Pharmacology Unit 1 NCLEX Questions

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Chapters 1-3, 7, 11-12, 15-17

c. Absorption, distribution, metabolism, excretion

It is important for the nurse to be aware of the four sequential processes of the pharmacokinetic phase. What are these processes?

a. Distribution, metabolism, excretion, absorption
b. Biotransformation, excretion, absorption, metabolism
c. Absorption, distribution, metabolism, excretion
d. Metabolism, distribution, absorption, excretion

a. Once daily
b. Twice daily

It is expected that the nurse will question the health care provider if a drug with a t1/2 of >24 hours is ordered to be given more than how often? (Select all that apply).

a. Once daily
b. Twice daily
c. Twice weekly
d. Once weekly

b. A drug not bound to protein is an active drug.

Which of these statements is correct?

a. A drug bound to protein is an active drug.
b. A drug not bound to protein is an active drug.
c. Most receptors are found under cell membrane.
d. Toxic effects can result if the trough level is low.

b. A narrow margin of safety

The nurse notices that one of the client's drugs has a low therapeutic index. What is the most important nursing implication of this?

a. A wide margin of safety
b. A narrow margin of safety
c. Measured 1 hour after administration
d. Measured 10 minutes after administration

a. Creatinine clearance

One of the client's drugs has a potential adverse effect of nephrotoxicity. Which test is most accurate to determine renal function?

a. Creatinine clearance
b. Blood urea nitrogen
c. Glomerular filtration rate
d. Renal clearance

d. Half-life

The nurse reviews the client's medication regimen, including the interval of drug dosage, which is related to which of the following?

a. Stimulation of receptors
b. Trough level
c. Therapeutic index
d. Half-life

a. Identify side effects of drugs that are nonspecific
b. Check peak and trough levels of drugs

Nursing responsibilities in the assessment phase of the nursing process include which responsibilities? (Select all that apply.)

a. Identify side effects of drugs that are nonspecific
b. Check peak and trough levels of drugs
c. Advise client to avoid fatty foods prior to ingesting an enteric coated tablet
d. Evaluate client's reaction to drug

b. Deficient knowledge

During a medication review session, a client comments, "I just do not know why I am taking all of these pills." This comment suggests which nursing diagnosis?

a. Risk for injury
b. Deficient knowledge
c. Risk for aspiration
d. Anxiety

c. The client will independently self-administer the prescribed dose of albuterol by the end of the second teaching session.

The nurse is developing goals in collaboration with the client. Which is the best goal statement?

a. The client will self-administer albuterol by tomorrow.
b. The client will self-administer the prescribed dose of albuterol by the end of the second teaching session.
c. The client will independently self-administer the prescribed dose of albuterol by the end of the second teaching session.
d. The client will organize her medications by tomorrow.

b. Establish a trust relationship.

The nurse is aware of the many factors related to effective health teaching about the medication. The most essential component of the teaching plan is to do which?

a. Provide written instructions.
b. Establish a trust relationship.
c. Use colorful charts.
d. Review community resources.

a. Importance of adherence to the prescribed regimen
b. How to administer medication (s)
c. What side/adverse effects to report to the health care provider

A medication health teaching plan is tailored to a specific client. Common topics for health teaching include which? (Select all that apply.)

a. Importance of adherence to the prescribed regimen
b. How to administer medication (s)
c. What side/adverse effects to report to the health care provider
d. Instruction of the client on what foods should be eaten

d. Readiness for enhanced self-care activities

The client's goals have been met during hospitalization. At the time of discharge, which nursing diagnosis is most probable?

a. Knowledge deficient
b. Ineffective coping
c. Readiness for enhanced social interaction
d. Readiness for enhanced self-care activities

a. "You should mix medications with coffee grounds before disposal."
c. "You should remove identifying information on the original container."

The client asks about disposal of medications. What are the nurse's best responses? (Select all that apply.)

a. "You should mix medications with coffee grounds before disposal."
b. "You should pour medications down the sink."
c. "You should remove identifying information on the original container."
d. "You should pulverize all tables before disposal."

d. "I prefer to chew the drug before swallowing it."

The client is taking duastride (Avodart). Which client comment indicates the need for more education about the drug?

a. "I'm glad I can take the medication with or without food."
b. "It is good that no lab tests and monitoring are required."
c. "This drug is expensive."
d. "I prefer to chew the drug before swallowing it."

b. Limit access to these drugs.
c. Use special labels.
d. Provide increased information to staff.

The nurse educator on the unit receives a list of high-alert drugs. Which strategies are recommended to decrease the risk of errors with these medication? (Select all that apply.)

a. Store medications alphabetically on their usual shelf.
b. Limit access to these drugs.
c. Use special labels.
d. Provide increased information to staff.

b. h.s.
c. T.I.W.
d. b.i.d.

The nurse is aware that according to The Joint Commission, which abbreviations are not on the do-not-use list for ordering or documenting medications? (Select all that apply.)

a. QD
b. h.s.
c. T.I.W.
d. b.i.d.

d. Explain the risks of not taking the medication.

The client refuses to take his prescribed medications. Which is the nurse's best response to this client?

a. Explain the benefits and side effects of the drug.
b. Leave the medication at the client's bedside to be taken later.
c. Persuade the client to take the medication.
d. Explain the risks of not taking the medication.

d. Uses eye contact sparingly

The nurse is performing a health assessment on a newly admitted client who is of Asian descent. The client looks at the floor whenever the nurse asks a question. Communication is enhanced when the nurse does which action?

a. Frequently touches the client
b. Asks questions that require only "yes" or "no" for answers
c. Discontinues the health assessment
d. Uses eye contact sparingly

b. Inform the prescriber that the antihypertensive drug therapy is not working

The nurse has been measuring the blood pressure of an African-American client every 4 hours for the past 3 days in a hospital setting. The blood pressure is consistently above 140/90. The client has been compliant with the antihypertensive drug therapy while hospitalized. The nurse will initially perform which action?

a. Question the client about the types of food consumed in the last 3 to 4 days.
b. Inform the prescriber that the antihypertensive drug therapy is not working
c. Increase blood pressure measurements to every 2 hours.
d. Place the client on a restricted fluid intake.

b. Delegate nursing care that involves touching to a female member of the nursing team whenever appropriate

A male nurse has been assigned to care for a young, married woman who practices Islam. It is important that the nurse perform which action?

a. Not touch any part of the client's body
b. Delegate nursing care that involves touching to a female member of the nursing team whenever appropriate
c. Touch the client only when her spouse is present
d. Communicate to the nurse manager that he cannot take care of female clients who practice Islam

c. The client repeats the nurse's instructions to her mother who is present during the teaching.

A nurse is teaching a 16-year old female client about a newly prescribed medication. The client is bilingual in Spanish and English. Which behavior best indicates the client's understanding of the instructions?

a. The client frequently nods her head while listening to the nurse's instructions.
b. The client states that she understands the instructions.
c. The client repeats the nurse's instructions to her mother who is present during the teaching.
d. The client does not ask the nurse for any clarification of the instructions.

b. Little relief of the pain

An Asian client is being treated in the emergency department for a fractured right ankle. The physician has ordered codeine for complaints of plain. The client denies any allergies. The nurse would anticipate that after administration of the codeine, the client will experience what response?

a. Quick relief of the pain
b. Little relief of the pain
c. Idiosyncratic responses
d. Signs of anaphylaxis

c. "I need to take the medicine as scheduled to reduce the possibility of damage to my body."

A Native American client is newly diagnosed with diabetes mellitus type 2 and is prescribed the antidiabetic drug metformin (Glucophage) 500 mg PO with morning and evening meals. Which statement best indicates to the nurse that the client will adhere to the pharmacotherapy?

a. "I will no longer put sugar on my cereal."
b. "I will feel better soon if I take this medicine."
c. "I need to take the medicine as scheduled to reduce the possibility of damage to my body."
d. "I have diabetes because of my ancestry."

a. "I need to administer this injection in the upper, outer quadrant of his buttocks."

An 8-month-old boy is discharged from the hospital with a plan of care to receive intramuscular (IM) injections each day. The parents have been taught how to administer IM injections. Which statements, if verbalized by the parents, indicates a need for more teaching?

a. "I need to administer this injection in the upper, outer quadrant of his buttocks."
b. "IM injections are safe for children if administered correctly."
c. "When I give my child this injection, the safest place for insertion is the thigh."
d. "I will need someone to assist me to hold my child while I give the injection."

c. Using an oral syringe

A 4-year-old client is to be discharged home on an oral liquid drug suspension of 4 mL per dose. Which would the nurse recommend to ensure the highest level of accuracy in home administration of the medication?

a. Using a household teaspoon
b. Using a cooking measuring spoon
c. Using an oral syringe
d. Using a graduated medicine cup

0.5 mL

A child is ordered to receive naloxone (Narcan) IV, STAT. The child's weight is 20 kg, and the recommended child's drug dosage is 0.01 mg/kg. Naloxone is available in 400 mcg/mL solution. The nurse should administer:

c. 8 mL

A pediatric client is ordered to receive 3 mg/kg of a medication. The client weighs 88 pounds. The medication is available in a 15 mg/mL elixir. How much medication should the client receive?

a. 2 mL
b. 4 mL
c. 8 mL
d. 16 mL

c. The most important assessment is to evaluate for drug accumulation, because the excretion of drugs in children is slower.

The nurse understands the differences between drug excretion in children and that in adults. With this knowledge, the nurse makes the which decision in administering medication to children?

a. Because most children need a higher dose of medications, the nurse will contact the physician for an increase in the ordered dose.
b. Because children excrete drugs rapidly, the nurse will need to assess carefully for therapeutic effects of the medication.
c. The most important assessment is to evaluate for drug accumulation, because the excretion of drugs in children is slower.
d. The excretion of most drugs is the same in children as in adults, but assessments are important to avoid side effects.

c. Providing age-appropriate explanations

A parent is learning to administer medication to a school-aged child. Which strategy should the nurse teach the parent to achieve cooperation in a child of this age?

a. Enlisting physical restraint
b. Tolerating violent reactions
c. Providing age-appropriate explanations
d. Establishing medication contracts

b. The dose will be decreased.

The nurse is caring for a neonate with lower-than-normal albumin levels. The nurse is ordered to administer a medication that is highly protein bound. The nurse knows that the dose needs to be altered in which way to respond to these factors?

a. The dose will be increased.
b. The dose will be decreased.
c. highly protein-bound drugs will be contraindicated.
d. The nurse must further clarify the medication order before administration.

a. That older adults consume 30% of all prescription medications

An older adult client comments, "It seems that all I do is take medicines." What does this comment reflect?

a. That older adults consume 30% of all prescription medications
b. That older adults may have multiple chronic conditions
c. That older adults may take too many OTC preparations
d. That older adults may take too many herbal preparations

a. Taking multiple drugs at one time
b. Impaired memory
c. Decreased dexterity

The client has nine medications prescribed to take daily. Which are common reasons for nonadherence to the drug regimen in the older adult? (Select all that apply.)

a. Taking multiple drugs at one time
b. Impaired memory
c. Decreased dexterity
d. Increased mobility

d. Increased pH of gastric secretions

The nurse reviews the client's list of medications with the client. The nurse knows that the 88-years-old client's slower absorption of oral medications is primarily because of which phenomenon?

a. Decreased cardiac output
b. Decreased blood flow
c. Decreased enzyme function
d. Increased pH of gastric secretions

a. First-pass effect

The older adult client has questions about oral drug metabolism. Which information should be included in this client's teaching plan?

a. First-pass effect
b. Enzyme function
c. Glomerular filtration rate
d. Motility

a. "You have increased circulation of free drug."

A 97-year-old client asks why a protein supplement has been prescribed. What is the nurse's best response to the client?

a. "You have increased circulation of free drug."
b. "You have decreased hepatic size."
c. "You have decreased calcium absorption."
d. "You have increased motility."

a. Short-intermediate acting
b. Rapidly eliminated

An 80-year-old client complains of recent onset of insomnia, saying, "If I could only get to sleep!" If a drug is prescribed, which drug characteristics would be best for this situation? (Select all that apply.)

a. Short-intermediate acting
b. Rapidly eliminated
c. Slowly eliminated
d. Multiple metabolites

d. vitamin E

The nurse is reviewing the client's laboratory test results and current medications. The nurse notes that the client's prothrombin time is prolonged. What vitamin might be contributing to this?

a. vitamin A
b. vitamin B
c. vitamin D
d. vitamin E

a. vitamin A

The client comes to the office with chief complaint of hair loss and peeling skin. The nurse notes that many vitamins are on the list of medications that the client reports using to treat liver disease. The client's complaint may be caused by excess of what vitamin?

a. vitamin A
b. vitamin B
c. vitamin C
d. vitamin D

b. Regulating calcium and phosphorus metabolism

The nurse routinely includes health teaching about vitamins to clients. Vitamin D has a major role in which process?

a. Ensuring night and color vision
b. Regulating calcium and phosphorus metabolism
c. Body growth
d. DNA and prothrombin synthesis

a. Colorectal cancer

The nurse is doing preconception counseling with the client. Folic acid is included in health teaching plan because it is known to prevent CNS anomalies and may offer protection from which disorder?

a. Colorectal cancer
b. Diabetes mellitus
c. Celiac disease
d. Migraine headaches

c. "Megadoses of vitamins can be harmful in the first trimester."

A prenatal client tells the nurse that she is not taking vitamins because she heard that "vitamins may cause damage to my baby." What is the best response by the nurse?

a. "Vitamins can only help you and your baby."
b. "Take extra vitamins now to make up for missed doses."
c. "Megadoses of vitamins can be harmful in the first trimester."
d. "Taking above the RDA of any vitamin is not recommended."

c. Fat-soluble vitamins are excreted slowly in urine.

The client asks the nurse about fat-soluble vitamins. What is the nurse's best response?

a. Fat-soluble vitamins are metabolized rapidly.
b. Fat-soluble vitamins cannot be stored in the liver.
c. Fat-soluble vitamins are excreted slowly in urine.
d. Fat-soluble vitamins cannot be toxic.

b. Whole milk and eggs

The client complains of night blindness. The nurse correctly recommends which food?

a. Skim milk and peas
b. Whole milk and eggs
c. Nuts and yeast
d. Enriched bread and cereal

b. B12

The alcoholic client has questions about his medications. The nurse correctly explains that alcoholism can be associated with deficiency of which vitamin?

a. A
b. B12
c. D
d. K

d. D

The client complains of anorexia, nausea, and vomiting. The client's list of medications includes multiple large doses of vitamins. The nurse notes that the client's complaints may be related to early signs of toxicity of which vitamin?

a. A
b. B.
c. C
d. D

a. Hypokalemia

The client has been vomiting and has weak, flabby muscles. The client's pulse is irregular. The nurse would correctly suspect what type of imbalance?

a. Hypokalemia
b. Hyperkalemia
c. Hypocalcemia
d. Hypercalcemia

b. It must be diluted.

The client is receiving potassium supplements. What is the most important nursing implication when administering this drug?

a. It cannot be given as an IV bolus.
b. It must be diluted.
c. It must be chilled before administration.
d. It must be given only at bedtime.

d. Severe hyperkalemia

The client is due to receive Kayexalate for complaints of nausea, vomiting, abdominal cramps, short QT interval, weakness and oliguria. The nurse is aware that this drug is used to treat which imbalance?

a. Hypocalcemia
b. Severe hypercalcemia
c. Hypokalemia
d. Severe hyperkalemia

c. Cortisone preparations

The nurse reviews the client's list of medications and results of laboratory tests. Which drugs type may cause an elevated serum sodium level?

a. Antifugals
b. Oral contraceptives
c. Cortisone preparations
d. Antiepileptics

b. Avoid selected laxatives and antacids.

The client's magnesium level is 2.7 mEq/L. Specific health teaching by the nurse for this client should include which suggestion?

a. Eat fruits, fish, and peanut butter.
b. Avoid selected laxatives and antacids.
c. Avoid magnesium, which is irritating to the stomach.
d. Measure weight daily.

a. Measure weight daily.
b. Know that thirst means a mild fluid deficit.
c. Monitor fluid intake.

The client is receiving fluid replacement. The nurse's health teaching with this client includes which suggestions? (Select all that apply.)

a. Measure weight daily.
b. Know that thirst means a mild fluid deficit.
c. Monitor fluid intake.
d. Avoid the use of calcium supplements.

c. 4

The client gained 10 pounds in 2 days. It is determined that the weight gain is caused by fluid retention. The nurse correctly estimates that the weight gain may be equivalent to how many liters of fluid?

a. 2
b. 3
c. 4
d. 5

a. Meat, milk, whole grain cereals, nuts

The health teaching for a client with hypophosphatemia includes eating which foods?

a. Meat, milk, whole grain cereals, nuts
b. Dairy products, vitamin D supplements
c. Dairy products, protein-rich foods
d. Dairy products, nuts, vitamin C supplements

a. "Tetracycline does not affect my medications."
b. "I can take as much calcium as I want."

The nurse reviews the client's medications as part of the initial interview for admission to the cardiac clinic. Which comment by the client indicates a need for health teaching? (Select all that apply.)

a. "Tetracycline does not affect my medications."
b. "I can take as much calcium as I want."
c. "Calcium increases the effects of my digoxin."
d. "Magnesium and potassium deficits can cause digoxin toxicity."

b. 125 mL

The nurse determines the client's gastric residual before administering an enteral feeding; the last feeding was 240 mL. The client will be discharged on enteral feedings. It is important to include in the health teaching plan that a residual of more than which amount would indicate a delayed gastric emptying (based on last feeding)?

a. 100 mL
b. 125 mL
c. 150 mL
d. 175 mL

d. Room temperature

It is essential for the client who self-administers the enteral feeding to know that the feeding should be administered at which temperature?

a. Slightly warmed
b. Chilled
c. Ice cold
d. Room temperature

c. Diarrhea

The nurse reviews the client's plan of care, which includes strategies to prevent which common complication of enteral feedings?

a. Aspiration
b. Constipation
c. Diarrhea
d. Muscle weakness

b. Air embolism

The client is receiving TPN. Health teaching for this client includes the Valsalva maneuver, which is done to prevent which condition?

a. Infection
b. Air embolism
c. Dehydration
d. Fat embolism

d. Hypoglycemia

The client has been on TPN for 1 month, and there is an order to discontinue TPN tomorrow. The nurse contacts the health care provider because sudden interruption of TPN therapy may cause which condition?

a. Dehydration
b. Tremors
c. Hyperglycemia
d. Hypoglycemia

b. Wear gloves when handling feeding tubing.
c. Label enteral equipment.
d. Verify that enteral tubing connects formula to feeding tube.

The nurse prepares to present the Be A.L.E.R.T. campaign to colleagues. Which instructions are important to include? (Select all that apply.)

a. Elevate head of bed to 90 degress.
b. Wear gloves when handling feeding tubing.
c. Label enteral equipment.
d. Verify that enteral tubing connects formula to feeding tube.

a. Every 24 hours

The client receives TPN at home. The visiting nurse assists the family with the care plan, which includes changing the TPN solution and tubing how often?

a. Every 24 hours
b. Every 36 hours
c. Every 48 hours
d. Every 72 hours

b. Adults: energy 34 kcal/kg/d; amino acids 2 g/kg/d

The visiting nurse has a caseload of adult and pediatric clients receiving TPN at home. The nurse carefully checks all orders for TPN solutions. Which order (all have appropriate amounts of essential fatty acids, vitamins, and minerals) requires the nurse to contact the health care provider?

a. Adults: water 32 mL/kg/d; energy 32 kcal/kg/d; amino acids 1.2 g/kg/d
b. Adults: energy 34 kcal/kg/d; amino acids 2 g/kg/d
c. Children: water 32 mL/kg/d; energy 120 kcal/kg/d; amino acids 2.5 g/kg/d
d. Children: water 38 mL/kg/d; energy 58 kcal/kg/d; amino acids 2g/kg/d

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