Pharmacology Final Exam
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Free Pharmacology Final Exam Questions
A client is prescribed an antibiotic for a bacterial infection and states, "I feel better now, so I'm going to stop taking it." Which response by the nurse is best?
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"You can stop the medication once your symptoms disappear."
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"You should save the remaining medication in case you become sick again."
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"You should complete the prescribed course unless your healthcare provider tells you otherwise."
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"You can take the medication only when you have a fever."
Explanation
Correct Answer:
(C) "You should complete the prescribed course unless your healthcare provider tells you otherwise." Completing the full prescribed course of antibiotics is essential to fully eradicate the bacterial infection and prevent the development of antibiotic-resistant bacteria, even after symptoms have improved or resolved.
Why the other options are incorrect:
A. "You can stop the medication once your symptoms disappear." This is incorrect and unsafe teaching; stopping antibiotics early, even when feeling better, can lead to incomplete treatment and antibiotic resistance.
B. "You should save the remaining medication in case you become sick again." This is inappropriate and unsafe; leftover antibiotics should not be saved or reused for future illnesses, as this can lead to improper self-treatment and resistance.
D. "You can take the medication only when you have a fever." This is incorrect; antibiotics must be taken consistently as prescribed for the full course, not intermittently based on symptoms like fever.
The provider prescribes acetaminophen 650 mg PO. The medication is available as 160 mg/5 mL. How many mL should the nurse administer?
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10.3 mL
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15.6 mL
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20.3 mL
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32.5 mL
Explanation
Correct Answer:
(C) 20.3 mL. Concentration: 160 mg/5 mL = 32 mg/mL. Volume: 650 mg ÷ 32 mg/mL = 20.3 mL
The nurse is providing discharge teaching to a client taking spironolactone. Which statement indicates that the client understands the teaching?
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"I will increase my intake of potassium supplements."
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"I will avoid foods that are high in potassium unless instructed otherwise."
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"I should take an extra dose if my ankles become swollen."
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"I should expect my blood pressure to increase."
Explanation
Correct Answer:
(B) "I will avoid foods that are high in potassium unless instructed otherwise." Spironolactone is a potassium-sparing diuretic that increases the risk of hyperkalemia; the client should avoid excessive intake of high-potassium foods and potassium supplements unless specifically directed by the provider, making this statement indicate correct understanding.
Why the other options are incorrect:
A. "I will increase my intake of potassium supplements." This is incorrect and dangerous; combining potassium supplements with a potassium-sparing diuretic significantly increases the risk of life-threatening hyperkalemia.
C. "I should take an extra dose if my ankles become swollen." This is incorrect; clients should never adjust their own medication dose without provider guidance, regardless of symptoms.
D. "I should expect my blood pressure to increase." This is incorrect; spironolactone is used to help lower blood pressure and reduce fluid retention, not increase blood pressure.
The nurse needs to infuse 1,000 mL of 0.9% sodium chloride over 8 hours. What should the IV pump be programmed to deliver?
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180 mL/hr
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125 mL/hr
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145 mL/hr
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150 mL/hr
Explanation
Correct Answer:
(B) 125 mL/hr. 1,000 mL ÷ 8 hr = 125 mL/hr
Which laboratory value is most important for the nurse to monitor in a client receiving an ACE inhibitor such as lisinopril?
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Potassium
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Hemoglobin
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Platelets
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Calcium
Explanation
Correct Answer:
(A) Potassium. ACE inhibitors like lisinopril can cause hyperkalemia by reducing aldosterone secretion, which decreases potassium excretion by the kidneys; monitoring potassium levels is essential to detect and prevent dangerous elevations that can lead to cardiac dysrhythmias.
Why the other options are incorrect:
B. Hemoglobin. Hemoglobin is not a primary lab value of concern specifically associated with ACE inhibitor therapy.
C. Platelets. Platelet counts are not typically affected by or monitored specifically for ACE inhibitor therapy.
D. Calcium. Calcium levels are not a primary concern associated with ACE inhibitor use; this is more relevant to other medication classes, such as certain diuretics.
The nurse must administer 500 mL of IV fluid over 4 hours. The IV tubing has a drop factor of 15 gtt/mL. How many gtt/min should the nurse administer?
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21 gtt/min
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25 gtt/min
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31 gtt/min
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42 gtt/min
Explanation
Correct Answer: (C) 31 gtt/min.
- Rate: 500 mL ÷ 4 hr = 125 mL/hr = 125 mL ÷ 60 min = 2.083 mL/min
- gtt/min: 2.083 mL/min × 15 gtt/mL = 31.25, rounded to 31 gtt/min
A client is prescribed an antibiotic, lisinopril, and an inhaled medication. During medication administration, the client suddenly develops difficulty breathing and swelling of the face. Which action should the nurse take first?
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Complete the medication administration record.
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Assess the client's airway and breathing.
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Ask the client whether they have eaten breakfast.
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Reassure the client that the symptoms are expected.
Explanation
Correct Answer:
(B) Assess the client's airway and breathing. Using the airway-breathing-circulation priority framework, sudden difficulty breathing and facial swelling suggest a potential anaphylactic reaction or angioedema; the nurse's first priority is always to assess and protect the client's airway and breathing, as this is a life-threatening emergency.
Why the other options are incorrect:
A. Complete the medication administration record. Documentation is important but should never take priority over addressing an immediate, life-threatening airway/breathing emergency.
C. Ask the client whether they have eaten breakfast. This is irrelevant to the client's acute, life-threatening presentation and delays urgent assessment and intervention.
D. Reassure the client that the symptoms are expected. This is inaccurate and dangerous; difficulty breathing and facial swelling are not expected, benign findings and require immediate emergency assessment and intervention, not false reassurance.
A nurse is administering IV antibiotics to a client who has a bacterial infection. Which assessment finding is the priority for the nurse to report?
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Temperature of 100.4°F (38°C)
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Mild nausea after the medication
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New onset of wheezing and facial swelling
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Decreased appetite
Explanation
Correct Answer:
(C) New onset of wheezing and facial swelling. These findings are classic signs of an acute allergic/anaphylactic reaction, a life-threatening emergency that requires immediate reporting and intervention to protect the client's airway and prevent respiratory compromise.
Why the other options are incorrect:
A. Temperature of 100.4°F (38°C). A mild fever is expected in a client with a bacterial infection and is not an urgent finding requiring immediate report.
B. Mild nausea after the medication. This is a common, mild, and expected side effect of many antibiotics that does not represent an emergency.
D. Decreased appetite. This is a nonspecific, mild finding that can accompany illness and antibiotic therapy but is not an urgent safety concern.
Which medication would the nurse expect to be used as a rescue medication for acute bronchospasm?
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Albuterol
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Inhaled corticosteroid
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Montelukast
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Fluticasone
Explanation
Correct Answer:
(A) Albuterol. Albuterol is a short-acting beta-2 agonist that works rapidly to relax bronchial smooth muscle and reverse acute bronchospasm, making it the appropriate rescue medication for immediate relief during an asthma attack or acute bronchospasm episode.
Why the other options are incorrect:
B. Inhaled corticosteroid. This is a long-term controller medication used to reduce airway inflammation over time and is not effective for immediate relief of acute bronchospasm.
C. Montelukast. This is a leukotriene receptor antagonist used for long-term asthma control/prevention, not for rapid relief during an acute bronchospasm episode.
D. Fluticasone. This is an inhaled corticosteroid used as a long-term controller medication for airway inflammation, not a fast-acting rescue medication for acute bronchospasm.
The nurse enters a client's room to administer medications and notices that the client states, "This pill looks different from the one I normally take." What should the nurse do first?
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Tell the client that medications may look different depending on the manufacturer.
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Administer the medication because it is listed on the MAR.
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Hold the medication until its identity and order are verified.
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Ask another client whether they recognize the medication.
Explanation
Correct Answer:
(C) Hold the medication until its identity and order are verified. Any client concern about a medication appearing different should always be taken seriously as a potential safety signal; the nurse's priority is to hold the medication and verify its identity and the order before administering it, in order to prevent a possible medication error.
Why the other options are incorrect:
A. Tell the client that medications may look different depending on the manufacturer. While this is sometimes true, assuming this without first verifying the medication's identity and order is unsafe and dismisses a valid client safety concern.
B. Administer the medication because it is listed on the MAR. The MAR listing the medication does not eliminate the possibility of a dispensing or administration error; the client's concern warrants verification before proceeding.
D. Ask another client whether they recognize the medication. This is an inappropriate and unsafe action that breaches confidentiality and does not provide a valid way to verify medication accuracy.
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