RN Pharmacology Online Practice 2023 A

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Free RN Pharmacology Online Practice 2023 A Questions

1.

A nurse is preparing to administer amoxicillin 250 mg PO to a school-age child. The amount available is amoxicillin oral suspension 200 mg/5 mL. How many mL should the nurse administer per dose? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

  • 6.3 mL
  • 5.5 mL
  • 6.5 mL
  • 7.0 mL

Explanation

Correct Answer Is:
A. 6.3 mL
Explanation
Given:
  • Desired Dose = 250 mg
  • Concentration = 200 mg/5 mL

First, convert the concentration into mg/mL:

Concentration (mg/mL)=200 mg÷5 mL=40 mg/mL

Now, use the desired dose and concentration to find the volume:

Volume to administer (mL)=250 mg÷40 mg/mL=6.25 mL

Rounding 6.25 to the nearest tenth gives us:

Volume to administer (mL)=6.3 mL

Therefore, the nurse should administer 6.3 mL of amoxicillin oral suspension per dose.

2.

A nurse is instructing a client on the application of nitroglycerin transdermal patches. Which of the following statements by the client indicates an understanding of the teaching?

  • "I should apply a patch every 5 minutes if I develop chest pain."
  • "I will take the patch off right after my evening meal."
  • "I will leave the patch off at least 1 day each week."
  • "I should discard the used patch by flushing it down the toilet."

Explanation

Correct Answer Is:
B. "I will take the patch off right after my evening meal."
Explanation
The proper use of nitroglycerin transdermal patches involves wearing the patch for a prescribed duration, typically 12-14 hours, followed by a 10-12 hour "nitrate-free" period to prevent tolerance. This usually aligns with removing the patch in the evening after the client’s last meal of the day, ensuring that they are without the patch overnight.
3.

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?

  • Report the incident to the charge nurse.
  • Notify the provider.
  • Fill out an incident report.
  • 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.
4.

A nurse is providing teaching to a client who is to start therapy with digoxin. For which of the following adverse effects should the nurse instruct the client to monitor and report to the provider?

  • Dry cough
  • Pedal edema
  • Bruising
  • Yellow-tinged vision

Explanation

Correct Answer Is:
D. Yellow-tinged vision
Explanation
Yellow-tinged vision (also known as xanthopsia) is a classic sign of digoxin toxicity. Digoxin, a cardiac glycoside, can cause visual disturbances, including yellow or green vision, halos around lights, and blurred vision. These are important indicators that the client may have digoxin toxicity, which can be life-threatening and requires immediate medical attention.
5.

A nurse is caring for a client who has a magnesium level of 3.1 mEq/L (1.3 to 2.1 mEq/L). The nurse should expect to administer which of the following medications?

  • Magnesium gluconate
  • Cinacalcet
  • Calcium gluconate
  • Regular insulin

Explanation

Correct Answer Is:
C. Calcium gluconate
Explanation
A magnesium level of 3.1 mEq/L is elevated, as the normal range is 1.3 to 2.1 mEq/L. Elevated magnesium levels can lead to symptoms such as muscle weakness, hypotension, respiratory depression, and even cardiac arrhythmias. The first-line treatment for severe hypermagnesemia is the administration of calcium gluconate, which helps to counteract the effects of excess magnesium, particularly on the heart, by stabilizing the myocardial cells and improving cardiac conduction.
6.

A nurse in an emergency department is caring for a client who has myasthenia gravis and is in a cholinergic crisis. Which of the following medications should the nurse plan to administer?

  • Potassium iodide
  • Glucagon
  • Atropine
  • Protamine

Explanation

Correct Answer Is:
C. Atropine
Explanation
A cholinergic crisis in myasthenia gravis is caused by excessive acetylcholine due to overdose of acetylcholinesterase inhibitors (e.g., pyridostigmine). Symptoms include excessive secretions, bradycardia, muscle weakness, and respiratory distress. Atropine is an anticholinergic that counteracts muscarinic effects (e.g., bradycardia, bronchial secretions). Potassium iodide (A) is used for thyroid storm. Glucagon (B) is used for hypoglycemia or beta‑blocker overdose. Protamine (D) reverses heparin.
7.

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?

  • Docusate sodium reduces the surface tension of the stools to change their consistency.
  • Docusate sodium causes rectal contractions.
  • Docusate sodium acts as a fiber agent, increasing bulk in the intestines.
  • 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.
8.

A nurse is providing discharge teaching about handling medication to a client who is to continue taking oral transmucosal fentanyl raspberry-flavored lozenges on a stick. Which of the following information should the nurse include in the teaching?

  • Chew on the medication stick to release the medication.
  • Leave the medication stick in one location of the mouth until melted.
  • Allow the medication 1 hour for analgesia effects to begin.
  • Store unused medication sticks in a storage container.

Explanation

Correct Answer Is:
B. Leave the medication stick in one location of the mouth until melted.
Explanation
Oral transmucosal fentanyl lozenges (often referred to as Actiq) should be allowed to dissolve slowly in the mouth. The medication stick should be held in one location in the mouth, typically between the cheek and gum, and not chewed. This allows for proper absorption of the medication through the mucous membranes. Chewing the stick would interfere with the intended absorption method and could lead to adverse effects.
9.

A nurse is monitoring an older adult client who has heart failure for adverse effects of hydrochlorothiazide after administering the medication. Which of the following findings should the nurse identify as an adverse effect of the medication?

  • Hypoglycemia
  • Orthostatic hypotension
  • Bradycardia
  • Conjunctivitis

Explanation

Correct Answer Is:
B. Orthostatic hypotension
Explanation
Hydrochlorothiazide is a thiazide diuretic commonly used to treat heart failure and hypertension. A known adverse effect of hydrochlorothiazide is orthostatic hypotension, which can occur due to the diuretic's effect on fluid balance and blood pressure. This effect is more pronounced in older adults due to changes in blood vessel elasticity and the body's ability to adjust to postural changes. The nurse should monitor for signs of dizziness, lightheadedness, or fainting when the client changes positions from lying to standing.
10.

A nurse is providing teaching to a client who has depression and a new prescription for fluoxetine. Which of the following statements by the client indicates an understanding of the teaching?

  • "I should start to feel better within 24 hours of starting this medication."
  • "I will be sure to follow a strict diet to avoid foods with tyramine."
  • "I will continue to take St. John's Wort to increase the effects of the medication."
  • "I should take acetaminophen instead of ibuprofen for my headaches while taking this medication."

Explanation

Correct Answer Is:
D. "I should take acetaminophen instead of ibuprofen for my headaches while taking this medication."
Explanation
Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) used to treat depression. One important consideration when taking fluoxetine is the potential interaction with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, which can increase the risk of bleeding, especially when taken with SSRIs. Acetaminophen is generally considered safer for pain relief because it does not have the same blood-thinning effects as NSAIDs.

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