Saunders Pharmacology Exam
Questions with Correct Answers
4.) The camp nurse asks the children preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the children that chemical sunscreens are
most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - ANSWER-4. At least 30 minutes
before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury.
When applying the medication, the client complains of local discomfort and burning.
Which of the following is the most appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site - ANSWER-3. Informing
the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The client
should be informed that the medication will cause local discomfort and burning and
that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to
the site of injury. The nurse monitors the client, knowing that which of the following
indicates that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site - ANSWER-1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion
of acid, thereby causing acidosis. Clients receiving this treatment should be
monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the
medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local
rather than systemic effects. An elevated blood pressure may be expected from the
pain that occurs with a burn injury.
,7.) Isotretinoin is prescribed for a client with severe acne. Before the administration
of this medication, the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count - ANSWER-2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the client's medication record and would
contact the (HCP) if the client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - ANSWER-1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification
of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4
are not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse
would monitor for the potential for increased systemic absorption of the medication if
the medication were being applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - ANSWER-2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is
higher from regions where the skin is especially permeable (scalp, axilla, face,
eyelids, neck, perineum, genitalia), and lower from regions in which permeability is
poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse
notes that the client is taking azelaic acid (Azelex). Because of the medication
prescription, the nurse would suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex - ANSWER-1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and
decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
,11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the
client with a partial-thickness burn, which has cultured positive for gram-negative
bacteria. The nurse is reinforcing information to the client about the medication.
Which statement made by the client indicates a lack of understanding about the
treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound." - ANSWER-3. "The
medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of
activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is
applied directly to the wound to assist in healing. It does not stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an
antineoplastic medication. During the infusion, the client complains of pain at the
insertion site. During an inspection of the site, the nurse notes redness and swelling
and that the rate of infusion of the medication has slowed. The nurse should take
which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion. - ANSWER-1. Notify
the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV,
great care must be taken to prevent the medication from escaping into the tissues
surrounding the injection site, because pain, tissue damage, and necrosis can result.
The nurse monitors for signs of extravasation, such as redness or swelling at the
insertion site and a decreased infusion rate. If extravasation occurs, the registered
nurse needs to be notified; he or she will then contact the health care provider.
13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin
intravenously. The nurse caring for the client anticipates that which diagnostic study
will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies - ANSWER-4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause
interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary
function studies along with hematological, hepatic, and renal function tests need to
be monitored. The nurse needs to monitor lung sounds for dyspnea and crackles,
which indicate pulmonary toxicity. The medication needs to be discontinued
immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the
specific use of this medication.
, 14.) The client with acute myelocytic leukemia is being treated with busulfan
(Myleran). Which laboratory value would the nurse specifically monitor during
treatment with this medication?
1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level - ANSWER-2. Uric acid level
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can
produce uric acid nephropathy, renal stones, and acute renal failure. Options 1, 3,
and 4 are not specifically related to this medication.
15.) The client with small cell lung cancer is being treated with etoposide (VePesid).
The nurse who is assisting in caring for the client during its administration
understands that which side effect is specifically associated with this medication?
1. Alopecia
2. Chest pain
3. Pulmonary fibrosis
4. Orthostatic hypotension - ANSWER-4. Orthostatic hypotension
Rationale:
A side effect specific to etoposide is orthostatic hypotension. The client's blood
pressure is monitored during the infusion. Hair loss occurs with nearly all the
antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this
medication.
16.) The clinic nurse is reviewing a teaching plan for the client receiving an
antineoplastic medication. When implementing the plan, the nurse tells the client:
1. To take aspirin (acetylsalicylic acid) as needed for headache
2. Drink beverages containing alcohol in moderate amounts each evening
3. Consult with health care providers (HCPs) before receiving immunizations
4. That it is not necessary to consult HCPs before receiving a flu vaccine at the local
health fair - ANSWER-3. Consult with health care providers (HCPs) before receiving
immunizations
Rationale:
Because antineoplastic medications lower the resistance of the body, clients must be
informed not to receive immunizations without a HCP's approval. Clients also need
to avoid contact with individuals who have recently received a live virus vaccine.
Clients need to avoid aspirin and aspirin-containing products to minimize the risk of
bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side
effects.
17.) The client with ovarian cancer is being treated with vincristine (Oncovin). The
nurse monitors the client, knowing that which of the following indicates a side effect
specific to this medication?
1. Diarrhea
2. Hair loss
3. Chest pain
4. Numbness and tingling in the fingers and toes - ANSWER-4. Numbness and
tingling in the fingers and toes
Rationale:
Questions with Correct Answers
4.) The camp nurse asks the children preparing to swim in the lake if they have
applied sunscreen. The nurse reminds the children that chemical sunscreens are
most effective when applied:
1. Immediately before swimming
2. 15 minutes before exposure to the sun
3. Immediately before exposure to the sun
4. At least 30 minutes before exposure to the sun - ANSWER-4. At least 30 minutes
before exposure to the sun
Rationale:
Sunscreens are most effective when applied at least 30 minutes before exposure to
the sun so that they can penetrate the skin. All sunscreens should be reapplied after
swimming or sweating.
5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury.
When applying the medication, the client complains of local discomfort and burning.
Which of the following is the most appropriate nursing action?
1. Notifying the registered nurse
2. Discontinuing the medication
3. Informing the client that this is normal
4. Applying a thinner film than prescribed to the burn site - ANSWER-3. Informing
the client that this is normal
Rationale:
Mafenide acetate is bacteriostatic for gram-negative and gram-positive organisms
and is used to treat burns to reduce bacteria present in avascular tissues. The client
should be informed that the medication will cause local discomfort and burning and
that this is a normal reaction; therefore options 1, 2, and 4 are incorrect
6.) The burn client is receiving treatments of topical mafenide acetate (Sulfamylon) to
the site of injury. The nurse monitors the client, knowing that which of the following
indicates that a systemic effect has occurred?
1.Hyperventilation
2.Elevated blood pressure
3.Local pain at the burn site
4.Local rash at the burn site - ANSWER-1.Hyperventilation
Rationale:
Mafenide acetate is a carbonic anhydrase inhibitor and can suppress renal excretion
of acid, thereby causing acidosis. Clients receiving this treatment should be
monitored for signs of an acid-base imbalance (hyperventilation). If this occurs, the
medication should be discontinued for 1 to 2 days. Options 3 and 4 describe local
rather than systemic effects. An elevated blood pressure may be expected from the
pain that occurs with a burn injury.
,7.) Isotretinoin is prescribed for a client with severe acne. Before the administration
of this medication, the nurse anticipates that which laboratory test will be prescribed?
1. Platelet count
2. Triglyceride level
3. Complete blood count
4. White blood cell count - ANSWER-2. Triglyceride level
Rationale:
Isotretinoin can elevate triglyceride levels. Blood triglyceride levels should be
measured before treatment and periodically thereafter until the effect on the
triglycerides has been evaluated. Options 1, 3, and 4 do not need to be monitored
specifically during this treatment.
8.) A client with severe acne is seen in the clinic and the health care provider (HCP)
prescribes isotretinoin. The nurse reviews the client's medication record and would
contact the (HCP) if the client is taking which medication?
1. Vitamin A
2. Digoxin (Lanoxin)
3. Furosemide (Lasix)
4. Phenytoin (Dilantin) - ANSWER-1. Vitamin A
Rationale:
Isotretinoin is a metabolite of vitamin A and can produce generalized intensification
of isotretinoin toxicity. Because of the potential for increased toxicity, vitamin A
supplements should be discontinued before isotretinoin therapy. Options 2, 3, and 4
are not contraindicated with the use of isotretinoin.
9.) The nurse is applying a topical corticosteroid to a client with eczema. The nurse
would monitor for the potential for increased systemic absorption of the medication if
the medication were being applied to which of the following body areas?
1. Back
2. Axilla
3. Soles of the feet
4. Palms of the hands - ANSWER-2. Axilla
Rationale:
Topical corticosteroids can be absorbed into the systemic circulation. Absorption is
higher from regions where the skin is especially permeable (scalp, axilla, face,
eyelids, neck, perineum, genitalia), and lower from regions in which permeability is
poor (back, palms, soles).
10.) The clinic nurse is performing an admission assessment on a client. The nurse
notes that the client is taking azelaic acid (Azelex). Because of the medication
prescription, the nurse would suspect that the client is being treated for:
1. Acne
2. Eczema
3. Hair loss
4. Herpes simplex - ANSWER-1. Acne
Rationale:
Azelaic acid is a topical medication used to treat mild to moderate acne. The acid
appears to work by suppressing the growth of Propionibacterium acnes and
decreasing the proliferation of keratinocytes. Options 2, 3, and 4 are incorrect.
,11.) The health care provider has prescribed silver sulfadiazine (Silvadene) for the
client with a partial-thickness burn, which has cultured positive for gram-negative
bacteria. The nurse is reinforcing information to the client about the medication.
Which statement made by the client indicates a lack of understanding about the
treatments?
1. "The medication is an antibacterial."
2. "The medication will help heal the burn."
3. "The medication will permanently stain my skin."
4. "The medication should be applied directly to the wound." - ANSWER-3. "The
medication will permanently stain my skin."
Rationale:
Silver sulfadiazine (Silvadene) is an antibacterial that has a broad spectrum of
activity against gram-negative bacteria, gram-positive bacteria, and yeast. It is
applied directly to the wound to assist in healing. It does not stain the skin.
12.) A nurse is caring for a client who is receiving an intravenous (IV) infusion of an
antineoplastic medication. During the infusion, the client complains of pain at the
insertion site. During an inspection of the site, the nurse notes redness and swelling
and that the rate of infusion of the medication has slowed. The nurse should take
which appropriate action?
1. Notify the registered nurse.
2. Administer pain medication to reduce the discomfort.
3. Apply ice and maintain the infusion rate, as prescribed.
4. Elevate the extremity of the IV site, and slow the infusion. - ANSWER-1. Notify
the registered nurse.
Rationale:
When antineoplastic medications (Chemotheraputic Agents) are administered via IV,
great care must be taken to prevent the medication from escaping into the tissues
surrounding the injection site, because pain, tissue damage, and necrosis can result.
The nurse monitors for signs of extravasation, such as redness or swelling at the
insertion site and a decreased infusion rate. If extravasation occurs, the registered
nurse needs to be notified; he or she will then contact the health care provider.
13.) The client with squamous cell carcinoma of the larynx is receiving bleomycin
intravenously. The nurse caring for the client anticipates that which diagnostic study
will be prescribed?
1. Echocardiography
2. Electrocardiography
3. Cervical radiography
4. Pulmonary function studies - ANSWER-4. Pulmonary function studies
Rationale:
Bleomycin is an antineoplastic medication (Chemotheraputic Agents) that can cause
interstitial pneumonitis, which can progress to pulmonary fibrosis. Pulmonary
function studies along with hematological, hepatic, and renal function tests need to
be monitored. The nurse needs to monitor lung sounds for dyspnea and crackles,
which indicate pulmonary toxicity. The medication needs to be discontinued
immediately if pulmonary toxicity occurs. Options 1, 2, and 3 are unrelated to the
specific use of this medication.
, 14.) The client with acute myelocytic leukemia is being treated with busulfan
(Myleran). Which laboratory value would the nurse specifically monitor during
treatment with this medication?
1. Clotting time
2. Uric acid level
3. Potassium level
4. Blood glucose level - ANSWER-2. Uric acid level
Rationale:
Busulfan (Myleran) can cause an increase in the uric acid level. Hyperuricemia can
produce uric acid nephropathy, renal stones, and acute renal failure. Options 1, 3,
and 4 are not specifically related to this medication.
15.) The client with small cell lung cancer is being treated with etoposide (VePesid).
The nurse who is assisting in caring for the client during its administration
understands that which side effect is specifically associated with this medication?
1. Alopecia
2. Chest pain
3. Pulmonary fibrosis
4. Orthostatic hypotension - ANSWER-4. Orthostatic hypotension
Rationale:
A side effect specific to etoposide is orthostatic hypotension. The client's blood
pressure is monitored during the infusion. Hair loss occurs with nearly all the
antineoplastic medications. Chest pain and pulmonary fibrosis are unrelated to this
medication.
16.) The clinic nurse is reviewing a teaching plan for the client receiving an
antineoplastic medication. When implementing the plan, the nurse tells the client:
1. To take aspirin (acetylsalicylic acid) as needed for headache
2. Drink beverages containing alcohol in moderate amounts each evening
3. Consult with health care providers (HCPs) before receiving immunizations
4. That it is not necessary to consult HCPs before receiving a flu vaccine at the local
health fair - ANSWER-3. Consult with health care providers (HCPs) before receiving
immunizations
Rationale:
Because antineoplastic medications lower the resistance of the body, clients must be
informed not to receive immunizations without a HCP's approval. Clients also need
to avoid contact with individuals who have recently received a live virus vaccine.
Clients need to avoid aspirin and aspirin-containing products to minimize the risk of
bleeding, and they need to avoid alcohol to minimize the risk of toxicity and side
effects.
17.) The client with ovarian cancer is being treated with vincristine (Oncovin). The
nurse monitors the client, knowing that which of the following indicates a side effect
specific to this medication?
1. Diarrhea
2. Hair loss
3. Chest pain
4. Numbness and tingling in the fingers and toes - ANSWER-4. Numbness and
tingling in the fingers and toes
Rationale:
