Pharmacology questions

Linton: Introduction to Medical-Surgical Nursing,
these are the questions I took from my nursing CD.

Chapter 1: Introduction

Review Questions
1. Controlled drugs are:
A. regulated by state and local laws more than federal laws.
B. categorized according to prescription or nonprescription status.
C. scheduled according to medical use and potential for abuse.
D. those that must demonstrate high standards of safety.

2. Why is it helpful for the nurse to know the generic names of more commonly used drugs?
3. Most modern drugs are:
A. synthetic products manufactured in laboratories.
B. synthetic modifications of natural products.
C. natural products derived from plants.
D. natural products derived from minerals.

Chapter 2: How Drugs Work

Review Questions
1. A person with liver disease may have impaired:
A. distribution.
B. absorption.
C. metabolism.
D. excretion.

2. Identify five factors that affect drug distribution in the body.

3. A drug is given orally. After absorption, most of the drug is inactivated as the blood passes through the liver, so there is no therapeutic effect. This is called:
A. tolerance.
B. first-pass effect.
C. antagonism.
D. pharmacodynamics.

4. The ability of drugs to attach to specialized regions of cells is the basis of which theory of drug action?
A. Chemical action
B. Physical action
C. Altered metabolic pathways
D. Receptor theory of drug action

5. Identify the factors that affect the way a person responds to a drug.

Chapter 3: Nurses and Drug Therapy

Review Questions
1. Which of the following statements is true regarding your responsibility for drug therapy?
A. You are not liable for mistakes as long as you follow orders.
B. You are accountable for your actions as a licensed nurse.
C. You cannot be expected to recognize adverse drug effects.
D. You cannot refuse to carry out a legal order.

2. During the initial admission assessment, a patient reports that he is allergic to a particular medication. The nurse should:
A. disregard the information as unimportant, because the patient will not be receiving that particular drug.
B. suspect that the patient overdosed on the drug.
C. ask what symptoms occurred with the allergic reaction.
D. determine whether the patient was taking any herbal supplements at the time.

3. In teaching a client about the adverse effects of a newly ordered drug, which of the following should be included?
A. Adverse effects that the client is likely to experience
B. A detailed list of all potential adverse effects
C. Percentages of particular adverse effects that occurred during clinical trials of the drug
D. Research data about rare adverse effects




Chapter 4: Anti-Inflammatory Drugs

Review Questions
1. Which body system is most often affected by adverse effects of PSIs?
A. Gastrointestinal
B. Central nervous
C. Cardiovascular
D. Endocrine

2. Teaching for the client who is taking a coxib should include which of the following?
A. “You may safely increase the dose as needed.”
B. “There is an increased risk of bleeding with this drug.”
C. “You will have no risk of increasing your blood pressure with this drug.”
D. “Notify your health care provider if abdominal pain or black stools occur.”

3. The actions of acetaminophen are similar to those of aspirin except that acetaminophen is NOT an:
A. anti-inflammatory.
B. analgesic.
C. antipyretic.
D. antimicrobial.

4. Aspirin should not be used to treat viral infections in children because it may cause:
A. kidney failure.
B. gastric ulcers.
C. Reye’s syndrome.
D. confusion.

Chapter 5: Anti-Infective Drugs

Review Questions
1. A client is to begin taking ampicillin. In her drug history, the nurse notes that she uses birth control pills for contraception and takes an over-the-counter antihistamine for allergies. What teaching will be important?
A. The antihistamine will interfere with the action of ampicillin.
B. Discontinue birth control pills while taking ampicillin.
C. Use an additional method of contraception while taking ampicillin.
D. Take ampicillin at least 1 hour before taking birth control pills.

2. When preparing to give a patient his first dose of ceftriaxone (Rocephin), the nurse asks if he is allergic to any drugs. He replies that he had an anaphylactic reaction to penicillin in the past. The nurse should:
A. administer the ceftriaxone and observe him closely for a reaction.
B. withhold the ceftriaxone and notify the health care provider.
C. tell him ceftriaxone is not a type of penicillin so it will be safe for him.
D. tell him this is what the doctor ordered.

3. The most serious adverse effects of aminoglycosides are:
A. constipation and abdominal pain.
B. migraine headaches and phlebitis.
C. muscle weakness and dry mouth.
D. ototoxicity and nephrotoxicity.

4. Which type of antimicrobial should not be given with dairy products?
A. Tetracycline
B. Aminoglycosides
C. Beta-lactams
D. Sulfonamides

5. A client is being treated with isoniazid (INH) to prevent development of active tuberculosis. Why has the health care provider also ordered pyridoxine (vitamin B6) in addition to the isoniazid?
A. People with tuberculosis tend to be undernourished and need vitamin supplements.
B. Vitamin B6 will decrease neurologic side effects of isoniazid.
C. Pyridoxine is effective against the organism that causes tuberculosis.
D. Vitamin B6 promotes absorption of isoniazid.

6. Why are multiple drugs recommended to treat active tuberculosis?

7. To be effective in the treatment of influenza A, amantadine (Symmetrel) must be given:
A. for a minimum of 2 weeks.
B. before symptoms develop.
C. 24 hours after exposure to the infection.
D. within 48 hours of the onset of symptoms.

8. Therapeutic effects of drugs used for treatment of the human immunodeficiency virus (HIV) are assessed by monitoring:
A. body temperature.
B. white blood cell counts.
C. CD4 T cell counts.
D. urine HIV RNA.

9. While receiving an intravenous infusion of amphotericin B, a patient complains of headache, nausea, and chills. The nurse should do which of the following?
A. Explain that this is expected.
B. Discontinue the infusion.
C. Contact the pharmacist for guidance.
D. Call the health care provider to request a change in drugs.

10. The adverse effects of amphotericin B infusions can be reduced by premedicating the patient with:
A. diphenhydramine, aspirin, and meperidine.
B. morphine, diazepam, and acetaminophen.
C. codeine, chlorpromazine, and Maalox.
D. meperidine, diazepam, and aspirin.


Chapter 6: Analgesics

Review Questions
1. Codeine, morphine, and meperidine are examples of:
A. nonsteroidal anti-inflammatory drugs.
B. opioid agonists.
C. opioid agonist-antagonists.
D. nonopioid analgesics.

2. The classic signs of opioid toxicity are:
A. nausea, vomiting, diarrhea.
B. respiratory depression, euphoria, physical dependence.
C. coma, respiratory depression, pinpoint pupils.
D. increased intracranial pressure, decreased reflexes, coma.

3. Place the patient in a recumbent position to administer parenteral opioids to reduce the risk of:
A. orthostatic hypotension.
B. respiratory depression.
C. increased intraocular pressure.
D. cardiac depression..

4. Nausea, vomiting, changes in vision and hearing, drowsiness, confusion, and hyperventilation are classic signs of:
A. opioid agonist-antagonist overdose.
B. orthostatic hypotension.
C. drug withdrawal.
D. salicylate toxicity.

5. The most important laboratory tests that the nurse should evaluate for a patient suspected of an acetaminophen overdose are:
A. hemoglobin, hematocrit, white blood cell count.
B. plasma salicylate.
C. liver function tests.
D. blood urea nitrogen and creatinine.

Chapter 7: Sedative/Hypnotics

Review Questions
1. Barbiturates are known as liver enzyme inducers. This means that:
A. an additional enzyme must be administered concurrently to prevent toxicity.
B. barbiturates will be metabolized very slowly.
C. use of barbiturates produces permanent alteration in drug-metabolizing enzymes.
D. barbiturates increase the liver’s ability to metabolize themselves, as well as other drugs given concurrently, producing drug tolerance.

2. Benzodiazepines are more commonly prescribed as hypnotics over the barbiturates because benzodiazepines:
A. induce liver enzymes.
B. provide pain relief also.
C. do not suppress REM sleep.
D. have no potential for physical dependence.

3. The antidote/antagonist specific for benzodiazepine overdose is:
A. naloxone (Narcan).
B. flumazenil (Romazicon).
C. neostigmine (Prostigmin).
D. naltrexone (ReVia, Trexan).


Chapter 8: General/Local Anesthetic Agents

Review Questions
1. Which of the following nursing actions is most appropriate to aid in excretion of a general anesthetic agent from a postoperative patient’s body?
A. Turn, cough, and deep breathe.
B. Increase IV fluid rate.
C. Offer oral fluids as soon as possible.
D. Use passive range-of-motion exercises.

2. Care for a patient who has received local anesthesia includes the knowledge that:
A. sensation returns before motor function.
B. motor function returns before sensation.
C. sensation and motor function return simultaneously.
D. close, frequent assessment of vital signs is not as important as for a patient receiving general anesthesia.

3. A patient has had topical local anesthesia applied to her mouth and throat for a diagnostic procedure. What is the most important information the nurse needs to know before offering her something to drink?
A. The patient’s urine output is adequate.
B. The patient is able to hold the glass herself.
C. The patient’s gag reflex has returned.
D. The nurse knows type of sedation used during the procedure.


Chapter 9: Skeletal Muscle Relaxants

Review Questions
1. Which of the following is the drug of choice to prevent or treat malignant hyperthermia?
A. diazepam (Valium)
B. acetaminophen (Tylenol)
C. edrophonium (Tensilon)
D. dantrolene (Dantrium)

2. A postsurgical patient who received succinylcholine as part of his anesthesia asks the nurse why his muscles and throat are so sore. The nurse’s best response is:
A. “This is a normal response to a muscle relaxant you received during surgery and should go away in 24 to 48 hours.”
B. “I’m very concerned about this. I will call your doctor right away.”
C. “You must have been fighting the anesthesia and had to be restrained.”
D. “I’ll get you some pain medication.”

3. Use of succinylcholine may be contraindicated for patients with severe burns or trauma because of the risk of:
A. hypoglycemia.
B. hyperkalemia.
C. hypocalcemia.
D. metabolic alkalosis.

4. Identify the difference in the mechanism of action between depolarizing and nondepolarizing neuromuscular blocking agents.

5. Why is use of tubocurarine contraindicated for persons with asthma, bronchospasm, or cardiac disease?


Chapter 9: Skeletal Muscle Relaxants

Review Questions
1. Which of the following is the drug of choice to prevent or treat malignant hyperthermia?
A. diazepam (Valium)
B. acetaminophen (Tylenol)
C. edrophonium (Tensilon)
D. dantrolene (Dantrium)

2. A postsurgical patient who received succinylcholine as part of his anesthesia asks the nurse why his muscles and throat are so sore. The nurse’s best response is:
A. “This is a normal response to a muscle relaxant you received during surgery and should go away in 24 to 48 hours.”
B. “I’m very concerned about this. I will call your doctor right away.”
C. “You must have been fighting the anesthesia and had to be restrained.”
D. “I’ll get you some pain medication.”

3. Use of succinylcholine may be contraindicated for patients with severe burns or trauma because of the risk of:
A. hypoglycemia.
B. hyperkalemia.
C. hypocalcemia.
D. metabolic alkalosis.

4. Identify the difference in the mechanism of action between depolarizing and nondepolarizing neuromuscular blocking agents.

5. Why is use of tubocurarine contraindicated for persons with asthma, bronchospasm, or cardiac disease?


Chapter 11: Falls, Immobility, Confusion, Incontinence, Dementia

Review Questions
1. Because of age-related changes in renal and hepatic function, the older person:
A. metabolizes drugs more slowly.
B. requires higher drug dosages.
C. is less likely to have drug toxicities.
D. can take multiple drugs without interactions.

2. A patient is taking an anti-inflammatory drug, a diuretic, antacids, and a bronchodilator. He complains of dizziness when he first stands up. Which drug is most likely causing the problem?
A. Anti-inflammatory
B. Diuretic
C. Antacid
D. Bronchodilator

3. A patient’s blood pressure is 130/72 and her pulse is 80 when she is supine. On standing, her blood pressure is 100/54 and her pulse is 60. This is characteristic of:
A. fluid retention.
B. allergic drug reaction.
C. orthostatic hypotension.
D. normal effects of position change.

4. Cholinesterase inhibitors may improve symptoms of Alzheimer’s disease by:
A. destroying pathogens.
B. repairing damaged neurons.
C. stimulating cerebral circulation.
D. increasing acetylcholine in the brain.

5. Aspirin may be given to patients with vascular dementia in an effort to prevent:
A. stroke.
B. varicose veins.
C. congestive heart failure.
D. peptic ulcer disease.


Match the type of bladder control problem on the right with the drug on the left that may cause it.
6. _____ Diuretics A. Unable to reach toilet quickly enough
7. _____ Anticholinergics B. Bladder becomes distended; overflows
8. _____ Sedatives/hypnotics C. Urine leaks under stress
9. _____ Alpha-adrenergic blockers D. Patient unaware of need to void


10. Stress incontinence due to atrophic vaginitis may be relieved by:
A. imipramine (Tofranil).
B. estrogen cream.
C. oxybutynin (Ditropan).
D. bethanechol (Urecholine).

Chapter 12: Terminal Illness

Review Questions
1. The goal of pain management during terminal illness is to:
A. identify a safe and effective dose.
B. prevent excessive sedation.
C. avoid development of drug addiction.
D. control pain without opioids.

2. A type of drug that can help relieve cough is:
A. ACE inhibitor.
B. antidepressant.
C. mucolytic.
D. bronchoconstrictor.

3. What action is common to metoclopramide (Reglan), dexamethasone (Decadron), prochlorperazine (Compazine), and diazepam (Valium)?
A. Tranquilizer
B. Anti-Inflammatory
C. Muscle relaxant
D. Antiemetic

4. Corticosteroids may be used to treat delirium caused by:
A. cerebral edema.
B. kidney failure.
C. carbon monoxide.
D. electrolyte imbalances.

5. Alprazolam (Xanax) and lorazepam (Ativan) may be used during terminal illness to treat:
A. insomnia.
B. dyspnea.
C. constipation.
D. anxiety.

6. Bulk laxatives are not recommended in terminal illness because of the risk of:
A. diarrhea.
B. ruptured appendix.
C. excess gas formation.
D. intestinal obstruction.

Chapter 13: Antineoplastic Drugs

Review Questions
1. It is important to protect patients from trauma when they have:
A. anemia.
B. stomatitis.
C. xerostomia.
D. thrombocytopenia.

2. Good hydration is important when giving cisplatin (Platinol) to prevent:
A. dehydration.
B. pneumonia.
C. nephrotoxicity.
D. hearing loss.

3. Peripheral neuropathy is characterized by:
A. altered sensation.
B. diarrhea.
C. muscle spasms.
D. hyperactive reflexes

4. When a client is receiving a drug that causes bone marrow depression, which of the following should be emphasized with the client and family members or caregivers?
A. Fatigue and weakness are not commonly experienced.
B. Wash hands often and avoid people with colds, flu, or other infections.
C. More nausea and vomiting may occur when blood cell counts are low.
D. Take acetaminophen for fever.

5. Monoclonal antibodies used in the treatment of cancer:
A. are highly toxic to both cancer cells and normal cells.
B. change the hormonal components of cancer cells.
C. protect normal cells from cytotoxic drugs.
D. target specific antigens or vital processes of cancer cells.

6. How do angiogenesis inhibitors produce their effects on tumor growth?

Chapter 14: Adrenergics

Review Questions
1. Beta1 receptors are located primarily in the_______________. Stimulation of these receptors produces_______________ and_______________________________.

2. Activation of beta2 receptors produces what effect on the lungs?
A. Bronchoconstriction
B. Bronchodilation
C. No effect

3. A patient who is using an isoproterenol inhaler for treatment of asthma tells the nurse that his saliva and sputum are “pink.” Based on his knowledge of this drug, the nurse responds:
A. “I will call your health care provider right away.”
B. “The drug may be causing a small amount of bleeding in your airway.”
C. “This is a type of allergic reaction to the drug.”
D. “This is a normal, harmless effect of the drug.”

4. Patient teaching regarding use of alpha-adrenergic drugs to relieve nasal congestion includes information that:
A. excessive use may cause rebound nasal congestion when the drug is discontinued.
B. it is permissible for the patient to increase the dose if previous dose is ineffective.
C. concurrent use of any OTC cold or allergy medication is safe.
D. these drugs do not produce any effects that could affect driving a car.

Chapter 15: Antiadrenergics

Review Questions
1. Instruct patients who are taking antiadrenergic drugs for treatment of hypertension not to abruptly stop taking the medication because of the risk for:
A. edema.
B. postural hypotension.
C. urinary retention.
D. rebound hypertension.

2. A patient is started on prazosin (Minipress) to treat his hypertension. Which of the following patient teaching instructions should be stressed?
A. Rise slowly from lying or sitting position.
B. Take drug on an empty stomach.
C. Force fluids to 2000 mL/day.
D. Medication must always be taken in the morning.

3. Which side effect should a patient be aware of when taking clonidine (Catapres)?
A. Anxiety
B. Diarrhea
C. Drowsiness
D. Irritability

4. A patient who is taking doxazosin (Cardura) for treatment of hypertension asks if it is all right to take Advil for arthritis pain. Based on knowledge of the drug, the nurse’s best response is:
A. “You may continue to take the Advil without any problems.”
B. “You should not take Advil because it may cause fluid retention and increase your blood pressure.”
C. “I don’t know. I’ll have to ask your health care provider.”
D. “You shouldn’t take Advil, but you could take Motrin without problem.

Chapter 16: Cholinergics

Review Questions
1. The nurse should be prepared to administer which of the following drugs as an antidote to cholinergic overdose?
A. epinephrine (Adrenalin)
B. propranolol (Inderal)
C. atropine sulfate
D. diphenhydramine (Benadryl)

2. Activation of nicotinic receptor produces what effect on the body?
Activation of muscarinic receptors stimulates or suppresses cellular activity in what
areas of the body?

3. A 62-year-old man has been admitted to the hospital for treatment of benign prostatic hypertrophy (BPH). How should the nurse respond to an order for bethanechol (Urecholine) to treat urinary retention in this situation?
A. Insert a Foley catheter before administration of the drug.
B. Provide a urinal because urinary frequency will increase following drug administration.
C. Give the medication as ordered.
D. Question the order because the patient’s urinary retention is due to an obstructive process.

4. A client who has been taking pyridostigmine (Mestinon) for treatment of myasthenia gravis tells the nurse that she has noticed an increase in saliva production, increased sweating, and some abdominal cramping. The nurse’s best response should be which of the following?
A. “These are usual side effects from this drug.”
B. “You must call your health care provider immediately, as these are signs of a drug overdose.”
C. “You should decrease the drug dose, then these effects will go away.”
D. “Taking the drug with food will eliminate this problem.”

Chapter 17: Anticholinergics

Review Questions
1. A client is to begin taking benztropine (Cogentin) for treatment of Parkinson’s disease. Which of the following instructions would be appropriate for this client?
A. Change positions slowly to prevent orthostatic hypotension.
B. Be sure a bathroom is near, as this medication may cause diarrhea.
C. Avoid overheating and wear loose, cool clothing because this drug impairs sweating.
D. Limit fluid intake because this medication will cause fluid retention.

2. Soon after the administration of the first dose of atropine, a patient complains of acute eye pain. The nurse should:
A. Prepare to treat an allergic reaction with diphenhydramine (Benadryl).
B. Administer a PRN dose of an analgesic.
C. Place a cool, damp cloth over the patient’s eyes for comfort.
D. Hold further doses of atropine and notify health care provider immediately.

3. A patient has bradycardia with a heart rate of 46 bpm. She is confused and her skin is cool and clammy. What is the drug of choice in this situation?
A. atropine sulfate
B. epinephrine (Adrenalin)
C. isoproterenol (Isuprel)
D. dopamine (Intropin)

4. The drug of choice to treat anticholinergic overdose is which of the following?
A. diphenhydramine (Benadryl)
B. physostigmine (Antilirium)
C. epinephrine (Adrenalin)
D. dantrolene (Dantrium)


Chapter 18: Anticonvulsants

Review Questions
1. Which of the following statements made by a client taking phenytoin indicates understanding of the nurse’s teaching?
A. “I will increase the dose if my seizures don’t stop.”
B. “I don’t need to contact my health care provider before taking an over-the-counter cold remedy.”
C. “I will take good care of my teeth and see my dentist regularly.”
D. “I cannot take this drug with food.”

2. Teaching for patients taking carbamazepine includes which one of the following points?
A. Use sunscreen and protective clothing when out of doors.
B. This drug has no significant side effects.
C. Changes in skin pigmentation are normal and of no concern.
D. Your urine may turn a harmless blue color.

3. Nutrition teaching regarding foods high in vitamin D and folic acid is necessary for clients taking which of the following anticonvulsant drugs?
A. Clonazepam and clorazepate
B. Diazepam and lorazepam
C. Carbamazepine and valproic acid
D. Phenytoin and phenobarbital

4. A 20-year-old client presents to the clinic with complaints of breast tenderness, nausea, vomiting, and absence of menses for 2 months. She has a history of a seizure disorder well controlled with carbamazepine (Tegretol). She tells the nurse that she has been taking her oral contraceptives as directed, but she wonders if she might be pregnant. The nurse’s best response to her concern should be which of the following?
A. “You can’t be pregnant if you have been taking your oral contraceptives correctly.”
B. “Carbamazepine can decrease the effectiveness of oral contraceptive drugs, so we need to do a pregnancy test.”
C. “There is no need to worry. Oral contraceptives are very effective.”
D. “Taking antiseizure drugs with oral contraceptives significantly decreases your risk of getting pregnant.”

Chapter 19: Antiparkinson Drugs

Review Questions
1. The basic pathophysiology of Parkinson’s disease is a deficiency in the brain content of which of the following substances?
A. Acetylcholine
B. Dopamine
C. Glutamate
D. Serotonin

2. Carbidopa is usually given together with levodopa because it:
A. crosses the blood-brain and acts directly on the central nervous system.
B. directly stimulates dopamine receptors in the brain.
C. decreases adverse effects of levodopa.
D. inhibits metabolism of levodopa.

3. A client who is receiving amantadine (Symmetrel) for treatment of Parkinson’s disease tells the nurse that he is very worried because he has developed a bluish color on his legs. The nurse’s best response is:
A. “This is a normal reaction to the drug. The coloration will go away when the drug is stopped.”
B. “This is indicative of a serious vascular side effect. Please notify your health care provider right away.”
C. “If you take your medication with meals, this effect will go away.”
D. “I am not sure what that color change means, so you should call your health care provider soon.”

4. A client has been on levodopa for 2 weeks. A family member calls the clinic to tell the nurse that there seems to be no change in her relative’s symptoms. What is the nurse’s most appropriate response?
A. “I will have your health care provider increase the dose, because the current one does not seem to be working.”
B. “Apparently this is not the correct drug to use. We will need to consider changing to another one.”
C. “It may take several weeks before medication effects are seen, and you may not see maximum effects for 6 months.”
D. “It may be that your relative has developed resistance to this particular drug.”

Chapter 20: Central Nervous System Stimulants

Review Questions
1. Parent teaching for children taking methylphenidate (Ritalin) for ADHD should include which of the following?
A. Give your child the drug at bedtime.
B. Drowsiness may be a side effect.
C. If necessary, the child may take over-the-counter cold products without problems.
D. Provide for periodic “drug-free” holidays.

2. Caffeine and other central nervous system stimulants may cause which of the following adverse effects?
A. Increased appetite
B. Sedation
C. Cardiac arrhythmias
D. Respiratory depression

3. A child is receiving atomoxetine (Strattera) for treatment of ADHD. Which of the following would indicate therapeutic effects?
A. Increased activity
B. Improved performance in schoolwork
C. Increased appetite
D. Rapid changes in growth


Chapter 21: Hematologic Drugs

Review Questions
1. A patient is receiving heparin per continuous IV infusion. Which of the following laboratory tests should be done to monitor the anticoagulation effects of heparin therapy?
A. Complete blood cell count
B. Activated partial thromboplastin time
C. Prothrombin time
D. International normalized ratio

2. Persons on warfarin therapy should be advised to avoid:
A. aspirin.
B. vitamin C.
C. coffee.
D. sunlight.

3. Which of the following laboratory tests will be ordered to monitor warfarin therapy?
A. Complete blood cell count
B. Activated partial thromboplastin time
C. Lee-White clotting time
D. International normalized ratio

Chapter 22: Immunologic Drugs

Review Questions
1. A patient who has had a kidney transplant is taking cyclosporine (Sandimmune) and corticosteroids. Cyclosporine is prescribed to:
A. prevent surgical infection.
B. stimulate urine production.
C. treat urinary infection.
D. prevent rejection of transplanted kidney.

2. What laboratory tests are particularly important for persons taking cyclosporine?
A. Blood urea nitrogen, creatinine
B. Complete blood cell counts
C. Prothrombin time
D. Blood glucose

3. Which of the following statements should be included in patient teaching related to immunosuppressant therapy?
A. “You will probably notice some hair loss.”
B. “Avoid people with active infections.”
C. “Consume a high-potassium diet.”
D. “You may have some dizziness caused by low blood pressure.”

Chapter 23: Antihypertensive Drugs

Review Questions
1. A client with a history of hypertension comes to the emergency department with a blood pressure of 250/135 mm Hg. Sodium nitroprusside (Nitropress) is prescribed per continuous intravenous infusion and continual blood pressure monitoring. The nurse understands that this drug’s immediate action is to lower blood pressure by:
A. decreasing heart rate.
B. increasing peripheral vascular resistance.
C. dilating arterioles and veins.
D. increasing cardiac output.

2. Single-drug therapy with an ACE inhibitor would be least effective in which of the following groups of people?
A. Older adults
B. Children
C. Asians
D. African Americans

3. Which of the following is a common side effect to therapy with an ACE inhibitor?
A. Dry, nonproductive, persistent cough
B. Constipation
C. Muscle weakness
D. Tinnitus

4. 4. A client who is taking verapamil for treatment of hypertension tells the nurse that he only takes his medication when he feels like his blood pressure is high. The nurse’s best response would be:
A. “That is a perfectly acceptable way to manage your high blood pressure.”
B. “Hypertension usually has no symptoms, so it is not safe to stop your medication on the basis of symptoms.”
C. “Since hypertension always has symptoms, you would have no reason to stop taking your medication.”
D. “Since you are not having symptoms, you must no longer have high blood pressure.”

5. A client who is taking prazosin (Minipress) for treatment of hypertension tells the nurse that she feels lightheaded upon arising. Identify four ways the client can avoid this problem.

Chapter 24: Antacids, Antiulcer Drugs

Review Questions
CASE STUDY: Mr. Kennon has been diagnosed with peptic ulcer disease, and the presence of Helicobacter pylori has been confirmed. His health care provider prescribes Helidac qid for 14 days and famotidine (Pepcid) 40 mg hs. Complete the following statements related to these drugs.

1. Helidac is a package containing ___________, ____________, and____________.

2. Why are multiple antimicrobial agents used to treat peptic ulcer disease?

3. Mr. Kennon complains he has a sore mouth and a tingling sensation in the fingers. These are most likely adverse effects of _________________________.

4. The action of famotidine is to _______________________________________.

5. Famotidine is preferred over cimetidine because of the adverse effects of cimetidine, which include ____________ , ____________, and _____________.

6. Mr. Kennon takes warfarin (Coumadin) for atrial fibrillation. How will the famotidine affect his metabolism of the warfarin?

Chapter 25: Antiemetics and Drugs Used to Treat Poisoning

Review Questions
1. A patient is to receive an antiemetic, ondansetron (Zofran), during a chemotherapy treatment. This drug would be most effective when administered:
A. before an emetogenic drug is administered.
B. when nausea occurs but before vomiting occurs.
C. after the patient has experienced both nausea and vomiting.
D. any time; timing of administration has no relationship to drug effectiveness.

2. The nurse should question an order for which of the following antiemetics for treatment of nausea associated with motion sickness?
A. scopolamine (Transderm Scop)
B. prochlorperazine (Compazine)
C. dimenhydrinate (Dramamine)
D. cyclizine (Marezine)

3. A patient being treated with levodopa for Parkinson’s disease is to receive an antiemetic following surgery. Which of the following drugs would not be appropriate to use?
A. promethazine (Phenergan)
B. hydroxyzine (Vistaril)
C. thiethylperazine (Torecan)
D. metoclopramide (Reglan)

Chapter 25: Antiemetics and Drugs Used to Treat Poisoning

Review Questions
1. A patient is to receive an antiemetic, ondansetron (Zofran), during a chemotherapy treatment. This drug would be most effective when administered:
A. before an emetogenic drug is administered.
B. when nausea occurs but before vomiting occurs.
C. after the patient has experienced both nausea and vomiting.
D. any time; timing of administration has no relationship to drug effectiveness.

2. The nurse should question an order for which of the following antiemetics for treatment of nausea associated with motion sickness?
A. scopolamine (Transderm Scop)
B. prochlorperazine (Compazine)
C. dimenhydrinate (Dramamine)
D. cyclizine (Marezine)

3. A patient being treated with levodopa for Parkinson’s disease is to receive an antiemetic following surgery. Which of the following drugs would not be appropriate to use?
A. promethazine (Phenergan)
B. hydroxyzine (Vistaril)
C. thiethylperazine (Torecan)
D. metoclopramide (Reglan)


Linton: Introduction to Medical-Surgical Nursing, 4th Edition

Pharmacology Tutorial

Chapter 27: Pituitary Hormones

Review Questions
1. Why is it important to teach patients taking vasopressin to avoid using OTC cold preparations without consulting the health care provider?

2. A patient with multiple sclerosis is receiving corticotropin as part of her drug therapy. She asks the nurse why the health care provider recommended use of a salt substitute. The nurse’s best response is:
A. “Patients with multiple sclerosis cannot tolerate regular salt.”
B. “If regular salt is used with corticotropin, the risk of ulcer development is increased.”
C. “Use of salt substitutes, which contain potassium instead of sodium, helps prevent edema and low potassium levels.”
D. “Your health care provider can best explain that to you.”

3. A child is taking somatropin as part of therapy for pituitary dwarfism. His parents tell the nurse that he has been complaining of hip pain for a week. The nurse’s best response is:
A. “This pain just means he is starting to grow.”
B. “You need to call your health care provider. The pain could indicate a problem with his hip or upper leg.”
C. “Children often complain of pain. This is nothing to worry about.”
D. “He probably just strained a muscle while playing. The pain should go away soon.”

Chapter 28: Female Hormones

Review Questions
1. Patients taking estrogens need to be regularly assessed for:
A. Increased intraocular pressure.
B. Bradycardia.
C. Decreased urinary output.
D. Hypertension.

2. Which of the following instructions should be included in patient teaching for tamoxifen?
A. Report bone pain to health care provider immediately and stop taking the drug.
B. The drug cannot be taken with food.
C. Use sunblocks and protective clothing when out of doors.
D. Sodium supplements are necessary to prevent hyponatremia.

3. Which of the following statements indicates that the client needs additional teaching about birth control pills?
A. “I will elevate my legs and take aspirin if I experience leg pain.”
B. “I will monitor my weight and have my blood pressure checked monthly.”
C. “I may gain weight while I am taking these pills.”
D. “I know nausea is common, but it should go away in a few weeks.”

4. A 76-year-old male is started on estrogen for metastatic prostate cancer. Which of the following statements leads the nurse to believe he understands the information about his medication?
A. “I will take my pill on an empty stomach.”
B. “I may experience impotence, but it should go away when the drug is stopped.”
C. “If my breasts become enlarged I will apply ice to them.”
D. “I may have some hair loss from this drug.”


Chapter 29: Male Hormones

Review Questions
1. When androgens are administered to older adult men, which of the following may occur?
A. Rapid bone growth
B. Loss of pubic hair
C. Gynecomastia
D. Prostatic enlargement

2. If a patient develops symptoms of hypercalcemia during androgen therapy, the nurse needs to instruct him to:
A. remain in bed to avoid injury.
B. drink 2000 to 3000 mL/day of fluid to prevent kidney stones.
C. reduce the dose of the medication.
D. discontinue the medication.

3. Physical changes that occur with the use of anabolic steroids in women include:
A. increased distribution of hair on face and body.
B. increased menstrual flow.
C. increased endurance.
D. thinning of skin.

4. Androgen therapy has been ordered for an 11-year-old boy who is experiencing hypogonadism. Which of the following statements made by this boy leads the nurse to believe that he has understood the teaching regarding the medication?
A. “I may have some temporary visual changes.”
B. “If I experience acne, the drug will need to be stopped.”
C. “I will need to have x-rays every 6 months.”
D. “I can expect to lose weight as a result of taking this drug.”

Chapter 30: Ophthalmic Drugs

Review Questions
1. Match the term on the left with the definition on the right.
_____ mydriasis A. right eye
_____ cycloplegia B. dilation of the pupil
_____ miosis C. left eye
_____ OD D. both eyes
_____ OS E. constriction of the pupil
_____ OU F. paralysis of ciliary body


2. Which statement is correct about topical ophthalmic drugs?
A. There is no risk of systemic effects.
B. They are used for diagnostic and treatment purposes.
C. Only topical drugs applied to the eye can affect the pupil.
D. Ophthalmic drugs have no serious adverse effects.

3. A patient is recovering from cataract surgery in the outpatient surgery department. He has been prescribed anti-infective ophthalmic drops and corticosteroid ophthalmic drops for use at home. What would be the most critical question to ask before teaching about the anti-infective ophthalmic drops?
A. “Do you have any allergies?”
B. “Are you taking any over-the-counter drugs?”
C. “What kind of work do you do?”
D. “Do you have any pain in your eye?”

4. Patient teaching for ophthalmic drugs should include which of the following?
A. Press the outer canthus of the eye after instilling eye drops.
B. Instill eye drops in the upper conjunctival sac.
C. To stabilize the eye dropper, touch the tip to the conjunctival sac.
D. Wait 5 minutes between instilling two medications.

Chapter 31: Otic Drugs

Review Questions
1. Following an acute episode of Ménière's disease, a patient is being discharged from the hospital with a prescription for meclizine (Antivert). Meclizine is classified as a/an:
A. anti-infective.
B. cerumenolytic.
C. antiemetic.
D. anesthetic.

2. A positive response to meclizine (Antivert) would be that the:
A. client sleeps soundly at night.
B. client states nausea is relieved.
C. client’s blood pressure decreases.
D. client states pain in ear is diminished.

3. Match the term on the left with the definition on the right.
_____ tinnitus A. left ear
_____ cerumen B. right ear
_____ AD C. both ears
_____ otic D. ringing in the ears
_____ ototoxic E. earwax
_____ AS F. related to the ear
_____ AU G. causing damage to acoustic nerve



Linton: Introduction to Medical-Surgical Nursing, 4th Edition

Answers to the Review Questions

Chapter 1
1. C
2. The generic name of a drug never changes, whereas there may be multiple trade names for the same drug.
3. A
Chapter 2
1. C
2. Physical and chemical characteristics; circulation to intended site of action; plasma protein binding; affinity for fatty tissue; barriers (brain and placenta).
3. B
4. D
5. Body weight; age; gender; genetics; biologic rhythms; medical conditions; tolerance; cumulation; drug interactions; psychological factors.
Chapter 3
1. B
2. C
3. A
Chapter 4
1. A
2. D
3. A
4. C
Chapter 5
1. C
2. B
3. D
4. A
5. B
6. The Mycobacterium tuberculosis quickly becomes resistant to single drugs.
7. D
8. C
9. A
10. A
Chapter 6
1. B
2. C
3. A
4. D
5. C
Chapter 7
1. D
2. C
3. B
Chapter 8
1. A
2. B
3. C
Chapter 9
1. D
2. A
3. B
4. Depolarizing agents act at the neuromuscular junction to combine with cholinergic receptors to cause muscle contraction but not relaxation (muscle paralysis preceded by muscle spasms).
Nondepolarizing agents prevent acetylcholine from acting at the neuromuscular junction, so muscles remain in a relaxed state.
5. Tubocurarine has significant histamine-releasing properties, so is contraindicated for persons with conditions that may be made worse by histamine release and vasodilation.
Chapter 10
1. D
2. C
3. B
4. A
Chapter 11
1. A
2. B
3. C
4. D
5. A
6. A
7. B
8. D
9. C
10. B
Chapter 12
1. A
2. C
3. D
4. A
5. D
6. D
Chapter 13
1. D
2. C
3. A
4. B
5. D
6. Angiogenesis inhibitors block growth of new blood vessels necessary to supply tumors with oxygen and nutrients so that tumor growth is halted.
Chapter 14
1. heart, increased heart rate, increased force of heart muscle contraction
2. B
3. D
4. A
Chapter 15
1. D
2. A
3. C
4. B
Chapter 16
1. C
2. Nicotinic activation causes skeletal muscle contraction, and, in the brain, promotes release of acetylcholine in the cerebral cortex. Muscarinic activation stimulates or suppresses cellular activity in the heart and blood vessels, gastrointestinal tract, respiratory tract, urinary tract, and the eye.
3. D
4. A
Chapter 17
1. C
2. D
3. A
4. B
Chapter 18
1. C
2. A
3. D
4. B
Chapter 19
1. B
2. D
3. A
4. C
Chapter 20
1. D
2. C
3. B
Chapter 21
1. B
2. A
3. D
Chapter 22
1. D
2. A
3. B
Chapter 23
1. C
2. D
3. A
4. B
5. Avoid sudden position changes (change positions slowly); exercise legs before arising; avoid hot baths or showers; avoid prolonged standing in one place.
Chapter 24
1. Bismuth tablets, metronidazole, tetracycline
2. To discourage emergence of drug-resistant H. pylori
3. Metronidazole
4. Inhibit gastric acid secretion
5. Antiandrogenic effects, central nervous system effects, inhibition of drug-metabolizing enyzmes
6. There is no significant interaction between famotidine and warfarin. (NOTE: Cimetidine prolongs the action of warfarin so that warfarin dose would need to be reduced if cimetidine was prescribed.)
Chapter 25
1. A
2. B
3. D
Chapter 26
1. C
2. A
3. B
Chapter 27
1. These preparations frequently contain epinephrine or ephedrine, which can increase blood pressure.
2. C
3. B
Chapter 28
1. D
2. C
3. A
4. B
Chapter 29
1. D
2. B
3. A
4. C
Chapter 30
1. B, F, E, A, C, D
2. B
3. A
4. D
Chapter 31
1. C
2. B
3. D, E, B, F, G, A, C