PN VATI PHARMACOLOGY EXAM
QUESTIONS AND ANSWERS |
VERIFIED
A nurse is assisting with the care of a client who has a myasthenia gravis and is
experiencing a cholinergic crisis. Which of the following medications should the
nurse expect the RN to administer?
💊 Bethanechol
💊 Propranolol
💊 Atropine
💊 Epinephrine
ANSWER: ATROPINE.
Rationale: A cholinergic crisis is the result of too much cholinesterase inhibitor
medication, which causes manifestations of excessive muscarinic stimulation, such as
muscle weakness, bradycardia, vomiting, and paralysis. Atropine is a muscarinic
antagonist that is administered IV to reverse anticholinergic effects. The nurse might
need to assist with respiratory support to provide adequate oxygenation to the client
until manifestations resolve.
A nurse is caring for a client who has bipolar disorder and a new prescription for
lithium. Which of the following laboratory values should the nurse plan to monitor
for potential adverse effects?
�Prothrombin Time
�Hematocrit
�Sodium
�Potassium
ANSWER: SODIUM.
Rationale: The nurse should monitor the client's sodium level while the client is taking
lithium. When the client's sodium level is low, the kidneys retain lithium, which can
cause toxicity. Because polyuria is an adverse effect of lithium in 50% to 70% of clients
treated, HYPOnatremia is a significant risk. The nurse should reinforce teaching with
the client about eating consistent amounts of sodium and drinking 2 to 3 L of fluid daily
to help prevent lithium toxicity.
A nurse is reinforcing teaching with a client who has a prescription for
rosuvastatin to treat high cholesterol levels. For which of the following adverse
effects should the nurse instruct the client to monitor and report to the provider
immediately?
➖ Muscle weakness
➖ Headache
➖ Abdominal pain
,➖ Insomnia
ANSWER: MUSCLE WEAKNESS.
Rationale: When using the urgent vs. non-urgent approach to client care, the nurse
should determine that the priority finding to report is muscle weakness (myalgia) or
tenderness because it can be a manifestation of rhabdomyolysis, a rare but potentially
fatal adverse effect of HMG-CoA reductase inhibitor (statin) thearpy. Rhabdomyolysis is
a disintegration of muscle tissue that causes elevations in creatine kinase, potentially
impairing renal function.
A nurse is reinforcing teaching with a newly licensed nurse regarding safe
procedures for medication administration. Which of the following statements by
the newly licensed nurse indicates an understanding of the teaching?
➖ "I will identify the client by verifying the client's name using the room number."
➖ "I can administer antibiotics 1 hour before the scheduled time."
➖ "I will check the label on the client's medication three times before
administering it."
➖ "I will leave the client's medication at the client's bedside."
ANSWER: "I WILL CHECK THE LABEL ON THE CLIENT'S MEDICATION THREE
TIMES BEFORE ADMINISTERING IT."
Rationale: The nurse should check the label three times; when the medications is
removed from the dispensing system, when the medication is being prepared for
administration, and at the client's bedside before administering the medication.
A nurse is preparing to administer Lactated Ringer's solution 350 mL to infuse
over 1 hr. The drop factor of the tubing is 10 gtt/mL. The nurse should set the
manual IV infusion to deliver how many gtt/min? (Round answer to the nearest
whole number.)
ANSWER: 58 gtt/min.
Rationale: 350mL divided by 60 minutes times drop factor of 10 = 58.333
A nurse is collecting data from a client who is receiving morphine to relieve post-
operative pain. The client's respiratory rate is 9/min. The nurse should notify the
provider and expect a stat prescription for which of the following medications?
💊 Naloxone
💊 Glucagon
💊Flumazenil
💊 Protamine
ANSWER: NALOXONE.
Rationale: Morphine is an opioid analgesic. Naloxone, an opiate antagonist, reverses
the effects of opioids, including respiratory depression and sedation. After administering
naloxone, the nurse should continue to monitor the client's respiratory function and pain
control.
A nurse is reinforcing teaching with a client who has a new prescription for
insulin. The client is taking propranolol. The nurse should teach the client to
monitor for which of the following findings as a manifestation of hypoglycemia?
➖ Tachycardia
➖ Difficulty breathing
➖ Sleep disturbance
, ➖ Hunger
ANSWER: HUNGER.
Rationale: Propranolol blocks the Beta 1 receptors, which suppresses the typical early
signs of hypoglycemia, such as tachycardia, sweating, and tremors. The nurse should
instruct clients who have diabetes mellitus and take propranolol to recognize alternative
indications of hypoglycemia, such as hunger and fatigue.
Adverse Effects of Propranolol
Insomnia and nightmares, and can cause difficulty breathing.
A nurse is reinforcing dietary teaching with a client who is taking furosemide.
Which of the following foods should the nurse recommend as the best source of
potassium?
➖ 1 cup baked potatoes
➖ 1 cup fresh blueberries
➖ 1 cup fresh watermelon
➖ 1 cup raw chopped cabbage
ANSWER: 1 CUP BAKED POTATOES.
Rationale: The nurse should determine that baked potatoes are the best source of
potassium to recommend because they contain 506mg of potassium per 1 cup serving.
Furosemide causes potassium loss and the client is at risk for HYPOkalemia. Therefore,
the nurse should instruct the client to increase the dietary potassium intake.
A nurse is reinforcing teaching with a client who has been prescribed isoniazid.
Which of the following client statements indicates an understanding of the
teaching?
➖ "I should expect my urine to turn reddish in color."
➖ "I will have a skin test to determine when I am no longer contagious."
➖ "I should notify my provider if I develop numbness in my feet."
➖ "I should expect to take this medication for 6 weeks."
ANSWER: "I SHOULD NOTIFY MY PROVIDER IF I DEVELOP NUMBNESS IN MY
FEET."
Rationale: The nurse should instruct the client to notify the provider for manifestations of
peripheral neuropathy, such as tingling, numbness, burning, or pain in extremities.
A nurse is assisting with the care of a client who has oral benzodiazepine toxicity.
The client has an IV infusing and is nonresponsive. Which of the following
interventions should the nurse anticipate first?
➖ Administering norepinephrine via continuous IV infusion
➖ Administering IV flumazenil
➖ Performing gastric lavage
➖ Preparing the client for mechanical ventilation
ANSWER: ADMINISTERING IV FLUMAZENIL.
Rationale: Evidence-based practice indicates that the priority action for a client who has
benzodiazepine toxicity is to administer IV flumazenil. Flumazenil is a benzodiazepine
receptor antagonist used to reverse sedation caused by benzodiazepine toxicity. The IV
medication begin working withing 1 to 2 min. Therefore, administering flumazenil is the
first action the nurse should anticipate.
QUESTIONS AND ANSWERS |
VERIFIED
A nurse is assisting with the care of a client who has a myasthenia gravis and is
experiencing a cholinergic crisis. Which of the following medications should the
nurse expect the RN to administer?
💊 Bethanechol
💊 Propranolol
💊 Atropine
💊 Epinephrine
ANSWER: ATROPINE.
Rationale: A cholinergic crisis is the result of too much cholinesterase inhibitor
medication, which causes manifestations of excessive muscarinic stimulation, such as
muscle weakness, bradycardia, vomiting, and paralysis. Atropine is a muscarinic
antagonist that is administered IV to reverse anticholinergic effects. The nurse might
need to assist with respiratory support to provide adequate oxygenation to the client
until manifestations resolve.
A nurse is caring for a client who has bipolar disorder and a new prescription for
lithium. Which of the following laboratory values should the nurse plan to monitor
for potential adverse effects?
�Prothrombin Time
�Hematocrit
�Sodium
�Potassium
ANSWER: SODIUM.
Rationale: The nurse should monitor the client's sodium level while the client is taking
lithium. When the client's sodium level is low, the kidneys retain lithium, which can
cause toxicity. Because polyuria is an adverse effect of lithium in 50% to 70% of clients
treated, HYPOnatremia is a significant risk. The nurse should reinforce teaching with
the client about eating consistent amounts of sodium and drinking 2 to 3 L of fluid daily
to help prevent lithium toxicity.
A nurse is reinforcing teaching with a client who has a prescription for
rosuvastatin to treat high cholesterol levels. For which of the following adverse
effects should the nurse instruct the client to monitor and report to the provider
immediately?
➖ Muscle weakness
➖ Headache
➖ Abdominal pain
,➖ Insomnia
ANSWER: MUSCLE WEAKNESS.
Rationale: When using the urgent vs. non-urgent approach to client care, the nurse
should determine that the priority finding to report is muscle weakness (myalgia) or
tenderness because it can be a manifestation of rhabdomyolysis, a rare but potentially
fatal adverse effect of HMG-CoA reductase inhibitor (statin) thearpy. Rhabdomyolysis is
a disintegration of muscle tissue that causes elevations in creatine kinase, potentially
impairing renal function.
A nurse is reinforcing teaching with a newly licensed nurse regarding safe
procedures for medication administration. Which of the following statements by
the newly licensed nurse indicates an understanding of the teaching?
➖ "I will identify the client by verifying the client's name using the room number."
➖ "I can administer antibiotics 1 hour before the scheduled time."
➖ "I will check the label on the client's medication three times before
administering it."
➖ "I will leave the client's medication at the client's bedside."
ANSWER: "I WILL CHECK THE LABEL ON THE CLIENT'S MEDICATION THREE
TIMES BEFORE ADMINISTERING IT."
Rationale: The nurse should check the label three times; when the medications is
removed from the dispensing system, when the medication is being prepared for
administration, and at the client's bedside before administering the medication.
A nurse is preparing to administer Lactated Ringer's solution 350 mL to infuse
over 1 hr. The drop factor of the tubing is 10 gtt/mL. The nurse should set the
manual IV infusion to deliver how many gtt/min? (Round answer to the nearest
whole number.)
ANSWER: 58 gtt/min.
Rationale: 350mL divided by 60 minutes times drop factor of 10 = 58.333
A nurse is collecting data from a client who is receiving morphine to relieve post-
operative pain. The client's respiratory rate is 9/min. The nurse should notify the
provider and expect a stat prescription for which of the following medications?
💊 Naloxone
💊 Glucagon
💊Flumazenil
💊 Protamine
ANSWER: NALOXONE.
Rationale: Morphine is an opioid analgesic. Naloxone, an opiate antagonist, reverses
the effects of opioids, including respiratory depression and sedation. After administering
naloxone, the nurse should continue to monitor the client's respiratory function and pain
control.
A nurse is reinforcing teaching with a client who has a new prescription for
insulin. The client is taking propranolol. The nurse should teach the client to
monitor for which of the following findings as a manifestation of hypoglycemia?
➖ Tachycardia
➖ Difficulty breathing
➖ Sleep disturbance
, ➖ Hunger
ANSWER: HUNGER.
Rationale: Propranolol blocks the Beta 1 receptors, which suppresses the typical early
signs of hypoglycemia, such as tachycardia, sweating, and tremors. The nurse should
instruct clients who have diabetes mellitus and take propranolol to recognize alternative
indications of hypoglycemia, such as hunger and fatigue.
Adverse Effects of Propranolol
Insomnia and nightmares, and can cause difficulty breathing.
A nurse is reinforcing dietary teaching with a client who is taking furosemide.
Which of the following foods should the nurse recommend as the best source of
potassium?
➖ 1 cup baked potatoes
➖ 1 cup fresh blueberries
➖ 1 cup fresh watermelon
➖ 1 cup raw chopped cabbage
ANSWER: 1 CUP BAKED POTATOES.
Rationale: The nurse should determine that baked potatoes are the best source of
potassium to recommend because they contain 506mg of potassium per 1 cup serving.
Furosemide causes potassium loss and the client is at risk for HYPOkalemia. Therefore,
the nurse should instruct the client to increase the dietary potassium intake.
A nurse is reinforcing teaching with a client who has been prescribed isoniazid.
Which of the following client statements indicates an understanding of the
teaching?
➖ "I should expect my urine to turn reddish in color."
➖ "I will have a skin test to determine when I am no longer contagious."
➖ "I should notify my provider if I develop numbness in my feet."
➖ "I should expect to take this medication for 6 weeks."
ANSWER: "I SHOULD NOTIFY MY PROVIDER IF I DEVELOP NUMBNESS IN MY
FEET."
Rationale: The nurse should instruct the client to notify the provider for manifestations of
peripheral neuropathy, such as tingling, numbness, burning, or pain in extremities.
A nurse is assisting with the care of a client who has oral benzodiazepine toxicity.
The client has an IV infusing and is nonresponsive. Which of the following
interventions should the nurse anticipate first?
➖ Administering norepinephrine via continuous IV infusion
➖ Administering IV flumazenil
➖ Performing gastric lavage
➖ Preparing the client for mechanical ventilation
ANSWER: ADMINISTERING IV FLUMAZENIL.
Rationale: Evidence-based practice indicates that the priority action for a client who has
benzodiazepine toxicity is to administer IV flumazenil. Flumazenil is a benzodiazepine
receptor antagonist used to reverse sedation caused by benzodiazepine toxicity. The IV
medication begin working withing 1 to 2 min. Therefore, administering flumazenil is the
first action the nurse should anticipate.
