NUR 2474 Pharmacology Final Exam NCLEX

NUR 2474 Pharmacology Final Exam NCLEX Style Practice EXAM SCORE 100% A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine (Synthroid). The child comes to the clinic for a well-child check up. The nurse will expect

the provider to:

a.change the dose of levothyroxine to 6 mcg/kg/day.b.discontinue the drug if the child's physical and mental development is normal.c.increase the dose to accommodate the child's increased growth.d.stop the drug for 4 weeks and check the child's TSH level. - Ans a.change the dose of levothyroxine to 6 mcg/kg/day.

A 7-year-old child with asthma uses a daily inhaled glucocorticoid and an albuterol MDI as needed. The provider has added montelukast (Singulair) to the child's regimen.Which statement by the child's parent indicates understanding of this medication?

a."I may notice mood changes in my child." b."I should give this medication twice daily." c."I will give my child one 4-mg chewable tablet daily." d."This drug can alleviate symptoms during an acute attack." - Ans a."I may notice mood changes in my child."

A 14-year-old male patient who plays football is admitted to the hospital. The nurse notes that the patient has short stature for his age according to a standard growth chart.The patient is muscular, has a deep voice, and needs to shave. The nurse notifies the provider of these findings. Which test will the nurse expect the provider to order?

a.Coagulation studies b.Complete blood count (CBC) with differential c.Liver function tests and serum cholesterol d.Serum glucose and hemoglobin A1c - Ans c.Liver function tests and serum cholesterol

A 50-year-old postmenopausal patient who has had a hysterectomy has moderate to severe vasomotor symptoms and is discussing estrogen therapy (ET) with the nurse.The patient is concerned about adverse effects of ET. The nurse will tell her that:

a.an estrogen-progesterone product will reduce side effects.b.an intravaginal preparation may be best for her.c.side effects of ET are uncommon among women her age.d.transdermal preparations have fewer side effects. - Ans d.transdermal preparations have fewer side effects.

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A breast-feeding patient must take a prescription medication for 2 weeks. The medication is safe, but the patient wants to make sure her baby receives as little of the drug as possible. What will the nurse tell the patient?

a.To give the baby formula as long as the mother is taking the medication b.To take the medication immediately after breast-feeding c.To pump breast milk and feed the baby by bottle d.To take the medication 1 hour before breast-feeding - Ans b.To take the medication immediately after breast-feeding

A child is receiving a combination albuterol/ipratropium (DuoNeb) inhalation treatment.The patient complains of a dry mouth and sore throat. What will the nurse do?

a.Contact the provider to report systemic anticholinergic side effects.b.Discontinue the aerosol treatment immediately.c.Notify the provider of a possible allergic reaction.d.Reassure the patient that these are expected side effects. - Ans d.Reassure the patient that these are expected side effects.

A child is to begin long-term glucocorticoid therapy. The parents ask the nurse about the effects of this drug on the child's growth. Which response by the nurse is correct?

a."A smaller dose may be indicated for your child." b."Ask your provider about every other day dosing." c."Long-acting glucocorticoid preparations should prevent growth suppression." d."Oral glucocorticoids rarely cause growth suppression." - Ans b."Ask your provider about every other day dosing."

A clinic nurse is assessing an adolescent male patient who has been receiving androgen therapy for hypogonadism via a transdermal patch. The patient's last clinic visit was 4 weeks earlier. Which part of the interval history is of most concern to the nurse?

a.Five pound weight gain b.Rash at the site of the patch c.Breast enlargement d.Presence of acne - Ans a.Five pound weight gain

A clinic patient who has been taking a glucocorticoid for arthritis for several months remarks to the nurse, "It's a good thing my symptoms are better, because my mother has been quite ill, and I have to take care of her." The patient's blood pressure is 100/60

mm Hg. The nurse will report this to the provider and ask about:

a.reducing the patient's dose.b.using every other day dosing.c.increasing the patient's dose. 2 / 4

d.tapering the dose. - Ans c.increasing the patient's dose.

A hospitalized patient complains of acute chest pain. The nurse administers a 0.3 mg sublingual nitroglycerin tablet, but the patient continues to complain of pain. Vital signs remain stable. What is the nurse's next step?

a.Apply a nitroglycerin transdermal patch.b.Continue dosing at 10-minute intervals.c.Give a second dose of nitroglycerin in 5 minutes.d.Request an order for intravenous nitroglycerin. - Ans c.Give a second dose of nitroglycerin in 5 minutes.

A male patient is being treated for benign prostatic hyperplasia (BPH) by another provider but cannot remember which drug he is taking. He comes to the clinic seeking treatment for erectile dysfunction and receives a prescription for sildenafil (Viagra).What will the nurse teach this patient?

a."Sildenafil is not safe to take in conjunction with finasteride (Proscar)." b."Sildenafil is safe with any medication for benign prostatic hyperplasia." c."To be safe, you should have a transurethral resection before starting sildenafil." d."You should not take sildenafil if you are taking silodosin (Rapaflo)." - Ans d."You should not take sildenafil if you are taking silodosin (Rapaflo)."

A male patient tells the nurse he awakens once or twice each night to void and has difficulty starting his stream of urine. He describes these symptoms as "annoying." The patient's provider examines him and notes that the prostate is moderately enlarged. The patient is sexually active and tells the nurse that he does not want to take any medication that will interfere with sexual function. The nurse anticipates the provider will

order:

a.doxazosin (Cardura).b.finasteride (Proscar).c.silodosin (Rapaflo).d.a transurethral prostatectomy. - Ans a.doxazosin (Cardura).

A man asks a nurse why he cannot use digoxin (Lanoxin) for his heart failure, because both of his parents used it for HF. The nurse will explain that digoxin is not first-line therapy for which reason?

a.It causes tachycardia and increases the cardiac workload.b.It does not correct the underlying pathology of heart failure.c.It has a wide therapeutic range that makes dosing difficult.d.It may actually shorten the patient's life expectancy. - Ans b.It does not correct the underlying pathology of heart failure.

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A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding

that penicillins:

a.disinhibit transpeptidases.b.disrupt bacterial cell wall synthesis.c.inhibit autolysins.d.inhibit host cell wall function. - Ans b.disrupt bacterial cell wall synthesis.

A nurse caring for a 5-year-old child notes that the child has discoloration of several teeth. When taking a medication history, the nurse will ask about which group of medications?

a.Glucocorticoids b.Salicylates c.Sulfonamides d.Tetracyclines - Ans d.Tetracyclines

A nurse counsels a patient who is to begin taking phenytoin (Dilantin) for epilepsy.Which statement by the patient indicates understanding of the teaching?

a."I should brush and floss my teeth regularly." b."Once therapeutic blood levels are reached, they are easy to maintain." c."I can consume alcohol in moderation while taking this drug." d."Rashes are a common side effect but are not serious." - Ans a."I should brush and floss my teeth regularly."

A nurse counsels a patient with diabetes who is starting therapy with an alpha- glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.)

a.Hypoglycemia b.Flatulence c.Elevated iron levels in the blood d.Fluid retention e.Diarrhea - Ans b.Flatulence e.Diarrhea

A nurse is administering morphine sulfate to a postoperative patient. Which are appropriate routine nursing actions when giving this drug? (Select all that apply.)

a.Counting respirations before and after giving the medication b.Encouraging physical activity and offering increased fluids c.Monitoring the patient's blood pressure closely for hypertension d.Palpating the patient's lower abdomen every 4 to 6 hours

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