Question 1

The nurse is reinforcing education to a client newly prescribed levetiracetam for seizures.  Which statement made by the client indicates a need for further instruction?

Accepted Answer

A) "Drowsiness is a common side effect of this medication and will improve over time." 
B) "I can begin driving again after I have been on this medication for a few weeks." 
C) "I need to immediately report any new or increased anxiety when on this medication." 
D) "I need to immediately report any new rash when on this medication."

Question 2

The nurse develops a teaching care plan for the client with a prescription to change antidepressant medications from imipramine to phenelzine.  Which instruction is appropriate to include in the teaching?

Accepted Answer

A) Continue avoiding foods high in tyramine until the imipramine withdrawal period is over 
B) Skip the nighttime dose of imipramine and start the phenelzine the next morning 
C) Taper down the imipramine, then discontinue for 2 weeks before starting phenelzine 
D) Taper down the imipramine while gradually increasing the phenelzine

Question 3

A client with chronic heart failure developed an intractable cough and an incident of angioedema after starting enalapril.  Which prescription does the nurse anticipate for this client?

Accepted Answer

A) Alprazolam 
B) Dextromethorphan 
C) Lisinopril 
D) Valsartan

Question 4

A client is prescribed long-term pharmacologic therapy with hydroxychloroquine to treat systemic lupus erythematosus.  Which intervention related to the drug's adverse effects should the nurse include in the teaching plan?

Accepted Answer

A) Have an ophthalmologic examination every 6 months 
B) Take the medication on an empty stomach 
C) Take vitamin D and calcium supplements 
D) Wear a MedicAlert bracelet

Question 5

The nurse is caring for a client who started receiving chemotherapy 10 days ago.  Today, the health care provider prescribes filgrastim.  Which of the following is an expected outcome of this medication?

Accepted Answer

A) Decrease in serum uric acid 
B) Increase in hemoglobin level 
C) Increase in neutrophil count 
D) Increase in platelet count

Question 6

A client in the emergency department is being discharged with a prescription for trimethoprim-sulfamethoxazole.  Which statement by the client would indicate a need for further evaluation?

Accepted Answer

A) "I developed a whole-body rash while on glyburide." 
B) "I drink at least 5 large bottles of water daily." 
C) "I had to stop using lisinopril due to a bad cough." 
D) "I have a birth control implant in place."

Question 7

An elderly client with depression, diabetes mellitus, and heart failure has received a new digoxin prescription for daily use.  Which client assessment indicates that the nurse should follow up on serum digoxin levels frequently?

Accepted Answer

A) Apical heart rate is 62/min 
B) Blood sugar level is 240 mg/dL (13.3 mmol/L) 
C) Client is taking 20 mg fluoxetine daily 
D) Serum creatinine is 2.3 mg/dL (203 µmol/L)

Question 8

The health care provider (HCP) prescribes naproxen for a client who has degenerative joint disease.  What instructions regarding this drug does the nurse include in the client's discharge plan?  Select all that apply.

Accepted Answer

A) Avoid driving while taking this medicine 
B) Change positions slowly 
C) Discontinue immediately if suicidal thoughts occur 
D) Notify the HCP of tarry stools 
E) Take the medicine with food

Question 9

A 45-year-old client with atrial fibrillation has been prescribed diltiazem.  Which client outcome would best indicate that the medication has had its intended effect?

Accepted Answer

A) Atrial fibrillation is converted to sinus rhythm 
B) Blood pressure is 126/78 mm Hg 
C) No signs or symptoms of stroke 
D) Ventricular rate decreased from 158/min to 88/min

Question 10

A 24-year-old female client is prescribed isotretinoin for severe cystic acne.  Which instruction is most important for the nurse to reinforce?

Accepted Answer

A) Apply lubricating eye drops when wearing contacts 
B) Do not break, crush, or chew capsules 
C) Use sunscreen routinely during therapy 
D) Use two forms of contraception consistently

Question 11

The nurse is speaking to a client who takes desmopressin nasal spray for diabetes insipidus.  Which statement by the client is most important for the nurse to report to the health care provider?

Accepted Answer

A) "I am tired of restricting my fluids but know I need to." 
B) "I feel like I am beginning to get sick with a bad cold." 
C) "I have been getting a lot of nasal pain with this spray." 
D) "I have recently started to experience frequent headaches."

Question 12

An elderly client with depression is given trazodone.  Which statement by the client indicates that additional teaching is needed?

Accepted Answer

A) "I will call the health care provider if I develop a prolonged erection." 
B) "I will get up slowly, in stages, from supine to standing." 
C) "I will take this medication at night to avoid daytime drowsiness." 
D) "It is okay to drink 2 glasses of wine at night."

Question 13

A client in the emergency department has an acute myocardial infarction.  The health care provider (HCP) has prescribed thrombolytic therapy.  Which assessment data should the nurse report immediately to the HCP?

Accepted Answer

A) Client has a history of cerebral arteriovenous malformation 
B) Client is currently menstruating 
C) Client rates chest pain as 8 on a scale of 0-10 
D) Current blood pressure is 170/92 mm Hg

Question 14

The nurse in an ambulatory care center is teaching a client with a diagnosis of persistent depressive disorder (dysthymia) about the appropriate use of bupropion hydrochloride SR.  Which statement made by the client indicates a need for further teaching?

Accepted Answer

A) "If I have a sudden change in my mood, I should call my physician immediately." 
B) "If I have trouble swallowing the tablet, I can cut it in half." 
C) "If I miss a dose, I should not double the next dose to catch up." 
D) "It may take several weeks before I get better."

Question 15

The nurse has provided education for a client newly prescribed alprazolam for generalized anxiety disorder.  Which client statement indicates that teaching has been effective?

Accepted Answer

A) "Eliminating aged cheeses and processed meats from my diet is essential." 
B) "I can skip doses on days that I am not feeling anxious." 
C) "I will take my daily dose at bedtime." 
D) "Using sunscreen is important as this drug will make me sensitive to sunlight."

Question 16

The nurse prepares to administer clozapine to a client with schizophrenia.  Which client statement would require priority investigation before administering the medication?

Accepted Answer

A) "I have gained a few pounds since I started this medication." 
B) "I have had a sore throat for 3 days and feel feverish today." 
C) "I have noticed increased salivation and drooling." 
D) "I often feel sleepy when I take this medication."

Question 17

A client is being discharged on enoxaparin therapy following total knee replacement surgery.  Which teaching instruction does the nurse include in the teaching plan?

Accepted Answer

A) "Eliminate green, leafy, vitamin K-rich vegetables from your diet." 
B) "Mild bruising or redness may occur at the injection site." 
C) "You can take over-the-counter drugs such as ibuprofen to relieve mild discomfort." 
D) "You will need PT/INR assessments at regular intervals while on enoxaparin therapy."

Question 18

The nurse in the same-day surgery unit admits a client who will receive general anesthesia.  The client has never had surgery before.  Which question is most critical for the nurse to ask the client during the preoperative assessment and health history?

Accepted Answer

A) "Has any family member ever had a bad reaction to general anesthesia?" 
B) "Have you ever experienced low back pain?" 
C) "Have you ever had an anaphylactic reaction to a bee sting?" 
D) "Have you ever received opioid pain medications?"

Question 19

The nurse is caring for a child with Kawasaki disease who is receiving IV immunoglobulin.  The child's parent wants to know why this treatment is required.  The nurse explains that this therapy is given to:

Accepted Answer

A) Fight the infection 
B) Minimize rash 
C) Prevent heart disease 
D) Reduce spleen size

Question 20

A client is 6 hours postoperative from hip surgery after receiving regional anesthesia and has epidural continuous anesthesia in place.  Which is the most important reason for the nurse to contact the health care provider?

Accepted Answer

A) Client reports paresthesia bilaterally since the surgery 
B) Fondaparinux is prescribed for STAT administration 
C) Lower-extremity muscle strength is 3/5 bilaterally 
D) Postoperative laboratory results show hemoglobin of 9.9 g/dL (99 g/L)

Exam 8: Pharmacology

The nurse is reinforcing education to a client newly prescribed levetiracetam for seizures. Which statement made by the client indicates a need for further instruction?

The nurse develops a teaching care plan for the client with a prescription to change antidepressant medications from imipramine to phenelzine. Which instruction is appropriate to include in the teaching?

A client with chronic heart failure developed an intractable cough and an incident of angioedema after starting enalapril. Which prescription does the nurse anticipate for this client?

A client is prescribed long-term pharmacologic therapy with hydroxychloroquine to treat systemic lupus erythematosus. Which intervention related to the drug's adverse effects should the nurse include in the teaching plan?

The nurse is caring for a client who started receiving chemotherapy 10 days ago. Today, the health care provider prescribes filgrastim. Which of the following is an expected outcome of this medication?

A client in the emergency department is being discharged with a prescription for trimethoprim-sulfamethoxazole. Which statement by the client would indicate a need for further evaluation?

An elderly client with depression, diabetes mellitus, and heart failure has received a new digoxin prescription for daily use. Which client assessment indicates that the nurse should follow up on serum digoxin levels frequently?

The health care provider (HCP) prescribes naproxen for a client who has degenerative joint disease. What instructions regarding this drug does the nurse include in the client's discharge plan? Select all that apply.

A 45-year-old client with atrial fibrillation has been prescribed diltiazem. Which client outcome would best indicate that the medication has had its intended effect?

A 24-year-old female client is prescribed isotretinoin for severe cystic acne. Which instruction is most important for the nurse to reinforce?

The nurse is speaking to a client who takes desmopressin nasal spray for diabetes insipidus. Which statement by the client is most important for the nurse to report to the health care provider?

An elderly client with depression is given trazodone. Which statement by the client indicates that additional teaching is needed?

A client in the emergency department has an acute myocardial infarction. The health care provider (HCP) has prescribed thrombolytic therapy. Which assessment data should the nurse report immediately to the HCP?

The nurse in an ambulatory care center is teaching a client with a diagnosis of persistent depressive disorder (dysthymia) about the appropriate use of bupropion hydrochloride SR. Which statement made by the client indicates a need for further teaching?

The nurse has provided education for a client newly prescribed alprazolam for generalized anxiety disorder. Which client statement indicates that teaching has been effective?

The nurse prepares to administer clozapine to a client with schizophrenia. Which client statement would require priority investigation before administering the medication?

A client is being discharged on enoxaparin therapy following total knee replacement surgery. Which teaching instruction does the nurse include in the teaching plan?

The nurse in the same-day surgery unit admits a client who will receive general anesthesia. The client has never had surgery before. Which question is most critical for the nurse to ask the client during the preoperative assessment and health history?

The nurse is caring for a child with Kawasaki disease who is receiving IV immunoglobulin. The child's parent wants to know why this treatment is required. The nurse explains that this therapy is given to:

A client is 6 hours postoperative from hip surgery after receiving regional anesthesia and has epidural continuous anesthesia in place. Which is the most important reason for the nurse to contact the health care provider?