Results for Lesson 6: Pharmacological and Parenteral Therapies

Questions are numbered by the order in which they appeared in the test.
Represents the correct answer.
Question 1
A parent asks the school nurse how to eliminate lice from Answers Correct D
their child. What is the most appropriate response by the Student's D
nurse?
A) Cut the child's hair short to remove the nits
B) Apply warm soaks to the head twice daily
Wash the child's linen and clothing in a bleach
C)
solution
D) Application of pediculicides
Review Information: The correct answer is D: Application of pediculicides
Treatment of head lice consists of application of pediculicides. Pediculicides vary, and
the directions must be followed carefully.

Wong, D.L., Perry, S.E., & Hockenberry, M.J. (2002). Maternal Child Nursing. (2nd
edition). Mosby: St. Louis, Missouri.

Potts, N.L. and Mandleco, B.L. (2002). Pediatric nursing, caring for children and their
families. USA: Thompson, Delmar, Learning.

Question 2
The nurse receives an order to give a client iron by deep Answers Correct D
injection. The nurse know that the reason for this route is Student's D
to
A) enhance absorption of the medication
B) ensure that the entire dose of medication is given
C) provide more even distribution of the drug
D) prevent the drug from causing tissue irritation
Review Information: The correct answer is D: prevent the drug from causing tissue
irritation
Deep injection or Z-track is a special method of giving medications via the
intramuscular route. Use of this technique prevents irritating or staining medications
from being tracked through tissue. Use of Z-track does not affect dose, absorption, or
distribution of the drug.
Altman, G. (2004). Delmar’s Fundamental and Advanced Nursing Skills, 2nd ed.
Albany, NY: Delmar.

Potter P. and Perry, A. (2005). Fundamental of Nursing. (6th Edition). St. Louis,
Missouri: Mosby.

Question 3
A nurse is providing care to a 63 year-old client with Answers Correct C
pneumonia. Which intervention promotes the client’s Student's C
comfort?
A) Increase oral fluid intake
B) Encourage visits from family and friends
C) Keep conversations short
D) Monitor vital signs frequently
Review Information: The correct answer is C: Keep conversations short
Keeping conversations short will promote the client’s comfort by decreasing demands
on the client’s breathing and energy. Increased intake is not related to comfort. While
the presence of family is supportive, demands on the client to interact with the visitors
may interfere with the client’s rest. Monitoring vital signs is an important assessment
but not related to promoting the client’s comfort.

Daniels, R. (2003). Delmar’s manual of laboratory and diagnostic tests. USA:

Thompson Delmar Learning.

Altman, G. (2004). Delmar’s Fundamental and Advanced Nursing Skills, 2nd ed.
Albany, NY: Delmar.

Question 4
While providing home care to a client with congestive Answers Correct C
heart failure, the nurse is asked how long diuretics must be Student's C
taken. What is the nurse’s best response?
"As you urinate more, you will need less medication
A)
to control fluid."
"You will have to take this medication for about a
B)
year."
"The medication must be continued so the fluid
C)
problem is controlled."
"Please talk to your health care provider about
D)
medications and treatments."
Review Information: The correct answer is C: "The medication must be continued so
the fluid problem is controlled."
This is the most therapeutic response and gives the client accurate information.

Smeltzer, S.C. and Bare, B.G. (2004). Medical surgical nursing. (10th edition).
Philadelphia, PA. Lippincott Williams & Wilkins.

Key, J.L. and Hayes, E.R. (2003). Pharmacology, a nursing process approach. (4th
edition). Philadelphia: Saunders.

Question 5
An antibiotic IM injection for a 2 year-old child is ordered. Answers Correct A
The total volume of the injection equals 2.0 ml. The correct Student's A
action is to
A) administer the medication in 2 separate injections
B) give the medication in the dorsal gluteal site
C) call to get a smaller volume ordered
check with pharmacy for a liquid form of the
D)
medication
Review Information: The correct answer is A: administer the medication in 2
separate injections
Intramuscular injections should not exceed a volume of 1 ml for small children.
Medication doses exceeding this volume should be split into 2 separate injections of
1.0 ml each. In adults the maximum intramuscular injection volume is 5 ml per site

Altman, G. (2004). Delmar’s Fundamental and Advanced Nursing Skills, 2nd ed.
Albany, NY: Delmar.

Potter P. and Perry, A. (2005). Fundamental of Nursing. (6th Edition). St. Louis,
Missouri: Mosby.

Question 6
A client is receiving intravenous heparin therapy. What Answers Correct A
medication should the nurse have available in the event of Student's A
an overdose of heparin?
A) Protamine
B) Amicar
C) Imferon
D) Diltiazem
Review Information: The correct answer is A: Protamine
Protamine binds heparin, making it ineffective.

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper
Saddle River, New Jersey: Pearson Prentice Hall.
Question 7
The nurse has given discharge instructions to parents of a Answers Correct B
child on phenytoin (Dilantin). Which of the following Student's B
statements suggests that the teaching was effective?
"We will call the health care provider if the child
A)
develops acne."
"Our child should brush and floss carefully after
B)
every meal."
"We will skip the next dose if vomiting or fever
C)
occur."
"When our child is seizure-free for 6 months, we can
D)
stop the medication."
Review Information: The correct answer is B: "Our child should brush and floss
carefully after every meal."
Phenytoin causes lymphoid hyperplasia that is most noticeable in the gums. Frequent
gum massage and careful attention to good oral hygiene may reduce the gingival
hyperplasia.

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Wong, D.L., Perry, S.E., & Hockenberry, M.J. (2002). Maternal Child Nursing. (2nd
edition). Mosby: St. Louis, Missouri.

Question 8
Although nonsteroidal anti-inflammatory drugs (NSAIDs) Answers Correct D
such as ibuprofen (Motrin) are beneficial in managing Student's D
arthritis pain, the nurse should caution clients about which
of the following common side effects?
A) Urinary incontinence
B) Constipation
C) Nystagmus
D) Occult bleeding
Review Information: The correct answer is D: Occult bleeding
Nonsteroidal anti-inflammatory drugs (NSAIDs) taken for long periods of time may
cause serious side effects, including bleeding in the gastrointestinal track.

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Smeltzer, S.C. and Bare, B.G. (2004). Medical surgical nursing. (10th edition).
Philadelphia, PA. Lippincott Williams & Wilkins.

Question 9
A client with heart failure has Lanoxin (digoxin) ordered. Answers Correct C
What would the nurse expect to find when evaluating for Student's C
the therapeutic effectiveness of this drug?
A) Diaphoresis with decreased urinary output
B) Increased heart rate with increased respirations
Improved respiratory status and increased urinary
C)
output
D) Decreased chest pain and decreased blood pressure
Review Information: The correct answer is C: Improved respiratory status and
increased urinary output
Digoxin, a cardiac glycoside, is used in clients with heart failure to slow and
strengthen the heartbeat. As cardiac output is improved, renal perfusion is improved
and urinary output increases. Clients can become toxic on this drug, indicated by
findings of bradycardia, dysrhythmia, and visual and GI disturbances. Clients being
treated with digoxin should have their apical pulse evaluated for 1 full minute prior to
the administration of the drug.

Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper
Saddle River, New Jersey: Pearson Prentice Hall.

White, L., and Duncan, G,. (2002). Medical-Surgical Nursing An Integrated Approach
(2nd ed.). Australia: Delmar.

Question 10
Why is it important for the nurse to monitor blood pressure Answers Correct A
in clients receiving antipsychotic drugs? Student's A
A) Orthostatic hypotension is a common side effect
Most antipsychotic drugs cause elevated blood
B)
pressure
This provides information on the amount of sodium
C)
allowed in the diet
It will indicate the need to institute antiparkinsonian
D)
drugs
Review Information: The correct answer is A: Orthostatic hypotension is a common
side effect
Clients should be made aware of the possibility of dizziness and syncope from
postural hypotension for about an hour after receiving medication. They should be
advised to get up slowly, especially from a supine position.

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Smeltzer, S.C. and Bare, B.G. (2004). Medical surgical nursing. (10th edition).
Philadelphia, PA. Lippincott Williams & Wilkins.

Question 11
The nurse is teaching a client about precautions with Answers Correct A
Coumadin therapy. The client should be instructed to avoid Student's A
which over-the-counter medication?
A) Non-steroidal anti-inflammatory drugs (NSAIDs)
B) Cough medicines with guaifenesin
C) Histamine blockers
D) Laxatives containing magnesium salts
Review Information: The correct answer is A: Non-steroidal anti-inflammatory drugs
(NSAIDs)
Medications with NSAIDs may increase the response to Coumadin (warfarin) and
increase the risk of bleeding.

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper
Saddle River, New Jersey: Pearson Prentice Hall.

Question 12
The nurse is caring for a client with clinical depression Answers Correct A
who is receiving a monoamine oxidase inhibitor (MAOI). Student's A
When providing instructions about precautions with this
medication, which action should the nurse stress to the
client as important?
A) Avoid chocolate and cheese
B) Take frequent naps
C) Take the medication with milk
D) Avoid walking without assistance
Review Information: The correct answer is A: Avoid chocolate and cheese
Foods high in tryptophan, tyramine and caffeine, such as chocolate, wine and cheese
may precipitate hypertensive crisis.

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper
Saddle River, New Jersey: Pearson Prentice Hall.

Question 13
A client is being discharged with a prescription for Answers Correct B
chlorpromazine (Thorazine). Before leaving for home, Student's B
which of these findings should the nurse teach the client to
report?
A) Change in libido, breast enlargement
B) Sore throat, fever
C) Abdominal pain, nausea, diarrhea
D) Dyspnea, nasal congestion
Review Information: The correct answer is B: Sore throat, fever
A sore throat and fever may be findings of agranulocytosis, a serious side effect of
chlorpromazine (Thorazine).

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper
Saddle River, New Jersey: Pearson Prentice Hall.

Question 14
A client diagnosed with cirrhosis of the liver and ascites is Answers Correct B
receiving spironolactone (Aldactone). The nurse Student's B
understands that this medication spares elimination of
which element?
A) Sodium
B) Potassium
C) Phosphate
D) Albumin
Review Information: The correct answer is B: Potassium
If ascites is present in the client with cirrhosis of the liver, potassium-sparing diuretics
such as Aldactone should be administered because it inhibits the action of aldosterone
on the kidneys.

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper
Saddle River, New Jersey: Pearson Prentice Hall.

Question 15
The nurse has been teaching a client with Insulin Answers Correct D
Dependent Diabetes Mellitus. Which statement by the Student's D
client indicates a need for further teaching?
"I use a sliding scale to adjust regular insulin to my
A)
sugar level."
"Since my eyesight is so bad, I ask the nurse to fill
B)
several syringes."
C) "I keep my regular insulin bottle in the refrigerator."
"I always make sure to shake the NPH bottle hard to
D)
mix it well."
Review Information: The correct answer is D: "I always make sure to shake the NPH
bottle hard to mix it well."
The bottle should by rolled gently, not shaken.

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper
Saddle River, New Jersey: Pearson Prentice Hall.

Question 16
The nurse is caring for a client receiving a blood Answers Correct A
transfusion who develops urticaria one-half hour after the Student's A
transfusion has begun. What is the first action the nurse
should take?
A) Stop the infusion
B) Slow the rate of infusion
C) Take vital signs and observe for further deterioration
D) Administer Benadryl and continue the infusion
Review Information: The correct answer is A: Stop the infusion
This is an indication of an allergy to the plasma protein. The priority action of the
nurse is to stop the transfusion.

Smeltzer, S.C. and Bare, B.G. (2004). Medical surgical nursing. (10th edition).
Philadelphia, PA. Lippincott Williams & Wilkins.

Delaune, S & Lander, P. (2002). Fundamentals in Nursing: Standards and Practice.

(2nd ed). Clinton Park, New York: Delmar.

Question 17
A client is recovering from a hip replacement and is taking Answers Correct D
Tylenol #3 every 3 hours for pain. In checking the client, Student's B
which finding suggests a side effect of the analgesic?
A) Bruising at the operative site
B) Elevated heart rate
C) Decreased platelet count
D) No bowel movement for 3 days
Review Information: The correct answer is D: No bowel movement for 3 days
With opioid analgesics, observe for respiratory depression, sedation, and constipation.
Bruising is not related to the analgesic, but could be the result of corticosteroids or
previously used anticoagulants. Elevated heart rate could be the result of
bronchodilators. Some antibiotics can lower platelet count.

Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper
Saddle River, New Jersey: Pearson Prentice Hall.

Key, J.L. and Hayes, E.R. (2003). Pharmacology, a nursing process approach. (4th
edition). Philadelphia: Saunders.

Question 18
A client with amyotrophic lateral sclerosis has a Answers Correct D
percutaneous endoscopic gastrostomy (PEG) tube for the Student's D
administration of feedings and medications. Which nursing
action is appropriate?
A) Pulverize all medications to a powdery condition
Squeeze the tube before using it to break up stagnant
B)
liquids
Cleanse the skin around the tube daily with hydrogen
C)
peroxide
Flush adequately with water before and after using
D)
the tube
Review Information: The correct answer is D: Flush adequately with water before
and after using the tube
Flushing the tube before and after use not only provides for good flow and keeps the
tube patent, it also provides water to maintain hydration. While medications should be
crushed to pass through the tube, it is flushing that moves them through. Not all
medications should be crushed, for example sustained release preparations should not
be cut or pulverized. Stagnant liquids are reduced by flushing after tube use. Cleansing
is important, but soap and water are sufficient without the added irritation of hydrogen
peroxide.

Smeltzer, S.C. and Bare, B.G. (2004). Medical surgical nursing. (10th edition).
Philadelphia, PA. Lippincott Williams & Wilkins.

Altman, G. (2004). Delmar’s Fundamental and Advanced Nursing Skills, 2nd ed.
Albany, NY: Delmar.
Question 19
A client has received 2 units of whole blood today Answers Correct B
following an episode of GI bleeding. Which of the Student's B
following laboratory reports would the nurse monitor most
closely?
A) Bleeding time
B) Hemoglobin and hematocrit
C) White blood cells
D) Platelets
Review Information: The correct answer is B: Hemoglobin and hematocrit
The post-transfusion hematocrit provides immediate information about red cell
replacement and about continued blood loss.

Smeltzer, S.C. and Bare, B.G. (2004). Medical surgical nursing. (10th edition).
Philadelphia, PA. Lippincott Williams & Wilkins.

Delaune, S & Lander, P. (2002). Fundamentals in Nursing: Standards and Practice.

(2nd ed). Clinton Park, New York: Delmar.

Question 20
Discharge instructions for a client taking alprazolam Answers Correct B
(Xanax) should include which of the following? Student's B
A) Sedative hypnotics are effective analgesics
Sudden cessation of alprazolam (Xanax) can cause
B)
rebound insomnia and nightmares
Caffeine beverages can increase the effect of sedative
C)
hypnotics
Avoidance of excessive exercise and high
D)
temperature is recommended
Review Information: The correct answer is B: Sudden cessation of alprazolam
(Xanax) can cause rebound insomnia and nightmares
Sudden cessation of any medication, unless medically necessary, is ill-advised.

Deglin, J.D. and Vallerand, A.H. (2001). Davis’ drug guide for nurses. (7th edition).
Philadelphia: F.A. Davis Company.

Wilson, B.A., Shannon, M.T., and Stang, C.L. (2004). Nurse’s drug guide. Upper
Saddle River, New Jersey: Pearson Prentice Hall.