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Pharmacology ATI 2013

1. A nurse is assessing a client who is receiving chloramphenicol (Chloromycetin).


Which of the following findings is an adverse effect of this medication?
o Ecchymosis (google)
o Ototoxicity
o Hypertension
o Anxiety
2. A nurse is caring for a client who is to receive 1,500 mL of 0.9% sodium chloride
IV over 8 hours. The nurse plans to use IV tubing with a drop factor of 10 gtt/mL.
How many gtt/min of IV fluid should the client receive? (Round your answer to
the nearest whole number).
31 gtt/min
3. A nurse is admitting a client to a long-term care facility. While reconciling the
medication prescribed at home with those prescribed in the facility, the nurse discovers
a discrepancy in the dosages. Which action should the nurse take?
o Clarify the medication dosages with the provider.
o Change the prescribed medication dosages to reconcile the discrepancy
o Contact the pharmacist regarding the dosage discrepancies
o Ask a family member to verify the medication dosages
4. A nurse is caring for a client who is receiving a fentanyl transdermal system
(Duragesic). What is important to document in the clients record?
o Fluid intake
o Skin integrity
o Respiratory rate p.471
o Pulse rate
5. A nurse is caring for a client who has acute angina and has a prescription for nitroglycerin.
Which of the following is an appropriate intervention for the nurse totake when administering this
medication?
o Massage the nitroglycerin ointment completely into the skin. (do not massage, med absorbs too
rapidly)
o Replace the nitroglycerin transdermal patch every 4 hours. (be med free btwn 10-12hr/day)
o Administer a sustained nitroglycerin tablet orally. P.286
o Administer a nitroglycerin tablet sublingually every 5 minutes. (do not take more than 3 tabs)
6. A nurse is preparing to administer infliximab (Remicade) to a client who has rheumatoid arthritis.
The nurse should watch the patient for which of the following adverse effects? (Select all that apply.)
p.440
o bradycardia
o urtipenia
o Jaundice
o fever
o polyuria

7. A nurse is providing teaching to a client who was recently diagnosed as HIV positive. The client is
beginning medication therapy with zidovudine (Retrovir). Which of the following statements should
the nurse include in the teaching. (Select all that apply.) p.341-342, google
o Must be taken with other retroviral medicines.
o Has few adverse effects (maybe this one too? Theres 4 adverse effects?)
o Cures an HIV infection
o Prevents you from transmitting the HIV infection
o Increases CD4+ cell count
8. A nurse is assessing a school age client who is experiencing seizure activity and is prescribed
diazepam (Valium) IV. The nurse should should clarify the order if the client is receiving a
continuous infusion of which of the following IV:
o Lactated Ringers solution
o 0.9% Sodium chloride with 100 units of regular insulin
o 0.9% sodium chloride
o 0.9% Sodium chloride with 20 mEq of potassium chloride
9. A nurse is assessing a client who is taking enalapril (Vasotec) for congestive heart failure. Which
of the following indicates an expected finding?
o Activity tolerance
o Orthostatic hypotension p.250-251
o Loss of strength
o Increase in blood pressure
10. A child with cerebral palsy is prescribed Baclofen (Lioresol). Which of the following
therapeutic effects should the nurse monitor?
o Increased urine output
o Increased energy
o Decreased anxiety
o Decreased spacity p.187
11. Clinical findings of a client who has a prescription for lithium carbonate (Lithobid). For which
reasons should the nurse withhold the medication and notify the provider?
o Lithium level 1.0 mEq/L p.187
o Potassium at 3.7 mEq/L
o Sodium at 143 mEq/L
o Lithium level 2.5 mEq/L
12.The nurse is caring for a client who has tuberculosis and is being treated with combination
medication therapy. To test the effectiveness of the treatment, the nurse should periodically monitor
which of the following laboratory results.
o TT
o ESD rate
o Sputum culture p.628
o INR

13. A nurse is caring for a client who is taking amoxicillin (Amoxil) and is experiencing
adverse effects. Which of the following instructions should the nurse give to this client?
o Stand up slowly after taking this medication.
o Monitor for increased urine output.
o Take this medication with a snack. P.176
o Administer the medication at bedtime.
14. A nurse is reviewing the medication administration record for a client who has
metastatic cancer and a fentanyl (Duragesic) transdermal patch for pain. The client reports a pain
level of 10 on a scale of 0 to 10. Which of the following medications should the nurse anticipate
administering?
o Hydromorphone (Dilaudid)
o Butorphanol (Stadol)
o Alprazolam (Xanax)
o Carbenezepine (Tegretol)
15. A nurse is caring for a client with PCA Morphine Sulfate. Which of the following
statements is not true?
o "I will not receive any pain medications during the lockout period"
o "I should push the button when the pain becomes severe" p.473
o "I will be asked to rate my pain occasionally"
o "I don't have to worry about getting an overdose of the medication"
16.A nurse is caring for a client who is to receive a series of allergy tests. The nurse should instruct
the client to avoid which medications for up to 4 weeks before the procedure?
o Acetemetaphen (Tylenol)
o Diphenhyramine (Benadryl)
o Albuterol (Accuneb)
o Psuedoephedrine hydrochloride (Sudafed)
17. A nurse administered meperidine (Demerol) intramuscularly to a client with an ankle fracture.
Which of the following actions should the nurse take next?
o Assess the clients respiratory status
o Document on the clients medication record
o Reassess the client's pain level
o Check the client's blood pressure
18. A nurse is caring for a client who has an order for clozapine (Clozaril) 350 mg PO daily. The
nurse should recognize that which of the following findings is a side effect of this medication?
o WBC 8,000 mm3
o Serum sodium 136 mg/dL
o Fasting blood glucose of 220 mg/dL p.116
o Weight loss of 2.26 kg (5 lb) in 2 weeks

19. A client with diabetes mellitus is admitted to the medical unit. The client has routine beforebreakfast prescription for 8 units of regular insulin and 18 units ofNPH. The primary care provider
adds an additional dose of Regular insulin based on the following:
Blood Glucose Regular Insulin Dose
121 to 150 2 units
151 to 180 4 units
201. 200 6 units
201 to 250 8 units
> 250 Call provider
The clients pre-breakfast glucose is 192 mg/dl. Which dosage of insulin should
the nurse administer?
o 8 units of Regular, 18 units of NPH
o 8 units of Regular, 24 units of NPH
o 14 units of Regular, 18 units of NPH
o 14 units of Regular, 24 units of NPH
20. A nurse is caring for a client who has a new prescription of zolpidem (Ambien) 10 mg by mouth.
Which comments by the client indicates understanding regarding this medication?
o I will take my medication at bedtime. P.199
o I will take this medication with food.
o I will stop taking this medication in 1 week, so I dont get addicted.
o I will take vitamin C to increase the effectiveness of this medication.
21. A nurse is monitoring a client who is taking fosinopril (Monopril). The nurse should understand
that this has a beneficial effect on which of the body systems?
o Gastrointestinal
o Cardiovascular p.250
o Pulmonary
o Reproductive
22. A nurse is assessing a client who is taking naproxen (Naprosyn). Which of the following is an
expected outcome for this client?
o Increased appetite
o Reduced bleeding
o Improved breathing
o Reduced pain p.438
23. A nurse is providing teaching to a client who just started taking lithium (Eskalith). Which of the
following statements indicates that the client understands the teaching?
o I should inject this medication subcutaneously.
o I should expect to feel better in just a few days.
o I should call my doctor if I develop hand tremors. P.99
o I should take this medication on an empty stomach.

24.A nurse is administering verapamil (Calan) to a client via IV bolus. The nurse should monitor for
which outcome?
o A rapid increase in aPTT.
o A sudden increase in heart rate.
o A sudden decrease in heart rate. P.256
o A rapid decrease of aPTT.
25.A nurse is caring for a client who has rheumatoid arthritits. The client is prescribed methotrexate
(Rheumatrex). Which of the following should the nurse instruct the client to monitor and report to the
provider?
o Sore throat p.439
o Urinary retention
o Constipation
o Insomnia
26.A nurse is caring for a client who has been prescribed Ceftriaxone (Rocephin). The nurse notes
that the clients chart lists a penicillin allergy. Which of the following actions should the nurse take
first?
o Notify the provider that the client is allergic to the medication.
o Teach the client about signs of allergic response.
o Question the client about previous allergic reactions.
P.594
o Administer the medication and monitor the client for allergic response.
27.A nurse is teaching a client who has decided to quit smoking about using a nicotine transdermal
system (Nicotrol). Which of the following instructions should the nurse include?
o Cleanse the skin with alcohol before applying the patch.
o Moisten the patch and hold it against the skin until it adheres.
o Apply the patch first thing in the morning and remove it at bedtime.
o Place the patch in the same skin area for the duration of the treatment.
28. A nurse is caring for a client who has been taking furosemide (Lasix) for 3 days to treat heart
failure. Which of the following findings indicate that the medication is effective?
o Reduced levels of HDL
o Potassium within the expected reference range
o Clear lung sounds p.236
o Increased level of consciousness
29. A client is questioning the nurse about why she is receiving frequent doses of IV antibiotics.
Which of the following responses by the nurse is appropriate?
o It helps to maintain a steady drug level
o It helps to prevent the emergence of drug-resistant bacteria
o It decreases the risk of an allergic reaction
o It decreases the length of necessary treatment

30. A female adult client is scheduled to start a prescription for azathioprine (Imuran) for active
Rheumatoid Arthritis. The nurse should inform the client about the need for which of the following
diagnostic tests prior medication?
o Erythrosedimentation rate
o Bone density scan
o Electrocardiogram
o Pregnancy Test p.384,google
31.A nurse is caring for a client who has been taking ferrous sulfate for the past 2 months. Which of
the following findings is expected?
o Increased energy p.392
o Reduced frequency of coughing
o Increased vision
o Decreased inflammation
32. A nurse is caring for a client who has a prescription for Metformin (Glucophage) twice daily.
Which of the following lab results projects the expected outcome?
o Hemoglobin A1C 6.4%
o Pre-meal plasma glucose 135mg/dl
o Bedtime blood glucose 150 mg/dl
o Systolic blood pressure 146 mm Hg
33. A nurse is teaching about IV betamethasone (Celestone Soluspan) with a client who is at 31
weeks of gestation and is in premature labor. Which of the following information should the nurse
include in the teaching?
o Prevents contractions of the uterus to avoid premature birth
o Promotes the production of surfactant in the fetal lung
o Decreases inflammation associated with an allergic reaction
o Suppresses the immune system to prevent fetal respiratory distress.
34.A nurse is providing teaching to a client who had a total gastrectomy. The client has a new
prescription for Cyanocobalamin (Vitamin B12). Which of the following client statements indicates
understanding of the teaching?
o I will have to take this medication for the rest of my life. P.394
o After I receive injections for a week, I will be able to switch to a pill.
o I need to have my vitamin B12 levels measured once a month.
o Increasing my intake of green, leafy vegetables will increase my vitamin B12 levels.
35. A nurse is planning teaching for a client who has leukemia and is receiving chemotherapy. The
client is taking Allopurinal (Zyloprim). The nurse should instruct the client that this medication will?
o Decrease blood glucose levels
o Prevent cardiac toxicity.
o Prevent urinary tract infections.
o Decrease uric acid levels. P.493

36.A nurse receives a phone call from a client who has heart failure and reports a dry cough for the
last week. After reviewing the clients medical record, the nurse asks the client to come to the
providers office. The nurse should then instruct the client to stop taking which of the following daily
medications until he sees his provider?
o Isosorbide (Imdur)
o Hydroclorothiazide (Hydrodiuril)
o Nifedipine (Procardia)
o Lisinopril (Zestril) p.250
37.A nurse is planning discharge teaching for a client who is to start therapy with repaglinide
(Prandin). Which of the following should the nurse include in the teaching?
o Take the medication 1 hour before mealtime.
o Hold the medication if your blood glucose is less than 120 mg/dL.
o Monitor for irritability and diaphoresis. P.513
o Increase your protein intake.
38.A nurse is caring for a client who is receiving anticoagulant therapy with Warfarin (Coumadin).
The client is prescribed Cefotetan (Cefotan) by intermittent IV bolus for pneumonia. The nurse
should monitor the client for which of the following?
o Hemorrhage p.594
o Hypoglycemia
o Hyperkalemia
o Paresthesias
39. A nurse is assessing a client who has been taking anti-tuberculosis medications for the past 3
months. The nurse should instruct the client to notify the provider if which of the following occurs?
o Weight gain
o Jaundice
o Alopecia
o Polyuria
40. A client who has supraventricular tachycardia (SVT) is receiving procainamide. The nurse
recognizes that the primary pharmacological action of this medication is to:
o Decrease cardiac preload
o Promote systemic vasoconstriction
o Decrease sinoatrial node conduction.
o Control the rate of cardiac contraction.
41. A client is receiving extended-release morphine sulfate (Avinza) 30mg PO every 12 hr. Three
hours after the last dose, the client requests pain medication. Which of the following assessment
finding is the best indicator of the patients need for more pain medication?
o Facial grimacing
o Elevated blood pressure
o Flushed skin
-Self report

42. A nurse is caring for a client who has a systemic infection. During the infusion of vancomycin
(Vancocin) the client develops a rash and becomes flushed. Which of the following is an appropriate
action for the nurse to take?
o Document a Penicillin allergy in the clients chart.
o Decrease the rate of administration.
o Obtain a prescription for oral vancomycin.
o Administer naloxone (Narcan) 1mg IV.
43. A nurse is caring for a client who has open angle glaucoma and was prescribed pilocarpine
(Pilocar) 1 gtt of 3% solution. The nurse should recognize that which of the following findings
indicates the client is developing systemic cholinergic toxicity?
o Stinging and burning sensation in her eye
o Hypertension
o Tachycardia
o Salivation and sweating
44. A client who has been taking atenolol (Tenormin) receives a new prescription for nifedipine
(Procardia). For which of the following interactions should the nurse monitor?
o Tachycardia
o Hypotension p.263
o Bleeding
o Angina
45. A client has an IV infusion of nitroprusside (Nitropress) at 2 mcg/kg/min. The order reads to
titrate the nitroprusside by 0.5 mcg/kg/min to maintain mean arterial pressure (MAP) to 70 to 110
mm HG. The client has a MAP of 120 mm Hg. The nurse should next titrate the nitroprusside to
which of the following dosages? (Round to the nearest tenth.)
1.5 ( I think youre supposed to subtract?)
46. A nurse is reviewing the laboratory tests for a client who had an acute myocardial infarction. The
client is prescribed warfarin (Coumadin) 10mg PO. The nurse notes an INR of 2.6. Which of the
following actions should the nurse take?
o Give the dose as prescribed. (Normal INR 2-3)
o Hold the next dose.
o Increase the dose by 2.5mg
o Decrease the dose by 5mg.
47. A nurse is caring for a client who has a new prescription for estrogen-progestin combination
(Ortho-Novum). Which of the following medications may interact with this medication and require
the use of additional non-hormonal birth control?
o Thiamine ( Vitamin B 1)
o Dilantin (Phenytoin) p.415
o Amalodipine (Norvasc)
o Docusate sodium (colace)

48. A nurse is providing teaching to a school-age child and his parents. The child has a new
prescription for methylphenidate (Concerta). For which of the following adverse effects should the
nurse monitor? (Select all that apply.) p.124
o Nose bleed
o Oliguria
o Weight loss
o Palpitations
o Insomnia
49. A nurse is caring for a postoperative client with PCA containing IV morphine. A nurse should
recognize which is the following priority assessment?
o Hypotension
o Bradypnea
o Drowsiness
o Urticaria
50. A nurse is caring for a client who is receiving therapy with the clonidine (Catapres)
transdermal patch. The client reports light-headedness and drowsiness. Which of the following
actions should the nurse take?
o Administer a prescribed antiemetic
o Remove the Patch
o Elevate the head of the bed
o Measure Blood pressure p.130
51. A nurse is assessing a client who takes diphenoxylate with atropine (Lomotil) for inflammatory
bowel disease. For which of the following should the nurse monitor?
o Hearing loss
o Increased oral secretions
o Bradycardia
o Urinary retention p.379
52. A nurse is caring for a client with Parkinsons disease. The client is taking carbidopa
levadopa (Sinemet) and reports nausea. Which of the following instructions should the nurse include
to reduce nausea?
o Give medication 1 hr before meals.
o Give medication with meals p.152
o Give medication 1 hr after meals
o Give medication with high-protein snacks.
53. A nurse is caring for an older adult client who is receiving gentamicin (Garamycin) following
abdominal surgery Which of the following physiological changes is most important for the nurse to
consider when administering this medication?
o Decreased serum albumin
o Decreased renal blood flow p.608

o Increased gastric pH
o Increased body fat
54. A client has a new prescription for oral nitroglycerin sustained-release capsules once a day.
During the nursing history the client reveals his usual medications. Which of the following
medications should the nurse question at this time?
o Diazepam (Valium)
o Lansoprazole (Prevacid)
o Gemfibrozil (Lopid)
o Sildenafil (Viagra) p.285
55. The nurse is caring for a client who is receiving muromonab-CD3 (orthoclode OKT3) and is
experiencing fever and 3+ pitting edema in the lower extremities. Which of the following actions
should the nurse take for the client?
o Administer corticosteroids as prescribed.
o Obtain a prescription for a WBC count
o Auscultate the clients lungs for adventitious sounds.
o Maintain strict fluid intake and output measurements.
56. A nurse is admitting a client who has chest pain to the emergency department. What medication
should the nurse anticipate administering to reduce cardiac demand?
o Heparin
o Pentazocine (Talwin)
o Morphine
o Butorphanol (Stadol)
57. A nurse is caring for four older adult clients who are taking digoxin (Lanoxin). Which of the
following clients is at greatest risk for developing digoxin toxicity?
o A client taking furosemide (Lasix) for edema p.274
o A client taking allopurinol (Zyloprim) for gout
o A client taking fluoxetine (Prozac) for depression
o A client taking pramipexole (Mirapex) for Parkinsons disease
58. A nurse is caring for a 4 year old client, who is taking amoxicillin (Amoxil) 50 mg/ kg/day PO in
three divided doses. Which of the following resources should the nurse consult to verify that the dose
is safe for the client?
o Medication administration record
o The clients health history
o Physicians desk reference
o The clients BMI record
59. A nurse is caring for a client who has a new prescription for sucraflate (Carafate). The client also
takes several other medications and herbal supplements. Which of the following requires that the
nurse provide additional teaching for this client?
o Phentoin (Dilantin) p.366
o Burpropion (Wellbutrin)

o Ginko biloba
o Valerian root
60. A nurse is caring for a client who has a prescription for levadopa carbidopa (Sinemet-CR). Which
of the following should the nurse recognize as an adverse effect of this medication?
o Constipation
o Weight gain
o Hirsultism
o Dyskinesia p.152
61.A nurse is caring for a client who has received acetaminophen (Tylenol) 650 mg and
Hydrocodone (Vicodin) 5 mg every 4 hr for the past 24 hr. Which of the following is an appropriate
action for the nurse to take?
o Complete an incident report
o Stagger the medications every 2 hr
o Suggest a time with the pharmacy.
o Decrease acetaminophen to 325 mg every 4 hr.
62. A nurse is caring for a client who has a new prescription for buproion (Welbutrin).
What should the nurse recognize as a contraindication for the use of this medication?
o Xerostomia
o GERD
o Seizure p.87
o Bradycardia
63. A nurse is caring for a client with a urinary tract infection. Her past history reveals an allergy to
thiazide diuretics. Which of the following medications is contraindicated?
o Nitrofurantoin (Macrodantin)
o Ciprofloxacin (Cipro)
o Amoxicillin/ clavulanate (Augmentin)
o Trimethoprim/ sulfamethoxazole (Bactrim)
64.A nurse is providing instruction to four clients regarding medication self-administration.
Which of the following actions by a client indicates a need for further teaching?
o Client rolls insulin suspension between his palms
o Client takes iron supplements at bedtime.
o Client uses cotton swab to apply antibiotic ointment.
o Client allows 1 min between puffs when he uses a metered-dose inhaler.
65. A nurse is caring for a client who is receiving penicillin by intermittent IV bolus. The client
develops cyanosis and tachycardia. A nurse should administer which of the following medications
first?
o Epinephrine (Adrenalin)
o Prednisone (Deltasone)
o Hydrocortisone sodium succinate (Solu-Cortef)
o Isoproterenol (Isuprel)

66. A nurse is preparing to administer insulin to a client with diabetes mellitus. The client is to
receive insulin aspart (NovoLog) 5 units and NPH insulin (Humulin N) 15 units subcutaneously in
the morning. Which of the following actions should the nurse take first?
o Inject 5 units of air into the insulin aspart vial.
o Inject 15 units of air into the NPH insulin vial. P.511
o Draw up 5 units of insulin aspart from the vial.
o Draw up 15 units of NPH insulin from the vial.
67. A nurse is providing care to a client who has heart failure. While verifying the orders with the
medication administration record the nurse notes that the prescription for digoxin (Lanoxin) was
transcribed incorrectly. As a result, the client received an extra dose of the medication yesterday.
Which of the following actions should the nurse take first?
o Complete an incident report.
o Notify the charge nurse.
o Obtain a set of vital signs.
o Withhold the next dose.
68. A nurse is caring for a client who is receiving haloperidol (Haldol). The nurse should document
which of the following findings are dystonia?
o Neck spasms p.57, 110
o Lip smacking
o Tremors
o Pacing
69. A nurse is completing discharge teaching for a client who has hypertension. The client has a new
prescription for spironolactone (aldactone). Which of the following statements by the client indicates
an understanding of the teaching?
o Ill increase my dietary fiber, because this medication causes constipation.
o Im aware that his medication can cause heart palpitations.
o Ill take aspirin every day, because it makes this medication more effective.
o I realize that I should use sugar substitutes when taking this medication.
70.A nurse is caring for a school age child who has been prescribed diphenhydramine (Benadryl).
Which of the following adverse effects has highest priority?
o Sedation
o Dry mucous membranes
o Ataxia
o Diarrhea