Practice Questions

Introduction to Pharmacology
• A patient in a rehabilitation center is beginning to
experience opioid withdrawal symptoms. The
nurse should expect to administer which drug as
part of the treatment?
• a.diazepam (Valium)
• b.methadone
• c.disulfiram (Antabuse)
• d.bupropion (Zyban)
ANS: B
Option B is correct because opioid withdrawal can be managed with either methadone or
clonidine. Options A and C are used for treatment of alcoholism, and Option D is used for
smoking-cessation programs.
• Before administering any medication, which action by the
nurse is most important regarding patient safety?
• a.Verifying orders with another nurse
• b.Documenting the medications given
• c.Counting medications in the medication cart drawers
• d.Checking the patient’s identification and allergy
bracelets

ANS: D
This action is important for the patient’s safety and reflects checking some of the
Five Rights of medication administration. The other actions do not affect safety.
• A patient has a 9-year history of a seizure disorder that has
been managed well with oral phenytoin (Dilantin) therapy.
He is to be NPO for surgery in the morning. What should
the nurse do about his morning dose of phenytoin?
• a.Give the same dose intravenously.
• b.Give him the morning dose with a small sip of water.
• c.Contact the physician for another dosage form of the
medication.
• d.Notify the operating room that the medication has been
withheld.
ANS: C
The physician should be contacted for an order of the appropriate dose form of
the medication. The route should not be changed without a physician’s order.
Withholding the medication may lead to seizure activity during the surgical
procedure.
• A patient has been given a prescription for levodopa-carbidopa
for her newly diagnosed Parkinson’s disease. She comments,
however, that her support group friend was given a prescription
for “plain levodopa.” The nurse recognizes that the difference in
the two prescriptions is:
• a.Levodopa alone cannot cross the blood-brain barrier.
• b.There is really no difference in the two prescriptions.
• c.The combination drug is more efficient in increasing the
dopamine level in the brain.
• d.There are concerns about drug-food interactions with levodopa
therapy that do not exist with the combination therapy.

ANS: C
The addition of carbidopa allows more of the levodopa to reach the site of action
without being broken down; thus, lower doses of levodopa are needed, and the
combination is more efficient in increasing the dopamine level in the brain.
Dopamine, rather than levodopa, cannot cross the blood-brain barrier.
• During a blood transfusion, a patient begins to have chills
and back pain. What action should the nurse take first?
• a.Observe for other symptoms.
• b.Slow the infusion rate and monitor her vital signs.
• c.Discontinue the infusion immediately and notify the
physician.
• d.Tell the patient that her symptoms are a normal reaction
to the blood product.

ANS: C
Because of the possibility of a transfusion reaction, the infusion should be
discontinued immediately and the physician notified.
• A nurse in a dermatology clinic is assessing a 75-year-old client who
has been taking doxepin (Sinequan) for 1 week as prescribed to relieve
itching caused by an allergic reaction. Because of the anticholinergic
effects of doxepin, the nurse will assess the client carefully for:

• a. Diarrhea.
• b. Excessive Salivation.
• c. Bradicardia.
• d. Urinary Retention.

ANS: D
This drug has anticholinergic effects, and urinary retention is
one such effect. Many older male clients have some degree of
benign prostatic hypertrophy and therefore this client is likely
to be particularly susceptible to this effect. .
 • A nurse is instructing a client who is starting
sumatriptan (Imitrex) subcutaneous injection
therapy. The nurse instructs the client to take this
medication:
• a. once daily to prevent migraine attacks.
• b. as soon as migraine symptoms appear.
• c. every 3 hours as needed during the migraine.
• d. 30 minutes after migraine symptoms begin.

ANS: B
Sumatriptan should be taken only during a migraine attack.
 • In reviewing the provider's orders for a client who
is experiencing severe pain, the nurse recognizes
that the fastest and most effective route by which
an analgesic medication can be absorbed is:
• a.intermuscular.
• b.transdermal.
• c.intraveneous.
• d.oral.

ANS: C
Intravenous injections deliver the medication directly into the
bloodstream, allowing rapid distribution throughout the body.
• During a routine checkup, a patient states that she is
unable to take the prescribed antihistamine because of one
of its most common adverse effects. The nurse suspects
that which adverse effect has been bothering this patient?
• a.Diarrhea
• b.Urticaria
• c.Drowsiness
• d.Decreased libido

ANS: C
Drowsiness is usually the chief complaint of people who take
antihistamines.
• Which is a priority nursing action when planning care for a
postoperative client who has received an opioid
antagonist?
• a. Assessing for a decreased heart rate.
• b. Making sure the head of the client's bed is flat.
• c. Monitoring for improvement in respiratory rate.
• d. Giving the drug when the client's stomach is empty

ANS: C
The therapeutic effect of an opioid antagonist such as naloxone
(Narcan) is to increase respiratory rate. Naloxone reverses the
respiratory depression caused by an opiate overdose. Because
most narcotics have a longer duration of action than naloxone
has, however, repeat doses of naloxone are often required.
• A client is prescribed two antihypertensive medications that are known
to interact synergistically. What can the nurse expect to find when
assessing the effects of these medications for this client?

• a. The effect of the two drugs given together is likely to produce

unpredictable effects.
• b. The effect of giving both drugs should be greater than that of either
administered alone.
• c. When these two drugs are given together, one of them will
deteriorate chemically.
• d. The action of one drug is lessened by the second to reduce the toxic
effects of the first.

ANS: B
This describes synergy, also referred to as potentiation. An
example would be: acetaminophen + codeine = increased
analgesia.
• Which of the following is the most important
compound that transfers genes from parents to
offspring?
• a.Chromatin
• b.DNA
• c.Alleles
• d.RNA

ANS: B
It is now recognized that DNA is the most important
compound in the body that serves to transfer genes from
parents to offspring.
• When reviewing the health history of a patient
who will be receiving antacids, the nurse recalls
that antacids containing magnesium should be
used cautiously in which conditions?
• a.Peptic ulcer disease
• b.Renal failure
• c.Hypertension
• d.Heart failure

ANS: B
The failing kidney cannot excrete the extra magnesium, and
accumulation may occur.
• A patient on chemotherapy is using ondansetron (Zofran)
--a serotonin blocker- for treatment of nausea. The nurse
will instruct the patient to watch for which adverse effect
from this drug?
• a.Dizziness
• b.Headache
• c.Dry mouth
• d.Blurred vision
ANS: B
Headache is an adverse effect of the serotonin blockers. The
other adverse effects listed may occur with anticholinergic
drugs.
• The nurse is preparing to give a new order for eardrops.
Contraindications to the use of otic preparations include:
• a.Escherichia coli infection.
• b.Perforated eardrum.
• c.Haemophilus influenzae infection.
• d.Ear canal itching.

ANS: B
Contraindications to the use of otic preparations include
perforated eardrum.