NUR2474 Pharmacology
Comprehensive Final Exam || With 150
Questions & 100% Correct Answers
(Rated A+)
2024
CONCEPTIAL RESEARCH
conceptialresearch@gmail.com
, NUR2474 Pharmacology
Comprehensive Final Exam || With 150
Questions & 100% Correct Answers
(Rated A+)
1. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The
nurse assesses the patient at the beginning of the shift and notes a heart rate of 62
beats per minute and a temperature of 97.2° F. The patient is lethargic and difficult to
arouse. The nurse will contact the provider to request an order for which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole) - ANSWER - c. Intravenous levothyroxine
*IV allows for a more rapid correction of thyroid hormone levels especially
hypothyroidism with symptoms of myxedema coma or severe hypothyroidism. This is
considered a medical emergency.
2. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid).
The nurse learns that the patient also takes warfarin (Coumadin). The nurse will
notify the provider to discuss _____ the _____ dose.
a. reducing levothyroxine
b. reducing warfarin
c. increasing levothyroxine
d. increasing warfarin - ANSWER - b. reducing warfarin
*Levothyroxine (Synthroid) can potentially increase the effects of warfarin, leading to
an increased risk of bleeding.
3. An older adult patient is diagnosed with hypothyroidism. The initial free T4 level is
0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders levothyroxine
(Levothroid) 100 mcg/day PO. What will the nurse do?
a. Administer the medication as ordered.
b. Contact the provider to discuss giving the levothyroxine IV.
c. Request an order to give desiccated thyroid (Armour Thyroid).
d. Suggest that the provider lower the dose. - ANSWER - d. Suggest that the
provider lower the dose.
*normal TSH is 0.4-4.
4. A 1-year-old child with cretinism has been receiving 8 mcg/kg/day of levothyroxine
(Synthroid). The child comes to the clinic for a well-child check up. The nurse will
expect the provider to:
,a. change the dose of levothyroxine to 6 mcg/kg/day.
b. discontinue the drug if the child's physical and mental development is normal.
c. increase the dose to accommodate the child's increased growth.
d. stop the drug for 4 weeks and check the child's TSH level. - ANSWER - a. change
the dose of levothyroxine to 6 mcg/kg/day.
*after 1 year of age, the organs are developed and higher does is no longer needed.
5. A patient who is receiving a final dose of intravenous (IV) cephalosporin begins to
complain of pain and irritation at the infusion site. The nurse observes signs of
redness at the IV insertion site and along the vein. What is the nurse's priority
action?
a. Apply warm packs to the arm, and infuse the medication at a slower rate.
b. Continue the infusion while elevating the arm.
c. Select an alternate intravenous site and administer the infusion more slowly. d.
Request central venous access. - ANSWER - c. Select an alternate intravenous site
and administer the infusion more slowly.
*infiltration
6. A nurse is teaching a nursing student what is meant by "generations" of
cephalosporins. Which statement by the student indicates understanding of the
teaching?
a."Cephalosporins are assigned to generations based on their relative costs to
administer."
b. "Cephalosporins have increased activity against gram-negative bacteria with each
generation.
c. "First-generation cephalosporins have better penetration of the cerebrospinal
fluid."d. "Later generations of cephalosporins have lower resistance to destruction by
beta- lactamases." - ANSWER - b. "Cephalosporins have increased activity against
gram-negative bacteria with each generation.
*this statement reflects the general trend seen in cephalosporins
7. A provider has ordered ceftriaxone 4 gm once daily for a patient with renal
impairment. What will the nurse do?
a. Administer the medication as prescribed.
b. Contact the provider to ask about giving the drug in divided doses.
c. Discuss increasing the interval between doses with the provider.
d. Discuss reducing the dose with the provider. - ANSWER - a. Administer the
medication as prescribed.
*?
, 8. A patient will be discharged home to complete treatment with intravenous
cefotetan with the assistance of a home nurse. The home care nurse will include
which instruction when teaching the patient about this drug treatment?
a. Abstain from alcohol consumption during therapy.
b. Avoid dairy products while taking this drug.
c. Take an antihistamine if a rash occurs.
d. Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain.
- ANSWER - a. Abstain from alcohol consumption during therapy.
*consuming alcohol while on this medication can lead to a disulfiram-like reaction
with symptoms such as flushing, headache, nausea, vomiting, and an increased
heart rate
9. The nurse is caring for a patient who is receiving vancomycin (Vancocin). The
nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The
patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg.
The nurse understands that these findings are consistent with:
a. allergic reaction.
b. red man syndrome.
c. rhabdomyolysis.
d. Stevens-Johnson syndrome. - ANSWER - b. red man syndrome.
*associated with the rapid infusion of vancomycin
10. A patient is to undergo orthopedic surgery, and the prescriber will order a
cephalosporin to be given preoperatively as prophylaxis against infection. The nurse
expects the provider to order which cephalosporin?
a. First-generation cephalosporin
b. Second-generation cephalosporin
c. Third-generation cephalosporin
d. Fourth-generation cephalosporin - ANSWER - a. First-generation cephalosporin
*due to its efficacy against common skin flora and lower risk of broad-spectrum
resistance.
1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four
patients who were just admitted. Which patient should the nurse assess first?
a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units
of 70/30 Novolin insulin.
b. The patient with a pulse of 58 beats per minute who is about to receive digoxin
(Lanoxin)
c. The patient with a blood pressure of 136/92 mm Hg who complains of having a
headache
d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin
(Vancocin) - ANSWER - a. The NPO patient with a blood glucose level of 80 mg/dL
who just received 20 units of 70/30 Novolin insulin.
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