Pharmacology Exam

1. A client with myasthenia gravis reports the occurrence of difficulty chewing. The
physician prescribes pyridostigmine bromide (Mestinon) to increase muscle strength for this
activity. The nurse instructs the client to take the medication at what time, in relation to
meals?

a. after dinner daily when most fatigued d. thirty minutes before each meal
b. before breakfast daily
c. as soon as arising in the morning

2. A client is advised to take senna (Senokot) for the treatment of constipation asks the
nurse how this medication works. The nurse responds knowing that it:

a. accumulates water in the stool and c. coats the bowel wall

increases peristalsis d. adds fiber and bulk to the stool
b. stimulates the vagus nerve

3. A client is receiving heparin sodium by continuous intravenous infusion. The nurse

monitors the client for which adverse effect of this therapy?

a. decreased blood pressure d. tinnitus

b. increased pulse rate
c. ecchymoses

4. A client is being treated for acute congestive heart failure (CHF) and the client’s vital
signs are as follows: BP 85/50 mm Hg; pulse, 96 bpm; respirations, 26 cpm. The physician
prescribes digoxin (Lanoxin). To evaluate a therapeutic effectiveness of this medication, the
nurse would expect which of the following changes in the client’s vital signs?

a. BP 85/50 mm Hg, pulse 60 bpm, respirations 26 cpm

b. BP 98/60 mm Hg, pulse 80 bpm, respirations 24 cpm
c. BP 130/70 mm Hg, pulse 104 bpm, respirations 20 cpm
d. BP 110/40 mm Hg, 110 bpm, respirations 20 cpm

5. Diazepam (Valium) is prescribed for a client with anxiety. The nurse instructs the client to
expect which side effect?

a. incoordination d. hypertension
b. cough
c. tinnitus

6. A client receives oxytocin (Pitocin) to induce labor. During the administration of the
oxytocin, it is most important for the nurse to monitor:
a. urinary output d. maternal blood glucose
b. fetal heart rate
c. central venous pressure

7. A clinic nurse is performing assessment on a client who is being seen in the clinic for the
first time. When asking about the client’s medication history, the client tells the nurse that
he takes nateglinide (Starlix). The nurse then questions the client about the presence of
which disorder that is treated with this medication?

a. hypothyroidism d. renal failure

b. insomnia
c. type 2 diabetes mellitus

8. A client who is taking rifampin (Rifadin) as part of the medication regimen for the
treatment of tuberculosis calls the clinic nurse and reports that her urine is a red-orange
color. The nurse tells the client to:

a. come to the clinic to provide a urine sample

b. stop the medication until further instructions are given by the physician
c. take the medication dose with an antacid to prevent this adverse effect
d. expect a red-orange color in urine, feces, sweat, sputum, and tears as a harmless side
effect

9. A nurse is caring for a client with a tracheostomy that has been diagnosed with a
respiratory infection. The client is receiving vancomycin hydrochloride (Vancocin) 500 mg
intravenously every 12 hours. Which of the following would indicate to the nurse that the
client is experiencing an adverse effect of the medication?

a. decreased hearing acuity d. bradycardia

b. photophobia
c. hypotension

10. A nurse is caring for a client with a diagnosis of metastatic breast carcinoma who is
receiving tamoxifen citrate (Nolvadex) 10 mg orally twice daily. Which of the following
would indicate to the nurse that the client is experiencing a side effect related to the
medication?

a. hypetension d. vaginal bleeding

b. diarrhea
c. nose bleeds

11. A client has just been given a prescription for diphenoxylate with atropine (Lomotil). The
nurse teaches the client which of the following about the use of this medication?

a. drooling may occur while taking this medication

b. irritability may occur while taking this medication
c. this medication contains a habit-forming ingredient
d. take the medication with a laxative of choice
a.
12.glaucoma
A nurse is gathering data from client about thed.client’s
urinarymedication
frequency history
and urgency
and notes
b. renal insufficiency
that the client is taking tolterodine tartrate (Detrol LA). The nurse determines that the client
c. taking
is pyloric the
stenosis
medication to treat which disorder?

13. A client has an order to receive psyllium (Metamucil) daily. The nurse administers this
medication with:

a. a multivitamin and mineral supplement d. eight ounces of liquid

b. a dose of an antacid
c. applesauce

14. A nurse is teaching a client taking cyclosporine (Sandimmune) after renal transplant
about medication information. The nurse tells the client to be especially alert for:

a. signs of infection d. hair loss

b. hypotension
c. weight loss

15. A nurse reinforces dietary instruction for the client receiving spironolactone (Aldactone).
Which food would the nurse instruct the client to avoid while taking this medication?

a. crackers d. popcorn
b. shrimp
c. apricots

16. Oral lactulose (Chronulac) is prescribed for the client with a hepatic disorder and the
nurse provides instructions to the client regarding this medication. Which statement by the
client indicates a need for further instructions?

a. “I need to take the medication with water’”

b. “ I need to increase fluid intake while taking the medication”
c. “ I need to increase fiber in the diet”
d. “I need to notify the physician of nausea occurs”

17. A home care nurse provides instructions to a client taking digoxin (Lanoxin) 0.25 mg
daily. Which statement by the client indcates a need for further instructions?

a. “I will take my prescribed antacid if I become nauseated”

b. “It is important to have my blood drawn when prescribed”
c. “I will check my pulse before I take my medication”
d. “I will carry a medication identification card with me”

18. A client with anxiety disorder is taking buspirone (BuSpar) and tells the nurse that it is
difficult to swallow the tablets. The nurse tells the client to:
a. dissolve the tablet in a cup of coffee medication
b. crush the tablet before taking it d. mix the tablet uncrushed in custard
c. call the physician for a change in

19. A nurse is caring for a child with CHF provides instructions to the parents regarding the
administration of digoxin (Lanoxin). Which statement by the mother indicates a need for
further instructions?

a. “If my child vomits after I give the medication, I will not repeat the dose”
b. “I will check my child’s pulse before giving the medication”
c. “I will check the dose of the medication with my husband before I give the medication”
d. “I will mix the medication with food”

20. A nurse provides instructions to a client who will begin an oral contraceptives. Which
statement by the client indicates the need for further instructions?

a. “I will take one pill daily at the same time every day”
b. “I will not need to use an additional birth control method once I start these pills”
c. “If I miss a pill I need to take it as soon as I remember”
d. “If I miss two pills I will take them both as soon as I remember and I will take two pills
the next day also”

21. A nurse provides instructions to a client taking clorazepate (Tranxene) for management
of an anxiety disorder. The nurse tells the client that:

a. drowsiness is a side effect that usually disappears with continued therapy

b. if dizziness occurs, call the physician
c. smoking increases the effectiveness of the medication
d. if gastrointestinal disturbances occur, discontinue the medication

22. A client with Parkinson’s disease has begun therapy with levodopa (L-dopa). The nurse
determines that the client understands the action of the medication if the client verbalizes
that results may not be apparent for:

a. 24 hours d. Two to three weeks

b. Two to three days
c. One week

23. A nurse in a physician’s office is reviewing the results of a client’s phenytoin (Dilantin)
level drawn that morning. The nurse determines that the client has a therapeutic drug level
if the client’s result was:

a. 3 mcg/ml d. 24mcg/ml
b. 8 mcg/ml
c. 15 mcg/ml

24. A nurse is caring for a client with a genitourinary tract infection receiving amoxicillin
(Augmentin) 500 mg every 8 hours. Which of the following would indicate to the nurse that
the client is experiencing an adverse effect related to the medication?
a. hypertension d. watery diarrhea
b. nausea
c. headache

25. A nurse is caring for a client with glaucoma who receives a daily dose of acetazolamide
(Diamox). Which of the following would indicate to the nurse that the client is experiencing
an adverse effect of the medication?

a. constipation d. irritability
b. difficulty swallowing
c. dark-colored urine and stools

26. A nurse is caring for a client with a diagnosis of meningitis who is receiving amphotericin
B (Fungizone) intravenously. Which of the following would indicate to the nurse that the
client is experiencing an adverse effect related to the medication?

a. nausea d. confusion
b. decreased urinary output
c. muscle weakness

27. A nurse has formulated a nursing diagnosis of Disturbed Body Image for a client who is
taking spironolactone (Aldactone). The nurse based this diagnosis on assessment of which
side effect of the medication?

a. edema d. decreased libido

b. weight gain
c. excitability

28. A nurse is caring for the client with a history of mild heart failure who is receiving
diltiazem hydrochloride (Cardizem) for hypertension. The nurse would assess the client for:

a. bradycardia d. apical pulse rate lower than baseline

b. wheezing
c. peripheral edema and weight gain

29. The wound of a client with an extensive burn injury is being treated with the application
of silver sulfadiazine (Silvadene). Which symptom would indicate to the nurse that the client
is experiencing a side effect related to systemic absorption?

a. pain at the wound site d. photosensitivity

b. burning and itching at the wound site
c. a localized rash

30. A nurse is caring for a client with a diagnosis of rheumatoid arthritis who is receiving
sulindac (Clinoril) 150 mg po twice daily. Which finding would indicate to the nurse that the
a. diarrhea
client d. tingling in the extremities
is experiencing a side effect related to the medication?
b. photophobia
c. fever

31. The nurse notes that the client is receiving filgrastim (Neupogen). The nurse checks
which of the following to determine medication effectiveness?

a. neutrophil count d. creatinine level

b. platelet count
c. blood urea nitrogen

32. A nurse is monitoring a client who is taking fluphenazine decanoate (Prolixin) for signs
of leucopenia. Which finding indicates a sign of this blood dyscrasia?

a. blurred vision d. dry mouth

b. constipation
c. sore throat

33. A nurse is administering amphotericin B (Fungizone) to a client intravenously to treat a

fungal infection. The nurse monitors the result of which electrolyte study during therapy
with this medication?

a. sodium d. chloride
b. potassium
c. calcium

34. A clinic nurse asks a client with diabetes mellitus being seen in the clinic for the first
time to list the medications that she is taking. Which combination of medications taken by
the client should the nurse report to the physician?

a. Acetohexamide (Dymelor) and trimethoprim-sulfamethoxazole (Bactrim)

b. Chlorpropamide (Diabenase) and amitriptyline (Elavil)
c. Glyburide (DiaBeta) and Lanoxin (Digoxin)
d. Tolbutamide (Orinase) and amoxicillin (Amoxil)

35. A nurse is caring for a client receiving streptogramin (Synercid) by intravenous

intermittent infusion for the treatment of a bone infection develops diarrhea. Which nursing
action would the nurse implement?

a. administer an antidiarrheal agent d. monitor the client’s temperature

b. notify the physician
c. discontinue the medication

36. A client has been taking fosinopril (Monopril) for 2 months. The nurse determines that
the client is having the intended effects of therapy if the nurse notes which of the following?
a. lowered BP d. increased monocyte count
b. lowered pulse rate
c. increased WBC

37. A client is taking labetalol (Normodyne). The nurse monitors the client for which
frequent side effect of the medication?

a. tachycardia d. night blindness

b. impotence
c. increased energy level

38. An older client has been using cascara sagrada on a long-term basis. The nurse
determines that which laboratory result is a result of the side effects of this medication?

a. sodium 135 mEq/L d. potassium 5.0 mEq/L

b. sodium 145 mEq/L
c. potassium 3.1 mEq/L

39. A client has an order to begin short-term therapy with enoxaparin (Lovenox). The nurse
explains to the client that this medication is being ordered to:

a. dissolve urinary calculi d. stop progression of multiple sclerosis

b. reduce the risk of deep vein thrombosis
c. relieve migraine headaches

40. Quinidine gluconate (Dura Quin) is prescribed for a client. The nurse reviews the client’s
medical record, knowing that which of the following is a contraindication in the use of this
medication?

a. complete atrioventricular (AV) block d. infection

b. muscle weakness
c. asthma

41. A client has been taking benzonatate (Tessalon) as ordered. The nurse tells the client
that this medication should do which of the following?

a. take away nausea and vomiting d. increase comfort level

b. calm the persistent cough
c. decrease anxiety level

42. Auranofin (Ridaura) is prescribed for a client with rheumatoid arthritis, and the nurse
monitors the client for signs of an adverse effect related to the medication. Which of the
following indicates an adverse effect?
a. nausea d. proteinuria
b. diarrhea
c. anorexia

43. A nurse is providing instructions to a client regarding quinapril hydrochloride (Accupril).

The nurse tells the client:

a. to take the medication with food only occurs

b. to rise slowly from a lying to a sitting d. that a therapeutic effect will be noted
position immediatedly
c. to discontinue the medication if nausea

44. A female client tells the clinic nurse that her skin is very dry and irritated. Which
product would the nurse suggest that the client apply to the dry skin?

a. glycerin emollient d. acetic acid solution

b. aspercreame
c. myoflex

45. A client with advanced cirrhosis of the liver is not tolerating protein well, as eveidenced
by abnormal laboratory values. The nurse anticipates that which of the following
medications will be prescribed for the client?

a. lactulose (Chronulac) d. thiamine (Vitamin B1)

b. ethacrynic acid (Edecrin)
c. folic acid (Folvite)

46. A nurse is planning dietary counseling for the client taking triamterene (Dyrenium). The
nurse plans to include which of the following in a list of foods that are acceptable?

a. baked potato d. pears canned in water

b. bananas
c. oranges

47. A client is taking famotidine (Pepcid) asks the home care nurse what would be the best
medication to take for a headache. The nurse tells the client that it would be best to take:

a. aspirin (acetylsalicylic acid, ASA) d. naproxen (Naprosyn)

b. ibuprofen (Motrin)
c. acetaminophen (Tylenol)

48. A nurse has taught a client taking a xanthine bronchodilator about beverages to avoid.
The nurse determines that the client understands the information if the client chooses which
of the following beverages from the dietary menu?
a. chocolate milk d. cola
b. cranberry juice
c. coffee

49. A client with histoplasmosis has an order for ketoconazole (Nizoral). The nurse teaches
the client to do which of the following while taking this medication?

a. take the medication on an empty c. avoid exposure to sunlight

stomach d. limit alcohol to 2 ounces per day
b. take the medication with an antacid

50. A nurse is preparing the client’s morning NPH insulin dose and notices a clumpy
precipitate inside the insulin vial. The nurse should:

a. draw up and administer the dose

b. shake the vial in an attempt to disperse the clumps
c. draw the dose from a new vial
d. warm the bottle under running water to dissolve the clump