Pharmacology NCLEX questions

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The nurse is administering the drug losartan (Cozaar) to a client with impaired liver function. Recognizing this medication is a prodrug, the nurse monitors what effect?

Reduction in the desired effect

What pharmacokinetic property makes it difficult to treat a patients brain tumor?

blood-brain barrier

The nurse administering an acidic drug to a client, and determines that drug absorption will be enhanced if the drug is administered:
a) with milk
b) on an empty stomach
c) with other acidic medications
d) after a lipid-soluble meal

b

A client with cirrhosis of the liver exhibits decreased metabolic activity. The nurse anticipates which possible change in the client's drug regimen?
a) a reduction in the dosage of drugs
b) an increase in the dosage of drugs

a

A client with renal failure is at particular risk for what condition?

rapid development of drug toxicity

The nurse is preparing to dicharge a patient who has received one last dose of a medication that has a half-life of 7 days. What should the nurse tell the client?

That they might continue to experience effects of the drug for several days

A client is started on a thyroid hormone and has blood drawn to measure the plasma concentration of the drug. The nurse explains that this will identify if:

the drug is in the therapeutic range

In situations in which it is critical to raise a client's drug plasma level quickly, what should the nurse be prepared to administer?

loading dose

When administering oral medications to a client, the nurse recognizes that some drugs might be completely metabolized by the liver circulation before entering general circulation. This effect is known as ___________.

first-pass effect

If the nurse administers medications to a client with renal failure, it is imperative that the client be assessed for what development?

drug toxicity

In what phase of the dose-response curve should the nurse expect a medication to be in the most desirable range of doses?
a) Phase 2
b) Phase 3
c) Phase 4
d) Phase 1

a

The nurse is administering a drug that will produce a therapeutic effect at a lower dose compared with another drug in the same class. the nurse recognizes that the first drug is considered:
a) More efficacious
b) Less toxic
c) More potent
d) More toxic

c

The nurse informs a client receiving antibiotic therapy that the drug being administered is the one more efficacious for the client's infection. When the client asks what this means, the nurse explains:
a) It is more potent that your other medication.
b) it is less toxic than other anitbiotics
c) It has fewer side effects than most other drugs.
d) It will have the desired response against the infection

d

When considering the pharmacotherapeutic effects of drugs administered to clients, the nurse considers which property of most importance:
a) Efficacy
b) Interaction with other drugs
c) Potency
d) Toxicity

a

When administering a drug that has agonist properties, the nurse recognizes it will have what effect?
a) It will occupy the receptor, and block it from action.
b) It will partially block the action of the receptor.
c) It will minimize the effect of the receptor module.
d) It will mimic the action of the receptor to which it binds

d

A client receiving a histamine antagonist asks the nurse how the drug works in the body. The nurse explains:
a) It mimics the action of the chemical histamine
b) It is a precursor to the histamine molecule naturally produced by your body.
c) It blocks the action of histamine in your stomach.
d) It stimulates the action of histamine in your stomach

c

A client has a history of multiple drug allergies and idiosyncratic responses. the nurse explains the study of pharmacogenetics helps to identify:
a) subtle genetic differences in drug-metabolizing enzymes
b) how to best prevent drug reactions
c) chemically altered receptor sites.
d) differences in drug receptor sites

a

A client given an anxiolytic drug becomes agitated, and displays paranoia. The nurse reports that the client most likely has experienced which type of drug reaction?
a) enzyme-specific reaction
b) unaltered reactions
c) adverse reactions
d) idiosyncratic reactions

d

It is important that the nurse recognize that the standard or average dose predicts a satisfactory therapeutic response in ____% of the population.

50

Since a median lethal dose cannot be determined in humans, the nurse recognizes that what measurement has a more practical value in a clinical setting?
a) therapeutic index
b) median toxicity dose
c) median therapeutic index
d) median effective dose

b

Which factor is most important for the nurse to assess when evaluating the effectiveness of a client's drug therapy?
a) the client verbalizes satisfaction with the drug
b) cost of the medication
c) the client verbalizes compliance with the drug
d) evidence of therapeutic benefit

d

The nurse is collecting the patient's health history pertinent to drug therapy. What information should be collected? (Name all that apply)
a) vital signs
b) use of drugs, alcohol or tobacco
c) pregnancy status
d) allergy information

b, c, d

When conducting patient teaching to a hearing impaired client, the nurse should:
a) sit next to the patient and speak in a high-pitched, loud voice
b) conduct the teaching in a quiet place with limited background noise
c) direct the teaching to a family member instead of the client
d) give written literature only

b

The client has been prescribed amoxicillin (Amoxil) 500 mg q8h for upper respiratory infection. which of the following would indicate that further teaching is needed:
a) I should take my medication around the clock
b) I should DC my medication when I no longer have a fever or produce coughing
c) I should take my medication on an empty stomach
d) I should tak my medicine until it is gone

b

Prior to initiating drug therapy in elderly clients, the nurse should assess the results of:
a) blood coagulation studies
b) 12-lead ECG
c) renal & hepatic function tests
d) chest x-ray & sputum culture

c

A 15 year-old teen who has been successfully managing her type 1 diabetes presents to the ER in diabetic ketoacidosis. She confides to the nurse that she deliberately skipped some doses of insulin because she did not want to gain weight. Which nursing diagnosis is most important to this situation?
a) Ineffective coping
b) noncompliance
c) lack of knowledge
d) self-care deficit

b

Which of the following nurse prescriptions would best assure understanding when developing a medication teaching plan for a 38 year-old client with limited reading skills.
a) use a videotaped explanation of the medication designed for pediatric clients
b) have the client verbalize drug information to the nurse after a teaching session
c) give written material to a family member
d) schedule a long teaching session to thoroughly cover the topic.

b

The nurse develops what goal for a patient with Type 1 diabetes?
a) the client will demonstrate self-injection of insulin, using a pre-loaded syringe, into the subcu tissue of the thigh prior to discharge
b) the client will be able to self manage his diabetic diet and medication
c) The nurse will teach the client to accurately draw up the medication dose in a syringe
d) the client will recognize and respond to the S&S of hypoglycemia prior to discharge.

a

A nurse teaching a client about her medicaiton includes what information?
a) SE that need to be reported to the PCP
b) a comparison of price between generic and brand names of the medication
c) the specific physiologic mechanism of action of the drug
d) the need to notify the PCP if a dose of the medication is missed

a

When evaluating the effectiveness of medication therapy, the nurse places priority on what?
a) assessing for signs of toxicity to the drug
b) determining if therapeutic a therapeutic effect has been reached
c) monitoring vital signs closely
d) check that the client is taking the medication properly

b

The nurse would recognize the need for further teaching if a pregnant client makes which of the following statements:
a) "my doctor may need to adjust the dosage of prescribed medications during my pregnancy"
b) "I should avoid taking unnecessary medications during my pregnancy"
c) "it is safe to take medications after the first trimester, since the baby is already formed"
d) "I should always consult my doctor before taking any OTC drug during pregnancy"

c

A 16-year-old adolescent who is 6 weeks pregnant has acne that has been exacerbated during the pregnancy. She asks the nurse if she can resume taking her isotretinoin (Accutane) prescription. The best response by the nurse is:
a) "you should reduce your accutane dose by half during pregnancy"
b) "you should check with your doctor at your next visit"
c) "Accutane is known to cause birth defects; you should never take it during pregnancy"
d) "since you have a prescription for Accutane, it is safe to take"

c

To reduce the effect of a prescribed medication on the infant of a breastfeeding mother, the nurse should plan to administer the medication:
a) At night.
b) In divided doses at regular intervals around the clock.
c) Immediately after breastfeeding.
d) Immediately before the next feeding.

c

The preferred site for injections in an infant is the ________.

vastus lateralis

A client with arthritis in the hands takes several prescriptions drugs. Which statement by this client requires follow up by the nurse?
a) "I care for my 2-year-old grandson twice a week."
b) "My arthritis medicine helps my stiff hands."
c) "I fill my prescriptions once per month."
d) "My pharmacist puts my pills in screw-top bottles to make it easier for me to take them."

a

When administering a drug to a school-aged child, the nurse should use what approach?
a) Tell the child it will be necessary to give a shot if the medication is not taken orally.
b) Describe all of the steps of inserting a suppository before administration.
c) Offer limited choices, such as taking the medicine from a cup or with a straw.
d) Mix bad-tasting medication in milk

c

An older client has hypoalbuminemia. The nurse understands administration of normal doses of protein-bound medications could result in:
a) Increased drug excretion.
b) Increased drug-to-drug interactions.
c) Diminished drug effects.
d) Allergic reaction

b

The nurse is planning to administer an intramuscular injection to a toddler who has been walking for 15 months. The nurse selects what site?
a) Ventrogluteal
b) Dorsogluteal
c) Vastus lateralis
d) Deltoid

c

A nurse is administering a liquid medication to a 13-month-old child. The most appropriate approach by the nurse is to:
a) Ask the child if she would like to take her medication now.
b) Mix the medication in 8 ounces of orange juice or a carbonated beverage.
c) Sit her up, hold the medicine cup to her lips, and kindly instruct her to drink.
d) Tell the child the medication is sweet-tasting.

c

Because of the physiologic and biochemical changes of aging, the nurse recognizes what adjustment in medications might be necessary?
a) The parenteral route of administration is preferred.
b) Dosages will need to be decreased.
c) Medications might need to be given more frequently.
d) Drugs should be given in the early a.m.

b

Establishing an early trusting nurse-client relationship positively impacts medication administration by:
a) Trusting the nurse to make decisions about drug therapy for the client.
b) Providing an avenue for client complaints.
c) Providing an atmosphere of influence by the nurse.
d) Increasing client compliance with the drug regimen

d

The nurse can encourage a client's positive expectations about drug therapy by:
a) Minimizing potential side effects of drugs.
b) Trivializing the limitation of drug therapy.
c) Explaining drug actions and potential side effects.
d) Suggesting alternatives to prescribed drug therapy

c

The client informs the nurse that he will use herbal compounds given to him by a family member to treat his hypertension. The appropriate action by the nurse is to:
a) Obtain more information and determine if the herbs are compatible with the medications that were prescribed.
b) Notify the physician immediately.
c) Inform the client that the physician will not treat him if he does not accept traditional medicine only.
d) Inform the client that the herbal treatments will be ineffective.

a

The nurse provides teaching about a drug to an elderly couple. To assure the instructions are understood, the nurse should:
a) Determine reading levels, and have clients repeat instructions to determine understanding.
b) Provide detailed written material about the drug.
c) Provide the labels and instructions in large print.
d) Review the medication instructions only when family members are present

a

The nurse understands an example of genetic polymorphism specific to Asian populations is:
a) Decreased drug effect from beta-adrenergic antagonists.
b) Fast clearance of isoniazid.
c) Slow clearance of isoniazid.
d) A decreased ability to metabolically convert codeine to morphine.

d

When administering medications to a group of clients, the nurse understands gender issues are related to drug therapy. Important considerations include:
a) Women suffer from Alzheimer's disease in greater numbers than do men.
b) All drug trials initially are conducted only on male subjects.
c) Men seek health care earlier than women.
d) Women are more likely to stop taking a drug because of side effects.

d

The client informs the nurse that she will decide whether to accept treatment after she prays with her family and minister. The nurse recognizes the role of spirituality in drug therapy as:
a) Harmful, especially if treatment is delayed.
b) Irrelevant, because medications act on scientific principles.
c) Important to the client's acceptance of medical treatment and response to treatment.
d) Harmless if it makes the client feel better.

c

A 14-year-old client refuses to take his insulin during school hours. The nurse bases client teaching and planning of medication on the understanding that:
a) School nurses do not enforce rules concerning drug administration.
b) Taking drugs at school can cause embarrassment and loss of self-esteem for many school-age children.
c) Parents protect the child by allowing him to be noncompliant.
d) This is typical behavior of adolescents

b

A nursing group is planning to provide health promotion activities to a rural community. Which of the following would be most important to include for this population? (Select all that apply.)
a) Prevention of poisoning
b) Prevention of suicide
c) Prevention of homicide
d) Prevention of accidental death

a, d

Because of a genetic polymorphism related to the enzyme mephenytoin hydroxylase, the nurse plans to closely monitor Asian- and African-American ethnic groups when administering which of the following drugs?
a) Codeine
b) Warfarin (Coumadin)
c) Isoniazid (INH)
d) Caffeine

b

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