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Pharmacology Clear and Simple 2nd Edition Watkins Test Bank

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Pharmacology Clear and Simple 2nd Edition Watkins Test Bank

ISBN-13: 978-0803625884

ISBN-10: 080362588X

 

Description

Pharmacology Clear and Simple 2nd Edition Watkins Test Bank

ISBN-13: 978-0803625884

ISBN-10: 080362588X

 

 

 

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Free Nursing Test Questions:

Chapter 17. Immunologic System Medications

 

Multiple Choice

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

 

____     1.   The nurse receives a call from the parent of a 6-year-old girl who complains of a headache, sinus congestion, and a cough. The parent asks, “Can I give him some Benadryl to help with all this congestion?” Which of the following statements by the nurse is best?

A. “How long has your child been ill?”
B. “It should be fine if he weighs more than 60 pounds.”
C. “What other over-the-counter medications have you given him?”
D. “We don’t recommend antihistamines in children.”

 

 

____     2.   The nurse is providing a follow-up phone call to a patient who recently started taking fexofenadine (Allegra). Which of the following statements by the patient would indicate the medication has been effective?

A. “My joint pain is much better now.”
B. “My nose isn’t running and itchy all the time now.”
C. “I don’t have any green drainage from that cut in my arm anymore.”
D. “I passed a large worm last nightRemember, I guess it’s working.”

 

 

____     3.   The LPN answers the phone call of a client who has been taking prednisolone (Prelone) for the treatment of an acute flare of systemic lupus erythematosus. The client says, “The doctor said something about stopping this medication but I can’t remember what she said.” Which response by the nurse is best?

A. “It is important to taper steroid medications slowlyRemember, the tapering schedule should have been part of the prescription and will be written on the label.”
B. “Once you need to start taking steroids, you usually stay on them indefinitely.”
C. “I will have to check your chart and call you back next week.”
D. “What did the pharmacy tell you about the medication?”

 

 

____     4.   An LPN takes her daughter to the primary care physician for a routine physical. In reviewing the client’s history of asthma and noting the child’s peak flow meter is in the yellow zone, the nurse would anticipate the physician to prescribe which of the following medications?

A. Loratadine (Claritin)
B. Beclomethasone (Vanceril)
C. Phenylephrine (Dimetapp)
D. Diflunisal (Dolobid)

 

 

____     5.   The LPN is talking to a neighbor who recently moved to the area and says, “My allergies are just crazy here! They’ve never been this bad before. The doctor actually gave me this nasal spray to help try and breathe through my nose again.” The nurse suspects the physician prescribed:

A. Celecoxib (Celebrex)
B. Cefterizine (Zyrtec)
C. Azathioprine (Imuran)
D. Fluticasone (Flovent)

 

 

____     6.   The LPN is talking to a family member who was recently given propanolamine/propanolamine (Rhindecon) to aid in the treatment of a severe sinus infection. Which statement by the nurse is best?

A. “That is a really potent antihistamineRemember, you will probably feel really dry.”
B. “Be aware that rebound nasal congestion occurs if you take that for more than a few days.”
C. “Wow, I thought they outlawed that stuff because kids were making drugs out of it.”
D. “That is a powerful antibiotic; you may get diarrhea with that.”

 

 

____     7.   The LPN notes a new prescription for naphazoline drops (Privine). How should the nurse administer this medication?

A. Place the drops on the tongue
B. Place the drops in the ear
C. Place the drops in the nose
D. Place the drops sublingually

 

 

____     8.   When asked by a client taking ibuprofen (Motrin) 8000 mg post-operatively after a robotic hysterectomy why the physician ordered this med, the best response by the nurse is:

A. “This medication helps ensure you don’t develop a post-op fever.”
B. “Ibuprofen is really good for reducing muscle spasms.”
C. “We’ve found that women who take this medication have decreased bleeding risk.”
D. “Motrin will help reduce both pain and inflammation after surgery.”

 

 

____     9.   An LPN is caring for a client who has orders for ketorolac (Toradol). The nurse notes the client has allergies to ibuprofen (Nuprin/Advil/Motrin) and diphenhydramine (Benadryl). Which of the following actions by the nurse is best?

A. Call the pharmacy to determine if there is any contraindication.
B. Give the medication and monitor for any signs or symptoms of rash.
C. Ask the RN to contact the physician for alternative orders for pain control.
D. Hold the medication and flag the chart for investigation by the RN.

 

 

____   10.   An LPN is assisting in the care of a patient with rheumatoid arthritis who takes celebrex (Celecoxib). The patient is on a pureed diet and the previous nurse on duty reported the client had some difficulty with oral pills. Which of the following actions by the nurse is best?

A. Crush the medication and sprinkle it on applesauce.
B. Contact the RN for direction.
C. Ask the physician for a different pain medication.
D. Hold the medication.

 

 

____   11.   The LPN is assisting with the admission of a client who takes sirolimus (Rapamune). Which of the following disease states would the nurse anticipate might be part of the client’s medical/surgical history?

A. Tuberculosis
B. Kidney transplant
C. Colorectal cancer
D. Methicillin-resistant staphylococcus aureus infection (MRSA)

 

 

____   12.   While talking to a cousin who has a history of lupus and takes azathioprine (Imuran), the LPN learns her cousin has recently been diagnosed with hypertension. The nurse is aware that which of the following medications may interact with the azathioprine (Imuran) therapy?

A. Diltiazem (Cardizem)
B. Pravastatin (Pravachol)
C. Losartan (Cozaar)
D. Acebutolol (Sectral)

 

 

____   13.   The LPN is working with a client newly prescribed minocycline (Dynacin). Which of the following precautions should the nurse include in the patient instructions?

A. “Be sure to wear a hat and sunscreen as this medication increases your sensitivity to the sun.”
B. “You can stop taking this medication once your symptoms are under control.”
C. “It is important that you eat low fat meals while you are on this medication.”
D. “This medication has a deadly interaction with alcoholRemember, you must not drink.”

 

 

____   14.   The LPN overhears an individual in the drug store mention, “I’m taking something called a Z-pak for my sinus infection.” The LPN is aware that the medication the individual takes is:

A. Ciprofloxacin
B. Sulfamethoxazole
C. Azithromycin
D. Ceftizoxime

 

 

____   15.   While working in a long-term care facility, the LPN notes an elderly woman is experiencing symptoms of an upper respiratory infection. The LPN reports these findings to the RN and anticipates the RN will seek orders for which of the following medications?

A. Ethambutol (Myambutol)
B. Clarithromycin (Biaxin)
C. Amphotericin B (Fungizone)
D. Nystatin (Mycostatin)

 

 

____   16.   The LPN is assisting in the care of a client taking gentamicin (Cidomycin). The nurse would be most concerned by which of the following lab values for this client?

A. Hmg = 12.7 g/dL
B. Na+ = 138 mEq/L
C. K+ = 3.6 mEq/L
D. Creatinine = 1.8 mg/dL

 

 

____   17.   The LPN is talking to a neighbor who spent multiple days in the hospital on intravenous antibiotics including erythromycin the week before. The individual states, “I’ve had such bad diarrhea all night and it really isn’t any better today.” Which of the following statements by the nurse is best?

A. “Antibiotics commonly cause diarrhea; be sure to drink plenty of fluids.”
B. “Have you noticed any blood or pus in the stool?”
C. “Is anyone else in the family experiencing the same symptoms?”
D. “Are you taking any other medications that cause diarrhea?”

 

 

____   18.   The LPN is assisting in the care of a client taking ethambutol (Myambutol), isoniazid (Nydrazid), and rifampin (Rifadin). The client is scheduled for an x-ray. Which action should the nurse take next?

A. Assess the client’s breath sounds and respiratory rate.
B. Contact the RN to be sure the client can be transported.
C. Place a mask on the client and send him to the x-ray department.
D. Call the x-ray department and request a portable film.

 

 

____   19.   The LPN working in an immunization clinic is preparing to provide tetanus immune globulin (BayTet). Which method of administration will the nurse use?

A. Intravenous
B. Intramuscular
C. Subcutaneous
D. Intradermal injection

 

 

____   20.   The nurse is caring for an infant with oral thrush whose medications include mycostatin (Nystatin) suspension. Which of the following actions should the nurse take?

A. Dilute the medication in water and provide it to the infant in a bottle.
B. Use a mouth swab to paint the inside of the infant’s mouth.
C. Use a needleless syringe and allow the baby to suck the medication out of the tip.
D. Dip a pacifier into the medication and allow the infant to suck on the pacifier.

 

 

____   21.   While helping to clean a patient with pneumonia who is incontinent, the nurse notes the patient’s groin folds are red, inflamed and excoriated and whitish discharge is noted from the vagina. Which of the following medications would the nurse anticipate being ordered?

A. Neomycin ointment
B. Calamine lotion
C. Hydrocortisone cream
D. Monistat cream

 

 

____   22.   An LPN working in a physician’s office receives a call from a woman who reports, “My daughter was just sent home from school. They said she has lice.” Which of the following instructions by the nurse is best?

A. “We will need to see her after hours. Can you come in at 5:30 p.m.?”
B. “Head lice are a common problem in school-age children; it is nothing to worry about.”
C. “There are a number of products, such as permethrin (Elimite)Remember,ld over the counter that are effective at treating head lice.”
D. “Once you shampoo her hair and comb it out with the special comb, she should be fine.”

 

 

____   23.   An LPN is preparing to go on a mission trip overseas to an area where malaria is prevalent. Which action by the nurse is best?

A. Seek an immunization against malaria at the county Health Department.
B. Talk to her physician about taking atovaquone/proguanil (Malarone).
C. Plan to stay in a hotel that provides bottled water.
D. Buy piperonyl butoxide/pyrethrins (Licide) shampoo and special soaps for the trip.

 

 

____   24.   The LPN working at the Health Department provides multiple vaccinations each day. Which type of immunity is being transferred to the clients in this process?

A. Active natural immunity
B. Passive natural immunity
C. Active artificial immunity
D. Passive artificial immunity

 

 

____   25.   The LPN is assisting in the care of a patient who received chlorambucil (Leukeran) two weeks ago for chronic myelogenous leukemia. Which of the following lab results would be most concerning to the nurse?

A. Glucose = 154 g/dl
B. Potassium = 4.2 mEq/L
C. Platelets = 84,000/mm3
D. Albumin = 4.0 g/dL

 

 

____   26.   The nurse is teaching a patient with prostate cancer about the planned treatment of goserelin acetate (Zoladex). Which of the following statements should be included in the patient teaching?

A. “You may experience hot flashes while taking these medications.”
B. “The doctor will follow CA-125 levels periodically to monitor the tumor’s response.”
C. “You may experience hair loss while taking Zoladex.”
D. “These medications rarely impact your sex life provided you had nerve-sparing surgery.”

 

 

____   27.   While talking with a friend who is to start cancer treatment using a monoclonal antibody, the LPN could include which statement regarding this class of medications?

A. “The nice thing about those medications is that they are designed to target only the cancer cells.”
B. “Those are powerful medications that destroy rapidly growing cells in your body.”
C. “The physician will give you a pre-treatment with something to tag the cancer cells so the antibody can find them.”
D. “Monoclonal antibodies stimulate your own immune system rather than fight the cancer cells themselves.”

 

 

____   28.   The LPN is notified that a friend will be undergoing brachytherapy for the treatment of cancer on Friday. The LPN is aware this individual will have what type of treatment?

A. Intravenous delivery of medications targeting the tumor cells.
B. Radiation beam treatment to the tumor area.
C. Oral delivery of a substance that is radioactive and will cause tumor cell destruction.
D. Surgical implantation of radioactive seeds into a tumor bed.

 

 

____   29.   The LPN is working with a client who has had iodine-125 seeds implanted for the treatment of cervical cancer. The LPN is aware this client is best placed in which of the following rooming situations?

A. In a semiprivate room with a woman who has breast cancer
B. In a private room at the end of the hall with lead-lined walls
C. In a private room near the nurse’s station for close monitoring
D. In a semiprivate room with a woman who has uterine cancer

 

 

Multiple Response

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

 

____     1.   Which of the following interventions would be helpful for a patient taking claritin (Loratadine) who complains of a dry mouth? (Select all that apply.)

A. Brushing at least twice daily
B. Increased intake of caffeine
C. Sugarless gum or candy
D. Use of alcohol-based mouth wash
E. Frequent mouth rinses with water

 

 

____     2.   The LPN begins taking over-the-counter antihistamine azelastine (Astelin). Which of the following side effects may be expected? (Select all that apply.)

A. Increased risk of infection
B. Nausea and vomiting
C. Sedation
D. Rash
E. Dizziness
F. Dry mouth

 

 

____     3.   While working in a rehab facility, the nurse recognizes ibuprofen (Motrin) should be used cautiously or not at all in clients with which of the following conditions? (Select all that apply.)

A. Gastrointestinal bleeding
B. Peripheral vascular disease
C. Myocardial infarction
D. Chronic pulmonary obstructive disease (COPD)
E. Renal compromise
F. Rheumatoid arthritis

 

 

____     4.   The LPN is caring for a client with an allergy to penicillin. The nurse would be concerned if which of the following medications were ordered? (Select all that apply.)

A. Ampicillin (Omnipen)
B. Amoxicillin (Amoxil)
C. Carbenicillin (Geocillin)
D. Nafcillin (Nallpen)
E. Doxycycline (Alodox)
F. Erythromycin (Ery-Tab)

 

 

____     5.   The LPN receives a call from her grown daughter who tells her, “I’ve got a bad case of bronchitis and the doctor gave me a shot of penicillin and gave me a prescription.” What information would it be important for the nurse to convey? (Select all that apply.)

A. Some people are allergic to penicillin.
B. Penicillin antibiotics can decrease the action of oral contraceptives.
C. Penicillin treats both gram positive and gram negative bacteria.
D. Her daughter should be sure to avoid other people for at least 24 hours.
E. Her daughter should stop taking the medication once her symptoms resolve.

 

 

____     6.   While working in an urgent care facility, the LPN assists in the care of a client who is started on cefaclor (Ceclor). The nurse should caution the client to avoid which of the following? (Select all that apply).

A. Alcohol
B. Dairy products
C. Foods high in iron
D. Diuretic medications
E. Electrolyte drinks

 

 

____     7.   A student nurse reviewing antibiotic therapy determines that which of the following medications should not be given during pregnancy due to the risk of altered bone growth and staining of the teeth in the fetus? (Select all that apply.)

A. Amikacin (Amikin)
B. Tetracycline (Sumycine)
C. Doxycycline (Adoxa)
D. Erythromycin (E.E. S. Granules)
E. Ciprofloxacin (Cipro)
F. Cefibuten (Cedax)

 

 

____     8.   The nurse is caring for a patient receiving antibiotic therapy with tobramycin 100 mg every 8 hours. Which of the following nursing actions are appropriate for this medication? (Select all that apply.)

A. Monitor the patient for signs of tinnitus, dizziness, or hearing loss.
B. Monitor renal function before and during therapy.
C. Monitor for symptoms of paralysis.
D. Infuse the medication using the same IV line that has continuous total parental nutrition running.
E. Stop the medication if the patient develops a fever over 101°F.

 

 

____     9.   A client with a urinary tract infection is taking sulfisoxazole (Gantrisin). The nurse recognizes that teaching has been effective by which of the following client statements? (Select all that apply.)

A. “If I miss a dose, I should take a double dose the next day.”
B. “I must take this medication with a high fiber meal or it will cause constipation.”
C. “If I notice a rash while taking this medication I should call the doctor.”
D. “Once the burning stops, I can stop taking this and save the rest of the pills in case I get another infection later this year.”
E. “I should not take this medication if I am pregnant.”

 

 

____   10.   While preparing to provide medications to a client with listed allergies to sulfa medications, the nurse would questions orders for which of the following medications? (Select all that apply.)

A. Sulfamethizole (Thiosulfil Forte)
B. Sulfamethoxazole (Gantanol)
C. Neomycin (Neo-Fradin)
D. Paromomycin (Humatin)
E. Sulfasalazine (Azulfidine)
F. Levofloxacin (Levaquin)

 

 

____   11.   The LPN caring for a client with tuberculosis instructs the client that the urine will be orange in color if the client is taking which of the following medications? (Select all that apply.)

A. Rifampin (Rifadin)
B. Cycloserine (Seromycin)
C. Ethambutol (Myambutol)
D. Rifabutrin (Mycobutin)
E. Ethionamide (Trecator SC)

 

 

____   12.   The LPN working with a client who has recurrent athlete’s foot is providing instruction related to topical miconazole (Micatin) cream. Which of the following statements would be included in the nurse’s teaching?

A. “Be sure to wear white socks and reduce the amount of time you wear shoes each day.”
B. “You should wash your hands before and after application.”
C. “Anti-viral medications are designed to kill invading viruses.”
D. “The antibiotic in the cream will kill the bacteria causing the itch.”
E. “Fungal infections like to grow in warm, moist places.”

 

 

____   13.   An LPN working in a primary care facility would anticipate acyclovir (Acivir) would most likely be prescribed for which of the following individuals? (Select all that apply.)

A. A 22-year-old patient with genital herpes
B. A 15-year-old patient with bronchitis
C. A 48-year-old patient with shingles
D. A 39-year-old patient with a bacterial sinus infection
E. A 2-year-old patient with oral thrush

 

 

____   14.   A client reports to the emergency room with symptoms that include sore throat, low-grade fever, runny nose, nausea, and stomachache. His blood tests show he is positive for influenza virus. The client is given a prescription for oseltamivir (Tamiflu) and sent home. The nurse will instruct the client regarding which of the following side effects related to the medication? (Select all that apply.)

A. Hypoglycemia
B. Confusion
C. Joint pain
D. Rash
E. Seizure
F. Nausea

 

 

____   15.   The LPN is assisting in the care of a client who receives fluorouracil (Adrucil) in the treatment of colorectal cancer. Which of the following assessments will be appropriate in the care of this client? (Select all that apply.)

A. Determine if the client is experiencing nausea or vomiting.
B. Maintain strict intake and output measurements.
C. Encourage high-fiber, spicy foods.
D. Monitor vital signs, particularly temperature, frequently.
E. Place client in contact precautions.
F. Advise the client to perform frequent oral care.

 

 

____   16.   The LPN has a neighbor with recurrent lymphocytic leukemia who receives weekly treatment with alemtuzumab (Campath). When the client goes in for weekly lab draws, the LPN is aware that the following lab results would be monitored prior to initiating therapy? (Select all that apply.)

A. Prothrombin time (PTT)
B. White blood cell count (WBC)
C. CD-8 count
D. Platelet count
E. C-reactive protein

 

 

____   17.   The LPN is talking to a friend who is undergoing treatment for breast cancer with docetaxel (Taxotere). The nurse anticipates the friend may discuss which of the following side effects associated with this treatment? (Select all that apply.)

A. Hot flashes
B. Alopecia
C. Neurotoxicity
D. Rash
E. Diarrhea

 

 

Completion

Complete each statement.

 

  1. The nurse is preparing to infuse cephalexin (Keflex) 1 gram in 100 mL over 30 minutes. What hourly rate in mL/hr should be set on the pump?

 

  1. The nurse is preparing to provide dexamethasone (Decadron) in liquid form. The ordered dose is 10 mg po bid. Liquid preparation is available in 2 mg/mL. How much should the nurse provide?

 

  1. The nurse is caring for a client receiving oral ofloxacin (Floxin) 400 mg every 12 hours and the pharmacy distributed 200-mg tablets. How many pills with the client take each day?

 

  1. The nurse is providing care for a 10-year-old child whose order reads, “Ciprofloxacin 15 mg/kg po q 12 hours.” The child weighs 77 lb (35 kg). What dose of ciprofloxacin in mg should be provided?

 

 

Chapter 17. Immunologic System Medications

Answer Section

 

MULTIPLE CHOICE

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antihistamines (p. 303–311; 312): Diphenhydramine (Benadryl) is an over-the-counter antihistamine that comes in children formulation. It is important to recognize that many over-the-counter products for cold and allergy symptoms contain antihistaminesRemember, knowing what the child has already taken will be an important assessment.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antihistamines (p. 303–311; 312): Fexofenadine is an antihistamine used to help control seasonal allergies. It will not affect joint pain, infectious processes, or treat worms.

 

  1. ANS:  A                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Glucocorticoids (p. 303–311; 312): Glucocorticoids must be used only as prescribed and discontinued slowly. Because of the serious side effects and long-term danger of immunosuppression, these medications are not given indefinitely. The nurse should check the chart to determine the ordering directions, but the client’s question should not be delayed an entire week. Knowing what the pharmacist said about the medications will not help in this scenario.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Glucocorticoids (p. 303-311; 312): Beclomethasone is an inhaled corticosteroid often used in the treatment of asthma. Loratadine is an antihistamine, phenylephrine is a decongestant, and diflunisal is an NSAID.

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Glucocorticoids (p. 303–311; 312): Glucocorticoids such as fluticasone are administered intranasally to combat allergic rhinitis. Celecoxib is an NSAID, cefterizine is an antihistamine, and azathioprine is an immunosuppressant.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Nasal Decongestants (p. 303–311; 312): Propanolamine is a nasal decongestant that causes vasoconstriction on the adrenergic receptor in the nose by affecting the sympathetic tone of the blood vessels. These medications are typically used for only 3 to 5 days; otherwise “rebound” nasal congestion occurs.

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Nasal Decongestants (p. 303–311; 312): Nasal decongestants such as naphazoline drops can alleviate nasal congestion intranasally by drying secretions. Other decongestants are given orally.

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Nonsteroidal Anti-inflammatory Drugs (p. 303–311; 312): NSAID agents are effective at reducing pain, inflammation, and fever. For this scenario, the medication is being used for pain and inflammation. The nurse should be aware it may mask a fever and should be alerted to other signs and symptoms of infection.

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Nonsteroidal Anti-inflammatory Drugs (p. 303–311; 312): Ketorolac is an NSAID given in IM or IV format with similar chemical properties to ibuprofen. There is a high likelihood the client is allergic to this medication and alternative pain control medications will be needed.

 

  1. ANS:  A                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Nonsteroidal Anti-inflammatory Drugs (p. 303–311; 312): This medication is an NSAID agent. It can be safely crushed and given with pudding or applesauce. There is no reason to contact the RN or physician and no contraindication to providing the medication in crushed form.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Immunosuppressants (p. 303-311; 312): Sirolimus is an immunosuppressant agent used to prevent rejection after organ transplantation.

 

  1. ANS:  A                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Immunosuppressants (p. 303-311; 312): Diltiazem is a calcium channel blocker, which is a class of medications that can interact with immunosuppressants. Pravastatin is a statin agent used to reduce cholesterol. Losartan is an angiotensin receptor blocker used to treat hypertension. Acebutolol is a beta-adrenergic blocker used to treat angina and hypertension.

 

  1. ANS:  A                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Tetracycline Medications (p. 303-311; 315): Minocycline is a tetracycline antibiotic that causes increased sensitivity to the sun – sunscreen and a hat should be advised. The medication, and all antibiotics, should be taken for their full course to avoid drug resistant strains of bacteria developing. No dietary restrictions are noted for this medication and alcohol is not listed as an interaction for this medication.

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Macrolide Medications (p. 303–311; 315): A Z-pak is a trade name for azithromycin, a macrolide antibiotic used in the treatment of bacterial infections resistant to penicillin.

 

  1. ANS:  B                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Macrolide Medications (p. 303-311; 315): Clarithromycin is a macrolide antibiotic typically used in the treatment of upper respiratory infections. Ethambutol is an anti-tuberculin medication. Amphotericin B and nystatin are both anti-fungal agents.

 

  1. ANS:  D                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Reduction of Risk Potential

NOT:  See Master the Essential Table and Aminoglycoside Medications (p. 303–311; 315): Gentamicin in is an aminoglycoside antibiotic. As a class, these antibiotics can cause renal compromise and should be used cautiously in clients with kidney dysfunction. The listed creatinine is higher than recognized normal levels, which are generally 0.6 to 1.2 mg/dL.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Sulfonamide Medications (p. 303–311; 315): While each of these assessments may be helpful, the highest priority is to determine if the individual is experiencing symptoms of pseudomembranous colitis, which should be reported to the physician.

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antituberculosis Medications (p. 303–311; 316): Ethambutol (Myambutol), isoniazid (Nydrazid), and rifampin (Rifadin) are anti-tuberculosis medications. Clients with tuberculosis are placed in respiratory isolation and must wear a mask when transported out of the room. A full respiratory assessment is not necessary prior to the film as there is no evidence in the stem that the client is in respiratory distress. A full set of films is preferable to a portable x-ray unless contraindicated.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antitoxins (p. 303–311; 316): Tetanus immune globulin is provided as an IM injection/vaccination to prevent tetanus.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antifungal Medications (p. 303–311; 316): Mycostatin is an antifungal agents used to treat oral thrush. The best way to apply the medication directly to the surface of the baby’s mucosa is with an oral swab. Diluting the medication or allowing the baby to suck it out of a medication syringe or from a pacifier will result in swallowing the medication, which is not as effective as direct application to the oral mucosa.

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antifungal Medications (p. 303–311; 316): Monistat is an antifungal cream used in the treatment of yeast infections. Clients who wear briefs may develop such infections due to the warm, moist environment of a diaper. Additionally, when clients take antibiotics their natural flora are killed allowing a fungal infection to develop. This client has pneumonia and is most likely receiving antibiotics.

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antiparasitic Medications (p. 303–311; 318): Medications containing permethrin (and other pediculocides used to treat parasites such as lice) can be purchased over the counter without a prescription. All treatment for lice must include treatment of close contacts as well as cleaning of bedding and any clothing or hair care items used on the client.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antiparasitic Medications (p. 303–311; 318): Atovaquone/Proguanil (Malarone) is an anti-malarial medication that should be taken in addition to personal protection such as long sleeves and pants and insect repellant. Malaria is carried by mosquitoes (not water or lice). There is no vaccine available.

 

  1. ANS:  C                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Comprehension                               MSC:  NCLEX Category: Health Promotion and Maintenance

NOT:  See Master the Essential Table and Vaccines (p. 303-311; 319): Vaccinations provide active artificial immunity. Active natural immunity occurs when a microbe passes into the body unintentionally and the body learns to fight it. Passive natural immunity is that which is passed from mother to fetus in-utero. Passive artificial immunity occurs when antibodies are passed from a donor to a recipient.

 

  1. ANS:  C                    PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Analysis         MSC:  NCLEX Category: Reduction of Risk Potential

NOT:  See Master the Essential Table and Alkylating Agents (p. 303–311; 321): Chlorambucil is an alkylating agent used in the treatment of leukemia and solid tumors. This class of medications can cause bone marrow suppression and in this scenario the only abnormal lab value is the platelet count, which normally ranges from 100,000 to 400,000/mm3.

 

  1. ANS:  A                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Analysis         MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Hormones (p. 303-311; 323): Goserelin acetate is a hormonal therapy used in the treatment of advanced prostate cancer. The medications alter the effect of testosterone in the client’s body and can result in hot flashes and other menopausal-like symptoms in the man. CA-125 is a tumor marker used to follow ovarian cancer. PSA is a tumor marker used to follow prostate cancer. Hair loss is rare with this medication, however because of the change in hormonal balance, there may be complications related to libido and sexual performance.

 

  1. ANS:  A                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Biologic Therapy (p. 303–311; 323): Monoclonal antibodies attack cancer cells only. They attach themselves to the tumor antigens and make them easily recognizable to the body’s immune system.

 

  1. ANS:  D                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Physiological Adaptation

NOT:  See Master the Essential Table and Radioactive Isotopes (p. 303–311; 324): Radioactive isotopes can be implanted in the form of seeds. This procedure is called brachytherapy.

 

  1. ANS:  B                    PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Physiological Adaptation

NOT:  See Master the Essential Table and Radioactive Isotopes (p. 303–311; 324): Radioactive isotopes must be handled very carefully and facility policy will dictate the handling and disposal of body fluids. These clients are not roomed with others to reduce the risk of radiation exposure. Specialized rooms with lead-lined walls away from other rooms will reduce the risk of radiation exposure to others.

 

MULTIPLE RESPONSE

 

  1. ANS:  A, C, E           PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antihistamines (p. 303–311; 312): Advise patient that good oral hygiene, frequent rinsing of mouth with water, and sugarless gum or candy may minimize dry mouth. Flossing is not helpful in addressing dry mouth. Caffeine has a diuretic effect and will not be helpful. Alcohol-based mouth rinse may increase a sensation of dryness.

 

  1. ANS:  C, E, F            PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antihistamines (p. 303–311; 312): Azelastine is an antihistamine. These medications can cause sedation, CNS depression, dizziness, muscle weakness, epigastric distress, and dry mouth. Increased risk of infection, nausea, and rash are not expected side effects with this medication.

 

  1. ANS:  A, E                PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Nonsteroidal Anti-inflammatory Drugs (p. 303–311; 312): Precautions or contraindications for NSAID agents include renal disease and GI bleeding since NSAIDs increase the risk for both conditions.

 

  1. ANS:  A, B, C, D       PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Penicillin Medications (p. 303-311; 314): The first four agents listed are derivatives of penicillin and should not be given to a client with a penicillin allergy. Doxycycline is a tetracycline antibiotic; erythromycin is a macrolide; both are potentially safe in a client with an allergy to penicillin.

 

  1. ANS:  A, B, C, D       PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Penicillin Medications (p. 303–311; 314): Antibiotic therapy should be taken until the entire course of medication is gone to avoid the development of resistant organisms. The other statements are all true and could be included in the client teaching.

 

  1. ANS:  A, D               PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Cephalosporin Medications (p. 303-311; 315): Cefaclor is a cephalosporin antibiotic. Alcohol and diuretics may interact with these medications and should be avoided. The medication does not interact with dairy products and may cause diarrhea so increased liquids and iron in the diet may help treat or reduce this risk.

 

  1. ANS:  B, C                PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Tetracycline Medications (p. 303–311; 315): Tetracycline and doxycycline belong to the tetracycline antibiotic family. These medications can cause decreased bone growth and discolored teeth in a fetus or child and should not be used in pregnancy. Amikacin is an aminoglycoside; erythromycin is a macrolide; ciprofloxacin is a quinolones; cefibuten is a cephalosporin.

 

  1. ANS:  A, B, C           PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Aminoglycoside Medications (p. 303–311; 315): Hearing loss can occur and prompt recognition and intervention are essential in preventing permanent damage. Monitor renal function as this medication is contraindicated for individuals with decreased kidney function and can cause kidney damage. Nurses should never infuse anything into a TPN line other than lipids ordered to accompany such infusions. Symptoms of infection may be expected in this client since they are receiving antibiotic therapy presumably to treat an infection.

 

  1. ANS:  C, E                PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Sulfonamide Medications (p. 303–311; 315): Sulfisoxazole is a sulfonamide antibiotic typically used to treat urinary tract infections. Doses should not be doubled in medications. Instead, a missed dose should be taken as soon as it is remembered or missed completely if it is time for the next dose. The medication can be taken with or without food and is much more likely to cause diarrhea than constipation. Pregnancy is a contraindication for this family of antibiotics.

 

  1. ANS:  A, B, E           PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Sulfonamide Medications (p. 303–311; 315): Sulfamethizole, sulfamethoxazole, and sulfasalazine are all sulfa antibiotics and should be questioned/not given to a client with allergies to sulfa medications.

 

  1. ANS:  A, D               PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Knowledge     MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antituberculosis Medications (p. 303–311; 316): Rifampin and rifabutrin will cause the urine, stool, tears, sweat, and saliva to turn red/orange in color. The other medications are anti-tuberculosis medications but do not cause this particular side effect.

 

  1. ANS:  A, B, E           PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Medications That Fight Viruses (p. 303–311; 317): Miconazole is a topical antifungal agent designed to treat fungal infections such as athlete’s foot. Clients are generally encouraged to reduce time in shoes, rotate shoes, and wear clean, white cotton socks while undergoing treatment to help reduce the heat and moisture that contribute to fungal growth.

 

  1. ANS:  A, C               PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Medications That Fight Viruses (p. 303–311; 317): Acyclovir is an anti-viral agent used in the treatment of herpes and other viruses like chicken pox and shingles. A client with bronchitis or a bacterial sinus infection will need an antibiotic; a client with thrush will need an antifungal.

 

  1. ANS:  B, D, F            PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Medications That Fight Viruses (p. 303-311; 317): Oseltamivir and other antivirals can cause confusion, diarrhea, headache, kidney disease, nausea, rash, urticaria, and vomiting.

 

  1. ANS:  A, B, D, F       PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Antimetabolite Medications and Box 17.1 (p. 303–311; 322): Antimetabolite medications can cause multiple side effects. It is important for all clients receiving chemotherapy that can cause nausea/vomiting to have this monitored and treated with antiemetics promptly. Strict intake and output should be monitored including caloric intake. MildRemember,ft foods are generally suggested to reduce the risk of GI irritation. Vital signs should be monitored frequently. Standard precautions are appropriate and there is no reason for the client to be placed in contact precautions. Frequent oral care will reduce the risk of stomatitis, which is particularly concerning with this medication.

 

  1. ANS:  B, D               PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Reduction of Risk Potential

NOT:  See Master the Essential Table and Biological Therapy (p. 303–311; 323): Alemtuzumab is a biological response modifier used in the treatment of multiple cancers including leukemia. Leukemia is a cancer of the white blood cells and bone marrow suppression is an expected side effect of the medication, thus the white blood cell count and platelet count will be monitored with each subsequent treatment. Prothrombin time is used to evaluate bleeding time. CD-8 count is monitored in clients with HIV. C-reactive protein is used to evaluate inflammation.

 

  1. ANS:  B, C, E            PTS:   1                    DIF:    Hard

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Plant Extracts (p. 303-311; 323): Docetaxel is a plant alkaloid. This class of medications is known for side effects including neurotoxicity and hair loss (alopecia) as well as altered GI function including sores in the mouth, constipation, nausea/vomiting, or diarrhea. Hot flashes or rash are not seen with this class of medications.

 

COMPLETION

 

  1. ANS:  200 mL/hr

 

PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Cephalosporin Medications (p. 303–311; 315): 100 mL divided by 30 minutes multiplied by the conversion factor of 60 minutes/hour = 200 mL/hr.

 

  1. ANS:  5 mL

 

PTS:   1                    DIF:    Easy

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Glucocorticoids (p. 303–311; 312): With a dose of 10 mg liquid preparation of 2 mg/mL the provided dose is 5 mL [10 mg ÷ 2 mg/mL = 5 mL].

 

  1. ANS:  4 pills

 

PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Quinolone Medications (p. 303–311; 315): Ofloxacin is a quinolone medication used in the treatment of upper respiratory infections. This drug calculation is done by recognizing that the 400-mg dose will require 2 pills (200 mg each) and that the client will take 2 doses each day for a total of 4 pills.

 

  1. ANS:  525 mg

 

PTS:   1                    DIF:    Moderate

TOP:   Therapeutic Classification: Immunological System Medications

KEY:  Application    MSC:  NCLEX Category: Pharmacological Therapies

NOT:  See Master the Essential Table and Quinolone Medications (p. 303–311; 315): Ciprofloxacin is a quinolone antibiotic. Dosage calculation requires multiplying 15 mg by 35 kg for a dose of 525 mg every 12 hours.

 

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