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Worksheets

Pharm Final Practice

Total questions: 50

Worksheet time: 50mins

Name
Class
Date
1.

When teaching a patient who is receiving allopurinol, what should the nurse encourage the patient to do?

a)

Eat more meat

b)

Increase Vitamin C intake

c)

Have yearly eye exams

d)

Take medication 2 hours before meals

2.

A patient is taking aspirin for arthritis. Which adverse reaction should the nurse teach the patient to report to the health care provider?

a)

Tinnitus

b)

Seizures

c)

Sinusitis

d)

Palpitations

3.

The nurse is caring for a postpartum woman who is refusing opioid analgesics but is rating her pain as a 7 or 8 on a 10-point pain scale. The nurse will contact the provider to request an order for which analgesic medication?

a)

Diclofenac Sodium

b)

Ketoprofen

c)

Ketorolac

d)

Naproxen

4.

A patient who has osteoarthritis with mild to moderate pain asks the nurse about taking over-the-counter ibuprofen. What will the nurse tell this patient?

a)

“It may take several weeks to achieve maximum therapeutic effects.”

b)

"Unlike aspirin, there is no increased risk of bleeding with ibuprofen.”

c)

“Take ibuprofen twice daily for maximum analgesic benefit"

d)

“Combine ibuprofen with naproxen for best effect"

5.

Which antigout medication is considered first-line to treat chronic tophaceous gout?

a)

Allopurinol

b)

Colchicine

c)

Probenecid

d)

Celecoxib

6.

When preparing discharge teaching for a client who has been prescribed ibuprofen for arthritis, Which statement would the nurse provide to the client on the mechanism of action?

a)

“Ibuprofen is a COX-2 inhibitor, so it blocks prostaglandin synthesis.”

b)

“Ibuprofen inhibits prostaglandin synthesis.

c)

“Ibuprofen binds with opiate receptor sites.”

d)

“Ibuprofen promotes vasodilation to increase blood flow.”

7.

For the patient receiving periodic morphine via intravenous push, which of the following findings would be of utmost concern to the nurse?

a)

Increased temperature

b)

Decreased bowel sounds

c)

Decreased respirations

d)

Increased RBC Count

8.

A patient is admitted to the emergency department with signs of respiratory depression after self-injection with hydromorphone. The admitting nurse knows that which drug will reverse respiratory depression caused by opioid overdose?

a)

Fentanyl

b)

Naloxone

c)

Butorphanol

d)

Sufenta

9.

An adolescent female has dysmenorrhea associated with heavy menstrual periods. The patient’s provider has recommended ibuprofen. When teaching this patient about this drug, the nurse will tell her that ibuprofen:

a)

May decrease the effectiveness of oral contraceptive pills

b)

may increase bleeding during her period

c)

should be taken on an empty stomach

d)

will decrease the duration of her periods

10.

One hour after receiving intravenous morphine sulfate, a patient reports generalized itching. The nurse assesses the patient and notes clear breath sounds, no rash, respirations of 14 breaths per minute, a heart rate of 68 beats per minute, and a blood pressure of 110/70 mm Hg. Which action will the nurse take?

a)

Administer naloxone to reverse opiate overdose

b)

Have resuscitation equipment available at the bedside.

c)

Prepare an epinephrine injection in case of an anaphylactic reaction

d)

Reassure the patient that this is a common side effect of this drug.

11.

The nurse is caring for a patient who is receiving an intravenous antibiotic. The nurse notes that the provider has ordered serum drug peak and trough levels. The nurse understands that these tests are necessary for which type of drugs?

a)

Drugs with a broad specturm

b)

Drugs with a narrow spectrum

c)

drugs with a broad therapeutic index

d)

Drugs with a narrow therapeutic index

12.

The nurse is caring for a patient who is receiving an intravenous antibiotic. The patient has a serum drug trough of 1.5 mcg/mL. The normal trough for this drug is 1.7 to 2.2 mcg/mL. What will the nurse expect the patient to experience?

a)

Inadequate therapeutic effects

b)

Increased risk for superinfection

c)

excessive adverse effects

d)

Signs of drug toxicity

13.

The nurse is caring for a patient who has recurrent urinary tract infections. The patient’s current infection is not responding to an antibiotic that has been used successfully several times in the past. The nurse understands that this is most likely due to:

a)

Acquired drug resistance

b)

Cross-resistance

c)

Inherent bacterial resistance

d)

Transferred resistance

14.

. The nurse is preparing to administer amoxicillin (Amoxil) to a patient and learns that the patient previously experienced a rash when taking penicillin. Which action will the nurse take?

a)

Administer the amoxicillin and have epinephrine available.

b)

Ask the provider to order an antihistamine.

c)

Contact the provider to discuss using a different antibiotic

d)

Request an order for a beta-lactamase resistant drug

15.

A patient is admitted to the hospital for treatment of pneumonia after complaining of high fever and shortness of breath. The patient was not able to produce sputum for a culture. The nurse will expect the patient’s provider to order which of the following?

a)

A broad-spectrum antibiotic

b)

a narrow-spectrum antibiotic

c)

multiple antibiotics

d)

a pneumococcal vaccine

16.

The nurse assumes care for a patient who is currently receiving a dose of intravenous vancomycin (Vancocin) infusing at 20 mg/min. The nurse notes red blotches on the patient’s face, neck, and chest and assesses a blood pressure of 80/55 mm Hg. Which action will the nurse take?

a)

Request an order for IV epinephrine to treat anaphylactic shock.

b)

Slow the infusion to 10 mg/min and observe the patient closely

c)

Stop the infusion and obtain an order for a BUN and serum creatinine

d)

Suspect Stevens-Johnson syndrome and notify the provider immediately

17.

A client, who recently completed five days of antibiotics, presents to the clinic with complaints of severe vaginal itching and discharge. Which mechanism will the nurse recognize as a possible cause of vaginal itching and discharge will the nurse recognize?

a)

Poor hygiene

b)

Hypersensitivity

c)

Kidney infection

d)

Superinfection

18.

The nurse is caring for a 7-year-old patient who will receive oral antibiotics. Which antibiotic order will the nurse question for this patient?

a)

Azithromycin

b)

Clarithromycin

c)

Clindamycin

d)

Tetracycline

19.

The nurse is counseling a patient who will begin taking a sulfonamide drug to treat a urinary tract infection. What information will the nurse include in teaching?

a)

Maintain adequate fluid intake

b)

if stomach upset occurs, take an antacid

c)

this is a safe drug to take while pregnant

d)

sore throat is a common, harmless side effect

20.

Which actions can contribute to bacterial resistance to antibiotics? (Select all that apply.)

a)

Frequent use of antibiotics

b)

Giving large doses of antibiotics

c)

Skipping doses

d)

Taking a full course of antibiotics

e)

Treating viral infections with antibiotics

21.

A patient is beginning isoniazid and rifampin treatment for tuberculosis. The nurse gives the patient which instruction?

a)

Do not skip doses

b)

Take both drugs three times daily

c)

Take an antacid with the drugs

d)

Take rifampin intially

22.

What will the nurse teach a patient who is taking isoniazid (INH)?

a)

You will need to take vitamin C to potentiate the action of INH.

b)

Multidrug therapy is necessary to prevent the occurrence of resistant bacteria.

c)

You should not be on that drug. I will check with the health care provider

d)

Pyridoxine (vitamin B6) will prevent numbness and tingling that can occur when taking isoniazid.

23.

The nurse is caring for a patient who is taking rifampin. The patient has red-orange urine. What is the nurse's best action?

a)

Collect a urine culture

b)

Document the finding and teach the patient

c)

Discard the first void and start a 24-hr urine collection

d)

Call the health care provider

24.

The nurse receives an order to administer a purine nucleoside antiviral medication. The nurse understands that this medication treats which type of virus?

a)

Hepatitis

b)

Herpes

c)

HIV

d)

Influenza

25.

The nurse is teaching a patient who will receive acyclovir for a herpes virus infection. What information will the nurse include when teaching this patient?

a)

Blood cell counts should be monitored closely

b)

dizziness and confusion are harmless side effects

c)

Increase fluid intake while taking this medication

d)

Side effects are rare with this medication

26.

A patient who is taking acyclovir (Zovirax) to treat an oral HSV-1 infection asks the nurse why oral care is so important. The nurse will tell the patient that meticulous oral care helps to:

a)

Minimize transmission of disease

b)

Prevent gingival hyperplasia

c)

Reduce viral resistance

d)

Shorten the duration of drug therapy

27.

A young adult female is prescribed metronidazole (Flagyl) to treat trichomoniasis. Which of the following is FALSE regarding metronidazole?

a)

Metronidazole is not appropriate for this patient because it is only indicated for bacterial infections.

b)

Alcohol use is contraindicated.

c)

Metronidazole is available in multiple dosage forms, including oral, topical, intravaginal, and IV product

d)

Metronidazole can be used for both bacterial and protozoal infections

28.

A recent laboratory results indicated an “undetectable” human immunodeficiency virus viral load. What is the nurse’s best response?

a)

Inform the patient that he must be seen immediately because the undetectable viral load indicates that his medication stopped working.

b)

Have the patient reschedule his clinic visit.

c)

Congratulate the patient on his treatment success.

d)

Educate the patient about the continued need for his medications and ongoing laboratory monitoring.

29.

During routine prenatal testing, a patient is diagnosed with human immunodeficiency virus infection. To help prevent perinatal transmission of human immunodeficiency virus to the fetus, what is the nurse’s best action?

a)

Provide the patient with contact information for an acquired immunodeficiency syndrome support group.

b)

Educate the patient about the risks of human immunodeficiency virus disease to the fetus.

c)

Notify the Centers for Disease Control and Prevention of the patient’s diagnosis.

d)

Provide written and oral education about the use of antiretroviral therapy during pregnancy.

30.

Which diseases are caused by herpes viruses? (Select all that apply.)

a)

Chicken Pox

b)

hepatitis

c)

Influenza

d)

Mononucleosis

e)

Shingles

31.

A patient who has HIV infection will begin treatment with efavirenz. The nurse expects this agent to be given in combination with other antiretrovirals in order to:

a)

avoid development of psychiatric comorbidities.

b)

prevent dizziness, sedation, and nightmares.

c)

reduce viral resistance.

d)

prevent severe rash and hepatotoxicity.

32.

The nurse is caring for a patient who is HIV-positive and has been receiving antiretroviral therapy for several months. The nurse experiences a needlestick injury resulting in exposure to the patient’s blood. The nurse asks the Occupational Health nurse if treatment is necessary. How will the Occupational Health nurse respond?

a)

You will require 1 week of ART

b)

You will require 2 weeks of ART

c)

You will require 3 weeks of ART

d)

You will require 4 weeks of ART

33.

Your patient is receiving basiliximab and develops cytokine release syndrome. You would expect to see:

a)

Coughing

b)

Chills

c)

Tremors

d)

Weakness

34.

The patient tells the nurse that he understands that transplant rejection may happen and asks what can be done to minimize risk of rejection and other negative outcomes. What will the nurse include in the teaching?

a)

“An anti-T-cell antibody should be used in conjunction with corticosteroid therapy for best results.”

b)

“ATG rabbit started immediately after transplant can help prevent rejection.”

c)

“Transplant rejection drugs can be used and while they have unwanted side effects, none are deadly.”

d)

“Caution needs to be taken when other immunosuppressant drugs are administered to avoid serious infections.”

35.

All transplant drugs have the same advisory, to use caution when administering them with another immunosuppressant drug because of the increased risk for:

a)

Nausea and vomiting

b)

Edema

c)

Anemia

d)

Infection

36.

The nurse is preparing to administer varicella vaccine to a young woman. Which of the following findings has the greatest implication for this young woman’s care?

a)

The patient tells the nurse she is “deathly afraid of needles.”

b)

The medical record indicates that the patient is allergic to eggs.

c)

The medical history indicates that the patient had leukemia as a young child.

d)

The patient appears to be pregnant.

37.

A woman who is pregnant tells the nurse she has not had any vaccines but wants to begin so that she can protect her unborn child. Which vaccine(s) may be administered to this patient?

a)

HPV

b)

Influenza

c)

MMR

d)

Varicella

38.

Which statement by a patient who has received teaching on tetracycline therapy indicates that more teaching is needed?

a)

I will store the medication away from light and extreme heat.”

b)

I will use an additional contraceptive technique because this drug may cause the oral contraceptive I take to be less effective.”

c)

“I will take this medication with an antacid.”

d)

“If my stomach becomes upset when taking this medication, I will take it with nondairy foods.”

39.

What are the signs and symptoms of digoxin toxicity? (Select all that apply)

a)

Dysuria

b)

Vomiting

c)

Tachycardia

d)

Yellow haloes in the visual field

e)

Diarrhea

40.

A patient will be discharged home with albuterol (Proventil) to use for asthma symptoms. What information will the nurse include when teaching this patient about this medication?

a)

Failure to respond to the medication indicates a need for a higher dose

b)

Monitor for hypoglycemia symptoms when using this medication.

c)

Palpitations are common with this drug even at normal, therapeutic doses

d)

Overuse of this medication can result in airway narrowing and bronchospasm

41.

A patient will begin taking simvastatin to decrease serum cholesterol, when teaching the patient about this medication, the nurse will counsel the patient to take which action

a)

return for annual lab testing

b)

take care when rising from a sitting to standing position

c)

take the medication in the evening for best effect

d)

use ibuprofen as needed for severe muscle aches and pain

42.

The nurse is caring for a patient who will begin taking omeprazole (Prevacid) 20 mg per day for 4 to 8 weeks to treat gastroesophageal reflux disease esophagitis. The nurse learns that the patient takes digoxin. The nurse will contact the provider for orders to:

a)

increase the dose of digoxin

b)

increase the omeprazole to 60 mg per day

c)

monitor for digoxin toxicity.

d)

Decrease the dose of omeprazole

43.

A patient is admitted to the emergency department with status epilepticus. Which drug should the nurse most likely prepare to administer to this patient?

a)

Carbamazepine

b)

Diazepam

c)

Phenytoin

d)

Valproic Acid

44.

An older patient exhibits a shuffling gait, lack of facial expression, and tremors at rest. The nurse will expect the provider to order which medication for this patient?

a)

Carbidopa-levodopa

b)

Donepezil

c)

Rivastigmine

d)

Tacrine

45.

The nurse is teaching a family member about an elderly parent’s new prescription for tacrine (Cognex) to treat Alzheimer disease (AD). The family member asks what to expect from this drug. The nurse will respond that the patient wil

a)

demonstrate improved ambulation.

b)

have reversal of all symptoms

c)

have decreased deterioration of cognition

d)

show improved communication ability.

46.

A patient will begin taking streptomycin as part of the medication regimen to treat tuberculosis. Before administering this medication, the nurse will review which laboratory values in the patient’s medical record?

a)

Complete blood count (CBC) with differential white cell count

b)

Blood urea nitrogen (BUN) and creatinine

c)

Potassium and magnesium levels

d)

Serum fasting glucose

47.

The nurse is caring for a patient who is diagnosed with tuberculosis. The patient tells the nurse that the provider plans to order a prophylactic antitubercular drug for family members and asks which drug will be ordered. The nurse will expect the provider to order which drug?

a)

Isoniazid

b)

Pyrazinamide

c)

Rifampin

d)

Streptomycin

48.

A patient is diagnosed with influenza and will begin taking a neuraminidase inhibitor. The nurse knows that this drug is effective when taken within how many hours of onset of flu symptoms?

a)

12 hrs

b)

24 hrs

c)

48 hrs

d)

72 hrs

49.

A patient with high cholesterol is ordered to take atorvastatin (Lipitor). What information will be included in the patient teaching? (Select all that apply.)

a)

Dietary management is not a priority

b)

The medication should be taken on an empty stomach

c)

the medicine should be taken with a full glass of water

d)

The patient should watch for body aches or gastrointestinal upset as side effects.

e)

The patient should have liver function tests frequently

50.

The nurse is assessing a patient who has gout who will begin taking allopurinol (Zyloprim). The nurse reviews the patient’s medical record and will be concerned about which of the following findings?

a)

History of kidney stones

b)

Increased serum uric acid

c)

Slight increase in WBC

d)

Increased serum glucose