RN Pharmacology Online Practice 2023 A
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A nurse at an urgent care clinic is collecting a history from a client who has a urinary tract infection. The nurse anticipates a prescription for ciprofloxacin. The nurse should identify that which of the following client statements indicates a contraindication for administering this medication?
- A. "I have tendonitis, so I haven't been able to exercise."
- B. "I take a stool softener for chronic constipation."
- C. "I take medicine for my thyroid."
- D. "I am allergic to sulfa."
Explanation
Correct Answer Is:
A. "I have tendonitis, so I haven't been able to exercise."Explanation
Ciprofloxacin, a fluoroquinolone antibiotic, has a black box warning regarding the risk of tendonitis and tendon rupture, particularly in older adults or those who have pre-existing tendon issues. The nurse should identify tendonitis as a contraindication or caution for using ciprofloxacin due to the increased risk of tendon injury, especially with physical activity or weight-bearing exercises.A nurse is caring for a 20-year-old client who has a prescription for isotretinoin for severe nodulocystic acne vulgaris. Before the client can obtain a refill, the nurse should advise the client that which of the following tests is required?
- A. Serum calcium
- B. Pregnancy test
- C. 24-hr urine collection for protein
- D. Aspartate aminotransferase level
Explanation
Correct Answer Is:
B. Pregnancy testExplanation
Isotretinoin, a powerful medication used to treat severe acne, is highly teratogenic, meaning it can cause severe birth defects if taken during pregnancy. Due to this risk, a pregnancy test is required before starting isotretinoin treatment and before each refill. Women of childbearing potential must be counseled about the risks, and they are typically required to use two forms of contraception while on the medication. A negative pregnancy test is necessary to proceed with the prescription.A nurse is preparing to administer heparin subcutaneously to a client. Which of the following actions should the nurse plan to take?
- A. Administer the medication outside the 5-cm (2-in) radius of the umbilicus.
- B. Aspirate for blood return before injecting.
- C. Rub vigorously after the injection to promote absorption.
- D. Place a pressure dressing on the injection site to prevent bleeding.
Explanation
Correct Answer Is:
A. Administer the medication outside the 5-cm (2-in) radius of the umbilicus.Explanation
When administering heparin subcutaneously, it is important to avoid injecting into areas close to the umbilicus, as this can increase the risk of irritation, bruising, or inconsistent absorption. The recommended injection sites are typically the fatty tissue of the abdomen (at least 2 inches from the umbilicus), as it ensures optimal absorption.A nurse is reviewing the medication administration record of a client who has hypocalcemia and a new prescription for IV calcium gluconate. The nurse should identify that which of the following medications can interact with calcium gluconate?
- A. Felodipine
- B. Guaifenesin
- C. Digoxin
- D. Regular insulin
Explanation
Correct Answer Is:
C. DigoxinExplanation
Calcium gluconate can potentiate the effects of digoxin, increasing the risk of digoxin toxicity (arrhythmias, nausea, visual disturbances). Therefore, IV calcium should be administered cautiously to clients on digoxin, with close monitoring of cardiac rhythm. Felodipine (A) is a calcium channel blocker but does not have a significant direct interaction with calcium gluconate. Guaifenesin (B) is an expectorant with no known interaction. Regular insulin (D) is not contraindicated, though calcium may be given with glucose and insulin for hyperkalemia, but that is a therapeutic combination, not an adverse interaction.A nurse is caring for a client who is receiving filgrastim. Which of the following findings should the nurse document to indicate the effectiveness of the therapy?
- A. Increased RBC count
- B. Increased neutrophil count
- C. Decreased prothrombin time
- D. Decreased triglycerides
Explanation
Correct Answer Is:
B. Increased neutrophil countExplanation
Filgrastim is a granulocyte colony-stimulating factor (G-CSF) that stimulates the production of neutrophils, which are a type of white blood cell. It is commonly used to treat neutropenia, especially in clients undergoing chemotherapy or those with other conditions that result in low neutrophil counts. An increase in the neutrophil count indicates the effectiveness of the therapy.A nurse in a provider's office is assessing a client who has been taking aspirin daily for the past year. For which of the following findings should the nurse immediately notify the provider?
- A. Hyperventilation
- B. Heartburn
- C. Anorexia
- D. Swollen ankles
Explanation
Correct Answer Is:
A. HyperventilationExplanation
Hyperventilation can be a sign of aspirin toxicity, particularly in chronic use. Aspirin can cause respiratory alkalosis, leading to symptoms such as rapid breathing or hyperventilation. If a client experiences hyperventilation while on long-term aspirin therapy, the nurse should immediately notify the provider as it may indicate toxicity, which requires prompt medical attention.A nurse is assessing a client 1 hour after administering morphine for pain. Which of the following findings should the nurse identify as the best indication that the morphine has been effective?
- A. The client's vital signs are within normal limits.
- B. The client has not requested additional medication.
- C. The client is resting comfortably with eyes closed.
- D. The client rates pain as 3 on a scale of 0 to 10.
Explanation
Correct Answer Is:
D. The client rates pain as 3 on a scale of 0 to 10.Explanation
The best indication of the effectiveness of pain medication like morphine is the client’s pain rating. A reduction in pain intensity, as indicated by a lower pain score (e.g., from a higher number to 3 on a 0-10 scale), directly reflects the medication’s effectiveness in managing the client’s pain.A nurse is teaching about self-administration of transdermal medication with a client who has a new prescription for nitroglycerin. Which of the following client statements indicates an understanding of the teaching?
- A. "I can apply the patch to a chest area that has hair."
- B. "I can take this medication while using an erectile dysfunction product."
- C. "I will remove the patch after 14 hours."
- D. "I need to apply a new patch to the same area every day."
Explanation
Correct Answer Is:
C. "I will remove the patch after 14 hours."Explanation
For nitroglycerin patches, the typical regimen involves applying the patch for 12-14 hours, followed by a 10-12 hour drug-free period to prevent tolerance. The client should remove the patch after 14 hours to give the body a break from continuous medication and avoid the development of tolerance to the medication’s effects.A nurse is teaching a client who has a new prescription for docusate sodium about the medication's mechanism of action. Which of the following information should the nurse include in the teaching?
- A. Docusate sodium reduces the surface tension of the stools to change their consistency.
- B. Docusate sodium causes rectal contractions.
- C. Docusate sodium acts as a fiber agent, increasing bulk in the intestines.
- D. Docusate sodium stimulates the motility of the intestines.
Explanation
Correct Answer Is:
A. Docusate sodium reduces the surface tension of the stools to change their consistency.Explanation
Docusate sodium is a stool softener that works by lowering the surface tension of stool, allowing water and fats to penetrate the stool more easily. This results in softer stools, making them easier to pass. It does not directly stimulate the intestines or act as a fiber agent, but rather helps to soften the stool to prevent straining during bowel movements.A nurse administers a dose of metformin to a client instead of the prescribed dose of metoclopramide. Which of the following actions should the nurse take first?
- A. Report the incident to the charge nurse.
- B. Notify the provider.
- C. Fill out an incident report.
- D. Check the client's blood glucose.
Explanation
Correct Answer Is:
D. Check the client's blood glucose.Explanation
Metformin is a medication used to lower blood glucose levels, while metoclopramide is a medication used to treat nausea and vomiting. The nurse should first assess the client's blood glucose level to determine if the incorrect dose of metformin is affecting the client’s current condition. Checking the blood glucose is a priority because metformin can cause a significant decrease in blood glucose levels, which could result in hypoglycemia. After assessing the client’s immediate safety, the nurse can then take the next appropriate actions.How to Order
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