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Test Bank For Pharmacology Clear and Simple A Guide to Drug Classifications and Dosage Calculations 4th Edition Watkins
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Test Bank For Pharmacology Clear and Simple A Guide to Drug Classifications and Dosage Calculations 4th Edition Watkins

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Test Bank For Pharmacology Clear and Simple A Guideto
Drug Classifications and Dosage Calculations 4th Edition By
Cynthia J. Watkins




TEST BANK

,Chapter 1. History of Pharmacology

Multiple Choice
Identify the choice that best completes the statement or answers the question.

1. While caring for a client who is taking furosemide (Lasix), the nurse recognizes dietary teaching has
been effective if the patient includes which of the following foods in his daily menus?
A. Broccoli and kiwi
B. Oranges and sweet potatoes
C. Kale and cucumbers
D. Bananas and melon

2. A client newly diagnosed with diabetes tells the nurse, ―I can’t take any insulin made from pigs or
cows.‖ Which of the following responses by the nurse is best?
A. ―Most insulin comes from animal sources, but I’m sure alternative options are
available.‖
B. ―Medications that are derived from animals are typically less expensive than
synthetic medications, but synthetic insulin is commonly available.‖
C. ―Most insulin is synthetic now to help reduce the risk of disease transmission.‖
D. ―The animals aren’t hurt in the production of medications, so you don’t need to
worry.‖
3. While providing medications to clients on the cardiac unit, the nurse anticipates that hydralazine
hydrochloride and isosorbide dinitrate (BiDil) would most likely be prescribed for which of the
following clients?
A. A 48-year-old Caucasian male diagnosed with atrial fibrillation
B. A 55-year-old African American female diagnosed with hypertension
C. A 63-year-old Caucasian female diagnosed with sick sinus syndrome
D. A 64-year-old African American male diagnosed with heart failure

4. While caring for a patient scheduled for knee replacement surgery, the nurse provides cefazolin
(Ancef) as ordered 30 minutes pre-operatively. The nurse knows that teaching has been effective by
which of the following client statements?
A. ―The antibiotic is given as a prophylactic to help reduce the risk of infection after
surgery.‖
B. ―This is a palliative medication to help ease the pain from surgery.‖
C. ―This medication will replace vitamins and minerals that may be lost due to
bleeding during surgery.‖
D. ―This medication will help the surgeon identify areas of bone destruction due to
arthritis.‖
5. While caring for a patient with a history of hypothyroidism, the nurse expects which of the following
medications to be included in the patient’s medication list?
A. Levothyroxine sodium (Synthroid)
B. Estrogen (Estradiol)
C. Iodine 131
D. Carbimazole (Methimazole)

, 6. The nurse is receiving a shift-to-shift report on a medical unit and is informed that a 55-year-old
patient with a history of vomiting is scheduled for a diagnostic radiograph of the upper
gastrointestinal tract. Which of the following statements would the nurse include in the client’s
teaching?
A. ―You will need to drink a large amount of prep to clear out your system before the
test.‖
B. ―It is important that you be given a prophylactic medication to prevent aspiration
during the test.‖
C. ―You will be asked to drink a barium contrast about 30 minutes before the test to
help highlight any digestive problems.‖
D. ―You will be given a sedative to help make you sleepy during the testing
procedure.‖
7. A student nurse is providing care for a 29-year-old patient with advanced cervical cancer who was
recently admitted with metastatic disease. While reviewing the patient’s medication list, the student
would categorize which of the following medications as palliative in nature?
A. Cisplatin (Platinol) 50 mg IV weekly to start day 8
B. Sorafenib (Nexavar) 200 mg orally twice daily for 7 days
C. Ondansetron (Zofran) 4 mg IV prior to chemotherapy
D. Morphine sulfate (Roxanol) 5 mg po every 4 hours as needed for pain

8. A woman experiencing menopausal symptoms asks the nurse about conjugated estrogen (Premarin).
Which of the following statements by the individual indicates an understanding of the medication’s
origin?
A. ―I’m against animal cruelty, so I don’t want to take anything made from animal
flesh.‖
B. ―I was told the medication is actually derived from the urine of pregnant horses.‖
C. ―Because I’m Jewish, I can’t take the medication since it comes from pigs.‖
D. ―I think harvesting medicines from cows seems rather odd.‖

9. The nurse working in a diagnostic center is responsible for verifying client allergies prior to testing.
A 47-year-old woman reports being allergic to iodine, and thus is unable to have which test?
A. Computerized axial tomography (CAT) scan
B. Magnetic resonance imaging (MRI)
C. Colonoscopy
D. Thyroid scan


Multiple Response
Identify one or more choices that best complete the statement or answer the question.

1. While working with patients in home care, a nurse becomes interested in additional ways to support
patient healing and comfort. Which of the following is recognized as an alternative therapy? (Select
all that apply.)
A. Acupuncture
B. Aromatherapy
C. Therapeutic touch
D. Stem cell treatment
E. Vegetarianism
F. Acupressure

,Chapter 1. History of Pharmacology
Answer Section

MULTIPLE CHOICE

1. ANS: B PTS: 1 DIF: Moderate TOP: Therapeutic Classification: Diuretic
KEY: Application MSC: NCLEX Category: Basic Care and Comfort
NOT: See Minerals (p. 7): Diuretic drugs such as furosemide (Lasix) cause the body to lose excess water
through the kidneys, and potassium, a vital mineral is also excreted with the water. Potassium is contained in
sweet potatoes, bananas, and oranges.
2. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Anti-diabetic medication KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Synthetic Medications (p. 8): Insulin can be obtained from pigs or cows, but a synthetic source is
most commonly used. This change occurred because of concern over the possible transmission of diseases
from animals to humans. Synthetic medications are usually more inexpensive because they are mass
produced.
3. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Combination drug (diuretic/nitrate)
KEY: Analysis MSC: NCLEX Category: Pharmacologic and Parenteral Therapy
NOT: See Synthetic medications (p. 8). BiDil is a combination of two generic drugs and is used to treat
African American patients with heart failure.
4. ANS: A PTS: 1 DIF: Easy
TOP: Therapeutic Classification: Antibiotics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Categorizing Medications (p. 8): Prophylactic medications are given to prevent problems such as
antibiotics given before surgery to prevent infection. Example of cefazolin is listed in Table 1.2.
5. ANS: A
Difficulty Level: Easy

PTS: 1 DIF: Easy TOP: Therapeutic Classification: Replacement hormones
KEY: Knowledge MSC: NCLEX Category: Pharmacological Therapies
NOT: See Categorizing Medications (p. 9): Replacement drugs are given to replace missing substances.
Levothyroxine sodium (Synthroid) is a drug that replaces missing thyroid hormone. Estrogen may be given to
women once they enter menopause. Iodine 131 is a radioactive medication used to help diagnose thyroid
abnormalities. Carbimazole is used to inhibit the production of thyroid hormone to treat hyperthyroidism.
6. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Diagnostic contrast KEY: Analysis
MSC: NCLEX Category: Reduction of Risk Potential
NOT: See Categorizing Medications (p. 8): Some drugs help diagnose a disease such as barium that patients
swallow to help highlight digestive problems on radiograph.
7. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Narcotics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Categorizing Medications (p. 8): Palliative drugs, such as pain relievers, do not cure disease, but
they make patients more comfortable. Morphine is listed as an example in Table 1.2. Cisplatin is an
antineoplastic agent and sorafenib is a biologic agent; both are designed to treat the cancer (destructive
medications), while ondansetron is given in a prophylactic measure to prevent nausea and vomiting related to
the chemotherapy.

, 8. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Hormonal therapy KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Sources of Drugs (p. 6): Cows and pigs are good sources of hormone replacements, but conjugated
estrogen (Premarin) comes from a pregnant mare’s urine.
9. ANS: D PTS: 1 DIF: Moderate TOP: Therapeutic Classification: NA
KEY: Application MSC: NCLEX Category: Pharmacological Therapies
NOT: See Toxins (p. 7): Radioactive iodine in small doses can help pinpoint problems in a patient’s thyroid.
Because the client is allergic to iodine, she should not have this test.


MULTIPLE RESPONSE

1. ANS: A, B, D, F PTS: 1 DIF: Easy TOP: Therapeutic Classification: NA
KEY: Knowledge MSC: NCLEX Category: Basic Care and Comfort
NOT: See Pharmacology in the 21st century (p. 5): Alternative therapies now seem to have a place in the
healing of patients. For example, aromatherapy involves the use of fragrant oils in baths; acupressure
originates from an ancient Chinese art. Along similar lines is acupuncture; therapeutic touch involves the use
of hand movements to stimulate circulation and healing. Stem cell research is considered mainstream medical
treatment. Dietary manipulation may promote health but is not a recognized alternative therapy.

,Chapter 2. Basics of Pharmacology

Multiple Choice
Identify the choice that best completes the statement or answers the question.

1. The nurse is preparing to apply valacyclovir (Valtrex) ointment to the shingles lesions located across
a client’s left side and lower back. Which of the following actions should the nurse take first?
A. Place the patient in a supine position.
B. Determine when the rash was first noted.
C. Ensure that the skin is clean and dry.
D. Take the patient’s vital signs.

2. The nurse is providing care for a client at 32 weeks’ gestation who started low-molecular heparin
injections after developing a deep vein thrombosis. The client asks the nurse, ―Why do I have to take
a shot? Why can’t I take the blood clot medicine that my dad takes orally?‖ Which of the following
responses by the nurse is best?
A. ―Anything that is fat-soluble, including warfarin (Coumadin), is able to cross the
placental barrier. Heparin is not fat-soluble so it doesn’t cross the barrier well.‖
B. ―The placenta is easily crossed by anything you take by mouth while you are
pregnant, but not by things absorbed in other ways.‖
C. ―Only water-soluble substances such as vitamins can cross the placental barrier, so
you could take either medication, but heparin is cheaper.‖
D. ―They are the same medication, but the shot is absorbed faster than the pill so the
doctor wants you to take daily shots.‖
3. The nurse is providing care to a client with HIV who has been prescribed fosamprenavir (Lexiva).
Which of the following statements by the client indicates that further teaching is necessary?
A. ―The metabolites of this medication may be excreted in active form.‖
B. ―I’m glad my kidneys work so well; otherwise the medication wouldn’t work.‖
C. ―This drug actually has to be broken down by my body to fight the virus.‖
D. ―Isn’t it fascinating that my liver has to metabolize the drug for it to work?‖

4. The nurse is working with a client who was recently started on insulin therapy. The client’s young
daughter asks, ―Why do you have to give her a shot? Why can’t you just give her a pill?‖ Which of
the following responses by the nurse is best?
A. ―Our bodies make insulin normally, so it is a liquid medication.‖
B. ―We do have diabetic medications in pill form. I’m not sure why the doctor
ordered it this way for your mom.‖
C. ―Insulin is manufactured and given this way so it absorbs more rapidly into the
body.‖
D. ―The acid in your mother’s stomach would destroy this medication, so it can’t be
swallowed.‖
5. The nurse is providing care for a 48-year-old male on the surgical unit. Gentamicin (Garamycin) 2
mg/kg every 8 hours has been started. The nurse would be most concerned by which of the following
findings?
A. Blood levels have been ordered every 24 hours

, B. The patient’s EGFR = 40 mL/min
C. The patient’s hemoglobin = 11.8 g/dL
D. The patient’s WBC = 14,000 c/mm3

6. A 16-year-old client comes to the urgent care clinic with symptoms of tonsillitis. The client tells the
nurse she takes tetracycline (Doxycycline) daily for the treatment of acne. The nurse would be most
concerned if the health care provider prescribed which of the following?
A. Amoxicillin clavulanate (Augmentin)
B. Cefdinir (Omnicef)
C. Cefixime (Suprax)
D. Ciprofloxacin (Cipro)

7. The nurse is providing care for a client experiencing muscle spasms. The physician has ordered
cyclobenzaprine (Flexeril). The nurse would inform the client to anticipate which of the following
side effects?
A. Hypocalcemia and hypotension
B. Dizziness and drowsiness
C. Nausea and headache
D. Flaccidity and urinary retention

8. While caring for clients on the medical unit, the nurse would see which of the following clients first?
A. A 28-year-old patient with HIV who has a temperature of 99.2°F
B. A 54-year-old patient with diverticulitis whose diet was just advanced to solid food
C. A 61-year-old patient who takes ibuprofen for arthritis complaining of severe
stomach pain
D. A 37-year-old patient with a kidney stone who is due for pain medication in 20
minutes
9. While preparing to provide a patient admitted to the hospital for a laparoscopic hysterectomy the
prescribed dose of ibuprofen (Motrin) 800 mg orally, which of the following actions would take
highest priority?
A. Determine if the client has eaten within the past hour.
B. Assess the client’s vaginal discharge.
C. Help the client ambulate in the hall.
D. Evaluate the client’s most recent renal panel labs.

10. The nurse is providing care for clients on the orthopedic unit. Which of the following assessment
findings is most concerning to the nurse?
A. A client who takes lisinopril (Zestril) and is complaining of limited range of
motion after shoulder surgery
B. A client with a fractured pelvis who takes warfarin sodium (Coumadin) and reports
having a black tarry stool during the night
C. A client 2 days post-op for knee replacement who takes
hydrocodone/acetaminophen (Vicodin) and refused to have labs drawn this
morning
D. A client 4 days after hip replacement surgery taking omeprazole (Prilosec) who
ordered spinach for dinner

, 11. While working in the neonatal intensive care unit, the nurse notes an infant’s oxygen saturation has
been 98% for the past 4 hours. The infant has been receiving oxygen at 4 L. Which of the following
actions by the nurse is best?
A. Turn the oxygen level down to 3 L and monitor closely to reduce the risk of eye
damage.
B. Leave the oxygen level at its current rate to reduce the risk of lung damage.
C. Turn the oxygen level down to 2 L and monitor closely to evaluate the infant’s
readiness for transfer out of the ICU.
D. Leave the oxygen level at its current rate and inform the parents the baby will need
supplemental oxygen at home.

Multiple Response
Identify one or more choices that best complete the statement or answer the question.

1. While providing oral medications, the nurse recognizes which of the following is true regarding the
absorption rate of a medication? (Select all that apply.)
A. The drug’s level of fat solubility should be high to ensure absorption.
B. A medication will be more readily absorbed if it has a high pH.
C. A drug will be more readily absorbed if it is acidic in nature.
D. Absorption will be more rapid if it is provided in liquid form.
E. Absorption is slower in the presence of food.
F. A lozenge should be chewed to release the maximum amount of medication.

2. While caring for multiple clients on the medical/surgical unit, the nurse would monitor which of the
following individuals for potential liver toxicity? (Select all that apply.)
A. A 14-year-old patient taking atomoxetine (Strattera) who has a history of ADHD
B. A 44-year-old patient admitted for pneumonia who has been taking acetaminophen
(Tylenol)
C. A 63-year-old patient with a history of atrial fibrillation who has an irregular apical
pulse
D. A 19-year-old patient with a history of alcohol abuse admitted for a tonsillectomy
E. A 71-year-old patient with a history of tuberculosis who took isoniazid (Laniazid)
F. A 15-year-old patient who took multiple aspirin as part of a suicide attempt

3. While working in the gastrointestinal diagnostic clinic, the nurse identifies which of the following
individuals as at high risk for developing a gastric ulcer? (Select all that apply.)
A. A 41-year-old patient with a family history of Crohn’s disease
B. A 54-year-old patient who reports smoking 1.5 packs of cigarettes/day for the past
40 years
C. A 29-year-old patient taking misoprostol (Cytotec)
D. A 16-year-old patient with a 6-month history of bulimia
E. A 44-year-old patient who reports taking ibuprofen (Advil) daily for low back pain

4. While providing medications to clients in the long-term care facility, which of the following actions
would the nurse use to prevent gastrointestinal side effects? (Select all that apply.)
A. Give clients yogurt to prevent diarrhea.
B. Increase client intake of fiber to reduce gastric motility.

,C. Provide milk or food with some medications to reduce the occurrence of nausea.
D. Improve absorption of the medication by giving it at night with a large snack.
E. Prevent constipation by providing fiber laxatives.

, Chapter 2. Basics of Pharmacology
Answer Section

MULTIPLE CHOICE

1. ANS: C PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication Provision; antivirals
KEY: Analysis MSC: NCLEX Category: Pharmacological Therapies
NOT: See Absorption (p. 15). When administering an ointment for a rash, make sure the skin is clean and
dry.
2. ANS: A PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Anticoagulant therapy KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Distribution (p. 16): The blood-placental barrier helps to filter drugs and other substances passing
from mother to fetus. Most lipid-soluble drugs readily cross this barrier but water-soluble drugs do not.
Warfarin (Coumadin) is fat-soluble and crosses the placental barrier while heparin does not. They are not the
same medication and cost is not part of the therapeutic decision.
3. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Medication Administration; antivirals
KEY: Analysis MSC: NCLEX Category: Pharmacological Therapies
NOT: See Metabolism (p. 16): The liver does most of the work of drug metabolism. In some instances, a
drug is administered in its inactive form to become activated through metabolism. This category of drugs is
known as prodrugs. An example of a prodrug is fosamprenavir (Lexiva).
4. ANS: D PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Antidiabetics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Metabolism (p. 16): Insulin given by mouth is virtually useless; stomach acid breaks down insulin
to an inactive form before it can be absorbed into the bloodstream. Oral diabetic medications are not forms of
insulin; they stimulate the pancreas to release insulin.
5. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Antibiotics KEY: Analysis
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Issues Affecting the Drug Cycle (p. 17): Gentamicin is known to be both nephrotoxic (toxic to the
kidneys) and ototoxic (toxic to the ears). Thus, kidney function and hearing would be monitored closely. The
EGFR is the best measurement of kidney function. Normal value is >60 mL/min. While the client’s
hemoglobin is low, the kidney function is more concerning. An elevated WBC count is expected in the
presence of an infection, which is the reason antibiotic therapy is provided. Routine blood levels to monitor
drug dosage is expected to help prevent toxicity.
6. ANS: A PTS: 1 DIF: Hard
TOP: Therapeutic Classification: Antibiotics KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See Issues Affecting Drug Cycle (p. 18): Antagonist drugs do the opposite by rendering another drug
less powerful. The antibiotic tetracycline becomes ineffective when it is taken with penicillin. Amoxicillin
clavulanate is a penicillin derivative.
7. ANS: B PTS: 1 DIF: Moderate
TOP: Therapeutic Classification: Muscle relaxants KEY: Application
MSC: NCLEX Category: Pharmacological Therapies
NOT: See The Importance of Side Effects (p. 18): Muscle relaxants such as Flexeril cause dizziness and
drowsiness in addition to their intended actions.

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