NR293 Exam 4 Actual Exam Style V2 | NR
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient with asthma is prescribed albuterol and beclomethasone inhalers. Which
instruction should the nurse provide regarding the sequence of administration?
A. Administer the albuterol first, wait 5 minutes, then administer the beclomethasone.
B. Administer the beclomethasone first, then the albuterol.
C. Mix both medications in a single nebulizer treatment.
D. Administer the medications at least 4 hours apart to prevent interactions.
Correct Answer: A
Expert Explanation: Albuterol is a rapid-acting bronchodilator that opens the airways to
allow better penetration of the corticosteroid. Waiting five minutes between the two
inhalers ensures the bronchodilation has occurred before the second medication is inhaled.
This sequence maximizes the therapeutic effect of the beclomethasone in the lower
respiratory tract.
2. Which laboratory value is the most important for a nurse to monitor in a patient receiving
long-term oral prednisone therapy?
A. Blood glucose levels
B. Serum sodium levels
C. Platelet count
,D. Creatinine clearance
Correct Answer: A
Expert Explanation: Prednisone is a corticosteroid that can cause significant
hyperglycemia by increasing gluconeogenesis. Monitoring blood glucose is essential even
in patients without a history of diabetes mellitus. This side effect occurs because
glucocorticoids interfere with insulin sensitivity and glucose metabolism.
3. A nurse is teaching a patient about the side effects of diphenhydramine. Which statement
by the patient indicates a need for further teaching?
A. I should avoid driving while taking this medication.
B. I will take this medication to help with my glaucoma.
C. I might experience a dry mouth while on this drug.
D. I should not drink alcohol while taking this medicine.
Correct Answer: B
Expert Explanation: Diphenhydramine has anticholinergic properties that can increase
intraocular pressure. Therefore, it is contraindicated in patients with narrow-angle
glaucoma. The patient needs to understand that this medication could worsen their
condition rather than help it.
4. A patient is prescribed levothyroxine for hypothyroidism. When is the best time for the
nurse to instruct the patient to take this medication?
A. Immediately after the evening meal
, B. At bedtime with a snack
C. With lunch to prevent gastric upset
D. In the morning, 30 to 60 minutes before breakfast
Correct Answer: D
Expert Explanation: Levothyroxine should be taken on an empty stomach to ensure
optimal absorption in the gastrointestinal tract. Food and other medications can
significantly interfere with the bioavailability of the synthetic thyroid hormone. Taking it
30 to 60 minutes before breakfast is the standard clinical recommendation for consistency.
5. The nurse is preparing to administer lispro insulin to a patient. When should the nurse
ensure the patient’s meal is available?
A. 2 hours after administration
B. 30 to 45 minutes after administration
C. 1 hour before administration
D. Within 15 minutes of administration
Correct Answer: D
Expert Explanation: Lispro is a rapid-acting insulin with an onset of action between 15
and 30 minutes. If the patient does not eat shortly after administration, they are at high risk
for hypoglycemia. Ensuring the tray is present or arriving immediately is a critical safety
intervention.
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient with asthma is prescribed albuterol and beclomethasone inhalers. Which
instruction should the nurse provide regarding the sequence of administration?
A. Administer the albuterol first, wait 5 minutes, then administer the beclomethasone.
B. Administer the beclomethasone first, then the albuterol.
C. Mix both medications in a single nebulizer treatment.
D. Administer the medications at least 4 hours apart to prevent interactions.
Correct Answer: A
Expert Explanation: Albuterol is a rapid-acting bronchodilator that opens the airways to
allow better penetration of the corticosteroid. Waiting five minutes between the two
inhalers ensures the bronchodilation has occurred before the second medication is inhaled.
This sequence maximizes the therapeutic effect of the beclomethasone in the lower
respiratory tract.
2. Which laboratory value is the most important for a nurse to monitor in a patient receiving
long-term oral prednisone therapy?
A. Blood glucose levels
B. Serum sodium levels
C. Platelet count
,D. Creatinine clearance
Correct Answer: A
Expert Explanation: Prednisone is a corticosteroid that can cause significant
hyperglycemia by increasing gluconeogenesis. Monitoring blood glucose is essential even
in patients without a history of diabetes mellitus. This side effect occurs because
glucocorticoids interfere with insulin sensitivity and glucose metabolism.
3. A nurse is teaching a patient about the side effects of diphenhydramine. Which statement
by the patient indicates a need for further teaching?
A. I should avoid driving while taking this medication.
B. I will take this medication to help with my glaucoma.
C. I might experience a dry mouth while on this drug.
D. I should not drink alcohol while taking this medicine.
Correct Answer: B
Expert Explanation: Diphenhydramine has anticholinergic properties that can increase
intraocular pressure. Therefore, it is contraindicated in patients with narrow-angle
glaucoma. The patient needs to understand that this medication could worsen their
condition rather than help it.
4. A patient is prescribed levothyroxine for hypothyroidism. When is the best time for the
nurse to instruct the patient to take this medication?
A. Immediately after the evening meal
, B. At bedtime with a snack
C. With lunch to prevent gastric upset
D. In the morning, 30 to 60 minutes before breakfast
Correct Answer: D
Expert Explanation: Levothyroxine should be taken on an empty stomach to ensure
optimal absorption in the gastrointestinal tract. Food and other medications can
significantly interfere with the bioavailability of the synthetic thyroid hormone. Taking it
30 to 60 minutes before breakfast is the standard clinical recommendation for consistency.
5. The nurse is preparing to administer lispro insulin to a patient. When should the nurse
ensure the patient’s meal is available?
A. 2 hours after administration
B. 30 to 45 minutes after administration
C. 1 hour before administration
D. Within 15 minutes of administration
Correct Answer: D
Expert Explanation: Lispro is a rapid-acting insulin with an onset of action between 15
and 30 minutes. If the patient does not eat shortly after administration, they are at high risk
for hypoglycemia. Ensuring the tray is present or arriving immediately is a critical safety
intervention.
