lOMoAR cPSD| 23589649
NUR 2474 PHARMACOLOGY
g g g
FINAL EXAM g
1. Thegnursegworkinggongaghigh-acuitygmedical-
surgicalgunitgisgprioritizinggcaregforgfourgpatientsgwhogweregjustgadmitted.gWhichgpatientgs
houldgthegnursegassessgfirst?
a. ThegNPOgpatientgwithgagbloodgglucoseglevelgofg80gmg/dLgwhogjustgreceivedg20gunitsgofg7
0/30gNovolinginsulin
b. Thegpatientgwithgagpulsegofg58gbeatsgpergminutegwhogisgaboutgtogreceivegdigoxing(
Lanoxin)
c. Thegpatientgwithgagbloodgpressuregofg136/92gmmgHggwhogcomplainsgofghavinggagh
eadache
d. Thegpatientgwithgangallergygtogpenicillingwhogisgreceivingganginfusiongofgvancomycing(
Vancocin)
2. Agpatientgwithgtypeg1gdiabetesgisgeatinggbreakfastgatg7:30gAM.gBloodgsugarsgaregongagsli
dinggscalegandgaregorderedgbeforegagmealgandgatgbedtime.gThegpatient'sgbloodgsugarglevelg
isg317gmg/dL.gWhichgformulationgofginsulingshouldgthegnursegpreparegtogadminister?
a. Noginsulingshouldgbegadministered.
b. NPH
c. 70/30gmix
d. Lisprog(Humalog)
3. Agpatientgwithgtypeg1gdiabetesgrecentlygbecamegpregnant.gThegnursegplansgagbloodgg
lucosegtestinggschedulegforgher.gWhatgisgthegrecommendedgmonitoringgschedule?
a. Beforegeachgmealgandgbeforegbed
b. Ingthegmorninggforgagfastingglevelgandgatg4gPMgforgthegpeakglevelgc
.gSixgorgsevengtimesgagday
d.gThreegtimesgagday,galonggwithgurinegglucosegtesting
, lOMoAR cPSD| 23589649
4. Angadolescentgpatientgrecentlygattendedgaghealthgfairgandghadgagserumgglucosegtest.gTh
egpatientgtelephonesgthegnursegandgsays,g"Myglevelgwasg125gmg/dL.gDoesgthatgmeangIghav
egdiabetes?"gWhatgisgthegnurse'sgmostgaccurategresponse?
a. "Unlessgyougweregfastinggforglongergthang8ghours,gthisgdoesgnotgnecessarilygmeangyough
avegdiabetes."
b. "Atgthisglevel,gyougprobablyghavegdiabetes.gYougwillgneedgangoralgglucosegtolerancegt
estgthisgweek."
c. "Thisglevelgisgconclusivegevidencegthatgyoughavegdiabetes."
d. "Thisglevelgisgconclusivegevidencegthatgyougdognotghavegdiabetes."
5. Insulingglarginegisgprescribedgforgaghospitalizedgpatientgwhogisgdiabetic.gWhengwillgthegn
ursegadministergthisgdrug?
a. Approximatelyg15gtog30gminutesgbeforegeachgmeal
b. Ingthegmorninggandgatg4gPMg
c.gOncegdailygatgbedtime
d.gAftergmealsgandgatgbedtime
6. Agpatientgwithgtypeg1gdiabetesgwhogtakesginsulingreportsgtakinggpropranololgforgh
ypertension.gWhygisgthegnursegconcerned?
a. Thegbetagblockergcangcauseginsulingresistance.
b. Usinggthegtwogagentsgtogethergincreasesgthegriskgofgketoacidosis.
c. Propranololgincreasesginsulingrequirementsgbecausegofgreceptorgblocking.g
d.gThegbetagblockergcangmaskgthegsymptomsgofghypoglycemia.
7. Whichgstatementgisgcorrectgaboutgthegcontrastgbetweengagcarbosegandgmiglitol?ga
.gMiglitolghasgnotgbeengassociatedgwithghepaticgdysfunction.
b. Withgmiglitol,gsucrosegcangbegusedgtogtreatghypoglycemia.
, lOMoAR cPSD| 23589649
c. MiglitolgisglessgeffectivegingAfricangAmericans.
d. Miglitolghasgnoggastrointestinalgsidegeffects.
8. Agnursegcounselsgagpatientgwithgdiabetesgwhogisgstartinggtherapygwithgangalpha-
gglucosidaseginhibitor.gThegpatientgshouldgbegeducatedgaboutgthegpotentialgforgwhichg
adversegreactions?g(Selectgallgthatgapply.)
a. Hypoglycemiag
b.gFlatulence
c.gElevatedgironglevelsgingthegblood
d.gFluidgretentiong
e.gDiarrhea
9. Thegnursegisgcaringgforgagpregnantgpatientgrecentlygdiagnosedgwithghypothyroidism.gTh
egpatientgtellsgthegnursegshegdoesgnotgwantgtogtakegmedicationsgwhilegshegisgpregnant.gWh
atgwillgthegnursegexplaingtogthisgpatient?
a. Hypothyroidismgisgagnormalgeffectgofgpregnancygandgusuallygisgofgnogconsequence.gb
.gNeuropsychologicgdeficitsgingthegfetusgcangoccurgifgthegconditiongisgnotgtreated.
c.gNogdangergtogthegfetusgexistsguntilgthegthirdgtrimester.
d.gTreatmentgisgrequiredgonlygifgthegpatientgisgexperiencinggsymptoms.
10. Agnursegisgteachinggagpatientgwhoghasgbeengdiagnosedgwithghypothyroidismgaboutgl
evothyroxineg(Synthroid).gWhichgstatementgbygthegpatientgindicatesgagneedgforgfurthergt
eaching?
a. "Igshouldgnotgtakegheartburngmedicationgwithoutgconsultinggmygprovider."
b. "Igshouldgreportginsomnia,gtremors,gandgangincreasedgheartgrategtogmygprovider."
c. "IfgIgtakegagmultivitamingwithgiron,gIgshouldgtakegitg4ghoursgaftergthegSynthroid."gd.
"IfgIgtakegcalciumgsupplements,gIgmaygneedgtogdecreasegmygdosegofgSynthroid."
, lOMoAR cPSD| 23589649
11. AgpatientgwithghypothyroidismgbeginsgtakinggPOglevothyroxineg(Synthroid).gThegnurseg
assessesgthegpatientgatgthegbeginninggofgthegshiftgandgnotesgagheartgrategofg62gbeatsgpergmi
nutegandgagtemperaturegofg97.2°gF.gThegpatientgisglethargicgandgdifficultgtogarouse.gThegnurs
egwillgcontactgthegprovidergtogrequestgangordergforgwhichgdrug?
a. Betagblocker
b. IncreasedgdosegofgPOglevothyroxineg
c.gIntravenousglevothyroxine
d.gMethimazoleg(Tapazole)
12. Agpatientgisgadmittedgtogtheghospitalgandgwillgbegingtakingglevothyroxineg(Synthroid).g
Thegnurseglearnsgthatgthegpatientgalsogtakesgwarfaring(Coumadin).gThegnursegwillgnotifygth
egprovidergtogdiscuss the dose.
a.greducingglevothyroxineg
b.greducinggwarfarin
c.gincreasingglevothyroxine
d.gincreasinggwarfarin
13. Angoldergadultgpatientgisgdiagnosedgwithghypothyroidism.gTheginitialgfreegT4glevelgis
0.5gmg/dL,gandgthegTSHglevelgisg8gmicrounits/mL.gThegprescribergordersglevothyroxineg(Levothroi
d)g100gmcg/daygPO.gWhatgwillgthegnursegdo?
a. Administergthegmedicationgasgordered.
b. ContactgthegprovidergtogdiscussggivinggtheglevothyroxinegIV.
c. Requestgangordergtoggivegdesiccatedgthyroidg(ArmourgThyroid).g
d.gSuggestgthatgthegproviderglowergthegdose.
14. Ag1-year-
oldgchildgwithgcretinismghasgbeengreceivingg8gmcg/kg/daygofglevothyroxineg(Synthroid).gTh
egchildgcomesgtogthegclinicgforgagwell-childgcheckgup.gThegnursegwillgexpectgthegprovidergto:
NUR 2474 PHARMACOLOGY
g g g
FINAL EXAM g
1. Thegnursegworkinggongaghigh-acuitygmedical-
surgicalgunitgisgprioritizinggcaregforgfourgpatientsgwhogweregjustgadmitted.gWhichgpatientgs
houldgthegnursegassessgfirst?
a. ThegNPOgpatientgwithgagbloodgglucoseglevelgofg80gmg/dLgwhogjustgreceivedg20gunitsgofg7
0/30gNovolinginsulin
b. Thegpatientgwithgagpulsegofg58gbeatsgpergminutegwhogisgaboutgtogreceivegdigoxing(
Lanoxin)
c. Thegpatientgwithgagbloodgpressuregofg136/92gmmgHggwhogcomplainsgofghavinggagh
eadache
d. Thegpatientgwithgangallergygtogpenicillingwhogisgreceivingganginfusiongofgvancomycing(
Vancocin)
2. Agpatientgwithgtypeg1gdiabetesgisgeatinggbreakfastgatg7:30gAM.gBloodgsugarsgaregongagsli
dinggscalegandgaregorderedgbeforegagmealgandgatgbedtime.gThegpatient'sgbloodgsugarglevelg
isg317gmg/dL.gWhichgformulationgofginsulingshouldgthegnursegpreparegtogadminister?
a. Noginsulingshouldgbegadministered.
b. NPH
c. 70/30gmix
d. Lisprog(Humalog)
3. Agpatientgwithgtypeg1gdiabetesgrecentlygbecamegpregnant.gThegnursegplansgagbloodgg
lucosegtestinggschedulegforgher.gWhatgisgthegrecommendedgmonitoringgschedule?
a. Beforegeachgmealgandgbeforegbed
b. Ingthegmorninggforgagfastingglevelgandgatg4gPMgforgthegpeakglevelgc
.gSixgorgsevengtimesgagday
d.gThreegtimesgagday,galonggwithgurinegglucosegtesting
, lOMoAR cPSD| 23589649
4. Angadolescentgpatientgrecentlygattendedgaghealthgfairgandghadgagserumgglucosegtest.gTh
egpatientgtelephonesgthegnursegandgsays,g"Myglevelgwasg125gmg/dL.gDoesgthatgmeangIghav
egdiabetes?"gWhatgisgthegnurse'sgmostgaccurategresponse?
a. "Unlessgyougweregfastinggforglongergthang8ghours,gthisgdoesgnotgnecessarilygmeangyough
avegdiabetes."
b. "Atgthisglevel,gyougprobablyghavegdiabetes.gYougwillgneedgangoralgglucosegtolerancegt
estgthisgweek."
c. "Thisglevelgisgconclusivegevidencegthatgyoughavegdiabetes."
d. "Thisglevelgisgconclusivegevidencegthatgyougdognotghavegdiabetes."
5. Insulingglarginegisgprescribedgforgaghospitalizedgpatientgwhogisgdiabetic.gWhengwillgthegn
ursegadministergthisgdrug?
a. Approximatelyg15gtog30gminutesgbeforegeachgmeal
b. Ingthegmorninggandgatg4gPMg
c.gOncegdailygatgbedtime
d.gAftergmealsgandgatgbedtime
6. Agpatientgwithgtypeg1gdiabetesgwhogtakesginsulingreportsgtakinggpropranololgforgh
ypertension.gWhygisgthegnursegconcerned?
a. Thegbetagblockergcangcauseginsulingresistance.
b. Usinggthegtwogagentsgtogethergincreasesgthegriskgofgketoacidosis.
c. Propranololgincreasesginsulingrequirementsgbecausegofgreceptorgblocking.g
d.gThegbetagblockergcangmaskgthegsymptomsgofghypoglycemia.
7. Whichgstatementgisgcorrectgaboutgthegcontrastgbetweengagcarbosegandgmiglitol?ga
.gMiglitolghasgnotgbeengassociatedgwithghepaticgdysfunction.
b. Withgmiglitol,gsucrosegcangbegusedgtogtreatghypoglycemia.
, lOMoAR cPSD| 23589649
c. MiglitolgisglessgeffectivegingAfricangAmericans.
d. Miglitolghasgnoggastrointestinalgsidegeffects.
8. Agnursegcounselsgagpatientgwithgdiabetesgwhogisgstartinggtherapygwithgangalpha-
gglucosidaseginhibitor.gThegpatientgshouldgbegeducatedgaboutgthegpotentialgforgwhichg
adversegreactions?g(Selectgallgthatgapply.)
a. Hypoglycemiag
b.gFlatulence
c.gElevatedgironglevelsgingthegblood
d.gFluidgretentiong
e.gDiarrhea
9. Thegnursegisgcaringgforgagpregnantgpatientgrecentlygdiagnosedgwithghypothyroidism.gTh
egpatientgtellsgthegnursegshegdoesgnotgwantgtogtakegmedicationsgwhilegshegisgpregnant.gWh
atgwillgthegnursegexplaingtogthisgpatient?
a. Hypothyroidismgisgagnormalgeffectgofgpregnancygandgusuallygisgofgnogconsequence.gb
.gNeuropsychologicgdeficitsgingthegfetusgcangoccurgifgthegconditiongisgnotgtreated.
c.gNogdangergtogthegfetusgexistsguntilgthegthirdgtrimester.
d.gTreatmentgisgrequiredgonlygifgthegpatientgisgexperiencinggsymptoms.
10. Agnursegisgteachinggagpatientgwhoghasgbeengdiagnosedgwithghypothyroidismgaboutgl
evothyroxineg(Synthroid).gWhichgstatementgbygthegpatientgindicatesgagneedgforgfurthergt
eaching?
a. "Igshouldgnotgtakegheartburngmedicationgwithoutgconsultinggmygprovider."
b. "Igshouldgreportginsomnia,gtremors,gandgangincreasedgheartgrategtogmygprovider."
c. "IfgIgtakegagmultivitamingwithgiron,gIgshouldgtakegitg4ghoursgaftergthegSynthroid."gd.
"IfgIgtakegcalciumgsupplements,gIgmaygneedgtogdecreasegmygdosegofgSynthroid."
, lOMoAR cPSD| 23589649
11. AgpatientgwithghypothyroidismgbeginsgtakinggPOglevothyroxineg(Synthroid).gThegnurseg
assessesgthegpatientgatgthegbeginninggofgthegshiftgandgnotesgagheartgrategofg62gbeatsgpergmi
nutegandgagtemperaturegofg97.2°gF.gThegpatientgisglethargicgandgdifficultgtogarouse.gThegnurs
egwillgcontactgthegprovidergtogrequestgangordergforgwhichgdrug?
a. Betagblocker
b. IncreasedgdosegofgPOglevothyroxineg
c.gIntravenousglevothyroxine
d.gMethimazoleg(Tapazole)
12. Agpatientgisgadmittedgtogtheghospitalgandgwillgbegingtakingglevothyroxineg(Synthroid).g
Thegnurseglearnsgthatgthegpatientgalsogtakesgwarfaring(Coumadin).gThegnursegwillgnotifygth
egprovidergtogdiscuss the dose.
a.greducingglevothyroxineg
b.greducinggwarfarin
c.gincreasingglevothyroxine
d.gincreasinggwarfarin
13. Angoldergadultgpatientgisgdiagnosedgwithghypothyroidism.gTheginitialgfreegT4glevelgis
0.5gmg/dL,gandgthegTSHglevelgisg8gmicrounits/mL.gThegprescribergordersglevothyroxineg(Levothroi
d)g100gmcg/daygPO.gWhatgwillgthegnursegdo?
a. Administergthegmedicationgasgordered.
b. ContactgthegprovidergtogdiscussggivinggtheglevothyroxinegIV.
c. Requestgangordergtoggivegdesiccatedgthyroidg(ArmourgThyroid).g
d.gSuggestgthatgthegproviderglowergthegdose.
14. Ag1-year-
oldgchildgwithgcretinismghasgbeengreceivingg8gmcg/kg/daygofglevothyroxineg(Synthroid).gTh
egchildgcomesgtogthegclinicgforgagwell-childgcheckgup.gThegnursegwillgexpectgthegprovidergto:
