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WorksheetsChapter 16 Nursing Pharmacology Questions
Total questions: 102
Worksheet time: 2hrs 42mins
A patient with rheumatoid arthritis is prescribed methotrexate. Which laboratory values should the nurse monitor most closely?
Complete blood count and platelet count
Blood urea nitrogen and creatinine
Liver function tests and creatinine
Electrolytes and blood glucose
A patient taking aspirin 81 mg daily asks when to stop the medication before scheduled surgery. What is the nurse's best response?
Stop taking it 3 days before surgery
Stop taking it 1 week before surgery
You can continue taking it until the day of surgery
Stop taking it 2 weeks before surgery
Which statement by a patient taking ibuprofen indicates a need for further teaching?
I take this medication with food to prevent stomach upset
I monitor for signs of bleeding while taking this medication
I can take this medication throughout my pregnancy for pain relief
I will have my kidney function checked regularly
A patient with gout is prescribed colchicine. Which assessment finding would be most concerning to the nurse?
Mild nausea after taking the medication
Decreased uric acid levels
Severe muscle pain and weakness
Increased fluid intake
Which medication requires once-weekly subcutaneous injection for rheumatoid arthritis?
Methotrexate
Etanercept
Hydroxychloroquine
Celecoxib
A patient asks about the maximum daily dose of acetaminophen. What is the current recommended maximum for adults?
4,000 mg per day
3,500 mg per day
3,000 mg per day
2,500 mg per day
Which patient would be at highest risk for acetaminophen toxicity?
A) A 25-year-old with occasional headaches
B) A 45-year-old who drinks 2 glasses of wine nightly
C) A 60-year-old with arthritis taking multiple OTC medications
D) A 30-year-old with a fever
A patient taking celecoxib (Celebrex) should be monitored for which serious adverse effect?
Hepatotoxicity
Nephrotoxicity
Cardiovascular events
Bone marrow suppression
Which conditions are treated with DMARDs?
Rheumatoid arthritis
Osteoarthritis
Inflammatory bowel disease
Gout
Psoriatic arthritis
A patient with inflammatory bowel disease is experiencing a flare-up. Which medication classes would the nurse expect to be prescribed? SELECT ALL THAT APPLY:
DMARDs
Glucocorticoids
Immunosuppressants
NSAIDs
Antibiotics
Which statement about COX-2 selective inhibitors is correct?
They have no risk of GI bleeding
They increase the risk of cardiovascular events
They are safer for long-term use than traditional NSAIDs
They do not affect kidney function
A patient taking etanercept develops a respiratory infection. What is the nurse's priority action?
Encourage increased fluid intake
Administer the next scheduled dose as ordered
Notify the healthcare provider immediately
Obtain a sputum culture
Which laboratory value would indicate salicylate toxicity?
Elevated liver enzymes
Decreased platelet count
Elevated BUN and creatinine
Altered mental status with respiratory alkalosis initially, then acidosis
A patient with gout asks about dietary modifications. Which food should the nurse recommend avoiding?
Dairy products
Citrus fruits
Organ meats and shellfish
Whole grains
Which assessments are priority for a patient taking NSAIDs long-term?
Blood pressure monitoring
BUN and creatinine levels
Signs of GI bleeding
Liver function tests
Complete blood count
A patient is prescribed hydroxychloroquine for rheumatoid arthritis. Which assessment is most important?
Cardiac function
Liver function
Kidney function
Respiratory function
Which medication would be contraindicated in a patient with a history of myocardial infarction?
Acetaminophen
Low-dose aspirin
Celecoxib
Methotrexate
A patient taking allopurinol for gout prevention should be monitored for which adverse effect?
Hypertension
Rhabdomyolysis
Thrombocytopenia
Hyperglycemia
A patient with rheumatoid arthritis asks about the difference between NSAIDs and DMARDs. What is the nurse's best explanation?
NSAIDs prevent joint damage while DMARDs only treat symptoms
DMARDs target the underlying cause of inflammation while NSAIDs treat symptoms
NSAIDs are safer for long-term use than DMARDs
DMARDs work faster than NSAIDs for pain relief
A patient is prescribed baclofen for muscle spasticity following a spinal cord injury. What is the most important patient education the nurse should provide?
Take this medication with food to prevent stomach upset
Avoid alcohol while taking this medication
Monitor your blood pressure regularly
Increase your fluid intake to prevent kidney stones
Which assessment finding would be most concerning in a patient taking dantrolene?
Mild drowsiness
Decreased appetite
Yellowing of the sclera
Muscle weakness
A patient asks about the difference between muscle spasm and spasticity. What is the nurse's best explanation?
Spasm is chronic while spasticity is acute
Spasm results from injury while spasticity results from CNS damage
Spasm affects voluntary muscles while spasticity affects involuntary muscles
There is no difference between the two terms
A patient taking cyclobenzaprine reports feeling confused and having a dry mouth. The nurse recognizes these as:
Signs of drug toxicity requiring immediate discontinuation
Expected anticholinergic effects of the medication
Symptoms of an allergic reaction
Signs of drug interaction with other medications
Which medication is the primary treatment for malignant hyperthermia?
Baclofen
Cyclobenzaprine
Dantrolene
Tizanidine
A patient prescribed methocarbamol asks why it's given as an injection. What is the nurse's best response?
The oral form is not as effective as the injection
The injection works faster for acute muscle spasms
Your specific medication formulation is designed for injection
The injection has fewer side effects than the oral form
Which adverse effects should the nurse monitor for in patients taking centrally acting muscle relaxants?
Drowsiness
Weakness
Confusion
Hepatotoxicity
Anticholinergic effects
A patient with multiple sclerosis is prescribed dantrolene. Which laboratory value should the nurse monitor most closely?
Complete blood count
Liver function tests
Kidney function tests
Electrolyte levels
Which patient would be at highest risk for complications from centrally acting muscle relaxants?
A) A 25-year-old with a sports injury
B) A 45-year-old taking multiple CNS depressants
C) A 55-year-old with diabetes
D) A 65-year-old with hypertension
A patient taking carisoprodol is planning to drive to work. What should the nurse advise?
Driving is safe as long as you take the medication with food
You can drive after the first week of taking the medication
Avoid driving until you know how the medication affects you
Driving is only unsafe if you drink alcohol
Which conditions are treated with dantrolene?
Malignant hyperthermia
Muscle spasticity
Spinal cord injury
Myasthenia gravis
Multiple sclerosis
The mechanism of action for centrally acting muscle relaxants involves:
Blocking sodium channels in muscle fibers
Increasing GABA neurotransmitter activity
Inhibiting calcium release in muscle cells
Blocking acetylcholine receptors
A pregnant patient asks about taking muscle relaxants for back pain. What is the nurse's best response?
Centrally acting muscle relaxants are safe during pregnancy
Only dantrolene is safe during pregnancy
Muscle relaxants are generally not recommended during pregnancy
You can take half the normal dose during pregnancy
Which assessment is most important before administering a muscle relaxant?
Blood pressure and heart rate
Pain level, mobility, and spasticity
Respiratory rate and oxygen saturation
Temperature and neurological status
A patient taking tizanidine reports experiencing nausea and fatigue. The nurse should:
Advise the patient to stop taking the medication immediately
Recognize these as common side effects and provide comfort measures
Increase the medication dose to improve effectiveness
Switch to a different muscle relaxant
Which patient education points are important for muscle relaxant therapy?
Avoid alcohol consumption
Be cautious when driving or operating machinery
Take with food to reduce GI upset
Monitor for signs of liver problems
Increase physical activity immediately
A patient with myasthenia gravis is prescribed dantrolene. What additional concern should the nurse monitor for?
Increased muscle strength
Interference with estrogen effectiveness
Improved neuromuscular transmission
Enhanced acetylcholine production
Which route of administration is NOT mentioned for dantrolene?
Oral (PO)
Intramuscular (IM)
Intravenous (IV)
Subcutaneous (SC)
A patient taking baclofen for spinal cord injury-related spasticity asks about long-term effects. The nurse should explain that:
Long-term use can lead to physical dependence
The medication loses effectiveness over time
Regular monitoring of liver function is required
The medication should be assessed for continued need and effectiveness
A patient is receiving succinylcholine for rapid sequence intubation. Which assessment finding would be MOST concerning to the nurse?
Muscle fasciculations
Serum potassium level of 6.2 mEq/L
Blood pressure of 110/70 mmHg
Heart rate of 88 bpm
The nurse is caring for a critically ill patient receiving rocuronium via continuous infusion. Which assessment tool should the nurse use to monitor the degree of paralysis?
Glasgow Coma Scale
Train of Four (TOF)
Richmond Agitation-Sedation Scale
Braden Scale
A patient received pancuronium 2 hours ago and is now showing signs of returning muscle function. In which order would the nurse expect motor function to return?
Head to toe
Toe to head
Arms to legs
Core to extremities
Which are essential safety requirements when administering neuromuscular blocking agents?
Secure airway must be established
Continuous cardiac monitoring
Patient must be conscious during administration
Reversal agents should be available
Sedation must be provided concurrently
A patient is scheduled for a brief surgical procedure requiring muscle relaxation. Which neuromuscular blocking agent would be MOST appropriate?
Pancuronium
Rocuronium
Succinylcholine
Cisatracurium
The nurse is monitoring a patient receiving cisatracurium. Which laboratory value requires immediate attention?
Serum creatinine 1.2 mg/dL
Hemoglobin 11 g/dL
Liver enzymes elevated 3x normal
White blood cell count 8,000/μL
A patient asks the nurse why they need sedation along with the "paralysis medication." What is the nurse's BEST response?
The paralysis medication will make you unconscious
Paralysis medications don't provide pain relief or sedation
Sedation is optional with these medications
The paralysis medication works better with sedation
Which adverse effects are associated with succinylcholine administration?
Respiratory depression
Hyperkalemia
Hypotension
Bronchospasm
Cardiac arrhythmias
A patient received succinylcholine 5 minutes ago. When should the nurse expect the effects to begin wearing off?
2-5 minutes
10-15 minutes
30-45 minutes
1-2 hours
The nurse is preparing to administer rocuronium to a patient. Which action is MOST important before administration?
Ensure that the airway is secure and that appropriate sedation is provided.
Check the patient's blood glucose level.
Assess the patient's pain score.
Obtain a urine sample for analysis.
A patient is receiving continuous pancuronium infusion. The Train of Four (TOF) assessment shows 1 out of 4 twitches. What is the nurse's BEST action?
Increase the infusion rate
Continue current infusion rate
Decrease the infusion rate
Stop the infusion immediately
Which statement about depolarizing neuromuscular blocking agents is CORRECT?
They block muscle contractions by antagonizing acetylcholine
They block muscle relaxation by acting as acetylcholine agonists
They have a longer duration of action than non-depolarizing agents
They provide sedation and pain relief
A patient develops bronchospasm after receiving a neuromuscular blocking agent. Which medication would the nurse expect to administer?
Epinephrine
Diphenhydramine
Albuterol
Methylprednisolone
The nurse is caring for a patient who received succinylcholine and is now experiencing malignant hyperthermia. Which finding would support this diagnosis?
Decreased body temperature
Bradycardia
Muscle rigidity
Decreased end-tidal CO2
A patient receiving rocuronium shows no muscle twitches on TOF assessment. What does this indicate?
The patient is under-paralyzed
The patient is adequately paralyzed
The patient is over-paralyzed
The equipment is malfunctioning
SELECT ALL THAT APPLY: Which assessments are priority when caring for a patient receiving
neuromuscular blocking agents?
Vital signs
Level of consciousness
Degree of paralysis
Pain assessment
Liver function tests
A patient is receiving cisatracurium for mechanical ventilation. The nurse notices the patient's eyes are open and tracking movement. What should the nurse do?
Increase the cisatracurium dose
Assess the patient's level of sedation
Document this as an expected finding
Notify the physician immediately
Which mechanism of action differentiates non-depolarizing from depolarizing neuromuscular blocking agents?
Non-depolarizing agents block acetylcholine receptors; depolarizing agents activate them
Non-depolarizing agents activate acetylcholine receptors; depolarizing agents block them
Non-depolarizing agents work faster than depolarizing agents
Non-depolarizing agents provide sedation; depolarizing agents do not
A patient received pancuronium 30 minutes ago and now requires reversal of the neuromuscular blockade. Which type of medication would the nurse expect to be ordered?
Benzodiazepine antagonist
Opioid antagonist
Anticholinesterase agent
Beta-blocker
A patient is scheduled for a minor surgical procedure and will receive propofol for sedation. Which assessment is the HIGHEST priority for the nurse before administration?
Blood glucose level
Respiratory status and airway patency
Bowel sounds
Temperature
The nurse is caring for a patient who received midazolam 30 minutes ago. Which finding would be MOST concerning?
Patient reports feeling drowsy
Respiratory rate of 8 breaths per minute
Patient appears disoriented
Patient reports mild nausea
A patient is receiving lidocaine for a local procedure. The nurse notices the patient is experiencing dizziness, confusion, and an irregular heart rhythm. What is the nurse's BEST action?
Continue monitoring as these are expected side effects
Stop the procedure immediately and notify the provider
Administer oxygen via nasal cannula
Increase the IV fluid rate
Which medication would the nurse expect to be used for procedural sedation in the emergency department?
Morphine
Midazolam
Acetaminophen
Lorazepam
A patient asks the nurse about the difference between general and local anesthetics. Which response by the nurse is MOST accurate?
General anesthetics only provide pain relief, while local anesthetics cause unconsciousness
General anesthetics cause unconsciousness and amnesia, while local anesthetics only block sensation in a specific area
There is no significant difference between the two types
Local anesthetics are always safer than general anesthetics
The nurse is monitoring a patient who received ketamine. Which adverse effect should the nurse anticipate?
Hypertension
Disorientation
Bradycardia
Hyperglycemia
A patient is scheduled for an epidural with bupivacaine. What is the MOST important patient education the nurse should provide?
You may experience temporary hair loss
Be careful of your skin and surroundings due to altered sensation
You will need to remain flat for 24 hours
Avoid all physical activity for one week
A patient receiving propofol develops bradycardia and hypotension. What is the nurse's FIRST action?
Increase the propofol infusion rate
Administer atropine
Stop the propofol infusion
Place the patient in Trendelenburg position
The nurse is caring for a patient who received lidocaine for a dental procedure. Which assessment finding indicates systemic absorption?
Localized numbness at the injection site
Mild burning sensation at the site
Cardiac arrhythmias
Temporary loss of taste
Which statement by the patient indicates understanding of discharge instructions after receiving midazolam?
I can drive home as soon as I feel alert
I should avoid alcohol for 24 hours
I can return to work immediately
I should take my regular medications with extra water
Which adverse effects are associated with non-barbiturate general anesthetics?
Drowsiness
Hypertension
Lethargy
Incontinence
GI distress
A patient is receiving ropivacaine for a regional nerve block. The nurse should monitor for which potential complication?
Allergic reaction only
Systemic toxicity if absorbed into circulation
Permanent nerve damage
Kidney dysfunction
The nurse is preparing emergency equipment for a patient receiving ketamine. Which equipment is MOST essential?
Defibrillator
Airway management supplies
Hemodialysis machine
Chest tube insertion kit
A patient asks why they need to avoid other CNS depressants when receiving propofol. What is the nurse's BEST response?
It will make the propofol less effective
The combination can cause dangerous CNS depression
"It will cause you to wake up too quickly"
"CNS depressants counteract the effects of propofol"
A patient receiving a local anesthetic experiences headache and localized burning. The nurse should:
Immediately stop the procedure and call the provider
Recognize these as expected adverse effects and continue monitoring
Administer pain medication
Apply ice to the injection site
Which patient would be at HIGHEST risk for complications from general anesthesia?
A 25-year-old healthy male
A 45-year-old with well-controlled diabetes
A 70-year-old with sleep apnea and heart disease
A 30-year-old pregnant woman
The nurse is educating a patient about balanced anesthesia. Which statement is MOST accurate?
You will receive only one medication for anesthesia
Multiple medications work together to provide optimal anesthesia
Balanced anesthesia is only used for emergency surgeries
This type of anesthesia has no side effects
A patient receiving morphine for post-operative pain has a respiratory rate of 8 breaths per minute. What is the nurse's priority action?
Encourage deep breathing exercises
Hold the next dose of morphine
Administer oxygen via nasal cannula
Notify the physician immediately
Which adverse effect is most common in patients taking opioid medications?
Respiratory depression
Constipation
Urinary retention
Euphoria
A patient asks about the difference between immediate-release and extended-release opioid formulations. What is the nurse's best explanation?
A) "Extended-release medications are stronger than immediate-release"
B) "Extended-release medications provide longer-lasting pain relief"
"Immediate-release medications have fewer side effects"
"There is no significant difference between the two"
Which routes of administration are appropriate for morphine?
Oral (PO)
Intravenous (IV)
Subcutaneous (SubQ)
Intramuscular (IM)
Rectal
A patient is prescribed naloxone (Narcan) for home use. Which statement by the patient indicates understanding of the medication?
I can use this to treat my chronic pain
This medication will help me sleep better
I should use this if someone has an opioid overdose
This medication prevents opioid addiction
The nurse is caring for a patient who received naloxone for opioid overdose. What is the most important follow-up assessment?
Blood pressure monitoring
Continuous respiratory monitoring
Neurological assessment
Cardiac rhythm monitoring
A patient taking tramadol asks why the dose is lower than other opioids. What is the nurse's best response?
Tramadol is a newer medication with fewer side effects
Tramadol has a different potency compared to other opioids
Tramadol is only used for mild pain
Tramadol works differently than other pain medications
Which assessment findings would indicate opioid-induced adverse effects?
Constipation
Respiratory rate of 8/min
Sedation
Urinary retention
Hypertension
A patient is prescribed sumatriptan for migraine headaches. Which assessment is most important before administration?
Pain level assessment
Blood pressure measurement
Neurological assessment
Respiratory rate
The mechanism of action for triptans in treating migraines involves:
Blocking pain receptors in the brain
Reducing inflammation in blood vessels
Binding to serotonin receptors and causing vasoconstriction
Increasing endorphin production
A patient taking methadone asks about stopping the medication. What is the nurse's most important response?
You can stop taking it anytime you want
Methadone should be discontinued gradually under medical supervision
You should switch to a different opioid first
Methadone is safe to stop immediately
A patient received naloxone 0.4 mg IV for opioid overdose. After 30 minutes, the patient becomes drowsy again. What should the nurse do?
Increase the oxygen flow rate
Prepare to administer another dose of naloxone
Administer a stimulant medication
Continue monitoring without intervention
Which opioid is primarily used to help treat opioid withdrawal symptoms?
Morphine
Fentanyl
Methadone
Codeine
A patient taking hydrocodone with acetaminophen (Vicodin) asks about the combination. The nurse's best explanation is:
"The combination reduces the risk of addiction"
"Acetaminophen enhances the pain-relieving effects"
"The combination reduces side effects"
"Acetaminophen prevents liver damage"
Which precautions should the nurse implement for a patient taking sumatriptan?
Fall precautions due to dizziness
Blood pressure monitoring
Cardiac monitoring
Respiratory monitoring
Assessment for serotonin interactions
A patient asks about the difference between opioid agonists and antagonists. What is the nurse's best explanation?
Agonists are stronger than antagonists
Agonists activate opioid receptors while antagonists block them
Antagonists are used for chronic pain while agonists are for acute pain
There is no significant difference between the two
The nurse is teaching a patient about fentanyl patches. Which statement requires further teaching?
I should apply the patch to clean, dry skin
I can cut the patch in half if I need a smaller dose
I should rotate the application sites
I should dispose of used patches safely
Which opioid receptor is primarily responsible for analgesia and respiratory depression?
Kappa receptors
Mu receptors
Delta receptors
Sigma receptors
A patient with chronic pain asks about the risk of opioid dependence. What is the nurse's most appropriate response?
Dependence only occurs with illegal drug use
Taking opioids as prescribed eliminates the risk of dependence
Physical dependence can occur even when taking medication as prescribed
Dependence is not a concern with prescription opioids
Which symptoms are associated with migraine headaches? (Select all that
apply)
Severe head pain
GI disturbances
Mood alterations
Photophobia
Muscle weakness
SELECT ALL THAT APPLY: Which routes of administration are appropriate for local anesthetics?
Topical
Intramuscular injection
Intravenous
Eye drops
Oral tablets
The nurse is caring for a patient who received lidocaine for a dental procedure. Which assessment finding indicates systemic absorption?
Localized numbness at the injection site
Mild burning sensation at the site
Cardiac arrhythmias
Temporary loss of taste
A patient receiving propofol develops bradycardia and hypotension. What is the nurse's FIRST action?
Increase the propofol infusion rate
Administer atropine
Stop the propofol infusion
Place the patient in Trendelenburg position
Which are appropriate uses for local anesthetics? (Select all that apply)
Topical application for minor skin procedures
Infiltration for suturing wounds
Nerve blocks for regional anesthesia
Inducing general anesthesia
Epidural anesthesia for labor and delivery
The nurse is preparing to administer a non-barbiturate general anesthetic.
Which safety measures should be implemented? (Select all that apply)
Have emergency airway equipment available
Continuously monitor vital signs
Ensure patient has eaten within 2 hours
Avoid concurrent CNS depressants
Monitor for signs of malignant hyperthermia
For which clinical scenarios would neuromuscular blocking agents be
indicated? (Select all that apply)
Mechanical ventilation in critically ill patients
Rapid sequence intubation
Pain management for chronic conditions
Surgical procedures requiring muscle relaxation
Sedation for diagnostic procedures
Which conditions would warrant the use of centrally acting muscle
relaxants? (Select all that apply)
Muscle spasticity
Spinal cord injuries
Short-term musculoskeletal conditions
Malignant hyperthermia
Chronic pain syndrome
Which medications are not contraindicated during pregnancy?
Acetaminophen
Ibuprofen
Etanercept
Colchicine
Aspirin (high dose)
