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06/18/2013

Pharmacology for Nursing NURS 440 NCLEX-RN Review Questions for Pharmacology Answers and rationales 1.

A client is to have mafenide(Sulfamylon ) cream applied t burned areas. The nurse should be aware that a serious side effect of Sulfamylon therapy is: a. Curling’s ulcer – does not occur b. Renal shutdown – does not occur c. Metabolic acidosis - Mafenide (Sulfamylon) interferes with the kidneys’ role in hydrogen ion excertion, resulting in metabolic acidosis. d. Hemolysis of RBC’s – does not occur 2. Ceftriaxone (Rocephin) 2.5g IVBP every 8 hours is ordered for a client with a severe infection. The pharmacy sends a vial labeled 5g per 10ml. When preparing the IVPB the nurse should use: a. b. c. d. 1ml 2.5ml 4.5ml 5ml – use ratio and proportion 5g: 10ml=2.5g:x ml 5x =25 x =5ml

3. A client with tetanus is to continue taking ampicillin after discharge. The nurse should explain the need to: a. Take ampicillin with meals – is best absorbed when taken on an empty stomach with water b. Notify the physician if diarrhea develops – a possible side effect that can be related to a superinfection; it can lead to fluid and electrolyte imbalance. c. Store the ampicillin in a light-resistant container – storage in a tight container is necessary, protection from light is not d. Continue the drug until a negative culture is obtained – culture is not repeated unless the client’s condition warrants it

4. A client will be taking sulfisoxazole (Gantrisin) at home. The nurse instructs the client to: a. Increase fluid intake – to prevent crystal formation, the client should have sufficient intake to produce 1000 to 1500 ml of urine daily while taking this drug b. Strain urine for crystals and stones – not necessary c. Stop the drug in the urinary output increases – urinary decrease is of concern, because it may indicate renal failure. If fluids are encouraged the client’s output should increase. d. Maintain the exact time schedule for drug taking – need not be taken at a strict time daily 5. A client who has been diagnosed as having Lyme disease is started on doxycycline, a tetracycline. When administering this drug, the nurse should: a. Administer medication with meals or a snack – food interferes with absorption, it should be given one hour before or two hours after meals or snacks b. Provide orange or other citrus fruit juice with the medication – has no influence on this drug c. Provide medication an hour before milk products are ingested– any product containing aluminum, magnesium, or calcium ions should not be taken in the hours before or after an oral dose, because it decreases absorption by as much as 25% to 50% d. Offer antacids 30 minutes after administration if GI side effects occur – will interfere with absorption of this drug 6. The nurse administers trimethoprim-sulfamethoxazol (Septra) as ordered to combat urinary tract infections. This drug belongs to the group of drugs know as: a. b. c. d. Antiseptics – wrong classification Analgesics - wrong classification Uricosurics – Sept does not inhibit the reabsorption uric acid Antiinfectives – Septra blocks two consecutive steps in bacterial synthesis of essential nucleic acids and protein

7. Vitamin B6 (pyridoxine) is given with isoniazid (INH) because it: a. Enhances tuberculostatic effect of isoniazid – pyridoxine does not enhanced the effect of INH b. Improves the immunologic response of the client – Vitamin B6 does not improve immunological status c. Provides the vitamin when isoniazid is interfering with natural vitamin synthesis – INH often leads to pyridoxine (Vitamin B6) deficiency because it competes with the vitamin for the same enzyme.

This is most often manifested by peripheral neuritis, which can be controlled by regular administration of vitamin B6 d. Accelerates destruction of remaining organisms after inhibition of their reproduction by isoniazid – pyridoxine does not destroy organisms 8. Whenever quinine is used, the nurse should be alert to symptoms of severe cinchonism, which include: a. Deafness – signs of cinchonism, such as deafness, tinnitus, headache, dizziness, and nausea, indicate that toxicity caused by excessive quinine has occurred b. Paresthesias – does not occur with quinine c. Difficulty breathing – does not occur with quinine d. Painful swollen joints – does not occur with quinine

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