ATI – Quiz – PN Learning System Pharmacology 1 – Practice Test – VNSG 1500

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A nurse is caring for an older adult client who has been diagnosed with depression and is prescribed tricyclic antidepressant amitriptyline (Elavil). Which of the following diagnostic tests should the nurse anticipate will be ordered prior to starting the client on this medication?

A. CBC (complete blood cell count)
B. EEG (electroencephalogram)
C. ECG (electrocardiogram)
D. Liver function profile

C. ECG (elctrocardiogram)

A nurse is providing teaching to a client who is to start taking allopurinol (Zyloprim). For which of the following side effects should the nurse instruct the client to discontinue taking the medication?

A. Nausea
B. Metallic Taste
C. Fever
D. Drowsiness

C. Fever

When administering the first dose of enalapril maleate (Vasotec) to a client, which of the following should the nurse recognize as the priority assessment?

A. Urine Output
B. Respiratory Rate
C. Blood Pressure
D. Level of Consciousness

C. Blood Pressure

A primary care provider has prescribed 250 mg PO Q6H of a medication for a client. The label reads 50 mg/mL. How many mL should the client receive in a 24 hour period?
20 ml

Rationale:
Dose needed = 250 mg;
Dose Available = 50 mg;
Quantity of the dose available = 1 ml.
Set up an equation and solve.
Have/Quantity = Desire/X
50mg/1ml = 250mg/X
50X = 250
X = 5ml, to be given QID
5 mL x 4 = 20 mL

A nurse is caring for a client who is to start epoetin alfa (Epogen) for chronic renal failure. The nurse should recognize that the epoetin alfa is used to do which of the following?

A. Stabalize electrolyte levels
B. Prevent Fluid Retention
C. Treat Anemia
D. Help lower BUN and creatinine levels

C. Treat Anemia

A client has been taking isoniazid (INH) and rifampin (Rifadin) for 3 weeks after being diagnosed with active pulmonary tuberculosis (TB). The client calls the clinic to report that his urine is a reddish orange color. Which of the following is an appropriate response by the nurse?

A. “Stop taking the INH for 2 to 3 days, and the discoloration should go away”
B. “Rifampin may turn all body fluids orange-red. This is a harmless side effect.”
C. “I’ll make an appointment for you to see the doctor this afternoon.”
D. “These medicaitons are known to cause bladder irritation when taken together.”

B. Rifampin may turn all body fluids orange-red. This is a harmless side effect.

A nurse is caring for a client receiving heparin for deep vein thrombosis (DVT) prophylaxis. The nurse correctly delivers the heparin by:

A. Using the subcutaneous sites in the abdomen.
B. Adminestering the injection using the Z-track method into the thigh.
C. Massaging the injection site after injeciton.
D. Administering the injection with a 22 gauge needle.

A. Using the subcutaneous sites in the abdomen.

A nurse is providing teaching to the parent of a child with asthma who is prescribed cromolyn sodium (Intal) via metered dose inhaler. Which of the following statements by the child’s parent should indicate to the nurse the need for further instruction?

A. “I will give my child a dose as soon as wheezing starts.”
B. “My child needs to do a mouth rinse after using the inhaler.”
C. “My child should breathe in slowly while depressing the canister.”
D. “If my child has difficulty breathing in the dose, a spacer should be used.”

A. “I will give my child a dose as soon as wheezing starts.”

A nurse is providing teaching to a client who is prescribed hydrochlorothiazide (Oretic) for hypertension. The nurse should instruct the client to take the medication:

A. when edema is present
B. at bedtime
C. on an empty stomach
D. in the morning

D. In the morning.

A client who is admitted with cirrhosis is prescribed lactulose (Cephulac) PO. For which of the following actions should the nurse administer lactulose?

A. to increase blood pressure
B. to prevent bleeding form the esophageal varices
C. to decrease heart rate
D. to reduce serum ammonia levels

D. To reduced serum ammonia levels.

A nurse is caring for a client prescribed amphotericin B(Fungizone). Which of the following should the nurse recognize as the best indicator of renal function?

A. Serum potassium levels
B. Daily weights
C. Intake and Output
D. Serum creatinine levels

D. Serum creatinine levels.

A nurse should be aware that metoclopramide (Reglan) is contraindicated for a client who:

A. Is receiving chemotherapy
B. Has an intestinal obstruction
C. Has galucoma
D. Is vomiting after undergoing a colon resection

B. Has an intestinal obstruction.

A client is being treated with a 10-day course of gentamicin sulfate (Garamycin). Which of the following findings should indicate to the nurse that the client is experiencing an adverse effect of this medication?

A. Hypoglycemia
B. Proteinuria
C. Elevated temperature
D. Visual disturbances

B. Proteinuria

A nurse is assessing a client in the clinic who is on tamoxifen (Nolvadex). The nurse should recognize that tamoxifen has which of the following actions?

A. Antimicrobial
B. Anti-estrogenic
C. Androgenic
D. Anti-inflammatory

B. Anti-estrogenic.

A nurse is caring for a pregnant client who is scheduled to have a contraction stress test (CST). The nurse should anticipate administering which of the following medications?

A. Oxytocin (Pitocin)
B. Nifedipine (Procardia)
C. Betamethasone (Clestone)
D. Rho (D) immune globulin (RhoGAM)

A. Oxytocin (Pitocin)

A nurse is caring for a client who is prescribed ergotamine tartrate (Ergomar). The nurse should recognize that ergotamine tartrate is indicated for which of the following?

A. Hypertenison
B. Migrane Headaches
C. Ulcerative Colitis
D. Anemia

B. Migrane Headaches

The nurse must calculate the daily dosage of a new medication for a child weighing 69 lb. The primary care provider has prescribed 10 mcg/kg per day PO in three divided doses. The nurse has on hand 0.1 mg tablets. Which of the following should the nurse calculate to be the daily dosage in milligrams?
0.31 mg

Rationale:
Three steps are needed to solve this problem. First, convert pounds to kilograms. You know that there are 2.2 lb/kg, therefore, 69/2.2 = 31.363 kg. Using rounding rules, this is 31.4 kg. Now determine the total daily dose based on the order of 10 mcg/kg per day. 10 mcg x 31.4 kg/day = 314 mcg/day. Finally, convert the dose from mcg to mg. You know that 1,000 mcg = 1 mg therefore 314 mcg = 0.314 mg. Again, using rounding rules, this is equal to 0.31 mg.

The primary care provider has prescribed a continuous enteral feeding of half strength Ensure, which comes in eight ounce cans, to begin infusing at 75 mL/hr. How much water should the nurse add to the can of Ensure to complete the health care provider’s prescription?
240 mL

Rationale:
In order to deliver a half-strength concentration, the feeding must be diluted with equal amounts of water. Consequently, for 240 mL (8 oz x 30 mL/oz) of formula, 240 mL of water would be added.

A nurse is providing teaching to the parents of a child who is prescribed valproic acid (Depakene) for seizures. The nurse instructs the parents that it will be necessary for the child to return to the clinic in 2 weeks to have which of the following diagnostic tests performed? (Select all that apply.)

A. Blood Urea Nitrogen (BUN)
B. Platelet Count
C. Aparate Aminotransferase (ASTL)
D. Urinalysis
E. Alanine Aminotransferase (ALT)

B. Platelet count
C. Aspartate aminotransferase (ASTL)
E. Alanine aminotransferase (ALT)

A client who is taking chlorpromazine hydrochloride (Thorazine) is experiencing extreme restlessness and involuntary movements. To treat these side effects, the nurse should anticipate administering which of the following medications?

A. Amatadine (Symmetrel)
B. Bupropion (Wellbutrin)
C. Phenelzine (Nardil)
D. Hydroxyzine (Atarax)

A. Amatadine (Symmetrel)

Amantadine (Symmetrel) is an antiparkinsonian drug used to treat extrapyramidal side effects, such as extreme restlessness and involuntary movements that result from typical antipsychotic medications, such as chlorpromazine hydrochloride.

When preparing the discharge plan for a client who has been on long term prednisone (Deltasone) therapy, the nurse should be aware that such clients are at risk for which of the following?

A. Gingival ulcerations
B. Orthostatic hypotension
C. Stress fractures
D. Weight loss

C. Stress fractures.

A nurse should recognize that aspirin therapy is contraindicated for children with viral illnesses due to the increased risk of which of the following?

A. Reye’s Syndrome
B. Renal Failure
C. Diabetes Mellitus
D. Wilms’ tumor

A. Reye’s syndrome.

Reyes syndrome has an increased incidence in children or adolescents who take aspirin during a viral illness, such as the flu or chickenpox.

A nurse is reviewing the admission prescriptions for a client who has just been admitted from the emergency room with a prescription for clopidogrel (Plavix). Which of the following precautions should the nurse plan to implement?

A. Neuropathic
B. Bleeding
C. Airborne
D. Contact

B. Bleeding

Plavix is an antithrombotic and antiplatelet aggregate used to lessen the chance of heart attack or stroke. Bleeding precautions attempt to limit client exposure to injury causing events that may lead to internal or external bleeding

A nurse is taking a medication history on a client who is to receive a first dose of ceftriaxone (Rocephin). Which of the following allergies should the nurse report to the primary care provider?

A. Gentamicin Sulfate (Garamycin)
B. Clindamycin (Cleocin)
C. Piperacillin Sodium
D. Sulfamethoxazole-trimethoprim (Bactrim)

C. Piperacillin sodium.

Clients with allergies to piperacillin sodium, a penicillin, may have a cross-sensitivity to Ceftriaxone, a third-generation cephalosporin. This should be reported to the primary care provider.

When administering diphenoxylate and atropine (Lomotil) to a client with ulcerative colitis, the nurse should monitor the client for the development of:

A. Toxic Megacolon
B. Pseudomembraneous Colitis
C. Increased Bleeding Time
D. Drug Addiction

A. Toxic megacolon.

Clients with ulcerative colitis are at risk for developing toxic megacolon, a condition characterized by paralysis of colonic peristalsis resulting in rapid dilatation of the bowel. The nurse should observe for the symptoms of: tachycardia, hypotension, elevated temperature, abdominal tenderness or cramping, and a reduction or cessation of diarrhea

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