtime. The client's blood sugar level is 317 mg/dL.
Which formulation of insulin should the nurse prepare to administer?
a.No insulin should be
administered.
b.NPH
c.70/30 mix
d.Lispro (Humalog)
A client with type 1 diabetes recently became pregnant. The nurse plans a blood glucose
testing schedule for her. What is the recommended monitoring schedule?
a.Before each meal and before bed
b.In the morning for a fasting level and at 4 PM for the peak level
c.Six or seven times a day
d.Three times a day, along with urine glucose testing
An adolescent client recently attended a health fair and had a serum glucose test. The client
telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?"
What is the nurse's most accurate response?
,• "Unless you were fasting for longer than 8 hours, this does not necessarily mean you
havediabetes."
• "At this level, you probably have diabetes. You will need an oral glucose tolerance test
thisweek."
• "This level is conclusive evidence that you have diabetes."
• "This level is conclusive evidence that you do not have diabetes."
Insulin glargine is prescribed for a hospitalized client who is diabetic. When will the nurse
administer this drug?
a.Approximately 15 to 30 minutes before each meal
b.In the morning and at 4 PM
c.Once daily at bedtime
d.After meals and at bedtime
A client with type 1 diabetes who takes insulin reports taking propranolol for hypertension.
Why is the nurse concerned?
a.The beta blocker can cause insulin resistance.
b.Using the two agents together increases the risk of ketoacidosis.
c.Propranolol increases insulin requirements because of receptor blocking.
d.The beta blocker can mask the symptoms of hypoglycemia.
Which statement is correct about the contrast between acarbose and miglitol?
• Miglitol has not been associated with hepatic dysfunction.
• With miglitol, sucrose can be used to treat hypoglycemia.
• Miglitol is less effective in African Americans.
• Miglitol has no gastrointestinal side effects.
A nurse counsels a client with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The client should be educated about the potential for which
adverse reactions?(Select all that apply.)
a.Hypoglycemia
b.Flatulence
c.Elevated iron levels in the
blood
d.Fluid retention
• Diarrhea
,The nurse is caring for a pregnant client recently diagnosed with hypothyroidism. The client
tells the nurse she does not want to take medications while she is pregnant. What will the
nurse explain to this client?
a.Hypothyroidism is a normal effect of pregnancy and usually is of no
consequence.
b.Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c.No danger to the fetus exists until the third trimester.
d.Treatment is required only if the client is experiencing symptoms.
A nurse is teaching a client who has been diagnosed with hypothyroidism about levothyroxine
(Synthroid). Which statement by the client indicates a need for further teaching?
• "I should not take heartburn medication without consulting my provider."
• "I should report insomnia, tremors, and an increased heart rate to my provider."
• "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."
• "If I take calcium supplements, I may need to decrease my dose of Synthroid."
A client with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses
the client at the beginning of the shift and notes a heart rate of 62 beats per minute and a
temperature of 97.2° F. The client is lethargic and difficult to arouse. The nurse will contact
the provider to request an order for which drug?
a.Beta blocker
b.Increased dose of PO
levothyroxine
c.Intravenous levothyroxine
d.Methimazole (Tapazole)
A client is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse
learns that the client also takes warfarin (Coumadin). The nurse will notify the provider to
discuss the dose.
a.reducing levothyroxine
b.reducing warfarin
c.increasing levothyroxine
d.increasing warfarin
, An older adult client is diagnosed with hypothyroidism. The initial free T4 level is 0.5 mg/dL,
and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine (Levothroid) 100
mcg/day PO. What will the nurse do?
a.Administer the medication as ordered.
b.Contact the provider to discuss giving the levothyroxine IV.
c.Request an order to give desiccated thyroid (Armour Thyroid).
d.Suggest that the provider lower the dose.
A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine
(Synthroid).The child comes to the clinic for a well-child check up. The nurse will expect the
provider to:
a.change the dose of levothyroxine to 6 mcg/kg/day.
b.discontinue the drug if the child's physical and mental development is normal.
c.increase the dose to accommodate the child's increased growth.
d.stop the drug for 4 weeks and check the child's TSH level.
A client who is receiving a final dose of intravenous (IV) cephalosporin begins to complain of
pain and irritation at the infusion site. The nurse observes signs of redness at the IV insertion
site and along the vein. What is the nurse's priority action?
a.Apply warm packs to the arm, and infuse the medication at a slower
rate.
b.Continue the infusion while elevating the arm.
c.Select an alternate intravenous site and administer the infusion more slowly.
d.Request central venous access.
A nurse is teaching a nursing student what is meant by "generations" of cephalosporins.
Whichstatement by the student indicates understanding of the teaching?
a."Cephalosporins are assigned to generations based on their relative costs to administer."
b."Cephalosporins have increased activity against gram-negative bacteria with each
generation."
c."First-generation cephalosporins have better penetration of the cerebrospinal fluid."
d."Later generations of cephalosporins have lower resistance to destruction by beta-
lactamases."
