RN Pharmacology 2023

Question 9

RN Pharmacology 2023. A nurse is caring for a client who has diabetes mellitus and is taking pioglitazone. The nurse should plan to monitor the client for which of the following adverse effects?

• Insomnia
• Tinnitus
• Fluid retention
• Orthostatic hypotension

Question 10

A nurse is caring for a client who is receiving phenytoin. Which of the following conditions should the nurse identify as an indication for this medication?

• Liver failure
• Kidney transplant
• Endocarditis
• Seizures

Question 11

A nurse in a mental health clinic is evaluating a client who is taking escitalopram. Which of the following statements by the client indicates this medication is having a therapeutic effect?

• “When I get in tense situations, I notice that I focus on my breathing pattern.”
• “I’ve asked my boss for special accommodations to help my anxiety.”
• “When I take the stairs to the third floor, I don’t get shortness of breath.”
• “I avoid crowds so that I don’t have feelings of nervousness.”

Question 12

A nurse is preparing to administer acyclovir 10 \mg/kg IV to a client who weighs 132 lbs. Available is acyclovir IV injectable solution 50 mg/mL. How many mL should the nurse administer? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

• Answer: 12

Question 13

A nurse is caring for a client who has received propofol during a colonoscopy. The nurse should monitor for which of the following as an adverse effect of the medication? RN Pharmacology 2023

• Increase in bowel function
• Decrease in respiratory rate
• Increase in heart rate
• Decrease in body temperature

Question 14

A nurse is caring for a client who received epidural anesthesia during hip surgery. Which of the following manifestations should the nurse monitor as an adverse reaction?

• Tachycardia
• Hypertension
• Rapid rise in temperature
• Severe headache

Question 15

A nurse is caring for a client who reports taking propranolol for several years but has recently stopped for financial reasons. The nurse should assess the client for which of the following findings?

• Bradypnea
• Rhinitis
• Hyperkalemia
• Tachycardia

Question 16

A nurse is assessing the vital signs of a client who is to begin taking verapamil. For which of the following findings should the nurse withhold the medication?

• Respiratory rate 12/min
• Pulse oximetry 94%
• Heart rate 48/min
• BP 140/100 mm Hg

Question 17

A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following prescribed medications should the nurse anticipate administering to the client?

• Methadone
• Bupropion
• Lorazepam
• Disulfiram

Question 18

A nurse is reviewing the medical record of a client who just received a dose of IV filgrastim. The client has cancer and is receiving cytotoxic chemotherapy. For which of the following findings should the nurse complete an incident report?

• The client had chemotherapy 12 hr before the medication was administered.
• The vial was out of the refrigerator for 2 hr before the medication was administered.
• The client had a decreased neutrophil count before the medication was administered.
• The client reported feeling nauseous after the medication was administered. RN Pharmacology 2023

Question 19

A nurse is caring for a toddler who has a prescription for a prescription PRN opioid analgesic. Which of the following findings indicate the nurse should administer the medication?

• Somnolence
• Facial frowning
• Relaxed facial affect
• Heart rate of 120/min

Question 20

A nurse is assessing a client who has hypertension and is receiving propranolol. Which of the following findings require an intervention by the nurse?

• SaO_2 95% on 2 L/min of oxygen
• Heart rate of 56/min
• Blood pressure 106/68 mm Hg
• Respirations 22/min

Question 21

A nurse is reviewing the electronic medical record of a client who has been taking famotidine for 6 months. Which of the following findings indicates the therapy has been ineffective?

• Heartburn
• Tinnitus
• Fever
• Muscle cramps

Question 22

A nurse is preparing to administer a new prescription of fluoxetine to a client. Which of the following client information indicates a contraindication to administering the medication?

• Takes metoprolol daily
• Has type 2 diabetes mellitus
• Takes selegiline daily
• History of panic disorder

Question 23

A nurse is reviewing the medication administration record for a client who received propranolol from a nurse on the previous shift. The nurse notes the client had an apical heart rate of 48/min prior to administration of the medication. Which of the following actions should the nurse take?

• Call the nurse to return to the facility.
• Notify the pharmacy.
• File an incident report.
• Notify the ethics committee.

Question 24

A nurse is teaching a client who has pernicious anemia to self-administer nasal cyanocobalamin. Which of the following information should the nurse include in the teaching?

• “Lie down for 1 hour after administering the medication.”
• “Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose.”
• “Plan to self-administer this medication for the next 6 months.”
• “Administer the medication into one nostril once per week.”

Question 25

A nurse is preparing to administer amphotericin B lipid complex via intermittent IV bolus to a client who has infective endocarditis. Which of the following actions should the nurse take?

• Prime the tubing with 0.9% sodium chloride.
• Use a gravity flow set.
• Discard the medication if it is yellow.
• Administer the medication over 2 hr.

Question 26 of 70

A nurse is preparing to administer medication to a client who has a prescription for epoetin alfa. Which of the following routes of administration should the nurse plan to use?

• Inhalation
• Intravenous
• Oral
• Transdermal

Question 27 of 70

A nurse is teaching a client who has a prescription for ferrous gluconate. Which of the following statements by the client indicates an understanding of the teaching?

• “I should notify my provider if my stools turn black.”
• “I should take this medication with 8 ounces of milk.”
• “I should stay upright for at least 15 minutes after taking this medication.”
• “I should take an antacid with this medication to prevent stomach upset.”

Question 28 of 70

A nurse is creating a medication reconciliation list for a client. Which of the following information should the nurse include in the reconciliation?

• The over-the-counter medications that the client takes at home.
• The client’s discontinued medications.
• The medications that the client has taken in the last 24 hr.
• The client’s medication allergies.

Question 29 of 70

A nurse is teaching a newly licensed nurse about medications used to treat breakthrough cancer pain. Which of the following medications should the nurse include in the teaching?

• Acetaminophen PO
• Aspirin rectal
• Fentanyl transmucosal
• Ketorolac IM

Question 30 of 70

A nurse is teaching a client who has rheumatoid arthritis about a new prescription for infliximab. Which of the following statements should the nurse include in the teaching? RN Pharmacology 2023

• “You might sunburn more easily while receiving this medication.”
• “You will receive an infusion of the medication every week for 6 weeks.”
• “You might experience a metallic taste during infusions of the medication.”
• “You will be at an increased risk for infection while receiving this medication.”

Question 31 of 70

A nurse is caring for a client who is receiving parenteral nutrition and identifies that the client has hyperkalemia. Which of the following actions should the nurse take?

• Discontinue the infusion.
• Obtain arterial blood gasses.
• Warm formula to room temperature.
• Place the client on a cardiac monitor.

Question 32 of 70

A nurse is caring for a client who is receiving total parenteral nutrition. The nurse should monitor the client for which of the following adverse effects?

• Diarrhea
• Aspiration pneumonia
• Electrolyte imbalance
• Nausea

Question 33 of 70

A client who has active tuberculosis and is taking rifampin reports that his urine and sweat have developed a red-orange tinge. Which of the following actions should the nurse take?

• Document this as an expected finding.
• Prepare the client for dialysis.
• Check the client’s liver function test results.
• Instruct the client to increase his fluid intake.

Question 34 of 70

A nurse is reviewing the medical record of an adult client who has a fever and a prescription for acetaminophen. Which of the following findings should the nurse identify as a contraindication for receiving this medication?

• Hepatitis B vaccine within the last week
• Chronic kidney disease
• Diabetes mellitus
• Alcohol use disorder

Question 35 of 70

A nurse is preparing to administer an influenza vaccine into a client’s deltoid muscle. Which of the following actions should the nurse take?

• Insert the needle at a 90° angle.
• Use a 2-inch needle to administer the medication.
• Instruct the client to extend their elbow prior to administration.
• Aspirate after inserting the needle.

Question 36 of 70

A nurse is teaching a client who has active pulmonary tuberculosis about management of medication for the disease. Which of the following statements is appropriate for the nurse to make?

• “You should anticipate taking medication to treat your disease for at least the next 3 years.”
• “You will need to undergo tuberculin skin tests every 6 months while taking medication for your disease.”
• “You will need to take two or more medications to treat your disease.”
• “You should report monthly to have your blood drawn to monitor kidney function while taking medication.”

Question 37 of 70

A nurse is transcribing a new prescription for a client which states, “Diphenhydramine 50 mg NOW.” Which of the following actions should the nurse take?

• Inform the client there is a prescription available if needed.
• Administer the medication within 90 min.
• Contact the provider to clarify the prescription.
• Notify the pharmacy to send the medication immediately.

Question 38 of 70

A nurse is providing teaching to a client who has diabetes insipidus and is receiving desmopressin. Which of the following statements should the nurse include in the teaching?

• “You can expect to have less urine output when you are taking this medication.”
• “You will need to check your blood glucose every morning while taking this medication.”
• “Your urine might have a reddish tint while taking this medication.”
• “You will need weekly laboratory work to determine your blood clotting time.”

Question 39 of 70

A nurse is caring for a client who is receiving hospice care and has a prescription for fentanyl buccal film. Which of the following methods should the nurse use to administer this medication?

• Dissolve the medication in water before administering it.
• Instruct the client to swallow the medication with a sip of water.
• Insert the medication against the mucous membrane of the cheek.
• Place the medication on the client’s tongue for dissolution

Question 40

A nurse is teaching a client who is pregnant and has iron-deficiency anemia about taking ferrous sulfate elixir. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)

• “Increase your intake of dairy products to increase the absorption of this medication.”
• “Take the medication with an antacid if it upsets your stomach.”
• “Drink the elixir using a straw to prevent staining your teeth.”
• “Stop taking the medication if your stools become green or black.”
• “Increase your fiber intake to prevent constipation.”

Question 41

A nurse is providing teaching to a client who is receiving intermittent parenteral cyclosporine. Which of the following conditions should the nurse recognize as an indication for this medication?

• Seizures
• Kidney transplant
• Hypokalemia
• Endocarditis

Question 42

A nurse is assessing a client who is taking warfarin. Which of the following findings should the nurse identify as the priority to report to the provider?

• Fever
• Melena
• Abdominal cramping
• Hair loss

Question 43

A nurse is preparing to administer digoxin 0.125 mg PO. Available is digoxin 0.25 mg/tablet. How many tablets should the nurse administer? (Round the answer to the nearest tenth. Use a leading zero if it applies. Do not use a trailing zero.)

• 0.5

Question 44

 A nurse is caring for a client who is taking rifampin. Which of the following findings should the nurse monitor for as an adverse effect of the medication?

• Irregular heart rate
• Jaundice
• Constipation
• Blurred vision

Question 45

A home health nurse is providing teaching to a client who has heart failure and a prescription for digoxin. The nurse should include that which of the following is an adverse effect of the medication? RN Pharmacology 2023

• Ringing in the ears
• Blurred vision
• Constipation
• Weight gain

Question 46

A nurse is assessing a client who was prescribed levothyroxine tablets for hypothyroidism. Which of the following statements by the client indicates they are taking the medication correctly?

• “I take my medication while I am eating breakfast.”
• “I take my medication along with a calcium supplement.”
• “I take my medication with a full glass of water.”
• “I avoid green leafy vegetables in my diet.”

Question 47

 A nurse is reviewing a provider’s prescriptions for medications. Which of the following prescriptions should the nurse clarify with the provider?

• Lisinopril 5 mg PO once daily
• Insulin glargine 10 units subcutaneously daily
• Spironolactone 25 mg PO once daily
• Timolol 0.25% 1 drop twice daily OU

Question 48

A nurse is preparing to administer subcutaneous heparin to a client. Which of the following actions should the nurse take?

• Massage the site after administering the medication.
• Insert the needle at least 5 cm (2 in) from the umbilicus.
• Use a 21-gauge needle for the injection.
• Aspirate before injecting the medication.

Question 49

A nurse is caring for a client who has hyperkalemia. Which of the following medications should the nurse plan to administer?

• Desmopressin sublingual
• Potassium chloride IV
• Sodium polystyrene sulfonate PO
• Spironolactone PO

Question 50

 A nurse is caring for a client who has just received ampicillin/sulbactam via intermittent IV bolus. The nurse should identify which of the following findings as an indication of an anaphylactic reaction?

• Decreased blood glucose level
• Decreased ALT and AST levels
• Hypotension
• Hyperactive deep-tendon reflexes

Question 51

A nurse is caring for a child who has cerebral palsy and a prescription for baclofen. Which of the following findings indicates the medication is effective?

• Decrease in anxiety
• Increase in energy
• Increase in appetite
• Decrease in spasticity

Question 52

A nurse in the emergency department is reviewing a medication record for a client who reports vomiting blood. The nurse should anticipate that the provider will discontinue which of the following medications?

• NPH insulin
• Furosemide
• Pantoprazole
• Clopidogrel

Question 53

A client who has Graves’ disease is prescribed methimazole. Which of the following effects should the nurse expect to see after the client has taken the medication for 2 months?

• Increased sleeping
• Warmer skin
• Increase in pulse rate
• Weight loss

Question 54

A nurse is caring for a client who has cirrhosis of the liver and is receiving spironolactone. Which of the following findings indicates that the client is responding to the treatment?

• Decreased ascites
• Decreased jaundice
• Increased appetite
• Increased energy

Question 55 RN Pharmacology 2023

A nurse is assessing a client who is taking furosemide for heart failure. Which of the following findings indicates an adverse effect of the medication?

• Increased blood pressure
• Hearing loss
• Decreased blood sugar
• Ankle edema

Question 56

A nurse is assessing a client who has just received an initial dose of penicillin. Which of the following findings should the nurse identify as an indication of an allergic reaction?

• Lethargy
• Constipation
• Stridor
• Nausea

Question 57

A nurse is assessing a client who is receiving a dose of IV amphotericin B. Which of the following findings should indicate to the nurse that the client is experiencing an acute infusion reaction?

• Dry cough
• Hyperglycemia
• Fever
• Pedal edema

Question 58 of 70

A nurse is assessing a client who is in labor and is receiving epidural anesthesia. Which of the following findings should the nurse identify as the priority? RN Pharmacology 2023

• Hypotension (Correct Answer)
• Temperature 39C, 102.2F
• Leg weakness
• Urinary retention

Question 59 of 70

A charge nurse is observing a newly licensed nurse care for a group of clients. Which of the following actions by the newly licensed nurse require the charge nurse to complete an incident report?

• The nurse requests a higher dose of morphine for a client who reports severe pain 30 min after receiving morphine 2 mg IV bolus.
• The nurse provides a morning dose of insulin for a client who has a fasting blood glucose level of 130 mg/dL74 to 106mg/dL
• The nurse provides a morning dose of lithium to a client who has a lithium level of 1.8 mEq/L 0.8 to 1.2 m Eq/L). (Correct Answer)
• The nurse administers ondansetron to a client who has two episodes of vomiting after receiving meperidine 75 mg IM.

Question 60

A nurse is assessing a client who is receiving IV magnesium sulfate for treatment of preeclampsia. Which of the following findings should the nurse report?

• 24 hr urine output 960 mL (Correct Answer)
• 1+Deep tendon reflexes
• Pupils equal, round, react to light, accommodation
• Blood pressure 122/88 mm Hg

Question 61

A nurse is discussing adverse reactions to pain medications in older adult clients with a newly licensed nurse. Which of the following findings should the nurse include as risk factors for an adverse drug reaction? (Select all that apply.)

• Multiple health problems (Correct Answer)
• Decreased percentage of body fat
• Polypharmacy (Correct Answer)
• Increased rate of absorption
• Decreased renal function (Correct Answer)

Question 62 of 70

A nurse is performing a medication reconciliation for a client. Which of the following should the nurse recognize as accurate regarding medication reconciliation?

• It is done when a medication is administered.
• All adverse effects of medications are identified.
• The process must be performed by an RN.
• It is done to prevent medication errors. (Correct Answer)

Question 63

A nurse is reviewing the medication list for a client who has a new prescription for hydrochlorothiazide. Which of the following should the nurse identify as a potential drug interaction?

• Insulin³
• Warfarin⁴
• Metformin⁵
• Digoxin (Correct Answer)

Question 66

A nurse is providing teaching to a client who has a new prescription for paroxetine. The nurse should instruct the client to monitor for which of the following adverse effects?

• Alopecia
• Peripheral edema
• Tinnitus
• Drowsiness

Question 67

A nurse is caring for a client who has major depression and a new prescription for citalopram. Which of the following adverse effects is the priority for the nurse to report to the provider?

• Confusion
• Insomnia
• Bruxism
• Weight loss

Question 68 of 70

A nurse is caring for a client who has a new prescription for furosemide. Which of the following findings should the nurse identify as an adverse effect of the medication?

• Hypersalivation
• Hyperkalemia
• Hypotension
• Hypoglycemia

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Question 69

A nurse is preparing to administer warfarin to a client. Which of the following findings indicates a contraindication?

• Blood pressure 144/78 mm Hg
• History of artificial heart valve
• Heart rate 106/min
• Decreased vitamin K level

Question 70 of 70

A nurse is caring for a client. The nurse is assessing the client. The client’s heart rate and temperature are the priority findings.

Word Choices:

• pain
• skin
• weight
• heart rate
• bowel sounds
• temperature