Pharmacology for NCLEX-PN

An antibiotic is prescribed to treat the infection at the pin site. 

If the client is allergic to penicillin, the nurse must question a medical prescription for which type of antibiotic?

A spinal tap will be performed to confirm a diagnosis of meningitis.

The nurse prepares to administer an I.V. containing 1 g of ceftriaxone to a client with bacterial meningitis. The drug has been added to 100 mL of lactated Ringer’s solution. At what rate should the nurse set the electronic infusion device to deliver 100 mL in 30 minutes? Record your answer using a whole number. mL

The client is treated with intranasal lypressin, 2 sprays q.i.d. and as needed. 

The nurse is evaluating the client self-administering the medication. What action indicates that the client is using the medication correctly?

A client with hypertension will begin taking furosemide 40 mg orally every day. 

What nursing assessment is the best indication that the furosemide has had a desired effect?

The client reports taking 400 mg of ibuprofen four times a day at home. 

What question is best for the nurse to determine whether the client is experiencing an adverse effect from taking nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen?

Methimazole is prescribed preoperatively to treat the client’s Graves’ disease. 

Before administering this medication, what is essential for the nurse to ask the client?

The client is prescribed acyclovir to treat the herpes lesions.

What statement to the nurse indicates that the client understands the purpose for the drug therapy?

The client who had an open cholecystectomy develops postoperative nausea and vomiting. Metoclopramide 10 mg is prescribed. 

What adverse effect associated with metoclopramide should the nurse report immediately?

To relieve the client’s urinary symptoms, phenazopyridine is prescribed. The nurse prepares information for client discussion. 

When instructing on changes in the urine characteristics when taking the new medication, which instruction is most appropriate?

A 25-year-old woman has repeated vaginal infections. The symptoms suggest that the client has candidiasis caused by the yeast-like microorganism Candida albicans (C. albicans). 

After C. albicans is identified as the causative organism, what type of treatment can the nurse expect will be prescribed?

Lifestyle changes prove insufficient for reducing the client’s cholesterol level. Atorvastatin is prescribed.

After providing medication instructions, the best evidence that the client knows this drug’s potential side effects is when the client states it may cause which adverse effect?

The nurse asks whether the pregnant client is taking the prescribed daily iron supplement. The client states, “I have not been taking the iron routinely because it causes constipation.” 

When providing information about iron supplements, what instruction by the nurse is most appropriate?

The primigravid client tells the nurse, “I plan to have an epidural for pain management,” and asks the nurse, “When can I expect to receive it?” 

An epidural is best performed when the client is how many centimeters dilated?

A client experienced a cerebral vascular accident (CVA) and is in the rehabilitative stage.

The client’s spouse will administer warfarin after the client is discharged. What teaching topics should the nurse include before discharge? Select all that apply.

The health care provider prescribes amoxicillin 125 mg P.O. every 12 hours for 10 days. The office nurse gives the first dose to the infant. 

When preparing to give medications, what action by the nurse best ensures that the prescribed dose of medication is a safe dose for the infant?

The child is placed on bed rest and started on penicillin V and aspirin.

The nurse would expect to withhold penicillin V and notify the health care provider if the child had a previous allergic reaction to a medication from what drug group?

Prednisone, a corticosteroid, is added to the short-term medication regimen.

What statement made by the client indicates to the nurse that further instruction regarding corticosteroid therapy is necessary?

The nurse has been working with a college student who suffers from bulimia, helping the client control the eating disorder.

The client recently diagnosed with bulimia has been taking an antidepressant for several weeks. Which client statement is evidence to the nurse that the priority therapeutic goal of medication use has occurred?

Methotrexate is prescribed for a client with severe rheumatoid arthritis. 

What client teaching is essential when beginning methotrexate therapy?

After a tonic-clonic (grand mal) seizure, the client progresses to the postictal phase.

Before discharge, when the nurse provides drug teaching about self-administering phenytoin sodium, what hygiene measure should the nurse emphasize?

The client with bilateral cataracts is scheduled to have a cataract removed from the right eye.

One hour before surgery, the nurse instills ophthalmic drops in the client’s eyes. Place the nurse’s actions in the correct sequence. Use all the options.

The client with bilateral cataracts is scheduled to have a cataract removed from the right eye.

The nurse is instructing a client’s spouse on instilling eyedrops postoperatively. Into which location would the nurse reinforce correct eyedrop placement?

The client with myxedema is treated with levothyroxine, one tablet P.O. every day. 

What statement provides the best evidence to the nurse that the client understands the prescribed drug therapy?

A client with hypertension will begin taking furosemide 40 mg orally every day.

What time of day should the nurse advise the client to take the prescribed furosemide?

Heparin sodium 7,500 units subcutaneously daily is prescribed.

What laboratory value would the nurse review before giving the heparin sodium injection?

A 23-year-old client experiences the following symptoms every fall: swollen nasal passages, endless sneezing, and red, watery, itchy eyes. The client makes an appointment with an allergist.

When the health care provider prescribes the first-generation antihistamine diphenhydramine for the client’s symptomatic relief, what side effect is most emphasized?

The registered nurse (RN) starts an infusion of whole blood and asks the licensed practical/vocational nurse (LPN/LVN) to continue monitoring the client during the blood transfusion.

As the licensed practical/vocational nurse is monitoring the client receiving a blood transfusion, what assessment finding is the best indication of a transfusion reaction?

Magnetic resonance imaging (MRI) reveals a large amount of fluid in the peritoneal cavity of the client with cirrhosis. A paracentesis is planned.

The health care provider prescribes spironolactone for a client with cirrhosis of the liver. What effect can the nurse expect after administering this medication?

To relieve the client’s urinary symptoms, phenazopyridine is prescribed. The nurse prepares information for client discussion.

What change in urine elimination provides the best nursing evidence that the phenazopyridine is achieving its intended therapeutic effect?

The client experiences almost total hair loss as antineoplastic drug therapy progresses.

What statement is most accurate when the nurse discusses hair loss with the client?

The nurse asks whether the pregnant client is taking the prescribed daily iron supplement. The client states, “I have not been taking the iron routinely because it causes constipation.”

To best enhance absorption of the iron supplement, what food(s) should the nurse recommend the client to consume more of in the diet? Select all that apply.

The nurse is caring for a client in preterm labor. The health care provider writes a prescription for terbutaline sulfate. 

The nurse should carefully monitor the client for what adverse reactions to terbutaline sulfate? Select all that apply.

The health care provider prescribes amoxicillin 125 mg P.O. every 12 hours for 10 days. The office nurse gives the first dose to the infant.

When explaining the prescribed antibiotic treatment to the parents, what instruction should the nurse emphasize?

The parents ask why the child is receiving aspirin instead of acetaminophen and are worried about their child getting Reye syndrome. 

What response by the nurse best explains why aspirin is preferred to acetaminophen in the treatment of rheumatic fever?

The child with attention deficit hyperactivity disorder will be treated with methylphenidate hydrochloride.

The nurse is correct in explaining to the parents that methylphenidate hydrochloride is classified as what type of drug?

A 30-year-old with a history of substance use disorder is admitted to the chemical dependency unit at a local hospital. 

If the client snorts cocaine on a regular basis, what physical assessment finding(s) will the nurse likely detect? Select all that apply.

Methotrexate is prescribed for a client with severe rheumatoid arthritis.

The nurse anticipates that the health care provider will suspend methotrexate therapy if what action occurs?

The nurse evaluates the medication profile because of the increased risk for falls. 

What classifications of drugs are most likely to result in falls? Select all that apply.

The client with chronic open-angle glaucoma is to administer timolol maleate ophthalmic eyedrops daily in each eye.

What medication should the nurse question if it is prescribed for a client with glaucoma?

The results of the diagnostic tests confirm that the client has myxedema.

What adverse effects of levothyroxine should the nurse monitor to detect? Select all that apply.

Heparin sodium 7,500 units subcutaneously daily is prescribed.

When the nurse withdraws the heparin sodium from the multidose vial, what technique is correct?

The client is given a prescription for codeine-guaifenesin 10-100 for cough. 

When the client asks why the health care provider prescribed this particular cough medicine, the nurse correctly responds that this medication is a combination medication with one medication liquefying mucus and the other doing which action?

The client asks the nurse why an antibiotic has been prescribed. 

What nursing explanation regarding the use of antibiotics for peptic ulcer therapy is most accurate?

A combination urinary anti-infective medication, trimethoprim/sulfamethoxazole, is prescribed twice a day for the client who is diagnosed with pyelonephritis.

What nursing instruction is most appropriate for preventing crystal formation in this client’s urine?

Because of her persistent symptoms, the client chooses to undergo surgery to correct the cystocele. She is instructed to catheterize herself for approximately 1 week after being discharged.

A postmenopausal woman receives a prescription for alendronate. What health teaching information should the nurse provide? Select all that apply.

The nurse asks whether the pregnant client is taking the prescribed daily iron supplement. The client states, “I have not been taking the iron routinely because it causes constipation.”

What information should the nurse also include about the side effects of iron tablet supplementation?

The nurse is caring for a client in preterm labor. The health care provider writes a prescription for terbutaline sulfate.

When is it necessary for the nurse to withhold the terbutaline sulfate and notify the health care provider?

A 9-year-old child is admitted to the hospital with a tentative diagnosis of type 1 (insulin-dependent) diabetes mellitus. The parents state that the child has been feeling sick for several days. The health care provider states that the child has signs and symptoms of diabetic ketoacidosis.

The health care provider prescribes I.V. insulin, and the registered nurse (RN) prepares to give it. The licensed practical/vocational nurse (LPN/LVN) is assisting the RN with the unstable client. What type of insulin should the LPN/LVN anticipate that the health care provider will prescribe?

The child with attention deficit hyperactivity disorder will be treated with methylphenidate hydrochloride.

Which statement by the parents helps provide the nurse with evidence that methylphenidate hydrochloride is achieving its desired effect on the child’s behavior?

A 30-year-old with a history of substance use disorder is admitted to the chemical dependency unit at a local hospital.

The client’s drug screen is positive for cocaine. What assessment is most appropriate for the nurse to add to the client’s plan of care?