PHARM KAPLAN INTEGRATED TEST – NCLEX-STYLE PHARMACOLOGY QUESTIONS AND RATIONALES
COMPLETE NURSING EXAM REVIEW MATERIAL
1. The nurse prepares to administer digoxin 0.01 mg/kg PO to a 2-month-old
infant. The infant weighs 5 kg.The sleeping infant's apical pulse is 70 bpm. The
nurse takes which most appropriate action?: Withholds the medication and notifies the health
care provider immediately.
Digoxin belongs to the class of medicines called digitalis glycosides. It is used to improve the strength and eflciency
of the heart, or to control the rate and rhythm of the heartbeat. This leads to better blood circulation and reduced
swelling of the hands and ankles in patients with heart problems.. It is used to treat congestive heart failure, usually
in combination with a diuretic (water pill) and an angiotensin-converting enzyme (ACE) inhibitor. It is also used to
treat a heart rhythm problem called atrial fibrillation.
What is a normal apical pulse for an infant?
newborn: 100-170 bpm. 6 months to 1 year: 90-130 bpm. 2 to 3 years: 80-120 bpm. 4 to 5 years: 70-110 bpm.
2. The nurse provides care for a client diagnosed with Hodgkin's disease. The
client received cyclophosphamide. Which laboratory value does the nurse
report to the healthcare provider?: Platelets 40,000 mm3 (40x10^9/L)
A normal platelet count in adults ranges from 150,000 to 450,000 platelets per microliter of blood.
Hodgkin's lymphoma is a type of cancer that attects the lymphatic system, which is part of the body's germ-fighting
immune system. In Hodgkin's lymphoma, white blood cells called lymphocytes grow out of control, causing swollen
lymph nodes and growths throughout the body.
Cyclophosphamide is used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in
children). Cyclophosphamide is also used for retinoblastoma (a type of eye cancer mainly in children), multiple
myeloma (cancer in the bone marrow), and mycosis fungoides (tumors on the skin). It belongs to the group of cancer
medicines called alkylating agents.
Cyclophosphamide is also used for some kinds of kidney disease.
Cyclophosphamide interferes with the growth of cancer cells, which are then destroyed by the body. Since the growth
of normal body cells may also be attected by cyclophosphamide, other ettects will also occur. Some of these may be
serious and must be reported to your doctor. Other ettects, like hair loss, may not be serious but may cause concern.
Some ettects may not occur for months or years after the medicine is used.
, PHARM KAPLAN INTEGRATED TEST – NCLEX-STYLE PHARMACOLOGY QUESTIONS AND RATIONALES
COMPLETE NURSING EXAM REVIEW MATERIAL
3. The nurse instructs a client who is to take rifampin. The nursing informs the
client that which adverse effect may occur?: Orange-colored urine
Rifampin is used together with other medicines to treat tuberculosis (TB) in many ditterent parts of the body. It is also
used by patients who have meningitis bacteria in their nose or throat who do not show symptoms of the infection to
prevent the spread of the bacteria to other patients. Rifampin is in a class of medications called antimycobacterials.
It works by killing the bacteria that cause infection. Antibiotics such as rifampin will not work for colds, flu, or other
viral infections.
What is the major adverse ettect of Rifampin?
Rifampin will cause urine, saliva, sputum, sweat, teeth, and tears to turn a reddish-orange to reddish-brown color.
This is to be expected while you are using this medicine. This ettect may also cause soft contact lenses to become
permanently discolored.
4. Th nurse reviews laboratory reports for a client receiving digoxin and
furosemide. Which laboratory values most concern the nurse?: K= 3.2 mEq/L (3.2
mmol) ; digoxin level= 2.2 ng/mL (2.8 n mmol/L)
Digoxin is a type of medicine called a cardiac glycoside. It's used to control some heart problems, such as irregular
heartbeats (arrhythmias) including atrial fibrillation. It can also help to manage the symptoms of heart failure, usually
with other medicines.
More common side ettects
Dizziness
fainting
fast, pounding, or irregular heartbeat or pulse
slow heartbeat
A normal Digoxin level should be 0.5 - 2 ng/mL. Any levels greater than 2 ng/mL is considered toxic.
Furosemide belongs to a group of medicines called loop diuretics (also known as water pills). Furosemide is given
to help treat fluid retention (edema) and swelling that is caused by congestive heart failure, liver disease, kidney
disease, or other medical conditions. It works by acting on the kidneys to increase the flow of urine. Furosemide is
also used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure
adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function
, PHARM KAPLAN INTEGRATED TEST – NCLEX-STYLE PHARMACOLOGY QUESTIONS AND RATIONALES
COMPLETE NURSING EXAM REVIEW MATERIAL
properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or
kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to
occur if blood pressure is controlled.
5. The nurse instructs the client who is to take risperidone daily. Which adverse
effects are included in the teaching?: Diarrhea (questionable) and increased salivation
Drug class: Atypical antipsychotics
Risperidone is used to treat schizophrenia, bipolar disorder, or irritability associated with autistic disorder. This
medicine should not be used to treat behavioral problems in older adults who have dementia.
Common risperidone side ettects include nausea, constipation, and dry mouth. More serious side ettects include
movement problems, hyperprolactinemia, and a greater risk of falls.
What are the adverse ettects of antipsychotics?
These ettects include:
antimuscarinic ettects
bed-wetting
blood disorders
body temperature problems
emotional ettects
eye problems
heart problems
liver disorders
metabolic syndrome
neuroleptic malignant syndrome (NMS)
neuromuscular side ettects
sedation (sleepiness)
seizures (fits)
sexual and hormonal problems
skin problems
suicidal feelings and behaviour
tardive dyskinesia (TD)
COMPLETE NURSING EXAM REVIEW MATERIAL
1. The nurse prepares to administer digoxin 0.01 mg/kg PO to a 2-month-old
infant. The infant weighs 5 kg.The sleeping infant's apical pulse is 70 bpm. The
nurse takes which most appropriate action?: Withholds the medication and notifies the health
care provider immediately.
Digoxin belongs to the class of medicines called digitalis glycosides. It is used to improve the strength and eflciency
of the heart, or to control the rate and rhythm of the heartbeat. This leads to better blood circulation and reduced
swelling of the hands and ankles in patients with heart problems.. It is used to treat congestive heart failure, usually
in combination with a diuretic (water pill) and an angiotensin-converting enzyme (ACE) inhibitor. It is also used to
treat a heart rhythm problem called atrial fibrillation.
What is a normal apical pulse for an infant?
newborn: 100-170 bpm. 6 months to 1 year: 90-130 bpm. 2 to 3 years: 80-120 bpm. 4 to 5 years: 70-110 bpm.
2. The nurse provides care for a client diagnosed with Hodgkin's disease. The
client received cyclophosphamide. Which laboratory value does the nurse
report to the healthcare provider?: Platelets 40,000 mm3 (40x10^9/L)
A normal platelet count in adults ranges from 150,000 to 450,000 platelets per microliter of blood.
Hodgkin's lymphoma is a type of cancer that attects the lymphatic system, which is part of the body's germ-fighting
immune system. In Hodgkin's lymphoma, white blood cells called lymphocytes grow out of control, causing swollen
lymph nodes and growths throughout the body.
Cyclophosphamide is used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in
children). Cyclophosphamide is also used for retinoblastoma (a type of eye cancer mainly in children), multiple
myeloma (cancer in the bone marrow), and mycosis fungoides (tumors on the skin). It belongs to the group of cancer
medicines called alkylating agents.
Cyclophosphamide is also used for some kinds of kidney disease.
Cyclophosphamide interferes with the growth of cancer cells, which are then destroyed by the body. Since the growth
of normal body cells may also be attected by cyclophosphamide, other ettects will also occur. Some of these may be
serious and must be reported to your doctor. Other ettects, like hair loss, may not be serious but may cause concern.
Some ettects may not occur for months or years after the medicine is used.
, PHARM KAPLAN INTEGRATED TEST – NCLEX-STYLE PHARMACOLOGY QUESTIONS AND RATIONALES
COMPLETE NURSING EXAM REVIEW MATERIAL
3. The nurse instructs a client who is to take rifampin. The nursing informs the
client that which adverse effect may occur?: Orange-colored urine
Rifampin is used together with other medicines to treat tuberculosis (TB) in many ditterent parts of the body. It is also
used by patients who have meningitis bacteria in their nose or throat who do not show symptoms of the infection to
prevent the spread of the bacteria to other patients. Rifampin is in a class of medications called antimycobacterials.
It works by killing the bacteria that cause infection. Antibiotics such as rifampin will not work for colds, flu, or other
viral infections.
What is the major adverse ettect of Rifampin?
Rifampin will cause urine, saliva, sputum, sweat, teeth, and tears to turn a reddish-orange to reddish-brown color.
This is to be expected while you are using this medicine. This ettect may also cause soft contact lenses to become
permanently discolored.
4. Th nurse reviews laboratory reports for a client receiving digoxin and
furosemide. Which laboratory values most concern the nurse?: K= 3.2 mEq/L (3.2
mmol) ; digoxin level= 2.2 ng/mL (2.8 n mmol/L)
Digoxin is a type of medicine called a cardiac glycoside. It's used to control some heart problems, such as irregular
heartbeats (arrhythmias) including atrial fibrillation. It can also help to manage the symptoms of heart failure, usually
with other medicines.
More common side ettects
Dizziness
fainting
fast, pounding, or irregular heartbeat or pulse
slow heartbeat
A normal Digoxin level should be 0.5 - 2 ng/mL. Any levels greater than 2 ng/mL is considered toxic.
Furosemide belongs to a group of medicines called loop diuretics (also known as water pills). Furosemide is given
to help treat fluid retention (edema) and swelling that is caused by congestive heart failure, liver disease, kidney
disease, or other medical conditions. It works by acting on the kidneys to increase the flow of urine. Furosemide is
also used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure
adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function
, PHARM KAPLAN INTEGRATED TEST – NCLEX-STYLE PHARMACOLOGY QUESTIONS AND RATIONALES
COMPLETE NURSING EXAM REVIEW MATERIAL
properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or
kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to
occur if blood pressure is controlled.
5. The nurse instructs the client who is to take risperidone daily. Which adverse
effects are included in the teaching?: Diarrhea (questionable) and increased salivation
Drug class: Atypical antipsychotics
Risperidone is used to treat schizophrenia, bipolar disorder, or irritability associated with autistic disorder. This
medicine should not be used to treat behavioral problems in older adults who have dementia.
Common risperidone side ettects include nausea, constipation, and dry mouth. More serious side ettects include
movement problems, hyperprolactinemia, and a greater risk of falls.
What are the adverse ettects of antipsychotics?
These ettects include:
antimuscarinic ettects
bed-wetting
blood disorders
body temperature problems
emotional ettects
eye problems
heart problems
liver disorders
metabolic syndrome
neuroleptic malignant syndrome (NMS)
neuromuscular side ettects
sedation (sleepiness)
seizures (fits)
sexual and hormonal problems
skin problems
suicidal feelings and behaviour
tardive dyskinesia (TD)
