A child is prescribed methylphenidate (Ritalin®) to treat attention deficit hyperactivity
disorder (ADHD). The parent expresses concern about using a controlled substance to
treat ADHD and asks the nurse about using a non-controlled substance. The nurse
knows ADHD can be treated with which non-controlled substance?
a. Methylphenidate (Concerta®)
b. Amphetamine aspartate (Adderall®)
c. Atomoxetine (Strattera®)
d. Dextroamphetamine sulphate (Dexedrine®)
ANS: c. Atomoxetine (Strattera®)
A client receiving vitamin K most likely has which of the following abnormal clinical
findings?
a. Diarrhea
b. Sudden severe confusion
c. Altered coagulation studies
d. Seizure activity
ANS: c. Altered coagulation studies
A concern among the older adult population is polypharmacy. What is the rationale for
the avoidance of cranberry-based beverages by this population?
a. It decreases the circulating inactive drugs
b. It decreases the elimination of drugs excreted by the kidneys
c. It reduces the capacity for liver enzyme to filter drug molecules
d. It enhances the elimination of sodium by the kidneys
ANS: b. It decreases the elimination of drugs excreted by the kidneys
A drug given by which route is altered by the first-pass effect?
a. Oral
b. Sublingual
c. Intravenous (IV)
d. Subcutaneous
ANS: a. Oral
A hospital nurse is assessing a newly admitted patient's culture and ethnicity. Which of
the following concepts is important for the nurse to understand regarding drug therapy
as it relates to an individual's race?
a. Polymorphism
b. Pharmacodynamics
c. Polypharmacy
d. Pharmacokinetics
ANS: a. Polymorphism
A hypertensive crisis may occur if adrenergic (sympathomimetic) drugs are given along
with drugs from which of the following drug classes?
a. β-Blockers
b. α1-Blockers
,c. Monoamine oxidase inhibitors (MAOIs)
d. Direct renin inhibitors
ANS: c. Monoamine oxidase inhibitors (MAOIs)
A male patient who misuses alcohol tells the nurse that he is treating himself with kava.
Which of the following instructions should the nurse include in patient teaching?
a. Use another herb besides kava.
b. Stop taking the kava now.
c. Use either the kava or the alcohol.
d. Avoid using the kava with alcohol.
ANS: b. Stop taking the kava now.
A mechanically ventilated patient receiving a neuromuscular blocking drug has tearing
in the eyes and increased heart rate and blood pressure. How does the nurse interpret
this clinical finding?
a. The patient's level of sedation is inadequate.
b. The patient is having an adverse reaction to the medication.
c. The patient's response to the drug is appropriate.
d. The patient's dose of the neuromuscular-blocking drug is insufficient.
ANS: a. The patient's level of sedation is inadequate.
A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she
is taking can be passed to her infant during breastfeeding. What is the nurse's best
response to the mother's question?
a. "Only certain medications pass to infants while breastfeeding."
b. "You should not take any medication while breastfeeding."
c. "I will leave the health care provider a message to return your call."
d. "Drugs can cross from mother to infant in breast milk, so it will depend on the drug
you are taking."
ANS: d. "Drugs can cross from mother to infant in breast milk, so it will depend on the
drug you are taking."
A nurse working in behavioural medicine is aware of the long-term consequences of
alcohol misuse. Deficiency in which of the following nutrients can occur and potentially
lead to Wernicke's encephalopathy?
a. Vitamin B1
b. Vitamin A
c. Vitamin E
d. Magnesium
ANS: a. Vitamin B1
A nurse working with older adult patients is concerned about the number of medications
prescribed for each patient. Which older adult assessment should be of highest priority
in relation to polypharmacy?
a. Non-adherence to drug regimen
b. Drug interactions
,c. Schedule of medications
d. Cost of medications
ANS: b. Drug interactions
A nurse working with patients who are diagnosed with ADHD is aware that such
patients often take CNS stimulant drugs. These medications are potent and have a high
potential for misuse and dependence. Based on this potential, how are these
medications classified?
a. Schedule IV
b. Schedule I
c. Schedule III
d. Schedule II
ANS: d. Schedule II
A nursing student is planning to administer a medication intramuscularly into the
dorsolateral region. As a preceptor, what is your best description of where she should
inject the medication?
a. A hand-breadth below the greater trochanter and the sacroiliac joint
b. As the dorsolateral region is no longer recommended for injection, a different site
should be selected.
c. Below the iliac spine and between the greater trochanter and the iliac crest
d. A "V" formation between the anterior superior iliac spine and the greater trochanter
ANS: b. As the dorsolateral region is no longer recommended for injection, a different
site should be selected.
A patient asks the nurse about using potassium supplements while taking
spironolactone (Aldactone®). What is the nurse's best response?
a. "I would recommend that you take two multivitamins every day."
b. "I will call your health care provider and discuss your concern."
c. "You will need to take potassium supplements for the medication to be effective."
d. "This diuretic is potassium sparing, so there is no need for extra potassium."
ANS: d. "This diuretic is potassium sparing, so there is no need for extra potassium."
A patient asks the nurse why the dose of IV pain medication being given is lower than
that of the patient's previous oral medication. What is the nurse's best response to the
patient?
a. "Medications given intravenously are not affected by the first-pass effect."
b. "Medications given orally bypass the portal circulatory system."
c. "Drugs administered intravenously enter the portal system before systemic
distribution."
d. "Drugs administered intravenously enter the portal system before systemic
distribution."
e. "Drugs administered intravenously enter the portal system before systemic
distribution."
ANS: a. "Medications given intravenously are not affected by the first-pass effect."
, A patient diagnosed with depression is being discharged with a prescription for TCAs
after no improvement of symptoms on an SSRI. Which information about this new
medication should the nurse give this patient?
a. There is a risk of toxicity when this medication is taken with alcohol.
b. This drug does not cause constipation, low blood pressure, or problems with sleep.
c. There are no drug or food contraindications with this medication.
d. Take St. John's wort every day to minimize the adverse effects of the medication.
ANS: a. There is a risk of toxicity when this medication is taken with alcohol.
A patient diagnosed with narcolepsy is prescribed a central nervous system (CNS)
stimulant. Which statement best describes the action of CNS stimulants?
a. CNS stimulants activate cyclic adenosine monophosphate.
b. CNS stimulants increase the release of neurotransmitters and block reuptake of
neurotransmitters.
c. CNS stimulants decrease the production of excitatory neurotransmitters.
d. CNS stimulants block or reduce the activity of inhibitory neurons.
ANS: b. CNS stimulants increase the release of neurotransmitters and block reuptake
of neurotransmitters.
A patient expresses concern to the nurse regarding postoperative nausea and vomiting
from anesthesia. Which of the following should the nurse say to the patient as the best
response to the patient's concern?
a. "I understand your concern, but intermittent vomiting often occurs after surgery."
b. "Don't worry, because you'll be heavily or completely sedated if that occurs."
c. "Nausea and vomiting occur less frequently than in the past because of the use of a
balanced approach to anesthesia."
d. "You will need to notify the charge nurse and health care provider if you feel
nauseated after surgery."
ANS: c. "Nausea and vomiting occur less frequently than in the past because of the use
of a balanced approach to anesthesia."
A patient is admitted to hospital with a diagnosis of benzodiazepine overdose. The
nurse anticipates that the health care provider will prescribe which antidote for
benzodiazepine overdose?
a. naloxone
b. naltrexone
c. flumazenil
d. nalmefene
ANS: c. flumazenil
A patient is admitted to the emergency department after taking an overdose of a
barbiturate 15 minutes before arrival. The nurse can anticipate that which drug will be
prescribed?
a. Naloxone
b. Charcoal (activated charcoal)
c. Ipecac (syrup)
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