Pharmacology Practice Exam
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse
knows that the purpose of this medication is to
a. decrease production of gastric secretions.
b. produce an adherent barrier over the ulcer.
c. maintain a gastric pH of 3.5 or above.
d. decrease gastric motor activity. - ANS-c. maintain a gastric pH of 3.5 or above.
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above (C)
which is necessary for pepsinogen inactivity. (A) is the purpose of H2 receptor
antagonists (cimetidine, ranitidine). (B) is the purpose of sucralfate (Carafate). (D) is the
purpose of anticholinergic drugs which are often used in conjunction with antacids to
allow the antacid to remain in the stomach longer.
In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the
drug is performing as intended?
a. An increase in urine output.
b. Two or three soft stools per day.
c. Watery, diarrhea stools.
d. Increased serum bilirubin. - ANS-b. Two or three soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through
the stool. Two to three stools a day indicate that lactulose is performing as intended (B).
(A) would be expected if the patient received a diuretic. (C) would indicate an overdose
of lactulose and is not expected. Lactulose does not affect (D).
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with
congestive heart failure. Which intervention should the nurse implement prior to
administering the digoxin?
a. Observe respiratory rate and depth.
b. Assess the serum potassium level.
c. Obtain the client's blood pressure.
d. Monitor the serum glucose level. - ANS-b. Assess the serum potassium level.
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons
,receiving digoxin (B). (A and C) will not affect the administration of digoxin. (D) should
be monitored if he/she is a diabetic and is perhaps receiving insulin.
Following the administration of sublingual nitroglycerin to a client experiencing an acute
anginal attack, which assessment finding indicates to the nurse that the desired effect
has been achieved?
a. Client states chest pain is relieved.
b. Client's pulse decreases from 120 to 90.
c. Client's systolic blood pressure decreases from 180 to 90.
d. Client's SaO2 level increases from 92% to 96%. - ANS-a. Client states chest pain is
relieved.
Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and
reduces chest pain (A). (B and D) would also occur if the angina was relieved, but are
not as significant as the client's subjective report of decreased pain. (C) may indicate a
reduction in pain, or a potentially serious side effect of the medication.
A client with congestive heart failure (CHF) is being discharged with a new prescription
for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's
discharge instruction should include reporting which problem to the healthcare provider?
a. Weight loss.
b. Dizziness.
c. Muscle cramps.
d. Dry mucous membranes. - ANS-b. Dizziness.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by
reversing vasoconstriction common in heart failure. This vasodilation can cause
hypotension and resultant dizziness (B). (A) is desired if fluid overload is present, and
may occur as the result of effective combination drug therapy such as diuretics with
ACE inhibitors. (C) often indicates hypokalemia in the client receiving diuretics.
Excessive diuretic administration may result in fluid volume deficit, manifested by
symptoms such as (D).
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse
knows that the action of this drug is to
a. decrease the amount of thyroid-stimulating hormone circulating in the blood.
, b. increase the amount of thyroid-stimulating hormone circulating in the blood. c.
increase the amount of T4 and decrease the amount of T3 produced by the thyroid. d.
inhibit synthesis of T3 and T4 by the thyroid gland. - ANS-d. inhibit synthesis of T3
and T4 by the thyroid gland.
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production
of thyroid hormones (D). It is often prescribed in preparation for thyroidectomy or
radioactive iodine therapy. Thyroid-stimulating hormone (TSH) is produced by the
pituitary gland, and PTU does not affect the pituitary (A and B). PTU inhibits the
synthesis of all thyroid hormones--both T3 and T4(C).
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which
observation by the nurse would indicate that the desired outcome of the medication is
being achieved?
a. Decreased blood pressure.
b. Lessening of tremors.
c. Increased salivation.
d. Increased attention span. - ANS-b. Lessening of tremors.
Sinemet increases the amount of levodopa to the CNS (dopamine to the brain).
Increased amounts of dopamine improve the symptoms of Parkinson's, such as
involuntary movements, resting tremors (B), shuffling gait, etc. (A) is a side effect of
Sinemet. Decreased drooling would be a desired effect, not (C). Sinemet does not affect
(D).
Following heparin treatment for a pulmonary embolism, a client is being discharged with
a prescription for warfarin (Coumadin). In conducting discharge teaching, the nurse
advises the client to have which diagnostic test monitored regularly after discharge?
a. Perfusion scan.
b. Prothrombin Time (PT/INR).
c. Activated partial thromboplastin (APTT).
d. Serum Coumadin level (SCL). - ANS-b. Prothrombin Time (PT/INR).
When used for a client with pulmonary embolus, the therapeutic goal for warfarin
therapy is a PT 1 to 2 times greater than the control, or an INR of 2 to 3 (B). A perfusion
might be performed to monitor lung function, but not monthly (A). APTT is monitored for
the client receiving heparin therapy (C). A blood level for Coumadin cannot be
An antacid (Maalox) is prescribed for a client with peptic ulcer disease. The nurse
knows that the purpose of this medication is to
a. decrease production of gastric secretions.
b. produce an adherent barrier over the ulcer.
c. maintain a gastric pH of 3.5 or above.
d. decrease gastric motor activity. - ANS-c. maintain a gastric pH of 3.5 or above.
The objective of antacids is to neutralize gastric acids and keep pH of 3.5 or above (C)
which is necessary for pepsinogen inactivity. (A) is the purpose of H2 receptor
antagonists (cimetidine, ranitidine). (B) is the purpose of sucralfate (Carafate). (D) is the
purpose of anticholinergic drugs which are often used in conjunction with antacids to
allow the antacid to remain in the stomach longer.
In evaluating the effects of lactulose (Cephulac), which outcome would indicate that the
drug is performing as intended?
a. An increase in urine output.
b. Two or three soft stools per day.
c. Watery, diarrhea stools.
d. Increased serum bilirubin. - ANS-b. Two or three soft stools per day.
Lactulose is administered to reduce blood ammonia by excretion of ammonia through
the stool. Two to three stools a day indicate that lactulose is performing as intended (B).
(A) would be expected if the patient received a diuretic. (C) would indicate an overdose
of lactulose and is not expected. Lactulose does not affect (D).
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with
congestive heart failure. Which intervention should the nurse implement prior to
administering the digoxin?
a. Observe respiratory rate and depth.
b. Assess the serum potassium level.
c. Obtain the client's blood pressure.
d. Monitor the serum glucose level. - ANS-b. Assess the serum potassium level.
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons
,receiving digoxin (B). (A and C) will not affect the administration of digoxin. (D) should
be monitored if he/she is a diabetic and is perhaps receiving insulin.
Following the administration of sublingual nitroglycerin to a client experiencing an acute
anginal attack, which assessment finding indicates to the nurse that the desired effect
has been achieved?
a. Client states chest pain is relieved.
b. Client's pulse decreases from 120 to 90.
c. Client's systolic blood pressure decreases from 180 to 90.
d. Client's SaO2 level increases from 92% to 96%. - ANS-a. Client states chest pain is
relieved.
Nitroglycerin reduces myocardial oxygen consumption which decreases ischemia and
reduces chest pain (A). (B and D) would also occur if the angina was relieved, but are
not as significant as the client's subjective report of decreased pain. (C) may indicate a
reduction in pain, or a potentially serious side effect of the medication.
A client with congestive heart failure (CHF) is being discharged with a new prescription
for the angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten). The nurse's
discharge instruction should include reporting which problem to the healthcare provider?
a. Weight loss.
b. Dizziness.
c. Muscle cramps.
d. Dry mucous membranes. - ANS-b. Dizziness.
Angiotensin-converting enzyme (ACE) inhibitors are used in CHF to reduce afterload by
reversing vasoconstriction common in heart failure. This vasodilation can cause
hypotension and resultant dizziness (B). (A) is desired if fluid overload is present, and
may occur as the result of effective combination drug therapy such as diuretics with
ACE inhibitors. (C) often indicates hypokalemia in the client receiving diuretics.
Excessive diuretic administration may result in fluid volume deficit, manifested by
symptoms such as (D).
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse
knows that the action of this drug is to
a. decrease the amount of thyroid-stimulating hormone circulating in the blood.
, b. increase the amount of thyroid-stimulating hormone circulating in the blood. c.
increase the amount of T4 and decrease the amount of T3 produced by the thyroid. d.
inhibit synthesis of T3 and T4 by the thyroid gland. - ANS-d. inhibit synthesis of T3
and T4 by the thyroid gland.
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production
of thyroid hormones (D). It is often prescribed in preparation for thyroidectomy or
radioactive iodine therapy. Thyroid-stimulating hormone (TSH) is produced by the
pituitary gland, and PTU does not affect the pituitary (A and B). PTU inhibits the
synthesis of all thyroid hormones--both T3 and T4(C).
A client with Parkinson's disease is taking carbidopa-levodopa (Sinemet). Which
observation by the nurse would indicate that the desired outcome of the medication is
being achieved?
a. Decreased blood pressure.
b. Lessening of tremors.
c. Increased salivation.
d. Increased attention span. - ANS-b. Lessening of tremors.
Sinemet increases the amount of levodopa to the CNS (dopamine to the brain).
Increased amounts of dopamine improve the symptoms of Parkinson's, such as
involuntary movements, resting tremors (B), shuffling gait, etc. (A) is a side effect of
Sinemet. Decreased drooling would be a desired effect, not (C). Sinemet does not affect
(D).
Following heparin treatment for a pulmonary embolism, a client is being discharged with
a prescription for warfarin (Coumadin). In conducting discharge teaching, the nurse
advises the client to have which diagnostic test monitored regularly after discharge?
a. Perfusion scan.
b. Prothrombin Time (PT/INR).
c. Activated partial thromboplastin (APTT).
d. Serum Coumadin level (SCL). - ANS-b. Prothrombin Time (PT/INR).
When used for a client with pulmonary embolus, the therapeutic goal for warfarin
therapy is a PT 1 to 2 times greater than the control, or an INR of 2 to 3 (B). A perfusion
might be performed to monitor lung function, but not monthly (A). APTT is monitored for
the client receiving heparin therapy (C). A blood level for Coumadin cannot be
