NURS 6521 Pharmacy Final Exam/ Walden University/ Questions and Answers/
41. A nurse practitioner understands when prescribing a
medication that there are certain questions to address.
Check all that apply.: Is there a need for the drug in treating the
presenting
problem?
Is this the best drug for the presenting problem? Can the patient
take the prescribed drug?
42. An elderly patient with a history of congestive heart
failure has been admitted to hospital with failure to thrive and
admission blood work reveals a hemoglobin level of 6.9 g/dL.
The care team has consequently administered two units of
packed red blood cells, but auscultation of the client's lungs
now reveals diffuse
crackles. Administration of what drug is likely to resolve the
patient's pul- monary edema?: Furosemide (Lasix)
43. In order to promote therapeutic drug effects, the nurse
should always encourage patients to: take their medication at
the prescribed times.
44. The nurse practitioner orders Amoxicillin 500 mg tid?
What is the total amount of
medication patient will take per day?: 1500 mg
45. A patient with mild low back pain has been advised to
take aceta- minophen. The
nurse will inform him that excessive intake of acetaminophen
may result in: liver damage
46. A nurse is teaching an older adult patient about
polypharmacy. Which of the
following statements best describe this term?: Taking several
drugs simultane- ously
47. A nurse is aware that diphenoxylate HCl with atropine
sulfate is an effective adjunct in the treatment of diarrhea.
For which of the following patients could the administration
of this drug be potentially harmful?: An
80-year-old man who has diarrhea secondary to Clostridium
difficile infection
48. A 70-year-old patient has just started taking lorazepam 10
days ago for anxiety issues related the death of her husband.
She is staying with her daughter for a
couple of weeks. The patient's daughter has noticed that her
mother is having
difficulty walking and seems to be confused at times and
calls the clinic to report this to the nurse. The nurse will
inform the daughter that...: a dose adjustment should be made
if these symptoms
persist.
49. An elderly woman is slated for a hemiarthroplasty (hip
replacement surgery) after falling and breaking her hip on the
stairs outside her home. The woman's pain in the time since
her injury has been severe, and her care team has been
treating it with morphine. Which of the following
administration schedules is most likely to control the
patient's pain?: Twice-daily doses of long-acting morphine, with
short-acting
morphine available for breakthrough pain
50. A 67-year-old man is admitted to the hospital with
pneumonia. He reports to the
nurse that he has chronic arthritis and circulation problems.
Further assess- ment
by the nurse reveals that the patient has a history of mild
hypertension. He explains that he owns a business and lives
alone. The nurse determines that he
is within the normal weight range for his height and age but
has a fondness for spicy foods and sweets. Which of the
mentioned patient variables will have the
greatest impact on the effectiveness of the patient's drug
therapy?: vascular impairment
51. A patient is admitted to the emergency department with
severe chest pain. The
emergency department physician orders intravenous
nitroglycerin 5 cg/min, titrate dose by 5 mcg/min every 3 to 5
minutes per infusion pump as needed. Before administering
the nitroglycerin, the nurse should prioritize which of the
following assessments?: Blood Pressure (BP)
52. Prior to administering a dose of 5-FU to a patient with
pancreatic cancer, the nurse is conducting the necessary
drug research. The nurse is aware that
5-FU
is a cell cycle-specific chemotherapeutic agent. Which of the
following state- ments best describes cell cycle-specific
drugs?: They affect cancerous cells during a particular phase of
cellular reproduction.
53. Which of the following would be the most important
safety-related in- struction for
a nurse to give to a patient taking baclofen (Lioresal)?:
Discontinue the use of alcohol
54. A nurse is assessing a patient who has come to the
emergency depart- ment
complaining of back spasms. The patient states that he has a
history of
opioid
addiction and does not want to take any drug that "puts me
at risk of becoming physically dependent." Which of the
following medications would the nurse question, if ordered?:
Cyclobenzaprine (Flexeril)
55. A patient with bronchial asthma is prescribed a sustainedrelease
prepa-
ration
of
theophylline.
To
help
minimize
the
adverse
effects
of
the
drug,
which
of
the
following
should
the
nurse
suggest?:
Take
it
on an empty
stomach,
1 hour before
or 2
hours
after meals
56. A middle-aged patient was diagnosed with major
depression after a suicide attempt several months ago and
has failed to respond apprecia- bly to treatment with SSRIs.
As a result, his psychiatrist has prescribed phenelzine. When
planning this patient's subsequent care, what nursing
diagnosis should the nurse prioritize?: Risk for Injury related to
drug-drug interactions or drug-nutrient interactions
57. Mr. Tan is a 69-year-old man who prides himself in
maintaining an active lifestyle and a healthy diet that includes
adequate fluid intake. However, Mr. Tan states
that he has experienced occasional constipation in recent
months. What remedy
should be the nurse's first suggestion?: BULK-FORMING
(fiber) LAXATIVES
58. What critical piece of information is missing from the
following medica- tion order:
Amoxicillin 250 mg every 8 hours?: Routes of Administration
59. The nurse practitioner orders Amoxicillin 250 mg/5 ml tid
for 10 days? The nurse
practitioner would expect the pharmacist to fill the
prescription bottle with how
many ml?: 150 ml
60. A 77-year-old woman who is 5 feet 3 inches tall and
weighs 89 lbs has been admitted to the hospital with a
diagnosis of failure to thrive. What action should the nurse
prioritize when addressing the woman's apparent lack of
nutrition?: Assess the reasons behind the patient's poor
nutritional
status
61. A 60-year-old African-American man lives with a number
of chronic health
problems. Genetic factors are likely to influence his etiology
and/or treatment of: Hypertension
62. A 49-year-old woman has been diagnosed with myalgia.
The physician has
recommended aspirin. The patient is concerned that the
aspirin will upset her
stomach. The nurse will encourage the patient to...: swallow the
tablet with milk or food.
63. A patient has recently been prescribed a drug that treats
his hypertension by
blocking the sympathetic receptors in his sympathetic
nervous system. This action is characteristic of: an adrenergic
antagonist
64. A patient is brought to the emergency department in
hypertensive crisis. Nitroprusside is administered
intravenously. The patient experiences di- aphoresis and
dizziness. Which of the following is the appropriate action by
the nurse?: Slow the rate of the infusion
65. A nurse is creating a plan of care for a 68-year-old woman
with a recent diagnosis of unstable angina and new
prescription for nitroglycerin. Which of the following nursing
diagnoses should the nurse prioritize in the planning of this
patient's care?: Acute Pain, Headache, related to adverse effects
of drug therapy
66. A 53-year-old man has been treated for severe asthma for
several years with prednisone. Recently, his physician
initiated alternate-day therapy for him. The
patient tells the nurse that he would rather take the medication
every day to prevent confusion. Which of the following would
be the best response by the nurse?: This schedule allows rest
periods so that adverse effects are
decreased but the anti-inflammatory effects continue.
67. A 70-year-old man who enjoys good health began taking
low-dose aspirin several months ago based on
recommendations that he read in a magazine article. During
the man's most recent visit to his care provider, routine blood
work
was ordered and the results indicated an unprecedented rise
in the man's serum
creatinine and blood urea nitrogen (BUN) levels. How should
a nurse best interpret these findings?: The man may be
experiencing nephrotoxic effects of aspirin
68. A nurse who provides care in a busy clinic is aware of the
high incidence and
prevalence of hyperlipidemia and the consequent need for
antihyperlipi- demics in
many patients. Treatment of high cholesterol using statins
would be contraindicated in which of the following patients?:
An obese male client who is a heavy alcohol user and who has
cirrhosis of the liver
69. A woman with numerous chronic health problems has
been diagnosed with a
benign gastric ulcer has begun treatment with ranitidine
(Zantac). Which of the following teaching points should the
nurse provide to this patient?: "Quit- ting smoking will significantly
increase the chance that this
drug will heal your ulcer."
70. A 47-year-old woman has been diagnosed with openangle
glaucoma.
Pilocarpine
drops
are
prescribed.
The
nurse's
assessment
reveals
that
the
patient
has
worn
soft
contact
lenses
for
15
years.
The
nurse
will
instruct
the
patient
to:
remove
the contact
lenses
before
applying
the drops.
71. It is determined that a patient, who is in a hepatic coma,
needs a laxative. Lactulose is prescribed. Which of the
following should the nurse monitor to assess the efficacy of
the lactulose therapy?: Blood ammonia levels
72. A nurse is a member of a research team that is exploring
unique dif- ferences in responses to drugs that each
individual possesses, based on genetic make-up.
This area of study is called: pharmacodynamics.
73. A nurse has been invited to speak to a support group for
persons with movement disorders and their families. Which of
the following statements by the nurse addresses the chronic
nature of these diseases and the relevant drug therapies?:
"Drugs do not cure these disorders; they instead enhance quality
of life."
74. A patient on 5-FU calls the clinic and reports that he has
between five and seven loose bowel movements daily. The
nurse will instruct the patient to: notify the clinic if the stools
are black or if there is evidence of
blood.
75. An adult patient who has been diagnosed with a rectal tumor
is scheduled to begin treatment with cisplatin. The nurse has
conducted patient teaching about the possibility of nausea
and vomiting. In order to reduce the patient's risk of severe
nausea, the nurse should: administer a combination of antiemet-
ics prior to the administration of the drug.
76. A nurse is assessing a female patient who is taking
diphenoxylate HCl with atropine sulfate. Which of the
following would lead the nurse to suspect that she is
experiencing an allergic reaction?: Urticaria (hives)
77. Following an assessment by her primary care provider, a
70-year-old resident of an assisted living facility has begun
taking daily oral doses of levothyroxine.
Which of the following assessment findings should prompt
the nurse to withhold
a scheduled dose of levothyroxine?: The resident's apical heart
rate is 112 beats/minute with a
regular rhythm
78. A 40-year-old woman with a diagnosis of fibromyalgia has
been pre- scribed
cyclobenzaprine (Flexeril) as an adjunct to her existing drug
regimen. What nursing diagnosis should the nurse prioritize
when updating the nursing care plan for this patient?: Risk for
Injury related to CNS depressant effects
79. A homeless man who is well known to care providers at the
local hospital has been admitted to the emergency department
after having a seizure out- side a mall. The man is known to be
a heavy alcohol user and is malnourished with a
very low body mass index. How are this patient's
characteristics likely to influence possible treatment with
phenytoin?: The patient's protein deficit will likely increase the
levels of the
free drug in his blood.
80. A clinic nurse is following a 9-year-old boy who is taking
somatropin. Which of
the following will the nurse monitor periodically?: Height
81. A Native American man who lives a traditional lifestyle is
scheduled to have heart surgery. The tribal chief has
requested that the tribe's medicine man
perform a ritual before the patient goes to surgery. The
nurse's response to this
request should be: As long as the ritual does not interfere with
the patient's preoperative care, it will be okay.
82. A 30-year-old woman is taking phenelzine (Nardil) 30mg
PO tid. The nurse knows that at that dosage, the patient will
need to be carefully monitored for: dizziness
83. A nurse is overseeing the care of a young man whose
ulcerative colitis is being treated with oral prednisone. Which
of the following actions should the nurse take in order to
minimize the potential for adverse drug effects and risks
associated with prednisone treatment?: Carefully assess the
patient for infec- tions
84. A patient with a diagnosis of nonsmall cell lung cancer is
currently undergoing
chemotherapy. At the encouragement of a family member, the
patient has announced to the nurse his intention to
complement this treatment with a regimen of herbal
remedies. How should the nurse respond to this patient's
statement?: "It's important to discuss what herbs you'll be taking
with your
doctor or the pharmacist to make sure there aren't any
interactions."
85. Mr. Nguyen, age 71, will soon be discharged home from
the hospital after a successful coronary artery bypass graft
(CABG). During patient education about his drug regimen, Mr.
Nguyen's nurse should prioritize teach about: - potential
adverse effects of the drugs that Mr. Nguyen will be
taking.
86. A 24-year-old factory worker has been prescribed
guaifenesin for the first time.
Which of the following will be a priority assessment by the
nurse before the patient's first dose?: The amount of alcohol
consumption
87. A patient will begin three new medications as part of her
treatment plan. The nurse practitioner understands that
proper disposal of medications is key when the nurse
practitioner states: Many medications can be potentially harmful
if taken by someone other than the person the medication was
prescribed.
88. Several months of treatment with a statin accompanied by
lifestyle mod- ifications
have failed to appreciably improve a patient's cholesterol
levels. Conse- quently,
the patient has been prescribed cholestyramine. The nurse
should recognize that this drugs achieves its therapeutic
effect by: oxidizing cholesterol to bile acids.
89. A patient has been prescribed several drugs and fluids to
be given intravenously.
Before the nurse starts the intravenous administration, a
priority assessment of
the patient will be to note the: skin surrounding the potential IV
site.
90. A 58-year-old man is admitted to the emergency
department. A diagnosis of severe digoxin toxicity is made.
Bradycardia is present, and an electrocardiogram (ECG)
confirms toxicity. The nurse will administer which of the
following drugs?: Digoxin immune fab
91. A 76-year-old woman has a complex medical history that
includes emphy- sema, osteoporosis, malnutrition, and
hypothyroidism. Recently, the woman fell outside her home as
a result of weakness and suffered a fracture to her femoral
head.
The woman's subsequent hip-replacement surgery has been
scheduled and the care team recognizes that the use of
isoflurane will be most significantly influenced by: her history
of emphysema.
92. A 75-year-old woman is prescribed magnesium hydroxide
for constipa- tion. The
nurse's assessment reveals that the patient is being treated
for rheumatoid arthritis and hypertension. The patient lives in
assisted living and is on a low- sodium diet. Before the
magnesium hydroxide therapy begins, it will be most important
for the nurse to assess the patient's: Medication History
93. A clinic nurse has been assigned a 49-year-old female
patient who has a history of diabetes. A recent diagnosis of
hypertension has been made, and the patient
has been prescribed a thiazide diuretic and labetalol. The
patient will be scheduled to return to the clinic once a month
for the next 6 months. A priority action by the nurse will be
to: monitor the patient's blood pressure
94. A female patient calls the clinic and reports that since she
has been taking dextromethorphan (Robitussin), she has
been extremely drowsy and dizzy. The nurse will question the
patient about which of the following?: The amount of grapefruit
or orange juice she has during the
day
95. A 79-year-old woman with a medical history that includes
osteoporosis has
recently moved to a long-term care facility. Medication
reconciliation indi-
cates
that the woman has been taking calcitonin, salmon for
several years. The nurse
should recognize that the most likely route for the
administration of this drug is: intranasal
96. An older adult who lives in a long-term care facility has
recently begun taking
losartan (Cozaar) for the treatment of hypertension. The nurse
who provides care for this resident should recognize that this
change in the resident's medication regimen make create a
risk for: falls
97. A patient with class-IV CHF has a medication regimen
consisting of metoprolol
(Lopressor), enalapril (Vasotec), and furosemide (Lasix). In
addition to regu- larly
assessing the patient s heart rate, the nurse should prioritize
assessment of the
patient's: blood pressure
98. A nurse is providing education to a 56-year-old man who
is admitted to the
emergency department with an acute asthma attack. The
nurse's initial as- sessment reveals that the patient has a
history of pneumonia, drinks large quantities of coffee, and
eats a high-calorie diet. Albuterol is prescribed for him. The
important consideration when the nurse is preparing a
teaching plan will be
that the patient: has a high coffee intake.