Karchs Focus on Nursing Pharmacology Study Guide

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Sample questions from Karchs Focus on Nursing Pharmacology Study Guide

This material has 24 questions with answers and rationales. Here are the first 5.

1. 1.A client received IV morphine 20 minutes ago. The client is difficult to arouse, respirations are 7/min and shallow, and oxygen saturation is 95% on supplemental oxygen. Which action is the priority?

   • A.Support ventilation, activate emergency assistance, and administer naloxone according to protocol.
   • B.Give the next prescribed analgesic to prevent pain recurrence.
   • C.Remove the oxygen to obtain a more accurate saturation.
   • D.Document adequate oxygenation and reassess in one hour.

   Rationale: B addresses opioid-associated respiratory depression and the immediate need for ventilation. A delays treatment and incorrectly relies on oxygen saturation. C can worsen respiratory failure. D removes support without correcting hypoventilation.

2. 2.A prescription reads amoxicillin 40 mg/kg/day orally in two equal doses. A child weighs 22 kg. The suspension contains 400 mg/5 mL. How many mL should the nurse administer per dose?

   • A.11 mL
   • B.5.5 mL
   • C.22 mL
   • D.2.75 mL

   Rationale: B is correct: 40 mg x 22 kg = 880 mg/day; divided into two doses gives 440 mg/dose. At 400 mg/5 mL, 440 mg requires 5.5 mL. A gives half the dose. C gives the entire daily amount at once. D gives twice the total daily amount per dose.

3. 3.Which statement by a client taking warfarin indicates correct understanding?

   • A.I should stop eating all vegetables containing vitamin K.
   • B.I can use ibuprofen freely because it does not change my INR.
   • C.I can double tomorrow's dose if I forget today's dose.
   • D.I should keep my vitamin K intake reasonably consistent.

   Rationale: C promotes stable anticoagulation. A creates unnecessary restriction and potentially unstable intake. B is unsafe because NSAIDs increase bleeding risk even without changing INR. D risks excessive anticoagulation; missed doses require drug-specific instructions.

4. 4.A client taking digoxin and furosemide reports nausea and unusual yellow-tinted vision. The apical pulse is 46/min and potassium is 2.8 mEq/L. What should the nurse do first?

   • A.Encourage potassium-rich food and give all scheduled medications.
   • B.Recheck the symptoms at the next routine visit.
   • C.Withhold digoxin and promptly assess rhythm and notify the prescriber.
   • D.Administer digoxin with food.

   Answer and rationale are in the full material.

5. 5.Which instruction is most appropriate for a client prescribed an inhaled corticosteroid?

   • A.Rinse your mouth and spit after each dose.
   • B.Use it as the only immediate treatment for sudden severe bronchospasm.
   • C.Stop it whenever symptoms are absent for one day.
   • D.Use a spacer with every dry-powder inhaler.

   Answer and rationale are in the full material.