NR293 Chamberlain College of Nursing Advanced Pharmacology Practice Exam With Answers (125 Solved Questions)

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lOMoARcPSD|28205643NR 293 Advanced Pharmacology ExamN/B: Questions andAnswers with Elaborations

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NR 293 Questions and AnswersChamberlain College of Nursing1.Which response best supports the observations that the nurseidentifies in a client who isexperiencing a placebo effect?✓Psychological response to inert medication2.Methylphenidate HCl (Concerta) is prescribed for dailyadministration to a 10-year-old child with attention deficit-hyperactivity disorder (ADHD). In preparing a teaching planfor theparents of this child newly diagnosed with ADHD, which instructionis most important for the nurse to provide to the parents?✓Administer the medication in the morning before the child goes toschool.3.Which physiologic mechanism explains a drug's increasedmetabolism that is triggeredby a disease process?✓Pharmacokinetics4.The health care provider prescribes ipratropium (Atrovent) for aclient. An allergic reaction to which other medication would causethe nurse to question the prescription forAtrovent?✓Atropine sulfate (Atropine)5.A 42-year-old client is admitted to the emergency department aftertaking an overdose ofamitriptyline (Elavil) in a suicide attempt.Which drug should the nurse plan to administer to reverse thecardiac & central nervous system effects of amitriptyline (Elavil)?✓Sodium bicarbonate6.A client who is hypertensive receives a prescription forhydrochlorothiazide (HCTZ) –thiazide diuretic cause potassiumwasting in the urine. When teaching about the sideeffects of thisdrug, which symptoms are most important for the nurse to instructthe client to report?✓Fatigue & muscle weakness7.The nurse is preparing to apply a surface anesthetic agent for aclient. Which actionshould the nurse implement to reduce therisk of systemic absorption?✓Avoid abraded skin areas when applying the anesthetic. –apply to

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the smallestsurface of intact skin

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8.The health care provider prescribes cisplatin (Platinol) to beadministered in 5% dextrose& 0.45% normal saline withmannitol (Osmitrol) added. Which assessment parameterswould be most helpful to the nurse in evaluating theeffectiveness of the Osmitrol therapy?✓Urine output9.A 19-year-old male client who has sustained a severe headinjury is intubated & placed on assisted mechanicalventilation. To facilitate optimal ventilation & prevent theclient from "fighting" the ventilator, the health care provideradministers pancuronium bromide(Pavulon) IV, withadjunctive opioid analgesia. What medication should thenurse maintain at the client's bedside?✓Neostigmine bromide (Prostigmin)10.The nurse is reviewing a client's laboratory results before aprocedure in which a neuromuscular blocking agent is ast&ing order. Whichfinding should the nurse report tothehealth care provider?✓Hypokalemia -Low potassium levels enhance the effectsof neuromuscularblocking agents11.A female client with myasthenia gravis is taking acholinesterase inhibitor & asks thenurse what can be doneto remedy her fatigue & difficulty swallowing. What actionshould the nurse implement?✓Develop a teaching plan for the client to self-adjust the doseof medication inresponse to symptoms. -Clients should be taught torecognize signs ofovermedication & undermedication so that theycan modify the dosagethemselves based on aprescribed sliding scale.12.A client receives pancuronium (Pavulon), a long-acting,nondepolarizing neuromuscularblocker, during surgicalanesthesia. Which client situation should alert the nurse toevaluate the client for a prolonged muscle relaxationresponse to this medication?✓Renal insufficiency

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13.A client is ordered 22 mg of gentamicin by IM injection. Thedrug is available in 20 mg/2mL. How many mL should beadministered?✓2.2 mL -(22 mg/20 mg)×2 mL = 2.2 mL14.A client is receiving oral griseofulvin (Grisactin) for apersistent tinea corporis infection.Which response by theclient indicates an accurate underst&ing of the drugteaching conducted by the nurse?✓"I'll wear sunscreen whenever I mow the lawn." -Photosensitivity is a side effect ofgriseofulvin (Grisactin), so clients should be cautionedto wear protectivesunscreen during sun exposure.

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15.The nurse has completed diabetic teaching for a client whohas been newly diagnosed with diabetes mellitus. Whichstatement by this client would indicate to the nurse thatfurther teaching is needed?✓"WhenIexercise,Ishouldplantoincreasemyinsulindosage." -Exercise helpsfacilitatetheentryofglucoseintothecell,soincreasing insulin doses withexercise would placethe client at high risk for a hypoglycemic reaction.16.The nurse is evaluating a client's underst&ing of theprescribed antilipemic drug lovastatin (Mevacor). Whichclient statement indicates that further teaching is needed?✓"I will take the medication every day before breakfast." -Theenzyme that helpsmetabolize cholesterol is activated at night, so thismedication should be takenwith the evening meal.17.A client with acute lymphocytic leukemia is to beginchemotherapy today. The health care provider'sprescription specifies that ondansetron (Zofran) is to beadministered IV30 minutes prior to the infusion of cisplatin(Platinol). What is the rationale for administering Zofranprior to the chemotherapy induction?✓Reduction or elimination of nausea & vomiting18.A client who arrives in the postanesthesia care unit (PACU)after surgery is not awakefrom general anesthesia. Whichaction should the nurse implementfirst?✓Review the medication administration record (MAR). -Most general anestheticsproduce cardiovascular & respiratory depression, so areview of the client's MAR identifies all themedications received during surgery & helps the nurseanticipate the client's response & emergence fromanesthesia.19.Which class of antineoplastic chemotherapy agents resemblesthe essential elements required for DNA & RNA synthesis &inhibits enzymes necessary for cellular function &replication?✓Antimetabolites

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20.A client who is HIV-positive is receiving combinationtherapy with the antiviral medication zidovudine(Retrovir). Which instruction should the nurse include inthisclient's teaching plan?✓Return to the clinic every 2 weeks for blood counts. -Bonemarrow depression withgranulocytopenia is a severe but commonadverse effect of zidovudine(Retrovir). Carefulmonitoring of CBCs is indicated.

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21.During administration of theophylline (Theo-Dur), the nurseshould monitor for signs oftoxicity. Which symptom wouldcause the nurse to suspect Theo-Dur toxicity?✓Restlessness -Other signs of toxicity are anorexia,nausea, vomiting, insomnia,tachycardia, arrhythmias, & seizures.22.Amoxicillin, 500 mg PO every 8 hours, is prescribed for aclient with an infection. The drug is available in a suspensionof 125 mg/5 mL. How many milliliters should the nurseadminister with each dose?✓20 mL23.A 45-year-old female client is receiving alprazolam(Xanax) for anxiety. Which clientbehaviors would indicatethat the drug is effective?✓The staff observes the client sitting in the day room readinga book.24.Which parameter is most important for the nurse tocheck prior to administering asubcutaneous injection ofheparin?✓Activated partial thromboplastin time (aPTT)25.A client is receiving antiinfective drug therapy for apostoperative infection. Whichcomplaint should alert thenurse to the possibility that the client has contracted asuperinfection?✓"My mouth feels sore." -Stomatitis caused by a thrushinfection, which can causemouth pain, is a sign of superinfection.26.A client is taking famotidine (Pepcid). Which clientstatement should the nurse furtherassess because it mayindicate that the client is experiencing a side effect of thisdrug?✓"I seem to be having difficulty thinking clearly." -A commonside effect of Pepcid isconfusion.27.A 2-month-old infant is scheduled to receive thefirst DPTimmunization. What is thepreferred injection site toadminister this immunization?✓Vastus lateralis

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28.Prior to administering a scheduled dose of digoxin(Lanoxin), the nurse reviews the client's current serumdigoxin level, which is 1.3 ng/dL. Which action should thenurseimplement?✓Give the dose of digoxin if the client's heart rate is within asafe range.29.The nurse is preparing to administer a secondary infusion ofa dobutamine solution to a client. The nurse notes that thesolution is brown in color. Which action should the nurseimplement?✓Administer the drug if the solution's reconstitution time isless than 24 hours.

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30.A client is being discharged with a prescription forsulfasalazine (Azulfidine) to treatulcerative colitis. Whichinstruction should the nurse provide to this client prior todischarge?✓Drink eight glasses offluid a day. -Adequate hydration isimportant for all sulfadrugs because they can crystallize in the urine. Ifpossible, the drug should betaken after eating to providelonger intestinal transit time.31.A psychiatric client is discharged from the hospital with aprescription for haloperidol (Haldol). Which instructionshould the nurse include in the discharge teaching plan forthis client?✓Use sunglasses & sunscreen when outdoors. -Photosensitivity is a common adverseeffect of haloperidol (Haldol).32.In addition to nitrate therapy, a client is receiving nifedipine(Procardia), 10 mg PO every 6 hours. The nurse should planto observe for which common side effect of this treatmentregimen?✓Hypotension -Nifedipine (Procardia) reduces peripheralvascular resistance &nitrates produce vasodilation, so concurrent use ofnitrates with nifedipine can cause hypotension withthe initial administration of these agents.33.A client is receiving pyridostigmine bromide (Mestinon)to control the symptoms ofmyasthenia gravis. Whichclient behavior would indicate that the drug therapy iseffective?✓Clear speech -Clear speech is the result of increasedmuscle strength. Muscleweakness characteristic of myasthenia gravis oftenfirst appears in the musclesof the neck & face.34.An older client who had a colon resection yesterday isreceiving a constant dose of hydromorphone (Dilaudid)via a patient-controlled analgesia (PCA) pump. Whichassessmentfinding is most significant & requires thatthe nurse intervene?✓Respirations decrease to 14 breaths/min. -Hydromorphone

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