ADULT HEALTH 2
PHARMACOLOGY EXAM
WITH DETAILED
VERIFIED ANSWERS AND
RATIONALES \ALREADY
GRADED A+\VERIFIED BY
EXPERT
The nurse is caring for a patient who is diagnosed with active tuberculosis. The patient tells the nurse
that the provider plans to order a prophylactic antitubercular drug for family members and asks which
drug will be ordered. The nurse will expect the provider to order which drug?
a. Isoniazid
b. Pyrazinamide
c. Rifampin
d. Streptomycin
ANS: A
INH is the drug of choice for prophylactic treatment of TB.
A patient is receiving antitubercular treatment for latent TB. The patient develops symptoms of
peripheral neuropathy and is started on pyridoxine (vitamin B6). The nurse suspects this was caused
by which of the following medications?
a. Ethambutol
b. Isoniazid
c. Rifampin
d. Kanamycin
,ANS: B Peripheral neuropathy can be a problem in patients taking isoniazid, especially for those who are
malnourished, have diabetes mellitus, or are alcoholics. This condition can be prevented if pyridoxine
(vitamin B6) is administered.
The nurse is teaching a patient about rifampin. Which statement by the patient indicates
understanding of the teaching?
a. "I should not wear soft contact lenses while taking rifampin."
b. "I will report any changes in my hearing while taking this drug."
c. "I will report orange urine to my provider immediately."
d. "I understand that renal toxicity is a common adverse effect."
ANS: A Patients taking rifampin should be warned that urine, feces, saliva, sputum, sweat, and tears may
turn a harmless red-orange color. Patients should not wear soft contact lenses to avoid permanent
staining. Streptomycin is associated with ototoxicity. Orange urine is a harmless side effect and does not
need to be reported. Renal toxicity is not common with rifampin.
A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in the initial phase of
treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse
anticipate the provider will order to replace the isoniazid?
a. Ciprofloxacin
b. Ethambutol
c. Kanamycin
d. Streptomycin sulfate
ANS: B If there is bacterial resistance to isoniazid, the first phase may be changed to ethambutol,
rifampin, and pyrazinamide. Ciprofloxacin, kanamycin, and streptomycin are not generally firstline
antitubercular drugs.
. A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis treatment regimen reports
tingling of the fingers and toes. The nurse will recommend discussing which treatment with the
provider?
a. Adding pyrazinamide
b. Changing to ethambutol
c. Increasing oral fluid intake
d. Taking pyridoxine (B6)
ANS: D Peripheral neuropathy is an adverse reaction to INH, so pyridoxine is usually given to prevent
this. It is not necessary to change medications. Increasing fluids will not help with this.
A patient asks the nurse about taking over-the-counter sleeping aids. the nurse will tell the patient
that the active ingredient in these products is often a(n)
a. antiemetic.
b. antihistamine.
,c. barbiturate.
d. benzodiazepine.
ANS: B The primary ingredient in OTC sleep aids is typically an antihistamine such as diphenhydramine,
not barbiturates or benzodiazepines. Melatonin can also be purchased as an over-the-counter product.
The nurse provides teaching for a patient who will begin taking phenytoin. Which statement by the
patient indicates understanding of the teaching?
a. "If I develop a rash, I should take diphenhydramine to control the itching."
b. "If I experience bleeding gums, I should stop taking the medication immediately."
c. "Most people develop diabetes while taking this medication."
d. "I should not be alarmed if my urine turns reddish-brown."
ANS: D Phenytoin can cause reddish-brown colored urine. Patients should be counseled to report a rash
to the provider because it could be a serious adverse reaction. Bleeding gums are common, but patients
should never stop taking anticonvulsants abruptly, or they may develop seizures. Changes in blood
glucose may occur but do not necessarily result in diabetes.
A patient who takes a monoamine oxidase (MAO) inhibitor asks the nurse about taking over-the
counter medications to treat cold symptoms. Which medication will the nurse counsel the patient to
avoid while taking a MAO inhibitor?
a. Diphenhydramine
b. Guaifenesin
c. Pseudoephedrine
d. Saline nasal spray
ANS: C
MAO inhibitors can cause hypertensive crises, which can be fatal when taken with sympathomimetic
drugs such as pseudoephedrine.
One hour after receiving intravenous morphine sulfate, a patient reports generalized itching. The
nurse assesses the patient and notes clear breath sounds, no rash, respirations of 14 breaths per
minute, a heart rate of 68 beats per minute, and a blood pressure of 110/70 mm Hg. Which action will
the nurse take?
a. Administer naloxone to reverse opiate overdose.
b. Have resuscitation equipment available at the bedside.
c. Prepare an epinephrine injection in case of an anaphylactic reaction.
d. Reassure the patient that this is a common side effect of this drug.
ANS: D Pruritus is a common opioid side effect and can be managed with diphenhydramine. Patients
developing anaphylaxis will have urticaria and hypotension, and these patients will need epinephrine
and resuscitation. Respiratory depression is a sign of morphine overdose, which will require naloxone.
Prior to administration of interferon alpha, the nurse will administer which medications?
a. Acetaminophen and diphenhydramine
, b. Heparin and meperidine
c. Lorazepam and furosemide
d. Narcotic analgesics and loratadine
ANS: A Patients receiving these drugs should be premedicated with acetaminophen to reduce chills and
fever and with diphenhydramine to reduce histamine effects.
. The nurse is caring for a patient who is receiving diphenhydramine. the nurse notes that the patient
has not voided for 12 hours. What action will the nurse take?
a. Encourage the patient to drink more fluids.
b. Evaluate the bladder to check for distension.
c. Request an order for an intravenous fluid bolus.
d. Request an order for urinary catheterization
ANS: B Diphenhydramine has anticholinergic effects, including urinary retention. thenurse should assess
for bladder distension to determine if this is thecase. Encouraging thepatient to drink more fluids or
giving intravenous fluids may be necessary if thepatient has oliguria secondary to dehydration. Urinary
catheterization is not indicated until urinary retention has been diagnosed.
A patient who has seasonal allergies with a runny nose during the daytime reports increasing
nighttime symptoms of coughing and sneezing that are interfering with sleep. the provider
recommends diphenhydramine at bedtime. What information will the nurse include when teaching
the patient about this medication?
a. "Avoid fluids at bedtime to prevent urinary retention."
b. "This will help clear your daytime symptoms, too."
c. "You should be able to sleep better when you take this medication."
d. "You should take this medication on an empty stomach."
ANS: C A side effect of diphenhydramine is drowsiness. Patients whose nighttime symptoms clear should
be able to sleep better, especially with drowsiness side effects. Avoiding fluids does not prevent urinary
retention. thehalf-life of diphenhydramine is short, so drug effects will not last through thenext day.
There is no need to take themedication on an empty stomach.
The nurse is caring for a patient who is hospitalized for an asthma exacerbation. the patient reports
taking diphenhydramine at home at night to help with symptoms of allergic rhinitis and cough. the
nurse will contact the patient's provider to request an order for which medication?
a. Benzonatate
b. Cetirizine
c. Dextromethorphan hydrobromide
d. Diphenhydramine
ANS: B Cetirizine is an antihistamine, which is indicated for this patient's symptoms. Diphenhydramine is
also an antihistamine but, because of its anticholinergic side effects, should be used with caution in
patients with acute asthma. Benzonatate and dextromethorphan are antitussives and not
antihistamines.
PHARMACOLOGY EXAM
WITH DETAILED
VERIFIED ANSWERS AND
RATIONALES \ALREADY
GRADED A+\VERIFIED BY
EXPERT
The nurse is caring for a patient who is diagnosed with active tuberculosis. The patient tells the nurse
that the provider plans to order a prophylactic antitubercular drug for family members and asks which
drug will be ordered. The nurse will expect the provider to order which drug?
a. Isoniazid
b. Pyrazinamide
c. Rifampin
d. Streptomycin
ANS: A
INH is the drug of choice for prophylactic treatment of TB.
A patient is receiving antitubercular treatment for latent TB. The patient develops symptoms of
peripheral neuropathy and is started on pyridoxine (vitamin B6). The nurse suspects this was caused
by which of the following medications?
a. Ethambutol
b. Isoniazid
c. Rifampin
d. Kanamycin
,ANS: B Peripheral neuropathy can be a problem in patients taking isoniazid, especially for those who are
malnourished, have diabetes mellitus, or are alcoholics. This condition can be prevented if pyridoxine
(vitamin B6) is administered.
The nurse is teaching a patient about rifampin. Which statement by the patient indicates
understanding of the teaching?
a. "I should not wear soft contact lenses while taking rifampin."
b. "I will report any changes in my hearing while taking this drug."
c. "I will report orange urine to my provider immediately."
d. "I understand that renal toxicity is a common adverse effect."
ANS: A Patients taking rifampin should be warned that urine, feces, saliva, sputum, sweat, and tears may
turn a harmless red-orange color. Patients should not wear soft contact lenses to avoid permanent
staining. Streptomycin is associated with ototoxicity. Orange urine is a harmless side effect and does not
need to be reported. Renal toxicity is not common with rifampin.
A patient is being treated with isoniazid (INH), rifampin, and pyrazinamide in the initial phase of
treatment for tuberculosis. The organism develops resistance to isoniazid. Which drug will the nurse
anticipate the provider will order to replace the isoniazid?
a. Ciprofloxacin
b. Ethambutol
c. Kanamycin
d. Streptomycin sulfate
ANS: B If there is bacterial resistance to isoniazid, the first phase may be changed to ethambutol,
rifampin, and pyrazinamide. Ciprofloxacin, kanamycin, and streptomycin are not generally firstline
antitubercular drugs.
. A patient who is taking isoniazid (INH) as part of a two-drug tuberculosis treatment regimen reports
tingling of the fingers and toes. The nurse will recommend discussing which treatment with the
provider?
a. Adding pyrazinamide
b. Changing to ethambutol
c. Increasing oral fluid intake
d. Taking pyridoxine (B6)
ANS: D Peripheral neuropathy is an adverse reaction to INH, so pyridoxine is usually given to prevent
this. It is not necessary to change medications. Increasing fluids will not help with this.
A patient asks the nurse about taking over-the-counter sleeping aids. the nurse will tell the patient
that the active ingredient in these products is often a(n)
a. antiemetic.
b. antihistamine.
,c. barbiturate.
d. benzodiazepine.
ANS: B The primary ingredient in OTC sleep aids is typically an antihistamine such as diphenhydramine,
not barbiturates or benzodiazepines. Melatonin can also be purchased as an over-the-counter product.
The nurse provides teaching for a patient who will begin taking phenytoin. Which statement by the
patient indicates understanding of the teaching?
a. "If I develop a rash, I should take diphenhydramine to control the itching."
b. "If I experience bleeding gums, I should stop taking the medication immediately."
c. "Most people develop diabetes while taking this medication."
d. "I should not be alarmed if my urine turns reddish-brown."
ANS: D Phenytoin can cause reddish-brown colored urine. Patients should be counseled to report a rash
to the provider because it could be a serious adverse reaction. Bleeding gums are common, but patients
should never stop taking anticonvulsants abruptly, or they may develop seizures. Changes in blood
glucose may occur but do not necessarily result in diabetes.
A patient who takes a monoamine oxidase (MAO) inhibitor asks the nurse about taking over-the
counter medications to treat cold symptoms. Which medication will the nurse counsel the patient to
avoid while taking a MAO inhibitor?
a. Diphenhydramine
b. Guaifenesin
c. Pseudoephedrine
d. Saline nasal spray
ANS: C
MAO inhibitors can cause hypertensive crises, which can be fatal when taken with sympathomimetic
drugs such as pseudoephedrine.
One hour after receiving intravenous morphine sulfate, a patient reports generalized itching. The
nurse assesses the patient and notes clear breath sounds, no rash, respirations of 14 breaths per
minute, a heart rate of 68 beats per minute, and a blood pressure of 110/70 mm Hg. Which action will
the nurse take?
a. Administer naloxone to reverse opiate overdose.
b. Have resuscitation equipment available at the bedside.
c. Prepare an epinephrine injection in case of an anaphylactic reaction.
d. Reassure the patient that this is a common side effect of this drug.
ANS: D Pruritus is a common opioid side effect and can be managed with diphenhydramine. Patients
developing anaphylaxis will have urticaria and hypotension, and these patients will need epinephrine
and resuscitation. Respiratory depression is a sign of morphine overdose, which will require naloxone.
Prior to administration of interferon alpha, the nurse will administer which medications?
a. Acetaminophen and diphenhydramine
, b. Heparin and meperidine
c. Lorazepam and furosemide
d. Narcotic analgesics and loratadine
ANS: A Patients receiving these drugs should be premedicated with acetaminophen to reduce chills and
fever and with diphenhydramine to reduce histamine effects.
. The nurse is caring for a patient who is receiving diphenhydramine. the nurse notes that the patient
has not voided for 12 hours. What action will the nurse take?
a. Encourage the patient to drink more fluids.
b. Evaluate the bladder to check for distension.
c. Request an order for an intravenous fluid bolus.
d. Request an order for urinary catheterization
ANS: B Diphenhydramine has anticholinergic effects, including urinary retention. thenurse should assess
for bladder distension to determine if this is thecase. Encouraging thepatient to drink more fluids or
giving intravenous fluids may be necessary if thepatient has oliguria secondary to dehydration. Urinary
catheterization is not indicated until urinary retention has been diagnosed.
A patient who has seasonal allergies with a runny nose during the daytime reports increasing
nighttime symptoms of coughing and sneezing that are interfering with sleep. the provider
recommends diphenhydramine at bedtime. What information will the nurse include when teaching
the patient about this medication?
a. "Avoid fluids at bedtime to prevent urinary retention."
b. "This will help clear your daytime symptoms, too."
c. "You should be able to sleep better when you take this medication."
d. "You should take this medication on an empty stomach."
ANS: C A side effect of diphenhydramine is drowsiness. Patients whose nighttime symptoms clear should
be able to sleep better, especially with drowsiness side effects. Avoiding fluids does not prevent urinary
retention. thehalf-life of diphenhydramine is short, so drug effects will not last through thenext day.
There is no need to take themedication on an empty stomach.
The nurse is caring for a patient who is hospitalized for an asthma exacerbation. the patient reports
taking diphenhydramine at home at night to help with symptoms of allergic rhinitis and cough. the
nurse will contact the patient's provider to request an order for which medication?
a. Benzonatate
b. Cetirizine
c. Dextromethorphan hydrobromide
d. Diphenhydramine
ANS: B Cetirizine is an antihistamine, which is indicated for this patient's symptoms. Diphenhydramine is
also an antihistamine but, because of its anticholinergic side effects, should be used with caution in
patients with acute asthma. Benzonatate and dextromethorphan are antitussives and not
antihistamines.
