Create Quiz on Pharmacology

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Sample questions from Create Quiz on Pharmacology

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.In a pediatric clinic, a parent reports giving an oral medication to an infant immediately after each feeding because the infant often spits up. The prescription specifies administration on an empty stomach. Which instruction should the nurse give?

   • A.Give the medication with a small amount of food to reduce gastric irritation.
   • B.Give the medication at the prescribed interval before or after feeding, as directed, and do not repeat a dose unless instructed.
   • C.Double the next dose if the infant spits up after taking the medication.
   • D.Repeat the full dose whenever the infant spits up within 30 minutes.

   Rationale: The prescribed food instructions should be followed because food can delay or reduce absorption of some medications. Repeating a dose after spitting up is unsafe because the amount absorbed is unknown; doubling a later dose also increases toxicity risk. Giving the medication with food contradicts the prescription. The exam takeaway is to avoid redosing an uncertain amount without guidance and to preserve the intended relationship between medication and meals.

2. 2.A client's vancomycin is prescribed every 12 hours, with a trough level drawn before the fourth dose. The dose is due at 0900. Which action best supports an interpretable trough result?

   • A.Draw the level at 0700, then administer the dose at 0900.
   • B.Administer the dose at 0900 and draw the level at 1100.
   • C.Draw the level at 0300, halfway between the scheduled doses.
   • D.Draw the level at 0900 immediately before administering the dose.

   Rationale: A trough is the lowest concentration, so it is collected immediately before the next dose; drawing it at 0900 before administration matches the order. A 0700 sample is early and may not represent the true trough, while a sample after dosing reflects a rising concentration. A midpoint sample is not a trough. The key is to coordinate specimen timing with the medication schedule and avoid delaying a prescribed dose unless directed.

3. 3.Refer to the client's chart. Which actions should the nurse take in response to the current findings? Select all that apply.

   • A.Hold the scheduled digoxin dose and contact the prescribing clinician.
   • B.Administer a potassium supplement without an order to counteract the digoxin effect.
   • C.Place the client on cardiac monitoring while the change in status is evaluated.
   • D.Give the scheduled dose because the apical pulse is above 60/min.
   • E.Assess for additional manifestations such as nausea, visual changes, and confusion.

   Rationale: The chart shows a new irregular pulse, nausea, potassium of 3.0 mEq/L, and a digoxin level of 2.4 ng/mL, all concerning for digoxin toxicity; the dose should be held and the prescriber notified. Cardiac monitoring is appropriate because the client has an irregular rhythm and elevated drug level, and further assessment for toxicity manifestations is warranted. A pulse above 60/min does not make the dose safe in the presence of these findings. Potassium replacement may be needed, but it requires a prescription and assessment of the client's clinical status.

4. 4.A client with chronic kidney disease is prescribed a medication that is primarily excreted unchanged by the kidneys. The client's estimated glomerular filtration rate has fallen substantially since the last visit. Which pharmacokinetic change is most likely if the dose is not adjusted?

   • A.Reduced clearance, increasing the risk of drug accumulation and toxicity.
   • B.Increased first-pass metabolism, lowering the active drug concentration.
   • C.Reduced absorption, causing the medication to become ineffective.
   • D.Increased clearance, shortening the medication's half-life.

   Answer and rationale are in the full material.

5. 5.At change of shift, the nurse receives report on four clients. Which client should the nurse assess first before administering a scheduled medication?

   • A.A client taking warfarin whose INR is 2.6 and who has no bleeding.
   • B.A client taking levothyroxine who asks whether breakfast can be eaten 20 minutes after the dose.
   • C.A client taking metoprolol whose apical pulse is 52/min and who reports new dizziness.
   • D.A client taking an oral antibiotic who reports one loose stool after the first dose.

   Answer and rationale are in the full material.