Practice Tests: Practice Exam #7 - 50 questions

All 50 questions are randomized each time you take the test, and do not appear in the same order here.

 
Pharmacological and Parenteral Therapies

1. A client is receiving intravenous heparin therapy. What medication should the nurse have available in the event of an overdose of heparin?
A) Protamine
B) Amicar
C) Imferon
D) Diltiazem

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2. Although nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Motrin) are beneficial in managing arthritis pain, the nurse should caution clients about which of the following common side effects?
A) Urinary incontinence
B) Constipation
C) Nystagmus
D) Occult bleeding

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3. A client is being discharged with a prescription for chlorpromazine (Thorazine). Before leaving for home, which of these findings should the nurse teach the client to report?
A) Change in libido, breast enlargement
B) Sore throat, fever
C) Abdominal pain, nausea, diarrhea
D) Dyspnea, nasal congestion

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4. The nurse receives an order to give a client iron by deep injection. The nurse know that the reason for this route is to
A) enhance absorption of the medication
B) ensure that the entire dose of medication is given
C) provide more even distribution of the drug
D) prevent the drug from causing tissue irritation

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5. A client diagnosed with cirrhosis of the liver and ascites is receiving spironolactone (Aldactone). The nurse understands that this medication spares elimination of which element?
A) Sodium
B) Potassium
C) Phosphate
D) Albumin

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6. Discharge instructions for a client taking alprazolam (Xanax) should include which of the following?
A) Sedative hypnotics are effective analgesics
B) Sudden cessation of alprazolam (Xanax) can cause rebound insomnia and nightmares
C) Caffeine beverages can increase the effect of sedative hypnotics
D) Avoidance of excessive exercise and high temperature is recommended

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7. A client has received 2 units of whole blood today following an episode of GI bleeding. Which of the following laboratory reports would the nurse monitor most closely?
A) Bleeding time
B) Hemoglobin and hematocrit
C) White blood cells
D) Platelets

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8. The nurse is caring for a client receiving a blood transfusion who develops urticaria one-half hour after the transfusion has begun. What is the first action the nurse should take?
A) Stop the infusion
B) Slow the rate of infusion
C) Take vital signs and observe for further deterioration
D) Administer Benadryl and continue the infusion

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9. A nurse is providing care to a 63 year-old client with pneumonia. Which intervention promotes the client’s comfort?
A) Increase oral fluid intake
B) Encourage visits from family and friends
C) Keep conversations short
D) Monitor vital signs frequently

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10. An antibiotic IM injection for a 2 year-old child is ordered. The total volume of the injection equals 2.0 ml. The correct action is to
A) administer the medication in 2 separate injections
B) give the medication in the dorsal gluteal site
C) call to get a smaller volume ordered
D) check with pharmacy for a liquid form of the medication

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11. A client is recovering from a hip replacement and is taking Tylenol #3 every 3 hours for pain. In checking the client, which finding suggests a side effect of the analgesic?
A) Bruising at the operative site
B) Elevated heart rate
C) Decreased platelet count
D) No bowel movement for 3 days

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12. Why is it important for the nurse to monitor blood pressure in clients receiving antipsychotic drugs?
A) Orthostatic hypotension is a common side effect
B) Most antipsychotic drugs cause elevated blood pressure
C) This provides information on the amount of sodium allowed in the diet
D) It will indicate the need to institute antiparkinsonian drugs

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13. A parent asks the school nurse how to eliminate lice from their child. What is the most appropriate response by the nurse?
A) Cut the child's hair short to remove the nits
B) Apply warm soaks to the head twice daily
C) Wash the child's linen and clothing in a bleach solution
D) Application of pediculicides

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14. The nurse has given discharge instructions to parents of a child on phenytoin (Dilantin). Which of the following statements suggests that the teaching was effective?
A) "We will call the health care provider if the child develops acne."
B) "Our child should brush and floss carefully after every meal."
C) "We will skip the next dose if vomiting or fever occur."
D) "When our child is seizure-free for 6 months, we can stop the medication."

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15. A client with heart failure has Lanoxin (digoxin) ordered. What would the nurse expect to find when evaluating for the therapeutic effectiveness of this drug?
A) Diaphoresis with decreased urinary output
B) Increased heart rate with increased respirations
C) Improved respiratory status and increased urinary output
D) Decreased chest pain and decreased blood pressure

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16. The nurse is teaching a client about precautions with Coumadin therapy. The client should be instructed to avoid which over-the-counter medication?
A) Non-steroidal anti-inflammatory drugs (NSAIDs)
B) Cough medicines with guaifenesin
C) Histamine blockers
D) Laxatives containing magnesium salts

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17. The nurse is caring for a client with clinical depression who is receiving a monoamine oxidase inhibitor (MAOI). When providing instructions about precautions with this medication, which action should the nurse stress to the client as important?
A) Avoid chocolate and cheese
B) Take frequent naps
C) Take the medication with milk
D) Avoid walking without assistance

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18. The nurse has been teaching a client with Insulin Dependent Diabetes Mellitus. Which statement by the client indicates a need for further teaching?
A) "I use a sliding scale to adjust regular insulin to my sugar level."
B) "Since my eyesight is so bad, I ask the nurse to fill several syringes."
C) "I keep my regular insulin bottle in the refrigerator."
D) "I always make sure to shake the NPH bottle hard to mix it well."

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19. A client with amyotrophic lateral sclerosis has a percutaneous endoscopic gastrostomy (PEG) tube for the administration of feedings and medications. Which nursing action is appropriate?
A) Pulverize all medications to a powdery condition
B) Squeeze the tube before using it to break up stagnant liquids
C) Cleanse the skin around the tube daily with hydrogen peroxide
D) Flush adequately with water before and after using the tube

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20. While providing home care to a client with congestive heart failure, the nurse is asked how long diuretics must be taken. What is the nurse’s best response?
A) "As you urinate more, you will need less medication to control fluid."
B) "You will have to take this medication for about a year."
C) "The medication must be continued so the fluid problem is controlled."
D) "Please talk to your health care provider about medications and treatments."

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Q&A Pharmacology



1. A post-operative client has a prescription for acetaminophen with codeine. What should the nurse recognizes as a primary effect of this combination?
A) Enhanced pain relief
B) Minimized side effects
C) Prevention of drug tolerance
D) Increased onset of action

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2. A nurse is caring for a client who is receiving methyldopa hydrochloride (Aldomet) intravenously. Which of the following assessment findings would indicate to the nurse that the client may be having an adverse reaction to the medication?
A) Headache
B) Mood changes
C) Hyperkalemia
D) Palpitations

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3. When providing discharge teaching to a client with asthma, the nurse will warn against the use of which of the following over-the-counter medications?
A) Cortisone ointments for skin rashes
B) Aspirin products for pain relief
C) Cough medications containing guaifenesin
D) Histamine blockers for gastric distress

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4. The nurse practicing in a long term care facility recognizes that elderly clients are at greater risk for drug toxicity than younger adults because of which of the following physiological changes of advancing age?
A) Drugs are absorbed more readily from the GI tract
B) Elders have less body water and more fat
C) The elderly have more rapid hepatic metabolism
D) Older people are often malnourished and anemic

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5. In providing care for a client with pain from a sickle cell crisis, which one of the following medication orders for pain control should be questioned by the nurse?
A) Demerol
B) Morphine
C) Methadone
D) Codeine

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6. The nurse is administering diltiazem (Cardizem) to a client. Prior to administration, it is important for the nurse to assess which parameter?
A) Temperature
B) Blood pressure
C) Vision
D) Bowel sounds

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7. A client with an aplastic sickle cell crisis is receiving a blood transfusion and begins to complain of "feeling hot." Almost immediately, the client begins to wheeze. What is the nurse's first action?
A) Stop the blood infusion
B) Notify the health care provider
C) Take/record vital signs
D) Send blood samples to lab

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8. A client with atrial fibrillation is receiving digoxin (Lanoxin). Which of these assessments is most important for the nurse to perform?
A) Monitor blood pressure every 4 hours
B) Measure apical pulse prior to administration
C) Maintain accurate intake and output records
D) Record an EKG strip after administration

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9. The nurse is caring for a 10 year-old client who will be placed on heparin therapy. Which assessment is critical for the nurse to make before initiating therapy
A) Vital signs
B) Weight
C) Lung sounds
D) Skin turgor

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10. The use of atropine for treatment of symptomatic bradycardia is contraindicated for a client with which of the following conditions?
A) Urinary incontinence
B) Glaucoma
C) Increased intracranial pressure
D) Right sided heart failure

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11. The health care provider orders an IV aminophylline infusion at 30 mg/hr. The pharmacy sends a 1,000 ml bag of D5W containing 500 mg of aminophylline. In order to administer 30 mg per hour, the RN will set the infusion rate at:
A) 20 ml per hour
B) 30 ml per hour
C) 50 ml per hour
D) 60 ml per hour

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12. The nurse is applying silver sulfadiazine (Silvadene) to a child with severe burns to arms and legs. Which side effect should the nurse be monitoring for?
A) Skin discoloration
B) Hardened eschar
C) Increased neutrophils
D) Urine sulfa crystals

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13. The nurse is caring for a client who is receiving procainamide (Pronestyl) intravenously. It is important for the nurse to monitor which of the following parameters?
A) Hourly urinary output
B) Serum potassium levels
C) Continuous EKG readings
D) Neurological signs

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14. The nurse is teaching a parent how to administer oral iron supplements to a 2 year-old child. Which of the following interventions should be included in the teaching?
A) Stop the medication if the stools become tarry green
B) Give the medicine with orange juice and through a straw
C) Add the medicine to a bottle of formula
D) Administer the iron with your child's meals

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15. A client with bi-polar disorder is taking lithium (Lithane). What should the nurse emphasize when teaching about this medication?
A) Take the medication before meals
B) Maintain adequate daily salt intake
C) Reduce fluid intake to minimize diuresis
D) Use antacids to prevent heartburn

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16. The nurse is assessing a 7 year-old after several days of treatment for a documented strep throat. Which of the following statements suggests that further teaching is needed?
A) "Sometimes I take my medicine with fruit juice."
B) "My mother makes me take my medicine right after school."
C) "Sometimes I take the pills in the morning and other times at night."
D) "I am feeling much better than I did last week."

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17. An elderly client is on an anticholinergic metered dose inhaler (MDI) for chronic obstructive pulmonary disease. The nurse would suggest a spacer to
A) enhance the administration of the medication
B) increase client compliance
C) improve aerosol delivery in clients who are not able to coordinate the MDI
D) prevent exacerbation of COPD

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18. The nurse is providing education for a client with newly diagnosed tuberculosis. Which statement should be included in the information that is given to the client?
A) "Isolate yourself from others until you are finished taking your medication."
B) "Follow up with your primary care provider in 3 months."
C) "Continue to take your medications even when you are feeling fine."
D) "Continue to get yearly tuberculin skin tests."

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19. The nurse is administering an intravenous vesicant chemotherapeutic agent to a client. Which assessment would require the nurse's immediate action?
A) Stomatitis lesion in the mouth
B) Severe nausea and vomiting
C) Complaints of pain at site of infusion
D) A rash on the client's extremities

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20. The nurse is instructing a client with moderate persistent asthma on the proper method for using MDIs (multi-dose inhalers). Which medication should be administered first?
A) Steroid
B) Anticholinergic
C) Mast cell stabilizer
D) Beta agonist

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21. The nurse is teaching a group of women in a community clinic about prevention of osteoporosis. Which of the following over-the-counter medications should the nurse recognize as having the most elemental calcium per tablet?
A) Calcium chloride
B) Calcium citrate
C) Calcium gluconate
D) Calcium carbonate

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22. The provider has ordered daily high doses of aspirin for a client with rheumatoid arthritis. The nurse instructs the client to discontinue the medication and contact the provider if which of the following symptoms occur?
A) Infection of the gums
B) Diarrhea for more than one day
C) Numbness in the lower extremities
D) Ringing in the ears

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23. A 5 year-old has been rushed to the emergency room several hours after acetaminophen poisoning. Which laboratory result should receive attention by the nurse?
A) Sedimentation rate
B) Profile 2
C) Bilirubin
D) Neutrophils

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24. The nurse is caring for a client with schizophrenia who has been treated with quetiapine (Seroquel) for 1 month. Today the client is increasingly agitated and complains of muscle stiffness. Which of these findings should be reported to the health care provider?
A) Elevated temperature and sweating.
B) Decreased pulse and blood pressure.
C) Mental confusion and general weakness.
D) Muscle spasms and seizures.

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25. A client is receiving dexamethasone (Decadron) therapy. What should the nurse plan to monitor in this client?
A) Urine output every 4 hours
B) Blood glucose levels every 12 hours
C) Neurological signs every 2 hours
D) Oxygen saturation every 8 hours

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26. The nurse is teaching a child and the family about the medication phenytoin (Dilantin) prescribed for seizure control. Which of the following side effects is most likely to occur?
A) Vertigo
B) Drowsiness
C) Gingival hyperplasia
D) Vomiting

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27. A newly admitted client has a diagnosis of depression. She complains of “twitching muscles” and a “racing heart”, and states she stopped taking Zoloft a few days ago because it was not helping her depression. Instead, she began to take her partner's Parnate. The nurse should immediately assess for which of these adverse reactions?
A) Pulmonary edema
B) Atrial fibrillation
C) Mental status changes
D) Muscle weakness

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28. A client has been receiving dexamethasone (Decadron) for control of cerebral edema. Which of the following assessments would indicate that the treatment is effective?
A) A positive Babinski's reflex
B) Increased response to motor stimuli
C) A widening pulse pressure
D) Temperature of 37 degrees Celsius

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29. The nurse is assessing a client who is on long term glucocorticoid therapy. Which of the following findings would the nurse expect?
A) Buffalo hump
B) Increased muscle mass
C) Peripheral edema
D) Jaundice

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30. A client is ordered atropine to be administered preoperatively. Which physiological effect should the nurse monitor for?
A) Elevate blood pressure
B) Drying up of secretions
C) Reduce heart rate
D) Enhance sedation

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Practice Tests: Practice Exam #7 - 50 questions