Deck 2: Basics of Pharmacology

Question 1

The nurse is preparing to apply valacyclovir (Valtrex) ointment to the shingles lesions located across a patient's left side and lower back. Which of the following actions should the nurse take first?

A) Place the patient in a supine position.
B) Determine when the rash was first noted.
C) Ensure that the skin is clean and dry.
D) Take the patient's vital signs.

Answer 1

Ensure that the skin is clean and dry.

Question 2

The nurse is providing care for a 48-year-old male on the surgical unit. Gentamicin (Garamycin) 2 mg/kg every 8 hours has been started. The nurse would be most concerned by which of the following findings?

A) Blood levels have been ordered every 24 hours.
B) The patient's eGFR is 40 mL/min.
C) The patient's hemoglobin is 11.8 g/dL.
D) The patient's WBC is 14,000 c/mm³.

Answer 2

The patient's eGFR is 40 mL/min.

Question 3

While working in the gastrointestinal diagnostic clinic, the nurse identifies which of the following patients as being at high risk for developing a gastric ulcer? (Select all that apply.)

A) A 41-year-old patient with a family history of Crohn's disease
B) A 54-year-old patient who reports smoking 1.5 packs of cigarettes/day for the past 40 years
C) A 29-year-old patient taking misoprostol (Cytotec)
D) A 16-year-old patient with a recent history of shingles
E) A 44-year-old patient who reports taking ibuprofen (Advil) daily for low back pain

Answer 3

A 54-year-old patient who reports smoking 1.5 packs of cigarettes/day for the past 40 years
A 44-year-old patient who reports taking ibuprofen (Advil) daily for low back pain

Question 4

While caring for patients on the medical unit, the nurse should see which of the following patients first?

A) A 28-year-old patient with HIV who has a temperature of 99.2°F
B) A 54-year-old patient with diverticulitis whose diet was just advanced to solid food
C) A 61-year-old patient who takes ibuprofen for arthritis and is complaining of severe stomach pain
D) A 37-year-old patient with a kidney stone who is due for pain medication in 20 minutes

Question 5

The nurse is providing care for a patient with HIV who has been prescribed fosamprenavir (Lexiva). Which of the following statements by the patient indicates that further teaching is necessary?

A) "The metabolites of this medication may be excreted in active form."
B) "I'm glad my kidneys work so well; otherwise, the medication wouldn't work."
C) "This drug actually has to be broken down by my body to fight the virus."
D) "Isn't it fascinating that my liver has to metabolize the drug for it to work?"

Question 6

The nurse is providing care for a patient who is at 32 weeks' gestation and is started on low-molecular heparin injections after developing a deep vein thrombosis. The patient asks the nurse, "Why do I need a shot? Why can't I take the blood clot medicine that my dad takes orally?" Which of the following responses by the nurse is best?

A) "Anything that is lipid-soluble, including warfarin (Coumadin), is able to cross the placental barrier. Heparin is not lipid-soluble, so it doesn't cross the barrier well."
B) "Medications by mouth easily cross the placenta while you are pregnant, but medications by other routes are not absorbed."
C) "Only water-soluble substances, such as vitamins, can cross the placental barrier, so you could take either medication, but heparin is less expensive."
D) "They are the same medication, but the shot is absorbed faster than the pill, so the doctor wants you to take daily shots."

Question 7

While caring for multiple patients on the medical/surgical unit, the nurse would monitor which of the following patients for potential liver toxicity? (Select all that apply.)

A) A 14-year-old patient who is taking atomoxetine (Strattera) and has a history of ADHD
B) A 44-year-old patient who was admitted for pneumonia and has been taking acetaminophen (Tylenol)
C) A 63-year-old patient with a history of atrial fibrillation who has an irregular apical pulse
D) A 19-year-old patient with a history of alcohol abuse admitted for a tonsillectomy
E) A 71-year-old patient with a history of tuberculosis who took isoniazid (Laniazid)
F) A 15-year-old patient who took multiple aspirin as part of a suicide attempt

Question 8

While working in the neonatal intensive care unit, the nurse notes an infant's oxygen saturation has been 98% for the past 4 hours. The infant has been receiving oxygen at 4 L/min. Which of the following actions by the nurse is best?

A) Turn the oxygen level down to 3 L/min and monitor closely to reduce the risk of eye damage.
B) Leave the oxygen level at its current rate to reduce the risk of lung damage.
C) Turn the oxygen level down to 2 L/min and monitor closely to evaluate the infant's readiness for transfer out of the ICU.
D) Leave the oxygen level at its current rate and inform the parents the infant will need supplemental oxygen at home.

Question 9

While providing oral medications, which of the following is true regarding the absorption rate of a medication? (Select all that apply.)

A) The medication's level of fat solubility should be high to ensure absorption.
B) A medication will be more readily absorbed if it has a high pH.
C) A medication will be more readily absorbed if it is acidic in nature.
D) Absorption will be more rapid if it is provided in liquid form.
E) Absorption is slower in the presence of food.
F) A lozenge should be chewed to release the maximum amount of medication.

Question 10

The nurse is providing care for a patient who is experiencing muscle spasms. The physician has ordered cyclobenzaprine (Flexeril). The nurse should inform the patient to anticipate which of the following side effects from this medication?

A) Hypocalcemia and hypotension
B) Dizziness and drowsiness
C) Nausea and headache
D) Flaccidity and urinary retention

Question 11

The nurse is working with a patient who was recently started on insulin therapy. The patient's young daughter asks, "Why do you have to give her a shot? Why can't you just give her a pill?" Which of the following responses by the nurse is best?

A) "Our bodies make insulin normally, so it is a liquid medication."
B) "We do have diabetic medications in pill form. I'm not sure why the doctor ordered it this way for your mom."
C) "Insulin is manufactured and given this way so it absorbs more rapidly into the body."
D) "The acid in your mother's stomach would destroy this medication, so it can't be swallowed."

Question 12

The nurse is caring for a patient who has had a surgical procedure. The physician prescribes ibuprofen (Motrin) 800 mg orally every 8 hours. Which of the following actions is most important regarding the ibuprofen order?

A) Determine whether the patient has eaten within the past hour.
B) Assess the most recent liver panel laboratory tests.
C) Help the patient ambulate in the hall.
D) Evaluate the patient's most recent renal panel laboratory tests.

Question 13

The nurse is providing care for patients on the orthopedic unit. Which of the following assessment findings would be most concerning to the nurse?

A) A patient who takes lisinopril (Zestril) and is complaining of limited range of motion after shoulder surgery.
B) A patient with a fractured pelvis who takes warfarin sodium (Coumadin) and reports having a black tarry stool during the night.
C) A patient 2 days postoperation for knee replacement who takes hydrocodone/acetaminophen (Vicodin) and refused to have labs drawn this morning.
D) A patient taking omeprazole (Prilosec) who ordered spinach for dinner 4 days after hip replacement surgery.

Question 14

A 16-year-old patient comes to the urgent care clinic with symptoms of tonsillitis. The patient tells the nurse she takes tetracycline (Doxycycline) daily for the treatment of acne. The nurse would be most concerned if the health care provider prescribed which of the following?

A) Amoxicillin clavulanate (Augmentin)
B) Cefdinir (Omnicef)
C) Cefixime (Suprax)
D) Ciprofloxacin (Cipro)

Question 15

While providing various medications to patients in the long-term care facility, the nurse might take which course of action to prevent gastrointestinal side effects? (Select all that apply.)

A) Give patients yogurt to prevent diarrhea.
B) Increase patients' intake of fiber.
C) Provide milk or food with some medications to reduce the occurrence of nausea.
D) Improve absorption of the medication by giving it at night with a large snack.
E) Take the medication with hot tea or coffee.