PHARMACOLOGY

Pre Test A
1. A 20 y/o client visiting the clinic requests the
use of oral contraceptives. When reviewing
the client’s history, which of the following
would alert the nurse to a possible
contraindication to using these agents?

a. Thrombophlebitis
b. UTI
c. Ulcerative colitis
d. Menorrhagia
2. A 30 y/o multipara has been prescribed oral
contraceptives as a method of birth control.
The nurse instructs the client that decreased
effectiveness may occur if the client is
prescribed which of the following?

a. Indomethacin (Indocin)
b. Amitiptyline (Elavil)
c. Ampicillin
d. Omeprazole (Prilosec)
3. A primigravid client in active labor has just
received an epidural block for pain. After
administration of the epidural block, for
which of the following would the nurse
frequently assess the client?

a. spinal headache
b. Hypotension
c. hyperreflexia
d. uterine relaxation
4. One hour after receiving intravenous
meperidine (Demerol) for pain during labor,
a primigravid client delivers a full-term
neonate with symptoms of respiratory
depression. The nurse anticipates that the
neonate will require the administration of
which of the following?
a. Betamethasone (Celestone)
b. Naltrexone (Trexan)
c. Promethazine (Phenergan)
d. Naloxone (Narcan)
5. A physician has ordered nalbuphine hcl
(Nubain) 10 mg IV for a client in active labor.
The pharmacy supplies a vial labeled as
50mg in a 5ml vial. Which of the following
amounts would the nurse administer?

a. 0.5 ml
b. 1.0 ml
c. 1.5 ml
d. 2.0 ml
6. A child with asthma continues to have a heart
rate of 160 bpm and a RR of 36
breaths/minute, the child appears restless
and anxious. The child is given albuterol
(Ventolin) via nebulizer. Which of the
following would indicate that the nebulizer
treatment has been effective?
a. pulse oximeter reading of 91%
b. nonproductive cough
c. expiratory wheezing
d. increase in peak expiratory flow rate
7. The nurse teaches the parents of a 2 y/o how
to instill antibiotic ear drops. Which of the
following statements about the direction to
pull on the earlobe indicates that the child’s
father has understood the teaching?
a. up and forward
b. up and backward
c. down and outward
d. down and backward
8. Which of the following techniques would be
most appropriate to use when determining
whether the parental teaching about how to
administer ear drops correctly has been
successful?
a. observing the parents instilling the ear drops
in the child’s ear
b. listening to the parents as they describe the
procedure
c. asking the parents to list the steps of the
procedure
d. asking the parents whether they have read
the handout on the procedure
9. When developing a teaching plan for the
parents of a child who is receiving digoxin
(Lanoxin), which of the following would be
most important for the nurse to include?

a. telling the parents about the side effects

b. discussing why the child is receiving this
medicine
c. explaining the difference between milligrams
and micrograms
d. showing the mother the correct prescribed
dosage
10. Which of the following would the nurse
explain to the mother of a child receiving digoxin
(Lanoxin) as the primary reason for giving this
drug?

a. to relax the walls of the heart’s arteries

b. to improve the strength of the heartbeat
c. to prevent the irregularities in ventricular
contractions
d. to decrease inflammation of the heart wall
11. Which of the following nursing measures
would be carried out for a child who is
receiving chemotherapy and allopurinol?

a. encouraging a high fluid intake

b. omitting carbonated fluids
c. giving foods that are high in potassium
d. limiting foods that are high in natural sugar
12. A child has an order to receive 250 ml of IV
fluids daily for 4 hours. The nurse would set
the infusion pump using microdrip tubing to
run at which of the following flow rates?

a. 10 ml/hr
b. 25 ml/hr
c. 42 ml/hr
d. 63 ml/hr
13. A child is to receive IV fluids rate of 95 ml/hr.
the tubing of the infusion delivers 10
drops/ml. at which of the following rates
would the nurse infuse the solution?

a. 10 drops/minute
b. 14 drops/minute
c. 16 drops/minute
d. 20 drops/minute
14. Which of the following statement by an
adolescent receiving gentamicin
sulfate would the nurse interpret as
indicating toxicity of the drug?

a. “ I’m feeling dizzy”

b. “ I have no appetite”
c. “ I urinate a lot now”
d. “ I haven’t moved my bowels in 3 days”
15. The mother of an infant who has an order for
40 mg of acetaminophen every 4 hours for
pain states that she use the infant drops,
which come in a concentration of 80 mg/ 0.8
ml. which of the following amounts would the
nurse tell the mother to give the infant?

a. one dropperful
b. ½ dropperful
c. 0.78 ml using a 1 ml syringe
d. 1.5 ml, using a 3ml syringe
16. When administering AtS04 preoperatively
to a client scheduled for lung surgery, the
nurse should tell the client which of the
following?

a. “ This medication will make you drowsy”

b. “ This medication will help you relax”
c. “ This medication will make your mouth feel dry”
d. “ This medication will reduce the risk of
postoperative infection”
17. The nurse is preparing to administer digoxin
(Lanoxin) 0.12 mg. scored 0.25 mg tablets
are available. How many tablets should the
nurse administer?

a. 0.5 tab
b. 1 tab
c. 1.5 tab
d. 2 tabs
18. Which of the following medications would the
nurse anticipate administering in the event of
heparin overdose?

a. warfarin sodium
b. protamine sulfate
c. acetylsalicylic acid
d. atropine sulfate
19. Chloral hydrate 1000 mg has been
ordered. It is available in syrup
containing 0.5g/5 ml. how many
milliliters should the nurse give?

a. 1.5 ml
b. 3.0 ml
c. 5.0 ml
d. 10.0 ml
20. The client is supposed to receive 500 ml of
5% dextrose on 0.45% NS with 20 mEq of
potassium chloride over the next 6 hours. The
infusion set administers 10 gtt/ml. to what flow
rate should the nurse adjust the IV flow?

a. 14 gtt/min
b. 18 gtt/min
c. 21 gtt/min
d. 25 gtt/min
21. What is the primary purpose of
administering aminophylline to a
client with emphysema?

a. to relieve the spasms of the diaphragm

b. to relax smooth muscles in the bronchioles
c. to promote efficient pulmonary circulation
d. to stimulate the medullary respiratory center
22. Diuretic therapy with torsemide (Demadex) is
started for a client with heart failure. When
calling the client 2 days after the drug
therapy is started, the nurse evaluates the
torsemide as effective when the client says
she has experienced which of the following
outcomes?
a. she has an improved appetite and is eating better
b. she weighs 6 pound less than she did 2 years ago
c. she is less thirsty than she was before the drug
therapy
d. she has clearer urine since starting the therapy
23. Which of the following techniques is
correct for the nurse to use when
inserting a rectal suppository for an
adult client?
a. insert the suppository while the client bears down
b. place the client in a supine position
c. position the suppository along the rectal wall
d. insert the suppository 2 inches into the rectum
24. A client receiving digoxin (Lanoxin) for CHF
undergoes cardiac catheterization to
evaluate his condition further. The procedure
reveals a cardiac output of 2.2 L/minute.
How would the nurse evaluate this cardiac
output?
a. high, because of the effects of digoxin
b. within normal limits, because of the effects of
digoxin
c. within normal limits, but not adequate to support
strenuous activity
d. low, requiring further medical intervention
25. Clients who are receiving total parenteral
nutrition are at risk for development of
which of the following complications?

a. hypostatic pneumonia
b. pulmonary hypotension
c. orthostatic hypotension
d. fluid imbalances
26. The client is receiving propantheline bromide
to treat cholecystitis. The nurse would
evaluate the client’s response to medication
by observing for which of the following side
effects?

a. urinary retention
b. Diarrhea
c. Hypertension
d. Diaphoresis
27. The nurse is preparing to start an IV
infusion. Before inserting the needle into a vein,
the nurse would apply a tourniquet to the client’s
arm to accomplish which of the following?

a. distend the veins

b. stabilize the veins
c. immobilize the arm
d. occlude arterial circulation
28. The physician orders Ringer’s lactate solution
to replace the fluid losses of a client. While
the solution is infusing, the nurse should
assess for which of the following symptoms
that might indicate fluid overload is
developing?

a. increasing abdominal girth

b. rapid, thready pulse
c. moist crackles on auscultation
d. increased urinary output
29. The client is to receive an IV infusion at
100ml/hour. The infusion set delivers
15gtt/ml. What is the flow rate of the
infusion?

a. 10 gtt/min
b. 15 gtt/min
c. 21 gtt/min
d. 25 gtt/min
30. Procaine Penivillin G 600,000 units IM has
been ordered. The nurse has available 1 ml
prefilled syringe labeled 600,000 units/ml.
how many ml should the nurse administer?

a. 0.25 ml
b. 0.50 ml
c. 1.0 ml
d. 2.5 ml
31. The nurse is administering eye drops to a
client with glaucoma. Which of the following
is a correct technique for instilling the eye
drops? The eyes are placed:

a. in the lower conjunctival sac

b. near the opening of the lacrimal ducts
c. on the cornea
d. on the scleral surface
32. A client has an anaphylactic reaction to
penicillin that results in respiratory distress.
Which of the following medications would the
nurse anticipates first?
a. Dopamine (Intropin)
b. Diphenhydramine (Benadryl)
c. Cimetidine (Tagamet)
d. Epinephrine
33. The nurse is preparing to give an IM injection.
Which of the following sites has the least
amount of blood vessels and major nerves
located in the area?

a. Deltoid
b. Dorsogluteal
c. vastus lateralis
d. triceps
34. The nurse is planning to teach the client how
to properly use a metered dose inhaler to
treat asthma. Which of the following
instructions should the nurse include in the
teaching plan?
a. rinse the mouth after each use of a steroid inhaler
b. inhale quickly when administering the medication
c. inhale the medication and exhale through the nose
d. cough and deep breath before inhaling the
medication
35. A client is receiving a transfusion of packed
RBC. Which of the following actions should
the nurse implement to safely administer the
blood?
a. keep the blood refrigerated on the nursing unit until
ready to administer
b. stay with the client during the first 15 minutes to
detect signs of reaction
c. do not infuse any blood that has been hanging for
more than 6 hours
d. administer the blood quickly if the client develops a
fever to prevent wasting it
36. A client is receiving a blood transfusion when
he begins to complain of difficulty of
breathing. The nurse notes an elevated BP
and a cough. Based on these signs, the
nurse suspects which of the following
complications?
a. anaphylactic reaction
b. circulatory overload
c. Sepsis
d. acute hemolytic reaction
37. The nurse administers an intradermal
injection to a client. Proper technique has
been used if the injection site demonstrates
which of the following?

a. minimal leaking
b. no swelling
c. tissue pallor
d. evidence of a bleb
38. The sudden onset of which of the following
signs or symptoms indicate a potentially
serious complication for the client receiving
an IV infusion?

a. noisy respirations
b. papillary constrictions
c. Halitosis
d. moist skin
39. The nurse is planning to initiate a blood
transfusion. Which of the following solutions
should the nurse select to prime the tubing
when preparing to administer the blood?

a. Ringer’s lactate solution

b. 0.9% NSS
c. 5% dextrose in 0.45% NSS
d. 5% in dextrose water
40. Which of the following actions by the
nurse will most likely ensure that the
correct client receives a medication?

a. have the client state his/her name

b. call the client by name
c. learn to recognize the client
d. check the client’s identification armband
41. When instructing clients with allergic
rhinitis about the use of nasal
decongestants, it is important to
emphasize that:
a. the condition will not benefit from environmental changes
b. continuous use of more than 3 days can result in
worsening the symptoms
c. the condition requires treatment only during cold season
d. the condition is self-limited and should not return
42. The nurse is teaching a client with
osteoporosis about taking Fosamax.
The nurse emphasizes that the client is
to take the medication:
a. at bedtime
b. with food
c. with a full glass of water and remain upright for 30
minutes
d. with a full glass of juice and then rest for 30 minutes
43. A client on the burn unit is receiving
Sulfonamide cream (Silvadene) as a topical
treatment for her burns. When reviewing the
daily laboratory results, the nurse notices
that the client’s WBC count has decreased.
The nurse recognizes that:
a. it is normal to have immunosuppression
b. this is normal; an increased WBC would be a concern
c. this is abnormal; the physician needs to be alerted
d. the WBC should be observed over several days to look for
a trend
44. Which of the following medication
could predispose a woman to
candidiasis?

a. Insulin
b. Lisinopril (Zestril)
c. Oral contraceptive pills
d. Phenytoin (Dilantin)
45. The nurse is preparing to administer an IM
injection to a client and chooses the vastus
lateralis muscle for the injection site. Into
which part of the thigh would the nurse
choose to correctly administer the
medication?
a. middle third of the thigh
b. lower third of the thigh
c. upper third of the thigh
d. wherever the thigh is the largest
46. Which of the following factors would be the
most important for the nurse to consider
when determining the angle at which to
insert the needle for a subcutaneous
injection?
a. size of the syringe
b. tissue turgor
c. length of the needle
d. amount of subcutaneous tissue
47. A client with osteoarthritis is learning about
his drug therapy. The nurse should instruct
the client that which of the following drugs is
considered the first line therapy for
osteoarthritis?
a. Corticosteroids
b. NSAIDs
c. Acetaminophen
d. Narcotic analgesics
48. The nurse notes that a placebo has been
ordered for use when a client requests pain
medication. Which of the following
statements is most accurate about the use of
placebos in the client’s plan of care?
a. it is appropriate to substitute placebos when the client
requests frequent doses of pain medication
b. placebos should be used when it is suspected that the
client is addicted to pain medication
c. the use of placebos violates the client’s right to ethical care
d. Placebos may be used whenever the use believes the
client is not really experiencing pain.
49. A client has been diagnosed with chlamydial
infection. Which of the following antibiotics
does the nurse anticipate will most likely be
prescribed?

a. Probenecid (Benemid)
b. Ampicillin (Principen)
c. Doxycycline (Vibramycin)
d. Acyclovir (Zovirax)
50. A client is receiving intravenous heparin for
treatment of DVT. Which of the following
precautions should the nurse incorporate
into the client’s plan of care as a result of
receiving heparin intravenously?
a. establish a separate IV infusion line for administration of
other prescribed drugs
b. check the client’s activated partial prothromboplastin
time (aPTT) values daily to monitor for therapeutic
anticoagulation
c. have Vitamin K injection available as an antidote to
potential heparin overdose
d. protect the heparin infusion from light to prevent
discoloration of the drug
51. The nurse wants to prepare a teaching
plan for a client who is taking
metoclopramide (Reglan). Which of the
following is considered a side effect of the
drug?

a. Constipation
b. urinary retention
c. Hypotension
d. extrapyramidal reactions
52. A client has been diagnosed with chronic
gastritis caused by Helicobacter pylori. The
nurse anticipates that which of the following
drug categories will be most effective in
treating gastritis?
a. Antacids
b. Antiemetics
c. antibiotic combinations
d. histamine2- receptor antagonists
53. A client who has been diagnosed with
cirrhosis asks the nurse if there are any
specific medications that he should avoid.
Which one of the following medications
should the nurse specifically tell the client
not to take?
a. Acetaminophen (Tylenol)
b. Cimetidine (Tagamet)
c. Neomycin sulfate
d. Spironolactone (Aldactone)
54. Which of the following medications would the
nurse expect to administer to a client
experiencing an oculogyric crisis?

a. Chlorpromazine (Thorazine) 50 mg
b. Procyclidine (Kemadrin) 5 mg
c. Thioridazine (Mellaril) 100 mg
d. Benztropine (Congentin) 1 mg
55. Which of the following would the nurse
include when teaching the family and a client
prescribed benzotropine (Congentin) 1 mg
PO twice daily, about the drug therapy?

a. the drug can be used with the OTC cough and cold
preparations
b. the client should not discontinue taking the drug abruptly
c. antacids can be used freely when taking this drug
d. alcohol consumption with benzotropine therapy need not
to be restricted
56. Which of the following would the nurse
include in a teaching plan that addresses the
side effects of antipsychotic medication?

a. information about all potential side effects

b. research data about rare side effects
c. side effects that can be seen or felt
d. percentages associated with each side effect
57. Clozapine (Clorazil) therapy has been initiated
for a client with schizophrenia who has been
unresponsiveness to other antipsychotics. The
client states, “Why do I have to have a blood
test every week?” which of the following
responses by the nurse would be most
appropriate?
a. “Weekly blood tests are necessary to determine safe dosage and
to monitor the effect of the medication of the blood”
b. “Weekly blood tests are done so that you can receive another
week’s supply of the medication.”
c. “Your physician will want to know how well you are progressing
with the medication therapy”
d. “Everyone taking clozapine (Clozaril) has to go through the same
procedure because it is required by the physician”
58. The mother of a 28 y/o who is taking
clozapine (Clozapine) states, “Something is
wrong. My son is drooling like a baby.”
Which of the following responses by the
nurse would be most helpful?
a. “ I wonder if he’s having an adverse reaction to
the medicine”
b. “Excessive saliva is common with this drug; here’s
a paper cup for him to spit up”
c. “ Don’t worry about it; this is only a minor
inconvenience compared to its benefits”
d. “I’ve seen this happen to other client who are
taking Clozapine”
59. A client taking Clozapine states, “ I think I’m
getting the flu. I have a fever and feel weak.”
Which of the following would the nurse do
next?
a. tell the client to wait another day to see if other symptoms
of the flu appear
b. advise the client to take some OTC meds for flu
c. discuss the importance of maintaining an adequate fluid
intake
d. report the client’s symptoms to the physician after taking
the client’s temperature
60. Assessment for which of the following side
effects would be the priority for a client who
is taking risperidone (Risperidal) 1 mg PO
twice daily?

a. Insomnia
b. Headache
c. Anxiety
d. orthostatic hypotension
61. A client taking risperidone (Risperidal) 2 mg
PO twice daily informs the clinic nurse that
she will be getting married in 3 months to
another client she met at the outpatient
clinic. During the client interview, which of
the following would be an area of priority
concern?
a. her fiancé’s medication compliance
b. money management
c. plan of pregnancy
d. living arrangement
62. A client whose symptoms of schizophrenia are
under control with olanzapine (Zyprexia), and
who is functioning at home and in her part time
employment, states that she is very concerned
about her 20 pounds weight gain since she
started taking the medication 6 months ago.
Which of the following is the most appropriate
response by the nurse?
a. suggest that the client talk with her physician about changing to
another psychotic
b. advise the client to decrease her dosage by one half
c. tell the client not to worry because she should stop gaining weight
d. discuss nutrition, daily diet, and exercise with the client
63. A 67 y/o client will be discharge to home with
imipramine (Tofranil). Which of the following
would be most important to include when
instructing the client and spouse about the
medication?
a. eat a high fiber diet
b. wear sunglasses outdoors
c. avoid ingestion of alcohol
d. urinate as soon as the urge is felt
 64. The nurse is teaching a client and family
about the phenelzine (Nardil). Which of the
following foods would the nurse urge the client to
avoid?

a. Eggs
b. Chicken
c. American cheese
d. Sour cream
65. When preparing the drug teaching plan for a
client who is taking phenelzine (Nardil),
which of the following signs and symptoms
would the nurse stress as most important to
report to the physician immediately?
a. urinary hesitancy
b. Palpitations
c. dry mouth
d. blurred vision