Nightingale Pharmacology II

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Sample questions from Nightingale Pharmacology II

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

1. 1.A nurse is preparing to administer an oral medication to a client who has difficulty swallowing. Which action best supports safe administration?

   • A.Crush the medication and mix it with applesauce without checking the label
   • B.Check whether the medication is extended-release or enteric-coated before altering it
   • C.Give the medication with a full glass of milk to prevent irritation
   • D.Dissolve the medication in hot water to speed absorption

   Rationale: Extended-release and enteric-coated products may be unsafe or ineffective if crushed, so verify the formulation before altering any medication. Crushing without checking can cause dose dumping or damage the protective coating. Hot water and milk are not universally appropriate because they may affect stability or absorption. The exam takeaway is to consult the product instructions or pharmacist when a client cannot swallow a dosage form.

2. 2.A nurse reviews a medication list for an older adult with reduced kidney function. Which factors can increase the risk of medication accumulation or toxicity? Select all that apply.

   • A.Taking two products that contain the same active ingredient
   • B.A lower glomerular filtration rate than expected for age
   • C.Taking a medication exactly as prescribed
   • D.Reduced renal clearance of a renally eliminated drug
   • E.A longer half-life caused by impaired elimination

   Rationale: Reduced renal clearance can slow drug elimination, and a lower glomerular filtration rate can signal the need for dose adjustment. A longer half-life from impaired elimination can allow drug levels to accumulate. Taking a medication exactly as prescribed does not by itself cause accumulation, although the prescribed dose may still require adjustment. Duplicate active ingredients can cause overdose, but they do not specifically describe accumulation from impaired renal elimination.

3. 3.A nurse is teaching a client about a newly prescribed medication with a short half-life that must be taken several times daily. Which statement best explains the schedule?

   • A.The medication is absorbed only when taken at bedtime
   • B.The schedule prevents the medication from being metabolized
   • C.Frequent doses keep the drug concentration within its therapeutic range
   • D.Short half-life means the drug cannot cause adverse effects

   Rationale: A short half-life means the drug concentration falls relatively quickly, so repeated doses may be needed to maintain therapeutic levels. The timing is not necessarily related to bedtime or absorption. Short half-life does not eliminate the possibility of adverse effects. Dosing frequency does not prevent metabolism; it compensates for ongoing elimination.

4. 4.A nurse prepares to administer a medication through a feeding tube. Which action is safest?

   • A.Mix all scheduled medications together to reduce the number of flushes
   • B.Stop the feeding for 24 hours after administering the medication
   • C.Crush every tablet finely and add it directly to the feeding formula
   • D.Verify that the medication can be given through the tube and administer each medication separately

   Answer and rationale are in the full material.

5. 5.A nurse is administering a medication with a narrow therapeutic index. Which approach best promotes safe dosing?

   • A.Monitor relevant drug levels and assess for toxicity as prescribed
   • B.Double the dose if the client reports no immediate effect
   • C.Use clinical response alone and omit laboratory monitoring
   • D.Give doses at irregular times to avoid tolerance

   Answer and rationale are in the full material.