pharm practice exam 1

Question 1

If phenobarbital has a four day half-life, and a client accidentally took 200 mg of the drug on Tuesday morning, and no intervention occurred, how much medication will remain in the bloodstream of that client on Thursday morning?

Answer 1

150mg

Question 2

You receive a patient with a new diagnosis of epilepsy. The doctor has order a larger than normal dose to reach the minimal effective serum concentration level. You realize this is known as what?

Answer 2

loading dose (administration of a large initial dose)

Question 3

Revision of a clients care plan goals is included in which phase of the nursing process?

Answer 3

evaluation (the phase of the nursing process during which the nurse determines whether the goals and teaching objectives are being met)

Question 4

A nurse is explaining evidence-based practice (EBP) to a new student nurse. Which statements are a part of EBP? (Select all that apply)

Answer 4

integrate clients preference into the clients care

guided by research , use the most currently approved approach to providing client care

Question 5

the nurse recognizes that which of the following are examples of objective data?

Answer 5

heart rate from radial pulse.
lab value.
observed conditions of the patients wound.
observed productive cough.

Question 6

the nurse acknowledges that the correct sequence of the 4 processes of pharmacokinetics are:

Answer 6

absorption
distribution
metabolism
excretion

Question 7

which of these assessments is not considered essential prior to giving medications to an acutely ill client?

Answer 7

mood

Question 8

the nurse is explaining the disintegration of enteric coated tablets to a client. where would the nurse teach that this occurs at in the body?

Answer 8

small intestines.

Question 9

a laboring mother wants to know why pain medication is not advisable. what rationales could the nurse offer for this?

Answer 9

the liver of an infant is not well developed, so the effects of sedation can linger in the infant.
epidural analgesia offers an alternative that will not harm the infant.
the blood brain barrier of an infant isn’t fully develop, so infants are at risk for sedation.

Question 10

when entering the clients room for assessment purposes, which of these things would be inappropriate by the nurse? (select all that apply)

Answer 10

the nurse shares his/her own date of birth
taking a picture of the clients wound and sharing it outside of work
agreeing to be friends on social media

Question 11

the nurse has just given a dose of antibiotic. which measurement checks for the highest plasma/serum concentration of the drug?

Answer 11

peak level

Question 12

Which of these factors might impair the absorption of an oral medication?

Answer 12

the presence of food in the stomach

Question 13

the nurse receives a client with a risk for injury due to taking sedatives. this is include in what phase of the nursing process?

Answer 13

nursing diagnosis

Question 14

the nurse is explaining to a new student nurse the nursing process/ which of the following is the correct order of this process?

Answer 14

assessment, nursing diagnoses, planning, implementation, evaluation

Question 15

a malnourished elderly client has a low albumin level (normal albumin range is 3.4 to 5.4 g/dL). what is the implication of this finding?

Answer 15

protein insufficiency can lead to loss of metabolizing enzymes and consequential drug accumulation.
less protein binding will occur. medication will be more free to bind with a target receptors. this may cause excessive effects.

Question 16

a client reports that he has been swallowing his nitroglycerin instead of leaving it under his tongue. teaching is needed. what can happen if sublingual medication are swallowed?

Answer 16

first pass may inactivate the medication.

Question 17

a client who takes theophylline for asthma is experiencing theophylline toxicity. which of these may be a contributing factor?

Answer 17

chewing the capsule
cirrhosis with gallstones
forgetfulness leading to double dosing

Question 18

the nurse knows that for a drug to pass rapidly through the GI membrane it needs to be what?

Answer 18

lipid soluble and nonionized

Question 19

the nurse is wanting to measure the margin of safety of a medication. which description below is correct for this measurement?

Answer 19

therapeutic index

Question 20

a client is going home on a medication that cannot be stopped suddenly, which is included in the discharge teaching. what part of the nursing process is this included in?

Answer 20

implementation

Question 21

A client interview consists of three phases. The nurse recognizes that those phases are:

Answer 21

orientation
working
termination

Question 22

During the admission history, the client states that he has trouble breathing at night. In obtaining data for a problem-oriented database, the nurse should first question the client about:

Answer 22

the onset and duration of his present breathing problem

Question 23

The nurse begins the assessment of a client that has come to the emergency department experiencing chest pain by asking the client about:

Answer 23

the onset, severity, and duration of the chest pain

Question 24

A nurse seeks to organize the data obtained from the client in a logical manner. The organizational method that identifies relationships between factors and symptoms in the database is known as:

Answer 24

clustering data

Question 25

The client recently became febrile and stated he "felt hot." The nurse takes the client's temperature and finds it to be 38.2° C. In addition, the pulse rate is 88 beats per minute, and his blood pressure is 168/80 mm Hg. Which of the following is an example of subjective data?

Answer 25

the statement regarding his feeling hot

Question 26

The nurse decides to interview the client using the open-ended question technique. Which of the following statements reflects this type of questioning?

Answer 26

"What do you think has been causing your current depression?"

Question 27

The nurse is gathering a nursing health history on the client. The client tells the nurse that he just lost his job. Job loss best fits into which of the following categories?

Answer 27

psychosocial history

Question 28

The nurse is going to perform the admission history for a newly admitted client on the medical unit. The optimum time for completion of the history is planned for:

Answer 28

after the client has become comfortably oriented to the room

Question 29

The nurse has completed an assessment and found that the client has "an activity and exercise abnormality." This type of wording indicates that which of the following organizing formats has been used?

Answer 29

Gordons functional health patterns

Question 30

After visiting with the client, the nurse documents the assessment data. Both objective and subjective information has been obtained during the assessment. Which of the following is classified as objective data?

Answer 30

elevated blood pressure

Question 31

The primary source of information when completing an assessment of a client that is alert and oriented as he is admitted to the medical center for diagnostic testing is the:

Answer 31

client

Question 32

The process of data collection should begin with the nurse performing a:

Answer 32

client interview

Question 33

During an interview, the nurse needs to obtain specific information about the signs and symptoms of the client's health problem. To obtain these data most efficiently, the nurse should use:

Answer 33

closed-ended questions

Question 34

The nurse is conducting an interview with the client and wants to clarify information that the client has shared. Which response by the nurse is an example of the clarifying technique of communication?

Answer 34

"Could you give me an example of how you handle stressors?"

Question 35

When clustering data according to functional health patterns, the nurse determines that the client is only able to ambulate short distances without becoming fatigued and requires rest periods during morning care. The health pattern that requires intervention is identified by the nurse as:

Answer 35

activity and exercise

Question 36

After visiting with the client, the nurse documents the assessment data. Both objective and subjective information have been obtained during the assessment. Which of the following is classified as subjective data?

Answer 36

states feels anxious and tense

Question 37

An ER nurse is interviewing a client who complains of abdominal pain. Which of the following questions asked by the nurse has priority at this time?

Answer 37

"when did your abdominal pain begin?"

Question 38

Which subjective assessment data are most supportive of a client's diagnosis of anxiety?

Answer 38

Claims "something is terribly wrong"

Question 39

Which of the following questions asked by the nurse during the assessment process is best directed towards gathering information regarding the client's depression?

Answer 39

"What do you believe is the cause of your depression?"

Question 40

Which of the following statements best reflects the nurse's correct understanding of the importance of selecting the optimum time for interviewing a client newly admitted to the unit?

Answer 40

"I have some questions to ask you regarding your admission history. I'll be back once you are settled in and comfortable."

Question 41

The nurse is conducting an admissions history interview with a client who has a history of gastroesophageal reflux disease (GERD). Which of the following questions shows the best example of relevant questioning by the nurse?

Answer 41

"Do you have any other gastrointestinal problems besides GERD?"

Question 42

A new graduate nurse missed cues regarding the client's emotional state at the time of admission. The most therapeutic response to the nurse by her mentor is:

Answer 42

"You will be less likely to miss client cues as you acquire more experience with assessments."

Question 43

The nurse is performing a problem-focused assessment when the client reports pain in his left shoulder. Which of the following nursing questions has priority when determining the nature of the pain?

Answer 43

"Can you rate your pain using the pain scale that we've discussed?"

Question 44

When following up on a client's report of hip pain during an admission assessment, the most nursing conclusive observation would be:

Answer 44

The client observed grimacing when positioning self in the bed

Question 45

When obtaining subjective assessment data, the nurse recognizes which of the following client scenarios as being the most likely to produce accurate, credible information?

Answer 45

a 81 year old receiving follow up treatment for hip replacement

Question 46

A nurse is observed conducting an assessment interview for a newly admitted client. Which of the following would require immediate follow-up by the nurse's mentor?

Answer 46

Frequently checking the time while waiting for the client to answer

Question 47

Which of the following assessment data provided by a client's family will have the greatest impact on the client's care while hospitalized?

Answer 47

"My husband doesn't like to let people know his arthritis is bothering him."

Question 48

What is the most appropriate method for the nurse to communicate a client's wishes to the nurses on the next shift?

Answer 48

Include the client's request in the shift report.

Question 49

While discussing a client's medication history, the client tells the nurse that she thinks she is allergic to a particular type of medication. Which of the following nursing actions has priority in this situation?

Answer 49

Review the client's medical record for confirmation of the allergy.

Question 50

The nurse realizes that in order to share information from a client's medical record with another facility, the client must provide written consent. The primary reason for this requirement is to:

Answer 50

Ensure the client's right to have his medical information regarded as personal and confidential

Question 51

The nurse recognizes that a client's hearing deficits impact the development of the nurse-client relationship. Which of the following has the greatest impact on minimizing this obstacle?

Answer 51

Using various forms of nonverbal communication

Question 52

Which of the following questions will provide the nurse with the best understanding of a terminally ill client's spiritual needs?

Answer 52

"Are there any spiritual needs you have that I may help with?"

Question 53

Which of the following statements made by the nurse should be included in the orientation phase of a nursing interview? (Select all that apply.)

Answer 53

1. "You're answers will be kept confidential." 2. "My name is Susan Smith and I'm a registered nurse." 4. "I need to ask you some questions that will help with planning your care." 5. "Only those directly involved in your care will have access to this information."

Question 54

The nurse has determined that the assessment data have resulted in a strong inference that the client is suffering from depression. Which of the following client responses to nursing questions best supports the possibility of depression? (Select all that apply.)

Answer 54

4. "I just can't seem to get excited about anything anymore." 5. "The family always thought that my father was depressed."

Question 55

The goal of the orientation phase of a nursing interview is to: (select all that apply)

Answer 55

1. Initiate the nurse-client relationship 2. Begin identifying the client's needs 3. Earn the trust and confidence of the client

Question 56

which drug form is most rapidly absorbed from the gastrointestinal (GI) tract?

Answer 56

suspension

Question 57

where does disintegration of enteric-coated tablets occur?

Answer 57

small intestine

Question 58

usually food has what effect on dissolution and absorption of medication?

Answer 58

decelerates

Question 59

which statement places the four processes of pharmacokinetics in the correct sequence?

Answer 59

absorption, distribution, metabolism, excretion

Question 60

``` Which factor(s) most commonly affect(s) a drug's absorption? (Select all that apply.) ```

Answer 60

hypotension, pain, stress

Question 61

The patient is taking diazepam (Valium) for anxiety. Two days later she is started on dicloxacillin for an infection. What does the nurse know will happen to the diazepam in the patient's body?

Answer 61

most of the diazepam is released, and it becomes more active

Question 62

What route of drug absorption has the greatest | bioavailability?

Answer 62

intravenous

Question 63

Which is the best description of a drug's serum half-life?

Answer 63

the time required after absorption for half of the drug to be eliminated

Question 64

the patient is taking a drug that has a half-life of 24 to 30 hours. in preparing discharge teaching, what is the dosing schedule the nurse anticipates will be prescribed for this medication?

Answer 64

the time required after absorption for half of the drug to be eliminated

Question 65

The patient is taking a drug that has a half-life of 24 to 30 hours. In preparing discharge teaching, what is the dosing schedule the nurse anticipates will be prescribed for this medication?

Answer 65

daily

Question 66

Which type of drug can be eliminated through the | kidneys?

Answer 66

water-soluble

Question 67

The older adult patient has a creatinine clearance of 30 mL/min. He has been prescribed trimethoprim (Proloprim) for a urinary tract infection. If the normal dose is 200 mg per day, what does the nurse anticipate will occur with the dosing regimen?

Answer 67

the dose will decrease by one-half

Question 68

Which is the best determinant of the biologic activity of a drug?

Answer 68

the fit of the drug at the receptor site

Question 69

Which type of drug prevents or inhibits a cellular response?

Answer 69

antagonist

Question 70

A receptor located in different parts of the body may initiate a variety of responses depending on the anatomic site. Which type of receptor responds in this manner?

Answer 70

non-specific

Question 71

Which indicator measures the margin of safety of a drug?

Answer 71

therapeutic index

Question 72

Before administering a medication, the nurse checks a drug reference book or pamphlet to obtain pertinent data. Which data should the nurse note? (Select all that apply.)

Answer 72

a. Contraindications b. Half-life d. Protein-binding effect e. Therapeutic range

Question 73

Which type of physiologic effect is not related to the desired effect(s) and are predictable or associated with the use of a specific drug?

Answer 73

side effects

Question 74

the nurse is giving a large initial dose of a drug to rapidly achieve minimum effective concentration in the plasma. what is this type of dosage called?

Answer 74

loading dose

Question 75

A time-response curve evaluates parameters of a drug's action. Which parameter(s) is/are part of the time-response curve? (Select all that apply.)

Answer 75

duration of action, onset of action, peak action

Question 76

which interventions regarding drug therapy should the nurse implement?

Answer 76

assess for side effects with a focus on undesirable side effects check reference books or drug inserts before administering the medication check the patients serum therapeutic range of drugs that have a narrow therapeutic range evaluate peak and trough levels prior to administering the medication

Question 77

issues related to absorption

Answer 77

blood flow, pain, stress, hunger, fasting, food, ph., exercise, and mode of administration, plus gastric emptying time, gastric ph, drug, complexes

Question 78

phases of pharmacokinetics

Answer 78

absorption, distribution, metabolism, excretion

Question 79

issues related to distribution

Answer 79

circulation, blood flow, affinity of the drug to the tissue, protein binding sites

Question 80

what issues the protein binding affect?

Answer 80

blood brain barrier

Question 81

what is protein binding?

Answer 81

drug competition for sites

Question 82

issue related to metabolism

Answer 82

half life, steady state, loading dose

Question 83

issue related to excretion

Answer 83

kidney

Question 84

issue related to half life

Answer 84

steady state and loading dose

Question 85

protein binding competition

Answer 85

depending on medication, could lower serum albumin or lower plasma protein levels

Question 86

neurotransmitters for sympathetic system

Answer 86

epinephrine, nor epinephrine, and dopamine

Question 87

neurotransmitters for parasympathetic system

Answer 87

acetylcholine

Question 88

cholinergic/