Applied Pharmacology in Health Care
Review Questions
Course Introduction
Applied Pharmacology in Health Care provides an in-depth exploration of the principles and practice of pharmacology as they pertain to clinical settings. Emphasizing the safe and effective use of medications, this course covers mechanisms of drug action, therapeutic uses, adverse effects, drug interactions, and factors influencing drug response. Through case studies and real-world scenarios, students learn to apply pharmacological knowledge in health assessment, patient education, and clinical decision-making. Special focus is given to pharmacotherapy for various disease states, dosage calculations, and the ethical and legal considerations central to medication management in diverse patient populations.
Recommended Textbook
Pharmacology for Canadian Health Care Practice 2nd Canadian Edition by Linda Lane Lilley
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59 Chapters
683 Verified Questions
683 Flashcards
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Chapter 1: Nursing Practice in Canada and Drug Therapy
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) When the nurse is considering the timing of a drug dose,which of the following factors is most important to assess?
A)The patient's identification
B)The patient's weight
C)The patient's last meal
D)Any drug or food allergies
Answer: C
Q2) Which activity best reflects the implementation phase of the nursing process for the patient who is newly diagnosed with type 1 diabetes mellitus?
A)Providing education regarding self-injection technique
B)Setting goals and outcome criteria with the patient's input
C)Recording a drug history regarding over-the-counter (OTC) medications used at home
D)Formulating nursing diagnoses regarding knowledge deficit related to new treatment regimen
Answer: A
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3
Chapter 2: Pharmacological Principles
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) A patient is experiencing chest pain and needs to take a sublingual form of nitroglycerin.Which of the following instructions should the nurse give to the patient regarding placement of the tablet?
A)Under the tongue
B)In the space between the cheek and the gum inside the mouth
C)At the back of the throat for easy swallowing
D)On a non-hairy area on the chest
Answer: A
Q2) The nurse is administering medications to a patient who is in liver failure due to end-stage cirrhosis.The nurse is aware that patients with liver failure are most likely to have problems with which pharmacokinetic phase?
A)Absorption
B)Distribution
C)Metabolism
D)Excretion
Answer: C
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Chapter 3: Considerations for Special Populations
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) Which of the following is true regarding young patients? Select all that apply.
A)The levels of microsomal enzymes are decreased.
B)Perfusion to the kidneys may be decreased,which may result in reduced renal function.
C)First-pass elimination is increased because of higher portal circulation.
D)First-pass elimination is reduced because of the immaturity of the liver.
E)Total body water content is much less than in adults.
F)Gastric emptying is slowed because of slow or irregular peristalsis.
G)Gastric emptying is more rapid because of increased peristaltic activity.
Answer: A,B,D,F
Q2) While assessing an 82-year-old woman,the nurse determines that she is experiencing polypharmacy.What is this experience most likely to indicate?
A)She has a lower risk of drug interactions.
B)She takes medications for one illness several times a day.
C)She risks problems only if she also takes over-the-counter medications.
D)She takes multiple medications for several different illnesses.
Answer: D
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Chapter 4: Ethnocultural, legal, and Ethical Considerations
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) A patient has a prescription for a drug that is classified as Schedule F.What important information should the nurse tell this patient about obtaining refills for this medication?
A)No prescription refills are permitted.
B)Refills may be obtained via telephone order.
C)Refills cannot exceed a 6-month period.
D)The patient may have no more than six refills in a 12-month period.
Q2) Which of the following best describes drug polymorphism?
A)Cultural and genetic effects on drug metabolism and excretion
B)Gender and cultural effects on drug absorption and distribution
C)Age or body composition effects on drug absorption or metabolism
D)Multi-drug use resulting in impaired excretion
Q3) Which of the following factors contributes to drug polymorphism?
A)The number of drugs ordered by the physician
B)The patient's drug history
C)The patient's diet and nutritional status
D)Different dosage forms of the same drug
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6
Chapter 5: Medication Errors
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6 Verified Questions
6 Flashcards
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Sample Questions
Q1) Which of the following is the proper notation of the dose of the drug ordered?
A)digoxin .125 mg
B)digoxin .1250 mg
C)digoxin 0.125 mg
D)digoxin 0.1250 mg
Q2) Health care professionals should report actual and potential medication errors to which of the following organizations?
A)Institute for Safe Medications Practices (ISMP)Canada
B)Accreditation Canada
C)Canadian Patient Safety Institute (CPSI)
D)Health Canada
Q3) Which of the following statements is true regarding an adverse drug reaction (ADR)? Select all that apply.
A)Adverse effects are ADRs that are usually predictable.
B)ADRs always result in harm to patients.
C)All ADRs are preventable if proper precautions are taken.
D)ADRs can be unexpected and unintended responses to medications.
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Chapter 6: Patient Education and Drug Therapy
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9 Flashcards
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Sample Questions
Q1) When the nurse is teaching a manual skill,such as self-injection of insulin,what is the best way to set up the teaching-learning session?
A)Providing written pamphlets for instruction
B)Showing a video and allow patients to practise as needed on their own
C)Verbally explaining the procedure and provide written handouts for reinforcement
D)After demonstrating the procedure,allowing the patient to do several return demonstrations
Q2) Which of the following are appropriate considerations when the nurse is assessing the learning needs of a patient? Select all that apply.
A)Cultural background
B)Social support
C)Level of education
D)Readiness to learn
E)Health beliefs
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8
Chapter 7: Over-The-Counter Drugs and Natural Health Products
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8 Verified Questions
8 Flashcards
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Sample Questions
Q1) A patient says that he eats large amounts of garlic for its cardiovascular benefits.Which of the following drugs,if taken,could have a potential interaction with the garlic?
A)acetaminophen (Tylenol)
B)warfarin (Coumadin)
C)digoxin (Lanoxin)
D)phenytoin (Dilantin)
Q2) The Natural Health Products Directorate ensures which of the following?
A)Access to safe,effective,and quality natural health products
B)Natural health products are held to the same standards as drugs.
C)Producers of natural health products must prove therapeutic efficacy.
D)Natural health products are protected by patent laws.
Q3) Patients from which of the following cultures will not complain of gastrointestinal symptoms caused by over-the-counter (OTC)drugs or natural health products?
A)Chinese
B)Japanese
C)Hispanic
D)Europeans
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Chapter 8: Vitamins and Minerals
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9 Verified Questions
9 Flashcards
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Sample Questions
Q1) Which nursing diagnosis is appropriate for the patient undergoing therapy with vitamin A?
A)Risk for impaired skin integrity related to vitamin deficiency
B)Disturbed sensory perception (visual)related to night blindness
C)Impaired physical mobility (muscle weakness) related to vitamin deficiency
D)Disturbed thought processes (confusion and psychosis)related to vitamin deficiency
Q2) Which dietary information is important for the patient taking calcium supplements?
A)Oral calcium supplements should be taken before meals.
B)Calcium products bind with tetracyclines,which increases the effects of tetracyclines.
C)Foods high in calcium include whole grain cereals, egg yolks, and liver.
D)Foods high in oxalate and zinc,such as spinach and legumes,decrease the absorption of oral calcium supplementation.
Q3) Which preparation is given to newborns within 1 hour of delivery?
A)Niacin (vitamin B )
B)Calciferol (vitamin D)
C)Aquasol A (vitamin A)
D)AquaMEPHYTON (vitamin K)
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Chapter 9: Problematic Substance Use
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) Which of the following statements is true regarding drugs used in cigarette smoking cessation programs?
A)Slow chewing of the nicotine gum releases an immediate dose of nicotine.
B)Acute relief from withdrawal symptoms is most easily achieved with the use of the transdermal patch.
C)Patient adherence is higher with the transdermal patch than with the nicotine gum.
D)The nicotine gum can be used only up to six times a day.
Q2) A 29-year-old male is admitted to the Critical Care Unit with the following symptoms: restlessness,hyperactive reflexes,talkativeness,confusion,dry mouth,and excessive sweating.The nurse suspects that he may be experiencing the effects of taking which of the following?
A)Opiates
B)Alcohol
C)Stimulants
D)Depressants
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11
Chapter 10: Photo Atlas of Drug Administration
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22 Verified Questions
22 Flashcards
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Sample Questions
Q1) What important action should the nurse take after administering an intravenous (IV)push medication through an IV lock?
A)Flushing the lock
B)Regulating the IV flow
C)Clamping the tubing for 10 minutes
D)Holding the patient's arm up to improve blood flow
Q2) Which of the following statements describes the proper way for the nurse to measure 4 mL of a liquid cough elixir for a child?
A)Use a teaspoon to measure and administer.
B)Hold the medication cup at eye level and fill it to the desired level.
C)Withdraw the elixir from the container with a syringe with a needle attached.
D)Withdraw the elixir from the container with a syringe without a needle attached.
Q3) When administering nasal spray,the nurse should instruct the patient as follows:
A)"You will need to blow your nose before I give this medication."
B)"You will need to blow your nose after I give this medication."
C)"When I give this medication, you will need to hold your breath."
D)"You should sit up for 5 minutes after you receive the nasal spray."
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12
Chapter 11: Analgesic Drugs
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) A patient was diagnosed with pancreatic cancer last month,and she has complained of a dull ache in her abdomen for the last 2 months.This pain has been gradually increasing,and the pain relievers she has taken at home are no longer effective.What type of pain is she experiencing?
A)Acute pain
B)Persistent pain
C)Somatic pain
D)Superficial pain
Q2) A patient is to receive acetylcysteine as part of treatment for an acetaminophen (Tylenol)overdose.Which action by the nurse is appropriate when giving this medication?
A)Giving the medication undiluted for full effect
B)Avoiding use of a straw when giving this medication
C)Disguising the flavour with a soft drink or flavoured water
D)Preparing to give this medication via a nebulizer
Q3) For which of the following is the herb feverfew commonly used?
A)Muscle aches
B)Headaches
C)Leg cramps
D)Incisional pain after surgery
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Chapter 12: General and Local Anaesthetics
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) Which of the following symptoms may occur if a patient is taking ginger and requires an anaesthetic?
A)Decreased blood pressure
B)Increased risk of bleeding
C)Increased risk of stroke
D)Migraine headaches
Q2) A patient is undergoing abdominal surgery and has been anaesthetized for 3 hours.Which of the following nursing diagnoses is appropriate for him?
A)Anxiety related to the use of an anaesthetic
B)Risk for injury related to increased sensorium from general anaesthesia
C)Decreased cardiac output related to systemic effects of local anaesthesia
D)Impaired gas exchange related to central nervous system (CNS)depression produced by general anaesthesia
Q3) Occurs last
A)Cessation of respirations due to paralysis of diaphragm and intercostal muscles
B)Total flaccid paralysis
C)Weakness
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14
Chapter 13: Central Nervous System Depressants and Muscle Relaxants
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) A patient is recovering from a minor automobile accident that occurred 1 week ago.He is taking cyclobenzaprine (Novo-Cycloprine)for muscular pain and goes to physical therapy three times a week.Which of the following nursing diagnoses would be appropriate for him?
A)Risk for falls related to decreased sensorium
B)Risk for addiction related to psychological dependency
C)Excess fluid volume related to potential adverse effects
D)Disturbed sleep pattern related to the drug's interference with rapid eye movement
(REM)sleep
Q2) One of the potential disadvantages of chloral hydrate (Chlorinum)is that tachyphylaxis may develop.Which of the following describes tachyphylaxis?
A)Rapid heart rate
B)Rapid respiration rate
C)A rapid decrease in response to the drug after repeated doses
D)A drug's ability to reach the therapeutic index level more rapidly than other drugs
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Page 15
Chapter 14: Antiepileptic Drugs
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11 Verified Questions
11 Flashcards
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Sample Questions
Q1) When administering phenytoin (Dilantin)intravenously,which of the following must the nurse remember?
A)Normal saline is the only solution to be used with phenytoin.
B)Intravenous (IV)doses must be given rapidly to raise blood levels quickly.
C)The patient should be monitored closely for tachycardia and increased blood pressure.
D)Phenytoin can be combined with other solutions without fear of precipitate formation.
Q2) While teaching a patient about taking his newly prescribed antiepileptic drug (AED)at home,what information should the nurse emphasize?
A)Driving will be allowed after 2 weeks of therapy.
B)If seizures recur,take a double dose of the medication.
C)Antacids can be taken with the AED to reduce gastrointestinal adverse effects.
D)Regular consistent dosing is important for successful treatment.
Q3) Which antiepileptic drug allows for once-a-day dosing?
A)tiagabine (Gabitril)
B)phenobarbital
C)valproic acid (Divalproex)
D)gabapentin (Neurontin)
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Chapter 15: Antiparkinsonian Drugs
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) When assessing the past medication history of a patient with a new diagnosis of Parkinson's disease,which of the following is a concern for the patient who will be taking levodopa-carbidopa (Sinemet)?
A)Glaucoma
B)Seizure disorder
C)Bladder difficulties
D)Benign prostatic hypertrophy
Q2) A patient taking a levodopa preparation for the first time calls the clinic to report a dark discoloration of his urine.Which of the following statements is true in this situation?
A)The discoloration of urine is a harmless effect of the drug.
B)The patient has taken this drug with red wine or cheese.
C)The patient is having an allergic reaction to the drug.
D)The patient has most likely taken extra drug doses.
Q3) Which of the following nursing diagnoses is appropriate for patients taking anticholinergic drugs?
A)Diarrhea
B)Urinary retention
C)Risk for infection
D)Ineffective tissue perfusion
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Page 17
Chapter 16: Psychotherapeutic Drugs
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16 Verified Questions
16 Flashcards
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Sample Questions
Q1) The wife of a patient who has been diagnosed with depression calls the office and says,"It's been an entire week since he started that new medicine for his depression and there's no change! What's wrong with him?" Which of the following statements is the best response by the nurse?
A)"The medication may not be effective for him.He may need to try another type."
B)"It may take up to 4 weeks to notice any therapeutic effects.Let's wait a little longer to see how he does."
C)"It sounds like he is tolerant to the drug. I'll check about increasing the dosage."
D)"Some patients never recover from depression.He may not respond to this therapy."
Q2) When administering an intramuscular injection of hydroxyzine (Atarax),which of the following does the nurse need to remember?
A)Administer it with lidocaine (Xylocaine)to reduce local irritation.
B)Inject the medication over 2 minutes to reduce irritation.
C)Apply ice to the site after the injection to enhance absorption.
D)Use the Z-track method to prevent tissue injury at the site of injection.
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18
Chapter 17: Central Nervous System Stimulant Drugs
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12 Verified Questions
12 Flashcards
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Sample Questions
Q1) A 10-year-old boy has been on methylphenidate hydrochloride (Ritalin)for almost 6 months.His mother reports that he seems to have stopped growing.Which of the following statements is the nurse's best response to the patient's mother?
A)Growth will occur with the onset of puberty.
B)Growth can be promoted with a high-protein diet.
C)Growth in 10-year-old children tends to be slower.
D)Temporary slowing of growth is expected with Ritalin therapy.
Q2) Which of the following conditions is an indication for a central nervous system (CNS)stimulant drug?
A)Insomnia
B)Depression
C)Appetite enhancement
D)Appetite suppression
Q3) Which of the following central nervous system (CNS)stimulant drugs is used to treat acute migraines?
A)zolmitriptan (Zomig)
B)Amphetamines
C)modafinil (Alertec)
D)methylphenidate hydrochloride (Ritalin)
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Page 19
Chapter 18: Adrenergic Drugs
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13 Flashcards
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Sample Questions
Q1) Inhaled salmeterol (Serevent)is indicated for which of the following conditions?
A)Relief of acute asthma attacks
B)Nasal decongestion
C)Long-term maintenance treatment of asthma
D)Treatment of anaphylaxis
Q2) A female patient is on a low-dose dobutamine drip for heart failure.She had been feeling "better" but now complains of feeling tightness in her chest and a bit of anxiety.Her heart rate,which was 86,is now up to 110,and her blood pressure,which was 120/80,is now 150/98.What is the nurse's immediate concern?
A)The patient is experiencing normal adverse effects of dobutamine therapy.
B)The patient may be experiencing an allergic reaction to the dobutamine.
C)The medication may be causing a worsening of a pre-existing cardiac disorder.
D)The dosage of the dobutamine should be increased to better control these symptoms.
Q3) Adrenergic drugs produce effects similar to which of the following?
A)The central nervous system
B)The somatic nervous system
C)The sympathetic nervous system
D)The parasympathetic nervous system
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20
Chapter 19: Adrenergic-Blocking Drugs
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12 Flashcards
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Sample Questions
Q1) A 58-year-old male has had a myocardial infarction (MI).He has begun rehabilitation and is ready for discharge.When he is given a prescription for metoprolol (Lopressor),he becomes upset,stating "I don't have high blood pressure! Why did my doctor give me this medicine?" Which of the following statements is the nurse's best explanation to the patient?
A)This medication prevents emboli that may lead to another MI.
B) -blockers are routinely prescribed for all post-MI patients.
C)It is being prescribed to prevent hypertension that often occurs post-MI.
D)Studies have shown that this medication has greatly increased survival in patients after an MI.
Q2) A 49-year-old male patient is in the clinic for a follow-up visit 6 months after starting a -blocker for treatment of hypertension.During this visit,his blood pressure is 169/98 mmHg,and he eventually confesses that he stopped taking this medicine 2 months ago because of an "embarrassing problem." What problem did he most likely experience with this medication that caused him to stop taking it?
A)Urge incontinence
B)Dizziness when standing up
C)Excessive flatus
D)Impotence
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Chapter 20: Cholinergic Drugs
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Sample Questions
Q1) Which drug is considered the antidote for anticholinergic poisoning and for poisoning by organophosphates and carbonates,such as common insecticides?
A)pilocarpine
B)bethanechol (Duvoid)
C)physostigmine
D)cholinesterase
Q2) A patient has been taking donepezil (Aricept)for 2 weeks as part of the treatment for early stages of Alzheimer's disease.Her daughter calls the physician's office and is upset because her mother has not shown any improvement.Which of the following is the nurse's best response to the patient's daughter?
A)"Increase the dosage to twice daily."
B)"It takes time for the cure to take effect."
C)"It may take up to 6 weeks to see an improvement."
D)"Have her take the medication on an empty stomach for improved absorption."
Q3) Increased heart rate
A)Muscarinic stimulation
B)Nicotinic stimulation
C)Both muscarinic stimulation and nicotinic stimulation
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Chapter 21: Cholinergic-Blocking Drugs
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Sample Questions
Q1) Which medication is the antidote to severe cases of atropine overdose?
A)atenolol (Tenormin)
B)bethanechol (Duvoid)
C)scopolamine (Transderm-V)
D)physostigmine salicylate
Q2) Atropine is appropriate for which of the following patients? Select all that apply.
A)A patient who has suddenly developed symptomatic bradycardia,with a heart rate 32 per minute
B)A patient who has suddenly developed symptomatic tachycardia,with a heart rate 180 per minute
C)A patient with severe narrow-angle glaucoma
D)Preoperatively to reduce salivary and gastrointestinal secretions
E)A patient newly diagnosed with myasthenia gravis
F)A patient with severe diarrhea
Q3) How long can a scopolamine patch prevent motion sickness?
A)1 day
B)2 days
C)3 days
D)4 days
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Page 23
Chapter 22: Positive Inotropic Drugs
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Sample Questions
Q1) A patient has been taking digoxin (Lanoxin)at home but has developed toxicity.The physician has ordered digoxin immune Fab (Digibind).The patient asks the nurse why the medication has been changed.Which of the following is the nurse's best response to the patient?
A)"It works faster than digoxin."
B)"It is safer than digoxin and can be taken orally."
C)"It helps to convert the fibrillating atria to a more normal rhythm."
D)"This new drug is an antidote to digoxin and will help to lower the blood levels."
Q2) A patient about to receive his morning dose of digoxin (Lanoxin)has an apical pulse of 70.What should the nurse do?
A)Administer the dose
B)Withhold the dose and notify the physician
C)Notify the physician and monitor the patient's vital signs
D)Recheck the pulse,making sure to count for 1 full minute
Q3) Which of the following conditions predispose a patient to digitalis toxicity?
A)Hypercalcemia and advanced age
B)Hyperthyroidism and liver dysfunction
C)Ventricular fibrillation and hyperkalemia
D)Dysrhythmias and hypernatremia
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Page 24
Chapter 23: Antidysrhythmic Drugs
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Sample Questions
Q1) A 62-year-old male is to receive lidocaine (Xylocaine)as treatment for symptomatic episodes of ventricular tachycardia.He has been taking propranolol (Inderal)and digoxin (Lanoxin)at home,and his blood pressure (BP)is 100/56.Which of the following is considered a risk factor that may cause a toxic reaction to lidocaine?
A)Hypotension
B)Digoxin therapy
C)Age and diagnosis
D)Concurrent administration of propranolol
Q2) A patient has been started on lidocaine (Xylocaine).The nurse will monitor the patient for which of the following adverse effects of this drug?
A)Drowsiness
B)Nystagmus
C)Dry mouth
D)Convulsions
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Chapter 24: Antianginal Drugs
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Sample Questions
Q1) Twenty-five percent of women die within 5 years of onset of heart failure because of coronary artery disease.
A)True
B)False
Q2) Women should maintain a sodium intake of less than 3 grams per day.
A)True
B)False
Q3) A patient is experiencing chest pain while playing tennis.He has a bottle of sublingual nitroglycerin with him.In this situation,which of the following actions are appropriate for the patient to take? Select all that apply.
A)Stop the activity and lie down or sit down.
B)Call 911 immediately.
C)Place a tablet under the tongue.
D)Place a tablet in the space between the gum and cheek.
E)If chest pain is not relieved after 1 minute,take another sublingual tablet.
F)Take another sublingual tablet if chest pain is not relieved after 5 minutes.
G)Take a sip of liquid to help dissolve the pill.
H)Call 911 if the pain is not relieved after taking 3 sublingual tablets in 15 minutes.
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Chapter 25: Antihypertensive Drugs
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Sample Questions
Q1) Why do patients on -adrenergic agonists require close assessment of pulse,blood pressure,and weight?
A)Due to strong vasoconstricting properties
B)Due to hypertensive effects
C)Due to strong vasodilating properties
D)Risk of fluid overload
Q2) A patient who has diabetes has been started on antihypertensive drug therapy.The health care provider evaluates that this treatment is effective if the blood pressure is _________________________.Fill in the blank.
Q3) Which of the following parameters determine the regulation of arterial blood pressure?
A)Cardiac output and vascular resistance
B)Heart rate and peripheral resistance
C)Blood volume and renal blood flow
D)Myocardial contractility and arteriolar constriction
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Chapter 26: Diuretic Drugs
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Sample Questions
Q1) Which of the following statements is true regarding loop diuretics?
A)They are also called aldosterone-inhibiting diuretics.
B)They are very potent,providing a diuretic effect that lasts at least 6 hours.
C)They are particularly useful when rapid diuresis is desired because their onset of action is rapid.
D)They have the disadvantage of ceasing to be effective when the creatinine clearance decreases below 25 mL/min.
Q2) A patient is being discharged to home on a single daily dose of a diuretic.To avoid unnecessary disruptions to the patient's daily routine,at what time does the health care provider instruct the patient to take the dose?
A)In the morning
B)At noon
C)With supper
D)At bedtime
Q3) The manifestations of potassium deficiency include which of the following?
A)Dyspnea
B)Diarrhea
C)Weakness
D)Hypertension
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Page 28
Chapter 27: Fluids and Electrolytes
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Q1) Lethargy
A)HYPO
B)HYPER
Q2) Increased thirst
A)HYPO
B)HYPER
Q3) During the infusion of albumin,the nurse should monitor the patient for the development of which of the following?
A)Hypernatremia
B)Fluid volume deficit
C)Fluid volume excess
D)Transfusion reaction
Q4) The nurse is planning to transfuse a patient with a unit of packed red blood cells (PRBCs).Which of the following patients is most likely be treated with this transfusion?
A)A patient with a coagulation disorder
B)A patient with severe anemia
C)A patient who has lost a massive amount of blood after emergency surgery
D)A patient who has a clotting factor deficiency
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Chapter 28: Coagulation Modifier Drugs
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Q1) What is the most frequent undesirable adverse effect of thrombolytic therapy?
A)Dysrhythmias
B)Nausea and vomiting
C)Anaphylactic reactions
D)Internal and superficial bleeding
Q2) Which of the following laboratory studies is used to monitor the therapeutic effects of heparin?
A)Prothrombin time (PT)
B)aPTT (activated partial thromboplastin time)
C)Vitamin K
D)Hematocrit
Q3) Which of the following laboratory studies is used to monitor the therapeutic effects of warfarin (Coumadin)?
A)International normalized ratio (INR)
B)aPTT (activated partial thromboplastin time)
C)Vitamin K
D)Hematocrit
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Chapter 29: Antilipemic Drugs
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Q1) Which of the following are considered risk factors for high blood cholesterol? Select all that apply.
A)Male 45 years or older
B)Female 45 years or older
C) Family history includes a sister who died at age 69 of a myocardial infarction
D)Family history includes a brother who died at age 40 of a myocardial infarction
E)Current cigarette smoker
F)Slight build
G)Hypertension
H)History of gallbladder disease
I)History of diabetes mellitus
Q2) A patient is taking gemfibrozil (Lopid)to lower her cholesterol level.What adverse effects should the nurse tell the patient about this medication?
A)Constipation
B)Diarrhea
C)Joint pain
D)Dry mouth
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Chapter 30: Pituitary Drugs
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Q1) Which of the following hormones is secreted by the posterior pituitary gland?
A)Growth hormone
B)Follicle-stimulating hormone
C)Antidiuretic hormone
D)Prolactin
Q2) A patient is receiving vasopressin (Pressyn).Which of the following therapeutic responses should the nurse expect to see?
A)Improved appetite
B)Increased serum albumin levels
C)Increased serum potassium levels
D)Decreased urinary output
Q3) An 8-year-old girl has been diagnosed with true pituitary dwarfism.She is being treated with somatropin (Humatrope).Which of the following is an expected outcome of using somatropin?
A)An increase in growth
B)Decreased urinary output
C)Increased muscle strength
D)An increase in height when she reaches puberty
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Chapter 31: Thyroid and Antithyroid Drugs
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Q1) Which of the following drugs should be avoided while taking thyroid replacement preparations?
A)Vitamin supplements
B)Antibiotics
C)Anticoagulants
D) -blockers
Q2) Which of the following signs indicate a too-high dose of thyroid replacement hormone?
A)Bradycardia,somnolence,and ataxia
B)Anxiety,weight loss,and insomnia
C)Dry skin, weakness, and weight gain
D)Drowsiness,coughing,and neck pain
Q3) A patient has been diagnosed with primary hypothyroidism.Which of the following statements accurately describes this condition?
A)The hypothalamus is not secreting thyrotropin-releasing hormone (TRH);therefore,thyroid-stimulating hormone (TSH)is not released from the pituitary gland.
B)The pituitary gland is dysfunctional and is not secreting TSH.
C)The abnormality is in the thyroid gland itself.
D)The abnormality is caused by an excess intake of iodine.
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Chapter 32: Antidiabetic Drugs
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Q1) Which of the following is a true statement regarding diazoxide,a glucose-elevating drug?
A)It is also naturally synthesized by the pancreas.
B)It is used for the treatment of hypotensive emergencies.
C)It inhibits the release of insulin from the pancreas.
D)It stimulates insulin release from the pancreas.
Q2) When administering morning medications for a newly admitted patient,the nurse notes that the patient has an allergy to sulfa drugs.The patient has an order for sulfonylurea gliclazide (Diamicron).What is the best action for the nurse to take?
A)Give the drug as ordered 30 minutes before breakfast.
B)Hold the drug and check the order with the physician.
C)Give the drug and monitor for adverse effects.
D)Give a reduced dose of the drug with breakfast.
Q3) What early signs of hypoglycemia should the nurse should tell the patient about?
A)Urticaria and rash
B)Nausea and diarrhea
C)Irritability and confusion
D)Fruity,acetone odour to the breath
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Chapter 33: Adrenal Drugs
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Q1) A patient is taking fludrocortisone (Florinef)for Addison's disease.His wife is concerned about all the problems that may occur with this therapy.Which of the following is a true statement about fludrocortisone therapy?
A)It may cause severe postural hypotension.
B)It should be taken with food or milk to minimize gastrointestinal upset.
C)The medication should be stopped immediately if nausea or vomiting occurs.
D)Weight gain of 2.25 kg or more in 1 week is an expected adverse effect.
Q2) Which of the following may be caused by systemically administered glucocorticoids?
A)Dehydration
B)Hypokalemia
C)Hyperkalemia
D)Hypoglycemia
Q3) Which of the following types of drugs can have an adverse interaction with corticosteroids?
A)Nonsteroidal anti-inflammatory drugs (NSAIDs)
B)Antibiotics
C)Narcotic analgesics
D)Oral anticoagulants
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Page 35
Chapter 34: Womens Health Drugs
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Q1) Which of the following drugs is used to treat primary or secondary amenorrhea and to alleviate the symptoms of endometriosis?
A)oxytocin (Pitocin)
B)estradiol transdermal (Estraderm)
C)raloxifene (Evista)
D)medroxyprogesterone (Depo-Provera)
Q2) The nurse is reviewing the risk factors for osteoporosis.Which of the following is considered a risk factor for osteoporosis?
A)White or Asian race
B)African race
C)History of participation in active sports
D)Obesity
Q3) The nurse is preparing to administer the contraceptive form of medroxyprogesterone (Depo-Provera).What route should be planned?
A)Oral
B)Intramuscular
C)Vaginal
D)Transdermal
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Chapter 35: Mens Health Drugs
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Q1) A male patient is requesting a prescription for sildenafil (Viagra).He should be assessed for the presence of which of the following conditions?
A)Fluid retention
B)Hypogonadism
C)The use of nitrates
D)Benign prostatic hypertrophy
Q2) A patient in the early stage of benign prostatic hypertrophy wants to try natural health products instead of conventional medications.Which natural health product is often used for this condition?
A)Ginkgo
B)Saw palmetto
C)Ginseng
D)Hawthorn
Q3) A patient is receiving androgenic anabolic steroids.This patient should be monitored for which serious adverse effect?
A)Renal failure
B)Peliosis of the liver
C)Cirrhosis of the liver
D)Heart failure
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Expectorants
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Q1) Which antihistamine is commonly used in the treatment of motion sickness?
A)azatadine
B)diphenhydramine (Allerdryl)
C)hydroxyzine
D)promethazine
Q2) A patient is taking guaifenesin (Balminil)as part of the treatment for influenza.Which of the following should the nurse also instruct the patient to do?
A)Force fluids to help loosen and liquefy secretions.
B)Report a fever to the doctor if her temperature is above 38.3°C.
C)Avoid driving a car or operating heavy machinery because of the sedating effects.
D)Avoid coughing to retain the effects of the medication for a longer period.
Q3) Because of many reported adverse events,which of the following children should not be given cough and cold medication?
A)Children younger than 2 years old
B)Children younger than 4 years old
C)Children younger than 6 years old
D)Children younger than 8 years old
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Page 38
Chapter 37: Bronchodilators and Other Respiratory Drugs
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Sample Questions
Q1) Which of the following is the rationale for using inhaled budesonide (Pulmicort)?
A)It causes bronchodilation.
B)It thins bronchial secretions.
C)It inhibits the activity of -agonists.
D)It provides an anti-inflammatory response.
Q2) A patient has prescriptions for two inhalers.One inhaler is a bronchodilator,and the other is a corticosteroid.Which instruction should the nurse give the patient regarding these inhalers?
A)The corticosteroid should be taken first.
B)The bronchodilator should be taken first.
C)The two drugs should be taken at least 2 hours apart.
D)The order of administration does not matter with these two drugs.
Q3) Which of the following is an adverse effects associated with the use of xanthine derivatives?
A)Diarrhea
B)Palpitations
C)Bradycardia
D)Drowsiness
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Chapter 38: Antibiotics, part 1: Sulfonamides, Penicillins,
Cephalosporins, Macrolides, and Tetracyclines
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Q1) Which class of antibiotics is often used with -lactamase inhibitors to extend the effectiveness of the drug?
A)Cephalosporins
B)Tetracyclines
C)Sulfonamides
D)Penicillins
Q2) During drug therapy for pneumonia,a female patient develops a superinfection.She asks the nurse how this could have happened.Which of the following statements is the nurse's best explanation to the patient?
A)Large doses of antibiotics kill normal flora.
B)The infection has spread from her lungs to the new site of infection.
C)The pneumonia-causing bacteria are resistant to the drugs.
D)She is having an allergic reaction to the antibiotics.
Q3) During antibiotic therapy,a significant drug interaction may occur with which of the following drug groups?
A)Anticoagulants
B)Estrogen-containing contraceptives
C)Antihypertensives
D)Antihistamines
Page 40
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Fluoroquinolones, and Other Drugs
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Q1) A patient who has been hospitalized for 2 weeks has developed a pressure ulcer that contains methicillin-resistant Staphylococcus aureus (MRSA).Which of the following antibiotics does the nurse expect will be chosen for his therapy?
A)penicillin
B)doxycycline (Apo-Doxy)
C)vancomycin (Vancocin)
D)erythromycin (Pediazole)
Q2) When administering vancomycin (Vancocin),what important information should the nurse keep in mind?
A)It is ineffective in the treatment of methicillin-resistant Staphylococcus aureus (MRSA).
B)It should be infused over at least 30 minutes.
C)Fluids should be restricted during vancomycin therapy.
D)Infuse the drug over 1 hour to reduce red man syndrome.
Q3) Metronidazole (Flagyl)is widely used for which type of infection?
A)Skin
B)Gynecological
C)Aerobic
D)Respiratory
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Chapter 40: Antiviral Drugs
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Sample Questions
Q1) Which of the following is a common adverse effect associated with oseltamavir (Tamiflu)?
A)Diarrhea
B)Sinusitis
C)Nausea
D)Constipation
Q2) A young adult calls the clinic to ask for a prescription for "the flu drug." He says he has had the flu for almost 4 days and just heard about a drug that can reduce the symptoms.Which of the following is a true statement about oseltamivir (Tamiflu)and zanamivir (Relenza)?
A)They do not stop the spread of influenza.
B)These drugs have few adverse effects.
C)As long as this patient starts treatment within the next 24 hours, the drug should be effective.
D)Treatment with these drugs should begin within 2 days of influenza symptom onset.
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Chapter 41: Antituberculosis Drugs
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Q1) Patients taking isoniazid (Isotamine)should watch for and report which of the following potential adverse effects?
A)Rash
B)Headache and nervousness
C)Insomnia
D)Numbness and tingling of extremities
Q2) Which antituberculosis drug may cause a decrease in visual acuity resulting from optic neuritis?
A)rifampin (Rifadin)
B)isoniazid (Isotamine)
C)ethambutol (Etibi)
D)streptomycin
Q3) When assessing patients who are to receive antituberculosis therapy,the nurse should monitor for signs of which of the following?
A)Glaucoma
B)Weight gain
C)Heart failure
D)Hepatic impairment
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43
Chapter 42: Antifungal Drugs
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Sample Questions
Q1) The nurse is administering one of the newer formulations of amphotericin
B,Amphotec.When giving this drug,what important information does the nurse need to remember?
A)The new formulation may be given in an oral form.
B)The newer doses are much lower than the older doses.
C)The newer doses are much higher than the older doses.
D)The newer and older forms have no differences in their doses.
Q2) The nurse is administering an antifungal medication.What assessment finding may indicate medication-induced renal damage?
A)Rash and chills
B)Increased urinary output
C)Decreased levels of blood urea nitrogen (BUN) and creatinine
D)Weight gain of more than 1 kg in 1 week
Q3) Which of the following are contraindications to the use of griseofulvin?
A)Lupus
B)Renal disease
C)Cardiac disease
D)Meningitis
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Sample Questions
Q1) A woman is travelling to a country that poses a high risk for malarial infections.What important information should the nurse teach her regarding prophylactic therapy with chloroquine?
A)The medication is better absorbed and has fewer adverse effects if taken on an empty stomach.
B)This drug should be started 3 weeks before exposure but can be discontinued after she leaves the area.
C)This drug is taken only when she observes mosquito bites because it can have toxic effects if taken unnecessarily.
D)This drug is usually started 2 weeks before exposure to malarial areas and continued for 8 weeks after leaving the area.
Q2) A patient is prescribed anthelmintic therapy.Which of the following adverse reactions should the nurse tell this patient about?
A)Nervousness
B)Insomnia
C)Decreased appetite
D)Constipation
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Chapter 44: Antiseptic and Disinfectant Drugs
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Q1) A client had a Foley catheter inserted during surgery.Two days later,he developed a urinary tract infection.What type of infection is this?
A)Superinfection
B)Therapy infection
C)Nosocomial infection
D)Community-acquired infection
Q2) How do antiseptics differ from disinfectants?
A)Antiseptics are used to sterilize surgical equipment.
B)Disinfectants are used as preoperative skin preparation.
C)Antiseptics are used on living tissue to kill microorganisms.
D)Disinfectants are used only on nonliving objects to destroy organisms.
Q3) A patient with a long-term intravenous catheter is going home.If he is allergic to seafood,which antiseptic drug is contraindicated?
A)povidone-iodine (Betadine)
B)Any peroxide drug
C)Any antibiotic drug
D)benzalkonium chloride (Amino-Prophyl)
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Chapter 45: Anti-Inflammatory, Anti-arthritic, and Related Drugs
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Q1) A 75-year-old female patient has been given naproxen sodium (Aleve)for the treatment of rheumatoid arthritis.Which of the following types of medication will have a possible interaction with this nonsteroidal anti-inflammatory drug (NSAID)?
A)Antibiotics
B)Decongestants
C)Anticoagulants
D)Antihistamines
Q2) Which of the following conditions are contraindications to the use of nonsteroidal anti-inflammatory drugs (NSAIDs)? Select all that apply.
A)Rhinitis
B)Arthralgia
C)Peptic ulcer disease
D)Pregnancy
E)Neuropathy
F)Epistaxis
G)Pericarditis
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Chapter 46: Immunosuppressant Drugs
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Q1) A female patient has started azathioprine (Imuran)therapy in preparation for her renal transplant surgery.Which expected adverse effect of azathioprine therapy should the nurse tell the patient about?
A)Tremors
B)Diarrhea
C)Leukopenia
D)Fluid retention
Q2) How is cyclosporine (Neoral)usually given intravenously?
A)In a single intravenous (IV)injectable form to minimize adverse effects
B)Initiated by an oral test dose;then,after 2 hours,an IV infusion is begun
C)Diluted with normal saline or 5% dextrose in water and infused over 2 to 6 hours
D)Given as an IV bolus for the first dose,then with an infusion pump for following doses
Q3) The use of sirolimus (Rapamune)can increase the chances of which of the following?
A)Lymphoma
B)Leukemia
C)Breast cancer
D)Bowel cancer
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Chapter 47: Immunizing Drugs and Pandemic
Preparedness
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Q1) The human papilloma virus (HPV)vaccine should be given to which age group of females?
A)2 to 4 years
B)6 to 8 years
C)9 to 13 years
D)14 to 18 years
Q2) A 45-year-old male has had a series of equine-made immunizing drugs in preparation for a trip to a Third World country.His wife brings him to the emergency room because he has developed edema of the face,tongue,and throat and is having trouble breathing.What is he experiencing?
A)Serum sickness
B)Cross-sensitivity
C)An adverse effect
D)An anaphylactic reaction
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49
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Q1) Which of the following is a true statement regarding nadir?
A)It is a therapeutic effect of radiation.
B)It is the lowest level reached by bone marrow cells following chemotherapy.
C)It occurs 30 days after chemotherapy treatment.
D)Antiemetics will prevent it.
Q2) A patient has had her first course of antineoplastic therapy and is experiencing gastrointestinal adverse effects,including anorexia and nausea.Which of the following is an appropriate goal for the patient dealing with this problem?
A)To eat three balanced meals a day within 4 days
B)To return to her normal eating pattern within 1 month
C)To maintain her normal weight by consuming healthy snacks as tolerated
D)To maintain a diet of six frequent feedings with a nutritional supplement as a snack within 2 weeks
Q3) Which of the following unique adverse effects is characteristic of the antineoplastic enzymes,such as asparaginase (Kidrolase)?
A)Hepatotoxicity
B)Impaired pancreatic function
C)Nephrotoxicity
D)Hypoglycemia
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Chapter
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Q1) Large,cumulative doses of doxorubicin (Adriamycin),a cytotoxic antibiotic,are known to cause which of the following adverse effects?
A)Severe emesis
B)Cardiomyopathy
C)Lung disease
D)Nephrotoxicity
Q2) Patients receiving antineoplastic drugs should be advised to take which of the following medications for minor aches and pains?
A)ibuprofen (Motrin)
B)acetylsalicylic acid (Aspirin)
C)acetaminophen (Tylenol)
D)naproxen
Q3) A patient is receiving cisplatin as part of her treatment for ovarian cancer.Which nursing diagnosis is appropriate for this antineoplastic drug?
A)Ineffective tissue perfusion related to cardiotoxicity
B)Disturbed sensory perception related to ototoxicity
C)Activity intolerance related to anemia-induced fatigue
D)Impaired urinary elimination pattern related to hyperuricemia
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Chapter 50: Biological Responsemodifying Drugs
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Q1) Which of the following is an effect of colony-stimulating factors (CSFs)?
A)Multiplication of T cells
B)Decreased neutrophil counts
C)Increased cytotoxic activity of natural killer (NK) cells
D)Stimulation of certain immune cells
Q2) A patient is to take antineoplastic therapy with monoclonal antibodies such as rituximab (Rituxan).The nurse should carefully assess this patient for which condition?
A)Anorexia
B)Neuropathy
C)Respiratory problems
D)Heart failure
Q3) Which of the following is recommended for the administration of sargramostim (Leukine)?
A)Roll the vial between the hands to mix.
B)Reconstitute with 1 mL of sterile saline with preservatives.
C)Shake the vial after reconstitution to ensure proper mixing.
D)For intravenous (IV)solutions,dilute the medication in 5% dextrose solutions.
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Chapter 51: Gene Therapy and Pharmacogenomics
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Q1) Which of the following is the main purpose of the Human Genome Project?
A)To study genetic diseases
B)To study genetic traits in humans
C)To discover new genetic diseases
D)To describe the entire genome of a human being
Q2) Which of the following is manufactured as a result of indirect gene therapy?
A)Vitamin K
B)epoetin (Eprex)
C)Human insulin
D)Heparin
Q3) Genotyping for presence of cytochrome P-450 2D6 (CYP2D6)enzymes and alleles will be helpful in which area of medicine?
A)Cardiology
B)Psychiatry
C)Respirology
D)Oncology
Q4) Name one clinical application of pharmacogenomics.
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Chapter 52: Acid-Controlling Drugs
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Q1) Which classification of medications is considered first-line therapy for treatment of erosive esophagitis?
A)H antagonists
B)Proton pump inhibitors
C)General antacids
D)Prostaglandin inhibitors
Q2) H antagonists,such as cimetidine,may inhibit the absorption of drugs that require an acidic gastrointestinal environment.Which of the following drugs requires an acidic gastrointestinal environment?
A)Nonsteroidal anti-inflammatory drugs (NSAIDs)
B)ranitidine (Zantac)
C)tetracycline
D)ketoconazole
Q3) Antacids containing magnesium should be used cautiously in patients with which condition?
A)Peptic ulcer disease
B)Renal failure
C)Hypertension
D)Heart failure
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Page 54
Chapter 53: Antidiarrheal Drugs and Laxatives
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Q1) Which type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?
A)Adsorbents
B)Anticholinergics
C)Intestinal flora modifiers
D)Lubricants
Q2) What classification is the laxative glycerin (Glycerin Suppositories)?
A)A saline laxative
B)An emollient laxative
C)A hyperosmotic laxative
D)A stimulant/irritant laxative
Q3) Mineral oil can interfere with the absorption of which vitamin?
A)Vitamin A
B)Vitamin B
C)Vitamin B
D)Vitamin C
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55
Chapter 54: Antiemetic and Antinausea Drugs
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Q1) A patient who has been newly diagnosed with vertigo will be taking an antihistamine antiemetic drug.What is important for the nurse to emphasize when teaching the patient about this drug?
A)Doses may be skipped if she is feeling well.
B)The patient should avoid driving because of possible drowsiness.
C)The patient may experience transient taste problems.
D)It is safe to take the dose with a glass of wine in the evening to help settle her stomach.
Q2) Which of the following interventions is correct regarding the management of nausea and vomiting?
A)Give antiemetics immediately after chemotherapy is administered.
B)Antiemetics are often administered 30 minutes to 3 hours before a chemotherapy drug is given.
C)Taking antiemetics at night may cause restlessness and interfere with sleep.
D)Antiemetics may be taken with a glass of wine to help settle the stomach.
Q3) Which drug is administered via a transdermal patch to prevent motion sickness?
A)meclizine (Bonamine)
B)prochlorperazine (Stemetil)
C)scopolamine (Transderm-V)
D)metoclopramide (Apo-Metoclop)
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Chapter 55: Pharmaconutrition
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Q1) Which of the following is the most common adverse effect from nutritional supplements?
A)Diarrhea
B)Constipation
C)Fluid overload
D)Peptic ulcer disease
Q2) An older adult patient needs to take an enteral supplement to improve her overall nutritional status.Which of the following formulations provides complex nutrients?
A)Ensure
B)Moducal
C)ProMod
D)Microlipid
Q3) A patient's peripheral parenteral nutrition bag has run dry before the physician ordered a new bag.The best action by the nurse is to hang which of the following solutions until the new bag arrives?
A)10% dextrose in water
B)20% dextrose in water
C)0.9% sodium chloride
D)Lactated Ringer's
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Chapter 56: Blood-Forming Drugs
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Sample Questions
Q1) A patient is prescribed oral iron supplementation.What important information should the nurse tell the patient about this treatment?
A)Take the iron tablets with milk or antacids.
B)Crush the pills as needed to help swallowing.
C)Avoid reclining positions for 15 to 30 minutes after taking the drug.
D)While on iron supplement,it is not necessary to eat foods high in iron such as meat;dark green,leafy vegetables;and dried beans.
Q2) A patient is to receive iron dextran (Dexiron)injections.What technique should the nurse use to administer this medication?
A)Intravenous (IV)mixed with 5% dextrose
B)Intramuscular (IM)injection in the upper arm
C)IM injection using the Z-track method
D)Subcutaneous injection with a half-inch,29-gauge needle
Q3) Which of the following may occur as a result of therapy with iron preparations?
A)Palpitations
B)Dizziness and syncope
C)Black and red tarry stools
D)Yellow discoloration of the urine
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Chapter 57: Dermatological Drugs
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Q1) Which of the following is likely to be prescribed for a child with impetigo?
A)lindane (Hexit)
B)nystatin (Flagistatin)
C)acyclovir (Zovirax)
D)bacitracin (Bacitin)
Q2) A 55-year-old obese patient was diagnosed with candidiasis in the skin folds under her breasts.At a follow-up visit 2 months later,she complains that the candidiasis has returned.She tells the nurse that she applied the medicine for a week and then stopped because the itching went away and the cream was messy.Which of the following statements is the nurse's best response regarding the patient's fungal infections of the skin?
A)Fungal infections often require prolonged therapy.
B)Fungal infections usually subside in a week or so;she must have caught a new infection.
C)If the cream is messy, she should apply a dressing.
D)This infection will probably never be cured.
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Chapter 58: Ophthalmic Drugs
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Q1) A patient has been taking the corticosteroid dexamethasone (AK Dex)but has developed bacterial conjunctivitis.He is given a prescription for gentamicin (Alcomicin)ointment.What interaction is possible if the two drugs are used concurrently?
A)The infection may become systemic.
B)The gentamicin effects may become more potent.
C)The corticosteroid may cause overgrowth of nonsusceptible organisms.
D)Immunosuppression may make elimination of the eye infection more difficult.
Q2) A patient with an eye injury requires an ocular examination to detect the presence of a foreign body.Which of the following drugs is used for this examination?
A)dapiprazole
B)fluorescein sodium (AK-Fluor)
C)atropine sulfate
D)cromolyn sodium
Q3) Which of the following drugs is used to reduce intraocular pressure?
A)cromolyn (Opticrom)
B)Polypeptides
C)Osmotic diuretics
D)Hyperosmolar sodium chloride
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Chapter 59: Otic Drugs
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Q1) Contraindications to the use of chloramphenicol otic preparations include which of the following?
A)Escherichia coli infection
B)Perforated eardrum
C)Haemophilus influenzae infection
D)Drug hypersensitivity to pramoxine
Q2) Which of the following describes the use of urea hydrogen peroxide (Earoxide)?
A)To reduce inflammation
B)To reduce production of cerumen
C)To loosen the cerumen for easier removal
D)To inhibit growth of microorganisms in the external canal
Q3) Which of the following is a true statement about otitis media?
A)It is treated with over-the-counter (OTC)medications.
B)In children,it commonly follows a lower respiratory tract infection.
C)Common symptoms include pain, fever, malaise, pressure, and a sensation of fullness in the ears.
D)Hearing deficits are associated only with inner ear infections,not otitis media.
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