Nursing 320 Pharmacology exam 5 at Denver College of Nursing
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Free Nursing 320 Pharmacology exam 5 at Denver College of Nursing Questions
1. 30. A patient has an order for Zithromax 1 g PO stat. The Zithromax bottle concentration is 200 mg per 5 mL. How many mL will you give? (Round to the nearest whole number.)
- A. 10 mL
- B. 15 mL
- C. 20 mL
- D. 25 mL
Explanation
Total dose needed = 1000 mg Concentration = 200 mg ÷ 5 mL = 40 mg/mL Volume = 1000 mg ÷ 40 mg/mL = 25 mL (already a whole number)
2. 13. A client with GERD has been taking omeprazole 40 mg daily for 18 months. The nurse knows that what potential adverse effect is the client at risk for?
- A. Exostosis, or bone overgrowth
- B. Drug-induced ototoxicity
- C. Osteoporosis-related fracture risk
- D. Diminished visual acuity
Explanation
Omeprazole is a proton pump inhibitor (PPI) that suppresses gastric acid secretion. Long-term use (typically over one year) is associated with decreased calcium absorption, leading to osteopenia or osteoporosis and a higher risk of hip, wrist, and spine fractures. PPIs can also reduce magnesium and vitamin B12 levels with chronic use, requiring monitoring and supplementation when appropriate.
3. 9. A patient is scheduled to have a pacemaker implanted at 0800 in the cardiac cath lab. The night shift nurse has an order to draw labs, check the patient’s vital signs, and start antibiotics prior to the day shift arriving. The nurse understands that the antibiotics are intended to:
- A. Treat a superinfection in the patient
- B. Provide empiric therapy
- C. Provide prophylactic therapy
- D. Provide definitive therapy
Explanation
Prophylactic therapy refers to the preventive use of antibiotics before surgery or certain medical procedures to reduce the risk of infection. In this case, administering antibiotics prior to pacemaker implantation helps prevent surgical site infection or endocarditis, which are serious complications in cardiac procedures. The goal is prevention—not treatment—of infection.
4. 31. A patient has an order for 500 mL of NS to infuse over 8 hours. How many mL per hour should be set on the pump? (Round to the nearest whole number.)
- A. 50 mL/h
- B. 63 mL/h
- C. 75 mL/h
- D. 90 mL/h
Explanation
To find mL per hour: 500 mL ÷ 8 hours = 62.5 mL/h → 63 mL/h (rounded to the nearest whole number)
5. 2. An elderly client presents to the Emergency Room with sepsis. The provider immediately starts the client on a broad-spectrum antibiotic but then changes the antibiotic when the culture and sensitivity results come back. The new antibiotic would be considered what type of antibiotic therapy?
- A. Definitive therapy
- B. Empiric therapy
- C. Prophylactic therapy
- D. Palliative therapy
Explanation
Definitive therapy is initiated after the causative organism has been identified through culture and sensitivity testing. Once the results are available, the healthcare provider changes from a broad-spectrum antibiotic to a targeted (narrow-spectrum) antibiotic that is most effective against the specific pathogen. This approach improves effectiveness, minimizes resistance, and reduces unnecessary exposure to broad-spectrum agents.
6. 15.A female client develops vaginal candidiasis while on antibiotic therapy for an upper respiratory infection. The nurse knows that this is caused by:
- A. Antibiotic therapy reduces normal vaginal bacterial flora, resulting in a superinfection.
- B. The infection spreading from the patient's lungs to the new site of infection.
- C. Unprotected sex during antibiotic treatment.
- D. An allergic reaction to the antibiotics.
Explanation
Antibiotic therapy can destroy normal bacterial flora that help maintain balance in areas like the vagina. When beneficial bacteria such as Lactobacillus are reduced, Candida albicans, a naturally occurring yeast, can overgrow and cause vaginal candidiasis (yeast infection). This type of infection is considered a superinfection resulting from microbial imbalance due to antibiotic use.
7. 23. A nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) who has been prescribed a combination inhaler containing a long-acting beta2-agonist (LABA) and an inhaled corticosteroid (ICS). Which therapeutic effect should the nurse expect from this medication?
- A. Reduction in frequency of COPD exacerbations
- B. Exacerbation of inflammation and bronchoconstriction
- C. Cure of underlying COPD pathology
- D. Prevention of pneumonia
Explanation
A combination of a long-acting beta2-agonist (LABA) and an inhaled corticosteroid (ICS) helps in reducing airway inflammation and maintaining bronchodilation, which leads to a decrease in the frequency and severity of COPD exacerbations. LABAs relax bronchial smooth muscles for sustained airflow improvement, while ICSs reduce airway inflammation and hyper-responsiveness, improving overall respiratory function and quality of life.
8. 25. A client is prescribed a proton pump inhibitor. The nurse knows that which of the following is the primary mechanism of action of proton pump inhibitors (PPIs)?
- A. They block histamine H2 receptors on parietal cells.
- B. They inhibit the H⁺/K⁺ ATPase enzyme in gastric parietal cells.
- C. They neutralize gastric acid directly.
- D. They increase gastric mucus production.
Explanation
Proton pump inhibitors (PPIs), such as omeprazole and pantoprazole, work by irreversibly inhibiting the H⁺/K⁺ ATPase enzyme system (also known as the proton pump) in the gastric parietal cells. This action blocks the final step of acid production, leading to a profound and sustained reduction in gastric acid secretion. PPIs are among the most effective drugs for treating conditions like GERD, peptic ulcer disease, and Zollinger-Ellison syndrome.
9. 3. A client with a diagnosis of sepsis is prescribed an antibiotic that kills bacteria. What type of antibiotic is this?
- A. Bacteriostatic
- B. Bactericidal
- C. Disinfectant
- D. Bacterial resistant
Explanation
A bactericidal antibiotic works by killing bacteria directly, leading to the destruction of the infectious organism. These antibiotics are especially useful in serious infections such as sepsis, meningitis, and endocarditis, where rapid bacterial eradication is critical. Examples include penicillins, cephalosporins, and aminoglycosides.
10. 12. A client has been diagnosed with delayed gastric emptying. The nurse knows that which drug would best treat this condition?
- A. Prokinetic drugs, such as metoclopramide (Reglan)
- B. Serotonin blockers, such as ondansetron (Zofran)
- C. Anticholinergic drugs, such as scopolamine
- D. Neuroleptic drugs, such as chlorpromazine (Thorazine)
Explanation
Metoclopramide (Reglan) is a prokinetic drug that enhances gastric motility and accelerates gastric emptying without increasing gastric secretions. It works by increasing the release of acetylcholine in the gastrointestinal tract, promoting movement of stomach contents into the small intestine. It is often used for gastroparesis (delayed gastric emptying), nausea, and GERD management.
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