Test Bank Basic Pharmacology Nurses 16th Edition, Clayton
Chapter 1: Drug Definitions, Standards, and Information Sources
1. What is the name under which a drug is listed by the U.S. Food and Drug Administration (FDA)?
2. Which source contains information specific to nutritional supplements?
a. USP Dictionary of USAN & International Drug Names
b. Natural Medicines Comprehensive Database
c. United States Pharmacopoeia/National Formulary (USP NF)
d. Drug Interaction Facts
3. What is the most comprehensive reference available to research a drug interaction?
a. Drug Facts and Comparisons
b. Drug Interaction Facts
c. Handbook on Injectable Drugs
d. Martindale—The Complete Drug Reference
4. The physician has written an order for a drug with which the nurse is unfamiliar. Which section of the Physicians’ Desk Reference (PDR) is most helpful to get information about this drug?
a. Manufacturer’s section
b. Brand and Generic Name section
c. Product Category section
d. Product Information section
5. Which online drug reference makes available to health care providers and the public a standard, comprehensive, up to date look up and downloadable resource about medicines?
a. American Drug Index
b. American Hospital Formulary
d. Physicians’ Desk Reference (PDR)
6. Which legislation authorizes the FDA to determine the safety of a drug before its marketing?
a. Federal Food, Drug, and Cosmetic Act (1938)
b. Durham Humphrey Amendment (1952)
c. Controlled Substances Act (1970)
d. Kefauver Harris Drug Amendment (1962)
7. Meperidine (Demerol) is a narcotic with a high potential for physical and psychological
dependency. Under which classification does this drug fall?
8. What would the FDA do to expedite drug development and approval for an outbreak of smallpox, for which there is no known treatment?
a. List smallpox as a health orphan disease.
b. Omit the preclinical research phase.
c. Extend the clinical research phase.
d. Fast track the investigational drug.
9. Which statement is true about over the counter (OTC) drugs?
a. They are not listed in the USP NF.
b. A prescription from a health care provider is needed.
c. They are sold without a prescription.
d. They are known only by their brand names.
10. Which is the most authoritative reference for medications that are injected?
a. Physician’s Desk Reference
b. Handbook on Injectable Drugs
d. Handbook of Nonprescription Drugs
Chapter 2: Basic Principles of Drug Action and Drug Interactions
1. The nurse assesses hives in a patient started on a new medication. What is the nurse’s priority
a. Notify physician of allergic reaction.
b. Notify physician of idiosyncratic reaction.
c. Notify physician of potential teratogenicity.
d. Notify physician of potential tolerance.
2. The nurse administers an initial dose of a steroid to a patient with asthma. Thirty minutes after
administration, the nurse finds the patient agitated and stating that “everyone is out to get me.” What
is the term for this unusual reaction?
a. Desired action
b. Adverse effect
c. Idiosyncratic reaction
d. Allergic reaction
3. Which is the best description of when drug interactions occur?
a. On administration of toxic dosages of a drug
b. On an increase in the pharmacodynamics of bound drugs
c. On the alteration of the effect of one drug by another drug
d. On increase of drug excretion
4. What occurs when two drugs compete for the same receptor site, resulting in increased activity of
the first drug?
a. Desired action
b. Synergistic effect
5. What do drug blood levels indicate?
a. They confirm if the patient is taking a generic form of a drug.
b. They determine if the patient has sufficient body fat to metabolize the drug.
c. They verify if the patient is taking someone else’s medications.
d. They determine if the amount of drug in the body is in a therapeutic range.
6. What is the process by which a drug is transported by circulating body fluids to receptor sites?
7. The nurse assesses which blood level to determine the amount of circulating medication in a
8. The nurse administers 50 mg of a drug at 6:00 AM that has a half life of 8 hours. What time will it
be when 25 mg of the drug has been eliminated from the body?
a. 8:00 AM
b. 11:00 AM
c. 2:00 PM
d. 6:00 PM
9. What will the nurse need to determine first in order to mix two drugs in the same syringe?
a. Absorption rate of the drugs
b. Compatibility of the drugs
c. Drug blood level of each drug
d. Medication adverse effects
10. A patient developed hives and itching after receiving a drug for the first time. Which instruction
by the nurse is accurate?
a. Stop the medication and encourage the patient to wear a medical alert bracelet that explains the
b. Explain to the patient that these are signs and symptoms of an anaphylactic reaction.
c. Emphasize to the patient the importance to inform medical personnel that in the future a lower
dosage of this drug is necessary.
d. Instruct the patient that it would be safe to take the drug again because this instance was a mild
Chapter 3: Drug Action Across the Life Span
1. What time will the trough blood level need to be drawn if the nurse administers the intravenous
medication dose at 9:00 AM?
a. 6:30 AM
b. 8:30 AM
c. 9:30 AM
d. 11:30 AM
2. What will the nurse expect the health care provider’s order to be when starting an older adult
patient on thyroid hormone replacement therapy?
a. Administering a loading dose of the drug
b. Directions on how to taper the drug
c. A dosage that is one third to one half of the regular dosage
d. A dosage that is double the regular dosage
3. Which drugs cause birth defects?
4. Which life threatening illness may occur as a result of aspirin (salicylate) administration during
viral illness to patients younger than 20 years of age?
a. Anaphylactic shock
b. Reye’s syndrome
d. Influenza A
5. Which classification of medications commonly causes allergic reactions in children?
6. After giving instructions to an expectant mother about taking medications during pregnancy,
which patient statement indicates the need for further teaching?
a. “I will not take herbal medicines during pregnancy.”
b. “For morning sickness, I will try crackers instead of taking a drug.”
c. “If I get a cold, I will avoid taking nonprescription medications until I check with my
d. “I will limit my alcohol intake to only one glass of wine weekly.”
7. When is the ideal time for a nursing mother to take her own medications?
a. Before the infant latches on to begin to breastfeed
b. As soon as the mother wakes up in the morning
c. Right before the mother goes to sleep at night
d. As soon as the infant finishes breastfeeding
8. Which age¬related change would affect transdermal drug absorption in geriatric patients the most?
a. Difficulty swallowing
b. Diminished kidney function
c. Changes in pigmentation
d. Altered circulatory status
9. Which intervention would be considered to reduce accumulation of a drug in a patient who has
decreased liver function?
a. Decreasing the time interval between dosages
b. Reducing the dosage
c. Administering the medication intravenously
d. Changing the drug to one that has a longer half life
10. The nurse is teaching an elderly patient with difficulty swallowing about his medications. Which
explanation by the nurse is most helpful?
a. “Enteric coated tablets can be crushed and taken with applesauce.”
b. “Tablets that are scored can be broken in half.”
c. “Medications labeled ‘SR’ can be crushed.”
d. “Avoid taking medications in liquid form.”
Chapter 4: The Nursing Process and Pharmacology
1. What is the primary purpose of the nursing assessment?
a. Identifying underlying pathologic conditions
b. Assisting the physician in identifying medical conditions
c. Determining the patient’s mental status
d. Exploring patient responses to health problems
2. What is the basis of the NANDA I taxonomy?
a. Functional health patterns
b. Human response patterns
c. Basic human needs
d. Pathophysiologic needs
3. Which task is included in the assessment step of the nursing process?
a. Establishing patient goals/outcomes
b. Implementing the nursing care plan (NCP)
c. Measuring goal/outcome achievement
d. Collecting and communicating data
4. Which statement regarding nursing diagnoses is accurate?
a. Nursing diagnoses remain the same for as long as the disease is present.
b. Nursing diagnoses are written to identify disease states.
c. Nursing diagnoses describe patient problems that nurses treat.
d. Nursing diagnoses identify causes related to illness.
5. What do the classification systems NIC and NOC provide?
a. Individualized data banks of treatments related to disease processes
b. Standardized language for reporting and analyzing nursing care delivery
c. A measure for cost containment within medical institutions
d. Specialized interventions for rare diseases
6. Which type of nursing diagnosis will be written when the patient exhibits factors that makes him
or her susceptible to the development of a problem?
a. Actual diagnosis
b. Risk diagnosis
c. Possible diagnosis
d. Wellness diagnosis
7. Which outcome statement identified by the nurse is written correctly?
a. After surgery, patient will express acceptance of loss of breast.
b. Patient will die with dignity.
c. At the end of the shift, the nurse will determine whether the patient is more comfortable.
d. Within the next 8 hours, urine output will be greater than 30 mL/hr.
8. Which is an example of an interdependent nursing action?
a. Assess lung sounds every 4 hours.
b. Educate the patient about the prescribed medication.
c. Administer Demerol 50 mg intramuscularly (IM) every 4 hours PRN.
d. Encourage the patient to express feelings.
9. What is the nurse’s primary source of information when obtaining a patient history?
a. The physician
b. The patient record
c. The family
d. The patient
10. An obese patient did not meet the goal of “by the end of the second week, is able to follow a
1500 calorie diet.” What will the nurse and the patient reassess?
a. Patient’s weight
b. Patient’s understanding of the 1500 calorie diet
c. Nurse’s feelings about obese patients
d. Health care agency’s ability to provide the prescribed diet
Chapter 5: Patient Education to Promote Health
1. The nurse is educating a 13¬year¬old boy newly diagnosed with diabetes and his parents about diet
and glucose monitoring. Which domain of learning is represented when the patient expresses
concern about feeling different from his peers?
d. Learning style
2. The nurse has taught a patient’s spouse to administer an injectable medication. After the spouse
completed a return demonstration of the injection in the hospital, the nurse does not feel confident
that this can be carried out independently at home and requests referral for a home health nurse. The
nurse is using which phase of the nursing process?
3. In preparing for health teaching with a patient who has an auditory learning style, which would be
a. Pamphlets from a pharmaceutical company
b. Models of equipment used in a procedure
c. Verbal description of the steps of a procedure
d. A workbook with space to record actions and results
4. Which is the most intangible portion of the learning process?
5. Which would positively affect readiness to learn?
a. Fear and denial
b. Willingness to attain an optimal level of health
c. Poor cognitive and motor development
d. Lack of trust and confidence in the staff
6. Which represents the psychomotor domain of learning?
a. The patient draws up insulin in a syringe.
b. The patient expresses a belief about medication use.
c. The patient is able to verbalize foods that should be avoided.
d. The patient relates past experience with smoking cessation.
7. Which is an example of ethnocentrism?
a. A 5¬year¬old Native American child colors in a book about diabetes.
b. A 14¬year¬old African American attends a support group to learn about disease management.
c. A 36¬year¬old Asian prefers to take herbs instead of an oral medication.
d. A 72¬year¬old Hispanic asks questions about potential adverse effects to a newly prescribed
8. What is the most important nursing consideration when teaching an older adult patient about a
newly prescribed medication?
a. Provide detailed information.
b. Lengthen the time of each teaching session.
c. Present information slowly.
d. Limit discussion on the necessity of learning the information.
9. The nurse caring for a Spanish speaking patient uses the assistance of an interpreter to help with
preoperative teaching. While implementing the education, the nurse should:
a. look directly at the patient.
b. never use pantomime gestures.
c. ask lengthy questions to provide clarity.
d. ask a family member to assist with interpretation.
10. A teaching plan has been developed by the nurse to educate the mother of a pre term infant on
prescribed medications. Before initiating this teaching plan, the nurse should:
a. recognize the individual’s health beliefs.
b. provide a formal learning setting.
c. ensure that information is generalized.
d. be sure that all care to the patient has been delivered.
Chapter 6: A Review of Arithmetic
1. Which medication consists of a liquid solvent that contains one or more dissolved substances?
d. Intravenous (IV) solution
2. What is the most accurate way for the nurse to document the administration of two milligrams of a
a. Two mg
b. 2.0 mg
c. 2 mg
d. II mg
3. 1/7 + 3/7 = _____
4. 2 1/2 + 1 1/3 = _____
5. 7/30 + 9/30 + 1/30 = _____
6. 1/18 + 1/9 + 1/12 + 1/4 = _____
7. 5/18 – 2/9 = _____
8. 10 7/9 – 6 1/6 = _____
9. 1 1/2 – 7/11 = _____
10. 11/15 – 1/4 = _____
Chapter 7: Principles of Medication Administration and Medication Safety
1. Where would the procedures and treatments directed by the health care provider be found?
a. Summary sheet
b. Physician’s order form
c. Physician’s progress notes
d. History and physical examination form
2. Which action will the nurse take when it is determined that the narcotic count is incorrect while
obtaining a medication from the narcotic area?
a. Determine the cause of the discrepancy at the end of the shift.
b. Notify the health care provider stat.
c. Call the nurse from the previous shift to determine if there was a discrepancy earlier.
d. Report the discrepancy to the charge nurse immediately.
3. Which action will the nurse take if a dosage is unclear on a health care provider’s order?
a. Ask the patient what dosage was given in the past.
b. Ask another physician to determine the correct dosage.
c. Tell the patient that the medication will not be given.
d. Contact the health care provider to verify the correct dosage.
4. What is the most reliable method to calculate a pediatric patient’s medication dosage?
c. Body surface area (BSA)
d. Placement on a growth scale
5. Which medication route provides the most rapid onset of a medication, but also poses the greatest
risk of adverse effects?
b. Subcutaneous (subcut)
c. Intramuscular (IM)
d. Intravenous (IV)
6. Which is known as the “fifth vital sign”?
7. Which is true regarding the unit dose drug distribution system?
a. The inventory is delivered to each nursing unit on a regular and recurring basis.
b. The system delivers one dose of each medication to be administered until the subsequent
delivery of inventory.
c. The use of single dose packages of drugs dispensed to fill each dose requirement as it is
d. The amount of inventory needed to dose all patients on the unit for a 24 hour interval.
8. The nursing assessment identifies that the client is nauseated and cannot take acetaminophen
(Tylenol) orally. Which is true regarding the substitution of this medication to suppository form?
a. It is standard practice when the patient is unable to take the ordered medication.
b. It is acceptable if the patient agrees to the altered route form.
c. It is preferable to having the patient miss a dose of the medication.
d. It is contraindicated without an order from the health care provider.
9. Which medication order requires nursing judgment and means “administer if needed”?
a. Morphine 4 mg IV stat
b. Morphine 4 mg IV prior to procedure
c. Morphine 4 mg IV four times a day
d. Morphine 4 mg IV every 4 hours PRN
10. What is medication reconciliation?
a. Comparing the patient’s current medication orders to all of the medications actually being
b. The administration of high alert medications that have been ordered on admission to an acute
c. The completion of an incident report following a variance that resulted in a serious
d. A printout of computerized patient data that identifies the times that all of the ordered
medications are to be administered
Chapter 8: Percutaneous Administration
1. A patient has an infected wound with large amounts of drainage. Which type of dressing would
the nurse use?
2. Where would the nurse apply nitroglycerin ointment on a male patient?
a. The same site that was previously used
b. A hairy area of the chest
c. The upper arm
d. The back of the knee
3. Where will the nurse administer a medication that was ordered to be given sublingually?
a. Between the molar teeth and cheek
b. Below the skin surface
c. Under the tongue
d. Into the conjunctival sac
4. Why are sublingual and buccal medications rapidly absorbed?
a. Their action is localized to the mouth.
b. They are metabolized in the liver.
c. Blood flow is diminished in these sites.
d. These drugs pass directly into systemic circulation.
5. Which medications must be sterile?
6. Which action will the nurse perform when doing a wet to dry dressing every 4 hours on a patient
with a deep wound?
a. Pack the wound tightly with gauze.
b. Saturate the dressing with as much liquid as possible.
c. Use Montgomery tapes or a binder to secure the dressing.
d. Apply the new moist dressing over the existing one.
7. When applying nitroglycerin topically, which nursing intervention is correct?
a. Secure the paper on two sides with tape.
b. Shave the area prior to application of the paper.
c. Wear gloves while placing the new paper.
d. Remind the patient to discontinue use of the medication if chest pain is relieved.
8. Where does the nurse correctly administer ophthalmic medication?
a. At the inner canthus of the eye
b. In the lower conjunctival sac
c. Directly onto the eyeball
d. To the outer corner of the eyelid
9. Which effect would be important for the nurse to address when teaching a patient about the
overuse of nose drops?
10. Which nursing assessment accurately describes the results of an intradermal skin test?
a. Itching and weeping
b. Erythema and induration
c. Swelling and coolness
d. Pallor and drainage
Chapter 9: Enteral Administration
1. In which position would the nurse place a patient before the administration of an enteral feeding?
c. Left lateral
2. Which type of lubricant would the nurse use to administer a rectal suppository?
a. Petroleum jelly
b. Mineral oil
c. Water soluble
3. Which is a characteristic of medication administration via the rectal route?
a. Irritation of the mouth
b. Nausea and vomiting
c. Bypassing of the digestive enzymes
d. Use of the first pass metabolism
4. Which medications are provided in dried, powdered form compressed into small disks?
5. Which action by the nurse is appropriate when administering enteric coated tablets?
a. Administer with an antacid.
b. Crush the tablet and mix with applesauce.
c. Encourage the patient to drink a full glass of water.
d. Instruct the patient to place the medication between the cheek and teeth.
6. Which route of administration would be ordered by the health care provider if a patient is
a. Gastrostomy tube
7. After entering the patient’s room to administer oral medications, which action will the nurse take
a. Assist the patient to sit upright.
b. Check the patient’s identification.
c. Inform the patient about the medications.
d. Offer the patient something to drink.
8. The nurse is preparing to administer a medication in tablet form to a patient. In administering this
medication, the nurse will encourage the patient to:
a. drink a large amount of water prior to administration so that swallowing is easier.
b. place the medication on the front of the tongue.
c. keep the head forward while swallowing.
d. minimize the amount of fluid taken following medication administration.
9. When assessing aspirated stomach contents, the nurse notes the color to be green with sediment.
The nurse is aware that this most likely represents _____ fluid.
10. Oral drug administration includes which principle(s)? (Select all that apply.)
a. Dependable rate of absorption
b. Most economical
c. Insulin able to be administered via this route
d. Drugs delivered directly by the oral, rectal, or nasogastric (NG) methods
e. Dosage forms are convenient and readily available
Chapter 10: Parenteral Administration: Safe Preparation of Parenteral Medications
1. Which part of the syringe contains the calibrations for drug volume measurement?
c. Luer Lok
2. Which needle will the nurse use to administer an intramuscular (IM) immunization on an 18
month old child?
a. 18¬gauge, 1 inch needle
b. 20¬gauge, 1/2 inch needle
c. 27¬gauge, 1 1/2 inch needle
d. 25¬gauge, 1/2 inch needle
3. Which syringe will the nurse use to administer insulin subcutaneously to a patient?
a. A syringe calibrated in minims
b. A syringe calibrated in units
c. A syringe calibrated in tenths of mL
d. A syringe calibrated in mL
4. Which action by the nurse is most accurate when drawing up medication from an ampule?
a. Consider the rim of the ampule as sterile.
b. Use a filter needle to withdraw the medication.
c. Wrap a paper towel around the neck of the ampule before breaking it.
d. Inject 0.5 mL of air into the ampule before withdrawing the medication.
5. Which action by the nurse is accurate when withdrawing medication into a syringe from a vial?
a. Inject an amount of air equal to the medication into the vial.
b. Break the thin neck of the vial container.
c. Remove the rubber stopper on the top of the vial.
d. Discard the initial 0.5 mL of medication to ensure sterility.
6. An adult patient is to receive two medications IM. Which action by the nurse is most important in
order to mix the medications in one syringe?
a. Assess for the presence of adequate muscle mass.
b. Ensure that the combined medication amount is less than 2 mL.
c. Determine the compatibility of the medications.
d. Use a needle that is 25 gauge.
7. The nurse is preparing to administer insulin. What does U 100 indicate?
a. 100 mL per unit
b. 10 units per mL
c. 100 units per mL
d. 10 units per 100 mL
8. After teaching a diabetic patient about proper disposal of used syringes and needles, which
statement by the patient indicates a need for further teaching?
a. “Even needles with sleeves should be disposed of appropriately.”
b. “It is unusual that anyone could get a needle injury or disease from used needles.”
c. “It is important for me to use the designated container to dispose of my syringes and needles.”
d. “I am going to purchase the ‘Sharps by Mail Disposal System’ once I am home.”
9. Which nursing action is accurate when administering parenteral medication?
a. Adjust the route of the medication, if needed.
b. Document the response to PRN medications at the end of the shift.
c. Request the pharmacist to provide education about the medication to the patient.
d. Use clinical judgment when rescheduling missed doses of a medication.
10. What is an advantage of administering a drug parenterally?
a. The duration of action is longer.
b. Medications given by this route are inexpensive.
c. The onset of action is more rapid.
d. The dose is usually larger than an oral dose.
Chapter 11: Parenteral Administration: Intradermal, Subcutaneous, and Intramuscular Routes
1. The nurse is educating a patient about diabetes. Based on recommendations from the American Diabetes Association, which statement by the nurse is best regarding site rotation?
a. “Insulin injection sites should always be in the abdomen to ensure absorption into the stomach.”
b. “It is important to rotate injection sites systematically within one area before progressing to a new site for injection.”
c. “Following exercise, site rotation is not indicated because the circulation in the muscles will absorb the medication efficiently.”
d. “If you aspirate, site rotation can be done every other day to avoid developing problems with absorption.”
2. Which technique by the nurse is accurate when administering heparin to a thin, older adult patient?
a. Aspirate before injecting the medication.
b. Inject at a 45-degree angle.
c. Inject at a 90-degree angle.
d. Massage site following injection.
3. The nurse is preparing to administer kindergarten immunizations at the local health clinic. Which anatomic site would be best for the injection of the immunizations containing 0.5 mL?
a. Rectus femoris
4. A 65-year-old man who weighs 180 lb (81.8 kg) is to receive 1.5 mL of a viscous antibiotic by intramuscular (IM) injection. Which needle and syringe will be used?
a. 5/8 inch, 25-gauge needle with 5 mL syringe
b. 1 inch, 28-gauge needle with 4 mL syringe
c. 1 1/2 inch, 21-gauge needle with 3 mL syringe
d. 3 inch, 16-gauge needle with 1.5 mL syringe
5. Which is the preferred IM site for injecting a 6-month-old child?
c. Vastus lateralis
d. Deltoid muscle
6. Which angle is appropriate when administering an IM medication in the dorsogluteal site to a 46 year old obese man?
a. 45 degrees
b. 60 degrees
c. 75 degrees
d. 90 degrees
7. Which parenteral route has the longest absorption time?
d. Intravenous (IV)
8. Which site is identified by the posterior superior iliac spine and greater trochanter?
c. Vastus lateralis
d. Rectus femoris
9. Which nursing action is accurate when administering an IM injection using the Z track method?
a. Use a 1-inch needle.
b. Add 0.5 mL of air to the syringe.
c. Vigorously massage the injection site.
d. Pinch up the skin.
10. Which gauge needles are used for subcut injections?
a. 14 to 16 gauge
b. 18 to 21 gauge
c. 22 to 24 gauge
d. 25 to 29 gauge
Chapter 12: Parenteral Administration: Intravenous Route
1. A patient is diagnosed with cancer and requires 6 months of chemotherapy infusions. Which type of intravenous (IV) access device will likely be used?
a. Peripheral venous access device
b. Midline catheter
c. Winged needle venous access device
d. Implantable venous infusion port
2. The nurse notes that a patient with cardiac disease has IV heparin infusing and that it is behind by 2 hours. What is the best nursing action?
a. Increase the IV rate and recheck in 1 hour.
b. Change the infusion rate to TKO.
c. Discontinue the solution using aseptic technique.
d. Contact the health care provider for consultation.
3. What is the composition of hypotonic intravenous solutions such as 0.45% NaCl?
a. Fewer dissolved particles than blood
b. Approximately the same number of dissolved particles as blood
c. Higher concentrations of dissolved particles than blood
d. Electrolytes and dextrose
4. Which condition would the nurse expect to be treated with an isotonic solution?
a. Fluid overload
b. Hemorrhagic shock
c. Cellular dehydration
d. Cerebral edema
5. The nurse determines that an elderly patient’s IV of D50.2NS with 20 mEq KCl at 75 mL/hr is running 3 hours behind. After determining the IV site is patent, what action will the nurse take?
a. Call the health care provider to obtain an order to decrease the IV rate.
b. Administer a bolus to make up the deficit.
c. Recalculate the flow rate and slowly make up the fluids.
d. Maintain the ordered rate.
6. Which technique by the nurse accurately maintains asepsis of a peripheral IV access device?
a. Wear gloves when hanging all IV solutions.
b. Apply a topical antibiotic ointment to the insertion site.
c. Change fluid administration sets according to institutional policy.
d. Flush with heparin before use.
7. Which needle is used to access implanted infusion devices?
8. The nurse assesses erythema, warmth, and burning pain along the patient’s IV site. Which complication is this patient most likely experiencing?
a. Air embolism
d. Pulmonary edema
9. An elderly patient receiving an infusion of an isotonic fluid at 100 mL/hr complains of dyspnea. The nurse notes shallow rapid respirations and a cough that produces frothy sputum. Which is the priority nursing action?
a. Assess the urine output.
b. Elevate the head of the bed.
c. Encourage the patient to cough.
d. Maintain the IV rate.
10. A diabetic patient requires the administration of insulin continuously at home. Which system would most likely be used in this instance?
a. Central line catheter
b. Microdrip set
c. Piggyback system
d. Syringe pump
Chapter 13: Drugs That Affect the Central Nervous System
1. Which condition would alert the nurse of the need to use beta adrenergic blockers cautiously?
b. Raynaud’s phenomenon
d. Cardiac dysrhythmias
2. A patient with chronic obstructive pulmonary disease (COPD) reports having insomnia and a racing heart after starting terbutaline therapy. Which explanation by the nurse is most accurate?
a. “The symptoms are typical and indicate that the medication is at a therapeutic level.”
b. “The symptoms will tend to resolve with continued therapy.”
c. “The symptoms are unusual and need to be reported to the health care provider immediately.”
d. “The symptoms are indicative of toxicity.”
3. What is the primary response to alpha 1 receptor stimulation?
d. Uterine relaxation
4. Which category of medications is used for peripheral vascular diseases characterized by excessive vasoconstriction, such as Raynaud’s disease?
a. Adrenergic agents
b. Alpha adrenergic blocking agents
c. Beta adrenergic blocking agents
d. Cholinergic agents
5. Why are beta blockers used cautiously in patients with respiratory conditions?
a. They mask the signs and symptoms of acute hypoglycemia.
b. They cause extensive vasodilation and cardiac overload.
c. They may produce severe bronchoconstriction.
d. They increase hypertensive episodes.
6. A patient with Parkinson’s disease asks the nurse why anticholinergics are used in the treatment. Which response by the nurse is most accurate?
a. “These drugs help you urinate.”
b. “These drugs will decrease your eye pressure.”
c. “These drugs inhibit the action of acetylcholine.”
d. “These drugs will assist in lowering your heart rate.”
7. Before the initiation of anticholinergic medications, it is important for the nurse to screen patients for which condition?
b. Infectious diseases
d. Closed angle glaucoma
8. Which nerve endings liberate norepinephrine?
9. The autonomic nervous system can be subdivided into which types of adrenergic receptors?
a. Nicotinic and muscarinic
b. Afferent and efferent
c. Alpha and beta
d. Agonists and antagonists
10. Prior to the administration of metoprolol, a beta adrenergic blocking agent, which is most important for the nurse to assess?
a. Blood pressure
b. Lung sounds
c. Mental status
d. Urine output
Chapter 14: Drugs Used for Sleep
1. The nurse finds that a patient is extremely agitated, yells frequently, and is attempting to get out of bed without assistance. What is the nurse’s initial action?
a. Administer zolpidem after taking the patient’s vital signs.
b. Close the patient’s door for privacy after administering Tylenol.
c. Administer benzodiazepine before calling the health care provider.
d. Spend uninterrupted time listening to the patient.
2. An older adult patient received a hypnotic agent at 9:00 PM. At 2:00 AM, the nurse discovers that the patient has removed her gown and is attempting to get out of bed without assistance. What type of medication effect is the patient exhibiting?
3. For what conditions are benzodiazepines prescribed?
a. Chronic amnesia
b. Chronic insomnia
c. Preoperative sedation
d. Psychotic episodes
4. A patient receiving diazepam (Valium) is complaining of nausea and vomiting and is becoming jaundiced. Which type of blood work will be performed?
a. Renal function tests
b. Liver function tests
c. Clotting times
d. Electrolyte panels
5. In addition to facilitating sleep, what is another benefit of sedatives?
a. Increased pain control postoperatively
b. Reduced bronchial secretions
c. Decreased patient anxiety
d. Increased patient alertness
6. Which two phases make up normal sleep?
a. Hypnagogic and hypnopompic
b. Rapid eye movement (REM) and non REM
c. Alpha and beta
d. Delta and theta
7. Which sleep pattern stage diminishes as an effect of aging?
a. Stage I
b. Stage II
c. Stage III
d. Stage IV
8. A patient has been prescribed lorazepam (Ativan), a benzodiazepine used to treat insomnia. Which action will the nurse take?
a. Advise the patient to take the medication with food.
b. Assess the patient’s blood pressure in sitting and lying positions.
c. Inform the patient to discontinue the medication once sleep improves.
d. Instruct the patient to lie down before taking the medication.
9. Which disease is associated with insufficient sleep?
c. Myocardial infarction
d. Renal failure
10. The nurse is caring for an older patient recently admitted to an assisted living center who is experiencing insomnia associated with the recent relocation. At bedtime, which nursing action will assist the patient to sleep?
a. Offering the patient hot tea
b. Encouraging the patient to ambulate in the hallway
c. Performing back massage
d. Administering an analgesic
Chapter 15: Drugs Used for Parkinson’s Disease
1. Which adverse effects associated with levodopa therapy would support the nursing diagnosis Risk for injury?
a. Nausea and vomiting
b. Orthostatic hypotension
c. Anorexia and depression
d. Tachycardia and palpitations
2. Which vitamin will reduce the therapeutic effects of levodopa?
3. Which cholinergic symptoms of Parkinson’s disease are reduced with anticholinergic drugs?
a. Cognitive impairments
c. Tremors and drooling
d. Postural abnormalities
4. What is the pharmacologic action of entacapone, a potent catechol O methyl transferase (COMT) inhibitor?
a. Slows the deterioration of dopaminergic nerve cells
b. Inhibits the relative excess of dopaminergic activity
c. Reduces the destruction of dopamine in peripheral tissues
d. Enhances the cholinergic symptoms of Parkinson’s disease
5. The nurse is teaching a patient with Parkinson’s disease about levodopa. Which statement by the nurse is accurate regarding drug administration?
a. “Take this medication in between meals.”
b. “Take this medication at bedtime to prevent dizziness.”
c. “Take this medication when your tremors get worse.”
d. “Take this medication with food or antacids to reduce GI upset.”
6. Dopamine agonists have been linked with which adverse effects in patients with Parkinson’s disease?
a. Oculogyric crisis
b. Tardive dyskinesia
c. Sudden sleep events
7. What is the rationale for administering levodopa instead of dopamine for treatment of Parkinson’s disease?
a. Dopamine does not cross the blood–brain barrier when administered orally.
b. Levodopa is much less expensive.
c. The half life of dopamine is too short.
d. Dopamine has too many reactions with other medications.
8. The nurse is providing education to a patient recently placed on selegiline disintegrating tablets. Which statement by the patient indicates a need for further teaching?
a. “This medication will help slow the development of symptoms.”
b. “I will place the tablet on my tongue before breakfast.”
c. “I may need to use a stool softener for constipation.”
d. “I should not push the tablet through the foil.”
9. The nurse is providing information to a patient recently prescribed entacapone. Which statement is correct?
a. This medication is not to be taken with carbidopa levodopa.
b. Dosage is adjusted according to the patient’s response.
c. There will be fewer incidences of dopaminergic effects, such as confusion.
d. This medication increases the production of dopamine in the brain.
10. The nurse is assessing an older patient with Parkinson’s disease who was started on entacapone 1 week ago. The patient has a history of coronary artery disease and takes an antihypertensive and aspirin. Which information would support the need for a reduction in medication dosage by the health care provider?
b. Brownish orange urine
Chapter 16: Drugs Used for Anxiety Disorders
1. What is the recommended time over which antianxiety medications must be gradually tapered before discontinuation?
a. 1 week
b. 1 month
c. 6 months
d. 1 year
2. Which is a benzodiazepine of choice when treating anxiety associated with alcohol withdrawal?
a. Chlordiazepoxide (Librium)
b. Oxazepam (Serax)
c. Diazepam (Valium)
d. Clorazepate (Tranxene)
3. Which is the drug of choice to treat a patient with obsessive compulsive disorder (OCD)?
a. Lorazepam (Ativan)
b. Buspirone (BuSpar)
c. Fluvoxamine (Luvox)
d. Hydroxyzine (Vistaril)
4. The outcome statement for a patient suffering from anxiety disorder reads, “After 1 week on alprazolam (Xanax) therapy, patient will exhibit a manageable level of anxiety.” Which assessment finding validates that this outcome is met?
a. Patient is unable to participate in group therapy conversations.
b. Patient reports persistent fear about dying of a rare illness.
c. Patient verifies that family reunions trigger anxiety and excessive drinking.
d. Patient reports sleeping better and increased interest in activities.
5. Which is true regarding psychological drug dependence?
a. It is easier to treat than physiological dependence.
b. It is not considered a true addiction.
c. It is easily controlled by influencing the patient’s perceptions.
d. It requires medical intervention to treat.
6. The nurse is preparing to educate a patient and significant other about antianxiety medications before the patient’s discharge. What is pertinent information to be included in the teaching plan?
a. Discuss, review, and validate the behavior monitoring system and intervention flow sheet the patient and significant other will continue to use following discharge.
b. Discuss the possible dependence associated with the medication at length to make sure the patient does not overuse the drug.
c. Instruct the patient to educate family members about the medication therapy, based on recollection of discussions with the nurse.
d. Provide all instructions verbally, with repetition as needed when requested by the patient.
7. What will the nurse caution a patient about when providing information about the prescribed azaspirone antidepressant?
a. Risk for addiction
b. Adverse effect of nausea
c. Risk of injury when using machinery
d. Additive effects of central nervous system (CNS) depression with alcohol
8. Which patient is most likely to respond quickly to antianxiety therapy with benzodiazepines?
a. Patient with a history of long-term anxiety
b. Patient with recent anxiety reactions
c. Patient with severe depression in addition to being anxious
d. Patient with incidents of auditory hallucinations
9. What instruction is most important for the nurse to teach the patient who has recently been prescribed alprazolam (Xanax)?
a. “The medication needs to be taken on an empty stomach.”
b. “You may feel dizzy or unsteady when rising to a standing position.”
c. “Smoking will require a reduction in dosage of the medication.”
d. “Over the counter medications are safe to take while on this medication.”
10. The nurse is developing a teaching plan for patients prescribed buspirone (BuSpar). Which information about this medication should be included?
a. There is minimal potential for abuse.
b. Signs of improvement can be seen within 3 days.
c. Sedation is increased compared with other antianxiety medications.
d. It stimulates the action of gamma-aminobutyric acid (GABA).
Chapter 17: Drugs Used for Mood Disorders
1. What occurs with mania associated with bipolar disorder?
a. Varying degrees of sadness
b. Distinct episodes of elation
d. Psychomotor retardation
2. Which postoperative narcotic analgesic will most likely be prescribed to a patient whose current medications include a monoamine oxidase inhibitor (MAOI), a thyroid hormone, and a multivitamin?
a. Meperidine (Demerol)
c. Ibuprofen (Advil)
d. Acetaminophen (Tylenol)
3. What is the major advantage of selective serotonin reuptake inhibitors (SSRIs) over other types of antidepressant therapy?
a. They are less expensive than the other classes of antidepressants.
b. They cure major depressive illnesses.
c. They do not cause the anticholinergic and cardiovascular adverse effects.
d. Therapeutic relief is immediate.
4. Lithium (Eskalith) is the drug of choice for which of the following disorders?
a. Psychotic episodes
b. Obsessive compulsive disorders (OCDs)
c. Bipolar disorders
d. Depressive disorders
5. Which psychological manifestation of depression will improve in response to antidepressant therapy?
a. Loss of energy
c. Sleep disturbances
d. Social withdrawal
6. On what is the choice of tricyclic antidepressants based?
a. The need to decrease the action of norepinephrine, dopamine, or serotonin
b. Patient age and gender
c. An absence of adverse effects, such as orthostatic hypotension
d. The need for stimulation and increased mental alertness
7. The nurse is teaching a patient about medication treatment for depression. The patient asks how long it will take before sleep and appetite will begin to improve. Which response by the nurse is most accurate?
a. 3 days
b. 1 week
c. 4 weeks
d. 2 months
8. What is the action of MAOIs on neurotransmitters?
a. Blocking their reuptake
b. Increasing their production
c. Blocking their destruction
d. Increasing their reuptake
9. A patient who is taking an MAOI to treat depression admits to eating pickled herring and cheese and drinking red wine. Which assessment finding alerts the nurse to a potential complication?
c. Neck stiffness
d. Urinary retention
10. Which assessment would the nurse expect to observe in a patient who has been prescribed trazodone for treatment anxiety?
a. Excessive thirst
b. Hand tremor
Chapter 18: Drugs Used for Psychoses
1. The nurse is assessing a patient who is complaining of hearing voices. What is this patient experiencing?
b. Flight of ideas
c. Disorganized thinking
2. A patient with schizophrenia has been nonadherent with his home medication regimen. He requires frequent admissions to the intensive psychiatric unit for treatment of acute psychotic episodes. Which medication regimen would be appropriate for this patient?
a. Daily home nursing visits to administer the prescribed oral medication
b. Continuous inpatient hospitalization for medication therapy
c. Administration of depot antipsychotic medication
d. Subcutaneous medication administration
3. What is the most common cause of nonadherence to antipsychotic pharmacologic treatment?
b. Increased symptoms of chemical dependency
c. Extrapyramidal effects
d. Inability of the patient to understand the need to take medications
4. Which type of adverse effects is present when a patient displays prolonged tonic contractions of the tongue, oculogyric crisis, and torticollis?
a. Dystonic reactions
d. Tardive dyskinesia
5. The nurse is teaching a patient who is taking clozapine (Clozaril) to have weekly blood tests for the first 6 months of treatment to monitor for which potential complication?
b. Vitamin deficiencies
c. Clotting abnormalities
6. A male patient becomes verbally aggressive and insists the nurse is poisoning him as she attempts to administer haloperidol (Haldol). Which action will the nurse take?
a. Support the patient’s decision to refuse the medication.
b. Discreetly ask an assistant to put the medication in the patient’s food.
c. Firmly redirect the patient to take the medication.
d. Speak privately with the patient and reinforce medication action.
7. Which statement is true regarding the adverse effects associated with antipsychotic medications?
a. Tardive dyskinesia is a common, reversible condition.
b. Painful dystonic reactions can occur in the first 72 hours of initiation of therapy.
c. Neuroleptic malignant syndrome (NMS) is a common adverse effect.
d. Pseudoparkinsonian symptoms can cause Parkinson’s disease.
8. To what does potency of an antipsychotic medication refer?
a. Severity of adverse effects associated with the drug
b. Length of time that it takes to reach a therapeutic blood level of the drug
c. Milligram doses used for the medication
d. Effectiveness of the drug in alleviating psychotic behavior
9. Dystonic reactions, pseudoparkinsonism, akathisia, and tardive dyskinesia are types of which effect?
a. Extrapyramidal symptoms
b. Allergic reactions
c. Idiosyncratic reactions
d. Therapeutic responses
10. Which is an appropriate nursing intervention for a patient who has recently been prescribed clozapine (Clozaril)?
a. Assess for signs and symptoms of hypoglycemia.
b. Encourage a low fiber diet.
c. Measure the patient’s waist circumference.
d. Monitor for insomnia.
Chapter 19: Drugs Used for Seizure Disorders
1. Which condition is associated with hydantoin therapy?
a. Postictal state
c. Seizure threshold reduction
d. Gingival hyperplasia
2. The nurse is preparing discharge instructions for a patient with a history of diabetes who has just been diagnosed with seizure disorder. The patient has been prescribed hydantoin therapy. What will the patient most likely experience?
d. Pupil dilation
3. What is a guideline for the nurse when administering phenytoin (Dilantin) intravenously?
a. Deliver rapidly.
b. Monitor for signs of tachycardia.
c. Assess for hypertensive crisis.
d. Administer without mixing with other medications.
4. For which condition may carbamazepine (Tegretol) be used?
a. Tardive dyskinesia
b. Psychotic episodes
c. Trigeminal neuralgia pain
5. What is the drug of choice when treating a generalized tonic clonic seizure?
a. Diazepam (Valium)
b. Haloperidol (Haldol)
c. Valproic acid (Depakene)
d. Risperidone (Risperdal)
6. Which response by the nurse is accurate when a patient who has been on lamotrigine (Lamictal) for seizure control reports a skin rash and urticaria?
a. Reassure the patient that this is a common adverse effect of the medication and not to worry.
b. Instruct the patient to discontinue use of the drug immediately.
c. Instruct the patient to decrease the dosage of the medication until the rash disappears.
d. Advise the patient that this adverse effect usually resolves but should be reported to the health care provider.
7. Which medication is used to control seizures or prevent migraine headaches?
a. Topiramate (Topamax)
b. Zonisamide (Zonegran)
c. Valproic acid (Depakene)
d. Tiagabine (Gabitril)
8. Which condition would indicate to the nurse that a patient has phenytoin (Dilantin) toxicity?
a. Oculogyric crisis
9. What information would be most important for the nurse to provide to a patient when teaching about the adverse effects of succinimide therapy?
a. Nausea, vomiting, and indigestion are common during the initiation of therapy.
b. Avoid taking the medication with food or milk to minimize adverse effects.
c. Sedation, drowsiness, and dizziness tend to worsen with continued therapy.
d. Reducing the dosage of medication will relieve symptoms of nausea.
10. What dose is within the acceptable range for administering IV phenytoin (Dilantin) to a patient with a seizure disorder?
a. 5 mg/min
b. 30 mg/min
c. 60 mg/min
d. 100 mg/min
Chapter 20: Drugs Used for Pain Management
1. The nurse is completing an assessment on a nonverbal adult patient. Which type of pain scale assessment tool is the most accurate to use?
2. Which action will the nurse take when a patient receiving morphine sulfate via percutaneous coronary angioplasty (PCA) has a shallow, irregular respiratory rate of 6 breaths/min?
a. Elevate the patient’s head of bed to facilitate lung expansion.
b. Increase the patient’s primary intravenous (IV) flow rate.
c. Complete the FLACC scale.
d. Notify the health care provider and prepare to administer naloxone (Narcan).
3. Which patient assessment would indicate to the nurse that salicylate toxicity is occurring?
a. Gastrointestinal (GI) bleeding
b. Increased bleeding times
d. Occasional nausea
4. What is the advantage of taking a nonsteroidal anti inflammatory drug (NSAID) that is a COX 2 inhibitor?
a. The medication is cheaper than aspirin.
b. There are fewer GI adverse effects.
c. They are more effective than COX 1 inhibitors.
d. They have no known adverse effects.
5. An 86 year old patient who was admitted with GI bleeding as a result of salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states that she doesn’t understand why Tylenol doesn’t work as well as the aspirin she had been taking. What would be the nurse’s best response?
a. “Tylenol and aspirin are chemically the same drug.”
b. “Tylenol is appropriate for only minor pain.”
c. “Tylenol does not help with inflammatory discomfort.”
d. “A therapeutic blood level must be established with Tylenol.”
6. What term is used to define an awareness of pain?
7. Which statement is true about neuropathic pain?
a. This pain is the result of a stimulus to pain receptors.
b. Patients describe it as dull and aching.
c. It commonly originates in the abdominal region.
d. The pain is a result of nerve injury.
8. How long after the administration of a parenteral pain medication will the nurse complete the next pain assessment to evaluate the effectiveness of the medication?
a. 10 minutes
b. 30 minutes
c. 1 hour
d. 2 hours
9. Which sign or symptom displayed by a patient would be indicative of opiate withdrawal?
10. Which medication is contraindicated when a patient is taking warfarin (Coumadin)?
b. Acetaminophen (Tylenol)
c. Propoxyphene (Darvon)
d. Morphine (Roxanol)
AND MUCH MORE