Test Bank for Pharmacology Clear and Simple A Guide to Drug Classifications and Dosage Calculations, 4th Edition (Chapters 1-20)

Name: Test Bank for Pharmacology Clear and Simple A Guide to Drug Classifications and Dosage Calculations, 4th Edition (Chapters 1-20)
Brand: Academic Documents Platform
Price: 16.99 USD
Availability: InStock
Author: Olivia Parker

Get the edge you need with Test Bank for Pharmacology Clear and Simple A Guide to Drug Classifications and Dosage Calculations, 4th Edition (Chapters 1-20), a top resource for acing your tests.

Olivia Parker

Contributor

4.6

about 2 months ago

Preview (31 of 153)

Test Bank For
Pharmacology Clear and Simple
A Guide to Drug Classifications and
Dosage Calculations
4th Edition
By
Cynthia J. Watkins

Chapter 1. History of Pharmacology
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. While caring for a client who is taking furosemide (Lasix), the nurse recognizes dietary teaching has been
effective if the patient includes which of the following foods in his daily menus?
A. Broccoli and kiwi
B. Oranges and sweet potatoes
C. Kale and cucumbers D. Bananas and melon
2. A client newly diagnosed with diabetes tells the nurse, ―I can’t take any insulin made from pigs or cows.‖
Which of the following responses by the nurse is best?
A. ―Most insulin comes from animal sources, but I’m sure alternative options are available.‖
B. ―Medications that are derived from animals are typically less expensive than synthetic
medications, but synthetic insulin is commonly available.‖
C. ―Most insulin is synthetic now to help reduce the risk of disease transmission.‖
D. ―The animals aren’t hurt in the production of medications, so you don’t need to worry.‖
3. While providing medications to clients on the cardiac unit, the nurse anticipates that hydralazine
hydrochloride and isosorbide dinitrate (BiDil) would most likely be prescribed for which of the following
clients?
A. A 48-year-old Caucasian male diagnosed with atrial fibrillation
B. A 55-year-old African American female diagnosed with hypertension
C. A 63-year-old Caucasian female diagnosed with sick sinus syndrome
D. A 64-year-old African American male diagnosed with heart failure
4. While caring for a patient scheduled for knee replacement surgery, the nurse provides cefazolin (Ancef) as
ordered 30 minutes pre-operatively. The nurse knows that teaching has been effective by which of the
following client statements?
A. ―The antibiotic is given as a prophylactic to help reduce the risk of infection after surgery.‖
B. ―This is a palliative medication to help ease the pain from surgery.‖
C. ―This medication will replace vitamins and minerals that may be lost due to bleeding during
surgery.‖
D. ―This medication will help the surgeon identify areas of bone destruction due to arthritis.‖
5. While caring for a patient with a history of hypothyroidism, the nurse expects which of the following
medications to be included in the patient’s medication list?
A. Levothyroxine sodium (Synthroid)
B. Estrogen (Estradiol)
C. Iodine 131
D. Carbimazole (Methimazole)

6. The nurse is receiving a shift-to-shift report on a medical unit and is informed that a 55-year-old patient
with a history of vomiting is scheduled for a diagnostic radiograph of the upper gastrointestinal tract.
Which of the following statements would the nurse include in the client’s teaching?
A. ―You will need to drink a large amount of prep to clear out your system before the
test.‖
B. ―It is important that you be given a prophylactic medication to prevent aspiration during the
test.‖
C. ―You will be asked to drink a barium contrast about 30 minutes before the test to help
highlight any digestive problems.‖
D. ―You will be given a sedative to help make you sleepy during the testing procedure.‖
7. A student nurse is providing care for a 29-year-old patient with advanced cervical cancer who was
recently admitted with metastatic disease. While reviewing the patient’s medication list, the student
would categorize which of the following medications as palliative in nature?
A. Cisplatin (Platinol) 50 mg IV weekly to start day 8
B. Sorafenib (Nexavar) 200 mg orally twice daily for 7 days
C. Ondansetron (Zofran) 4 mg IV prior to chemotherapy
D. Morphine sulfate (Roxanol) 5 mg po every 4 hours as needed for pain
8. A woman experiencing menopausal symptoms asks the nurse about conjugated estrogen (Premarin). Which
of the following statements by the individual indicates an understanding of the medication’s origin?
A. ―I’m against animal cruelty, so I don’t want to take anything made from animal flesh.‖
B. ―I was told the medication is actually derived from the urine of pregnant horses.‖
C. ―Because I’m Jewish, I can’t take the medication since it comes from pigs.‖
D. ―I think harvesting medicines from cows seems rather odd.‖
9. The nurse working in a diagnostic center is responsible for verifying client allergies prior to testing. A 47-
year-old woman reports being allergic to iodine, and thus is unable to have which test? A. Computerized
axial tomography (CAT) scan
B. Magnetic resonance imaging (MRI)
C. Colonoscopy
D. Thyroid scan
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. While working with patients in home care, a nurse becomes interested in additional ways to support
patient healing and comfort. Which of the following is recognized as an alternative therapy? (Select
all that apply.)
A. Acupuncture
B. Aromatherapy
C. Therapeutic touch
D. Stem cell treatment
E. Vegetarianism
F. Acupressure

Loading page 4...

Chapter 1. History of Pharmacology Answer
Section
MULTIPLE CHOICE
1. ANS: B PTS: 1 DIF: Moderate TOP: Therapeutic Classification: Diuretic
KEY: Application MSC: NCLEX Category: Basic Care and Comfort
NOT: See Minerals (p. 7): Diuretic drugs such as furosemide (Lasix) cause the body to lose excess water
through the kidneys, and potassium, a vital mineral is also excreted with the water. Potassium is contained in
sweet potatoes, bananas, and oranges.
2. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Anti-diabetic medication KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Synthetic Medications (p. 8): Insulin can be obtained from pigs or cows, but a synthetic source is
most commonly used. This change occurred because of concern over the possible transmission of diseases
from animals to humans. Synthetic medications are usually more inexpensive because they are mass
produced.
3. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Combination drug (diuretic/nitrate)
KEY: Analysis MSC: NCLEX Category: Pharmacologic and Parenteral Therapy
NOT: See Synthetic medications (p. 8). BiDil is a combination of two generic drugs and is used to treat
African American patients with heart failure.
4. ANS: A PTS: 1 DIF: Easy
TOP: Therapeutic Classification: Antibiotics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Categorizing Medications (p. 8): Prophylactic medications are given to prevent problems such as
antibiotics given before surgery to prevent infection. Example of cefazolin is listed in Table 1.2.
5. ANS: A
Difficulty Level: Easy
PTS: 1 DIF: Easy TOP: Therapeutic Classification: Replacement hormones KEY: Knowledge MSC:
NCLEX Category: Pharmacological Therapies
NOT: See Categorizing Medications (p. 9): Replacement drugs are given to replace missing substances.
Levothyroxine sodium (Synthroid) is a drug that replaces missing thyroid hormone. Estrogen may be given to
women once they enter menopause. Iodine 131 is a radioactive medication used to help diagnose thyroid
abnormalities. Carbimazole is used to inhibit the production of thyroid hormone to treat hyperthyroidism.
6. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Diagnostic contrast KEY: Analysis
MSC: NCLEX Category: Reduction of Risk Potential
NOT: See Categorizing Medications (p. 8): Some drugs help diagnose a disease such as barium that patients
swallow to help highlight digestive problems on radiograph.
7. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Narcotics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Categorizing Medications (p. 8): Palliative drugs, such as pain relievers, do not cure disease, but
they make patients more comfortable. Morphine is listed as an example in Table 1.2. Cisplatin is an
antineoplastic agent and sorafenib is a biologic agent; both are designed to treat the cancer (destructive
medications), while ondansetron is given in a prophylactic measure to prevent nausea and vomiting related to
the chemotherapy.
8. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Hormonal therapy KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies

Loading page 5...

NOT: See Sources of Drugs (p. 6): Cows and pigs are good sources of hormone replacements, but conjugated
estrogen (Premarin) comes from a pregnant mare’s urine.
9. ANS: D PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Toxins (p. 7): Radioactive iodine in small doses can help pinpoint problems in a patient’s thyroid.
Because the client is allergic to iodine, she should not have this test.
MULTIPLE RESPONSE
1. ANS: A, B, D, F PTS: 1 DIF: Easy TOP: Therapeutic Classification: NA KEY: Knowledge MSC: NCLEX
Category: Basic Care and Comfort
NOT: See Pharmacology in the 21st century (p. 5): Alternative therapies now seem to have a place in the
healing of patients. For example, aromatherapy involves the use of fragrant oils in baths; acupressure
originates from an ancient Chinese art. Along similar lines is acupuncture; therapeutic touch involves the use
of hand movements to stimulate circulation and healing. Stem cell research is considered mainstream medical
treatment. Dietary manipulation may promote health but is not a recognized alternative therapy.
Chapter 2. Basics of Pharmacology
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse is preparing to apply valacyclovir (Valtrex) ointment to the shingles lesions located across a
client’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.
2. The nurse is providing care for a client at 32 weeks’ gestation who started low-molecular heparin
injections after developing a deep vein thrombosis. The client asks the nurse, ―Why do I have to
take 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 fat-soluble, including warfarin (Coumadin), is able to cross the placental
barrier. Heparin is not fat-soluble so it doesn’t cross the barrier well.‖
B. ―The placenta is easily crossed by anything you take by mouth while you are pregnant, but not
by things absorbed in other ways.‖
C. ―Only water-soluble substances such as vitamins can cross the placental barrier, so you could
take either medication, but heparin is cheaper.‖
D. ―They are the same medication, but the shot is absorbed faster than the pill so the doctor wants
you to take daily shots.‖
3. The nurse is providing care to a client with HIV who has been prescribed fosamprenavir (Lexiva).
Which of the following statements by the client 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?‖
4. The nurse is working with a client who was recently started on insulin therapy. The client’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.‖

Loading page 6...

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.‖
5. 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 = 40 mL/min
C. The patient’s hemoglobin = 11.8 g/dL
D. The patient’s WBC = 14,000 c/mm3
6. A 16-year-old client comes to the urgent care clinic with symptoms of tonsillitis. The client 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)
7. The nurse is providing care for a client experiencing muscle spasms. The physician has ordered
cyclobenzaprine (Flexeril). The nurse would inform the client to anticipate which of the following side
effects?
A. Hypocalcemia and hypotension
B. Dizziness and drowsiness
C. Nausea and headache
D. Flaccidity and urinary retention
8. While caring for clients on the medical unit, the nurse would see which of the following clients 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 complaining of severe stomach pain
D. A 37-year-old patient with a kidney stone who is due for pain medication in 20 minutes
9. While preparing to provide a patient admitted to the hospital for a laparoscopic hysterectomy the prescribed
dose of ibuprofen (Motrin) 800 mg orally, which of the following actions would take highest priority?
A. Determine if the client has eaten within the past hour.
B. Assess the client’s vaginal discharge.
C. Help the client ambulate in the hall.
D. Evaluate the client’s most recent renal panel labs.
10. The nurse is providing care for clients on the orthopedic unit. Which of the following assessment findings is
most concerning to the nurse?
A. A client who takes lisinopril (Zestril) and is complaining of limited range of motion after
shoulder surgery
B. A client with a fractured pelvis who takes warfarin sodium (Coumadin) and reports having a
black tarry stool during the night
C. A client 2 days post-op for knee replacement who takes hydrocodone/acetaminophen (Vicodin)
and refused to have labs drawn this morning

Loading page 7...

D. A client 4 days after hip replacement surgery taking omeprazole (Prilosec) who ordered spinach
for dinner
11. 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. Which of the following actions by
the nurse is best?
A. Turn the oxygen level down to 3 L 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 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 baby will need supplemental
oxygen at home.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. While providing oral medications, the nurse recognizes which of the following is true regarding the
absorption rate of a medication? (Select all that apply.)
A. The drug’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 drug 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.
2. While caring for multiple clients on the medical/surgical unit, the nurse would monitor which of the
following individuals for potential liver toxicity? (Select all that apply.)
A. A 14-year-old patient taking atomoxetine (Strattera) who has a history of ADHD
B. A 44-year-old patient admitted for pneumonia who 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
3. While working in the gastrointestinal diagnostic clinic, the nurse identifies which of the following individuals
as 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 6-month history of bulimia
E. A 44-year-old patient who reports taking ibuprofen (Advil) daily for low back pain
4. While providing medications to clients in the long-term care facility, which of the following actions would
the nurse use to prevent gastrointestinal side effects? (Select all that apply.) A. Give clients yogurt to prevent
diarrhea.
B. Increase client intake of fiber to reduce gastric motility.
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. Prevent constipation by providing fiber laxatives.

Loading page 8...

Chapter 2. Basics of Pharmacology Answer Section
MULTIPLE CHOICE
1. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication Provision; antivirals
KEY: Analysis MSC: NCLEX Category: Pharmacological Therapies
NOT: See Absorption (p. 15). When administering an ointment for a rash, make sure the skin is clean and dry.
2. ANS: A PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Anticoagulant therapy KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Distribution (p. 16): The blood-placental barrier helps to filter drugs and other substances passing
from mother to fetus. Most lipid-soluble drugs readily cross this barrier but water-soluble drugs do not.
Warfarin (Coumadin) is fat-soluble and crosses the placental barrier while heparin does not. They are not the
same medication and cost is not part of the therapeutic decision.
3. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication Administration; antivirals
KEY: Analysis MSC: NCLEX Category: Pharmacological Therapies
NOT: See Metabolism (p. 16): The liver does most of the work of drug metabolism. In some instances, a drug
is administered in its inactive form to become activated through metabolism. This category of drugs is known
as prodrugs. An example of a prodrug is fosamprenavir (Lexiva).
4. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Antidiabetics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Metabolism (p. 16): Insulin given by mouth is virtually useless; stomach acid breaks down insulin
to an inactive form before it can be absorbed into the bloodstream. Oral diabetic medications are not forms of
insulin; they stimulate the pancreas to release insulin.
5. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Antibiotics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Issues Affecting the Drug Cycle (p. 17): Gentamicin is known to be both nephrotoxic (toxic to the
kidneys) and ototoxic (toxic to the ears). Thus, kidney function and hearing would be monitored closely. The
EGFR is the best measurement of kidney function. Normal value is >60 mL/min. While the client’s
hemoglobin is low, the kidney function is more concerning. An elevated WBC count is expected in the
presence of an infection, which is the reason antibiotic therapy is provided. Routine blood levels to monitor
drug dosage is expected to help prevent toxicity.
6. ANS: A PTS: 1 DIF: Hard
TOP: Therapeutic Classification: Antibiotics KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Issues Affecting Drug Cycle (p. 18): Antagonist drugs do the opposite by rendering another drug
less powerful. The antibiotic tetracycline becomes ineffective when it is taken with penicillin. Amoxicillin
clavulanate is a penicillin derivative.
7. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Muscle relaxants KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See The Importance of Side Effects (p. 18): Muscle relaxants such as Flexeril cause dizziness and
drowsiness in addition to their intended actions.
8. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Anti-inflammatory agents KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Side Effects (p. 19): Clients who take nonsteroidal anti-inflammatory medications on a long-term
basis run the risk of developing ulcers. This client is the most unstable and should be seen first.

Loading page 9...

9. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Anti-inflammatory agents KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Side Effects (p. 19): If kidney damage or impairment is suspected, BUN levels may be monitored
to evaluate kidney function. Clients taking anti-inflammatory agents are at increased risk of kidney damage
because these drugs are primarily metabolized through the kidneys instead of the liver.
10. ANS: B PTS: 1 DIF: Hard
TOP: Therapeutic Classification: Anticoagulants KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Side Effects (p. 19): Any patient taking an anticoagulant such as Coumadin to decrease clotting
should be carefully monitored for signs of bleeding, including dark tarry stools. Coumadin levels should be
monitored to ensure the drug level is therapeutic but not toxic.
11. ANS: A PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Analysis MSC: NCLEX Category: Pharmacological Therapies
NOT: See Side Effects (p. 19): A serious problem is the use of oxygen in premature infants. At high doses,
oxygen is very damaging to the eyes. For this reason, oxygen is now used at the lowest therapeutic dose
possible for all age groups. This oxygen saturation level is very good, has been stable for 4 hours, and thus a
trial on lower concentrations is warranted. Transfer out of ICU will depend on additional factors. Long-term
use of oxygen can’t be determined at this time.
MULTIPLE RESPONSE
1. ANS: A, C, D, E PTS: 1 DIF: Hard TOP: Therapeutic Classification: NA
KEY: Analysis MSC: NCLEX Category: Pharmacological Therapies
NOT: See Absorption (p. 15): The more soluble a medication is in fat or lipids, the more easily it is absorbed
through the stomach. Medications with a low (acidic) pH are easily absorbed in the stomach. Liquid
medications act faster than pills. A large amount of food slows absorption. If a patient sucks on a lozenge,
more medication is released in the mouth than if the lozenge is chewed or swallowed.
2. ANS: B, D, E, F PTS: 1 DIF: Hard
TOP: Therapeutic Classification: Medication Administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Side Effects (p. 18): Alcohol, acetaminophen, isoniazid, and aspirin can cause liver damage.
3. ANS: B, E PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Anti-inflammatory agents KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Side Effects (p. 19): The synthetic prostaglandin misoprostol (Cytotec) may be given to prevent the
development of ulcers. Clients taking anti-inflammatory agents such as ibuprofen are at increased risk for
ulcer formation. These patients are also urged to stop smoking to reduce the risk of ulcers.
4. ANS: A, C, E PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication Administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Side Effects (p. 19): Side effects are managed on an individual basis. Some medications require
ingestion with milk or food. For certain drugs, adding yogurt to the diet is suggested to prevent diarrhea, and
other drugs may require the addition of a high-fiber laxative to the diet to prevent constipation. Fiber will
increase GI motility. The presence of food slows absorption rates.
Chapter 3. Patient Safety in Medication Administration
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The student nurse is preparing to provide medications to a client scheduled to receive lisinopril (Zestril) 10
mg PO daily and ofloxacin (Floxin) 2 drops o.s. three times daily. Which of the following actions by the
student is best?
A. Provide the lisinopril by mouth and the ofloxacin into the right ear.

Loading page 10...

B. Provide the lisinopril into the right ear and the ofloxacin into the right eye.
C. Provide the lisinopril into the left ear and the ofloxacin orally.
D. Provide the lisinopril orally and the ofloxacin into the left eye.
2. When providing medications from floor stock to a client on the Alzheimer’s unit of a long-term-care
facility, the nurse demonstrates the principle of right drug by which of the following?
A. Checks the label before taking the medication out of the cabinet, checks the label before pouring
the medication, checks the label before placing the bottle back in the cabinet
B. Checks the label before taking the medication out of the cabinet, checks the label before pouring
the medication, checks the label before leaving the medication room
C. Checks the label after removing the bottle from the cabinet, checks the label after pouring the
dose of medication, checks the label before closing the cabinet door
D. Checks the label while removing the bottle from the cabinet, checks the label after pouring the
dose of medication, checks the label while replacing the bottle in the cabinet
3. The nurse is preparing to discharge a client originally admitted for community-acquired pneumonia who
has a discharge prescription for cefditoren (Spectracef). Which of the following instructions would the
nurse include in the discharge teaching?
A. ―Be sure to take the medication until your cough is gone.‖
B. ―It is important that you take the medication with meals.‖
C. ―Taking the medication at set time intervals will help blood levels stay constant.‖
D. ―Keeping the medication on the counter top will help you remember to take it.‖
4. While working in an urgent care center, the nurse assists in the care of a client with allergic rhinitis who has
been given a prescription for beclomethasone nasal spray (Beconase), 2 sprays in each nostril 2 to 4 times
daily. The nurse would provide further instruction to which of the following client statements?
A. ―This will help my nose to not run so constantly.‖
B. ―I should spray this in each nostril whenever my nose starts to drip.‖
C. ―I can use this before I go to work, midday, and again at bedtime.‖
D. ―This medication is a mild steroid and will reduce swelling and irritation of my nasal passages.‖
5. The nurse is conducting a home visit for a 43-year-old client. The client, who has three children under the
age of 12, is 3 days post-mastectomy. The nurse would be most concerned by which of the following?
A. The client has a calendar for appointments and a list with physician contact information by the
phone.
B. The client keeps her medications in a daily pill box that sits on the kitchen windowsill.
C. The client reports that it was too uncomfortable to wear the temporary prosthesis she had been
given.
D. The children are participating in a support group for family members of people with cancer.
6. The nurse is providing medications to a client with a gastrostomy tube. Diclofenac (Cambia) has been
ordered. Prior to administration, the nurse should take which of the following actions? A. Ensure that the
medication comes as a liquid preparation.
B. Obtain a 3-mL syringe and needle with a safety device.
C. Document the medication provision.
D. Ask the client to state her name and room number.
7. A nurse on the pediatric unit is preparing to pass medications for a 10-year-old client with exacerbation of
asthma. Amphetamine (Adderall) and fluticasone (Advair) are scheduled. The nurse must be aware of
which of the following?

Loading page 11...

A. Adderall and Advair should not be given at the same time.
B. Adderall is used to reduce bronchospasms.
C. Advair must be given with food.
D. Adderall and Advair each have look-alike/sound-alike medications.
8. A nurse working in the GI clinic is performing pre-op phone calls. The nurse calls a client who is
scheduled for a colonoscopy to inform the client of the following orders, ―Begin clear liquid diet 24
hours prior to the exam; take magnesium citrate (Citroma) 1 bottle PO 12 hours prior to the exam
and another 8 hours prior to the exam; remain NPO for 6 hours prior to the study.‖ The test is
scheduled the next day at 2 p.m. The nurse would instruct the patient to:
A. ―Only have liquids to drink at this point until the test. Use the enema prep at 2 a.m.
and then again at 6 a.m. You can’t have anything to eat or drink after waking in the morning.‖
B. ―Start a clear liquid diet today at 2 p.m. Drink a bottle of prep at 2 a.m. and another at 6 a.m.,
and then don’t eat or drink anything after 8 a.m.‖
C. ―Don’t eat anything solid starting with lunch today. Give yourself an enema with the prep at 6
a.m. and again at noon, and don’t have anything to eat or drink after 8 a.m.‖
D. ―Start a clear liquid diet with dinner today. Drink the prep 12 hours and 8 hours before your test
at 2 p.m. tomorrow, and be sure not to eat anything solid after you get up in the morning.‖
9. While working in a surgical clinic, the nurse notes orders that read, ―.25 mg digoxin (Lanoxin) IV now.‖
Which action by the nurse is best?
A. Give .25 mg of digoxin intravenously.
B. Give 25 mg of digoxin as an injection into the skin.
C. Contact the physician for clarification of the order.
D. Give .25 mL of digoxin as an intramuscular injection.
10. A client being seen in the outpatient clinic has been given a new prescription for tetracycline (Doxycycline)
orally each day. The client reported current medications include a multivitamin with calcium, St. John’s
Wort, and omeprazole (Prilosec). The nurse would provide additional teaching for which client statement?
A. ―I should try to take the medication at roughly the same time each day.‖
B. ―I can take this medication with my other morning meds.‖
C. ―I should take this medication at least an hour before or 2 hours after I eat.‖
D. ―Drinking extra water is important when taking this medication.‖
11. The nurse receives a phone call from an elderly woman who states that her husband has recently started
taking atorvastatin (Lipitor) and is complaining of having sore muscles. Which response by the nurse is
best?
A. ―Does your husband smoke cigarettes?‖
B. ―What type of exercise is your husband doing?‖
C. ―Does your husband have a history of heart disease?‖
D. ―Your husband should be seen in the clinic today for some tests.‖
12. A nurse from the adult medical unit is pulled to the geriatric unit. The nurse notes many of the common
medications provided are in lower doses than typically prescribed. What action by the nurse is the highest
priority?
A. Notify the charge nurse that clients may have received inappropriate medication dosages.
B. Call the nursing supervisor to investigate the nurse’s concerns.
C. Don’t worry about the discrepancy since this is not the nurse’s unit.

Loading page 12...

D. Evaluate the lab values of each client to determine liver and kidney function.
13. While working on a geriatric unit, the nurse would be most concerned by which of these findings? A. An
81-year-old client is scheduled to take 12 pills at 9 a.m.
B. A 72-year-old client given a sleeping pill the night before seems confused.
C. A 69-year-old client with a deep vein thrombosis has an order for an anticoagulant.
D. A 74-year-old client with diabetes has a fasting glucose result of 88 g/dL.
14. The nurse notes that an elderly client admitted with metastatic cancer has a low serum protein level.
Which action by the nurse is best?
A. No action is required because the patient is terminal.
B. Increase the frequency of vital sign monitoring.
C. Determine the most recent complete blood count (CBC) results.
D. Increase awareness and assessment of potential medication side effects.
15. Shortly after providing a new sleeping pill to a client on the medical unit, the nurse answers the client’s call
light. Which of the following findings would indicate to the nurse that the client is experiencing an
anaphylactic reaction to the medication?
A. The client’s respiratory rate is 28 and slightly labored.
B. The client complains of continued wakefulness and agitation.
C. The client states that she feels nauseated and has a headache.

Loading page 13...

D. The client reports feeling hot and has a rash across her chest.
16. A nurse working at the poison control center receives a call from a young woman babysitting for a 4-year-
old child who reportedly swallowed some of the parent’s medication. Which statement by the nurse is best?
A. ―I’m calling emergency personnel for you now.‖
B. ―What do the pills look like?‖
C. ―Have the child drink a glass of milk.‖
D. ―What is the name of the pills?‖
17. The nurse is preparing to provide medications to a client in a double room. The client’s roommate has
multiple visitors present. Which of the following actions would the nurse take first? A. Identify the action
and side effect of each medication as it is provided.
B. Pull the client’s bedside curtain and talk in subdued tones.
C. Ask the client to state his name and birth date to verify identity.
D. Determine what questions the client has about his medications.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. While providing medications in the clinical lab, a student would perform actions related to safe
administration that include which of the following? (Select all that apply.)
A. Right medication
B. Right dose
C. Right time
D. Right room
E. Right patient F. Right route
2. While supervising a student nurse providing morning medications to clients in the long-term-care facility, the
nurse would intervene if the student was observed performing which of the following actions? (Select all that
apply.)
A. The student checks the patient’s arm band to verify identity.
B. The student verifies the medication order.
C. The student scans the medication with the computer scanner.
D. The student checks the medication’s expiration date.
E. The student prepares a medication scheduled for 1800.
F. The student asks the client to state his first name prior to giving the medication.
3. A female nursing student is 18 weeks pregnant while attending her pharmacology class. Which of the
following facts related to fetal effects of medications will the student recognize as true? (Select all that
apply.)
A. Category A drugs are known to have minimal risk to the fetus.
B. Category C drugs are known to cause severe risk to the fetus in human trials.
C. Drugs that are classified as teratogenic are not able to cross the placental barrier.
D. Category X drugs have not been studied in pregnant women.
E. Category B drugs have slight risk to the fetus; both animal and human studies have
been done.

Loading page 14...

4. A nurse is working with a group of male veterans participating in a smoking-cessation program. The nurse
recognizes that which of the following statements related to medications in these clients is true? (Select all
that apply.)
A. An increased number of medications will have teratogenic effects in this population.
B. Medications are likely to be absorbed and distributed more rapidly.
C. This population has a decreased lipase secretion.
D. These clients may need larger doses of liver-metabolized drugs.
E. Drugs will be metabolized more slowly by this population.
5. A nurse working in the emergency room is preparing for the admission of a 34-year-old client with a drug
overdose. Which of the following equipment and/or orders will the nurse anticipate? A. Telemetry
monitoring
B. Blood transfusion
C. Activated charcoal
D. Dialysis machine
E. Nasogastric tube and 60-mL syringe for lavage
F. Contrast for magnetic resonance imaging (MRI) testing
6. A nurse working on the orthopedic unit is providing discharge instructions for a client with a fractured femur.
When explaining the client’s narcotic pain medication, the nurse would include which statement? (Select all
that apply.)
A. ―This medication may make you sleepy, so you can’t drive while taking it.‖ B. ―Narcotics can
cause constipation, so be sure to drink extra fluid and eat a high-fiber diet.‖
C. ―Many patients who take this feel dizzy or light-headed, so you must be careful of falls,
especially at night.‖
D. ―Only take the number of pills prescribed per day. Taking more can be dangerous.‖
E. ―You can take this medication as many times as needed for pain control.‖
7. An RN is working to support clinical trials in clients with cancer. Which of the following would be an
anticipated part of this role? (Select all that apply.)
A. Educating the clients about the treatment, side effects, and alternative therapies
B. Ensuring that informed consent to participate is obtained
C. Documenting client and family understanding related to the trial
D. Providing payment to the client for participation in the trial
E. Ordering medications from the pharmacy based on clients’ height and weight
Matching
Place the following steps of medication administration for an ordered medication in the correct
order.
A. Ask the client to state his/her name and birth date.
B. Open the medication packaging.
C. Verify the medication and dose.
D. Scan the medication with the computer scanner.
1. First
2. Second
3. Third

Loading page 15...

Loading page 16...

Chapter 3. Patient Safety in Medication Administration
Answer Section
MULTIPLE CHOICE
1. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication Administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Table 3.2 (p. 29): PO is by mouth (orally) and o.s. is left eye.
2. ANS: A PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication Administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Check the label before you take the bottle from the shelf, check
the label before you pour the drug out, check the label before you put the bottle back on the shelf.
3. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Antibiotics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Some medications, such as antibiotics need to be given a standard
number of hours apart around the clock to maintain a consistent blood level. Most antibiotics work best when
taken on an empty stomach (p. 31). Store medications safely locked away.
4. ANS: B PTS: 1 DIF: Easy
TOP: Therapeutic Classification: Inhaled Steroids KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Emphasize that patients need to adhere to the exact prescription
and avoid self-medication.
5. ANS: B PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Analysis MSC: NCLEX Category: Pharmacological Therapies
NOT: See Fast Tip 3.1 (p. 27): Store medications safely no matter what age others are in the household.
Discomfort at the surgical incision site should be investigated to ensure that no infection is present, but
tenderness 3 days after surgery is still expected and may interfere with prosthetic use.
6. ANS: A PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Anti-inflammatory agents KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: Patient Rights for Safety (p. 27): A liquid formulation may be necessary if the drug must be given
through a feeding tube. A needle should not be necessary for g-tube administration. Documentation should
not occur until after the medication is given. Clients should be asked to state name and birth date for proper
identification.
7. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Amphetamine mixtures KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Medication Administration Table 3.1 (p. 28): Adderall and Advair each have other drugs with look-
alike/sound-alike names. Adderall is used to treat ADHD symptoms. Advair is provided in diskus/inhalation
format for clients with asthma and food is not a factor in its provision. These two medications can be given at
the same time.
8. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Laxatives KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Table 3.2: NPO means nothing by mouth; PO means orally. Giving specific
directions/instructions, including times for prep, will help ensure that clients understand and follow the
correct procedure for medication administration.
9. ANS: C PTS: 1 DIF: Moderate

Loading page 17...

TOP: Therapeutic Classification: Amionoglycocides KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Table 3.2 and 3.3: IV means intravenous (into a vein), but without a zero in front of the decimal
point, this order should be clarified.
10. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Antibiotics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Factors Affecting Medication Administration (p. 31): Administering tetracycline with calcium
prevents the absorption of the antibiotic. Most antibiotics work best when taken on an empty stomach. Many
antibiotics can cause diarrhea, so drinking extra fluids is important.
11. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Lipid lowering agents KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Age, gender and culture (p. 31): Toxic drug levels can be found in elderly patients, even with
normal doses. The aging process alters liver and kidney function and leads to accumulation of medications.
Atorvastatin can cause muscle breakdown, a condition that is worsened in the presence of kidney or liver
disease, so it will be important to have the client evaluated and have laboratory testing done.
12. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication administration KEY: Analysis
MSC: NCLEX Category: Dosage Calculations
NOT: See Age, gender and culture (p. 31): The aging process alters liver and kidney function and leads to
accumulation of medications. Because of these factors, doses may need to be adjusted for elderly patients.
13. ANS: B PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Analysis MSC: NCLEX Category: Coordinated Care
NOT: See Age, gender and culture (p. 31): Of special concern are sedative-hypnotics. These medications are
commonly associated with adverse drug events and can worsen agitation and exacerbate dementia. Another
concern for geriatric patients is polypharmacy, but this is not the highest priority in this scenario.
Anticoagulant medication is an appropriate treatment for deep vein thrombosis. A reading of 88 g/dL is a
normal fasting blood glucose.
14. ANS: D PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Physiological Adaptation
NOT: See Patients with Organ Dysfunction (p. 34): Decreased serum protein levels can alter the capacity of a
drug to bond. More unbound medication is therefore available and this can lead to side effects. Serum protein
levels may indirectly impact blood volume and therefore blood pressure, but this is not the highest priority.
Recent CBC results may be indirectly affected by low serum protein levels, but this is not the highest priority
for this scenario.
15. ANS: A PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Analysis MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Emergencies (p. 36): A severe allergic reaction is called anaphylaxis. Patients experiencing
anaphylaxis have difficulty breathing and may have other symptoms such as itching, wheezing, anxiety, and
light-headedness.
16. ANS: A PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Analysis MSC: NCLEX Category: Safety and Infection Control
NOT: See Patient Emergencies (p. 36): If you receive a call from a patient who has ingested a toxic
substance, call 911. This child needs immediate medical attention, which should take priority over other
actions or assessment. Learning more about the medications will be helpful and milk may be appropriate to
reduce acidity, but the priority is to have emergency personnel respond first.
17. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication Administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies

Loading page 18...

NOT: See Patient Consent (p. 35): Patients have the right to receive medications in a quiet, private place. The
first action in this scenario is to attempt to provide client privacy by pulling the bedside curtain and speaking
in subdued tones.
MULTIPLE RESPONSE
1. ANS: A, B, C, E, F PTS: 1 DIF: Easy
TOP: Therapeutic Classification: Medication Administration KEY: Knowledge
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26) The seven right of medication administration include right patient,
right drug, right dose, right time, right route, right technique, and right documentation.
2. ANS: E, F PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication administration KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26) The seven rights of medication administration include right
patient, right drug, right dose, right time, right route, right technique, and right documentation. Before you
administer any medication, make sure that you have the right patient by asking the individual to state his or
her full name and birth date. Verify that you have the correct medication for the patient. In a hospital,
scanning a bar code to double-check a medication with a computer system may help reduce medication
errors. 1800 is 6 p.m.; this is not a morning medication and would not be provided at this time. Both first and
last name and birthdate should be stated prior to provision of medications.
3. ANS: A, E PTS: 1 DIF: Hard TOP: Therapeutic Classification: NA
KEY: Knowledge MSC: NCLEX Category: Pharmacological Therapies
NOT: See Pregnancy and Table 3.5 (p. 33): Category A medications have the lowest risk. Category B
medications have slight risk, with animal studies showing no risk or, if risk is noted, human studies have
shown no risk. Category C medications have moderate risk based on animal studies, and controlled studies
have not been done on women. Category X medications have the highest risk as studies have shown
significant risk. Teratogenic drugs cross the placental barrier and cause deformities.
4. ANS: B, D PTS: 1 DIF: Hard TOP: Therapeutic Classification: NA
KEY: Knowledge MSC: NCLEX Category: Pharmacological Therapies
NOT: See Age, gender and culture (p. 32–33): Medications are absorbed and distributed in the body more
quickly in men than in women. Smoking cigarettes induces liver enzymes to metabolize drugs more rapidly,
so clients may need larger doses of liver-metabolized drugs. Teratogenic effects are related to fetal
development and will not impact male clients. Lipase secretion is decreased in infants as compared with
adults.
5. ANS: A, C, E PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Physiological Adaptation
NOT: See Patient Emergencies (p. 36): Actions will depend on the type of toxin but may include
administration of activated charcoal, lavage (pumping of the patient’s stomach), and monitoring the patient
for changes in vital signs, including heart rate (telemetry). Blood transfusion, dialysis, and MRI testing is not
immediately anticipated and would only be ordered if the client was experiencing bleeding, kidney failure, or
symptoms of a stroke, respectively.
6. ANS: A, B, C, D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Narcotics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Protecting the Patient: Ethical and Safety Considerations (p. 34): It is your responsibility as a
health professional to educate the patient about the risks associated with taking more than the prescribed
dose.
7. ANS: A, B, C PTS: 1 DIF: Hard TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Coordinated Care
NOT: See Patient consent (p. 35): A patient who is taking an experimental drug has the right to informed
consent, which includes understanding the treatment and its effects, alternative treatments, and possible

Loading page 19...

outcome if the treatment is declined. It is essential to document informed consent. Clients are generally not
paid to participate in clinical trials. RNs are not able to order medications.
MATCHING
1. ANS: A PTS: 1 DIF: Easy
TOP: Therapeutic Classification: Medication Administration KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Before you administer any medication, make sure that you have
the right patient by asking the individual to state his or her full name and birth date. Verify that you have the
correct medication for the patient. In a hospital, scanning bar codes to double-check a medication with a
computer system may help reduce medication errors.
2. ANS: D PTS: 1 DIF: Easy
TOP: Therapeutic Classification: Medication Administration KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Before you administer any medication, make sure that you have
the right patient by asking the individual to state his or her full name and birth date. Verify that you have the
correct medication for the patient. In a hospital, scanning bar codes to double-check a medication with a
computer system may help reduce medication errors.
3. ANS: B PTS: 1 DIF: Easy
TOP: Therapeutic Classification: Medication Administration KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Before you administer any medication, make sure that you have
the right patient by asking the individual to state his or her full name and birth date. Verify that you have the
correct medication for the patient. In a hospital, scanning bar codes to double-check a medication with a
computer system may help reduce medication errors.
4. ANS: C PTS: 1 DIF: Easy
TOP: Therapeutic Classification: Medication Administration KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Patient Rights for Safety (p. 26): Before you administer any medication, make sure that you have
the right patient by asking the individual to state his or her full name and birth date. Verify that you have the
correct medication for the patient. In a hospital, scanning bar codes to double-check a medication with a
computer system may help reduce medication errors.
Chapter 4. Regulations
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. While shopping for an over-the-counter cough suppressant, the nurse identifies the medication will be
classified as:
A. A Schedule I medication
B. A Schedule III medication
C. A Schedule V medication
D. Nonscheduled medication
2. Nurses are protected from unnecessary job-related risks due to the regulations set by:
A. Food and Drug Administration (FDA)
B. Drug Enforcement Administration (DEA)
C. Occupational Safety and Health Administration (OSHA)
D. Joint Commission on Accreditation of Healthcare Organizations (JCAHO)
3. The nurse provides a client admitted with gastroesophageal reflux a dose of intravenous pantoprazole
(Protonix). Fifteen minutes later, the client calls for help and is gasping for breath. Emergency measures are

Loading page 20...

instituted and the client is transferred to the intensive care unit. Which action should be included in the
nurse’s follow-up activities?
A. Notify the nursing supervisor that the client experienced a common side effect to the drug.
B. Identify the episode as an adverse reaction and ensure it is reported to the FDA.
C. Call the hospital administrator to report an act of medication fraud.
D. Contact the local news channel to arrange an investigation.
4. A client with advanced colorectal cancer is going to start taking long-acting morphine sulfate (MS Contin).
Which of the following statements by the nurse is best?
A. ―I will call the prescription into your local pharmacy.‖
B. ―You are only allowed to have one refill on this medication before you have to see the doctor
again.‖
C. ―This is considered a Schedule IV medication, so there are strict guidelines we must follow.‖
D. ―I am faxing the prescription to the pharmacy, but you must also take this written prescription
with you to pick it up.‖
5. A client with a compressed disc in the lumbar region takes Vicodin every 6 hours for pain control.
He tells the nurse, ―This pain medication just doesn’t seem to be working anymore.‖ Which
response by the nurse is best?
A. ―Are you taking the medication with a full glass of water?‖
B. ―You may be developing a tolerance to the medication.‖
C. ―We will have to draw some lab work to see if your stomach is digesting the medication
correctly.‖
D. ―How did you rank your pain on a 0–10 scale with your original injury?‖
6. A co-worker tearfully confides that she is struggling with a growing dependence on sleeping medication and
other drugs to maintain her work schedule on the night shift. Which action by the nurse is best?
A. Refer the co-worker to the employee assistance program.
B. Encourage the co-worker to switch to herbal remedies.
C. Suggest the co-worker try to get a daytime position.
D. Ask if the co-worker needs help with childcare.
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. A student nurse is reminded to follow OSHA guidelines when providing care to clients in the hospital. Which
of the following actions will the student take to comply with this direction? (Select all that apply.)
A. Wear a uniform that identifies the student’s status
B. Wear gloves when providing a client bath
C. Hand washing before providing client care
D. Needle disposal in an identified ―sharps‖ container
E. Wear a face mask when caring for a client with heart failure
2. A clinical trial nurse is helping to register a patient to a phase II double-blind trial comparing a new
medication to a placebo. Which of the following would the nurse include in the patient teaching?
(Select all that apply.)
A. ―Neither you, the doctor, or I will know if you are getting the real medication or not.‖
B. ―A computer will randomly determine which people get the actual study drug.‖
C. ―This trial is designed to determine if a benefit is found when using the drug.‖
D. ―Less than 100 people will be participating in this study.‖
E. ―The results of the study will not be known for at least 5 years.‖

Loading page 21...

3. A nurse working with a client who is experiencing withdrawal from a medication would track which of the
following symptoms? (Select all that apply.)
A. Tremors
B. Pin-point pupils
C. Hallucinations
D. Low blood pressure
E. Emotional distress
F. Feelings of euphoria
4. The nurse manager on a surgical unit suspects one of the nurses may be dealing with a substance abuse
problem. Which of the following symptoms would support this suspicion? (Select all that apply.)
A. The individual’s uniform is frequently wrinkled or disheveled.
B. The individual has called in sick three times in the past month.
C. The individual has made two medication errors in the past week.
D. The individual is irritable and withdrawn.
E. The individual was seen crying in the medication room after a patient death.
F. The individual has lost an estimated 10 pounds in the past 8 weeks.
Chapter 4. Regulations Answer Section
MULTIPLE CHOICE
1. ANS: C PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA KEY: Comprehension MSC: NCLEX
Category: Pharmacological Therapies
NOT: See Table 4.4 (p. 45) and Table 4.7 (p. 57): Schedule I medications have high abuse potential. Schedule
III medications have lower abuse potential with moderate to low dependence risk. Schedule V medications
have even lower abuse potential and include over-the-counter cough suppressants.
2. ANS: C PTS: 1 DIF: Easy TOP: Therapeutic Classification: NA
KEY: Knowledge MSC: NCLEX Category: Pharmacological Therapies
NOT: See Modern Regulating Agencies (p. 46): OSHA is a branch of the Department of Labor that helps
ensure all workers are not exposed to unnecessary job-related risks.
3. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: GERD agents KEY: Analysis
MSC: NCLEX Category: Safety and Infection Control
NOT: See Food and Drug Administration (p. 47): A side effect that can cause severe harm or death is
commonly called an adverse reaction. An example is airway swelling. It is your responsibility as an allied
health professional to report an adverse reaction to a medication to the FDA’s MedWatch.
4. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Narcotics KEY: Analysis
MSC: NCLEX Category: Psychosocial Integrity
NOT: See Drug Control (p. 57): Morphine is a Schedule II medication. An office assistant cannot call in the
prescription, and no refills are permitted. The office staff may fax the prescription to the pharmacy, but the
clients must also give a handwritten prescription to the pharmacist to receive the medication.
5. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Narcotics KEY: Analysis
MSC: NCLEX Category: Psychosocial Integrity
NOT: See Substance Abuse (p. 59): Requiring greater amounts of a drug occurs when clients develop a
tolerance to the medication. The amount of water consumed will not contribute to drug efficacy. Kidney or
liver dysfunction may contribute to drug metabolism, but lab results are not typically used to determine
digestion of a medication. The level of pain associated with the original injury is not helpful to the current
situation.
6. ANS: A PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA

Loading page 22...

KEY: Application MSC: NCLEX Category: Coordinated Care
NOT: See Treating Substance Abuse (p. 60): Follow your facility’s protocol on referral of impaired
employees for substance abuse treatment. Many employers have employee assistance programs or support
groups organized through the human resource department.
MULTIPLE RESPONSE
1. ANS: B, C, D PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA KEY: Analysis MSC: NCLEX
Category: Safety and Infection Control
NOT: See Modern Regulating Agencies (p. 46): OSHA regulations for protecting yourself on the job include
hand washing before any patient is handled. Medications should not be touched without wearing gloves.
Gloves should be worn during client care in case of exposure to blood or body fluids. Sharp objects should be
disposed of in a specialized sharps disposal container. Face masks are part of additional precautions when
providing care for clients with a respiratory infection - a client with heart failure is not considered infectious.
2. ANS: A, B, C PTS: 1 DIF: Hard TOP: Therapeutic Classification: NA
KEY: Analysis MSC: NCLEX Category: Pharmacological Therapies
NOT: See Clinical Trials (p. 51-52) and Table 4.6: Clinical trials are studies performed after testing is done in
a laboratory. During the study the effect of the active drug is compared to a placebo (an inactive substance).
Most studies are double-blind, meaning neither the participant nor the clinicians know who is receiving the
active drug. Phase II clinical trials involve hundreds of patients and are designed to see whether a drug works
as desired. Phase II trials last several months to 2 years.
3. ANS: A, C, E PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA KEY: Knowledge MSC: NCLEX
Category: Psychosocial Integrity
NOT: See Substance Abuse (p. 59): Patients who stop taking a medication may experience symptoms of
withdrawal, such as tremors, emotional distress, and hallucinations.
4. ANS: A, B, C, D, F PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: NA KEY: Application
MSC: NCLEX Category: Psychosocial Integrity
NOT: See Box 4.3 (p. 61): Signs of possible substance abuse include: being late or absent frequently due to
illness, irritable and defensive or withdrawn behavior, frequent mistakes, changes in appearance such as
weight change, and poor or deteriorated hygiene.
Chapter 5. Prescriptions and Labels
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse notes orders for lorazepam (Ativan) 1 mg PO qhs prn. Which action by the nurse is best?
A. Give the client 1 mg at noon each day.
B. Ask the client at bedtime if he/she would like to take an Ativan.
C. Schedule the Ativan daily with breakfast.
D. Instruct the client to ask for Ativan any time it is needed.
2. The following order is written for a 28-year-old client with asthma, ―Budesonide nasal (Pulmicort) 2
sprays each nostril bid.‖ The nurse will instruct the client to take this medication:
A. Once daily with two sprays in each nostril
B. Once each evening with one spray in each nostril
C. One spray in each nostril twice daily
D. Two sprays in each nostril two times each day
3. A client with Alzheimer’s disease is started on donepezil (Aricept) 10 mg PO qhs. The nurse will
administer this medication at:
A. 6 p.m.
B. 6 a.m.
C. 9 p.m.

Loading page 23...

D. 9 a.m.
4. A client with diabetes mellitus is ordered sliding scale insulin glulisine (Apidra) 2 to 10 units ac and hs
based on blood glucose results. The nurse will need to check the client’s blood sugar:
A. Before each meal and at bedtime
B. Fasting in the morning and again at bedtime
C. Just before breakfast and again at dinner
D. After each meal
5. A neighbor calls the nurse saying, ―This bottle of infant acetaminophen (Tylenol) doesn’t have a dropper; it
has a little cup. How do I know how much to give to my 3-month-old daughter?‖ Which
response by the nurse is best?
A. ―How much did you give your three-year-old son when he was a baby?‖
B. ―Read the label on the back of the box to find the strength and recommended dosage.‖
C. ―Why do you need to give the baby Tylenol?‖
D. ―Tylenol is no longer given to infants or children.‖
6. While caring for a client being sent home with a prescription for oxycodone and acetaminophen
(Percocet), the nurse must caution the client to avoid which of the following?
A. Eye drops or medications causing pupil constriction
B. Alcoholic beverages and grapefruit juice
C. Cold remedies and other products containing Tylenol D. Fiber laxatives and other stool
softeners
7. An 18-year-old patient calls a physician’s office to request a refill for birth control pills. Which response by
the nurse is best?
A. ―The physician must see you at least every 6 months to provide prescription
refills.‖
B. ―If you’ve been seen by the doctor in the last year, a prescription refill can be called to your
pharmacy.‖
C. ―All birth control medications require a hand-written prescription, so you will need to pick this up
at the desk at your convenience.‖
D. ―Are you sexually active?‖
8. The nurse is providing care for a client who is taking dulasteride (Avodart) for benign prostatic
hypertrophy (BPH). The client’s prescription reads, ―Take daily by mouth.‖ Thirty pills have been
dispensed and the prescription allows for five refills. The nurse anticipates seeing the client again in:
A. 1 month
B. 3 months
C. 6 months
D. 1 year
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
1. The nurse notes a prescription for eletriptan (Relpax) to be taken prn for migraine headaches. What
additional information would the nurse expect to see on the prescription bottle? (Select all that apply.)
A. Picture of the medication
B. Drug dosage
C. Physician DEA number
D. Subscription information

Loading page 24...

E. Client’s name and address
F. Pharmacy contact information
2. A 34-year-old patient recovering from a motor vehicle accident is receiving physical therapy. The client has
been prescribed metaxalone (Skelaxin) 800 mg tablet qid. Which of following directions or warning labels
would the nurse expect to see on the prescription label? (Select all that apply.) A. Avoid alcoholic beverages
when taking this medication
B. Take four times each day
C. Take three times a day with meals
D. May cause drowsiness or dizziness
E. Shake well
Chapter 5. Prescriptions and Labels Answer
Section
MULTIPLE CHOICE
1. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Antianxiety agents KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Medication Labels/Abbreviations (p. 70): PO means the medication is given orally; prn means it is
given as needed/desired; qhs means given at bedtime.
2. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Asthma medications KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Medication Labels/Abbreviations (p. 70): Bid stands for twice daily. The prescription is written for
2 sprays in each nostril.
3. ANS: C PTS: 1 DIF: Easy
TOP: Therapeutic Classification: Alzheimer’s agents KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Medication Labels/Abbreviations (p. 70): Qhs means at bedtime.
4. ANS: A PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Antidiabetic agents KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Medication Labels/Abbreviations (p. 70): Ac means before meals; hs means at bedtime.
5. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Pain medications KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Manufacturer Labels and Names (p. 73): Over-the-counter drugs also contain labels or instructions
on drug use based on age and weight. Infant Tylenol concentration has recently been changed to match the
pediatric dosing, but the product is still safely administered to infants and children.
6. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Narcotics KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Manufacturer Labels and Names (p. 73): Over-the-counter medications can interact negatively with
prescription drugs. Some cold medications increase the action of sedatives so a person taking both would be
sleepier than expected. Percocet is a narcotic. Alcoholic beverages should be avoided but there is no
interaction with grapefruit juice. A daily limit of 3 grams of Tylenol is recommended so products containing
additional Tylenol should be avoided.
7. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Hormonal therapy KEY: Application
MSC: NCLEX Category: Pharmacological Therapies

Loading page 25...

NOT: See Medication Labels/Abbreviations (p. 69): A prescriber may refill a prescription without asking to
see the patient again, especially if the patient has a chronic condition or is taking birth control pills.
8. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: BPH agents KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Inscription (p. 69): The medication is taken daily and an estimated 6-month supply has been
provided (current script plus five refills).
MULTIPLE RESPONSE
1. ANS: B, D, E, F PTS: 1 DIF: Hard
TOP: Therapeutic Classification: Antimigraine agents KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Medication Labels (p. 71): A pharmacy label will contain the pharmacy contact information, date
filled, prescription number, client name, address, prescription directions including drug name, dose, and
directions, subscription information including number of pills prescribed and refill information, and the
physician’s name and contact information. The DEA number is required on the written, faxed, or phoned-in
prescription, but is not necessarily printed on the prescription label. Pictures of the medication can be found
in a physician’s desk reference but are not located on the prescription label.
2. ANS: A, B, D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Muscle relaxants KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Medication Labels/Abbreviations (p. 70–71): Qid means four times each day. Metaxalone is a
muscle relaxant that can cause drowsiness; clients should avoid alcoholic beverages. There is no need to
shake tablets.
Chapter 6. Basic Review of Mathematics
Problem
1. The nurse is caring for a client on peritoneal dialysis. During a dialysis session, 2,000 mL of
dialysate solution was infused and 1850 mL returned. The client consumed 1 cup of coffee, 120 mL
of apple juice, and 1 bowl of oatmeal without milk. Calculate the client’s intake in mL.
2. While caring for a client on a 1,700-calorie diet restriction, the nurse notes the client has consumed
415 calories for breakfast. If 300 calories are allotted for beverages and snacks, how many calories
remain for the client’s meals?
3. The nurse is caring for a client who takes lisinopril (Zestril) 10 mg tid. Discharge orders include a
prescription for a 30-day supply. How many pills will be in the bottle when the prescription is
filled?
4. A young girl is started on 5 mg of paroxetine (Paxil) daily. The pharmacy provides 10-mg tablets.
How much will the nurse provide?
5. The nurse is providing ondansetron (Zofran) 4 mg as an intravenous injection. The pharmacy
provides ondansetron in 8 mg/2 mL vials. How much medication will the nurse draw up? Provide
the answer in mL.
6. The nurse is caring for a client placed on a 2,000-calorie diet. If two snacks are responsible for 20%
of the caloric intake, how many calories can be consumed with each snack?
7. While assisting with meal planning for a client placed on an 1,800-calorie diet, the nurse plans for
meals to make up 80% of the calorie consumption and wants to make each meal equivalent. How
many calories should the nurse plan for each of three meals?
8. A client consumes 1/2 cup grape juice, 2/3 of a 10 oz bowl of broth, 1/4 of a 4 oz bowl of gelatin,
and 1/3 a carton of milk, which holds 240 mL. Calculate the client’s intake in mL.
9. While working in the pediatric clinic, the nurse receives a call from a client trying to figure out how
much infant acetaminophen (Tylenol) to give to her child. The doctor has prescribed 45 mg every 4

Loading page 26...

hours. The medication is provided in 60 mg/5 mL concentration. How much medication (in mL)
should the client provide per dose? (Round to the nearest mL)
10. The physician recommends a teenager start taking 600 mg ibuprofen (Advil) tid starting 2 days
prior to her menstrual cycle and that she continue the medication for one week. The medication
comes in 200-mg strength tablets. How many tablets will the client consume during the week?
Chapter 6. Basic Review of Mathematics Answer
Section
PROBLEM
1. ANS:
510 mL
PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Basic Care and Comfort
NOT: See Addition Calculations (p. 79–80): The client has 150 mL dialysate solution, 240 mL coffee, 120 mL
juice. 150 + 240 + 120 is 510 mL.
2. ANS:
985 calories
PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Basic Care and Comfort
NOT: See Subtraction Calculations (p. 80–81): 1,700 calories allowed each day, minus the calories for
breakfast (415) and snacks (300) is written as: 1,700 – 715 and totals 985.
3. ANS:
90 pills
PTS: 1 DIF: Easy TOP: Therapeutic Classification: Antihypertensive
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Multiplication Calculations (p. 81): Tid means three times per day, so the client will take 3 pills per
day for 30 days (3 x 30), totaling 90 pills.
4. ANS:
1/2 pill
PTS: 1 DIF: Easy TOP: Therapeutic Classification: Antidepressants
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Adding Fractions (p. 87): Sometimes a patient is required to take partial tablets. The dose is one-
half (5 divided by 10) the available pill, so 1/2 pill is given.
5. ANS:
1 mL
PTS: 1 DIF: Easy TOP: Therapeutic Classification: Antiemetics
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Solving for Unknown (p. 99): The ordered dose is 4 mg. The medication is provided in 8-mg vials.
The dose is half of the available vial (4 divided by 8) so half the vial will be given. Because there are 2 mL in
each vial, half the vial is (1/2 multiplied by 2), which equals 1 mL.
6. ANS:
200 calories
PTS: 1 DIF: Easy TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Basic Care and Comfort
NOT: See Percentages (p. 95): 20% of 2,000 calories is 400 calories (0.2 x 2000), divided by 2 results in 200
calories per snack.
7. ANS:
480 calories
PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Basic Care and Comfort

Loading page 27...

NOT: See Percentages (p. 95): 80% of the 1,800 calorie intake is 1,440 calories (0.8 x 1,800). 1,440 is
divided equally between three meals (1,440/3) for 480 calories per meal.
8. ANS:
430 mL
PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Basic Care and Comfort
NOT: See Fractions (p. 87): 1/2 cup is 120 mL, 2/3 of 10 oz (300 mL) is 200 mL, 1/4 of 4 oz (120 mL) is 30
mL, 1/3 of 240 mL is 80 mL. 120 + 200 + 30 + 80 is 430.
9. ANS:
4 mL
PTS: 1 DIF: Moderate TOP: Therapeutic Classification: Medication Administration
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Fractions (p. 87): 60 mg in 5 mL is equivalent to 12 mg per mL. 45 mg divided by 12 mg/mL is
3.75 mL, which is rounded to 4 mL.
10. ANS:
63 tablets
PTS: 1 DIF: Moderate TOP: Therapeutic Classification: Medication Administration
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Multiplication Calculations (p. 81): A 600-mg dose requires 3 pills per dose (600 mg/200 mg per
pill). Tid means the client takes three doses per day, which is 9 pills per day (3 pills x 3 doses per day). One
week of medication is 7 days x 9 pills per day, or 63 pills total for the week.
Chapter 7. Measurement Systems
Completion
Complete each statement.
1. The nurse is providing care for a newborn that weighs 8 lb 8 oz. The physician has ordered
medications based on a kg weight. How much does the infant weigh in kg? Round to the nearest
whole number.
2. While working in the pediatric clinic, the nurse weighs a 5-year-old child as 20.5 kg. The mother
asks, ―How much is that in pounds?‖ Provide the child’s weight to the nearest whole pound.
3. While removing the dinner tray from a client’s room, the nurse notes the client drank 1 cup of
water, 6 oz of beef broth, 4 oz of gelatin, 120 mL of juice and 1 2-oz popsicle. What would the
nurse record for intake in mL?
4. While attempting to track the intake of an elderly client, the nurse asks the client to identify what
the client drank that day. The client reports, ―I had a small cup of tea, a juice glass full of juice,
and 2 cups of milk.‖ The nurse would record how many oz for this client’s intake?
5. While preparing to dispense a dose of liquid medication for a client with a gastrostomy tube, the
nurse notes the ordered dose is 15 mL. How many cc will the nurse draw into the cath-tipped
syringe when dispensing the medication?
6. The physician has ordered a child’s antibiotic dose as 5 mg/kg. The child weighs 14 kg. The
antibiotic is provided in a vial with 10 mg/mL. How many mL of antibiotic will be dispensed?
Round to the nearest whole number.
7. The nurse is mixing diluent with a powdered medication. The package directions instruct the nurse
to mix 3 mL of sterile water to achieve a concentration of 4 mg/mL. The client’s dose is 6 mg. How
many mL will the nurse withdraw to provide to the client? Round to the nearest tenth.
8. A client is ordered 25 mg of diphenhydramine (Benadryl) by intramuscular injection. The
medication is supplied in a 1-mL vial with 50 mg dosage. How much will the nurse inject?
9. The nurse is preparing to provide sliding scale insulin coverage to a client with diabetes. The
client’s blood sugar is 240 g/dL. The sliding scale indicates the client should receive 8 units of

Loading page 28...

insulin. The insulin is provided in a multi-dose vial with a concentration of 100 units/10 mL. How
many mL of insulin will the nurse provide?
10. The nurse is caring for a client who is to receive cefoperazone (Cefodbid) 1.5 g in 100 mL normal
saline intravenously over 30 minutes. The nurse begins the infusion and a little while later the client
calls to report itching so the nurse stops the infusion. The pump reading has recorded 44 mL
infused. Approximately how much medication (in mg) did the client receive?
Chapter 7. Measurement Systems Answer Section
COMPLETION
1. ANS: 4 kg
PTS: 1 DIF: Easy TOP: Therapeutic Classification: Medication Administration
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Measurement System (p. 109): 1 kg equals 2.2 lb; 1 lb equals 0.45 kg; 1 lb equals 16 oz. The infant
weights 8 lb, 8 oz. 8oz is one-half pound, so 8.5 lb x 0.45 equals 3.825 or 4 kg.
2. ANS: 45 lb
PTS: 1 DIF: Easy TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
3. ANS: 720 mL
PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Household System (p. 112): 8 oz equals 1 cup equals 240 mL. 1 cup of water is 240 mL, 6 oz beef
broth is 180 mL, 4 oz of gelatin is 120 mL, 120 mL of juice, and 2 oz of popsicle is 60 mL. Add 240 + 180 +
120 + 120 + 30 for a total of 720 mL.
4. ANS: 26 oz
PTS: 1 DIF: Easy TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Household System (p. 110): A teacup is 6 oz, the juice glass is 4 oz, the 2 cups of milk are 16 oz,
so 6 + 4 + 16 equals 26 oz. 5. ANS: 15 cc
PTS: 1 DIF: Easy TOP: Therapeutic Classification: Medication Administration
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Metric System (p. 112–113): 1 cubic centimeter (cc) equals 1 mL of fluid.
6. ANS: 7 mL
PTS: 1 DIF: Easy TOP: Therapeutic Classification: Medication Administration
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Household and Metric System (p. 110, 115): 14 kg multiplied by 5 mg/kg equals 70 mg. 70 mg
divided by 10 mg/mL equals 7 mL. 7. ANS: 1.5 mL
PTS: 1 DIF: Easy TOP: Therapeutic Classification: Medication Administration KEY: Application MSC:
NCLEX Category: Pharmacological Therapies
NOT: See Metric System (p. 117): The dose of 6 mg is divided by 4 mg/mL for a total of 1.5 mL.
8. ANS: 0.5 mL
PTS: 1 DIF: Easy TOP: Therapeutic Classification: Medication Administration
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Metric System (p. 115): The 25-mg dose is one half of the supplied dose, so 0.5 mL will be
injected.
9. ANS: 0.8 mL
PTS: 1 DIF: Moderate TOP: Therapeutic Classification: Medication Administration
KEY: Application MSC: NCLEX Category: Pharmacological Therapies

Loading page 29...

NOT: See Metric System (p. 117): 100 units in 10 mL is equivalent to 10 units per mL. The client is to
receive 8 units of insulin coverage. 8 units divided by 10 units/mL equals 0.8 mL.
10. ANS: 660 mg
PTS: 1 DIF: Moderate TOP: Therapeutic Classification: Medication Administration
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Metric System (p. 117): 1.5 g in 100 mL is equivalent to 1,500 mg in 100 mL or 15 mg in 1 mL. 44
mL of medication has infused. 44 times 15 equals 660 mg.
Chapter 8. Dosage Calculations
Multiple Choice
Identify the choice that best completes the statement or answers the question.
1. The nurse provides a client with 20 mL of megestrol acetate (Megace 40 mg/mL strength) and the client
reports, ―I usually take one teaspoon of the long-acting formulation; are you sure this is the right stuff?‖ The
nurse checks with the pharmacy and learns 5 mL of megestrol extended release (Megace ES 125 mg/mL) is
equivalent to 800 mg of Megace. Which response by the nurse is best?
A. ―You are right; you should only take 5 mL of this medication.‖
B. ―The two doses are equal since we don’t carry the long-acting medication.‖
C. ―You should be taking 20 mL of medication at home as well.‖
D. ―We will hold the medication at this time and verify the order with the physician.‖
2. A client admitted to the hospital with acute renal failure typically takes moexipril (Univasc) for
hypertension. The client’s creatinine clearance is 32 mL/min and the pharmacy recommends a 50%
dose reduction for this medication. The client’s typical dose is 7.5 mg. The nurse would expect the
physician to order:
A. 3.75 mg
B. 2.25 mg
C. 4.25 mg
D. 5.75 mg
3. The nurse is preparing potassium bicarbonate (TriLyte) for a pediatric client scheduled for a colonoscopy.
The directions state to provide the prep at an estimated rate of 25 mL/kg/hr. The child weighs 55 lb. The
nurse should encourage the child to drink how much of the solution each hour? A. 1 cup
B. 2 cups
C. 2.5 cups D. 4 cups
4. The student nurse is preparing to give a client 20 mEq of potassium chloride (K-LOR). Directions say to mix
the powdered medication with at least 4 oz of juice or water. The instructor would be satisfied with the
student’s preparation if the student had which of the following?
A. 80 mL of apple juice
B. 120 mL of grape juice
C. 2/3 cup of water
D. 1 cup of fruit punch
5. While monitoring a client receiving chemotherapy set to infuse over 3 hours, the nurse notes after the first
hour that just over 160 mL of the original 500 mL has infused. Which action by the nurse is best?
A. Alter the pump setting to infuse at 150 mL/hr.
B. Alter the pump setting to infuse at 200 mL/hr to ensure the medication finishes on time.
C. Assure the client the infusion is running appropriately and document current assessment.

Loading page 30...

D. Instruct the client the infusion will be completed in another 2.5 hours and do not change the
infusion rate.
6. The nurse is caring for a client starting diuretic therapy and is placed on strict intake and output
measurements. In counseling this client to maintain at least 1,500 mL intake per day, which beverages should
the nurse instruct the client to avoid?
A. Citrus juices and alcohol
B. Coffee, beer, and most soda pop
C. Tomato juice, diet drinks, and lemonade
D. Electrolyte-based drinks, tea, and artificial sweeteners
7. The nurse is preparing to provide evening medications. It is currently 8 p.m. The nurse will pass medications
scheduled at which military time?
A. 1600
B. 1800
C. 2000
D. 2200
Completion
Complete each statement.
1. The nurse is preparing to provide finasteride (Proscar) 5 mg daily in combination with doxazosin
(Cardura) 2 mg daily to a client with benign prostatic hypertrophy. The pharmacy provides the
finasteride in a 5-mg tablet and the doxazosin in a 1-mg tablet. How many pills will the nurse
provide?
2. While working in the pediatric clinic, the nurse examines the mouth of a 5-year-old patient being
treated for leukemia and notes white patches and scattered ecchymosis. The nurse suspects the child
has thrush and expects the physician to order fluconazole (Diflucan). This medication is typically
dosed at 3 mg/kg. The child weighs 42 lb. How many mg will be in each dose? (Round to the nearest
10 mg).
3. The nurse is passing morning meds for a client with hypertension taking fosinopril (Monopril) 30
mg. The pharmacy supplies this medication as a 20-mg tablet. How many tablets will the nurse
provide?
4. The nurse is preparing to provide losartan (Cozaar) suspension (2.5 mg/mL) for a client whose dose
is 50 mg. How many mL will be provided?
5. The nurse receives orders to start metronidazole (Flagyl) 50 mg/kg/24 hours divided into three equal
doses for a child that weighs 33 lbs. The medication is provided in 250-mg tablets. How many
tablets will the nurse provide with each dose?
6. Meloxicam (Mobic) is dispensed in solution with 7.5 mg/5 mL. The physician has ordered 0.125
mg/kg daily for a child with juvenile arthritis who weighs 68 lbs. How many mL will the nurse
provide? (Round to the nearest tenth).
7. Trimethoprim and sulfamethoxazole (Septra) suspension contains 200 mg sulfamethaxazole in each
teaspoon. The physician has ordered 2 teaspoons every 12 hours. What is the total daily dose of
sulfamethaxazole in mg?
8. The nurse is caring for a 12-year-old patient who, after a kidney transplantation, is to receive
sirolimus (Rapamune). The child weighs 38 kg and has a body surface area of 1.2 m2. The
medication has been ordered at a dose of 1 mg/m2/day and is provided by pharmacy in a 60 mg/60
mL-solution mixed in glass bottle for oral provision. How many mL will the nurse provide?
9. A nurse working in the oncology clinic is providing doxorubicin (Adriamycin) 60 mg/m2 to a client
whose body surface area is 1.6 m2. What dose of doxorubicin (in mg) will be sent by the pharmacy?

Loading page 31...

30 more pages available. Scroll down to load them.

Preview Mode

100%

Study Now!

XY-Copilot AI

Unlimited Access

Secure Payment

Instant Access

24/7 Support

AI Assistant

Document Details

Subject

Pharmacology

Test Bank for Pharmacology Clear and Simple A Guide to Drug Classifications and Dosage Calculations, 4th Edition (Chapters 1-20)

Study Now!

Document Details

Related Documents

ACCP Updates in Therapeutics® 2022: Pharmacotherapy Preparatory Review and Recertification Course (2022)

Test Bank for Lilley's Pharmacology for Canadian Health Care Practice, 4th Edition (Chapters 1-58)

Test Bank for Basic and Clinical Pharmacology, 14th Edition (Chapters 1-33)

Stahl's Essential Psychopharmacology: Neuroscientific Basis and Practical Applications 4th Edition Test Bank

Pharmacology For Nurses: A Pathophysiologic Approach , 4th Edition Test Bank

Test Bank For Basic Pharmacology For Nurses, 16e, 16th Edition

Class Notes for Core Concepts in Pharmacology, 5th Edition

2023 MSN622 Final Exam with Answers (117 Solved Questions)

MN553 Final Exam Quiz with Answers (97 Solved Questions)

2024-2025 MN553 Advanced Pharmacology Final Exam with Answers (94 Solved Questions)