Nursing Pharmacology Final Exam at Fox Valley Technical College

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Ace Your Test with Nursing Pharmacology Final Exam Actual Questions and Solutions - Full Set

Free Nursing Pharmacology Final Exam at Fox Valley Technical College Questions

1.

The nurse is caring for a client prescribed a Tetracycline antibiotic and providing discharge education. Which of the following responses indicates the teaching has been effective? (Select 5 that apply)

  • A. "I will continue to take the whole bottle of antibiotics even if I start to feel better sooner."
  • B. "I should start to feel better in the next couple of days, but I will call the provider if I feel worse."
  • C. "I will take the antibiotic until symptoms start to improve and save the remaining pills in case it comes back later."
  • D. "The antibiotic might cause some nausea or diarrhea which are expected and normal while on this medication."
  • E. "I'll take this antibiotic with my calcium tablets and multivitamin, so I don't forget to take it in the morning."
  • F. "I can just call the pharmacy to request the second bottle of medication if this bottle doesn't help."
  • G. "I may need to use an alternative form of birth control while taking this medication."
  • H. "I should take a probiotic or eat yogurt to replace some of the good bacteria lost from the antibiotics."
  • I. "The antibiotics may cause rash, hives, or trouble breathing which is normal and expected."
  • J. "I will need lab draws to recheck my white blood cell count at day 5 and 10 to ensure the antibiotic is working."

Explanation

Explanation
Explanation of Correct Answers:

A – Completing the full course prevents antibiotic resistance.
It is essential for clients to complete the full prescribed course of antibiotics to ensure the infection is completely treated and to prevent the development of antibiotic resistance.

B – Improvement should occur within days; worsening symptoms require follow‑up.
Clients should begin to feel better within a few days of starting tetracycline therapy. However, if symptoms worsen or new symptoms arise, clients should follow up with their healthcare provider for evaluation and possible adjustment of treatment.

D – GI upset (nausea, diarrhea) is common and expected.
Gastrointestinal issues like nausea and diarrhea are common side effects of tetracycline antibiotics. Clients should be informed that these are typical reactions but should seek advice if the symptoms become severe.

G – Tetracycline can reduce the effectiveness of oral contraceptives; a backup method is advised.
Tetracycline antibiotics can lower the effectiveness of oral contraceptives, so it is crucial for clients to use a backup form of contraception, such as condoms, during the course of antibiotic treatment.

H – Probiotics/yogurt can help maintain gut flora during antibiotic therapy.
Since antibiotics like tetracycline can disrupt the natural balance of gut bacteria, clients are advised to take probiotics or eat yogurt to help replenish beneficial bacteria and reduce the risk of gastrointestinal issues like diarrhea.


Correct Answer Is:
A. "I will continue to take the whole bottle of antibiotics even if I start to feel better sooner."
B. "I should start to feel better in the next couple of days, but I will call the provider if I feel worse."
D. "The antibiotic might cause some nausea or diarrhea which are expected and normal while on this medication."
G. "I may need to use an alternative form of birth control while taking this medication."
H. "I should take a probiotic or eat yogurt to replace some of the good bacteria lost from the antibiotics."
2.

The physician writes orders for a client who is a type 2 diabetic. Which order would the nurse question?

  • A. Use insulin lispro for a sliding scale via insulin pen
  • B. Administer regular & NPH insulin mixed in the same syringe
  • C. Administer metformin 500 mg BID
  • D. Administer insulin glargine (Lantus) based on sliding scale ACHS

Explanation

Explanation
Insulin glargine (Lantus) is a long-acting basal insulin designed to provide a steady level of insulin over 24 hours. It is not appropriate for sliding-scale use because it does not have a rapid onset or peak effect. Sliding-scale insulin requires short- or rapid-acting insulin to correct blood glucose levels. Using Lantus on a sliding scale increases the risk of hypoglycemia and poor glucose control.
Correct Answer Is:
D. Administer insulin glargine (Lantus) based on sliding scale ACHS
3.

A client with COPD is on several medications for maintenance of the progressive disease. Which of the following would the nurse anticipate being ordered for daily use for this client? (Select 3 that apply).

  • A. Guaifenesin (Mucinex)
  • B. Oxymetazoline (Afrin)
  • C. Salmeterol (Serevent)
  • D. Tiotropium (Spiriva)
  • E. Methylprednisolone (Solumedrol)
  • F. Dextromethorphan (Delsym)
  • G. Sotalol (Betapace)
  • H. Bethanechol (Urecholine)

Explanation

Explanation
Explanation of Correct Answers:

C. Salmeterol (Serevent)
Salmeterol is a long-acting beta-agonist (LABA) bronchodilator, used for maintenance therapy in COPD. It works by relaxing the muscles of the airways to help keep them open, making it easier to breathe. It is typically ordered for daily use to control symptoms and prevent flare-ups in COPD patients.

D. Tiotropium (Spiriva)
Tiotropium is an anticholinergic bronchodilator, and it is commonly used as a maintenance treatment for COPD. It helps to relax and open the airways, improving airflow, and is generally administered once daily for long-term symptom control.

E. Methylprednisolone (Solumedrol)
Methylprednisolone is a systemic corticosteroid that is often prescribed for exacerbations of COPD but can also be used for long-term management in certain cases. It helps to reduce inflammation in the airways and improve symptoms. However, it is used with caution due to the potential for long-term side effects.


Correct Answer Is:
C. Salmeterol (Serevent)
D. Tiotropium (Spiriva)
E. Methylprednisolone (Solumedrol)
4.

A client has been using fluticasone (Flovent) for his asthma. He returns to the health care provider's office because he has a sore mouth. Assessment reveals white patches in the client's tongue. What is the best explanation for this?

  • A. The client has been consuming hot beverages after the use of the inhaler, which irritated his throat.
  • B. The client has limited his fluid intake, resulting in a dry mouth and tongue.
  • C. The white patches are just the residue of the inhaler propellant that is coating the inside of his mouth.
  • D. The client likely has developed thrush because he is not rinsing effectively after using the inhaler.

Explanation

Explanation
Explanation of Correct Answer:
D. The client likely has developed thrush because he is not rinsing effectively after using the inhaler.
Fluticasone (Flovent) is an inhaled corticosteroid used for asthma. One common side effect of inhaled corticosteroids is the development of oral thrush (candidiasis), which is a fungal infection in the mouth characterized by white patches on the tongue and inside of the cheeks. This happens because corticosteroids can alter the normal balance of microorganisms in the mouth, allowing fungi like Candida to grow. Rinsing the mouth after using the inhaler helps to prevent this side effect by removing residual medication and reducing the risk of thrush.
Correct Answer Is:
D. The client likely has developed thrush because he is not rinsing effectively after using the inhaler.
5.

What is the mechanism of action of the H1-receptor blockers such as diphenhydramine (Benadryl)?

  • A. They block the leukotriene receptors in the nasal passages.
  • B. They block catecholamines in the respiratory tract.
  • C. They block histamine in smooth muscle found in the respiratory tract.
  • D. They are primarily blocking histamine in the gastric parietal cells.

Explanation

Explanation
Explanation of Correct Answer:
C. They block histamine in smooth muscle found in the respiratory tract.
H1-receptor blockers, such as diphenhydramine (Benadryl), are antihistamines that work by blocking histamine receptors (specifically H1 receptors) in various tissues, including the respiratory tract. Histamine is a chemical released during allergic reactions that causes symptoms like bronchoconstriction, nasal congestion, and swelling. By blocking these receptors, antihistamines help relieve symptoms like sneezing, runny nose, and congestion associated with allergic reactions.
Correct Answer Is:
C. They block histamine in smooth muscle found in the respiratory tract.
6.

A nursing student is reviewing cardiac medications. Which of the following statements is correct?

  • A. The most potent diuretics are potassium-sparing diuretics like Spironolactone or Triamterene
  • B. Warfarin is an anticoagulant that requires INR monitoring
  • C. Alteplase is given to most clients in the hospital prophylactically to prevent blood clots.
  • D. Ezetimibe (Zetia) is an HMG CoA reductase inhibitor

Explanation

Explanation
Warfarin is an oral anticoagulant that works by inhibiting vitamin K-dependent clotting factors. It requires monitoring of the INR (International Normalized Ratio) to ensure the blood is thin enough to prevent clots without causing excessive bleeding. The therapeutic range for INR is typically between 2.0 and 3.0 for most indications, and it is important to regularly check INR levels to adjust the dosage.
Correct Answer Is:
B. Warfarin is an anticoagulant that requires INR monitoring
7.

The nursing student is reviewing medications with the instructor. Which of the following statements is not correct and needs additional follow-up from the instructor?

  • A. Client with Parkinson's disease need the carbidopa to allow the levodopa to cross the blood brain barrier.
  • B. Client who receives haloperidol treatment for schizophrenia will reverse the disease.
  • C. Client with Alzheimer’s can be prescribed donepezil to slow the progression of the disease.
  • D. Clients with cerebral palsy may have an intrathecal baclofen pump to control muscle spasticity.

Explanation

Explanation
Haloperidol does not reverse schizophrenia. Antipsychotic medications are used to control symptoms such as hallucinations, delusions, and disorganized thinking, but they do not cure or reverse the underlying disorder. Schizophrenia is a chronic mental illness that requires long-term management, and symptom control varies among individuals.
Correct Answer Is:
B. Client who receives haloperidol treatment for schizophrenia will reverse the disease.
8.

Soon after beginning sertraline (Zoloft) and cyclobenzaprine (Flexeril), a patient is admitted to the emergency department with nausea, tremors, rapid heart rate, and confusion. The health care provider should suspect which of the following?

  • A. Neuroleptic malignant syndrome
  • B. Stevens-Johnson syndrome
  • C. Serotonin syndrome
  • D. Extrapyramidal symptoms

Explanation

Explanation
The symptoms described—nausea, tremors, tachycardia, and confusion—are classic findings of excess serotonergic activity. Sertraline is an SSRI, and cyclobenzaprine has serotonergic properties; when combined, they can precipitate serotonin toxicity. This condition presents with autonomic instability, neuromuscular hyperactivity, and altered mental status and requires prompt recognition and management.
Correct Answer Is:
C. Serotonin syndrome
9.

A nurse is educating a patient about nicotine replacement therapy using a nicotine patch. Which statement by the patient indicates a need for further teaching about the proper use of the nicotine patch?

  • A. "I will apply the patch to a clean, dry area of skin on my upper arm or chest."
  • B. "I should change the patch to a different site each day to prevent skin irritation."
  • C. "If I experience vivid dreams or trouble sleeping while using the patch, I should remove it before bedtime."
  • D. "I can continue smoking while using the nicotine patch to help gradually reduce my nicotine intake."

Explanation

Explanation
The patient should not continue smoking while using the nicotine patch. The nicotine patch provides a steady, controlled amount of nicotine, and smoking while using the patch could lead to nicotine overdose, causing symptoms like nausea, dizziness, and increased heart rate. The patient should stop smoking while using the patch and rely on the nicotine replacement therapy to reduce cravings and withdrawal symptoms.
Correct Answer Is:
D. "I can continue smoking while using the nicotine patch to help gradually reduce my nicotine intake."
10.

The nurse is caring for a client who is receiving Vancomycin due to having an infected wound with MRSA. The nurse needs to draw a blood level just prior to the next scheduled intravenous (IV) dose this morning. How will this Vancomycin lab level be documented?

  • A. Trough level
  • B. Peak level
  • C. Random serum level
  • D. Drug toxicity screening

Explanation

Explanation
A trough level refers to the lowest concentration of a drug in the blood, which is typically measured just before the next scheduled dose. In the case of Vancomycin, the trough level is crucial to assess whether the drug's concentration is low enough to avoid toxicity but still effective for treating the infection. For Vancomycin, the trough level is drawn prior to the next dose to ensure the drug is within therapeutic range.
Correct Answer Is:
A. Trough level

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