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RASMUSSEN PHARMACOLOGY EXAM 1, 2, 3 AND FINAL
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RASMUSSEN PHARMACOLOGY EXAM 1
A nurse is caring for a client experiencing IV extravasation. The facility requires the administration of an antidote for the prescribed IV solution. After stopping the IV infusion, which of the following actions should the nurse take first?
A. Remove the IV catheter. B. Withdraw the solution from the IV access. C. Administer the antidote to the vesicant. D. Insert a new IV access in a different extremity. ---------CORRECT ANSWER-----------------B. Withdraw the solution from the IV access. According to evidence-based practice, the nurse should first withdraw the solution from the IV access. This reduces the amount of vesicant in the body, and lowers the risk of tissue damage. A nurse is preparing to administer an IM dose of penicillin to a client who has a new prescription. The client states when they took penicillin 3 years ago, they developed a rash. Which of the following actions should the nurse take?
A. Administer the prescribed dose. B. Withhold the medication. C. Ask the provider to change the prescription to an oral form. D. Administer an oral antihistamine at the same time. ---------CORRECT ANSWER-----------------B. Withhold the medication and notify the provider of the client's previous reaction to penicillin so that an alternative antibiotic can be prescribed. Allergic reactions to penicillin can range from mild to severe anaphylaxis, and prior sensitization should be reported to the provider.
A nurse is reviewing a client's health record and notes that the client experienced permanent extrapyramidal effects caused by a previous medication. The nurse should recognize that the medication affected which of the following systems in the client?
A. Cardiovascular B. Immune C. Central nervous D. Gastrointestinal ---------CORRECT ANSWER-----------------Central nervous. C. CORRECT: Realize that extrapyramidal effects are movement disorders that can be caused by a number of central nervous system medications (traditional/FGA antipsychotic medications). A nurse is teaching a client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include? A. Increase intake of protein-rich foods. B. Expect muscle twitching to occur. C. Take this medication with food. D. Anticipate relief of manifestations in 24 hr. ---------CORRECT ANSWER-- ---------------C. The client should take this medication with food to reduce GI effects. A nurse is caring for a client who is receiving moderate sedation with diazepam IV. The client is oversedated. Which of the following medications should the nurse expect to administer to this client? A. Ketamine B. Naltrexone C. Flumazenil D. Fluvoxamine ---------CORRECT ANSWER-----------------C. CORRECT: Flumazenil is a competitive benzodiazepine antagonist used to reverse the sedation and other effects of benzodiazepines.
D. Weight loss ---------CORRECT ANSWER-----------------A. CORRECT: Orthostatic hypotension is an adverse of effect of MAOIs, including phenelzine A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.) A. Expect therapeutic effects in 24 to 48 hr. B. Discontinue the medication after a week of improved mood. C. Change positions slowly to minimize dizziness. D. Decrease dietary fiber intake to control diarrhea. E. Chew sugarless gum to prevent dry mouth. ---------CORRECT ANSWER-----------------C. CORRECT: Changing positions slowly helps prevent orthostatic hypotension, which is an adverse effect of amitriptyline. E. CORRECT: Chewing sugarless gum can minimize dry mouth, which is an adverse effect of amitriptyline. A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for posttraumatic stress disorder. Which of the following statements should the nurse include in the teaching? A. "You can have a decreased desire for intimacy while taking this medication." B. "You should take this medication at bedtime to help promote sleep." C. "You will have fewer urinary adverse effects if you urinate just before taking this medication." D. "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication." ---------CORRECT ANSWER----------- ------A. CORRECT: Decreased libido is a potential adverse effect of fluoxetine and other SSRIs
A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome? A. Bruising B. Fever C. Tinnitus D. Rash ---------CORRECT ANSWER-----------------B. CORRECT: Fever is a manifestation of serotonin syndrome, which can result from taking an SSRI such as sertraline. A nurse is reviewing laboratory findings and notes that a client's lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse?
A. Hold the medication and notify the provider. B. Prepare the client for hemodialysis. C. Administer an additional oral dose of lithium. D. Request a stat repeat of the laboratory test. ---------CORRECT ANSWER-----------------A. CORRECT: Hold the medication and notify the provider is the appropriate action for a client who has severe toxicity, as evidenced by a plasma lithium level of 2.1 mEq/L. A nurse is caring for a client who has a new prescription for lithium. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following? A. Avoid the use of acetaminophen for headaches. B. Restrict intake of foods rich in sodium. C. Decrease fluid intake to less than 1,500 mL daily. D. Limit aerobic activity in hot weather. ---------CORRECT ANSWER---------- -------D. CORRECT: The client should avoid activities that have the potential to cause sodium/water depletion, which can increase the risk for toxicity.
A. Constipation B. Neck spasms C. Drowsiness D. Sexual dysfunction ---------CORRECT ANSWER-----------------B. CORRECT: Neck spasms are an indication of acute dystonia (EPS). The greatest risk to this client is respiratory insufficiency if the laryngeal muscles are also effected. Therefore, this is the priority finding to report. A patient asks the nurse about drug interactions with OTC preparations. What is the nurse's best response? A. "Discuss this with the health care provider." B. "There are not many interactions, so don't worry about it." C. "Read the labels carefully, and check with your health care provider." D. "Avoid over-the-counter preparations." ---------CORRECT ANSWER------ -----------C. "Read the labels carefully, and check with your health care provider." The patient should always check with the healthcare provider prior to starting new medications, and since this is referring to OTCs, the patient should also read labels for interactions and contraindications. A provider prescribes phenobarbital for a client who has a seizure disorder. The medication has a long half-life of 4 days. How many times per day should the nurse expect to administer this medication? A.One B.Two C.Three D.Four ---------CORRECT ANSWER-----------------•A. One. Medications with long half-lives remain at their therapeutic levels between doses for long periods of time. The nurse should expect to administer this medication once a day.
A nurse educator is reviewing medication metabolism at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? A. Increased renal excretion B. Increased medication-metabolizing enzymes C. Liver failure D. Hypertension ---------CORRECT ANSWER-----------------C. Liver failure. Liver failure decreases metabolism and thus increases the concentration of a medication. This requires decreasing the dosage. A nurse is teaching a client about transdermal patches. Which of the following statements should the nurse identify as an indication that the client understands?
A. "It doesn't' matter if I clean the site before I apply the patch." B. "I will rotate the application sites weekly." C. "I will apply the patch to an area of skin with no hair." D. "I will place the new patch on the site of the old patch." --------- CORRECT ANSWER-----------------C. "I will apply the patch to an area of skin with no hair."The client should apply the patch to a hairless area of skin to promote absorption of the medication. A nurse is preparing a client's medications. Which of the following actions should the nurse take in following legal practice guidelines? (Select all that apply.)
A. Teach the client about the medication. B. Determine the dosage. C. Monitor for adverse effects. D. Lock compartments for controlled substances. E. Determine the client's insurance status. ---------CORRECT ANSWER----- ------------A. Teach the medication as part of the rights of medication administration.
not receive a medication and are different from instances where an undesirable effect or more monitoring are needed. A nurse is assessing a client before administering medications. Which of the following data should the nurse obtain? (Select all that apply.)
A. Use of herbal products B. Daily fluid intake C. Ability to swallow D. Allergies ---------CORRECT ANSWER-----------------A. CORRECT: Inquire about the client's use of herbal products, which often contain caffeine, prior to medication administration because caffeine can affect medication biotransformation.
C. CORRECT: Determine the client's ability to swallow to see what route or formulation of the medication the client requires.
D. CORRECT: Inquire about food allergies during the preassessment to identify any potential reactions or interactions. A nurse is working with a newly licensed nurse who is administering medications to clients. Which of the following actions should the nurse identify as an indication that the newly hired nurse understands medication error prevention?
A. Taking all medications out of the unit-dose wrappers before entering the client's room B. Checking the prescription when a single dose requires administration of multiple tablets C. Administering a medication, then looking up the usual dosage range D. Relying on another nurse to clarify a medication prescription --------- CORRECT ANSWER-----------------B. Checking the prescription when a single dose requires administration of multiple tablets. If a single dose requires multiple tablets, it is possible that an error has occurred in the prescription or transcription of the medication. This action could prevent a medication error.
You have been assigned to care for Jim. He is 29 and has been diagnosed with schizophrenia. Jim has been prescribed chlorpromazine. He lives with his parents. You have been asked to talk with Jim's family. His parents have questions about the side effects of chlorpromazine. While Jim is in a group session, you meet with his parents. The mother asks what Jim's provider means by saying that chlorpromazine causes EPS. Which teaching statement by the nurse regarding EPS is INCORRECT? --------- CORRECT ANSWER-----------------"There are many drugs to manage late EPS" Jim's mom says that if these symptoms create problems, she wants to know what can be done to help the situation. Which response by the nurse would be appropriate? ---------CORRECT ANSWER-----------------"Early EPS can be treated with anticholinergic drugs, beta blockers, or benzos" Jim's mother states that she is concerned. "Understand that Jim will need to take the medication for the rest of his life. How am I ever going to get him to take these pills if the side effects are so bad?" Which teaching statement by the nurse is INCORRECT? ---------CORRECT ANSWER------- ----------"Adherence can be improved by hiding Jim's pills in his morning eggs." You are a nursing student on your medical surgical rotation. Mrs. S. has been diagnosed with depression. As part of her treatment, she has been prescribed fluoxetine. Your clinical instructor has informed you that Mrs. S has many questions about the use of fluoxetine for the treatment of depression. Mrs. S asks: "How does fluoxetine work?" Which response by the nurse would be most appropriate? ---------CORRECT ANSWER----------- ------"Fluoxetine increases the concentration of serotonin in the synapse, minimizing the symptoms of depression."
CORRECT ANSWER-----------------Therapeutic range needs to be routinely evaluated with a blood test. You are working at a community wellness center for one of your clinical rotations. a 57 yr old woman, Ms. L, comes into the wellness center and asks to speak with you. She states that she cannot sleep and you begin to ask her questions about the nature of her sleep disturbance. Which response by the nurse would be most appropriate? ---------CORRECT ANSWER-----------------It is important to collect baseline data about the nature of your sleep disturbances to determine the best possible treatment. Ms. L sees the primary care provider at the wellness center and is prescribed triazolam to help with her sleep disturbance. As Ms. L is leaving the wellness center, she says to you, "Well, now that I have the pill, I'll be on my way. This is all I need." Which response by the nurse would be most appropriate? ---------CORRECT ANSWER-----------------"It would be best for you to not rely on the drug alone to assist with sleep. If you have a minute, I'd like to review some healthy tips for getting a better night sleep." Ms. L asks you another question, "Why wouldn't the prescriber give me a refill on this prescription?". Which response by the nurse would be most appropriate? ---------CORRECT ANSWER-----------------Insomnia is usually self-limiting. Drug therapy should be short-term. What can you tell me about paroxetine?....Which response by the nurse would be most appropriate? ---------CORRECT ANSWER----------------- Paroxetine allows the brain to have increased levels of serotonin, which should lessen feelings of anxiety.
You are the nurse doing home visits in a retirement community. Your client is an 85 yr old man who has been diagnosed with Alzheimers disease. His adult children are with him for the visit. They want to know about the disease and what treatment options exist. After you explain the progression of the disease, they ask if it is curable. How should you answer? --------- CORRECT ANSWER-----------------There are medications that may help delay cognitive decline, but the disease is not curable. Next, they ask how the drug done-evil can work to help his disease. How should you answer? ---------CORRECT ANSWER-----------------It prevents the breakdown of ACh, so more is available for transmitting nerve impulses. They also asks what side effects they can expect Dad to have with donepezil. How should you answer? ---------CORRECT ANSWER------------- ----The most common effects are nausea and diarrhea, but vomiting, dyspepsia, dizziness, and headaches are also common. Teaching statements about interferon that are CORRECT. --------- CORRECT ANSWER-----------------Interferon beta is a naturally occurring glycoprotein within the body, interferon beta can decrease the frequency and severity of attacks, and interferon beta suppresses T-helper cell activity in the immune system. Teaching statement about interferon beta that is INCORRECT --------- CORRECT ANSWER-----------------Interferon beta prevents infections by strengthening the immune system
Which statement made by the nurse would be inappropriate to include in the teaching plan for this client? ---------CORRECT ANSWER----------------- "Take the medication with a glass of grapefruit juice each morning." My son is John Smith. He is 8 yrs old and the dr put him on methylphenidate. He has been on it for 10 days now. John weighs 62lbs and when my friends son went on methylphenidate he lost weight. Will this happen to John? Which response by the nurse is most appropriate? --------- CORRECT ANSWER-----------------"Giving John his first dose of methylphenidate after breakfast and his second dose in the early afternoon is the most effective strategy for preventing weight loss." Why aren't the pills making it easier for him to sleep? Which teaching statement by the nurse is INCORRECT? ---------CORRECT ANSWER------- ----------"Your child probably is not sleeping because he plays too many video games. If you take away his video games, he should begin to sleep better." The parent states, "I'm just going to stop the pills. I don't care what the doctor says. I think the pills aren't good for him." Which response by the nurse would be appropriate? ---------CORRECT ANSWER-----------------"You should discuss your concerns with John's provider. Discontinuing medications suddenly can lead to extreme fatigue and depression." Characteristics to consider in pharmacology ---------CORRECT ANSWER--- --------------Effectiveness, safety, selectiveness Maximum benefit with minimal harm Properties to Consider in pharmacology ---------CORRECT ANSWER-------- ---------Can the patient afford the medication? Can the patient physically
take the medication? Will this medication interact with other medications the patient is taking? 5 rights of medication administration ---------CORRECT ANSWER------------- ----right patient, right drug, right dose, right route, right time Medication Errors Stats ---------CORRECT ANSWER-----------------According to an FDA 2016 update, medication errors injure approximately 1.3 mil people each year. John Hopkins researchers estimate 400,000 deaths annually from errors What medications can't be crushed? ---------CORRECT ANSWER------------- ----time released: XR, XL, SR, ER Pharmacokinetic ---------CORRECT ANSWER-----------------Process whereby drugs move throughout the body (absorption, distribution, metabolism, and excretion) to achieve drug action. Absorption ---------CORRECT ANSWER-----------------movement of a drug from it's site of administration into the bloodstream A client taking phenytoin suddenly develops hives. What is the best explanation for this occurrence and the nurse's best response? --------- CORRECT ANSWER-----------------An allergic response and the medication should be stopped
Which of the following is least likely to occur during the assessment phase of drug therapy? ---------CORRECT ANSWER-----------------Developing outcomes for effective responses to drug therapy After administering a medication, the client complains of an upset stomach. The nurse recognizes this as a negative effect of the drug and identifies it as which of the following? ---------CORRECT ANSWER-----------------Side effect A child diagnosed with ADHD begins taking a CNS stimulant. Which statement by the child's parents indicates a need for further teaching? ------ ---CORRECT ANSWER-----------------This drug will make my child more impulsive at school Which side effects of a cholinesterase inhibitor would be most concerning to a nurse? ---------CORRECT ANSWER-----------------Symptomatic bradycardia that may lead to fainting A client is taking a FGA and the nurse notices the client has trouble speaking, chewing and observes slow, worm-like movement of the tongue. The nurse suspects which of the following adverse effects is occurring? ---- -----CORRECT ANSWER-----------------Tardive dyskinesia A client is receiving lamotrigine as a treatment for partial seizures. Which assessment finding will lead the nurse to stop the drug and contact the provider immediately? ---------CORRECT ANSWER-----------------Rash
A client tells their provider they have had difficulty sleeping for the past 6 months. They are requesting a sleep aid to take as needed. Which med would the nurse expect? ---------CORRECT ANSWER----------------- Alprazolam The nurse should include which intervention in the care-plan for a patient on lithium? ---------CORRECT ANSWER-----------------Report impaired coordination and tremors A teenager was brought into the ER following a lorazepam overdose. What antidote should the nurse expect to administer? ---------CORRECT ANSWER-----------------Flumazenil The provider ordered diazepam 2.5 mg. Available is 5mg/mL. How many mL do you give? ---------CORRECT ANSWER-----------------0. A nurse is preparing to administer a drug. The drug has been linked to symptoms of Parkinson's disease in some clients. What should the nurse do? ---------CORRECT ANSWER-----------------Warn the client about the effects and provide assurance A client reportedly overdosed on phenobarbital. What medication does the nurse expect to administer? ---------CORRECT ANSWER----------------- Activated charcoal If handwritten orders are illegible, what should the nurse do? --------- CORRECT ANSWER-----------------Contact the provider to clarify order
