wayground logo

Free Printable Worksheets

Font size

S
M
L
XL
Worksheets

Pharmacology Review

Total questions: 205

Worksheet time: 4hrs 40mins

Name
Class
Date
1.

Aulrhianna is a patient who has been prescribed a glucocorticoid inhaler for her chronic respiratory condition. The nurse is providing her with instructions on how to use the inhaler safely. What should the nurse advise Aulrhianna to do?

  • Use the glucocorticoid inhaler at the first sign of wheezing.
    Rationale: Glucocorticoid inhalers are not intended for immediate relief of acute symptoms such as wheezing. They are used for long-term control and prevention of inflammation in chronic respiratory conditions.
  • Take the glucocorticoid inhaler before the beta2 adrenergic agonist inhaler.
    Rationale: Beta2 adrenergic agonists are typically used first to open the airways, allowing the glucocorticoid medication to be more effective. Therefore, glucocorticoids should be taken after beta2 agonists, not before.
  • Swish the mouth with water and expel the water from the mouth after use.
    Rationale: This is the correct action. Rinsing the mouth after using a glucocorticoid inhaler helps prevent oral thrush (fungal infection) and irritation, which are common side effects of inhaled steroids.

a)

Use the glucocorticoid inhaler at the first sign of wheezing.

b)

Take the glucocorticoid inhaler before the beta2 adrenergic agonist inhaler.

c)

Swish the mouth with water and expel the water from the mouth after use.

2.

During a science class, Jaidon and Nana are discussing medications that help loosen bronchial secretions. From which of the following groups do these drugs belong?

a)

Decongestants

b)

Expectorants

c)

Antitussives

3.

Jaidon was prescribed an antihistamine for his allergies. He noticed that while his allergy symptoms improved, he also experienced decreased secretions, urinary retention, and constipation. What properties of antihistamine medications are responsible for these side effects?

a)

Cholinergic

b)

Antitussive

c)

Anticholinergic

4.

Nana is experiencing sudden shortness of breath and wheezing due to an asthma attack. For quick relief of her asthmatic symptoms, what type of drug would be used first?

a)

Short-acting inhaled Beta2 agonist


Rationale: Short-acting inhaled Beta2 agonists (such as albuterol) are the first-line treatment for rapid relief of acute asthma symptoms because they quickly relax bronchial smooth muscle and open the airways.

b)

Inhaled glucocorticoid


Rationale: Inhaled glucocorticoids are used for long-term control and prevention of asthma symptoms, not for immediate relief during an acute attack.

c)

Theophylline preparation


Rationale: Theophylline is rarely used for acute relief due to its slower onset of action and potential side effects; it is more commonly used as a maintenance therapy.

5.

Jaidon is prescribed oral calcium supplements. To ensure the calcium is properly absorbed from the GI tract, which of the following should also be included in his regimen?

a)

Vitamin D

b)

Phosphorus

c)

Sodium

6.

Jaidon is a nurse caring for a patient with a potassium level of 2.7 mEq/L (normal range: 3.5-5 mEq/L). The physician has written several orders for potassium chloride (KCl) administration. Which of the following orders should Jaidon question before proceeding?

  • A. Check for adequate urinary output
  • B. Give 40 mEq KCL undiluted IVP
  • C. Give 40 mEq KCL po

a)

A. Check for adequate urinary output

b)

B. Give 40 mEq KCL undiluted IVP

c)

C. Give 40 mEq KCL po

7.

Jaidon, a nurse, is instructing Nana, a client, on how to take KCl. What should Jaidon tell Nana?

a)

With 4 ounces or more of fluid, or at mealtime

b)

At bedtime; fluid intake is not necessary

c)

Daily with sips of water

8.

During a clinical skills lab, Aulrhianna and Jaidon are reviewing a case where a client’s serum potassium is 6.5 mEq/L. The instructor asks them: What is the most effective method to correct this hyperkalemia?


Options:
1. To administer sodium polystyrene sulfonate (Kayexalate)
2. To administer IV sodium bicarbonate (NaHCO3)
3. Insulin and glucose administration

Rationales:
1. To administer sodium polystyrene sulfonate (Kayexalate):
Kayexalate is a cation-exchange resin that binds potassium in the gut and promotes its excretion, making it an effective treatment for hyperkalemia.

2. To administer IV sodium bicarbonate (NaHCO3):
Sodium bicarbonate can temporarily shift potassium into cells, but it does not remove potassium from the body. It is less effective for long-term correction.

3. Insulin and glucose administration:
Insulin with glucose can also shift potassium into cells, providing a rapid but temporary reduction in serum potassium. It does not eliminate potassium from the body.

a)

To administer sodium polystyrene sulfonate (Kayexalate

b)

To administer IV sodium bicarbonate (NaHCO3)

c)

Insulin and glucose administration

9.

An elderly patient in the emergency room was receiving an infusion of Lactated Ringer’s due to dehydration. Two hours later, Nana and Jaidon, who are student nurses assisting in the ER, find the patient currently has a bounding pulse, is short of breath, has crackles upon auscultation of lung fields and has distended neck veins. What does this patient show signs of?


Options:
1. Hypervolemia, and needs a decrease in fluids
2. Hypovolemia, and needs an increase in fluids
3. Nothing; no adjustment is needed

Rationales:
1. Hypervolemia, and needs a decrease in fluids: Correct. The patient is showing classic signs of fluid overload (hypervolemia): bounding pulse, shortness of breath, crackles in the lungs, and distended neck veins. These symptoms indicate excess fluid in the circulatory system, requiring a reduction in fluid administration.
2. Hypovolemia, and needs an increase in fluids: Incorrect. Hypovolemia presents with symptoms such as low blood pressure, tachycardia, and poor skin turgor, not fluid overload signs like crackles and distended veins.
3. Nothing; no adjustment is needed: Incorrect. The patient’s symptoms indicate a complication from fluid therapy and require immediate intervention to prevent further harm.

a)

Hypervolemia, and needs a decrease in fluids

b)

Hypovolemia, and needs an increase in fluids

c)

Nothing; no adjustment is needed

10.

During a clinical skills lab, Aulrhianna and Jaidon are discussing IV fluids. Jaidon asks, "If a patient is ordered to receive Lactated Ringer’s solution, what type of IV solution is this?"


Options:
1. cyrstalloid
2. colloid

Rationales:
1. cyrstalloid: Correct. Lactated Ringer’s solution is a crystalloid IV solution, which means it contains water and electrolytes that can easily pass through semipermeable membranes.
2. colloid: Incorrect. Colloid solutions contain larger molecules, such as proteins, that do not easily pass through membranes. Lactated Ringer’s is not a colloid.

a)

cyrstalloid

b)

colloid

11.

Nana is assisting in the hospital and is ordered to administer 0.9% NS solution to a patient. This is what type of IV solution?


Options:
1. isotonic crystalloid
2. isotonic colloid
3. hypotonic crystalloid
4. hypertonic crystalloid

Rationales:
1. isotonic crystalloid: Correct. 0.9% Normal Saline (NS) is an isotonic crystalloid solution, meaning it has the same osmolarity as blood plasma and does not cause fluid shifts between compartments.
2. isotonic colloid: Incorrect. Colloids contain larger molecules like proteins; NS is not a colloid.
3. hypotonic crystalloid: Incorrect. Hypotonic solutions have lower osmolarity than plasma; NS is isotonic.
4. hypertonic crystalloid: Incorrect. Hypertonic solutions have higher osmolarity than plasma; NS is not hypertonic.

a)

isotonic crystalloid

b)

isotonic colloid

c)

hypotonic crystalloid

d)

hypertonic crystalloid

12.

Aulrhianna and Jaidon are studying for their pharmacology exam. They come across a case where a patient is diagnosed with gastroesophageal reflux disease (GERD). Which drugs may be used in the treatment of GERD (select all that apply):

  • Proton Pump Inhibitors
  • Statins
  • Histamine2 Blockers
  • Neuromuscular junction blockers

Rationales:

  • Proton Pump Inhibitors: Correct. These drugs reduce stomach acid production and are commonly used to treat GERD.
  • Statins: Incorrect. Statins are used to lower cholesterol and do not treat GERD.
  • Histamine2 Blockers: Correct. These drugs also decrease stomach acid and are effective in GERD management.
  • Neuromuscular junction blockers: Incorrect. These drugs are used for muscle relaxation during surgery and have no role in GERD treatment.

a)

Proton Pump Inhibitors

b)

Statins

c)

Histamine2 Blockers

d)

Neuromuscular junction blockers

13.

Aulrhianna, a nurse, is preparing to administer a known vesicant to her patient. Prior to administration, she assesses the IV site for infiltration. Aulrhianna knows signs and symptoms of infiltration include (select all that apply):

a)

Swelling at the site

b)

Pallor at the site

c)

Redness at the site

d)

Warm to the touch at the site

14.

Aulrhianna and Jaidon are discussing bulk-forming laxatives. Which of the following is important to remember when taking them?

a)

They should be taken with sufficient water to prevent fecal impaction

b)

They decrease peristalsis and gastrointestinal motility

c)

They produce watery stools

15.

Nana accidentally ingested a potentially harmful substance. What is the goal behind administration of activated charcoal or syrup of Ipecac in this situation?

a)

Promote vomiting


Rationale: Syrup of Ipecac is used to induce vomiting in cases of poisoning, helping to expel the toxic substance from the stomach. Activated charcoal, however, does not promote vomiting but is used to absorb poison in the gastrointestinal tract. Thus, this option is partially correct for Ipecac but not for activated charcoal.

b)

Resolve nausea


Rationale: Neither activated charcoal nor syrup of Ipecac is administered to resolve nausea. Their primary use is in the management of poisoning, not for symptomatic relief of nausea.

c)

Absorb poison


Rationale: Activated charcoal is specifically administered to absorb poison in the gastrointestinal tract, preventing its absorption into the bloodstream. Syrup of Ipecac, on the other hand, is used to induce vomiting rather than absorb poison. This option is correct for activated charcoal.

16.

Jaidon is learning about anti-emetic medications in class. He comes across prochlorperazine (Compazine) and wants to know how it works. How does prochlorperazine help prevent vomiting?

a)

It blocks the acetylcholine receptors associated with vomiting

b)

It blocks the histamine receptor sites and inhibits the CTZ

c)

It prohibits the muscle contraction in the abdominal wall, preventing vomiting

17.

During a first aid training session, Aulrhianna and Jaidon are learning about how to treat patients who have experienced trauma or have lost large amounts of fluid through the alimentary tract. Their instructor asks them which type of fluids are most commonly used in these situations.

a)

hypertonic

b)

hypotonic

c)

isotonic

18.

Nana is caring for a client who has been prescribed Mylanta, an antacid. Nana wants to ensure the medication is given at the most effective time. The ideal interval for taking Mylanta is:

  • 1-3 hours after meals
  • 1-3 hours before meals
  • 30 minutes before meals

a)

1-3 hours after meals

b)

1-3 hours before meals

c)

30 minutes before meals

19.

Jaidon, a nurse, teaches Nana, a patient with heart failure, to avoid the use of sodium phosphate laxatives. What is the correct rationale for this teaching?

  • A. the absorption of sodium causes fluid retention with exacerbates heart failure
  • B. the patient should avoid all laxatives due to their side effects
  • C. the absorption of sodium phosphate will alleviate fluid retention and help the symptoms of heart failure

Rationales:

  • A. Correct. Sodium phosphate laxatives can lead to increased sodium absorption, which causes fluid retention. This can worsen heart failure symptoms due to the heart's reduced ability to manage excess fluid.
  • B. Incorrect. Not all laxatives need to be avoided; the concern is specifically with sodium-containing laxatives due to their effect on fluid balance.
  • C. Incorrect. Sodium phosphate does not alleviate fluid retention; it can actually worsen it, making heart failure symptoms more severe.

a)

A. the absorption of sodium causes fluid retention with exacerbates heart failure

b)

B. the patient should avoid all laxatives due to their side effects

c)

C. the absorption of sodium phosphate will alleviate fluid retention and help the symptoms of heart failure

20.

Nana is learning about inhaled anticholinergic medications in her pharmacology class. Her instructor asks, "Nana, can you tell us which local anticholinergic effects are commonly caused by these medications? (select all that apply)"

  • A. dry mouth
  • B. hoarseness
  • C. cough
  • D. bronchospasm

a)

A. dry mouth

b)

B. hoarseness

c)

C. cough

d)

D. bronchospasm

21.

Nana is learning about the effects of long-term steroid use in her pharmacology class. Her instructor asks her to identify which complications can occur with prolonged steroid therapy. (select all that apply)

  • A. bone loss
  • B. hyperglycemia
  • C. infections
  • D. fluid retention (weight gain)
  • E. hoarseness

Rationales:

  • A. bone loss: Steroids can decrease bone formation and increase bone resorption, leading to osteoporosis.
  • B. hyperglycemia: Steroids increase glucose production and decrease its utilization, causing elevated blood sugar levels.
  • C. infections: Steroids suppress the immune system, making individuals more susceptible to infections.
  • D. fluid retention (weight gain): Steroids can cause sodium and water retention, resulting in weight gain and edema.
  • E. hoarseness: This is not a common complication of long-term steroid use.

a)

A. bone loss

b)

B. hyperglycemia

c)

C. infections

d)

D. fluid retention (weight gain)

e)

E. hoarseness

22.

Nana is caring for a patient who is to receive oral guaifenesin (Mucinex) twice a day. Today, Nana was busy and gave the medication 2 hours after the scheduled dose was due. What type of problem does this represent?


Options:
1. “Right time” problem
2. “Right dose” problem
3. “Right route” problem
4. “Right medication” problem

Rationales:
1. “Right time” problem: Correct. Administering medication later than the scheduled time is a violation of the “right time” principle in medication administration.
2. “Right dose” problem: Incorrect. There is no indication that the dose given was incorrect.
3. “Right route” problem: Incorrect. The medication was given orally as prescribed.
4. “Right medication” problem: Incorrect. The correct medication (guaifenesin) was administered.

a)

“Right time” problem

b)

“Right dose” problem

c)

“Right route” problem

d)

“Right medication” problem

23.

Nurse Nana is preparing to administer medication to Jaidon. When considering the timing of the drug dose, which factor is appropriate for Nana to consider when deciding when to give the drug?

a)

The patient’s ability to swallow

b)

The patient’s height

c)

The patient’s last meal

d)

The patient’s allergies

24.

While administering an intravenous medication to Nana, the patient says to the nurse, “I usually take pills. Why does this medication have to be given in the arm?” What is the nurse’s best answer?


Options:
1. “The medication will cause fewer adverse effects when given intravenously.”
2. “The intravenous medication will have delayed absorption into the body’s tissues.”
3. “The action of the medication will begin sooner when given intravenously.”
4. “There is a lower chance of allergic reactions when drugs are given intravenously.”

Rationales:
Option 1: This is incorrect because intravenous medications do not necessarily cause fewer adverse effects; in fact, they may cause more rapid or severe reactions due to immediate entry into the bloodstream.
Option 2: This is incorrect because intravenous medications are absorbed immediately, not with a delay.
Option 3: This is correct. Intravenous administration allows the medication to act more quickly because it is delivered directly into the bloodstream.
Option 4: This is incorrect because intravenous drugs can actually cause more immediate allergic reactions due to direct access to the circulatory system.

a)

“The medication will cause fewer adverse effects when given intravenously.”

b)

“The intravenous medication will have delayed absorption into the body’s tissues.”

c)

“The action of the medication will begin sooner when given intravenously.”

d)

“There is a lower chance of allergic reactions when drugs are given intravenously.”

25.

Jaidon, a nurse, is administering parenteral drugs to a patient. Which statement is true regarding parenteral drugs?

a)

Parenteral drugs bypass the first-pass effect.

b)

Absorption of parenteral drugs is affected by reduced blood flow to the stomach.

c)

Absorption of parenteral drugs is faster when the stomach is empty.

d)

Parenteral drugs exert their effects while circulating in the bloodstream.

26.

During a pharmacology class, Nana asks the nurse educator to explain what a drug’s half-life means. The nurse responds that a drug’s half-life is the time it takes for

a)

the drug to cause half of its therapeutic response.

b)

one half of the original amount of a drug to reach the target cells.

c)

one half of the original amount of a drug to be removed from the body.

d)

one half of the original amount of a drug to be absorbed into the circulation.

27.

Aulrhianna is caring for a patient who is experiencing chest pain and needs to take a sublingual form of nitroglycerin. Where does Aulrhianna instruct the patient to place the tablet?

  • A. Under the tongue
  • B. On top of the tongue
  • C. At the back of the throat
  • D. In the space between the cheek and the gum

a)

Under the tongue

b)

On top of the tongue

c)

At the back of the throat

d)

In the space between the cheek and the gum

28.

Nana is taking a medication to improve her bone health. Which response would indicate that the drug is having its intended therapeutic effect?

  • A. Ankle swelling
  • B. Bone strengthening
  • C. Constipation
  • D. Dizziness

a)

Ankle swelling

b)

Bone strengthening

c)

Constipation

d)

Dizziness

29.

During a pharmacy class discussion, Aulrhianna and Jaidon are reviewing different types of drug names. Which type of drug name would Aulrhianna point out is used mainly by drug developers and manufacturers, and not by prescribers?


Options:
1. Generic name
2. Brand or trade name
3. Chemical name
4. Proprietary name

Rationales:
1. Generic name: This is the standard name for a drug, used by prescribers and in official documents.
2. Brand or trade name: This is the name given by the manufacturer for marketing purposes, commonly used by prescribers.
3. Chemical name: Correct. The chemical name describes the drug's chemical structure and is mainly used by developers and manufacturers, not by prescribers.
4. Proprietary name: This is another term for the brand or trade name, used for marketing and prescribing.

a)

Generic name

b)

Brand or trade name

c)

Chemical name

d)

Proprietary name

30.

During a classroom discussion, Aulrhianna, Nana, and Jaidon are learning about drug manufacturing in the United States. Their teacher asks them which group is responsible for enforcing established standards for drug manufacturing. What is the correct answer?

a)

United States Pharmacopeia

b)

National Institutes of Health

c)

Food and Drug Administration

d)

Association of Pharmaceutical Manufacturers

31.

Nana is learning about hormones in her biology class. Her teacher explains that some medications act as testosterone agonists. How are the effects of naturally occurring testosterone changed when a patient, like Jaidon, is taking a drug that is a testosterone agonist?


Rationales:
  • Effects are increased: A testosterone agonist mimics or enhances the action of naturally occurring testosterone, leading to increased effects.
  • Effects are decreased: This would occur with an antagonist, not an agonist.
  • Effects are eliminated: An agonist does not eliminate the effects; it enhances them.
  • Effects are unchanged: The presence of an agonist would change the effects, typically increasing them.

a)

Effects are increased

b)

Effects are decreased

c)

Effects are eliminated

d)

Effects are unchanged

32.

Nana is a nurse teaching her patient, Jaidon, about adverse drug reactions (ADRs). Which precaution is most important for Nana to include in her teaching?


Options:
1. “Take your medications right before you go to bed so that you can sleep through an ADR.”
Rationale: This is incorrect. Sleeping through an ADR could delay recognition and treatment of a potentially serious reaction.

2. “Keep a written record of the date and time an ADR occurs.”
Rationale: While documenting ADRs is helpful for healthcare providers, it is not the most immediate precaution to take.

3. “Stop taking the drug and flush it down the toilet.”
Rationale: This is not recommended. Stopping medication without medical advice and improper disposal can be unsafe and environmentally harmful.

4. “Immediately seek medical help.”
Rationale: Correct. Prompt medical attention is crucial to manage ADRs and prevent complications.

a)

“Take your medications right before you go to bed so that you can sleep through an ADR.”

b)

“Keep a written record of the date and time an ADR occurs.”

c)

“Stop taking the drug and flush it down the toilet.”

d)

“Immediately seek medical help.”

33.

Aulrhianna, Jaidon, and Nana are discussing different ways medicines can be given to patients. Which drug administration route is most likely to result in reduced drug bioavailability?


Options:
1. Enteral
2. Intravenous
3. Transdermal
4. Subcutaneous

Rationales:
Enteral: Drugs administered via the enteral route (such as oral) often undergo first-pass metabolism in the liver, which can significantly reduce their bioavailability.
Intravenous: IV administration delivers the drug directly into the bloodstream, resulting in 100% bioavailability.
Transdermal: Transdermal delivery bypasses the gastrointestinal tract and first-pass metabolism, generally resulting in higher bioavailability than enteral.
Subcutaneous: Subcutaneous injections also bypass the GI tract and first-pass metabolism, usually providing good bioavailability.

Correct Answer: Enteral

a)

Enteral

b)

Intravenous

c)

Transdermal

d)

Subcutaneous

34.

Aulrhianna is learning about different drug delivery methods in her pharmacology class. She is curious about the disadvantages of the transdermal drug delivery route. Which factor is a major disadvantage of the transdermal drug delivery route?

a)

Only a prescriber can administer drugs by the transdermal route.


Rationale: This is incorrect. Transdermal drug delivery systems are designed for patient self-administration and do not require a prescriber to apply them.

b)

Transdermal drugs must be sterile rather than clean.


Rationale: This is incorrect. Transdermal patches do not need to be sterile; they only need to be clean, as they are applied to intact skin.

c)

First pass drug loss by this route is the most extensive.


Rationale: This is incorrect. Transdermal drug delivery bypasses the first-pass metabolism in the liver, which is a major advantage, not a disadvantage.

d)

Drug absorption is dependent on adequate circulation.


Rationale: This is correct. The major disadvantage of the transdermal route is that drug absorption can be affected by poor peripheral circulation, which may reduce the effectiveness of the medication.

35.

Jaidon is caring for a patient who has a deficiency of an enzyme that prepares a specific drug for elimination. When planning care for this patient, Jaidon remains alert for which response or issue?


Options:
1. Toxic blood levels of the drug are more likely to occur.
2. Higher drug dosages will be needed for the intended action to occur.
3. The drug will be eliminated more rapidly in the feces rather than in the urine.
4. Delivery of this drug by the parenteral route is more effective than by the enteral route.

Rationales:
1. Toxic blood levels of the drug are more likely to occur.
This is correct. If the enzyme responsible for drug metabolism is deficient, the drug will not be prepared for elimination efficiently, leading to accumulation and possible toxicity.
2. Higher drug dosages will be needed for the intended action to occur.
This is incorrect. A deficiency in the metabolizing enzyme means the drug stays in the system longer, so lower doses may be needed, not higher.
3. The drug will be eliminated more rapidly in the feces rather than in the urine.
This is incorrect. The route of elimination does not necessarily change; rather, the drug is eliminated more slowly overall.
4. Delivery of this drug by the parenteral route is more effective than by the enteral route.
This is incorrect. The route of administration does not address the underlying enzyme deficiency affecting drug metabolism and elimination.

a)

Toxic blood levels of the drug are more likely to occur.

b)

Higher drug dosages will be needed for the intended action to occur.

c)

The drug will be eliminated more rapidly in the feces rather than in the urine.

d)

Delivery of this drug by the parenteral route is more effective than by the enteral route.

36.

Nana is reviewing the health records of a patient who has all of the following health problems. Which problem should Nana be most alert for, due to an increased risk for drug side effects?

  • Asthma
  • Kidney disease
  • GI ulcers
  • Chronic high blood pressure

a)

Asthma

b)

Kidney disease

c)

GI ulcers

d)

Chronic high blood pressure

37.

Nana, a nurse, administers orally 400 mg of a drug with a half-life of 2 hours to Jaidon at noon. At which time will Jaidon’s blood drug level first be less than 40 mg?


Options:
1.

2:00 PM


2.

6:00 PM


3.

8:00 PM


4.

Midnight


Rationales:
1. 2:00 PM: At 2:00 PM (2 hours after administration), the drug level will be 200 mg (half of 400 mg), which is still much higher than 40 mg.
2. 6:00 PM: At 6:00 PM (6 hours after administration), the drug level will be 50 mg (400 → 200 → 100 → 50 mg). This is still above 40 mg.
3. 8:00 PM: At 8:00 PM (8 hours after administration), the drug level will be 25 mg (400 → 200 → 100 → 50 → 25 mg). This is the first time the drug level drops below 40 mg.
4. Midnight: At midnight (12 hours after administration), the drug level will be 12.5 mg, which is below 40 mg, but the drug level was already below 40 mg at 8:00 PM.
Correct Answer:

8:00 PM

a)

2:00 PM

b)

6:00 PM

c)

8:00 PM

d)

Midnight

38.

Jaidon is caring for a patient who is prescribed a drug with an extremely short half-life for chest pain (angina). Which modification in drug dosage or scheduling does Jaidon expect?


Options:
1. Once-daily dosing
2. More frequent dosing
3. Larger first dose and smaller repeat doses
4. Parenteral doses greater than enteral doses

Rationales:
1. Once-daily dosing: Not appropriate for drugs with a short half-life, as the drug would be eliminated quickly and not maintain therapeutic levels.
2. More frequent dosing: Correct. Drugs with a short half-life require more frequent dosing to maintain effective blood levels and therapeutic effect.
3. Larger first dose and smaller repeat doses: This is a loading dose strategy, which is not specifically related to short half-life but rather to achieving rapid therapeutic levels.
4. Parenteral doses greater than enteral doses: This relates to bioavailability, not half-life. The route of administration does not address the issue of rapid elimination.

a)

Once-daily dosing

b)

More frequent dosing

c)

Larger first dose and smaller repeat doses

d)

Parenteral doses greater than enteral doses

39.

During a classroom discussion, Jaidon, Nana, and Aulrhianna are learning about how drugs are eliminated from the body. Their teacher asks, "Which body tissues or fluids are routes of drug elimination? (Select all that apply.)"

  • A. Bone marrow
  • B. Heart
  • C. Liver
  • D. Lungs
  • E. Tears

a)

A. Bone marrow

b)

B. Heart

c)

C. Liver

d)

D. Lungs

e)

E. Tears

40.

Nurse Nana is about to administer a prescribed drug to a patient who is alert and oriented. What is the best way for Nana to make sure that the right patient is receiving the medication?


Options:
1. Ask the patient to state his or her name.
2. Check the patient’s wrist band.
3. Look at the patient’s chart.
4. Have the patient state his or her name and birth date.

a)

Ask the patient to state his or her name.

b)

Check the patient’s wrist band.

c)

Look at the patient’s chart.

d)

Have the patient state his or her name and birth date.

41.

Nana, a nurse, is caring for a patient who has been prescribed omeprazole (Prilosec) 60 mg once a day orally. The patient, Jaidon, is having difficulty with swallowing and has a feeding tube in place. What is Nana’s best action?


Options:
1. Open the capsule and mix the contents with water, then give the drug through the feeding tube.
2. Raise the head of the bed 90 degrees and mix the capsule in applesauce for easier swallowing.
3. Contact the prescriber and pharmacist about using another drug or another form of the drug.
4. Hold the tube feeding for at least 30 minutes before giving the drug.

Rationales:
Option 1: Omeprazole capsules should not be opened and mixed with water for tube administration, as this can affect drug absorption and efficacy.
Option 2: Mixing the capsule in applesauce is not appropriate for a patient with a feeding tube and swallowing difficulties.
Option 3: Correct. The nurse should contact the prescriber and pharmacist to discuss alternative formulations or medications suitable for tube administration.
Option 4: Holding tube feeding may be necessary for some medications, but it does not address the issue of drug formulation and administration in this scenario.

a)

Open the capsule and mix the contents with water, then give the drug through the feeding tube.

b)

Raise the head of the bed 90 degrees and mix the capsule in applesauce for easier swallowing.

c)

Contact the prescriber and pharmacist about using another drug or another form of the drug.

d)

Hold the tube feeding for at least 30 minutes before giving the drug.

42.

Jaidon is a patient with severe postoperative pain and is ordered to receive morphine 2 mg intravenously. Jaidon asks the nurse, Nana, if the drug could be taken by mouth instead. What is Nana’s best response?


Options:
1. “Giving the drug intravenously will give you faster pain relief.”
2. “I will call your prescriber and ask if the order can be changed.”
3. “Your surgeon wants you to receive the drug intravenously.”
4. “We can substitute the intravenous drug with an oral drug.”

Rationales:
1. Correct. Intravenous administration of morphine provides faster onset of pain relief compared to oral administration, which is important for severe postoperative pain.
2. While contacting the prescriber is appropriate if the patient cannot tolerate IV medication, the best initial response is to explain the reason for IV administration.
3. This response does not address the patient’s concern or provide education about the medication.
4. Substituting IV morphine with oral medication is not appropriate without a prescriber’s order and may not provide adequate pain relief as quickly.

a)

“Giving the drug intravenously will give you faster pain relief.”

b)

“I will call your prescriber and ask if the order can be changed.”

c)

“Your surgeon wants you to receive the drug intravenously.”

d)

“We can substitute the intravenous drug with an oral drug.”

43.

Nana, a nursing student, is assisting in the care of a patient who is to receive nitroglycerin ointment, 1 inch STAT, for elevated blood pressure. What must Nana do before giving this drug?

a)

Shave the hair off the patient’s chest.

b)

Place the patient on a heart monitor.

c)

Put on a pair of disposable gloves.

d)

Measure the dose directly on the patient’s skin.

44.

Jaidon was prescribed a medication that needs to be absorbed quickly into his bloodstream. His doctor instructed him to place the drug in a specific part of his body for rapid absorption. Where should Jaidon place the sublingual drug?


Rationales:
  • Between the cheek and the upper jaw: This describes the buccal route, not sublingual.
  • Under the tongue: Correct. Sublingual administration involves placing the drug under the tongue for rapid absorption.
  • In the nose: This is the intranasal route, not sublingual.
  • In the eyes: This is the ophthalmic route, not sublingual.

a)

Between the cheek and the upper jaw

b)

Under the tongue

c)

In the nose

d)

In the eyes

45.

Nurse Nana is preparing to give ear drops to 2-year-old Jaidon. What administration technique should Nana use?


Options:
1. Pull the earlobe down and back.
2. Pull the earlobe up and out.
3. Keep the earlobe straight.
4. Hang the patient’s head over the side of the bed.

Rationales:
1. Pull the earlobe down and back. (Correct): For children under 3 years old, the ear canal is more horizontal, so pulling the earlobe down and back straightens the canal for proper administration.
2. Pull the earlobe up and out.: This technique is used for adults and older children, not for a 2-year-old.
3. Keep the earlobe straight.: This does not help in straightening the ear canal for medication administration.
4. Hang the patient’s head over the side of the bed.: This is not a recommended or safe position for administering ear drops.

a)

Pull the earlobe down and back.

b)

Pull the earlobe up and out.

c)

Keep the earlobe straight.

d)

Hang the patient’s head over the side of the bed.

46.

The prescriber orders a new drug over the telephone for a nursing home patient, Nana, who has symptoms of a urinary tract infection. The order is for Gantanol, 2 g now and then 1 g every 12 hours for the next 10 days. What further information is most important for the nurse, Jaidon, to obtain from the prescriber?


Options:
1. “How many refills are needed?”
2. “Do you want the drug given orally or intravenously?”
3. “Which brand of drug should be given, or is this a generic drug?”
4. “Does this drug need to be given with a meal or on an empty stomach?”

Rationales:
Option 1: While refills are important for ongoing therapy, the route of administration is more urgent for immediate patient safety.
Option 2 (Correct): It is essential to clarify whether the drug should be given orally or intravenously, as this affects how the medication is prepared and administered, and impacts patient safety.
Option 3: The brand or generic status is less critical than knowing the correct route for administration.
Option 4: Timing with meals is important for absorption, but not as immediately crucial as the route of administration for a new drug order.

a)

“How many refills are needed?”

b)

“Do you want the drug given orally or intravenously?”

c)

“Which brand of drug should be given, or is this a generic drug?”

d)

“Does this drug need to be given with a meal or on an empty stomach?”

47.

Jaidon is a nurse caring for a patient who had surgery 2 days ago. The physician orders all of the following drugs for the patient. Which drug order should Jaidon administer first?

  • Alphamine (cyanocobalamin) 100 mcg intramuscularly once
  • Benadryl (diphenhydramine) 25 mg orally every 8 hours
  • Compazine (prochlorperazine) 10 mg orally STAT
  • Dalmane (flurazepam) 30 mg orally at night PRN

a)

Alphamine (cyanocobalamin) 100 mcg intramuscularly once

b)

Benadryl (diphenhydramine) 25 mg orally every 8 hours

c)

Compazine (prochlorperazine) 10 mg orally STAT

d)

Dalmane (flurazepam) 30 mg orally at night PRN

48.

The nurse asks the patient, Jaidon, to state his name and birth date, and Jaidon responds correctly. The nurse then gives Jaidon the prescribed drug tablet. Jaidon says “I haven’t ever taken a green pill before.” What is the nurse’s best response?


Options:
1. “Go ahead and take the drug. The same medications from different drug companies may have a different color.”
2. “Go ahead and take the drug. It is likely that your health care provider has prescribed a new drug for you.”
3. “Don’t take this drug right now. It is probably not the one prescribed for you.”
4. “Don’t take this drug right now. Let me recheck everything to be sure.”

Rationales:
Option 1: This response dismisses the patient’s concern and does not verify the medication, which could lead to a medication error.
Option 2: This response assumes a change in prescription without verification, which is unsafe.
Option 3: This response is cautious but assumes the medication is incorrect without checking.
Option 4 (Correct): This response prioritizes patient safety by rechecking the medication before administration, ensuring the right drug is given.

a)

“Go ahead and take the drug. The same medications from different drug companies may have a different color.”

b)

“Go ahead and take the drug. It is likely that your health care provider has prescribed a new drug for you.”

c)

“Don’t take this drug right now. It is probably not the one prescribed for you.”

d)

“Don’t take this drug right now. Let me recheck everything to be sure.”

49.

Nana, a nurse, is about to administer a new medication to a patient for the first time. Which question is most important for Nana to ask the patient before giving the drug?

a)

“Are you allergic to any drugs?”
Rationale: This is the most important question because administering a drug to a patient with a known allergy can cause serious, potentially life-threatening reactions. Identifying allergies helps prevent adverse events.

b)

“Do you know what this drug is for?”
Rationale: While patient education is important, it is not the most critical safety concern before administration. This question helps assess patient understanding but does not directly prevent harm.

c)

“When was the last time you ate or drank?”
Rationale: This may be relevant for certain drugs that require fasting, but it is not universally important for all medications. It is not the primary safety concern before giving a new drug.

d)

“What other drugs have you taken in the last 24 hours?”
Rationale: Knowing other medications helps prevent drug interactions, but checking for allergies is the first and most crucial step to avoid immediate harm.

50.

When nurse Nana brings in the next dose of a drug that patient Jaidon first received 6 hours ago, Jaidon reports a “pounding” heart rate ever since taking the last dose. What is Nana’s best first action?


Options:
1. Document the report as the only action.
2. Check the patient’s vital signs for changes.
3. Hold the dose and notify the prescriber immediately.
4. Reassure the patient that this is an expected response to the drug.

Rationales:
1. Documentation is important, but assessment should occur first to determine the severity of the reaction.
2. Correct. Checking vital signs helps assess the patient’s current status and guides further action.
3. Holding the dose and notifying the prescriber may be necessary, but assessment should precede this step.
4. Reassuring the patient without assessment may overlook a potentially serious adverse effect.

a)

Document the report as the only action.

b)

Check the patient’s vital signs for changes.

c)

Hold the dose and notify the prescriber immediately.

d)

Reassure the patient that this is an expected response to the drug.

51.

Which action is most important when the nurse prepares to administer an oral drug to a patient of any age?

a)

Asking the patient whether he or she prefers a tablet or a capsule

b)

Determining when the patient last ate or drank

c)

Assessing whether the patient has nausea

d)

Checking the patient’s ability to swallow

52.

Which technique is used with intramuscular drug injections but not with intradermal drug injections?

a)

Ensuring the site selected is appropriate for injection

b)

Cleansing the selected site before inserting the needle

c)

Aspirating the syringe before injecting the drug solution

d)

Checking for allergic or sensitivity reactions to the injection

53.

When compared with the subcutaneous route, what are the advantages of giving drugs intramuscularly (IM)? (Select all that apply.)

a)

IM injections require a smaller, shorter needle.

b)

IM drugs are absorbed faster than subcutaneous drugs.

c)

IM injections can be much larger that subcutaneous injections.

d)

IM injections do not require the rotation of injection sites.

e)

IM injections are less painful than subcutaneous injections.

54.

A patient is treated with an antibiotic for an infection of the leg. After 2 days of taking the antibiotic, the patient calls the clinic and reports that he has a rash all over his body. The nurse is aware that a rash can be an adverse effect of an antibiotic and can be either a biologic, chemical, or physiologic action of the drug, which is an example of:

a)

Pharmacotherapeutics

b)

Pharmacokinetics

c)

Pharmacodynamics

d)

Pharmacogenetics

55.

A nurse has been assigned the task of preparing educational materials for patients with diabetes. The nurse has included the drug name, the reason the drug was prescribed, the intended effect of the drug, along with important adverse effects that should be reported to the nurse or health care provider. Which of the following information is essential to include in the educational materials?

a)

Drug administration method

b)

Core drug knowledge

c)

Vital signs of the patient

d)

Diagnosis and outcome identification mechanism

56.

Which of the following activities would the nurse expect to complete during the evaluation phase of the nursing process in drug therapy?

a)

Compare the outcome expected with the actual patient outcome.

b)

Reconsider core drug knowledge and core patient variables.

c)

Ask questions to prepare an effective patient education program.

d)

Establish a baseline for the patient’s treatment and care.

57.

When administering heparin subcutaneously, the nurse should

a)

Aspirate after injection

b)

Aspirate before the injection

c)

Vigorously massage the site

d)

Never aspirate

58.

Children’s medication dosages are most often calculated using the child’s body surface area and

a)

Age

b)

Diagnosis

c)

Height

d)

Weight

59.

When the patient demonstrates a rash 30 minutes after she has taken a dose of penicillin, the nurse recognizes that the patient is likely demonstrating which type of drug reaction?

a)

Allergy

b)

Anaphylaxis

c)

Antagonistic

d)

Idiosyncratic

60.

Which of the following patients is likely to have altered metabolism of medications?

a)

School-age children

b)

Adolescents

c)

Middle adults

d)

Elderly

61.

What is involved in the absorption, distribution, metabolism, and excretion of medication?

a)

Pharmacology

b)

Pharmacotherapeutics

c)

Pharmacokinetics

d)

Pharmacodynamics

62.

In terms of categories of controlled substance, which of the following descriptions reflects schedule IV drugs?

a)

May lead to severe psychological dependence

b)

Has the highest potential for abuse

c)

May lead to limited physical dependence

d)

deemed safe for use in pregnancy

63.

A medication order has a.c. written after the medication dosage. What does a.c. stand for?

a)

Before meals

b)

After meals

c)

Before

d)

After

64.

A nurse knows that patient education has been effective when the patient states

a)

“I must take my parenteral medication with food.”

b)

“If I am 30 minutes late taking my medication, I should skip that dose.”

c)

“I will rotate the location where I give myself injections.”

d)

“Once I start feeling better, I will stop taking my medication.”

65.

The nurse knows that the purpose of aspiration on IM injections is to

a)

Ensure proper placement of the needle.

b)

Increase the force of the injection.

c)

Reduce the discomfort of the injection.

d)

Prolong the absorption time of the medication.

66.

The nurse is planning to administer a tuberculin test with a 27-gauge, 3/8-inch needle. The nurse should insert the needle at an angle of _____ degrees.

a)

15

b)

45

c)

90

d)

180

67.

The nurse knows to assess for signs of medication toxicity within older adults because of which physiological change?

a)

Reduced glomerular filtration

b)

Delayed esophageal clearance

c)

Decreased gastric peristalsis

d)

Decreased cognitive function

68.

A patient is in need of immediate pain relief for a severe headache. The nurse knows that which medication will be absorbed the quickest?

a)

Tylenol 650 mg PO

b)

Morphine 4 mg SQ

c)

Ketorolac (Toradol) 8 mg IM

d)

Hydromorphone (Dilaudid) 4 mg IV

69.

The nurse knows that an idiosyncratic event with the stimulant pseudoephedrine (Sudafed) is occurring when the patient

a)

Experiences blurred vision while driving.

b)

Falls asleep during daily activities.

c)

Presents with a pruritus rash.

d)

Develops xerostomia.

70.

A patient needs assistance excreting a gaseous medication. What is the correct nursing action?

a)

Encourage the patient to cough and deep-breathe.

b)

Suction the patient’s respiratory secretions.

c)

Administer the antidote via inhalation.

d)

Administer 100% FiO2 via simple face mask.

71.

What is the nurse’s priority action to protect a patient from medication error?

a)

Requesting that the prescriber write out an order, rather than giving a verbal order

b)

Asking anxious family members to leave the room before giving a medication

c)

Checking the patient’s room number against the medication administration record

d)

Administering as many of the medications as possible at one time

72.

The nurse knows that a subcutaneous injection takes longer to absorb because

a)

Fewer blood vessels are found under the subcutaneous level.

b)

Adipose tissue takes longer to metabolize medication.

c)

Connective tissue holds medication in place longer.

d)

Some medication leaks out after instillation.

73.

The nurse realizes which patient is at greatest risk for an unintended synergistic effect?

a)

72-year-old who is seeing four different specialists

b)

4-year-old who has mistakenly taken the entire packet of his mother’s birth control pills

c)

50-year-old who was prescribed a second blood pressure medication

d)

35-year-old drug addict who has ingested meth mixed with several household chemicals

74.

Which nursing action is the number one priority for ensuring that medication stays in the target therapeutic range?

a)

Drawing the peak and trough levels at the same time each day

b)

Administering a double dose after a dose was missed

c)

Delivering the same amount of the drug at the same time each day

d)

Increasing absorption by holding all other medications 1 hour before administration

75.

Which term refers to the movement of a drug from the site of administration to the bloodstream?

a)

absorption

b)

distribution

c)

metabolism

d)

excretion

76.

After receiving diphenhydramine, a patient complains that his mouth is very dry. This is not uncommon for patients taking this medication. Which drug effect is this patient experiencing?

a)

Side effect

b)

Adverse reaction

c)

Toxic reaction

d)

Supportive effect

77.

While receiving an intravenous dose of an antibiotic, levofloxacin, a patient develops severe shortness of breath, wheezing, and severe hypotension. Which action should the nurse take first?

a)

Administer epinephrine IM.

b)

Give bolus dose of intravenous fluids.

c)

Stop the infusion of medication.

d)

Prepare for endotracheal intubation.

78.

Laboratory test results indicate that warfarin anticoagulant therapy is suddenly ineffective in a patient who has been taking the drug for an extended time. The nurse suspects an interaction with herbal medications. What type of interaction does she suspect?

a)

Antagonistic drug interaction

b)

Synergistic drug interaction

c)

Idiosyncratic reaction

d)

Drug incompatibility

79.

The nurse explains that a drug may have several names. The trade name is the only name that can be:

a)

used in an order.

b)

trademarked.

c)

recognized as its chemical makeup.

d)

used by retailers to sell the drug.

80.

When categorizing medications, drug classifications may be defined by the effects of the drug and:

a)

the symptoms the drug relieves.

b)

patient tolerance.

c)

the nursing implications.

d)

the dosage amounts.

81.

A patient complains about the taste of the sublingual nitroglycerin and admits that he swallows it rather than holding it under his tongue. The nurse explains that sublingual medications:

a)

can be inserted rectally without loss of absorption potential.

b)

should not be swallowed because it alters the absorption potential.

c)

can be held against the roof of the mouth with the tongue to reduce taste.

d)

can be taken between the cheek and tongue to diminish taste.

82.

Dosage Calculations: Calculate the dosage of medication needed for a patient weighing 150 lbs, when the prescribed dosage is 0.1 mg/kg and the medication is available in 5 mg tablets.

a)

2 tablets

b)

0.68 tablets

c)

1.5 tablets

d)

0.05 tablets

83.

Dosage Calculations: A patient is prescribed to receive 500 mg of medication. The medication is available in 250 mg/5 mL. How many milliliters should the nurse administer?

a)

20

b)

10

c)

15

d)

5

84.

Dosage Calculations: A child weighing 22 lbs is prescribed to receive 50 mg of medication. The medication is available in 25 mg/2 mL. How many milliliters should the nurse administer?

a)

4

b)

8

c)

2

d)

6

85.

Medication Administration: A medication is ordered to be administered at a rate of 60 drops per minute. The IV tubing delivers 15 drops per mL. How many milliliters per hour should the nurse set the IV pump to?

a)

120

b)

180

c)

300

d)

240

86.

Medication Administration: A patient is prescribed to receive 2 grams of medication. The medication is available in 500 mg tablets. How many tablets should the nurse administer?

a)

4

b)

10

c)

8

d)

6

87.

Medication Administration: A child is prescribed to receive 75 mg of medication. The medication is available in 25 mg/mL. How many milliliters should the nurse administer?

a)

3

b)

5

c)

10

d)

15

88.

IV Infusion Rate Calculations: A patient is to receive 1000 mL of IV fluid over 8 hours. What is the infusion rate in mL/hour?

a)

250

b)

500

c)

750

d)

125

89.

IV Infusion Rate Calculations: A medication is ordered to be administered at a rate of 10 mcg/kg/minute. The patient weighs 70 kg. The medication is available in 500 mcg/mL. How many milliliters per hour should the nurse set the IV pump to?

a)

1.8 mL/hour

b)

5.5 mL/hour

c)

3.2 mL/hour

d)

2.1 mL/hour

90.

Pediatric Dosages: A child weighing 30 lbs is prescribed to receive 100 mg of medication. The medication is available in 50 mg/2 mL. How many milliliters should the nurse administer?

a)

2 mL

b)

6 mL

c)

8 mL

d)

4 mL

91.

Pediatric Dosages: A child weighing 18 lbs is prescribed to receive 75 mg of medication. The medication is available in 25 mg/1 mL. How many milliliters should the nurse administer?

a)

3

b)

2

c)

5

d)

10

92.

A nurse is teaching the parent of a child who has a Wilm’s tumor. Which of the following statements should the nurse include in the teaching? (Select all that apply)

a)

Chemo will go on for 12 months

b)

Wilma tumors are typically genetic in nature

c)

Surgery is done usually within 48 hours of diagnosis

d)

Palpating the tumor could cause spread of the cancer

e)

Further treatments will start immediately after surgery

93.

A nurse is caring for a toddler who has a Wilms tumor. Which of the following should be include in the plan of care?

a)

Abdominal palpating to identify the size of the tumor

b)

Preparation for surgery

c)

Teaching about dialysis

d)

Obtaining 24 hour urine specimen

94.

A nurse is caring for a client who is schedule for a thoracentesis at the bedside. Which of the following items should the nurse ensure is in the client’s room? (Select all)

a)

Oxygen equipment

b)

Incentive spirometer

c)

Pulse oximeter

d)

Thoracentesis tray

e)

Suture removal kit

95.

A nurse is caring for a client who has a tension pneumothorax. The nurse knows that, as a result of the tension pneumothorax, air continues to accumulate and the intrapleural pressure rises which……

a)

Causes small blend to develop in the lung on the affected side

b)

Allows air to flow freely through the chest wall during inspiration and expiration

c)

Causes less air to enter on inspiration and exceed the barometric pressure

d)

Will cause the mediastinum to shift away from the affected side and decrease venous return

96.

A nurse is teaching a client about the risk for cancer. Which of the following client statements indicates the need for further teaching?

a)

I see a dermatologist regularly for the mole on my thigh

b)

I take Milk of Magnesia for occasional constipation

c)

I apply sunscreen even on cloudy days

d)

I used to smoke but switched to chewing tobacco 3 years ago

97.

A nurse is planning care for a child who has cystic fibrosis. Which of the following interventions should be included in the plan on care?

a)

Provide a low calorie, low protein diet

b)

Administer pancreatic enzymes with meals and snacks

c)

Promoter an increase in fluids after 1800

d)

Restrict physical activity

98.

A nurse is caring for an infant who has a myelomeningocele. Which of the following should she include in the plan of care?

a)

Assist mom with breastfeeding

b)

Assess the infants temperature rectally

c)

Placed the infant in a supine position

d)

Apply a moist dressing on the sac

99.

The client is being evaluated to rule out ALS. Which signs/symptoms would the nurse note to confirm the diagnosis?

a)

Muscle atrophy and flaccidity

b)

Fatigue and malnutrition

c)

Slurred speech and dysphagia

d)

Weakness and paralysis

100.

The client diagnosed with ALS asks the nurse, "I know this disease is going to kill me. What will happen to me in the end?" Which statement by the nurse would be most appropriate?

a)

“You are afraid of how you will die?”

b)

“Most people of ALS die of respiratory failure.”

c)

“Don’t talk like that, you have to stay positive.”

d)

“ALS is not a killer. You can live a long life.”

101.

1. The 40-year-old woman has had Raynaud's phenomenon for some time. She is now reporting red spots on the hands, forearms, palms, face, and lips. What other manifestations should the nurse assess for when she is assessing for scleroderma (select all that apply)?

a)

Calcinosis

b)

Difficulty swallowing

c)

Sclerodactyly

d)

Weakened leg muscles

e)

Weight loss

102.

The nurse is assigned to care for a client admitted to the hospital with a diagnosis of systemic lupus erythematosus (SLE). The nurse reviews the health care provider's prescriptions. Which of the following medications would the nurse expect to be prescribed?

a)

Antibiotic

b)

Antidirrheal

c)

Corticosteroid

d)

Opioid analgesic

103.

1. During a routine health check-up visit a client states, “I’ve been experiencing severe pain and stiffness in my joints lately.” As the nurse, you will ask the client what questions to assess for other possible signs and symptoms of rheumatoid arthritis? Select-all-that-apply:

a)

“Are you experiencing fatigue and fever as well?”

b)

“Does your pain and stiffness tend to be the worst before bedtime?”

c)

“Is your pain and stiffness aggravated by extreme temperatures?”

d)

“Is your pain and stiffness symmetrical on the body?”

104.

A female client expresses her concern about becoming pregnant while her partner is on ribavirin therapy for chronic hepatitis C. What should the nurse advise the client?

a)

She can plan pregnancy now

b)

She should avoid getting pregnant now

c)

She should not get pregnant with this partner ever

d)

She should avoid any sexual intercourse after conception

105.

The nurse provides discharge instructions to a client with newly diagnosed cirrhosis. Which statement made by the client indicates the need for further teaching?

a)

"I should take frequent rest periods."

b)

“I can eat anything that appeals to me.”

c)

“I can do without my glass of wine at dinner.”

d)

"I should take only medications that have been prescribed."

106.

Maria was recently diagnosed with Hodgkin’s lymphoma. Upon the early diagnosis, the nurse will expect which of the following areas is often involved?

a)

Chest

b)

Neck

c)

Groin

d)

Pelvis

107.

A clinical instructor is conducting a lecture about chemotherapy. Which of the following statements is correct about the rate of cell growth in relation to chemotherapy?

a)

Faster growing cells are more susceptible to chemotherapy

b)

Faster growing cells are less susceptible to chemotherapy

c)

Slower growing cells are more susceptible to chemotherapy

d)

Non-dividing cells are more susceptible to chemotherapy

108.

A client with leukemia has neutropenia. Which of the following functions must be frequently assessed?

a)

Heart sounds

b)

Lung sounds

c)

Blood pressure

d)

Bowel sounds

109.

The nurse has received 1 unit of blood from the blood bank and has rechecked the blood bag properly with a second nurse. Prior the facilitation of the blood transfusion, what is the priority assessment?

a)

Intake and output

b)

Diet orders

c)

Vital signs

d)

Skin turgor

110.

The nurse newly off orientation is assigned to care for a suicidal client. Initially, which is the nurse’s highest care priority?

a)

Assessing the client’s home environment and relationships outside the hospital

b)

Exploring the nurse’s own feelings about suicide

c)

Discussing the future with the client

d)

Referring the client to a clergyperson to discuss the moral implications of suicide

111.

A 14-year-old client is brought to the clinic by her mother. Her mother expresses concern about her daughter’s weight loss and constant dieting. Nurse Kris conducts a health history interview. Which of the following comments indicates that the client may be suffering from anorexia nervosa?

a)

“I like the way I look. I just need to keep my weight down because I’m a cheerleader.”

b)

“I don’t like the food my mother cooks. I eat plenty of fast food when I’m out with my friends.”

c)

“I just can’t seem to get down to the weight I want to be. I’m so fat compared to other girls.”

d)

“I do diet around my periods; otherwise, I just get so bloated.”

112.

The nurse is aware that which client is at highest risk for suicide?

a)

One who appears depressed, frequently thinks of dying, and gives away all personal possessions

b)

One who plans a violent death and has the means readily available

c)

One who tells others that he or she might do something if life doesn’t get better soon

d)

One who talks about wanting to die

113.

The nurse is aware that the victims of domestic violence should be assessed for what important information?

a)

Reasons they stay in the abusive relationship (for example, lack of financial autonomy and isolation)

b)

Readiness to leave the perpetrator and knowledge of resources

c)

Use of drugs and alcohol

d)

History of previous victimization

114.

Eighteen hours after undergoing an emergency appendectomy, a client with a reported history of social drinking displays these vital signs: temperature, 101.6° F (38.7° C); heart rate, 126 beats/minute; respiratory rate, 24 breaths/minute; and blood pressure, 140/96 mm Hg. The client exhibits gross hand tremors and is screaming for someone to kill the bugs in the bed. The nurse should suspect:

a)

A postoperative infection

b)

Alcohol withdrawal

c)

Acute sepsis

d)

Pneumonia

115.

A client arrives at the mental health clinic with a complaint of lack of sexual desire. In the initial interview, which assessments would the nurse make? Select all that apply

a)

Mood

b)

Energy level

c)

Medications being taken

d)

Previous level of sexual activity

e)

Recurring nightmares

116.

Which medication would most likely be prescribed for a client in alcohol withdrawal?

a)

Haloperidol (Haldol)

b)

Chloridiazepoxide (Librium)

c)

Methadone (Dolophine)

d)

Phenytoin (Dilantin)

117.

Which characteristic is least likely to predispose a child to Tourette's disorder?

a)

Absence of parental bonding

b)

Family history of Tourette’s

c)

Abnormalities of brain neurotransmitters

d)

Structural abnormalities of the brain

118.

An anticoagulant drug is classified by its

a)

chemical type.

b)

source of origin.

c)

physiologic action.

d)

therapeutic action.

119.

An order for a drug to be given as needed is called a ________________ order.

a)

standing

b)

oral

c)

stat

d)

PRN

120.

Which form of drug preparation tends to act more quickly?

a)

Solid

b)

Semisolid

c)

Liquid

d)

Gas

121.

____________________ is the study of the four basic processes of absorption, distribution, metabolism, and excretion in response to drugs.

a)

Pharmacokinetics

b)

Pharmacodynamics

c)

Biotransformation

d)

Sympathomimetics

122.

The time between the administration of a drug and the first appearance of its effects is called...

a)

peak effect.

b)

onset.

c)

duration.

d)

reaction time.

123.

When a drug travels from the site of administration into the bloodstream, it is called

a)

absorption.

b)

distribution.

c)

metabolism.

d)

excretion.

124.

Most drugs are excreted and eliminated by the

a)

lungs

b)

colon

c)

kidney

d)

Liver

125.

A drug that enhances the effect of another drug is called a(n)

a)

agonist.

b)

synergist.

c)

antagonist.

d)

receptor blocker.

126.

Volatile anesthetic agents are eliminated from the body via

a)

the kidneys.

b)

the skin.

c)

the circulatory system.

d)

the lungs.

127.

Why would a local anesthetic, injected into an infected wound, not produce the intended effect?

a)

Because the local anesthetic was not strong enough

b)

Because the local anesthetic was not absorbed

c)

Because the local anesthetic could not reach the site of action

d)

Because the local anesthetic could not bind to proteins

128.

Which federal action sets the standards for quality and requires proper medication labeling for preparations containing morphine?

a)

Durham-Humphrey Amendments

b)

Food, Drug, and Cosmetic Act

c)

Pure Food and Drug Act

d)

Controlled Substances Act

129.

A medication’s generic name is

a)

never capitalized on the label.

b)

followed by the registered trademark (®) symbol.

c)

its formula.

d)

its proprietary name.

130.

The organization that internationally regulates medications is

a)

The Joint Commission.

b)

FDA.

c)

OSHA.

d)

The World Health Organization.

131.

Drugs that have an abuse potential as well as an accepted use in the surgical setting are on the ____________ schedule.

a)

C-I

b)

C-II

c)

C-III

d)

C-IV

132.

Which categories of medications under the FDA’s pregnancy categories are considered to be within safe limits for use during pregnancy?

a)

Categories B and C

b)

Categories A and B

c)

Categories C and D

d)

Categories A and X

133.

How should an outdated multiuse vial of a local anesthetic be handled?

a)

By finishing the vial

b)

By returning it to pharmacy

c)

By giving it to anesthesia team

d)

By discarding the vial

134.

Seven o’clock in the morning, military time, would be written as

a)

0007.

b)

0070.

c)

0700.

d)

7000.

135.

What is 25% of 50?

a)

10

b)

12.5

c)

10.5

d)

12

136.

1 gram of an antibiotic is equal to __________ mL of fluid.

a)

1

b)

2

c)

5

d)

10

137.

When changing shifts, the incoming surgical technologist notices one of the medications on the sterile field is not accurately labeled. What should he or she do?

a)

Discard the medication and ask the circulator for a new dose.

b)

Ask the scrub person to label the medication before leaving.

c)

Ask the circulator to show him or her the empty vial and then label it properly.

d)

Ask the surgeon what to do.

138.

The five rights of medication administration include all of the following except

a)

right drug.

b)

right dose.

c)

right patient.

d)

right physician.

e)

right time.

139.

Improper or inadequate labeling of medications may be considered

a)

malpractice.

b)

tort.

c)

materia medica.

d)

negligence.

140.

All of the following items must be read aloud when identifying a drug except

a)

drug name.

b)

manufacturer.

c)

strength.

d)

expiration date.

141.

When recapping a needle, you should

a)

throw the needle into the trash.

b)

use the two-handed method.

c)

use the one-handed method.

d)

hand the uncapped needle to the circulator.

142.

Who is responsible for passing a medication to the surgeon for administration during the surgical procedure?

a)

Anesthesiologist

b)

Scrubbed surgical technologist

c)

Circulating nurse

d)

Another scrubbed surgeon

143.

Why should the scrubbed surgical technologist repeat the medication label information aloud?

a)

To ensure that he or she can read

b)

So that he or she can be heard

c)

To confirm the correct drug

d)

So that the surgical team will know

144.

What is the first action that should be taken by the scrubbed surgical technologist when withdrawing medication from an inverted vial held by the circulator?

a)

Puncture the rubber stopper.

b)

Remove the rubber stopper.

c)

Remove the syringe plunger.

d)

Draw air into the syringe.

145.

Which hypodermic needle has the smallest lumen?

a)

18-gauge

b)

21-gauge

c)

25-gauge

d)

27-gauge

146.

A 30-gauge hypodermic needle is larger in diameter than an 18-gauge needle.

a)

True

b)

False

147.

When passing local at the beginning of a procedure the Surgical Technologist should...

a)

Remove the cap and state the contents of the syringe out loud.

b)

Keep the cap on and pass the syringe.

c)

Place the local on the surgical field for the doctor to use when ready.

d)

State the contents of the syringe out loud including side effects.

148.

What steps should a Surgical Technologist take if the incorrect medication is given (mark all that apply)

a)

Notify the surgeon immediately.

b)

Notify the unit supervisor.

c)

Follow institutional policy.

d)

Break down your back table.

149.

Disease-causing microorganisms are called

a)

broad spectrum.

b)

bacteriostatic.

c)

pathogens.

d)

ototoxic.

150.

Endogenous infection occurs from

a)

outside the patient’s body.

b)

the patient’s own bacteria.

c)

a tear in the surgeon’s glove.

d)

contaminated surgical supplies.

151.

When a microorganism’s DNA sequence is altered to prevent destruction by an agent, the microorganism is said to have developed a(n)

a)

antibiotic resistance.

b)

broad-spectrum coverage.

c)

plasma membrane.

d)

bacteriostatic effect.

152.

Among the most common causative agents of SSI are bacteria known as

a)

Bacillus subtilis.

b)

Streptococcus pneumoniae.

c)

Staphylococcus epidermidis.

d)

Staphylococcus aureus

153.

An antimicrobial agent used to inhibit bacterial growth is called

a)

bactericidal.

b)

bacteriogenic.

c)

bacteriophagic.

d)

bacteriostatic.

154.

Which major group of antibiotics is classified into five generations on the basis of the spectrum of its activity?

a)

Cephalosporins

b)

Macrolides

c)

Tetracyclines

d)

Penicillins

155.

Antibiotics are natural chemicals, which are produced by

a)

microorganisms.

b)

metabolites.

c)

human cells.

d)

sulfa drugs.

156.

Antibiotics assist the surgical patient’s own defenses to prevent or diminish

a)

venereal diseases.

b)

lack of aseptic technique.

c)

growth of bacteria.

d)

surgical site infections.

157.

To cause an infection, a pathogen must have a(n)

a)

source.

b)

bacteria.

c)

unclean environment.

d)

S. aureus.

158.

Surgical instruments that are improperly cleaned prior to sterilization are an example of a(n) contaminating ____________.

a)

endogenous source.

b)

exogenous source.

c)

bactericidal source.

d)

resistant source.

159.

Which is the correct group of antibiotics that belong to the beta-lactam class?

a)

Penicillins, cephalosporins, carbapenems

b)

Cephalosporins, carbapenems, aminoglycosides

c)

Monobactams, aminoglycosides, macrolides

d)

Fluoroquinolones, aminoglycosides, penicillins

160.

A sulfonamide cream that is used as a topical dressing for burn patients is called

a)

bacitracin cream.

b)

silvadene cream.

c)

Chloromycetin.

d)

Cubicin.

161.

Acetic acid is used to

a)

remove small skin lesions.

b)

enhance radiographic studies.

c)

identify cervical dysplasia.

d)

reveal corneal abrasions

162.

All of the following dyes are blue except

a)

methylene blue.

b)

indigo carmine.

c)

Lymphazurin.

d)

Lugol solution.

163.

Which procedure uses methylene blue in order to verify patent tubes?

a)

Lymph node biopsy

b)

Cystoscopy

c)

Z-plasty

d)

Chromotubation

164.

The definition of a diuretic medication is an agent that prevents the reabsorption of sodium and water by the

a)

lungs.

b)

colon.

c)

kidneys.

d)

small intestines.

165.

Which term indicates an abnormally high concentration of potassium in the blood?

a)

Hypernatremia

b)

Creatinine

c)

Homeostasis

d)

Hyperkalemia

166.

The diuretic medication that draws fluid out of tissues and into the circulatory system is called

a)

osmotic.

b)

high ceiling.

c)

loop.

d)

thiazide.

167.

Which drug is classified as a loop diuretic medication and is used to decrease intracranial pressure?

a)

Aldactone

b)

Osmitrol

c)

Esidrix

d)

Lasix

168.

What cardiac condition requires treatment with diuretics?

a)

Congestive heart failure

b)

Bradycardia

c)

Tachycardia

d)

Cardiac arrhythmia

169.

Which electrolyte may be seriously depleted in patients taking certain diuretics?

a)

Sodium (Na⁺)

b)

Chloride (Cl⁻)

c)

Calcium (Ca)

d)

Potassium (K⁺)

170.

Diuretics cause the elimination of excess fluid by preventing the reabsorption of

a)

sodium.

b)

chloride.

c)

potassium.

d)

calcium.

171.

The only diuretic administered from the sterile back table is

a)

furosemide.

b)

hydrochlorothiazide.

c)

mannitol.

d)

acetazolamide.

172.

How many nephrons are present within the kidneys?

a)

Two

b)

Four

c)

Millions

d)

Hundreds

173.

Steroidal hormones that promote male characteristics are

a)

hypogonadists.

b)

recombinants.

c)

catecholamines.

d)

androgens.

174.

Nonsteroidal hormones are synthesized from

a)

cholesterol.

b)

amino acids.

c)

aldosterone.

d)

glucose.

175.

Which gland is called the master gland?

a)

Pituitary

b)

Adrenal

c)

Pancreas

d)

Parathyroid

176.

Which gland has both endocrine and exocrine functions?

a)

Pituitary

b)

Thyroid

c)

Pancreas

d)

Adrenal

177.

Which hormone is necessary for the stimulation of uterine contractions during labor and delivery?

a)

Thyroxine

b)

Oxytocin

c)

Pitressin

d)

Norepinephrine

178.

Oxytocin is available under which trade name?

a)

Pitocin

b)

Vasopressin

c)

Pitressin

d)

Celestone

179.

Epinephrine is combined with local anesthetics to

a)

prolong the effects of local anesthesia.

b)

inhibit the postoperative inflammatory response.

c)

induce amnesia.

d)

prevent blood clot formation.

180.

What will happen if epinephrine 1:1000 is injected?

a)

Bradycardia and hypotension

b)

Bradycardia and hypertension

c)

Tachycardia and hypertension

d)

Tachycardia and hypotension

181.

Drugs that relieve symptoms of a condition but do not cure it are

a)

palliative.

b)

recombinant.

c)

androgen.

d)

asymptomatic.

182.

The pancreatic duct transports all of the following into the duodenum except

a)

insulin.

b)

amylase.

c)

lipase.

d)

proteinase.

183.

Which one of the following hormones is given for palliative treatment of metastatic breast cancer and androgen-dependent prostate cancer?

a)

Testosterone

b)

Estrogen

c)

Progesterone

d)

Androgen

184.

Agents that inhibit the process of blood clot formation are called

a)

coagulants.

b)

anticoagulants.

c)

hemostatics.

d)

thrombolytics.

185.

Agents that dissolve already formed clots are called

a)

coagulants.

b)

anticoagulants.

c)

hemostatics.

d)

thrombolytics.

186.

During the third stage of blood clot formation, __________ is formed.

a)

thromboplastin

b)

prothrombin

c)

thrombin

d)

fibrin

187.

Which hemostatic agent creates a mechanical barrier to control bleeding?

a)

Tannic acid

b)

Silver nitrate

c)

Collastat

d)

Bone wax

188.

Which hemostatic agent causes a chemical burn to stop capillary bleeding?

a)

Silver nitrate

b)

Konakion

c)

Helistat

d)

Heparin

189.

Which parenteral anticoagulant is used most often?

a)

Protamine sulfate

b)

Calcium chloride

c)

Enoxaparin sodium

d)

Heparin sodium

190.

A “net” that traps blood cells to form a clot is called

a)

fibrin.

b)

thrombin.

c)

platelets.

d)

plasma.

191.

______________ is an example of a flowable form of absorbable gelatin.

a)

Gelfoam

b)

Gelfilm

c)

Tisseel

d)

Floseal

192.

Hemostatic agents are effective against major arterial or venous bleeding.

a)

True

b)

False

193.

What prep solution is acceptable for eyes, including the eyelids, brows, and cheeks?

a)

Lacri-lube

b)

Balanced salt solution

c)

Viscoat

d)

Betadine Ophthalmic

194.

Drugs that constrict the pupil by stimulating the iris muscle are called

a)

viscoelastic agents.

b)

miotics.

c)

mydriatics.

d)

Cycloplegics

195.

Major electrolytes found in body fluids are sodium, chloride, calcium, and

a)

glucose.

b)

potassium.

c)

creatinine.

d)

urea.

196.

Food and fluid restrictions preoperatively can result in the surgical patient needing

a)

food.

b)

IV fluids.

c)

blood replacement.

d)

oral medications.

197.

The intravenous (IV) solution used during blood transfusion is

a)

water.

b)

lactated Ringer solution.

c)

normal saline.

d)

plasmaLyte.

198.

Proteins responsible for transporting oxygen to cells are

a)

leukocytes.

b)

platelets.

c)

antigens.

d)

hemoglobin.

199.

Another name for donor blood is

a)

homologous.

b)

autologous.

c)

autotransfusion.

d)

synthetic.

200.

What blood product is given when clotting factors are required?

a)

Whole blood

b)

Packed cells

c)

Plasma

d)

Erythrocytes

201.

The irrigation solution that is conductive and is used with caution in the presence of the ESU is

a)

sterile water.

b)

physiosol.

c)

sobrital.

d)

saline.

202.

Which of the following is NOT a common route of drug administration?

a)

Subdermal

b)

Intravenous

c)

Oral

d)

Topical

203.

Which class of drugs is primarily used to prevent blood clot formation during surgery?

a)

Antibiotics

b)

Diuretics

c)

Anticoagulants

d)

Analgesics

204.

Which of the following is NOT considered one of the five rights of medication administration?

a)

Right dose.

b)

Right prescription.

c)

Right patient.

d)

Right route.

205.

What is the primary organ responsible for the metabolism of most drugs in the body?

a)

Liver

b)

Colon

c)

Kidneys

d)

Lungs