Pharmacology Exam 2 NClex Questions

Nonselective beta-blockers may be used to treat hypertension and
supraventricular arrhythmias

An example of a cardioselective beta-blocker includes
atenolol (Tenormin)

When teaching a patient about beta-blockers such as atenolol (Tenormin) and metoprolol (Lopressor), it is important to inform the patient that
abrupt medication withdrawal may lead to a rebound hypertensive crisis

Propranolol (Inderal) is an effective
nonselective beta-adrenergic antagonist

During assessment of a patient diagnosed with pheochromocytoma, the nurse auscultates a blood pressure of 210/110 mm Hg. The nurse would expect to administer which medication?
phentolamine (Regitine)

When assessing for cardiovascular effects of a beta-blocker, the nurse understands that these drugs produce
a negative inotropic, negative chronotropic, and negative dromotropic effect

Beta-blockers are used to treat which disorders? (Select all that apply)
*Angina pectoris
*Cardiac dysrhythmias

The priority nursing diagnosis for a patient taking metoprolol (Lopressor) would be
Ineffective tissue perfusion (cerebral and cardiovascular) related to effects of medication

Patient teaching for a patient being discharged on a beta-blocker includes which statement?
“If you take your pulse and it is less than 60, hold your medicine and call your health care provider for instructions.”

The nurse is admitting a patient with a history of angina and hypertension who is currently experiencing moderate heart failure. The patient’s current medication regimen includes digoxin, furosemide, and accupril. Which medication would be most beneficial to add to this patient’s treatment plan?
carvedilol (Coreg)

Epinephrine, as an adrenergic (sympathomimetic) drug, produces which of the following therapeutic effects?
Increased heart rate and contractility

The doctor has ordered dopamine to treat your patient’s hypovolemic shock due to severe blood loss. For the medication to be effective, the physician must also order
fluid replacement

Your patient is receiving dobutamine as a continuous infusion. Titration of this medication is based upon which factors? (Select all that apply.)
*Heart rate
*Blood pressure
*Urine output

Your patient is to receive dopamine 5 mcg/kg/min. He weighs 176 lb. You have dopamine 400 mg in 500 mL D5W. You will infuse this at
30 mL/hr.

When assessing for cardiovascular effects of an adrenerigic (sympathomimetic) drug, the nurse understands that these drugs produce
a positive inotropic, positive chronotropic, and positive dromotropic effect

A hypertensive crisis may occur if adrenergic (sympathomimetic) drugs are given along with
MAO inhibitors

The nurse assesses the intravenous infusion site of a patient receiving dopamine and finds it is infiltrated. The nurse will prepare which of the following medications to treat this infiltration?
phentolamine (Regitine)

A patient using Afrin nasal spray complains of worsening cold symptoms and tells the nurse, “I don’t understand why this is not working. I am using it almost every 3 hours!” The nurse’s response based on knowledge that
the patient is suffering from rebound congestion related to excessive use of the Afrin nasal spray

Cholinergic (parasympathomimetic) drugs have which therapeutic effect?
Increased gastroinstestinal motility

Cholinergic (parasympathomimetic) drugs are indicated for which situation
Lowering intraocular pressure in patients with glaucoma

During postoperative teaching, the nurse explains that the patient is receiving bethanechol (Urecholine) to treat
urinary atony

Adverse reactions to bethanechol include

The nurse would question an order for cevimeline (Evoxac) in a patient with a history of
narrow-angle glaucoma

The nurse administering donepezil (Aricept) to a patient understands that the expected therapeutic action of this drug is to
increase levels of acetylcholine in the brain by blocking its breakdown

When providing teaching to a patient diagnosed with myasthenia gravis, which instruction regarding the administration of physostigmine (Antilirium) is most appropriate?
Take the medication 30 minutes before meals

Side effects to expect from anticholinergic (parasympatholytic) drugs, such as atropine, include which effects? (Select all that apply)
*Dilated pupils (mydriasis)
*Urinary retention
*Dry mouth

A patient presents with symptomatic bardycardia. The nurse prepared to administer which dose of atropine intravenously?
0.5 mg

A patient presents to the emergency room with insecticide poisoning. The nurse prepares to administer which dose of atropine intravenously?
2 mg

The nurse monitors a patient taking tolterodine (Detrol) for which thereapeutic effect?
Decreased in urinary frequency

The nurse monitors a patient prescribed dicyclomine (Bentyl) for which therapeutic effect?
Decrease in gastrointestinal motility

A priority nursing diagnosis for a patient receiving anticholinergic (parasympatholytic) drugs would be
Impaired gas exchange related to thickened respiratory secretions

Which would be the most appropriate application time for a patient prescribed a scopolamine patch for motion sickness?
4 to 5 hours before travel

Which is an expected outcome associated with the administration of digoxin?
Decreased heart rate

The patient has a serum digoxin level drawn and it comes back 0.4 ng/mL. The nurse recognized that this is:
below the therapeutic level

A patient is taking digoxin 0.25 mg and furosemide (Lasix) 40 mg. When the nurse enters the room, the patient states, “There are nice yellow halos around the lights.” which action will the nurse take?
Evaluate the patient for other symptoms of digoxin toxicity

The patient weighs 44 lb and is to be digitalized. The digitazlizing dose is to be 0.03 mg/kg in three divided doses. How much will the nurse administer per dose?
0.2 mg

Which are therapeutic effects of digoxin?
Positive inotropic, negative chronotropic, and negative dromotropic

Which effects would alert the nurse to suspect early digitalis toxicity?
Nausea and vomiting

Phosphodiesterase inhibitors have an added advantage in treating hear failure because they cause a positive inotropic effect and

The nurse reviews a patient’s laboratory values and finds a digoxin level of 10 and a serum potassium level of 6.2. The nurse would notify the health care provider and anticipate administering
digoxin immune FAB

Assessment of a patient is receiving a positive inotropic drug would include reviewing which values?
Serum electrolytes

The nurse would question the use of milrinone (Primacor) in a patient with which disorder?
systolic heart failure

When teaching a patient regarding the administration of digoxin, the nurse instructs the patient not to take this medication with which food?
Wheat bran

Which is an indication for use of the antidysrhythmic drug lidocaine?
Ventricular arrhythmias

When giving adelnosine, it is important to remember to
give it as a fast intravenous push

To prevent the occurrence of cinchonism in a patient prescribed quinidine, the nurse emphasizes the importance of
avoiding ingestion of antacids

Adenosine is used to treat which condition?
Paroxysmal supraventricular tachycardia (PSVT)

Sodium channel blockers are considered which class of antiarrhythmic drugs?
Class I

Ibutilide (Corvert) is a class III antiarrythmnic drug that is used for
conversion of recent-onset of atrial fibrillation and flutter

For which potential side effects would the nurse monitor patients prescribed amiodarone? Select all that apply
*Bluish skin discoloration

Before administering a dose of an antiarrhythmic drug to an assigned patient, which assessments wold be of highest priority?
Apical pulse and blood pressure

Which classification of drugs is used to treat both hypertension and dysrhythmias?
Calcium channel blockers

Calcium channel blockers have which pharmacodynamic effect?
Coronary vasodilation

Amiodarone toxicity is evidenced in which body system?

Which instruction should be included in the discharge teaching for a patient with a transdermal nitroglycerin patch?
“Apply the patch to a nonhairy, nonfatty area of the upper torso or arms”

Nitrates relieve angina pain by reducing preload, which is
blood volume within the heart

Which are common side effects of nitroglycerin? Select all that apply

Which statements by the patient demonstrates a need for further education regarding nitroglycerin?
“I can take up to three tablets at 5-min. intervals for chest pain.”

Calcium channel blocers reduce myocardial oxygen demand by reducing afterload, which is
pressure against which the heart must pump

Which nitrate preparation or dosage form has the longest duration of action?
Transdermal nitroglycerin patch

In order to prevent the development of tolerance, the nurse instructs the patient to perform which action?
Apply the nitroglycerin patch for 14 hours each and remove for 10 hours at night

Before administering isosorbide mononitrate (Imdur), a priority assessment would include
blood pressure

The patient asks how nitroglcerin should be stored while traveling. What is the nurse’s best response?
“it’s best to keep it in its original container away from heat and light.”

Patient teaching regarding sublingual nitroglycerin should include which statement?
“Sit or lie down after you take a nitroglycerin tablet to prevent dizziness.”

What is the best way to prevent tolerance to nitrates when using transdermal patches?
Remove the patch at night for 8 hours, and then apply a new patch in the morning

Which statement indicates that the patient understands discharge teaching about nitroglycerin?
“I will need to keep the nitroglycerin stored in the bottle it comes in.”

A patient who is taking sublingual nitroglycerin is complaining of flushing and headaches. What is the nurse’s best response?
“These are the most common side effects of nitroglycerin. They should subside with continued use of nitroglycerin.”

When applying nitroglycerin ointment, the nurse should perform which action?
Apply the ointment to a nofatty, nonhairy part of the upper torso

When titrating intravenous nitroglycerin, what does the nurse monitor? Select all that apply
*Blood pressure
*Heart rate
*Chest pain

A patient receiving intravenous nitroglycerin at 20 mcg/min complains of dizziness. Nursing assessment reveals a blood pressure of 85/40 mm Hg. heart rate of 110 beats/min, and respiratory rate of 16 breaths/min. What is the nurse’s best action?
Decrease the intravenous nitroglycerin by 10 mcg/min

Nitrates relieve angina pain by reducing afterload, which is
pressure against which the heart must pump

During patient teaching, the nurse explains that nitroglycerin relieves chest pain primarily by which action?
Decreasing the workload of the heart

It is most important to instruct a patient prescribed nitroglycerin to avoid which substances?
Erectile dysfunction medications

When caring for a patient with angina, the nurse would question an order for a noncardioselective beta-blocker in a patient with coexisting
bronchial asthma

Which statement, if made by your patient, signifies that additional patient teaching regarding antihypertensive treatment is required?
“I will check my blood pressure every day and take my medication when it is over 140/90.”

An annoying side effect of ACE inhibitors that may be minimized by switching to an angiotensin receptor blocking drug includes
a dry, nonproductive cough

Which would the nurse question if ordered concurrently with ACE inhibitors?

Which would be a priorit assessment prior to administering eplerenone (Inspra)?
Serum electrolytes

The nurse would plan to administer which calcium channel blocking drug to a patient with cerebral arterial spasms following a subarachnoid hemorrhage?
nimodipine (Nimotop)

The nurse would question an order for a calcium channel blocking drug in a patient with which condition?

Which statement would be most appropriate during discharge teaching for a patient receiving transdermal clonidine (Catapres)?
“The patch should be applied to a nonhairy site, and abrupt withdrawal should be avoided.”

When explaining different medication regimens to treat hypertension during a community education program, it would be accurate to state that African-American probably respond best to which combination of medications?
Diuretics and calcium channel blockers

Carvedilol (Coreg) is classified as a
Dual action alpha, and beta-receptor blocker

When administering nitroprusside (Nipride) intravenously, the nurse would monitro for which sign of toxicity? Select all that apply
*Abdominal pain
*Muscle twitching

The nurse would monitro for reflex tachycardia in a patient receiving which classification of antihypertensive drugs?
Direct-acting vasodilators

A patient prescribed prazosin (Minipress) does not have a history of hypertension. The nurse would assess for what disorder for which this medication is also used?
Obstructive benign prostatic hyperplasia

ACE inhibitors and angiotensin receptor blockers both work to decrease blood pressure by
preventing aldosterone secretion

Which is a priority nursing diagnosis for a patient taking an antihypertensive medication?
Ineffective tissue perfusion related to disease process and/or medication

When teaching a patient about carvedilol (Coreg), the nurse explains that this medication reduces blood pressure by (Select all that apply)
*reducing heart rate

Which laborator value might indicate an adverse response to hydrochlorothiazide (HydroDiuril)?
Glucose levels

When teaching a patient why spironolactone (Aldactone and furosemide (Lasix) are prescribed together, the nurse’s statements are based on knowledge that
this combingation promotes diuresis but decreases the risk of hypokalemia

Which laboratory value depics a known side effect of furosemide (Lasix)?

A patient is admitted to the hospital with pneumonia and has a history of chronic renal insufficiency. The physician orders furosemide (Lasix) 40 mg twice a day because it
is effective in treating patients with renal insufficiency

A patient taking spironolactone (Aldacone) requests assistance with dietary choices. The nurse would recomment which food choices? (Select all that apply)
*Lean meat

The nurse would question the use of mannitol on which of the following patients?
A 47 year old patient with anuria

Acetazolamide (Diamox) is used to treat which disorder? Select all that apply
*Edema associated with heart failure
*High-altitude sickness
*Open-angle glaucoma

When preparing to administer furosemide (Lasix) intravenously to a patient with renal dysfunction, the nurse plans implementation based on knowledge that the medication should be administered no faster than which rate?
4 mg/min

Potassium-sparing diuretics may cause which adverse reactions? Select all that apply

A patient asks about taking postassium supplements while taking spironolactone (Aldactone). What is the nurse’s best response?
“You are on a diuretic that is potassium-sparing, so there is no need for extra potassium.”

The nurse would expect to administer which diuretic to treat a patient diagnosed with primary hyperaldosteronism?
spironolactone (Aldactone)

The nurse prepares to administer which diuretic to treat a patient suffering from acute pulmonary edema?
furosemide (Lasix)

When assessing for therapeutic effects of mannitol, the nurse would expect to see
decreased intracranial pressure

When assessing a patient on triamterene (Dyrenium), the nurse would specifically monitor for which adverse effect?

When teaching a patient about signs and symptoms of hypokalemia, the nurse will instruct the patient to notify the health care provider if which occurs?
Leg cramps

The nurse would question the health care provider if which type of diuretics is prescribed to a patient with gout?
Thiazide diuretics

The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin?
Activated partial thromboplastin time (aPTT)

A patient who has been anticoagulated with warfarin (Coumadin) is admitted with gastrointestinal bleeding. The nurse will anticipate administering which substance?
vitamin K

The nurse understands that a patient’s international normalized ratio (INR) value of 2.5 means that
the patient’s warfarin dose is therapeutic

Which statement when made by the patient indicates deficient knowledge regarding warfarin?
“I will increase the dark green leafy vegetables in my diet.”

Which of the following medications has antiplatelet properties?

While preparing a patient with acute chest pain for an emergency angioplasty, the nurse would
tirofiban (Aggrastat)

Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This drug is in which drug group?
Low molecular weight heparin

The patient asks what the difference is between dalteparin (Fragmin) and heparin. What is the nurse’s best respons?
“Dalteparin is a low molecular weight heparin that has a more predictable anticoagulant effect.”

Before emergency surgery, the nurse would anticipate administering which medication to a patient receiving heparin?
protamine sulfate

Nursing care for a patient receiving alteplase (Activase) would include which action? Select all that apply
*Record vital signs and report changes
*Observe for signs and symptoms of bleeding
*Assess for cardiac dysrhythmias

A patient who is taking an anticoagulant requests as aspirin for headache relief. What is the nurse’s bes action?
Take advantage of a teachable moment to inform the patient of potential drug interactions with anticoagulants

A patient is started on oral anticoagulant therapy while still receiving intravenous heparin. The patient is concerned about risk for bleeding. What is the nurse’s best response?
“It is usually takes 4 to 5 days to achieve a full therapeutic effect for warfarin, so the heparin is continued to help prevent blood clots until the warfarin is working up to speed.”

The nurse evaluates understanding of discharge instructions regarding warfarin (Coumadin) when the patient states
“I should use a soft toothbrush for dental hygiene.”

Before administering alteplase (Activase), it is important for the nurse to perform which action?
Perform all necessary venipunctures

The nurse formulates a plan of care for a patient receiving heparin based upon which nursing diagnosis?
Risk for injury

The nurse recognized that patient teaching regarding warfarin (Coumadin) has been successful when the patient acknowledges an increased risk of bleeding with conccurent use of which herbal product? Select all that apply

While observing a patient self-administer enoxaparin (Lovenox), the nurse identifies the need for further teaching when the patient
Massages the site after administration of the medication

Which statement will indicate to the nurse that the patient understands the discharge instructions regarding cholestyramine (Questran)?
“I will decrease fiber in my diet.”

The nurse plans which of the following interventions to decrease the flushing reaction of niacin?
Administer aspirin 30 minutes before nicotinic acid

HMG-CoA reductase inhibitors (statins) are generally administered at which time?
In the evening

Which are common side effects of fenofibrate (Tricor), a fibric acid derivative? Select all that apply
*ausea, vomiting, and abdominal pain
*Increase in gallstone formation

Discharge teaching for a patient receiving an antilipemic medication would include
“Continue your exercise program, and maintain a diet high in omega-3 fatty acids.”

What is the mechanism of action of ezetimibe (Zetia)?
Inhibiting absorption of dietary and biliary cholesterol in the small intestine

Cholestyramine (Questran) decreases lipid levels by
binding to bile in the intestinal tract, forming an insoluble complex that is excreted in the feces.

Which statement, made by the patient, demonstrates a knowledge deficit regarding colestipol (Colestid)?
“I should mix and stir the powder in as small an amount of fluid as possible in order to maintain potency of the medication.”

Atorvastatin (Lipitor) decreases lipid levels by
Inhibiting HMG-CoA reductase, the enzyme responsible for the biosynthesis of cholesterol in the liver.

Which test will the nurse use to assess for adverse reactions to HMG-CoA reductase inhibitors?
Liver functin tests

Discharge teaching for a patient receiving simvastatin (Zocor) should include the importance of reporting which symptoms that might indicate a serious adverse reaction to the medication?
Muscle pain

The nurse would question an order for simvastatin (Zocor) in a patient with which condition?
Hepatic disease

A patient with elevated triglyceride levels unresponsive to HMG-CoA reductase inhibitors will most likely be prescribed which drug?
gemfibrozil (Lopid)

The nurse would question an order for colesevelam (Welchol) in a patient with which conditon?
Complete bowel obstruction

The nurse will assess a patient receiving gemfibrozil (Lopid) and warfarin (Coumadin) for which adverse effect?
Increased risk of bleeding

In which step of the nursing process does the nurse determine the outcome of medication administration? Planning Evaluation Assessment Implementation Evaluation The nurse plans care for a male patient who is 80 years old. The nursing diagnosis is noncompliance with …

a. Asthma A client is diagnosed with a pulmonary disorder that causes COPD. Lungs tissue changes are normally reversible with this condition. The nurse understands that which is the client’s most likely diagnosis? a. Asthma b. Emphysema c. Bronchiectasis d. …

The physician has ordered an I.V. of 5% dextose in Lactated Ringers solution at 125mL/hr. The I.V. tubing available delivers 10 drops per mL. At how many drops per minute will the Lactated Ringers infuse? The nurse correctly administers the …

b. 0.5 to 2.0 ng/mL A newly admitted client takes digoxin 0.25 mg/day. The nurse knows that which is the serum therapeutic range for digoxin? a. 0.1 to 1.5 ng/mL b. 0.5 to 2.0 ng/mL c. 1.0 to 2.5 ng/mL …

c. Absorption, distribution, metabolism, excretion It is important for the nurse to be aware of the four sequential processes of the pharmacokinetic phase. What are these processes? a. Distribution, metabolism, excretion, absorption b. Biotransformation, excretion, absorption, metabolism c. Absorption, distribution, …

A patient is taking two prescription medications that both cause bradycardia. The nurse should monitor the patient for which type of effect? A. An increased therapeutic effect B. An increased adverse effect C. A reduced therapeutic effect D. A reduced …

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