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Last Pharm test before Final

Total questions: 70

Worksheet time: 18hrs 30mins

Name
Class
Date
1.

A nurse is caring for a client who has been taking phenylephrine nasal drops for the past 10 days for sinusitis. The nurse should assess the client for which of the following manifestations as an adverse effect of this medication?

a)

Sedation

b)

Nasal Congestion

c)

Productive Cough

d)

Constipation

2.

A nurse is teaching a client who has a new prescription for dextromethorphan to suppress a cough. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication?

a)

Diarrhea

b)

Anxiety

c)

Sedation

d)

Palpitations

3.

A nurse is teaching the family of a child who has cystic fibrosis and a new prescription for acetlycysteine. Which of the following information should the nurse include in the instructions?

a)

"Expect this medication to suppress your child's cough"

b)

"Expect this medication to smell like rotten eggs"

c)

"Expect this medication to cause euphoria"

d)

"Expect this medication to turn your child's urine orange"

4.

A nurse is teaching a client who has a new prescription for diphenhydramine for allergic rhinitis. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication? (select all that apply)

a)

Dry mouth

b)

Nonproductive cough

c)

Skin rash

d)

Drowsiness

e)

Urinary Hesitation

5.

A nurse is teaching a client about the use of fluticasone to treat perennial rhinitis. Which of the following statements by the client indicates an understanding of the teaching?

a)

"I should use the spray every 4 hours while I am awake"

b)

"It can take as long as 3 weeks before the medication takes a maximum effect"

c)

"This medication can also be used to treat motion sickness"

d)

"I can use this medication when my nasal passages are blocked"

6.

A nurse is teaching a client who has a new prescription for beclomethasone. Which of the following instructions should the nurse include?

a)

"Rinse your mouth after each use of the medication"

b)

"Limit fluid intake while taking this medication"

c)

"Increase your intake of vitamin B12 while taking this medication"

d)

"You can take the medication as needed"

7.

A nurse is providing instructions to a client who has a new prescription for albuterol and beclomethasone inhalers for the control of asthma. Which of the following instructions should the nurse include in the teaching?

a)

Take the albuterol at the same time each day

b)

Administer the albuterol inhaler prior to using the beclomethasone inhaler

c)

Use beclomethasone if experiencing an acute episode

d)

Avoid shaking the beclomethasone before use

8.

A nurse is providing instructions to a client who has a new prescription for albuterol, PO. Which of the following instructions should the nurse include?

a)

"You can take this medication to abort an acute asthma attack"

b)

"Tremors are an adverse effect of this medication"

c)

"Prolonged use of this medication can cause hyperglycemia"

d)

"This medication can slow skeletal growth rate"

9.

A nurse is teaching a client who has a prescription for long-term use of oral prednisone for treatment of chronic asthma. The nurse should instruct the client to monitor for which of the following manifestations as an adverse effect of this medication?

a)

Weight gain

b)

Nervousness

c)

Bradycardia

d)

Constipation

10.

A nurse is teaching a client who will begin taking aluminum hydroxide. Which of the following information should the nurse include in the teaching?

a)

"If constipation develops, switch to a calcium-based antacid"

b)

"Take this medication two hours before or after other medications"

c)

"This medication increases the risk for pneumonia"

d)

"Have your magnesium level monitored while taking this medication

11.

A nurse is teaching a client who has a new prescription for omeprazole. Which of the following information should the nurse include in the teaching?

a)

Take this medication at bedtime

b)

This medication decreases the production of gastric acid

c)

Take this medication 2 hours after eating

d)

This medication can cause hyperkalemia

12.

A nurse is teaching a client who takes phenytoin and has a new prescription for sucralfate tablets. Which of the following instructions should the nurse include?

a)

Take an antacid with the sucralfate

b)

Take sucralfate with a glass of milk

c)

Allow a 2 hour interval between these medications

d)

Chew the sucralfate thoroughly before swallowing

13.

A nurse is caring for four clients who has peptic ulcer disease. The nurse should identify misoprostol is contraindicated for which of the following clients?

a)

A client who is pregnant

b)

A client who has osteoarthritis

c)

A client who has a kidney stone

d)

A client who has a urinary tract infection

14.

A nurse is teaching a client about Cimetidine. Which of the following are adverse effects of Cimetidine? (select all that apply)

a)

Increased libido

b)

Insomnia

c)

Enlargement of breast tissue

d)

Confusion

e)

Decreased sperm count

15.

A nurse is caring for a client who received prochlorperazine 4 hours ago. The client reports spasms of the face. The nurse should expect a prescription for which of the following medications?

a)

Fomepizole

b)

Naloxone

c)

Phytonadione

d)

Diphenhydramine

16.

A nurse is planning to adminsiter ondansetron to a client. For which of the following adverse effects of ondansetron should the nurse monitor? (select all that apply)

a)

Headache

b)

Diarrhea

c)

Shortened PR interval

d)

Hyperglycemia

e)

Prolonged QT interval

17.

A nurse is providing instructions about the use of laxatives to a client who has heart failure. The nurse should tell the client to avoid which of the following laxatives?

a)

Sodium Phosphate

b)

Psyllium

c)

Bisacodly

d)

Polethylene Glycol

18.

A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should expect a prescription for which of the following medications?

a)

Lubiprostone

b)

Metoclopramide

c)

Bisacodyl

d)

Loperamide

19.

A nurse is teaching a client about probiotic supplements. Which of the following information should the nurse include? (select all that apply)

a)

"Probiotics are micro-organisms that are normally found in the GI tract"

b)

"Probiotics are used to treat Clostridium difficile"

c)

"Probiotics are used to treat benign prostatic hyperplasia"

d)

"You can experience bloating while taking probiotic supplements"

e)

"If you are prescribed an antibiotic, you should take it at the same time you take your probiotic supplement"

20.

A nurse is reviewing the health care record of a client who is asking about conjugated equine estrogens. The nurse should inform the client this medication is contraindicated in which of the following conditions?

a)

Atrophic vaginitis

b)

Dysfunctional uterine bleeding

c)

Osteoporosis

d)

Thrombophlebitis

21.

A nurse is providing teaching to a female client who is taking testosterone to treat advanced breast cancer. The nurse should tell the client that which of the following are adverse effects of this medication? (select all that apply)

a)

Deepening voice

b)

Weight gain

c)

Low blood pressure

d)

Dry mouth

e)

Facial hair

22.

A nurse is explaining the mechanism of action of combination oral contraceptives to a group of clients. The nurse should tell the clients that which of the following actions occur with the use of combination oral contraceptives? (select all that apply)

a)

Thickening the cervical mucous

b)

Inducing maturation of ovarian follicle

c)

Increasing development of the corpus luteum

d)

Altering the endometrial lining

e)

Inhibiting ovulation

23.

A nurse is providing teaching to a client who will start alfuzosin for treatment of benign prostatic hyperplasia. The nurse should instruct the client that which of the following is an adverse effect of this medication?

a)

Bradycardia

b)

Edema

c)

Hypotension

d)

Tremor

24.

A nurse is caring for a client who has angina and asks about obtaining a prescription for sildenafil to treat erectile dysfunction. Which of the following medications is contraindicated with sildenafil?

a)

Aspirin

b)

Isosorbide

c)

Clopidogrel

d)

Atorvastatin

25.

A nurse is teaching clients about the use of insulin to treat type 1 diabetes mellitus. For which of the following types of insulin should the nurse tell the clients to expect a peak effect 1 to 5 hours after administration

a)

Insulin glargine

b)

NPH insulin

c)

Regular insulin

d)

Insulin lispro

26.

A nurse is caring for a client who has been taking acarbose for type 2 diabetes mellitus. Which of the following laboratory tests should the nurse plan to monitor?

a)

WBC

b)

Amylase

c)

Platelet Count

d)

Liver Function tests

27.

A nurse is providing teaching to a client who has type 2 diabetes mellitus and is starting repaglinide. Which of the following statements by the client indicates understanding of the administration of this medication?

a)

"I'll take this medication after I eat"

b)

"I'll Take this medicine 30 minutes before I eat"

c)

"I'll take this medicine just before I go to bed"

d)

"I'll take this medication at least 1 hour before I eat"

28.

A nurse is providing teaching for a client who has a new prescription for metformin. Which of the following findings should the nurse instruct the client to report as an adverse effect of merformin?

a)

Somnolence

b)

Constipation

c)

Fluid Retention

d)

Weight Gain

29.

A nurse is providing teaching to a client who has a prescription for pramlintide for type 1 diabetes mellitus. Which of the following should the nurse include in the teaching? (select all that apply)

a)

"take oral medications 30 minutes before injection"

b)

"Use upper arms as preferred injection sites"

c)

"Mix pramlintide with the breakfast dose of insulin"

d)

"Inject pramlintide just before a meal"

e)

"Discard open vials after 28 days"

30.

A nurse is caring for a client who is taking propylthiouracil. Which of the following findings should the nurse monitor for as an adverse effect of this medication?

a)

Bradycardia

b)

Insomnia

c)

Heat Intolerance

d)

Weight Loss

31.

A nurse is teaching a client who has Grave's disease and a new prescription for propranolol. Which of the following client statements indicates effective teaching?

a)

"Propranolol helps increase blood flow to my thyroid gland"

b)

"Propranolol is used to prevent excess glucose in my blood"

c)

"Propranolol will decrease my tremors and fast heart beat"

d)

"Propranolol promotes a decrease of thyroid hormone in my body"

32.

A nurse is caring for an older adult client who has hypothyroidism and a new prescription for levothyroxine. Which of the following dosage schedules should the nurse expect for this client?

a)

The client will start at a high dosage, and the amount will be tapered as needed

b)

The client will remain on the initial dosage during the course of treatment

c)

The client's dosage will be adjusted based on blood levels

d)

The client will start on a low dosage, which can be gradually increased

33.

A nurse is caring for a client who is taking for somatropin to stimulate growth. The nurse should plan to monitor the client's urine for which of the following?

a)

Bilirubin

b)

Protein

c)

Potassium

d)

Calcium

34.

A nurse is reviewing the medical record of a client who takes desmopressin for diabetes insipidus. Which of the following findings is an adverse effect of desmopressin?

a)

Hypovolemia

b)

Hypercalcemia

c)

Agitation

d)

Headache

35.

A nurse is admitting a client for total hip arthroplasty. The client takes hydrocortisone for Addison's disease. Which of the following actions is the nurse's priority?

a)

Administering a supplemental dose of hydrocortisone

b)

Instructing the client about coughing and deep breathing

c)

Collecting additional information about the client's history of Addison's disease

d)

Inserting an indwelling urinary catheter

36.

A patient has been taking Finasteride for almost 1 year. The nurse knows that which is most important to evaluate at this time?

a)

Complete blood count

b)

PSA levels

c)

Blood pressure

d)

Fluid retention

37.

The nurse is performing an assessment of a patient who is asking for a prescription for Sildenafi. Which finding would be contraindication to its use

a)

65 years of age

b)

History of thyroid disease

c)

Medication list that includes nitrates

d)

Medication list that includes saw palmetto

38.

During a counseling session for a group of teenage athlete's, the use of androgenic steroids is discussed. The nurse will explain that which problem is a rare but devastating effect of androgenic steroid use?

a)

Peliosis of the liver

b)

Bradycardia

c)

Kidney Failure

d)

Tachydysrhythmias

39.

The nurse is teaching a patient about he possible adverse effect of priapism, which may occur when taking erectile dysfunction drugs. The nurse emphasizes that, if this occurs, the most important action is which of these?

a)

Stay in bed until the erection ceases

b)

Apply an ice pack for 30 minutes

c)

Turn toward his left side and rest

d)

seek medical attention immediately

40.

A patient is asking about the use of saw palmetto for prostate health. The nurse tells him that drugs that interact with saw palmetto include which of these? (select all that apply)

a)

Acetaminophen

b)

Nitrates

c)

Hormones

d)

NSAIDs

e)

Antihypertensive Drugs

41.

When the testoderm form of testosterone is ordered to treat hypogonadism in a teenage boy, which instructions by the nurse are correct? (select all that apply)

a)

Place the patch on clean, dry skin on the back, upper arms, abdomen, or thighs

b)

Place the patch on clean, dry scrotal skin that has been shaved

c)

Place the patch on clean, dry scrotal skin, but do not shave the skin first

d)

Place the patch on any clean, dry, non-hairy area of the body.

e)

Remove the old patch before applying a new patch

42.

The nurse is reviewing the medication list for a patient and notes that finasteride 5 mg daily is on the list. This drug is for which of these problems?

a)

Benign Prostatic Hypertrophy (BPH)

b)

Erectile Dysfunction

c)

Alopecia in male patients

d)

Alopecia in male and female patients

43.

When assessing a patient who is to receive a decongestant, the nurse will recognize that a potential contraindication to this drug would be which condition? (select all that apply)

a)

Glaucoma

b)

Fever

c)

Hypertension

d)

Peptic Ulcer Disease

e)

Allergic Rhinitis

44.

When giving decongestants, the nurse must remember that these drugs have alpha-adrenergic-stimulating effects that may result in which effect?

a)

Fever

b)

Bradycardia

c)

Hypertension

d)

CNS Depression

45.

The nurse is reviewing a patient's medication orders for prn (as necessary) medications that can be given to a patient who has bronchitis with a productive cough. Which drug will the nurse choose?

a)

An antitussive

b)

An expectorant

c)

An antihistamine

d)

a decongestant

46.

The nurse knows that an antitussive cough medication would be the best choice for which patient?

a)

A patient with a productive cough

b)

A patient with chronic paranasal sinusitis

c)

A patient who has had recent abdominal surgery

d)

A patient who has influenza

47.

A patient is taking a decongestant to help reduce symptoms of a cold. The nurse will instruct the patient to observe for which possible symptom, which may indicate an adverse effect of this drug?

a)

Increased cough

b)

Dry mouth

c)

Slower heart rate

d)

Heart palpitations

48.

The nurse is giving an antihistamine and will observe the patient for which side effects? (select all that apply)

a)

Dizziness

b)

"Hangover" Effect

c)

Drowsiness

d)

Dry Mouth

e)

Tachycardia

49.

The nurse notes in a patient's medication history that the patient is taking benzonatate as needed. Based on this finding, the nurse interprets that the patient has which problem?

a)

Cough

b)

Seasonal Allergies

c)

Chronic Rhinitis

d)

Motion sickness

50.

A patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. The nurse will choose which medication that is appropriate for this situation?

a)

A beta agonist, such as albuterol

b)

a leukotriene receptor agonist, such as montelukast

c)

A corticosteroid, such as fluticasone

d)

An anticholinergic, such as ipratropium

51.

After a nebulizer treatment with the beta agonist albuterol, the patient complains of feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98 BPM. The nurse knows that this reaction is which of these?

a)

An expected adverse effect of the medication

b)

An allergic reaction to the medication

c)

An indication that he has received an overdose of the medication

d)

An idiosyncratic reaction to the medication

52.

A patient is receiving ipratropium via an inhaler. The nurse will assess the patient for which of these adverse effects? (select all that apply)

a)

CNS depression

b)

Dry mouth or throat

c)

Increased appetite

d)

Nasal congestion

e)

Headache

53.

During a teaching session for a patient who will be receiving a new prescription for the LTRA montelukast, the nurse will tell the patient that the drug has which therapeutic effect?

a)

Improves the respiratory drive

b)

Loosens and removes thickened secretions

c)

Reduces inflammation in the airway

d)

Stimulates immediate bronchodialation

54.

After the patient takes a dose of an inhaled corticosteroid, such as fluticasone, what is the most important action the patient needs to do next?

a)

Hold the breath for 60 seconds

b)

Rinse out the mouth with water

c)

Follow the corticosteroid with a bronchodilator inhaler, if ordered

d)

Repeat the dose in 15 minutes if the patient feels short of breath

55.

The nurse is teaching a patient about the inhaler fluticasone/salmeterol. Which statements by the patient indicate a correct understanding of this medication? (select all that apply)

a)

I will rinse my mouth with water after each dose

b)

I need to use this inhaler whenever I feel short of breath, but no less than 4 hours between doses

c)

This medication is take twice a day, every 12 hours

d)

I can take this inhaler if I get short of breath while exercising

e)

I will call my doctor if I notice white patches inside my mouth

56.

A patient who is taking a xanthine derivative for COPD asks the nurse, "I miss my morning coffee. I can't wait to go home and have some." What is the nurse's best response?

a)

I know how you feel. I'd miss my coffee too

b)

I can get some coffee for you. I'll be right back

c)

It's important not to take coffee or other caffeinated products with this medicine, as it may cause increased heart rate as well as other problems.

d)

You've ben on this medicine for a few days. I can call your prescriber to ask whether you can have some coffee

57.

When monitoring for a therapeutic response to prednisone, the nurse will look for which potential outcomes? (select all that apply)

a)

Increased lymphocyte levels

b)

Decreased inflammation

c)

Increased growth characteristics

d)

Decrease in Cushing's syndrome characteristics

e)

Prevention of organ rejection in a patient who had an organ transplant

58.

The nurse has provided teaching about oral corticosteroid therapy to a patient. Which statement by the patient shows a need for more teaching?

a)

I will report any fever or sore throat symptoms

b)

I will stay away from anyone who has a cold or infection

c)

I can stop this medication if I have severe side effects

d)

I will take this drug with food or milk

59.

During long-term corticosteroid therapy, the nurse will monitor the patient for Cushing's syndrome, which is manifested by which of these?

a)

Weight loss

b)

Moon Face

c)

Hypotension

d)

Thickened hair growth

60.

When teaching a patient who has been prescribed a daily dose of prednisone, the nurse knows that the patient will be told to take the medication at which time of day to help reduce adrenal suppression?

a)

In the morning

b)

At lunchtime

c)

At dinnertime

d)

At bedtime

61.

Which teaching is appropriate for a patient who is taking an inhaled glucocorticoid for asthma?

a)

Exhale while pushing in on the canister of the inhaler

b)

Blow your nose after taking the medication

c)

Rinse your mouth thoroughly after taking the medication

d)

Do not eat immediately after taking the medication

62.

During long term corticosteroid therapy, the nurse will monitor the patient's laboratory results for adverse effects, such as: (select all that apply)

a)

Increased serum potassium levels

b)

Decreased serum potassium levels

c)

Increased sodium levels

d)

Decreased sodium levels

e)

Hyperglycemia

63.

Which is the most appropriate timing regarding the nurse's administration of a rapid-acting insulin to a hospitalized patient?

a)

Give it 15 minutes before the patient begins a meal

b)

Give it a half hour before a meal

c)

Give it 1 hour after a meal

d)

The timing of the insulin injection does not matter with insulin lispro

64.

Which statement is appropriate for the nurse to include in patient teaching regarding type 2 diabetes?

a)

Insulin injections are never used with type 2 diabetes

b)

You do not need to measure your blood glucose levels because you are not taking insulin injections

c)

A person with type 2 diabetes still has some functioning beta cells in his or her pancreas

d)

Patients with type 2 diabetes usually have better control over their diabetes than those with type 1

65.

The nurse monitoring a patient for a therapeutic response to oral diabetes drugs will look for which of these?

a)

Fewer episodes of diabetic ketoacidosis (DKA)

b)

Weight loss of 5 pounds

c)

Hemoglobin A1C levels of less than 7%

d)

Glucose levels of 150 mg/dL

66.

A patient with type 2 diabetes is scheduled for magnetic resonance imaging (MRI) with contrast dye. The nurse reviews the orders and notices that the patient is receiving metformin. Which action by the nurse is appropriate?

a)

Proceed with the MRI as scheduled

b)

Notify radiology department that the patient is receiving metformin

c)

Expect to hold the metformin the day of the test and for 48 hours after the test is performed

d)

Call the prescriber regarding holding the metformin for 2 days before the MRI is performed

67.

A patient with type 2 diabetes has a new prescription for repaglinide. After 1 week, she calls the office to ask what to do, because she keeps missing meals. "I work right through lunch sometimes, and I'm not sure whether I need to take it. What do I need to do?" What is the nurse's best response?

a)

You need to try not to skip meals, but if that happens you will need to skip that dose of repaglinide

b)

We will probably need to change your prescription to insulin injections because you can't eat meals on a regular basis

c)

Go ahead and take the pill when you first remember that you missed it

d)

Take both pills with the next meal, and try to eat a little extra to make up for what you missed at lunchtime

68.

When checking a patient's fingerstick blood glucose level, the nurse obtains a reading of 42 mg/dL. The patient is awake but states he feels a bit "cloudy-headed." After double-checking the patient's glucose level and getting the same reading, which action by the nurse is most appropriate?

a)

Administer two packets of table sugar

b)

Administer oral glucose in form of a semisolid gel

c)

Administer 50% dextrose IV push

d)

Administer the morning dose of lispro insulin

69.

A patient is taking metformin for a new-onset type 2 diabetes mellitus. When reviewing potential adverse effects, the nurse will include information about: (select all that apply)

a)

Abdominal bloating

b)

Nausea

c)

Diarrhea

d)

Metallic Taste

e)

Headache

70.

A patient who has a new diagnosis of type 2 diabetes asks the nurse about a new insulin that can be inhaled. "Is there a reason I can't take this drug?" Which conditions, if present in the patient, would be a concern? (select all that apply)

a)

Atrial Fibrillation

b)

History of smoking

c)

Chronic lung disease

d)

Hypothyroidism

e)

Rheumatoid Arthritis