RN VATI Pharmacology 2019 exam
questions and answers
A nurse is preparing to administer diclofenac to a client who has chronic bursitis. Which of the
following actions should the nurse take?
a. administer the medication at bedtime
b. avoid administering the medication with antacids
c. administer the medication with food
d. crush the medication prior to administration
Administer the medication with food
Diclofenac is an NSAID and can cause gastric irritation. Clients should take NSAIDs with food or
milk to minimize gastric irritation.he nurse should not administer the medication at bedtime
because the client should remain upright for 15 to 30 min after administration to prevent
esophageal irritation. Diclofenac is available as an enteric-coated tablet for delayed release.
Clients should not crush or chew sustained-release medications because doing so will increase
gastrointestinal adverse effects and decrease the effectiveness of the medication.
A nurse is planning care for a client who has asthma and a prescription for methylprednisolone.
Which of the following laboratory values should the nurse monitor while the client is receiving
this medication?
a. Aspartate aminotransferase (AST)
b. Fibrin split products
c. BUN
d. Glucose
Glucose
Methylprednisolone therapy increases the synthesis of glucose and decreases the uptake of
glucose by the muscles and adipose tissues, resulting in increased circulating glucose. Therefore,
it is important for the nurse to monitor blood glucose levels regularly while clients are receiving
corticosteroid therapy.
Aspartate aminotransferase is an enzyme that is present in the heart, liver, skeletal muscles, and
other highly metabolic tissues. AST levels are increased in conditions that cause cellular injury,
such as liver disease; however, methylprednisolone therapy does not affect AST levels. Fibrin
split products are present in the serum when thromboses are present. Increased levels of fibrin
,split products can increase disseminated intravascular coagulation (DIC); however,
methylprednisolone therapy does not affect blood clotting. BUN levels reflect kidney function
and glomerular filtration. Hydration status and nephrotoxic medications can alter BUN levels;
however, methylprednisolone therapy does not affect renal function.
A nurse is caring for a client who is postmenopausal and has a prescription for raloxifene. The
nurse should instruct the client that raloxifene is prescribed for which of the following reasons?
a. To treat irritable bowel syndrome
b. To reduce the risk for breast cancer
c. To reduce the occurrence of hot flashes
d. To lower the risk of pulmonary embolism
To reduce the risk for breast cancer
Raloxifene can lower the risk for breast cancer in postmenopausal clients who have a high risk
for developing estrogen-receptive types of breast cancer. The medication also reduces the risk
for and can treat postmenopausal osteoporosis.Raloxifene is a selective estrogen receptor
modulator. In clients who are postmenopausal, it can reduce the risk for and treat osteoporosis
and protect against breast cancer.
Hot flashes are an adverse effect of raloxifene. Raloxifene reduces the occurrence of fractures
related to osteoporosis and reduces the cholesterol level in clients who are
postmenopausal.Raloxifene can cause several significant cardiovascular and respiratory adverse
effects, such as thromboembolism, stroke, peripheral edema, pneumonia, and the development
of pulmonary emboli. Clients should not take this medication prior to periods of prolonged
immobilization, such as surgery. A history of thromboembolic events is a contraindication for
taking this medication.
A nurse is caring for a client who is receiving heparin by continuous IV infusion for treatment of
venous thrombosis. Which of the following laboratory values should the nurse monitor for in
order to titrate the heparin dose?
a. platelet function assay
b. aPTT
c. INR
d. Amylase
aPTT
The nurse should monitor the aPTT of a client who is receiving heparin by continuous IV
infusion. When beginning heparin therapy, the nurse should monitor the aPTT every 4 to 6 hr.
Once the client has achieved the desired range, the nurse should monitor the aPTT daily.
,The nurse should monitor the platelet function assay of a client who has a bleeding disorder.
This test evaluates platelet function and ability to cause hemostasis; however, heparin does not
affect it.The nurse should monitor a client's INR to evaluate the effects of warfarin therapy. The
nurse should ensure the collection of the client's blood specimen prior to administering the
daily warfarin dose.The nurse should review the amylase levels of a client who has pancreatitis.
Amylase is a pancreatic enzyme that increases in clients who have acute or chronic pancreatitis;
however, heparin does not affect this enzyme.
A nurse is assessing a client who has a positive Trousseau's sign. Wich of the following
medications should the nurse plan to administer?
a. sodium bicarbonate
b. manesium sulfate
c. calcium gluconate
d. potassium chloride
Calcium gluconate
The nurse should identify that a positive Trousseau's sign is a manifestation of hypocalcemia.
Therefore, the nurse should plan to administer calcium gluconate to treat hypocalcemia.
Sodium bicarbonate is administered to treat metabolic acidosis. The nurse should recognize that
sodium bicarbonate is not used to treat a positive Trousseau's sign.Magnesium sulfate is
administered to treat hypomagnesemia. The nurse should recognize that magnesium sulfate is
not used to treat a positive Trousseau's sign. Potassium chloride is administered to treat
hypokalemia. The nurse should recognize that potassium chloride is not used to treat a positive
Trousseau's sign.
A nurse is preparing to administer morphine 0.3 mg/kg PO to a school-aged child who weighs
88 lb. Available is morphine oral solution 2mg/ml. How many mL should the nurse administer?
6 mL
A nurse is administering haloperidol to a client who has schizophrenia. For which of the
following adverse effects should the nurse monitor?
a. gingival hyperplasia
b. muscle rigidity
c. polyuria
d. bruising
Muscle rigidity
A client who is taking haloperidol, a first-generation antipsychotic agent, can develop
, extrapyramidal effects, such as parkinsonism, which manifests as tremors, bradykinesia, loss of
balance, mask-like facial expression, shuffling gait, and muscle rigidity.
Haloperidol is an antipsychotic agent that can cause akathisia (motor restlessness) within hours
of receiving the first dose; however, gingival hyperplasia is not an adverse effect of haloperidol.
Phenytoin is an example of a medication that causes gingival hyperplasia.Haloperidol has
several genitourinary adverse effects, including urinary retention and impotence; however,
urinary output does not typically increase.Haloperidol has significant cardiovascular effects,
including dysrhythmias, myocardial infarction, severe heart failure, and hypotension; however, it
does not affect blood coagulation.
A nurse receives a verbal prescription from the provider for hydrochlorothiazide 25 mg by
mouth daily for a client who has hypertension. Which of the following indicates how the nurse
should transcribe the prescription in the client's medical record?
a. Hydrochlorothiazide 25.0 mg orally q.d.
b. Hydrochlorothiazide 25 mg PO daily
c. HCTZ 25.0 mg by mouth daily
d. HCTZ 25 mg PO OD
Hydrochlorothiazide 25 mg PO daily
The nurse should transcribe the provider's prescription by spelling out the name of the
medication, recording the dosage as a whole number, and spelling out the word "daily." The
abbreviation PO is acceptable for use to indicate the route by mouth.
The nurse should not transcribe a trailing zero after a decimal point because if the decimal point
is not seen, it could be mistaken as 250 mg. The abbreviation q.d. is not acceptable because it
could be mistaken for q.i.d. The nurse should write out the word "daily."The nurse should not
transcribe the medication name abbreviated as HCTZ, because it could be mistaken for
hydrocortisone. The nurse should not place a trailing zero after a decimal point because if the
decimal point is not seen, it could be mistaken as 250 mg.The nurse should not transcribe the
medication name abbreviated as HCTZ, because it could be mistaken for hydrocortisone. The
abbreviation OD is not acceptable for use because it could be mistaken for "right eye." The
nurse should write out the word "daily."
A nurse is planning care for a client who is taking tamoxifen for treatment of breast cancer.
Which of the following interventions should the nurse include in the plan? SATA
a. Monitor the client's calcium level
b. Monitor the client for pulmonary embolus
c. Advise the client of the potential for menstrual irregularities