NSG 3032, PHARMACOLOGY II: EXAM 1 PP AND NCLEX
Ch. 59, 51,52,40,41,15-17,47-48
Ch.59
PowerPoint Questions:
1. A patient presents to the emergency department with severe respiratory distress,
hives, and edema after being stung on the face by a bee. Which are accurate
nursing assessments of the situation?
A. Hypotension and bronchospasm will progress rapidly if treatment is delayed.
B. The patient is suffering from anaphylactic shock.
C. Epinephrine and diphenhydramine are the drugs of choice as first-line
agents.
D. Prompt treatment with drug therapy will prevent this syndrome from
occurring again.
Answer: A, B, C
Rationale: Treatment will not prevent anaphylaxis from occurring again. All other
statements are true.
2. Which finding indicates that administration of glucagon has been effective? The
patient experiences
A. an improvement in level of consciousness.
B. an elevation in respiratory rate.
C. suppression of heart rate.
D. reduction in blood pressure.
Answer: A
Rationale: Glucagon is used for treatment of patients with severe hypoglycemia.
An improved level of consciousness indicates elevation of blood sugar. A blood
sugar analysis should also be obtained.
3. A patient is experiencing both atrial and ventricular dysrhythmias. The nurse
anticipates administration of which medication?
A. Adenosine
B. Amiodarone
C. Atropine
D. Epinephrine
Answer: B
Rationale: Amiodarone is used for the treatment of atrial and ventricular
dysrhythmias. Adenosine is used for the treatment of PSVT. Atropine is used for
,the treatment of symptomatic bradycardia. Epinephrine is used for the treatment of
cardiac arrest.
NCLEX
1. The nurse is administering atropine 0.3 mg IV to a 75-year-old patient with a
heart rate of 45, and his heart rate decreases to 38. What is the most likely
explanation?
a. Atropine exerts its effects by stimulating the vagus nerve.
b. The ordered dose was too low.
c. Adenosine was indicated, not atropine.
d. Atropine typically slows heart rate first and then increases it.
1. 2. An 80-year-old woman with a hip fracture received morphine 3 mg IV 20
minutes ago. The patient's son runs to the nurses' station and says that his
mother is no longer responding to him. What actions should the nurse take?
a. Assess the patient; call for additional assistance; support breathing with
a bag-valve-mask device as indicated, and prepare to administer
flumazenil.
b. Call the physician and report that the patient most likely suffered a
stroke and now has elevated intracranial pressure; prepare to administer
mannitol.
c. Assess the patient; call for additional assistance; support breathing with
a bag-valve-mask device as indicated, and prepare to administer
naloxone.
d. Explain to the patient's son that the morphine is taking effect and that
unresponsiveness is the desired outcome to best manage her pain.
2. 3. The nurse is caring for a 21-year-old woman with a closed head injury.
Her intracranial pressure is 35 (normal <20). Her serum osmolality is 330.
The nurse should anticipate which action?
a. Administer mannitol.
b. Withhold mannitol at this time, but take other measures to reduce
intracranial pressure.
c. Administer sodium nitroprusside.
d. Take no action at this time because the patient has a serum osmolality
of 330, which will offset the effects of the elevated intracranial pressure.
3. 4. A dopamine infusion was started in a patient's antecubital vein during
resuscitation after cardiac arrest. The electronic infusion device is now
sounding an alert for an occlusion. What is the most important immediate
concern for the nurse?
, a. Infiltration with phentolamine will be necessary if there is
extravasation.
b. An interruption in the infusion can produce hypotension in the patient.
c. The device will need to be reported to the hospital's clinical
engineering department for service.
d. The patient could develop hypertension as a result of the alarm.
4. 5. Adenosine is ordered for a patient in the emergency department.
Immediately after intravenous administration, the nurse observes a short
period of asystole on the cardiac monitor that resolves spontaneously. What
is the most appropriate initial action for the nurse?
a. Call for the doctor.
b. Prepare epinephrine and atropine for intravenous administration.
c. Initiate CPR.
d. Closely observe the patient and the cardiac monitor.
5. 6. A patient on the medical-surgical unit has suffered an acute anaphylactic
reaction during infusion of an IV antibiotic with hives and bronchospasm.
The nurse practitioner has written a number of stat medication orders. What
is the priority medication to administer first?
a. steroid dose pack
b. dopamine
c. epinephrine
d. diphenhydramine
6. 7. The nurse receives a stat order to administer 50% dextrose solution
intravenously to a 1-year-old child with hypoglycemia. How should this
medication best be prepared for safe administration to the child?
a. Use a filter needle.
b. Draw the medication into a tuberculin syringe.
c. Dilute 1 : 1 with sterile water to produce dextrose 25%.
d. Shake the solution vigorously before injection.
7. 8. A 51-year-old woman has been reportedly taking Xanax for a severe
anxiety disorder following her mother's death. She was brought into the
emergency department because she became unresponsive while at work in
an insurance office. Knowing her history, what should the nurse anticipate
administering?
a. mannitol
b. naloxone
c. activated charcoal
d. flumazenil
8. 9. A 25-year-old woman was admitted to the emergency department after a
successful prehospital resuscitation from cardiac arrest owing to an asthma
Ch. 59, 51,52,40,41,15-17,47-48
Ch.59
PowerPoint Questions:
1. A patient presents to the emergency department with severe respiratory distress,
hives, and edema after being stung on the face by a bee. Which are accurate
nursing assessments of the situation?
A. Hypotension and bronchospasm will progress rapidly if treatment is delayed.
B. The patient is suffering from anaphylactic shock.
C. Epinephrine and diphenhydramine are the drugs of choice as first-line
agents.
D. Prompt treatment with drug therapy will prevent this syndrome from
occurring again.
Answer: A, B, C
Rationale: Treatment will not prevent anaphylaxis from occurring again. All other
statements are true.
2. Which finding indicates that administration of glucagon has been effective? The
patient experiences
A. an improvement in level of consciousness.
B. an elevation in respiratory rate.
C. suppression of heart rate.
D. reduction in blood pressure.
Answer: A
Rationale: Glucagon is used for treatment of patients with severe hypoglycemia.
An improved level of consciousness indicates elevation of blood sugar. A blood
sugar analysis should also be obtained.
3. A patient is experiencing both atrial and ventricular dysrhythmias. The nurse
anticipates administration of which medication?
A. Adenosine
B. Amiodarone
C. Atropine
D. Epinephrine
Answer: B
Rationale: Amiodarone is used for the treatment of atrial and ventricular
dysrhythmias. Adenosine is used for the treatment of PSVT. Atropine is used for
,the treatment of symptomatic bradycardia. Epinephrine is used for the treatment of
cardiac arrest.
NCLEX
1. The nurse is administering atropine 0.3 mg IV to a 75-year-old patient with a
heart rate of 45, and his heart rate decreases to 38. What is the most likely
explanation?
a. Atropine exerts its effects by stimulating the vagus nerve.
b. The ordered dose was too low.
c. Adenosine was indicated, not atropine.
d. Atropine typically slows heart rate first and then increases it.
1. 2. An 80-year-old woman with a hip fracture received morphine 3 mg IV 20
minutes ago. The patient's son runs to the nurses' station and says that his
mother is no longer responding to him. What actions should the nurse take?
a. Assess the patient; call for additional assistance; support breathing with
a bag-valve-mask device as indicated, and prepare to administer
flumazenil.
b. Call the physician and report that the patient most likely suffered a
stroke and now has elevated intracranial pressure; prepare to administer
mannitol.
c. Assess the patient; call for additional assistance; support breathing with
a bag-valve-mask device as indicated, and prepare to administer
naloxone.
d. Explain to the patient's son that the morphine is taking effect and that
unresponsiveness is the desired outcome to best manage her pain.
2. 3. The nurse is caring for a 21-year-old woman with a closed head injury.
Her intracranial pressure is 35 (normal <20). Her serum osmolality is 330.
The nurse should anticipate which action?
a. Administer mannitol.
b. Withhold mannitol at this time, but take other measures to reduce
intracranial pressure.
c. Administer sodium nitroprusside.
d. Take no action at this time because the patient has a serum osmolality
of 330, which will offset the effects of the elevated intracranial pressure.
3. 4. A dopamine infusion was started in a patient's antecubital vein during
resuscitation after cardiac arrest. The electronic infusion device is now
sounding an alert for an occlusion. What is the most important immediate
concern for the nurse?
, a. Infiltration with phentolamine will be necessary if there is
extravasation.
b. An interruption in the infusion can produce hypotension in the patient.
c. The device will need to be reported to the hospital's clinical
engineering department for service.
d. The patient could develop hypertension as a result of the alarm.
4. 5. Adenosine is ordered for a patient in the emergency department.
Immediately after intravenous administration, the nurse observes a short
period of asystole on the cardiac monitor that resolves spontaneously. What
is the most appropriate initial action for the nurse?
a. Call for the doctor.
b. Prepare epinephrine and atropine for intravenous administration.
c. Initiate CPR.
d. Closely observe the patient and the cardiac monitor.
5. 6. A patient on the medical-surgical unit has suffered an acute anaphylactic
reaction during infusion of an IV antibiotic with hives and bronchospasm.
The nurse practitioner has written a number of stat medication orders. What
is the priority medication to administer first?
a. steroid dose pack
b. dopamine
c. epinephrine
d. diphenhydramine
6. 7. The nurse receives a stat order to administer 50% dextrose solution
intravenously to a 1-year-old child with hypoglycemia. How should this
medication best be prepared for safe administration to the child?
a. Use a filter needle.
b. Draw the medication into a tuberculin syringe.
c. Dilute 1 : 1 with sterile water to produce dextrose 25%.
d. Shake the solution vigorously before injection.
7. 8. A 51-year-old woman has been reportedly taking Xanax for a severe
anxiety disorder following her mother's death. She was brought into the
emergency department because she became unresponsive while at work in
an insurance office. Knowing her history, what should the nurse anticipate
administering?
a. mannitol
b. naloxone
c. activated charcoal
d. flumazenil
8. 9. A 25-year-old woman was admitted to the emergency department after a
successful prehospital resuscitation from cardiac arrest owing to an asthma
