NURS 180 Week 3 Quiz (Latest 2026/2027) | Pharmacology Study Guide | Questions & Verified Answers | Pass Guaranteed | Grade A | WCU

NURS 180 Week 3 Quiz (Latest 2026/2027) | Pharmacology Study Guide | Questions & Verified Answers | Pass Guaranteed | Grade A | WCU A nurse is teaching a client who has rheumatoid arthritis about taking methotrexate. Which of the following information should the nurse include? A. Take an antiemetic 1 hr following administration. B. Drink 2 to 3 L of water per day. C. Take the medication with an NSAID. D. Rinse mouth 2 times per day with an alcohol based mouthwash. B. Drink 2 to 3 L of water per day. Methotrexate can cause renal toxicity. The client should drink 2 to 3 L of water per day to promote excretion of the medication. A nurse is providing teaching to a client who has a new prescription for hydroxychloroquine to treat mild manifestations of rheumatoid arthritis. Which of the following information should the nurse include in the teaching? A. This medication should be taken between meals. B. This medication can turn skin an orange color. C. Wear sunglasses when out in bright sunshine. D. Avoid crushing the medication. C. Wear sunglasses when out in bright sunshine. The nurse should instruct the client to wear sunglasses to decrease photophobia when taking hydroxychloroquine. Clients should have an ophthalmologic examination before treatment because the medication can cause retinopathy. A nurse is teaching a client who takes acetaminophen daily to manage mild knee pain. The nurse should instruct the client to monitor for which of the following adverse reactions to this medication? A. Tinnitus B. Muscle pain C. Hyperglycemia D. Jaundice D. Jaundice Acetaminophen can cause hepatotoxicity. The client should monitor and report jaundice, abdominal pain, clay colored stools, and fever. A nurse is admitting a client who states he takes ginkgo biloba every day to improve his memory. The nurse should identify a potential interaction with which of the following medications the client is taking? A. Famotidine B. Levothyroxine C. Warfarin D. Loratadine C. Warfarin The nurse should identify a potential interaction between gingko biloba and warfarin. Ginkgo might suppress coagulation and should be used with caution with antiplatelet drugs such as aspirin or anticoagulants such as warfarin or heparin. A nurse is monitoring a client who took an overdose of acetaminophen 72 hr ago. The nurse should identify which of the following findings is a manifestation of acetaminophen poisoning? A. Constipation B. Xerostomia C. Tinnitus D. Vomiting D. Vomiting The nurse should expect a client who has acetaminophen poisoning to have early manifestations of nausea, vomiting, abdominal distress, diarrhea, and sweating. A nurse is preparing to administer morphine 4 mg IV bolus to a client who reports pain. Available is morphine 10 mg/mL. Which of the following actions should the nurse take? A. Discard the extra medication in a sharps container. B. Save the extra medication for a later dosing. C. Send the waste amount to the pharmacy. D. Have another nurse witness the disposal of the extra medication. D. Have another nurse witness the disposal of the extra medication. Any excess narcotic must be disposed. The disposal must be witnessed and documented by a second nurse. A nurse is preparing a presentation about glucosamine to a group of clients. Which of the following information should the nurse include in the teaching? A. "Glucosamine may help to increase joint functionality." B. "Glucosamine can be used in the treatment of herpes simplex infections." C. "Glucosamine can improve age-related memory impairment." D. "Glucosamine is derived from red peppers." A. "Glucosamine may help to increase joint functionality." The nurse should include in the teaching that glucosamine may increase joint functionality by decreasing destruction of cartilage. A nurse is teaching a client who has a new prescription for diazepam. Which of the following information should the nurse include in the teaching? A. Diazepam can cause drowsiness. B. This medication must be swallowed whole. C. It is important to avoid foods that contain tyramine. D. Grapefruit juice inactivates this medication. A. Diazepam can cause drowsiness. Diazepam has sedative properties, so the client should not engage in potentially hazardous activities after receiving diazepam. A nurse is teaching a client who has a new prescription for colchicine to treat gout. Which of the following instructions should the nurse include? A. "Take this medication with food if nausea develops." B. "Monitor for muscle pain." C. "Expect to have increased bruising." D. "Increase your intake of grapefruit juice." B. "Monitor for muscle pain." This medication can cause rhabdomyolysis. The client should monitor and report muscle pain. A nurse is teaching a client who has a new prescription for aspirin to treat rheumatoid arthritis. The nurse should include to monitor for which of the following adverse effects of this medication? A. Constipation B. Bleeding C. Blurred vision D. Insomnia B. Bleeding Aspirin can cause bleeding, tinnitus, gastric ulceration, nausea, and heartburn. The client should monitor and report manifestations of bleeding, such as black tarry stools. A nurse is teaching a client who has multiple sclerosis and a new prescription for dantrolene. Which of the following statements bt the client indicates an understanding of the teaching? A. "I need to apply a sunscreen when I go outside." B. "I can take an over-the-counter antihistamine for allergies when I'm taking this drug." C. "I should take this medication when my spasms are bad." D. "My muscle strength should improve a lot in 2 to 3 days." A. "I need to apply a sunscreen when I go outside." This medication can cause photosensitivity; therefore, the client should protect her skin by wearing a hat and using sunscreen while in sunlight. A nurse is providing teaching to a client who has gout and a new prescription for allopurinol. Which of the following statements by the client indicates an understanding of the teaching? A. "If I get a rash from this medication, I will take my usual antihistamine." B. "I need to increase my fluid intake while taking this medication." C. "I should take this medicine on an empty stomach." D. "If I get a fever while taking this medication, I will take some aspirin." B. "I need to increase my fluid intake while taking this medication." Clients who have gout should increase their fluid intake to 2 to 3L per day to prevent toxicity of allopurinol and decrease uric acid levels. A nurse is providing teaching to a client who has osteoporosis and a new prescription for alendronate. Which of the following adverse effects should the nurse instruct the client to report to the provider? (Select All that Apply.) A. Tinnitus B. Drowsiness C. Blurred vision D. Dysphagia E. Jaw pain C. Blurred vision D. Dysphagia E. Jaw pain Jaw pain is correct. Alendronate can cause osteonecrosis of the jaw, so the client should report this adverse effect to the provider. Blurred vision is correct. Alendronate can cause ocular inflammation, so the client should report vision problems to the provider.Dysphagia is correct. Alendronate can cause esophagitis, so the client should report any difficulty or pain with swallowing. A nurse is caring for a client who has just begun therapy with alprazolam to treat anxiety. The nurse should monitor the client for which of the following adverse effects of this medication? A. Insomnia B. Bradycardia C. Hearing loss D. Hypertension A. Insomnia The nurse should monitor the client for paradoxical effects such as insomnia and excitation. If these occur, the medication should be withdrawn. A nurse is preparing to administer morphine IV to a client. Which of the following medications should the nurse plan to have available? A. Flumazenil B. Naloxone C. Protamine D. Neostigmine B. Naloxone Naloxone is given to reverse the effects of morphine. Then nurse should monitor the client for respiratory depression, bradycardia, and hypotension. A nurse is assessing a client who has acute cocaine toxicity. Which of the following findings should the nurse expect? (Select All that Apply.) A. Report of tinnitus B. Tremor C. Fever D. Agitation E. Bradycardia B. Tremor C. Fever D. Agitation Tremor is correct. Tremor and dizziness are manifestations of acute cocaine toxicity.Agitation is correct. Agitation and hallucinations are manifestations of acute cocaine toxicity. Fever is correct. Hyperpyrexia is a manifestation of acute cocaine toxicity. A nurse is caring for a female client who has rheumatoid arthritis and asks the nurse if it is safe for her to take aspirin. The nurse should recognize which of the following findings in the client's history is a contraindication to this medication. A. Report of recent migraine headaches B. History of gastric ulcers C. Current diagnosis of glaucoma D. Prior reports of amenorrhea B. History of gastric ulcers Aspirin is contraindicated for clients who have a history of gastrointestinal bleeding and peptic ulcer disease because it impedes platelet aggregation. An adverse effect of aspirin is gastric bleeding. A nurse is teaching a client who has multiple sclerosis about a new prescription for baclofen. Which of the following instructions should the nurse include in the teaching? A. "Do not take antihistamines with this medication." B. "Take the medication on an empty stomach." C. "Stop taking the medication immediately for a headache." D. "Expect to develop diarrhea initially." A. "Do not take antihistamines with this medication." The nurse should instruct the client not to take antihistamines while taking baclofen. Antihistamines will intensity the depressant effects of baclofen. A nurse is preparing to administer nalbuphine to a postoperative client who is experiencing pain. The nurse should monitor the client for which of the following potential adverse effects of this medication? A. Miosis B. Joint pain C. Diarrhea D. Oliguria A. Miosis Adverse effects of nalbuphine include visual disturbances such as miosis, blurred vision, and diplopia. A nurse is providing teaching to a client who has rheumatoid arthritis and a new prescription for methotrexate. Which of the following instructions should the nurse include? (Select All that Apply.) A. Expect to feel the medication's effects immediately. B. Take NSAIDS to help minimize the adverse effects of the medication. C. Report unexplained bruising to the provider. D. Do not drink alcoholic beverages while taking this medication. E. Avoid people who have infections. C. Report unexplained bruising to the provider. D. Do not drink alcoholic beverages while taking this medication. E. Avoid people who have infections. Report unexplained bruising to the provider is correct. Methotrexate can cause thrombocytopenia. Clients should report bruising or petechiae as they may indicate a low platelet count.Avoid people who have infections is correct. Methotrexate causes bone marrow suppression and increases the risk for infection.Take NSAIDs to help minimize the adverse effects of the medication is incorrect. NSAIDs interact with methotrexate and should be avoided. Providers sometimes prescribe folic acid to help minimize the side effects of methotrexate. A nurse is providing teaching for a client who has a new prescription for alprazolam to treat insomnia. Which of the following instructions should the nurse include? A. "Take this medication every night before sleep." B. "Take this mediation with a high-fat meal." C. "Avoid activities that require alertness, such as driving." D. "Monitor for peripheral edema." C. "Avoid activities that require alertness, such as driving." The client should avoid activities that require alertness. Alprazolam is a benzodiazepine that causes sedation and dizziness. A nurse is caring for a client who is to start therapy with ibuprofen for hip pain. Which of the following information should the nurse provide about ibuprofen? A. Take the medication with an aspirin to increase effectiveness. B. Take the medication with food. C. Taking the maximum dose will offer stroke prevention. D. Sustained-release forms may be crushed for easier administration. B. Take the medication with food. To minimize gastric irritation, the nurse should instruct the client to take ibuprofen with food, water, or milk. A nurse is caring for a client who has a fractured ulna and a new prescription for cyclobenzaprine. Before administering, which of the following explanations should the nurse provide to explain the purpose of the medication? A. The medication will kill microorganisms that can cause infection at the fracture site. B. Cyclobenzaprine will reduce itching that might occur as the fracture begins to heal. C. The medication will relieve muscle spasms that might occur with a fracture. D. Cyclobenzaprine will relieve any nausea associated with a fracture. C. The medication will relieve muscle spasms that might occur with a fracture. The nurse should explain that the provider prescribed cyclobenzaprine to relieve muscle spasms that can accompany the acute pain of fractures. A nurse is teaching a client who has a new prescription for cyclobenzaprine. Which of the following information should the nurse include in the teaching? A. Discontinue medication if nausea occurs. B. Expect urine to turn orange. C. Monitor for increased muscle spasms. D. Avoid driving until effects are known. D. Avoid driving until effects are known. Cyclobenzaprine can cause drowsiness and dizziness. Instruct the client to avoid driving if these effects occur. A nurse is teaching a client who has a new prescription for ibuprofen to treat hip pain. Which of the following instructions should the nurse include in the teaching? A. Expect ringing in your ears. B. Take the medication with food. C. Store the medication in the refrigerator. D. Monitor for weight loss. B. Take the medication with food. To minimize gastric irritation, the client should take ibuprofen with food or immediately after a meal. A charge nurse is teaching a group of nurses about the antagonist action of medications. The nurse should include in the teaching that which of the following antagonist medications is used for benzodiazepines? A. Flumazenil B. Diphenhydramine C. Protamine D. Naloxone A. Flumazenil The nurse should teach that flumazenil is an antagonist that reverses the effects of benzodiazepines by recognition site on the GABA/benzodiazepine receptor complex. A nurse is assessing a client who reports acute pain. The nurses should anticipate which of the following findings? A. Increased heart rate B. Decreased respiratory rate. C. Hyperactive bowel sounds D. Decreased blood pressure A. Increased heart rate Acute pain stimulates the sympathetic nervous system and can cause an increase in heart rate. A hospice nurse is caring for a client who has terminal cancer and takes PO morphine for pain relief. The client reports that he had to increase the dose of morphine this week to obtain pain relief. Which of the following scenarios should the nurse document as the explanation for this situation? A. The client not been taking the medication properly. B. The client is experiencing episodes of confusion. C. The client has become addicted to the medication. D. The client developed a tolerance to the medication. D. The client developed a tolerance to the medication. The nurse should document that the client has developed a tolerance to the medication. Morphine is a narcotic analgesic used for the treatment of severe pain. Tolerance is an adverse effect of narcotic analgesics in which a larger dose is needed to produce the same response. A nurse is caring for a client who has acute respiratory distress syndrome (ARDS) and requires mechanical ventilation. The client received a prescription for pancuronium. The nurse recognizes that this medication is for which of the following purposes? A. Decrease chest wall compliance B. Suppress respiratory effort C. Induce sedation D. Decrease respiratory secretions B. Suppress respiratory effort Neuromuscular blocking agents, such as pancuronium, induce paralysis and suppress the client's respiratory efforts to the point of apnea, allowing the mechanical ventilator to take over the work of breathing for the client. This therapy is especially helpful for a client who has ARDS and poor lung compliance. Name the Pain Mediating chemicals? Substance P, prostaglandins, bradykinins, and histamines Name body’s natural pain killers a. Serotonin, Enkephalins, Endorphins Name the three opioid receptors Mu, Kappa, Delta Mu Receptors Stimulated by opioid drugs. When these receptors are stimulated, they cause analgesia, or relief of pain. Unfortunately, it also causes respiratory depression, euphoria, sedation, and physical dependence Kappa Receptors a. stimulated by opioid drugs to a much lesser extent. When these receptors are stimulated, they cause analgesia, sedation, and psychotomimetic effects, which are effects that mimic psychoses such as hallucinations and delusion Delta Receptors opioid drugs do not produce any pharmacology-related effects when delta receptors are stimulated Which opioid receptors cause more adverse effects? Mu receptors What are uricosurics? Anti-inflammatory that decrease the serum levels of uric acid, a chemical in the body that can cause gout. What are the centrally acting non opioids? Treats moderate to moderately severe pain. Tramadol, or Ultram What is the difference in the functions of cyclooxygenase 1 and 2? COX1 - Stimulates the release of prostaglandins that work to maintain homeostasis in the body. They act to protect the gastric mucosa, enhance platelet aggregation, and promote renal function COX 2- stimulate the release of prostaglandins in response to injury, which results in inflammation, fever, and pain What is salicylism? A buildup of aspirin in the body to toxic levels, which can occur if clients ingest more aspirin than they excrete What are the symptoms of Reyes syndrome? a. Rare but serious disorder that has occurred secondary to giving aspirin to a child who has a viral infection (influenza or chickenpox) b. Vomiting, confusion, seizures, loss of consciousness c. Can cause liver and brain damage and even death What are the signs and symptoms of GI bleed? Vomiting blood, bloody stool, hypotension, tachycardia and other signs of hypovolemic / hemmorhagic shock. What should a client take if he or she is taking COX 1 and COX 2 inhibitors on a long-term basis? Low-dose aspirin to prevent embolic events What is the prophylactic dose of aspirin? 81 mg/day What are the signs and symptoms of thrombi formation due to NSAID's? Chest pain or heaviness, shortness of breath, sudden and severe headache, one-sided numbness, visual disturbances, or confusion 1. What will happen if the client takes NSAID’s and ACE inhibitors? a. The use of aspirin along with ACE inhibitors and angiotensin receptor blockers increase the risk of renal failure, as well as decreasing the anti-hypertensive effects of ACE inhibitors 1. Why does COX2 inhibitors increases chance of cardiovascular problems? Vasoconstriction combined with platelet aggregation increases the risk of cardiovascular events Can you give celecoxib and antacids together? Why or why not? Yes, if they are at high risk for gastric bleeding What happens to a fetus or newborn when celecoxib is given during the third trimester? Celecoxib is a teratogenic drug during the third trimester, causing premature of the ductus arteriosus. What is the ductus arteriosus? vessel a growing fetus has that connects the pulmonary artery with the aorta, instead of going to the lungs the blood goes to the body Why cannot acetaminophen decrease inflammation or cause gastric ulcers as ibuprofen? It is a COX inhibitor, but its effects are limited to the CNS. It still effectively relieves pain and reduces fever, but due to a lack of peripheral inhibition, it has no anti-inflammatory or anticoagulant effects. This lack of peripheral inhibition also explains why it doesn't adversely affect the gastric mucosa or platelets, significantly decreasing the risk of gastric ulcers and cardiovascular events. What decreases the absorption of acetaminophen? Cholestyramine, or Questran What is the mechanism of action of centrally acting non opioid? The centrally acting non opioid tramadol exerts it pharmacologic actions by binding to selected opioid receptors and blocking reuptake of norepinephrine and serotonin in the CNS. How would you treat respiratory depression caused by centrally acting non opioid? If the respiratory rate falls below 12 per minute, stimulate breathing. Prepare to administer an opioid antagonist, such as naloxone, to restore the respiratory rate. However, naloxone might only be moderately effective in reversing respiratory depression caused by tramadol, so the best intervention is prevention How long will it take for the client feel pain relief after taking tramadol? Clients will not feel its therapeutic effects until approximately one hour after administration. What are the contraindications of tramadol? Contraindicated in clients who are acute intoxicated with alcohol, opioids, or psychotropic drugs, have seizure disorders, respiratory depression, or under the age of 12, or are under the age of 18 following tonsillectomy and/or adenoidectomy. Use tramadol with caution in clients who have substance abuse history, liver or renal disease, increased intracranial pressure, and in older adults. Which herbal medication interacts with tramadol? Administering tramadol concurrently with St. John's wort increases its sedative effects. What is a hypertensive crisis? A severe increase in blood pressure that can lead to a stroke. Extremely high blood pressure — a systolic or = 180 or a diastolic or = 120 mm Hg or higher damages blood vessels. They become inflamed and may leak fluid or blood. As a result, the heart may not be able to pump blood effectively. What is serotonin syndrome? - occurs w/ any drug which increases serotonin - hyperthermia, confusion, myoclonus, cardiovascular collapse, flushing, diarrhea, seizures Why is methadone used as a substitute for other opioids? Methadone is another synthetic opioid that is chemically similar to morphine, but you use it primarily as a substitute for opioids in drug abuse programs. It blocks the euphoric effects of opioids and reduces cravings in people addicted to a drug in this group. Opioids mimics which natural pain killers? Mimics the actions of naturally occurring opioids, endorphins, and enkephalins. How should you treat clients with cancer pain with opioids? When administering an opioid agonist to clients with terminal cancer pain, give the drug on a fixed, around the clock dosing schedule, rather than as needed. What schedule classification does opioids belong? Schedule II What is hyperpyrexic syndrome? Manifests as excitation, seizures, and hyperpyrexia, which is a highly elevated temperature What does butorphanol does to the heart? Butorphanol increase cardiac workload, so avoid using in clients who have a disorder that affects cardiac output. What adverse effect could happen to the heart's rhythm when taking opioid antagonist? Ventricular arrhythmias. The heart rate ad respiratory rate will increase, but remain alert for abnormal rate or rhythms. What is the mechanism of action of allopurinol and probenecid? Inhibit the enzyme xanthin oxidase, or XO, from converting hypoxanthine and xanthine into uric. Probenecid inhibits tubular reabsorption of uric acid in the kidneys, thus promoting its excretion. What is rheumatoid arthritis? RA is an inflammatory, systemic, autoimmune disease of the joints and surrounding structure. RA primarily affects synovial joints but can also occur in any area in which connective tissue is widespread. Can result in joint stiffness, pain, swelling, and deformity. Affects men and women of all ages but is more common in young to middle-age women. Although the exact etiology remains unknown, research indicates that both environmental and genetic factors play factor. Osteoclast bone cell that absorbs and removes unwanted bony tissue, reabsorption of the bone Osteoblast bone-forming cell How does non biologic DMARD’s work? a. Immunosuppressive drugs that decrease joint inflammation and, as a result, joint damage. In addition to providing symptomatic relief, they can also delay the progression of rheumatoid arthritis (RA). b. They can slow or even stop the progression of RA because of their immunosuppressive effect. Some of these drugs also treat cancer, but in much larger doses. What are the examples of biologic DMARD's and how do they work? a. Example: etanercept (Enbrel), infliximab, also called Remicade, and adalimumab, also called Humira. b. Drug Classification - antirheumatic c. Inactivation of tumor necrosis factor (TNF) resulting in reduced inflammation and immunosuppression. These drugs suppress inflammation, but in a different way than nonbiologic DMARD drugs. These drugs are tumor necrosis factor antagonists, which are drugs that bind with naturally occurring tumor necrosis factor, preventing them from attaching to cells on the surface of synovial tissue in the joints. This prevents it from stimulating an inflammatory reaction in the joints of client with RA. You may give it with methotrexate, a nonbiologic DMARD drug, for an enhanced effect. What past medical history would you ask to the client before administering biologic DMARD? Heart failure can reoccur in clients with a previous history, as well as in clients who have no experience with heart failure. Reactivation of latent tuberculosis, can occur, as well as new development of TB. What is the contraindications of calcitonin? Clients who are allergic to salmon or other fish protein (as determined by healthcare provider), as it derives from that source What decreases absorption of calcium supplements? Glucocorticoids decrease absorption of a calcium supplement; therefore, they should not be given at the same time. On the contrary, if you give a calcium supplement at the same time as thyroid hormones, tetracycline, or quinolone antibiotics, it decreases absorption of all these drugs. Clients on thiazide diuretic and a calcium supplement may be more likely to develop hypercalcemia because of decreased excretion of calcium. Foods like cereals, rhubarb, and spinach decrease absorption of calcium.