ATI Custom NUR3025 Pharmacology Exam Two_V5
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Free ATI Custom NUR3025 Pharmacology Exam Two_V5 Questions
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Aspirate for a blood return before depressing the plunger.
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Administer the medication 2.54 cm (1 in) from the umbilicus.
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The nurse should not expel the air bubble in the prefilled syringe.
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Insert the needle at a 45° angle.
Explanation
Correct Answer: (C) The nurse should not expel the air bubble in the prefilled syringe.
Enoxaparin (Lovenox) comes in prefilled syringes that contain a small air bubble. This air bubble should never be expelled before injection. The bubble serves a specific purpose — when injected last, it locks the medication into the subcutaneous tissue and helps prevent the drug from tracking back along the needle path, which reduces the risk of bruising and ensures the full dose is delivered.
Why the other options are incorrect:
A. Aspirate for blood return before depressing the plunger — Aspiration is never performed for subcutaneous injections, including enoxaparin. Aspirating can cause tissue damage and is not part of the correct technique for subcutaneous administration.
B. Administer 2.54 cm (1 inch) from the umbilicus — Enoxaparin should be administered at least 5 cm (2 inches) away from the umbilicus, not 1 inch. Injecting too close to the umbilicus can cause significant bruising and inadequate absorption.
D. Insert the needle at a 45° angle — Enoxaparin is administered subcutaneously using a 90° angle while pinching a skin fold. A 45° angle may be used for very thin patients, but the standard technique for subcutaneous enoxaparin is 90°.
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Verify the patient's name from the ID armband.
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Ask the patient to state their full name and date of birth.
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Ask the patient to state their last name.
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Ask the patient to state their full name and date of birth, and compare this information to the medication administration record and the patient's ID armband.
Explanation
Correct Answer: (D) Ask the patient to state their full name and date of birth, and compare this information to the medication administration record and the patient's ID armband.
The safest and most comprehensive patient identification method uses two identifiers — full name and date of birth — and cross-references the patient's verbal response with both the medication administration record and the ID armband. This three-way verification process is consistent with The Joint Commission's National Patient Safety Goals and minimizes the risk of medication errors.
Why the other options are incorrect:
A. Verify the patient's name from the ID armband alone — Reading the armband without engaging the patient is passive and does not account for errors such as a misplaced armband or a patient who cannot correct a wrong identification.
B. Ask the patient to state their full name and date of birth only — While better than a single identifier, this method is incomplete without cross-referencing the information against the medication administration record and armband for full verification.
C. Ask the patient to state their last name — A single identifier such as last name is insufficient for safe patient identification, as multiple patients may share the same surname.
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Corticosteroid
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Anticholinergic
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Long-acting beta 2 agonist
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Short-acting beta 2 agonist
Explanation
Short-acting beta 2 agonists (SABAs) such as albuterol are the first-line rescue medications for acute asthma attacks. They work by rapidly relaxing bronchial smooth muscle, causing bronchodilation and relieving airflow obstruction within minutes. Their fast onset makes them the initial treatment of choice in any acute bronchospasm emergency.
Why the other options are incorrect:
A. Corticosteroid — Corticosteroids reduce airway inflammation but have a delayed onset of several hours. They are used as adjunct therapy in acute attacks but are not the initial treatment for immediate bronchospasm relief.
B. Anticholinergic — Anticholinergics such as ipratropium may be used as an adjunct to SABAs in severe acute asthma but are not the initial first-line treatment.
C. Long-acting beta 2 agonist — LABAs such as salmeterol are controller medications used for long-term asthma management. They are contraindicated as monotherapy for acute attacks because their slow onset makes them ineffective for immediate bronchospasm relief.
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To build a long-term immunity against future herpes outbreaks.
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To ensure the complete eradication of the herpes simplex virus from the body.
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To prevent the virus from becoming dormant again.
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To decrease the severity and duration of the current outbreak and prevent complications.
Explanation
Correct Answer: (D) To decrease the severity and duration of the current outbreak and prevent complications.
Antiviral medications such as acyclovir do not cure or eradicate the herpes simplex virus, nor do they build immunity or prevent dormancy. Their primary purpose is to reduce the severity of symptoms, shorten the duration of the outbreak, and prevent complications such as secondary bacterial infections or spread of the virus. Completing the full course ensures maximum therapeutic effect during the active outbreak.
Why Other Options are Incorrect:
A. To build long-term immunity — Antiviral medications do not stimulate immune memory or create lasting immunity against herpes simplex virus recurrences.
B. To ensure complete eradication of the virus — The herpes simplex virus cannot be completely eradicated from the body. It remains latent in nerve ganglia for life, and antivirals only suppress active replication.
C. To prevent the virus from becoming dormant again — Antivirals do not prevent the virus from returning to dormancy. After the active outbreak resolves, the virus will naturally re-enter a latent state in the nervous system.
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Absorption of parenteral drugs is faster when the stomach is empty.
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Parenteral drugs bypass the first-pass effect.
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Absorption of parenteral drugs is affected by pH of the stomach.
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Parenteral drugs only exert their effects while circulating in the intestines.
Explanation
Correct Answer: (B) Parenteral drugs bypass the first-pass effect.
Parenteral drugs are administered outside the gastrointestinal tract, meaning they enter systemic circulation directly and bypass hepatic first-pass metabolism, resulting in higher bioavailability compared to oral drugs.
Why the other options are incorrect:
A. Stomach emptiness affects oral drug absorption, not parenteral administration, which bypasses the GI tract entirely.
C. Gastric pH influences oral drug absorption. Since parenteral drugs bypass the GI tract, stomach pH is irrelevant.
D. Parenteral drugs circulate systemically through the bloodstream, not through the intestines, and exert effects at target receptor sites throughout the body.
Indication or Action options: Removes ammonia Treats nausea and vomiting Coats and protects ulcers Softens stool Stimulates a bowel movement
- Removes ammonia
- Treats nausea and vomiting
- Coats and protects ulcers
- Softens stool
- Stimulates a bowel movement
Explanation
Sucralfate is a cytoprotective agent used in the treatment of peptic ulcer disease. It works by forming a protective paste-like coating over ulcerated areas in the gastrointestinal mucosa, shielding them from acid, bile, and pepsin to promote healing. It does not neutralize acid but physically protects the damaged tissue.
Why the other options are incorrect:
Removes ammonia — This is the action of lactulose, which traps and eliminates ammonia through the colon, used in hepatic encephalopathy.
Treats nausea and vomiting — This describes the action of antiemetics such as ondansetron or promethazine, not sucralfate.
Softens stool — Stool softening is the action of docusate sodium (Colace), a stool softener, not sucralfate.
Stimulates a bowel movement — This describes stimulant laxatives such as bisacodyl or senna, not sucralfate.
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Blood pressure
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Pulse
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Temperature
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Respirations
Explanation
Correct Answer: (D) Respirations.
Hydromorphone is a potent opioid analgesic, and the most serious and life-threatening adverse effect of opioids is respiratory depression. The nurse's primary concern is monitoring the patient's respiratory rate and depth, as a significant decrease can indicate opioid toxicity requiring immediate intervention such as naloxone administration.
Why the other options are incorrect:
A. Blood pressure — Opioids can cause mild hypotension, but this is generally not the most critical concern compared to the risk of respiratory depression.
B. Pulse — While opioids can affect heart rate, changes in pulse are less immediately life-threatening than respiratory depression in the context of opioid administration.
C. Temperature — Temperature is not significantly affected by hydromorphone and is not the primary safety concern when administering this medication.
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Wrong route
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Wrong drug
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Wrong dose
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Wrong time
Explanation
Correct Answer: (D) Wrong time.
The heparin infusion was ordered to be discontinued at 1000 but was still running at 1900 — nine hours past the scheduled stop time. This is a wrong time medication error, as the prescribed timing of the medication administration or discontinuation was not followed correctly.
Why Other Options are Incorrect:
A. Wrong route — The route of administration (IV infusion) was correct as prescribed. The error was not related to how the medication was delivered.
B. Wrong drug — The correct medication (heparin) was being administered. The error did not involve giving the wrong drug.
C. Wrong dose — There is no information indicating the dose or rate was incorrect. The error was specifically that the medication was not stopped at the prescribed time.
Explanation
Using the IV flow rate formula: Flow rate (gtts/min) = Volume (mL) × Drop factor (gtt/mL) ÷ Time (minutes) = 500 mL × 10 gtt/mL ÷ 120 minutes = 5000 ÷ 120 = 41.67 ≈ 42 gtts/min
Explanation
To calculate the flow rate in mL/hr when the infusion runs over 30 minutes: Flow rate = Volume ÷ Time (in hours) = 100 mL ÷ 0.5 hr = 200 mL/hr
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