Nclex pharmacology

1. Which of the following laboratory results shows adverse effect of garamycin?

a) elevated SGOT and SGPT

b) decreased wbc count
c) increased platelet count
d) elevated BUN and serum creatinine

2. The client is on heparin therapy. Which of the following health teaching is essential?

a) use a safety razor to shave

b) use a soft sponge toothbrush
c) take ecotrin for pain
d) use compression support stockings

3. Which of the following medications would the nurse be prepared to administer to a client in liver
failure?

a) neomycin and lactulose

b) phenytoin sodium
c) diazepam
d) phenobarbital

4. What is the difference between epidural analgesia and analgesia given through intravenous route?

a) epidural analgesia has longer effect in the body

b) epidural analgesia has more sedative effect
c) epidural analgesia is more effective in relieving pain
d) epidural analgesia has fewer side effects

5. A client is receiving Synthroid. Which of the following assessment data indicates that the client is
experiencing a side effect of the drug?

a) muscle weakness and fatigue

b) headache and lethargy
c) tachycardia and weight loss
d) anorexia and obesity

6. The client has hepatic encephalopathy. She is receiving lactulose. What is the expected outcome of
the medication?
a) increased level of awareness
b) increased albumin levels
c) increased number of stools
d) increased serum protein levels

7. The nurse is preparing to administer Terbutaline (Brethine) to a multigravid client in preterm labor.
Before administering this drug intravenously, the nurse should assess which of the following?

a) hematocrit level
b) weight gain
c) urinary output
d) heart rate

8. The physician orders Betamethasone (Celestone) for a 34-year old multigravid client at 32 weeks
gestation who is experiencing preterm labor. The nurse explains that this drug is given for which of the
following reasons?

a) to enhance fetal lung maturity

b) to counter the effects of tocolytic therapy
c) to treat chorioamnionitis
d) to decrease neonatal production of surfactant

9. Which of the following comments indicates that a client understands the nurse's teaching about
Sertraline (Zoloft)?

a) this medicine will probably cause me to gain weight

b) this medicine can cause delayed ejaculations
c) dry mouth is a permanent side effect of Zoloft
d) I can take my medicine with St. John's wort

10. When the nurse begins to give the patient a prescribed medication, the patient says, "You are
poisoning me with the pills you are giving me." Which of these responses by the nurse is most
appropriate?

a) tell me why you think I am doing that to you

b) this isn't the first dose I've given you
c) I'll get a fresh package of pills so you can see me open the sealed package
d) are the other nurses giving you these pills?
11. A patient who is known to be a narcotic abuser is involved in an automobile accident and has
extensive surgery. In planning for analgesia post-surgery, the nurse should be aware that this patient is
likely to:

a) tolerate pain than a patient who is not a drug abuser

b) require greater doses of medication before pain is relieved
c) refuse medication to prove addiction is not a problem
d) tolerate oral medication better than intravenous doses

12. When a patient is taking an antianxiety drug, such as Alprazolam (Xanax), the nurse should instruct
the patient to:

a) avoid alcoholic beverages

b) increase potassium intake
c) discontinue use of drugs like tylenol
d) check for signs of edema

13. A client is to receive morphine sulfate 10mg IM. The morphine for injection is available in 8 mg per 1
ml. How many ml should the client receive?

14. A newborn baby boy was given Aquamephyton. The mother asks the purpose of the medication.
Which of the following is most appropriate explanation to the mother?

a) this is given to prevent infectious diseases in the future

b) this is given to prevent blood clot formation
c) this is given to enhance immune system function
d) this is given to prevent bleeding

15. The patient is admitted for treatment of Garamycin IV drip. After 24 hours of receiving the
medication, which of the following laboratory results are to be checked? Select all that apply

a) BUN
b) creatinine
c) peak and through
d) glucose
e) protein
f) hemoglobin
g) CBC

16. The client with liver cirrhosis has an ammonia level of 80 mcg/dl. Which of the following medications
does the nurse anticipate to be ordered for the client?
a) dulcolax
b) metamucil
c) lactulose
d) senokot

17. Which of the following indicates effectiveness of Spirolactone, in the client with liver cirrhosis?

a) increase in weight
b) decrease in abdominal girth
c) increase in serum potassium level
d) decrease in jaundice

18. Which of the following is a contraindication to influenza vaccine?

a) chronic illness
b) allergy to eggs
c) diabetes mellitus
d) chronic obstructive pulmonary disease

19. Sulfasalazine (Azulfidine) is prescribed for a client with a diagnosis of ulcerative colitis. A nurse
instructs the client about the medication. Which statement when made by the client indicates that he
understands the teaching about the medication?

a) I should avoid exposure to sunlight

b) this medication will cause constipation
c) this medication should be taken with meals
d) this medication should be taken as prescribed

20. Which of the following assessment data when made by the nurse indicates effectiveness of lithium?

a) the client paces along the hallway during the night

b) the client refuses to eat in the dining room
c) the client is able to attend the conference on time
d) the client washes his hands less frequently

21. Which of the following assessment findings indicate that propylthiouracil (PTU) is effective in the
treatment of grave's disease?

a) the exopthalmos is decreased

b) the weight decreased
c) the edema decreased
d) the pulse rate decreased
22. What medication does the nurse expect to be prescribed for a client with adrenal insufficiency?

a) epinephrine
b) hydrocortisone
c) cyclophosphamide
d) amphogel

23. A patient is on coumadin therapy. Which statement when made by the client will concern the
nurse?

a) I will refrain from taking aspirin for my headache

b) I'm glad I'll be able to eat lettuce, spinach and other green vegetables
c) I will use soft-bristled toothbrush
d) I will drink 8-10 glasses of water everyday

24. Which of the following complaints when made by the client who is receiving penicillin should
concern the nurse most?

a) erythema in the lips and eyelids

b) difficulty in swallowing
c) itchiness of the skin
d) dryness of the mouth

25. What assessment parameter will the nurse check prior to giving potassium supplement per slow IV
infusion drip?

a) blood pressure
b) complete blood count
c) liver enzymes
d) urine output

26. Which of the following signs and symptoms indicates toxicity of gentamycin sulfate (garamycin)?

a) nausea and vomiting

b) hypotension
c) numbness of fingers and toes
d) ringing in the ears

27. The client has history of allergy to sulfonamides and penicillin. Which of the following drugs may
safely be given to the client?
a) ampicillin
b) cloxacillin
c) ciprofloxacin
d) co-trimoxazole

28. The client is receiving Floricef. Which of the following types of diet should the nurse advise the client
to have?

a) low sodium, high potassium, high protein

b) low sodium, low potassium, low protein
c) high sodium, high potassium, high protein
d) high sodium, high potassium, low protein

29. The client is receiving Questran. Which of the following should be included in the client teaching?

a) limit fluid intake

b) take fat-soluble vitamins
c) include potassium-rich foods in the diet
d) provide low-fiber diet

30. Which of the following health teachings should be included by the nurse for a client on prolonged
Dilantin treatment?

a) wear long-sleeved clothing

b) use soft-bristled toothbrush
c) notify physician if urine becomes reddish brown
d) take the medication one hour before meals

31. 60-year old man is receiving Tagamet/IV. After 30 minutes of infusion, he complains of headache
and dizziness. Which of the following actions should the nurse take first?

a) stop infusion
b) call the physician
c) take vital signs
d) elevate the head of bed

32. The client is receiving Gentamycin sulfate (garamycin), an amoniglycoside. Which of the following
laboratory tests should the nurse monitor?

a) BUN, serum creatinine

b) SGOT, SGPT
c) serum glucose levels
d) complete blood count

33. Which of the following statements by the client indicates effectiveness of benzodiazepines?

a) my appetite to eat has greatly improved

b) I am less confused than before
c) I can remember things better now
d) I am now sleeping more than I used to

34. Which of the following assessment indicates the need for Dilantin (phenytoin) administration after
dialysis?

a) headache, nausea, vomiting

b) hypertension, headache, restlessness
c) nausea, vomiting, restlessness
d) dizziness, headache, restlessness

35. The client is on Mestinon therapy. Which of the following signs and symptoms when experienced by
the client need to be reported to the physician? Select all that apply

a) weakness
b) diarrhea
c) reduced tremors
d) increased muscle strength
e) nausea and vomiting
f) abdominal cramps
g) headache, dizziness

36. The client is on coumadin therapy. Which of the following is inappropriate action by the nurse?

a) monitor prothrombin time

b) observe for signs and symptoms of bleeding
c) provide vitamin K-rich foods
d) have aquamephyton readily available

37. The physician order is acetaminophen (tylenol) gr xv, P.O., PRN. Available stock is tylenol 325 mg.
tablet. How many tablets should be given?

38. The physician ordered gentamycin (garamycin) 50 mg IM. Available stock is gentamycin 80mg/2ml in
a vial. How many ml. should be administered to client?

39. Which of the following indicates effectiveness of lactulose in a client with hepatic encephalopathy?
a) dehydration is resolved
b) level of consciousness (LOC) has improved
c) 4 watery stools in 24 hours
d) jaundice is diminished

40. Which of the following is not a side effect of dilaudid?

a) respiratory depression
b) urinary retention
c) hypertension
d) constipation

41. The client is receiving Spironolactone (Aldactone). Which of the following diets is recommended for
the client?

a) high-potassium diet
b) high-protein diet
c) low-potassium diet
d) low protein diet

42. The client is receiving Gentamycin sulfate (Garamycin). Which of the following are side effects of
the drug? Select all that apply.

a) photosensitivity
b) elevated BUN
c) elevated serum creatinine
d) hearing loss
e) increased urine output
f) nausea and vomiting

43. The client is receiving amphogel (AL-OH). Which of the following are side effects of the drug? Select
all that apply.

a) constipation
b) hypophosphatemia
c) hyperkalemia
d) hypercalcemia
e) diarrhea
f) hypermagnesemia

44. The client is receiving Pepcid (Famotidine). Which of the following should be included when giving
health teachings to the client?

a) take the medication with meals

b) avoid taking aspirin
c) take the medication with milk
d) take the medication before meals

45. The client is in digitalis therapy. What question should the nurse ask to know if the client is
experiencing digitalis toxicity?

a) do you feel dizzy?

b) do you experience lack of appetite to eat?
c) do you have constipation?
d) do you experience tightening of your ring?

46. The client is taking Sudafed. Which herbal drug should not be taken by the client?

a) valerian
b) feverfew
c) black cohosh
d) billberry

47. The client is taking neupogen. Which of the following is the desired effect of the drug?

a) increased in plasma
b) increased in platelet
c) increase in RBC'S
d) increase in WBC

48. The client is on Coumadin therapy. The prothrombin time (PT) is 32 secs. Which of the following is
the most appropriate action by the nurse?

a) withhold the drug

b) continue giving the drug
c) report the result to the physician
d) increase the dose

49. A woman in preterm labor will receive Betamethasone. What is the purpose of this medication?

a) to delay the delivery of the fetus

b) to promote fetal lung maturity
c) to relax the uterus
d) to shorten second stage of labor

50. Which of the following signs and symptoms indicates early digitalis toxicity?

a) the client complains of dryness of mouth

b) the client complains of watery stools
c) the client complains of blurring of visions
d) the client complains of numbness of fingers and toes

51. A medication is ordered to be given, 1250 mg. BID. Available stock is 10 gram in 50 ml. How many
ml. will be given per dose?

52. The client with schizophrenia has been prescribed with Thorazine (Chlorpromazine) 25 mg QID. He
experiences protrusion and rolling of tongue, involuntary movements of the body and extremities,
sucking and smacking movements of the lips. These signs and symptoms indicate which of the following
adverse reactions to the drug?

a) pseudoparkinsonism
b) akathisia
c) acute dystonia
d) tardive dyskinesia

53. You will administer an IV solution of D5LR 3L for fluid replacement on a patient with mild
dehydration for 24 hours. What is the infusion rate in drops per minute? Answer in whole numbers

54. The patient with supraventricular tachycardia has been treated with digoxin. What should be
considered when giving the medication? Select all that apply

a) monitor digoxin blood levels

b) check and count apical pulse for a whole minute
c) recognize symptoms of hypokalemia
d) withhold medication when client complains of visual disturbances and refer to opthalmologist
e) place digoxin under the tongue
f) give digoxin bolus dose as ordered

55. The client is prescribed with Lisinopril (Zestril) for treatment of hypertension. She asks you about
the possible side effects of the medication. Which of the following are possible side effects of the drug?
Select all that apply

a) dizziness
b) headache
c) constipation
d) hyperglycemia
e) hypotension
f) impotence

56. The client receives thyroid replacement therapy and notes inadequacy when which of the following
findings occur?

a) prolonged QT interval
b) tachycardia
c) nervousness
d) hypothermia

57. A patient is undergoing testing to confirm diagnosis of myasthenia gravis. The nurse explains that the
diagnosis is confirmed when muscle function improves after the patient receives an IV injection of a
medication. What is this drug administered to the patient during the test?

58. The nurse is caring for a 10-year old client newly diagnosed with tonic-clonic seizure disorder. What
instructions do you give the mother about phenytoin?

a) monitor the child for skin rash

b) maintain adequate amounts of fluids
c) the child will be frequently having blood works done
d) maintain good oral hygiene, brushing and flossing
e) report to the physician any problems with walking, coordination, slurred speech, and nausea

59. Which of the following drugs will be administered first in the patient with bronchial asthma?

a) corticosteroid
b) bronchodilator
c) antihistamine
d) mucolytic

60. Which of the following drugs is administered first, in a client with asthma?

a) robitussin DM
b) benadryl (diphenhydramine)
c) beclomethasone (vanceril)
d) theophylline (theo-dur)

61. The nurse will administer drugs to several patients. Which of the following drugs should she
administer first?
a) hydralazine for a client with PIH
b) antibiotic for ruptured abscess
c) insulin for a client with high blood glucose
d) diuretic for the client with congestive heart failure

62. When administering Synthroid (Levothyroxine), which of the following considerations should be
observed by the nurse?

a) assess pulse rate prior to administration

b) administer the medication on full stomach
c) advise client to increase fluid intake
d) monitor intake and output

63. Which of the following is an important nursing consideration when administering Garamycin?

a) monitor blood pressure

b) monitor intake and output
c) monitor body temperature
d) monitor pulse rate

64. When a client is on Chlorothiazide therapy, which of the following should be included in the health
teachings to the client?

a) include fruits and green leafy vegetables in the diet

b) include milk and cheese in the diet
c) include meat in the diet
d) include beans and rice in the diet

65. The nurse will administer an IV fluid of 1,000 mls for 10 hours. The IV set has a drop factor of 10
gtts/ml. How many gtts/min should the nurse regulate the IV fluid.

66. The patient is receiving heparin. What should the nurse keep readily available?

a) aquamephyton
b) coumadin
c) ASA
d) protamine sulfate

67. Which of the following drugs more likely will be prescribed for a client with Zollinger-Ellison
syndrome?

a) tapazole
b) propylthiouracil
c) omeprazole
d) hydrochlorothiazide

68. The client's serum albumin level is 2 mg/dL. Which of the following drugs does the nurse anticipate
to be ordered by the physician?

a) hetastarch
b) ciprofloxacin
c) lisinopril (zestril)
d) furosemide (lasix)

69. Which of the following indicates effectiveness of levodopa in a client with Parkinson's disease?

a) relief of tremors and rigidity

b) improved emotional state
c) improve of memory
d) return of sensation

70. The client is receiving Retrovir. Which of the following are potential side effects of the drugs? Select
all that apply

a) tingling sensation
b) elevated BUN, serum creatinine
c) hyperglycemia
d) elevated liver enzymes
e) hypertension

71. A nursing student needs to administer potassium chloride intravenously as prescribed to a client
with hypokalemia. The nursing instructor determines that the student is unprepared for this procedure
if the student states that which of the following is part of the plan for preparation and administration of
the potassium?

a) obtaining a controlled IV infusion pump

b) monitoring urine output during administration
c) diluting in appropriate amount of normal saline
d) preparing the medication for bolus administration  

72. A client is brought to the emergency room stating that he has accidentally been taking two times his
prescribed dose of warfarin (Coumadin) for the past week. After noting that the client has no evidence
of obvious bleeding, the nurse plans to do which of the following next?
a) prepares to administer the antidote
b) draws a sample for type crossmatch and transfuse the client
c) draws a sample for an activated partial thromboplastin (aPTT)
d) draws a sample for prothrombin (PT) and international normalized ration (INR) level

73. Methylergonovine (Methergine) is prescribed for a woman to treat postpartum hemorrhage. Before
administration of methylergonovine, the priority nursing assessment is to check the:

a) uterine tone
b) blood pressure
c) amount of lochia
d) deep tendon reflexes

74. A nurse is preparing to administer beractant (survanta) to a premature infant who has respiratory
distress syndrome. The nurse plans to administer the medication by which of the following routes?

a) intradermal
b) intratracheal
c) subcutaneous
d) intramuscular

75. A nurse is caring for a client who is receiving oxytocin (Pitocin) to induce labor. The nurse
discontinuous the oxytocin infusion if which of the following is noted on assessment of the client?

a) fatigue
b) drowsiness
c) uterine hyperstimulation
d) early decelerations of the fetal heart rate

76. The home care nurse provides medication instructions to an older hypertensive client who is taking
lisinopril (Prinivil), 20 mg orally daily. Which statement, if made by the client, indicates that further
teaching is necessary?

a) I can skip a dose once a week

b) I need to change my position slowly
c) I take the pill after breakfast each day
d) If I get bad headache, I should call my doctor immediately

77. The nurse is providing medication instructions to an older client who is taking digoxin (Lanoxin) daily.
Th nurse notes that which age-related body changes could place the client at risk for digoxin toxicity?

a) decreased muscle strength and loss of bone density

b) decreased cough efficiency and decreased vital capacity
c) decrease salivation and decreased gastrointestinal motility
d) decreased lean body mass and decreased glomerular filtration rate

78. Antibiotics are prescribed for a child after myringotomy with insertion of tymphanostomy tubes and
the nurse provides discharge instructions to the parents regarding the administration of the antibiotics.
Which statement, if made by the parents, indicates that they understood the instructions?

a) administer the antibiotics until they are gone

b) administer the antibiotics if the child has a fever
c) administer the antibiotics until the child feels better
d) begin to taper the antibiotics after 3 days of full course

79. Acetylsalicylic acid (aspirin) is prescribed for a child with rheumatic fever. A nurse would question
this order if there were documented evidence that the child had which of the following?

a) joint pain
b) arthralgia
c) facial edema
d) a viral infection

80. Cloxacillin, 200mg orally every 8 hours, is prescribed for a child with an elevated temperature who is
suspected of having a respiratory tract infection. The child weighs 17 lb. The safe pediatric dosage is 50
mg/kg/day. The nurse determines that:

a) the dose prescribed is safe

b) the dose prescribed is too low
c) the dose prescribed is too high
d) there is not enough information to determine the safe dose

81. Sodium hypochlorite (Dakin's solution) is prescribed for a client with a leg wound that is draining
purulent material and the home health nurse teaches a family member how to perform wound
treatments. Which statement, if made by the family member, indicates a need for further teaching?

a) a fresh solution needs to be prepared frequently

b) the solution should not come in contact with normal skin tissue
c) I should rinse the solution off immediately following the irrigation
d) I will soak a sterile dressing with solution and pack it into the wound

82. Dextranomer (Debrisan) is prescribed for a client with a pressure ulcer. The nursing instructor asks
the nursing student preparing to perform the treatment about the medication and procedure. Which
statement, if made by the student, indicates a need for further research?

a) it is effective in wet wounds only

b) it should be packed lightly into the wound
c) the wound bed must be dried thoroughly before applying the medication
d) maceration of tissue surrounding the wound can occur from the medication

83. The clinic nurse is performing an admission on a client. The nurse notes that the client is taking
azelaic acid (Azelex). Because of the medication prescription, the nurse would suspect that the client is
being treated for:

a) acne
b) eczema
c) hair loss
d) herpes simplex

84. The physician has prescribed silver sulfadiazine (Silvadene) for the client with a partial-thickness
burn, which has cultured positive for gram-negative bacteria, and the nurse provides information to the
client about the medication. Which statement made by the client indicates a lack of understanding
about the treatments?

a) the medication is antibacterial

b) the medication will help heal the burn
c) the medication will permanently stain my skin
d) the medication should be applied directly to the wound

85. The registered nurse is observing a newly hired nurse perform a dressing change on a client with a
leg ulcer. Sutilains (Travase) is being used to treat the ulcer. Which observation by the registered nurse
would indicate an inaccurate action by the newly hired nurse when performing the dressing change?

a) the nurse cleans the wound with a sterile saline

b) the nurse places the sutilains in the refrigerator following use
c) the nurse dries the wound and covers the sutilains application with a dry sterile dressing
d) the nurse moistens  the wound with sterile normal saline and then applies the sutilains