Q& a Pharmacology

Q & A Pharmacology

Question Number 1 of 40

A client with an aplastic sickle cell crisis is receiving a blood transfusion and begins to complain of "feeling

hot". Almost immediately, the client begins to wheeze. What is the nurse's first action?

A) Stop the blood infusion
B) Notify the health care provider
C) Take/record vital signs
D) Send blood samples to lab

The correct answer is A: Stop the blood infusion

If a reaction of any type is suspected during administration of blood products, stop the infusion immediately,
keep the line open with saline, notify the health care provider, monitor vital signs and other changes, and
then send a blood sample to the lab.

Question Number 1 of 40

The use of atropine for treatment of symptomatic bradycardia is contraindicated for a client with which of the

following conditions?

A) Urinary incontinence

B) Glaucoma

C) Increased intracranial pressure

D) Right sided heart failure

The correct answer is B: Glaucoma

Atropine is contraindicated in clients with angle-closure glaucoma because it can cause pupillary dilation

with an increase in aqueous humor with resultant increase in optic pressure.

Question Number 2 of 40

The nurse is assessing a client who is on long term glucocorticoid therapy. Which of the following findings

would the nurse expect?

A) Buffalo hump
B) Increased muscle mass
C) Peripheral edema

D) Jaundice

The correct answer is A: Buffalo hump

With high doses of glucocorticoid, iatrogenic Cushing''s syndrome develops. The exaggerated physiological
action causes abnormal fat distribution which results in a moon-shaped face, a dorsocervical pad on the
neck (buffalo hump) and truncal obesity with slender limbs

Question Number 3 of 40

The nurse is caring for a client who is receiving procainnamide (Pronestyl) intravenously. It is important for

the nurse to monitor which of the following parameters?

A) Hourly urinary output
B) Serum potassium levels
C) Continuous EKG readings

D) Neurological signs

The correct answer is C: Continuous EKG readings

Procainnamide (Pronestyl) is used to suppress cardiac arrythmias. When administered intravenously, it must

be accompanied by continuous cardiac monitoring by ECG.

Question Number 4 of 40

In providing care for a client with pain from a sickle cell crisis, which one of the following medication orders

for pain control should be questioned by the nurse?

A) Demerol

B) Morphine

C) Methadone

D) Codeine

The correct answer is A: Demerol

Meperidine is not recommended in clients with sickle cell disease. Normeperidine, a metabolite of meperidine, is a central nervous system stimulant that produces anxiety, tremors, myoclonus, and generalized seizures when it accumulates with repetitive dosing. Clients with sickle cell disease are particularly at risk for normeperidine-induced seizures

Question Number 5 of 40

The health care provider has written "Morphine sulfate 2 mgs IV every 3-4 hours prn for pain" on the chart of

a child weighing 22 lb. (10 kg). What is the nurse's initial action?

A) Check with the pharmacist
B) Hold the medication and contact the health care provider
C) Administer the prescribed dose as ordered
D) Give the dose every 6-8 hours

The correct answer is B: Hold the medication and contact the health care provider

The usual pediatric dose of morphine is 0.1 mg/kg every 3 to 4 hours. At 10 kg, this child should receive 1.0

mg every 3 to 4 hours

Question Number 6 of 40

The nurse is administering an intravenous vesicant chemotherapeutic agent to a client. Which assessment

would require the nurse's immediate action?

A) Stomatitis lesion in the mouth
B) Severe nausea and vomiting
C) Complaints of pain at site of infusion
D) A rash on the client's extremities

The correct answer is C: Complaints of pain at site of infusion

A vesicant is a chemotherapeutic agent capable of causing blistering of tissues and possible tissue necrosis
if there is extravasation. These agents are irritants which cause pain along the vein wall, with or without
inflammation.

Question Number 7 of 40

The nurse is providing education for a client with newly diagnosed tuberculosis. Which statement should be

included in the information that is given to the client?

A) "Isolate yourself from others until you are finished taking your medication."

B) "Follow up with your primary care health care provider in 3 months."

C) "Continue to take your medications even when you are feeling fine."

D) "Continue to get yearly tuberculin skin tests."

The correct answer is C: "Continue to take your medications even when you are feeling fine."

The most important piece of information the tuberculosis client needs is to understand the importance of
medication compliance even if he is no longer experiencing symptoms. Clients are most infective early in the
course of therapy. The numbers of acid-fast bacilli are greatly reduced as early as 2 weeks after therapy
begins

Question Number 8 of 40

A client with anemia has a new prescription for ferrous sulfate. In teaching the client about diet and iron
supplements, the nurse should emphasize that absorption of iron is enhanced if taken with which
substance?

A) Acetaminophen

B) Orange juice

C) Low fat milk

D) An antacid

The correct answer is B: Orange juice

Ascorbic acid enhances absorption of iron

Question Number 9 of 40

The nurse is administering diltiazem (Cardizem) to a client. Prior to administration, it is important for the

nurse to assess which parameter?

A) Temperature

B) Blood pressure

C) Vision

D) Bowel sounds

The correct answer is B: Blood pressure

Diltiazem (Cardizem) is a calcium channel blocker that causes systemic vasodilation resulting in decreased

blood pressure

Question Number 10 of 40

A nurse is caring for a client who is receiving methyldopa hydrochloride (Aldomet) intravenously. Which of
the following assessment findings would indicate to the nurse that the client may be having an adverse
reaction to the medication?

A) Headache

B) Mood changes
C) Hyperkalemia
D) Palpitations

The correct answer is B: Mood changes

The nurse should assess the client for alterations in mental

status such as mood changes. These symptoms should be reported promptly

Question Number 11 of 40

The nurse is caring for a client with schizophrenia who has been treated with Quetiapine (Seroquel) for 1
month. Today the client is increasingly agitated and complains of muscle stiffness. Which of these
assessments should be reported to the health care provider?

A) Elevated temperature and sweating.
B) Decreased pulse and blood pressure.
C) Mental confusion and general weakness.
D) Muscle spasms and seizures.