TEST 1 - SAMPLE QUESTIONS

Question 1

Which of the following principles does the nurse apply when calculating pediatric dosages?

A. Clark’s rule calculates dosage based on the child’s age and uses a nomogram to determine body surface area.
B. Fried’s and Young’s rules calculate the dosage based on milligrams of drug per kilogram of body weight.
C. Dosage calculation according to body weight is the most accurate method because it takes into account differences in maturational development.
D. Dosage calculation by body surface area is the most accurate method because it takes into account the difference in size of the child and/or neonate.

Answer 1

D

Question 2

Knowing that albumin in neonates and infants has a lower binding capacity for medications, a healthcare provider would do which of the following to minimize the risk of toxicity?

A. Decrease the amount of drug given
B. Increase the amount of drug given
C. Shorten the time interval between doses
D. Administer the medication intravenously

Answer 2

A

Question 3

The physiological changes that normally occur in the older adult have which of the following implications for the nurse who is assessing drug response in this client?

A. Drug half-life is lengthened
B. Drug metabolism is faster
C. Drug elimination is faster
D. Protein binding is more efficient

Answer 3

A

Question 4

During client teaching the nurse advises lactating mothers that drug effects may be minimized by taking medications within which of the following timeframes?

A. Right after breastfeeding
B. Two hours after breastfeeding
C. One hour before breastfeeding
D. Right before breastfeeding

Answer 4

A

Question 5

Which of the following is most important when obtaining a pharmacologic history from a client?
 A.	Allergies
 B.	Alcohol intake
 C.	Home remedy use
 D.	Use of over-the-counter medications

Answer 5

A

Question 6

Which of the following actions should the nurse take when administering medications to a client?

A. Double-check the medication orders before administering
B. Check the client’s armband before administering the medication
C. Call the client by name when entering the room in order to verify right person
D. Prepare medications for all clients first, then administer by room in order to manage time appropriately

Answer 6

B

Question 7

Which of the following activities is the nurse responsible for during the evaluation phase of drug administration?

A. Gathering data in a drug and dietary history
B. Preparing and administering medications safely and as ordered
C. Planning measurable outcomes for the client related to drug therapy
D. Monitoring the client continuously for therapeutic as well as adverse effects

Answer 7

D

Question 8

Which of the following terms is the process by which drugs influence cell physiology?

A. Pharmacology
B. Pharmacokinetics
C. Pharmacodynamics
D. Pharmacotherapeutics

Answer 8

C

Question 9

Which of the following explains pharmacokinetics? The study of:

A. Adverse reactions to medications
B. Physiologic interactions of drugs
C. Interactions between various drugs
D. Distribution rates between various body compartments

Answer 9

D

Question 10

Which of the following is another name for biotransformation of a drug?

A. Dilution
B. Excretion
C. Absorption
D. Metabolism

Answer 10

D

Question 11

By which of the following routes are drugs altered by the first-pass effect?

A. Oral
B. Sublingual
C. Intravenous
D. Subcutaneous

Answer 11

A

Question 12

Which of the following definitions best explains drug half-life? Drug half-life is defined as the amount of time required for 50% of a drug to:

A. Exert a response
B. Be absorbed by the body
C. Be eliminated by the body
D. Reach a therapeutic level

Answer 12

C

Question 13

Which of the following strategies would increase the absorption of a medication administered intramuscularly?

A. Massaging the site after injection
B. Applying cold packs to the injection site
C. Lowering the extremity below the level of the heart
D. Administering the medication via the Z-track method

Answer 13

A

Question 14

Which of the following characteristics is true about highly protein-bound drugs? Highly protein-bound drugs:

A. Increase the risk of drug–drug interactions
B. Typically provide a short duration of action
C. Must be administered with 240 mL of water
D. Have a decreased effect in clients with a low albumin level

Answer 14

A

Question 15

Which of the following administration routes would achieve the most rapid onset of action?

A. Subcutaneously
B. Intravenously
C. Intramuscularly
D. Intrathecally

Answer 15

B

Question 16

Which of the following would clients with renal failure most likely experience problems with?

A. Excretion
B. Absorption
C. Metabolism
D. Distribution

Answer 16

A

Question 17

Which of the following explains the ratio between a drug’s therapeutic effect and toxic effect?

A. Affinity
B. Tolerance
C. Cumulative effect
D. Therapeutic ratio

Answer 17

D

Question 18

Which of the following are examples of how drugs can exert their action on the body? (choose all that apply)

A. Interaction with receptors
B. Making the cell perform a new function
C. Inhibiting the action of a specific enzyme
D. Altering metabolic chemical processes

Answer 18

A,C,D

Question 19

Which of the following affects the absorption of medications administered orally? (choose all that apply)

A. pH of the stomach
B. Form of drug preparation
C. Presence of food in the stomach
D. Client position upon intake of medication

Answer 19

A,B,C

Question 20

Which of the following roles is the nurse responsible for in the development of new and investigational drugs?

A. Selecting clients to participate in Phase I studies
B. Identifying clients who are receiving placebo drugs during Phase III studies
C. Monitoring for and reporting any adverse effects noted during Phase IV studies
D. Informing clients of the specific drug they are receiving during the double-blind, placebo-controlled phase of the study

Answer 20

C

Question 21

Which of the following is an ethical responsibility of the nurse?

A. Employ beneficence, the duty to do no harm to a client
B. Withhold information from the client as requested by the family
C. Impose one’s own values upon the client when doing so would help the client
D. Transfer care of a client to another professional nurse if caring for the client would violate personal ethical principles

Answer 21

D

Question 22

Which of the following statements best reflects the nurse’s knowledge of cultural influences on drug therapy and other health practices?

A. Dietary habits and practices can be of little value to the care of an ill adult.
B. Most cultures are fairly standard in reference to the use of medications during illness.
C. Some cultures believe cold drinks are unhealthy for the sick person and should be avoided.
D. Regardless of one’s cultural background, it is crucial to always adhere to recommended medical practices.

Answer 22

C

Question 23

Which of the following statements is accurate when discussing self-treatment options with a client?

A. “Over-the-counter medications are not as potent as prescription drugs.”
B. “Herbal remedies have not demonstrated any adverse effects with their use.”
C. “The use of over-the-counter medications is gradually decreasing with the increased availability of more effective prescription medications.”
D. “Over-the-counter medications can, at times, be used in place of prescription drugs. It is important to discuss the use of these with your healthcare provider.”

Answer 23

D

Question 24

Which of the following would be the nurse’s best response when the client questions a nurse about natural health/herbal treatments for arthritic pain?

A. “Ginkgo biloba has shown tremendous benefit as an anti-inflammatory agent.”
B. “High doses of vitamins have been used for many years to help maintain joint health.”
C. “There really are no safe herbal treatments for pain. Your best action would be to take your prescription medications.”
D. “Glucosamine sulphate with chondroitin has demonstrated promising results in the treatment of joint stiffness and pain. Consult your healthcare provider.”

Answer 24

D

Question 25

Which of the following strategies would the nurse apply when administering a medication subcutaneously?

A. Use a 1- to 1½-inch, 23- to 25-gauge needle.
B. Only aspirate with specific medications, such as heparin.
C. Landmark between the greater trochanter and superior iliac crest for the vastus lateralis site.
D. Insert the needle at a 45- to 90-degree angle, depending on client size, to penetrate subcutaneous tissue.

Answer 25

D

Question 26

Z-track intramuscular injections are indicated in which of the following situations?

A. With any injection that is given into the ventrogluteal muscle
B. When there is insufficient muscle mass in the landmarked area
C. When massaging the area after medication administration is contraindicated
D. With medications that are known to be irritating, painful, and/or staining to tissues

Answer 26

D

Question 27

Which of the following are the appropriate landmarks for an intramuscular injection into the dorsogluteal region?

A. A handbreadth below the greater trochanter and the sacroiliac joint
B. Below the iliac spine and between the greater trochanter and the iliac crest
C. A “V” formation between the anterior superior iliac spine and the greater trochanter
D. Anterior to the diagonal line from the greater trochanter to the posterior superior iliac spine

Answer 27

D

Question 28

You are to administer nitroglycerin 0.4 mg sublingually. The tablets are dispensed as 200 µg tablets. How many tablets would you administer per dose?

A. 1 tablet
B. 2 tablets
C. 3 tablets
D. 4 tablets

Answer 28

B

Question 29

The order is for levothyroxine 0.075 mg daily for your client. The pharmacy sends levothyroxine 0.05 mg scored tablets. How many tablets will you give?

A. ½ tablet
B. 1 tablet
C. 1.5 tablets
D. 2 tablets

Answer 29

C

Question 30

The nurse is to administer phenobarbital 65 mg intramuscularly. If the phenobarbital is available at 65 mg/mL, how much would the nurse adminsiter?

A. 0.68 mL
B. 1 mL
C. 1.38 mL
D. 1.65 mL

Answer 30

B

Question 31

The nurse is to administer 40 units of regular insulin. The pharmacy sends 100 units regular insulin, but there are no insulin syringes. Using a 3 mL syringe with a 25 g needle, how many millilitres of this insulin will the nurse administer?

A. 0.4 mL
B. 1 mL
C. 1.4 mL
D. 4 mL

Answer 31

A

Question 32

The nurse is to administer ceftriaxone 750 mg. Reconstitution directions for this powdered drug are to add 5.3 mL of sterile water or normal saline to the vial to prepare a dosage strength of 1 g/mL. How much of the solution should the nurse administer?

A. 0.5 mL
B. 0.75 mL
C. 1.25 mL
D. 1.5 mL

Answer 32

B

Question 33

The nurse is to administer penicillin 400,000 units. The nurse has penicillin 300,000 units per mL. How much solution should the nurse administer?

A. 0.75 mL
B. 1.25 mL
C. 1.33 mL
D. 1.75 mL

Answer 33

C

Question 34

When assessing a client for adverse effects related to morphine sulphate, which of the following would the nurse NOT expect?

A. Diarrhea
B. Decreased peristalsis
C. Delayed gastric emptying
D. Common bile duct spasm

Answer 34

A

Question 35

A client needs to switch analgesic agents secondary to an adverse reaction to the present regimen. The client is concerned that he will not receive an effective dose of a new agent to control pain. The nurse responds based on knowledge that potencies of analgesics are determined using an equianalgesic table comparing doses with which of the following analgesics?

A. meperidine
B. fentanyl
C. codeine
D. morphine

Answer 35

D

Question 36

A client is admitted to the psychiatric unit for treatment of narcotic addiction. The nurse would anticipate administration of which of the following medications?

A. morphine
B. methadone
C. meperidine
D. naloxone

Answer 36

B

Question 37

A client has been admitted after overdosing on acetaminophen, with a total ingested dose of 14 g. The nurse plans to monitor this client for development of which of the following signs and symptoms related to the overdose?

A. Renal failure
B. Kidney stones
C. Acute hepatic necrosis
D. Metabolic alkalosis

Answer 37

C

Question 38

While admitting a client for treatment of an acetaminophen overdose, the nurse prepares to administer which of the following medications to prevent toxicity?

A. vitamin K
B. naloxone
C. acetylcysteine
D. methylprednisolone

Answer 38

C

Question 39

Massage therapy is ordered as adjunct treatment for a client with musculoskeletal pain. Which of the following is the nurse’s best response when the client asks the nurse how “rubbing my muscles” will help the pain go away? Massaging muscles

A. helps relax the contracted fibres and decrease painful stimuli
B. decreases the inflammatory response that initiates the painful stimuli
C. activates large sensory nerve fibres that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain
D. activates small sensory nerve fibres that send signals to the spinal cord to open the gate and allow endorphins to reach the muscles and relieve the pain

Answer 39

C

Question 40

Which of the following would the nurse monitor when assessing for the most serious adverse reaction to a narcotic analgesic?

A. Respiratory rate
B. Heart rate
C. Blood pressure
D. Mental status

Answer 40

A

Question 41

Which of the following medications is used to treat a client suffering from severe adverse effects of a narcotic analgesic?

A. naloxone
B. acetylcysteine
C. methylprednisolone
D. protamine sulphate

Answer 41

A

Question 42

A client admitted to the hospital with a diagnosis of pneumonia asks the nurse why she is receiving codeine when she does not have any pain. The nurse’s response is based on knowledge that codeine also has what effect?

A. Antitussive
B. Expectorant
C. Immunostimulant
D. Immunosuppressant

Answer 42

A

Question 43

Which of the following adverse effects related to morphine sulphate would the nurse assess for? Stimulation of:

A. Vomiting centre
B. Cough reflex centre
C. Respiratory rate and depth
D. Autonomic control over circulation

Answer 43

A

Question 44

The nurse is preparing to administer an injection of morphine to a client when the respiratory rate is assessed at 10 breaths/min. Which of the following is the nurse’s best action?

A. Administer a smaller dose and record the findings
B. Notify the physician and delay drug administration
C. Administer the prescribed dose and notify the physician
D. Hold the drug, record the assessment, and recheck in 1 hour

Answer 44

B

Question 45

Which of the following actions would minimize the gastrointestinal (GI) side effects experienced by a client receiving narcotic analgesics for chronic pain?

A. Taking Lomotil with each dose
B. Eating foods high in lactobacilli
C. Increasing fluid and fibre in the diet
D. Taking the medication on an empty stomach

Answer 45

C

Question 46

Which of the following would the nurse teach a client prescribed the fentanyl transdermal delivery system about when to change the patch?

A. When pain recurs
B. Every 24 hours
C. Every 72 hours
D. Once a week

Answer 46

C

Question 47

Which of the following principles should the nurse use when planning pharmacological therapy for a client with pain?

A. Pain relief is best obtained by administering analgesics around the clock
B. Analgesics should be administered as needed (prn) to minimize side effects
C. Clients should request analgesics when the pain level reaches a “6” on a scale of 1-10
D. Narcotic analgesics should not be used for more than 24 hours secondary to the risk of addiction

Answer 47

A

Question 48

In developing a plan of care for a client receiving morphine sulphate, which of the following nursing diagnoses is a priority?

A. Alteration in comfort: acute pain
B. Constipation related to GI side effects
C. Impaired gas exchange related to respiratory depression
D. Risk for injury related to central nervous system (CNS) side effects

Answer 48

C

Question 49

You have an order to give a 6 month old infant who has thrush (oral candidiasis) Fluconazole suspension 6 mg/kg PO OD for 14 days. The child weight is 8 lbs. Fluconazole availability is 10 mg/ml. How many ml of Fluconazole will you give this infant daily?

A. 2.2 ml
B. 48 ml
C. 21.6 ml
D. 4.8 ml

Answer 49

A

Question 50

You have an order to give amoxicillin 10 mg/kg Suspension PO TID for 10 days for an ear infection. Available amoxicillin suspension is 250 ml/5 ml. The dose not to exceed 250 mg in 24 hours. The child weighs 8 kg. How many ml will you give this child in 24 hours?

A. 1.6 ml
B. 3.2 ml
C. 4.8 ml
D. 5 ml

Answer 50

C

Question 51

Which of the following disorders would the nurse suspect a client suffers from if lithium is noted on a client’s drug history upon admission?

A. Bipolar disorder
B. Absence seizures
C. Obsessive–compulsive disorder
D. Paranoid schizophrenia

Answer 51

A

Question 52

Which of the following best describes the function of selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs)?

A. Increasing the placebo effect
B. Increasing alertness levels in the brain
C. Blocking the reuptake of neurotransmitters at nerve endings
D. Decreasing levels of epinephrine and serotonin at nerve endings

Answer 52

C

SSRIs block the reuptake of serotonin. TCAs block the reuptake of norepinephrine and serotonin.

Question 53

A child is noted to be taking imipramine, but the parents deny a history of depression. Which of the following diagnoses would this child suffer from?

A. Manic episodes
B. Absence seizures
C. Nocturnal enuresis
D. Obsessive-compulsive disorder

Answer 53

C

Imipramine causes urinary retention and delayed micturition, side effects that make it useful to treat nocturnal enuresis (bedwetting) in children.

Question 54

Which of the following should the nurse emphasize when teaching a client about TCAs?

A. The drugs are often given with monoamine oxidase (MAO) inhibitors for synergistic effect
B. Dietary restrictions of beer and chocolate are needed to prevent a hypertensive crisis
C. The client should notify the healthcare provider if therapeutic effects are not noted within 10 days
D. Common side effects can be relieved by increasing fluid and fibre intake as well as sucking on hard candy

Answer 54

D

TCAs cause anticholinergic side effects, including constipation and dry mouth.

Question 55

Which of the following should the client be cautioned against while taking an MAO inhibitor?

A. Eating aged cheese
B. Sunbathing at the pool
C. Participating in a bowling league
D. Smoking a low-nicotine cigarette

Answer 55

A

Eating foods high in tyramine, including aged cheese, can cause a hypertensive crisis in clients taking MAO inhibitors.

Question 56

Which of the following is bupropion, a second-generation antidepressant, also used for?

A. Aiding in smoking cessation
B. Treating orthostatic hypotension
C. Treating nocturnal enuresis in children
D. Increasing appetite in clients undergoing chemotherapy

Answer 56

A

A sustained-released form of bupropion is useful in helping clients quit smoking.

Question 57

Which of the following is the rationale for clients taking antipsychotic medications periodically being prescribed a “drug-free holiday”? To prevent

A. Noncompliance due to side effects
B. Higher costs by decreasing amount of drug used
C. Destructive behaviours by allowing client to regain control
D. Tardive dyskinesia and other extrapyramidal reactions

Answer 57

D

Drug-free holidays are recommended to attempt to prevent tardive dyskinesia in clients who are taking phenothiazines.

Question 58

Which of the following statements made by a client demonstrates a lack of understanding of client teaching regarding phenothiazine drug therapy?

A. “I need to change positions slowly to prevent dizziness.”
B. “I will need to wear sunscreen and protective clothing when outdoors.”
C. “It is okay to take this drug with a small glass of wine to help me relax.”
D. “I should call my doctor if I notice any uncontrollable movements of my tongue.”

Answer 58

C

Drinking alcohol with phenothiazines puts the client at risk for increased CNS depression.

Question 59

Which of the following laboratory tests should be monitored frequently to assess for a potential life-threatening adverse reaction to clozapine?

A. Renal panel
B. Liver function tests
C. Complete blood count
D. Immunoglobulin levels

Answer 59

C

Clients taking clozapine must be monitored for the life-threatening side effect of agranulocytosis, evidenced by a severe reduction in the number of white blood cells.

Question 60

Which of the following extrapyramidal side effects should the nurse monitor for in a client taking an antipsychotic medication?

A. Dystonia
B. Orthostatic hypotension
C. Dry mouth and constipation
D. Neuroleptic malignant syndrome

Answer 60

A

Dystonia, an impairment of muscle tone, is the only extrapyramidal side effect listed. The other side effects also occur but are not extrapyramidal effects.

Question 61

Which of the following is an atypical antipsychotic medication useful for treatment of schizophrenia?

A. amoxapine
B. phenelzine
C. risperidone
D. trazodone

Answer 61

C

Risperidone is effective against both negative and positive symptoms of schizophrenia. The other medications listed are antidepressants.

Question 62

Which of the following is the best rationale that the nurse can provide to the mother of a child with attention-deficit/hyperactivity disorder (ADHD) who wants to understand how a drug like methylphenidate, a CNS stimulant, can help her child who is hyperactive?

A. Methylphenidate has a paradoxical effect in children
B. Amphetamines, in general, are not the drug of choice to treat ADHD
C. Methylphenidate must be given along with a sedative-hypnotic for the treatment of ADHD
D. Amphetamines decrease mental alertness and increase drowsiness, thus decreasing the ADHD symptoms.

Answer 62

A

Methylphenidate, a CNS stimulant, has a paradoxical effect in children, producing calmness in children with hyperactive behaviour. The exact mechanism of action is not clearly understood.

Question 63

Which of the following statements correctly identifies the pharmacodynamics of central nervous system stimulants? CNS stimulants:

A. block the activity of inhibitory neurons
B. increase the presynaptic amount of neurotransmitter
C. decrease the production of excitatory neurotransmitters
D. enhance the effects of phosphodiesterase and subsequent breakdown of cyclic adenosine monophosphate (cAMP).

Answer 63

B

CNS stimulation occurs when the amount and duration of action of excitatory neurotransmitters are increased.

Question 64

Which of the following side effects would the nurse monitor for in a client taking analeptics?
A.	Bradycardia
B.	Hypotension
C.	Nervousness
D.	Decreased mental alertness

Answer 64

C

Analeptics are CNS stimulants, thus causing nervousness as a side effect.

Question 65

Which of the following disease processes/conditions may be exacerbated in a client using caffeine?

A. Heart block
B. Constipation
C. Myelin degeneration
D. Cardiac dysrhythmias

Answer 65

D

Caffeine stimulates the CNS, causing sympathomimetic effects, including cardiac dysrhythmias.

Question 66

Which of the following would the nurse encourage her client to do to reduce the GI side effects of orlistat?

A. Increase fluid and fibre in the diet
B. Take the medication with an antacid
C. Supplement diet with fat-soluble vitamins
D. Limit dietary intake of fat to

Answer 66

D

Orlistat is an anorexiant that works by blocking the absorption of fat from the GI tract. Limiting intake of fat reduces the GI side effects associated with increased fat content in stool (flatulence, oily spotting, and fecal urgency).