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NUR 2474 / NUR 2474 Pharmacology Final Exam NCLEX Style Rated A+
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NUR 2474 / NUR 2474 PharmacologyFinal Exam NCLEX Style Rated A+
A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine
(Synthroid). Which statement by the patient indicates a need for further teaching?
a."I should not take heartburn medication without consulting my provider."
b."I should report insomnia, tremors, and an increased heart rate to my provider."
c."If I take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid." -
ANSWER-d."If I take calcium supplements, I may need to decrease my dose of
Synthroid."
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
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
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.
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.
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.
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."
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.
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.
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.
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
A patient receiving a cephalosporin develops a secondary intestinal infection caused
by Clostridium difficile. What is an appropriate treatment for this patient?
a.Adding an antibiotic, such as vancomycin (Vancocin), to the patient's regimen
b.Discontinuing the cephalosporin and beginning metronidazole (Flagyl) c.Discontinuing all
antibiotics and providing fluid replacement
, d.Increasing the dose of the cephalosporin and providing isolation measures -
ANSWER-b.Discontinuing the cephalosporin and beginning metronidazole (Flagyl)
Besides the cost of administering a given drug, which are considerations when a provider
selects a cephalosporin to treat an infection? (Select all that apply.)
a.Adverse effects
b.Antimicrobial spectrum
c.Brand name
d.Manufacturer
e.Pharmacokinetics - ANSWER-a.Adverse effects
b.Antimicrobial spectrum
e.Pharmacokinetics
A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered
piperacillin and amikacin, both to be given intravenously. What will the nurse do?
a.Make sure to administer the drugs at different times using different IV tubing. b.Suggest
giving larger doses of piperacillin and discontinuing the amikacin. c.Suggest that a fixed-dose
combination of piperacillin and tazobactam (Zosyn) be used.
d.Watch the patient closely for allergic reactions, because this risk is increased with this
combination. - ANSWER-a.Make sure to administer the drugs at different times using different
IV tubing.
A nurse assisting a nursing student with medications asks the student to describe how penicillins
(PCNs) work to treat bacterial infections. The student is correct in responding that penicillins:
a.disinhibit transpeptidases.
b.disrupt bacterial cell wall synthesis.
c.inhibit autolysins.
d.inhibit host cell wall function. - ANSWER-b.disrupt bacterial cell wall synthesis.
A patient is about to receive penicillin G for an infection that is highly sensitive to this drug.
While obtaining the patient's medication history, the nurse learns that the patient experienced
a rash when given amoxicillin (Amoxil) as a child 20 years earlier. What will the nurse do?
a.Ask the provider to order a cephalosporin.
b.Reassure the patient that allergic responses diminish over time.
c.Request an order for a skin test to assess the current risk.
d.Suggest using a desensitization schedule to administer the drug. - ANSWER-c.Request
an order for a skin test to assess the current risk.
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