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WorksheetsPharma Exam 2
Total questions: 75
Worksheet time: 31mins
The nurse determines that the client understands the correct administration of guaifenesin when the client states:
A. I will take the medication with meals.
B. I will take the tablet with a full glass of water.
C. I will decrease my daily fluid intake while on this medication.
D. I will take an extra dose if a fever develops.
The nurse is administering albuterol to a client.
Which adverse effect should the nurse monitor for following administration of this medication?
A. Increased heart rate
B. Hyperkalemia
C. Hyperglycemia
D. Drowsiness
A client is scheduled to receive acetylcysteine 20% solution diluted in 0.9% normal saline by nebulizer.
Which outcome should the nurse expect from the administration of this medication?
A. Decreased wheezes
B. Decreased coughing
C. Bronchodilation
D. Thinned secretions
The nurse is monitoring a client who is taking metoprolol, a cardioselective beta-blocker.
Which finding indicates a potential adverse complication associated with this medication?
A. Decrease in resting heart rate
B. Complaint of nausea
C. Audible expiratory wheezes
D. Decrease in blood pressure
A hypertensive client has been prescribed a clonidine hydrochloride transdermal patch. The nurse provides instructions on its proper use.
Which statement by the client indicates a need for further teaching?
A. "I will apply the patch to a hairless body site."
B. "I will apply the patch to the skin on the upper arm."
C. "I will change the patch every 24 hours."
D. "I will apply the patch to skin areas that are not broken."
A client is seen in the clinic complaining of anorexia and nausea. The healthcare provider suspects digoxin toxicity. While waiting for test results, the nurse should assess the client for which additional signs or symptoms that support this diagnosis?
A. Edema
B. Anorexia
C. Weakness
D. Photophobia
E. Constipation
The nurse is reviewing clients prescribed lisinopril, an ACE inhibitor. Which client condition should be the priority for the nurse to assess first?
A. 64-year-old complaining of insomnia
B. 32-year-old with swelling of the tongue
C. 53-year-old with new nausea
D. 82-year-old with new dry cough
A nurse is reviewing the health history of a client newly prescribed ipratropium bromide (Atrovent). Which of the following findings should the nurse report to the healthcare provider?
A. History of asthma
B. History of glaucoma
C. History of seasonal allergies
D. History of hypertension
A client with asthma is prescribed theophylline. Which of the following findings in the patient’s history is most concerning?
A. Type 2 diabetes
B. Hypothyroidism
C. Seizure disorder
D. Iron-deficiency anemia
Which of the following patient statements indicates a need for further teaching about the use of montelukast (Singulair)?
A. “I take this medication every night, even if I don’t have symptoms.”
B. “This medication is used to stop asthma attacks.”
C. “I’ll tell my provider if I feel sad or have trouble sleeping.”
D. “I take this on an empty stomach.”
A nurse is preparing to administer pseudoephedrine to a patient with nasal congestion. Which patient history finding requires intervention?
A. Hypothyroidism
B. Controlled asthma
C. Hypertension
D. Osteoarthritis
A nurse is caring for a client prescribed albuterol (ProAir). Which of the following assessment findings would require notifying the provider?
A. Heart rate of 104 bpm
B. Patient reports feeling "shaky"
C. Patient has a history of atrial fibrillation
D. Respiratory rate of 20 breaths/min
A nurse is teaching a client with asthma about short-acting beta2 agonists (SABAs) like albuterol. Which of the following statements about SABAs are correct?
Select all that apply.
A. They are used for acute symptom relief.
B. They can cause tachycardia and palpitations.
C. They should be taken every morning and night regardless of symptoms.
D. They work by relaxing airway smooth muscle.
E. They take several weeks to reach full therapeutic effect.
Which of the following are potential adverse effects or precautions associated with the use of anticholinergic bronchodilators like ipratropium or tiotropium?
Select all that apply.
A. Dry mouth
B. Increased intraocular pressure
C. Urinary retention
D. Risk for hypoglycemia
E. Blurred vision
A nurse is reviewing teaching for a client prescribed an inhaled corticosteroid for asthma. Which instructions should the nurse include?
Select all that apply.
A. Use this medication for immediate relief of wheezing.
B. Rinse your mouth after each use.
C. Use your bronchodilator inhaler first if both are prescribed.
D. Monitor for signs of oral thrush.
E. This medication may take weeks to be fully effective.
A nurse is reviewing a client’s health history prior to administering carvedilol, a nonselective beta-blocker. Which of the following findings should the nurse report to the healthcare provider immediately?
A. The client has a history of migraine headaches.
B. The client has a history of asthma.
C. The client has a history of hypothyroidism.
D. Expect peak effects within 5 minutes.
Which medication should be used for asthma patients as the first step to open up the airway?
A. Short-acting beta2 agonists
B. Long-acting beta2 agonists
C. Inhaled low-dose glucocorticoids
D. Combination inhaled glucocorticoids/long-acting beta2 agonists
A nurse is teaching a client who has chronic obstructive pulmonary disease (COPD) about how to use a metered-dose inhaler (MDI) without a spacer.
Which statement made by the client indicates a need for further teaching?
A. "I will shake the canister before each puff."
B. "After I breathe in, I will hold my breath for 10 seconds before I breathe out again."
C. "I will take a deep breath out before I take my first puff."
D. "After I press down, I will breathe in for 2–3 seconds."
A nurse is teaching a client how to use a metered-dose inhaler (MDI). Which statement by the client indicates a need for further teaching?
A. "I will press the canister and breathe in at the same time over 2 to 3 seconds."
B. "After inhaling the medication, I’ll hold my breath for about 10 seconds."
C. "I will wait at least 15 seconds between puffs."
D. "I will exhale completely before placing the inhaler in my mouth."
A client is prescribed dextromethorphan (Delsym). The nurse should monitor for which adverse effects, especially at high doses? Select all that apply.
A. Hallucinations
B. Respiratory depression
C. Seizures
D. Bradycardia
E. Ataxia
A nurse is monitoring a client taking montelukast (Singulair) for asthma control. Which findings or instructions are appropriate for this therapy?
Select all that apply.
A. Report changes in mood or behavior.
B. Use during acute asthma attacks.
C. Take every evening, even when symptoms are not present.
D. Monitor liver function tests (LFTs) regularly.
E. May take up to 1 week to notice improvement.
Which of the following are nursing considerations when administering theophylline to a client?
Select all that apply.
A. Monitor for signs of toxicity such as tremors or seizures.
B. Avoid use in clients with seizure disorders.
C. It may interact with medications like warfarin.
D. Expect peak effects within 5 minutes.
E. Maintain therapeutic serum levels between 10–20 mcg/mL.
Which assessment data is most important for the nurse to obtain before administering nifedipine, a calcium channel blocker used to treat hypertension and angina?
A. Telemetry strip
B. Blood pressure
C. Radial pulse
D. Calcium level
A nurse is educating a client who has been prescribed diltiazem, a calcium channel blocker.
Which statement by the client indicates correct understanding of the medication’s therapeutic effect?
A. "It increases the force of contraction of heart tissue."
B. "It helps my heart pump harder to improve circulation."
C. "It leads to an increase in calcium influx in the smooth muscle."
D. "It prevents entry of calcium ions into smooth muscle."
Which of the following are important considerations for a client prescribed acetylcysteine (Mucomyst) as a mucolytic?
Select all that apply.
A. It is administered orally and must be taken with food.
B. It can cause bronchospasm in some patients.
C. It has a strong sulfur smell, like rotten eggs.
D. It is administered via inhalation for respiratory conditions.
E. It is used in the treatment of chronic bronchitis and cystic fibrosis.
The nurse is preparing to administer a dose of naloxone intravenously to a client with an opioid overdose. Which supportive medical equipment should the nurse plan to have at the client's bedside if needed?
1. Nasogastric tube
2. Paracentesis tray
3. Resuscitation equipment
4. Central line insertion tray
The nurse teaches a client about the effects of diphenhydramine, which has been prescribed as a cough suppressant. The nurse determines that the client needs further instruction if the client makes which statement?
1. "I will take the medication on an empty stomach."
2. "I won't drink alcohol while taking this medication."
3. "I won't do activities that require mental alertness while taking this medication."
4. "I will use sugarless gum, candy, or oral rinses to decrease dryness in my mouth."
The nurse understands a patient who is treated for hypertension may be switched to an angiotensin receptor blocker (ARB) because of which angiotensin-converting enzyme (ACE) inhibitor adverse effect?
A. Dry, nonproductive cough
B. Hypokalemia
C. Fatigue
D. Orthostatic hypotension
Which medication should the nurse question if prescribed together with ACE inhibitors?
A. Docusate sodium (Colace)
B. Furosemide (Lasix)
C. Potassium chloride (K-Dur)
D. Morphine
Before administering eplerenone (Inspra) to a patient, what is the priority nursing action?
A. Auscultate heart sounds.
B. Obtain serum thiocyanate level.
C. Assess level of consciousness.
D. Check serum electrolytes.
To prevent cerebral artery spasms after a subarachnoid hemorrhage, the nurse anticipates administering which calcium channel blocker?
A. Amlodipine (Norvasc)
B. Nimodipine (Nimotop)
C. Diltiazem (Cardizem)
D. Verapamil (Calan)
A patient who is prescribed tamsulosin (Flomax) does not have a history of hypertension. The nurse knows this medication is also used for what condition?
A. Migraine headache
B. Pulmonary emboli
C. Subarachnoid hemorrhage
D. Benign prostatic hyperplasia (BPH)
The nurse is teaching a client newly prescribed an ACE inhibitor about how the medication helps lower blood pressure. Which of the following statements by the nurse best explains the action of ACE inhibitors and ARBs?
A. "These medications help your body hold on to sodium and water."
B. "They work by breaking down a chemical called bradykinin."
C. "They stop your body from making a hormone called angiotensin II."
D. "Prevent aldosterone secretion"
When teaching a patient about a new prescription for carvedilol (Coreg), the nurse explains that this medication reduces blood pressure by which action? (Select all that apply.)
A. Decreases heart rate
B. Promotes excretion of sodium
C. Relaxes muscle tone
D. Peripheral vasodilation
E. Increases urine output
Which lab value requires immediate follow-up for a client receiving lisinopril?
A. Potassium 5.4 mEq/L
B. Sodium 138 mEq/L
C. Creatinine 1.0 mg/dL
D. Hemoglobin 13.5 g/dL
A client has recently begun medication therapy with propranolol. The long-term care nurse would plan to notify the primary health care provider (PHCP) if which assessment finding is noted?
A. Complaints of insomnia
B. Audible expiratory wheezes
C. Decrease in heart rate from 86 to 78 beats/min
D. Decrease in blood pressure from 162/90 to 136/84 mm Hg
The nurse is providing medication information to a client who is beginning medication therapy with enalapril. The nurse would tell the client that which is an anticipated, although unpleasant, side effect of this medication?
A. Rapid pulse
B. Persistent dry cough
C. Increased blood pressure
D. Metallic taste in the mouth
The nurse is caring for a client receiving an albuterol/ipratropium nebulized breathing treatment. Which report from the client would the nurse note as an expected side effect of this combination medication?
A. "I feel as though my heart is racing."
B. "I feel more bloated than usual."
C. "My eyes have been watering lately."
D. "I haven't had a bowel movement in 4 days."
A client has begun to use a methylxanthine bronchodilator. What beverage would the nurse plan to teach the client to avoid while taking this medication?
Coffee
Orange juice
Mineral water
Cranberry juice
A client begins therapy with theophylline. The nurse plans to teach the client to limit the intake of which items while taking this medication?
Coffee, cola, and chocolate
Oysters, lobster, and shrimp
Melons, oranges, and pineapple
Cottage cheese, cream cheese, and dairy creamers
The primary health care provider (PHCP) writes a prescription for lisinopril for a hospitalized client with hypertension. The nurse caring for the client determines that the medication has been prescribed to treat which disorder?
Hypertension
Immune disorder
Venous insufficiency
Gastroesophageal reflux disorder
The nurse is teaching a client about the effects of diphenhydramine, an ingredient in the cough suppressant prescribed for the client. The nurse would plan to tell the client to take which measure while taking this medication?
Take it on an empty stomach.
Avoid activities requiring mental alertness.
Use alcohol for additional effect in reducing cough.
Avoid chewing sugarless gum or using oral mouth rinses.
A client taking verapamil has been given information about side effects of this medication. The nurse determines that the client understands the information if the client states to watch for which most common side effect of this medication?
Weight loss
Constipation
Nasal stuffiness
Abdominal cramping
Atenolol has been prescribed for a client, and the client asks the nurse about the action of the medication. How would the nurse respond regarding the action of this medication?
Slows the heart rate
Increases cardiac output
Increases myocardial oxygen demand
Maintains the blood pressure at a level within the 140/90 mm Hg range
The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states that they will immediately report which finding?
Impaired sense of hearing
Gastrointestinal side effects
Orange-red discoloration of body secretions
Difficulty in discriminating the color red from green
The nurse is providing education to a client who is being started on atenolol. Which statement by the client indicates that teaching has been effective?
"I am taking this medication for hypertension."
"It is to help manage my rheumatoid arthritis."
"This medication will help my ulcerative colitis."
"This medication will reverse my second-degree heart block."
A client is to begin a 6-month course of therapy with isoniazid. The nurse would plan to teach the client to take which action?
Use alcohol in small amounts only.
Report yellow eyes or skin immediately.
Increase intake of Swiss or aged cheeses.
Avoid vitamin supplements during therapy.
The nurse is monitoring a client who is taking propranolol. Which assessment finding indicates a potential adverse complication associated with this medication?
The development of complaints of insomnia
The development of audible expiratory wheezes
A baseline blood pressure of 150/80 mm Hg followed by a blood pressure of 138/72 mm Hg after two doses of the medication
A baseline resting heart rate of 88 beats/minute followed by a resting heart rate of 72 beats/minute after two doses of the medication
A client has begun therapy with a xanthine bronchodilator. The nurse determines that the client understands dietary alterations if the client states to limit which items while taking this medication? Select all that apply.
Milk , Oysters
Coffee , Chocolate
Oysters, Oranges
Pineapple , Grapefruit
A client is being treated for moderate hypertension and has been taking diltiazem for several months. The client schedules an appointment with the primary health care provider because of episodes of chest pain, and Prinzmetal's angina is diagnosed. The client asks the nurse which therapeutic effects the medication will provide, and the nurse provides education. Which statement by the client indicates that the teaching has been effective?
"It increases the force of contraction of heart tissues."
"It increases oxygen demands within the myocardium."
"It prevents an influx of calcium ions in the smooth muscle."
"It leads to an increase in calcium absorption in the smooth muscle."
The nurse is performing an assessment on a client with a diagnosis of chronic angina pectoris. The client is receiving sotalol orally daily. Which assessment finding indicates to the nurse that the client is experiencing a side or adverse effect related to the medication?
Palpitations
Dry mouth
Difficulty swallowing
Diaphoresis
The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who is receiving theophylline. The nurse monitors the serum theophylline level and concludes that the medication dosage may need to be increased if which value is noted?
20 mg/mL (40 mcmol/L)
15 mg/mL (40 mcmol/L)
10 mg/mL (60 mcmol/L)
5 mg/mL (20 mcmol/L)
Terbutaline is prescribed for a client with bronchitis. The nurse checks the client's medical history for which disorder in which the medication would be used with caution?
Osteoarthritis
Hypothyroidism
Diabetes mellitus
Polycystic disease
A client taking rifampin reports, "My urine has blood in it." When the nurse assesses the urine, it is brown. Which is the nurse's best action?
Notify the primary health care provider (PHCP).
Chart the finding as a normal response to the rifampin.
Immediately start prescribed intravenous (IV) fluids to prevent shock.
Get the client into bed, and put the bed in modified Trendelenburg's position.
A client has been started on long-term therapy with rifampin. The nurse would provide which information to the client about the medication?
Would always be taken with food or antacids
Would be double-dosed if one dose is forgotten
May be discontinued independently if symptoms are gone in 3 months
Causes orange discoloration of sweat, tears, urine, and feces
A client taking an angiotensin-converting enzyme (ACE) inhibitor to treat hypertension calls the clinic nurse and reports a dry, nonproductive cough that is very bothersome. The nurse would respond by making which statement?
"The medication may need to be changed."
"The cough must be the start of a respiratory infection."
"The medication needs to be taken with large amounts of water to prevent the cough."
"This sometimes happens, and you will need to take a cough medication with each dose of medication."
A client is scheduled for a dose of ramipril. The nurse would check which measurement before administering the medication?
Weight
Apical pulse
Blood pressure
Potassium level
Which is the nurse's priority assessment for monitoring for adverse effects for the client taking isoniazid?
Skin color
Urine color
Hydration status
Respiratory effort
A client with hypertension has a new prescription for a medication called moexipril. The nurse plans to provide written directions that tell the client to take the medication at which time?
At bedtime
With meals
1 hour before meals
With a snack in late afternoon
The nurse has given a client taking ethambutol information about the medication. The nurse determines that the client understands the instructions if the client states that he or she will immediately report which finding?
Impaired sense of hearing
Gastrointestinal side effects
Orange-red discoloration of body secretions
Difficulty in discriminating the color red from green
A client with a prescription to take theophylline daily has been given medication instructions by the nurse. What statement by the client indicates the need for further education regarding the prescription?
"I will take the daily dose at bedtime."
"I need to drink at least 2 liters of fluid per day."
"I know to avoid changing brands of the medication without my primary health care provider's approval."
"I'll avoid over-the-counter cough and cold medications unless approved by my health care provider."
The nurse has a prescription to give a client salmeterol, 2 puffs, and beclomethasone dipropionate, 2 puffs, by metered-dose inhaler. The nurse would administer the medication using which procedure?
Beclomethasone first and then the salmeterol
Salmeterol first and then the beclomethasone
Alternating a single puff of each, beginning with the salmeterol
Alternating a single puff of each, beginning with the beclomethasone
A client with tuberculosis is starting antituberculosis therapy with isoniazid. Before giving the client the first dose, the nurse would ensure that which baseline study has been completed?
Electrolyte levels
Coagulation times
Liver enzyme levels (LFT)
Serum creatinine level
A client diagnosed with active tuberculosis has been prescribed a combination of isoniazid and rifampin for treatment. The nurse teaches the client to perform which action?
Report any change in urine color.
Take both medications with food.
Take both medications together once a day.
Expect to take the medications for 2 to 3 weeks.
The nurse would monitor the client receiving the first dose of albuterol for which side or adverse effect of this medication?
Drowsiness
Tachycardia
Hyperkalemia
Hyperglycemia
When evaluating an asthmatic client's knowledge of self-care, the nurse recognizes that additional instruction is needed when the client makes which statement?
"I use my corticosteroid inhaler each time I feel short of breath."
"I see my doctor if I have an upper respiratory infection and always get a flu shot."
"I use my bronchodilator inhaler before walking so that I don't become short of breath."
"I use my bronchodilator inhaler before I visit places like the zoo because of my allergies."
A client with cardiac disease has begun taking propranolol, and the nurse provides information to the client about the medication. The nurse would tell the client to contact the primary health care provider (PHCP) if which symptoms develop?
Insomnia and headache
Nausea and constipation
Night cough and dyspnea
Drowsiness and nightmares
A client with chronic obstructive pulmonary disease (COPD) is being changed from an oral glucocorticoid to triamcinolone by inhalation. The client asks why this change is necessary. Which statement by the nurse to the client is accurate?
"Inhaled glucocorticoids cure the condition."
"Inhaled glucocorticoids treat this condition more effectively."
"Inhaled glucocorticoids decrease the symptoms more quickly."
"Inhaled glucocorticoids are preferred because of decreased adverse effects."
The nurse is administering a dose of pirbuterol to a client. The nurse would monitor for which side or adverse effect of this medication?
Drowsiness
Hypokalemia
Hyperglycemia
Increased pulse
The nurse is reviewing the record of a client who arrives at the health care clinic. The nurse notes that irbesartan has been prescribed for the client. The nurse would suspect that the client has which condition?
Hypertension
Hypothyroidism
Diabetes mellitus
Renal transplant rejection
The primary health care provider (PHCP) writes a prescription for atenolol for a client who was admitted to the hospital. The nurse contacts the PHCP to verify the prescription if which finding is noted in the assessment data?
Temperature is 100.1° F (37.8° C).
Apical heart rate is 48 beats/min.
Blood pressure is 138/82 mm Hg.
Pedal pulses are bounding and strong.
The client has a prescription to receive pirbuterol 2 puffs and beclomethasone dipropionate 2 puffs by metered-dose inhaler. The nurse plans to give these medications in which way to ensure effectiveness?
Administering the pirbuterol before the beclomethasone
Alternating a single puff of each hourly, beginning with the beclomethasone
Alternating a single puff of beclomethasone with pirbuterol, repeating the steps
Administering the pirbuterol, waiting 30 minutes, and administering the beclomethasone
The clinic nurse is providing instructions to a client with hypertension who will be taking captopril. Which statement by the client indicates a need for further instruction?
"I need to change positions slowly."
"I need to avoid taking hot baths or showers."
"I need to drink at least 4 quarts (4 liters) of water daily."
"I need to sit down and rest if dizziness or light-headedness occurs."
A client has been taking isoniazid for 2 months. The client complains to the nurse about numbness, paresthesias, and tingling in the extremities. The nurse interprets that the client is experiencing which problem?
Hypercalcemia
Peripheral neuritis
Small blood vessel spasm
Impaired peripheral circulation
A client with an exacerbation of chronic obstructive pulmonary disease (COPD) has been on oral glucocorticoids and is currently being weaned to triamcinolone by inhalation. The nurse determines that the client understands the potential adverse effects to watch for during this medication change when the client states the need to report which signs and symptoms?
Chills, fever, and generalized rash
Vomiting, diarrhea, and increased thirst
Blurred vision, headache, and insomnia
Anorexia, nausea, weakness, and fatigue
