Questions with Correct Answers

ATI NCLEX Pharmacology Assessment 1 Questions with Correct Answers A nurse is teaching a client who will start using transdermal fentanyl. Which of the following statements should the nurse identify as an indication that the client understands the teaching

• "I can use an electric blanket while in bed"
• "I will replace the patch every day"
• "I should apply the patch to my upper thigh"
• "I can take an oral analgesic for breakthrough pain" - Correct Answer D

Fentanyl is a transdermal opioid agonist for managing persistent, moderate to severe chronic pain. It takes up to 24 hr after the client applies the patch for medication levels to reach their peak. Use short acting analgesics to treat acute or breakthrough pain -- A, heat causes an increase in the release of the medication from the patch, as well as vasodilation, which can increase the absorption of the medication B, the patch releases the med steadily over 72 hrs, but some times they can change it every 48 hr C, apply the patch to the skin of the upper torso for optimal absorption A nurse is teaching a client who has a new prescription for levodopa- carbidopa. Which of the following instructions should the nurse include in the teaching

• Report muscle twitching to your provider
• Reduce your daily fluid intake
• Take the medication with a high protein meal
• Discontinue the medication if your urine turns a dark color - Correct Answer A

Levodopa carbidopa can cause dyskinesias with toxicity and to report muscle twitching, tremors, and spastic winking -- B, reducing fluid intake can increase risk of orthostatic hypotension. Drink at least 2-3 L of fluid daily C, protein reduces the absorption of levodopa carbidopa D, urine and sweat can become dark in color, but this is harmless A nurse is caring for a client who has primary hypothyroidism and has been taking levothyroxine for 8 weeks. The current thyroid stimulating hormone (TSH) level is 5.2 1 / 3

microunits/mL. The nurse should expect which of the following prescriptions regarding the client's medication?

• Decrease in the dosage
• Discontinue the medication
• Increase in the dosage
• Maintain the current dosage - Correct Answer C

A TSH of 5.2 is above the expected reference range, which indicates the thyroid hormone level is not adequate (so the TSH is trying to increase to compensate and release more thyroid hormone). Increase the dosage to achieve a therapeutic TSH, undergo lab testing in 6-8 weeks after dosage increase to reassess the TSH level A nurse is assessing a client who has chronic pain disorder and is requesting pain medication. Which of the following findings should the nurse identify as the most reliable indicator of the client's pain

• The client's behavior
• Changes in the client's vital signs
• The client's facial expression
• The client's verbal report - Correct Answer D

The nurse should ask the client about the location, quality, and intensity of the pain A nurse is assessing a client who is dehydrated. Which of the following findings is an indication of hypokalemia

• Muscle weakness
• Hyperactive bowel sounds
• Positive Chvostek's sign
• Red tongue - Correct Answer A

Weakness, fatigue, and lethargy are manifestations of hypokalemia -- B, decreased bowel motility is a manifestation of hypokalemia. Hyperactive bowel sounds is a manifestation of hyperkalemia C, positive Chvosteks sign is a manifestation of hypocalcemia and hypomagnesemia D, dry, swollen red tongue is manifestation of hypernatremia A nurse is reviewing the medication administration records of four clients. Which of the following situations should the nurse identify as an indication of a medication administration error

• A nurse administers aminoglycoside antibiotic via intermittent IV bolus over 30 min 2 / 3

• A nurse administers medications from a dry powder inhaler without the use of a

spacer

• A nurse injects an IM medication into the vastus lateralis site of an adult
• A nurse crushes an extended release tablet and mixes it with applesauce - Correct

Answer D Extended or sustained release preparations release medication levels over a long period of time to sustain therapeutic relief. Crushing, breaking, or chewing releases the medication all at once into the blood and alters the pharmacokinetics of the medication, which can be life threatening A nurse is assessing a client who is taking esomeprazole. Which of the following statements by the client should the nurse identify as an indication that the medication is having an effective therapeutic response?

• "My headaches are gone"
• "My mouth isn't so dry anymore"
• "The burning in my throat is gone"
• "I have regular bowel movements" - Correct Answer C

Esomeprazole is a proton pump inhibitor and works in the parietal cells of the stomach by inhibiting the proton pump enzyme that generates gastric acid secretion. It treats ulcers, duodenal ulcers, and GERD. Heartburn is a common manifestation of GERD, so the absence of burning is an indication that the med is working -- A, headaches are an adverse effect of esomeprazole B, dry mouth is an adverse effect of esomeprazole D, constipation and diarrhea are an adverse effect of esomeprazole A nurse is assessing a client for pain who is 4 hr postoperative following surgery and still experiencing the effects of anesthesia. Which of the following findings should the nurse identify as an indication that the client might be experiencing pain and requires pain medication

• Reduced blood glucose
• Pupil constriction
• Diaphoresis
• Facial flushing - Correct Answer C

A client in pain can be come diaphroetic in an attempt to keep the body temperature under control during stress -- A, blood glucose can increase in a client who has pain as the body attempts to make more energy available

• / 3