byron pharmacology questions

7/30/2019 Byron Pharmacology Questions

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I WILL PASS THE BOARD EXAM!

CRACKING PHARMACOLOGY QUESTIONS

Pharmacology is one of the mostdifficult nursing content areas to masterand feel comfortable with. One reason

that it is so difficult is because of theenormous number of medicationsavailable. Another reason is that there isa cast amount of information to knowabout each medication. Therefore, it isimportant for you to spend ample timereviewing pharmacology in preparationfor the Nurse Licensure Examinationand it is BEST to do your review from aQuestion and Answer perspective.

Remember to read the questioncarefully, noting the keywords and theissue of the question, and always use theprocess of elimination to select thecorrect option. It is still best to use yournursing knowledge to answer thequestion. However, a question mayappear on your examination thatcontains a medication with which youare unfamiliar. When this occurs, theguidelines and the strategies to answer apharmacology question correctly will be

valuable for you.

Pharmacology GuidelinesHow will the Pharmacology Guideline be helpful in answering Pharmacology Questionsand what are these guidelines?

There are some specific guidelines tofollow when you administer medicationto a client. In addition to the five rightsfor medication administration, theseguidelines include client assessment andassessment of other factors related tothe medication, such as checking certainlaboratory values or vital signs; checkingfor potential interactions or

contraindications related to themedication; client teaching; monitoringfor intended effects, side effects, adverseeffects, or toxic effects; and evaluatingthe clients response to the medicationtherapy. When you are presented with apharmacology question and are trying toselect the correct option, using theguidelines will assist you in eliminatingincorrect options.

Pharmacology: Assessment Guidelines to Follow

Always assess for client allergies or hypersensitivity to a medication.

Always assess the client for existing medical disorders that are contraindicated withthe administration of a prescribed medication.

Always assess for potential interactions related to the education.

Always check pertinent laboratory results.

Always check the clients vital signs, particularly if medications such asantihypertensive or cardiac medications are being administered.

Cracking Pharmacology QuestionsTest-Taking Strategies Compilation by beeronRN 2008

GUIDELINES and STRATEGIES

Read the question carefully!Note the keywordsNote the issue.Use the process of elimination.Use nursing knowledge.Use pharmacology guidelines.Use test-taking strategies.


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Always assess the client for intended effects, side effects, adverse effects or toxiceffects of the medication.

Always assess the clients response to the medication.

Answer: BTest-Taking Strategy:

Remember to read the question carefully, noting the issue of the question and the keywords.In this question, the keyword is priority, and the issue is the action that the nurse will take.Using the pharmacology guidelines will direct you to option B. Also, use the steps of thenursing process will direct you to the correct option because Option B is the only option thataddresses assessment.

Pharmacology: General Guidelines to Follow

Medication absorption, distribution, metabolism and excretion are affected by ageand physiological processes; the older client and the neonate and infant are at greaterrisk for toxicity than an adult.

Many medications are contraindicated in pregnancy and during breast-feeding.

Antacids are not usually administered with medication because the antacid will affectthe absorption of the medication.

Enteric-coated and sustained-release tablets should not be crushed; also, capsules

should not be opened.

Nursing interventions always include monitoring for intended effects, side effects,adverse effects or toxic effects of the medication.

Nursing intervention always include client education.

The nurse or the client should never adjust or change a medication dose, abruptlystop taking a medication, or discontinue a medication.

The nurse may withhold a medication if he or she suspects that the client is

experiencing an adverse effect or toxic effect of a medication; the nurse must

immediately contact the physician if either of these effects occurs. The client needs to avoid taking over-the-counter medications or any other

medications, such as herbal preparations, unless they are approved for se by thehealth care provider.

The client needs to know how to correctly administer the medication.

The client needs to be aware of the side effects of the medications and how to checkhis or her own temperature, pulse, and blood pressure.


Sample Question: Pharmacology

The nurse notes that the physician prescribed cotrimoxazole (Bactrim) for aclient with a urinary tract infection. Which priority action will the nursetake before administering the medication?

A. Call the pharmacy to order the medication.B. Ask the client about an allergy to sulfonamides.C. Check the medication supply room to find out whether the

medication needs to be ordered.D. Inform the client about the need to increase fluid intake.


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The client needs to take the prescribed dose for the prescribed length of therapy andunderstand the necessity of compliance.

The client needs to avoid consuming alcohol and to avoid smoking.

The client needs to follow up with a health care provider as prescribed.

Answer: DTest-Taking Strategy:

Remember to read the question carefully, noting the issue of the question and the keywords.In this question, the keywords are most appropriately, and the issue is the clients complaintof an upset stomach. Recalling that antacids are not usually administered with medicationand that the nurse would not tell a client to discontinue a medication will assist ineliminating Options A and B. from the remaining options, focusing on the issue will assist ineliminating Option C.

Medication EffectsWhat are the differences between an intended effect, a side effect, an adverse effect, and atoxic effect of a medication?

Intended Effect: an intended effect is the desired and expected effect of a medication. For

example, the intended effect of morphine sulfate is pain relief.

Answer: A

Test-Taking Strategy:Remember to read the question carefully, noting the issue of the question and the keywords.In this question, the keywords areprovided relief from and the issue is intended effect of themedication. Note that the question provides the clients diagnosis. Recalling thepathophysiology related to RA will assist in directing you to Option A. also note that OptionsB, C, and D are similar in that they all address gastrointestinal symptoms. When options aresimilar, it is best to eliminate those options because they are unlikely to be correct. Inaddition Options B, C, and D are side effects of ibuprofen, not intended effects.


Sample Question: Pharmacology GuidelinesA client taking amitriptyline hydrochloride (Elavil) calls the nurse at thephysicians office and reports that he has an upset stomach whenever hetakes the medication. The nurse most appropriately tells the client to:

A. Take the medication with an antacid.B. Stop the medication for 2 days, and then resume the prescribed

medication schedule.C. Take the medication on an empty stomach.D. Take the medication with food.

Sample Question: Intended EffectIbuprofen (Advil) is prescribed for a client with rheumatoid arthritis. On afollow-up visit to the physicians office, the nurse asks the client whether themedication has provided relief from which of the following symptoms?

A. Joint pain.B. Dyspepsia.C. Diarrhea.D. Flatulence.


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Side Effect: is a physiological effect of a medication that is unrelated to the desiredmedication effects. For example, a side effect of an antihistamine medication is drowsiness.

A side effect of a medication is not usually life-threatening, and normally there are measuresthat will either eliminate the side effects or alleviate the discomfort associated with it.

Answer: BTest-Taking Strategy:Remember to read the question carefully, noting the issue of the question and the keywords.In this question, the keywords and the issue are a side effect of the medication. Eliminate

Options A and D first because they are similar and both indicate the presence of hepatitis, anadverse effect of the medication. From the remaining options, eliminate Option C because ofthe word severe. Remember, the question asks for a side effect, not an adverse effect.

Adverse Effect: more severe than a side effect and is always an undesirable effect. Forexample, an adverse effect of sulfonamide is hypersensitivity that may be evidenced by arash, fever, and shortness of breath. An adverse effect can range from a mild effect to asevere effect such as anaphylaxis. Adverse effects are always reported to the health careprovider.

Answer: DTest-Taking Strategy:Remember to read the question carefully, noting the issue of the question and the keywords.In this question, the keywords and the issue are an adverse effect of the medication.Eliminate Options A and C first because they are similar and both relate to thegastrointestinal system. From the remaining options, eliminate Option B because it is anintended effect of the medication. Also, recall that furosemide is a diuretic and can causeelectrolyte imbalances, and that muscle weakness is an indication of hypokalemia.Remember, the question asks about an adverse effect.

Toxic Effect: occurs when the medication level in the body exceeds the therapeutic leveleither from overdosing of medication accumulation. Toxic effects are always reported to thehealth care provider. Toxic effects are most often identified by monitoring the plasma(serum) therapeutic range of the medication. For example, the therapeutic blood level of


Sample Question: Side Effect

Erythromycin (E-mycin) has been prescribed for a client with a respiratoryinfection. The nurse tells the client that which frequent side effect can occurfrom this medication?

A. Yellow discoloration to the white part of the eye.B. Abdominal cramping.C. Severe diarrhea.D. Yellow-colored skin.

Sample Question: Adverse EffectA client with congestive heart failure (CHF) is receiving furosemide (Lasix).

The nurse monitors the client for which adverse effect of the medication?A. Nausea.B. Increase urinary output.C. Gastric upset.D. Muscle weakness.


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digoxin (Lanoxin) is 0.5 to 2.0 g/ mL; if the blood level is greater than 2 g/ mL, the clientexperiences toxicity and the nurse needs to monitor for these signs and symptoms. Forexample, in digoxin toxicity, the client may experience gastrointestinal disturbances, such asanorexia, nausea and vomiting, or ocular disturbances, such as photophobia, light flashes, orhalos around bright objects.

Answer: C

Test-Taking Strategy:Remember to read the question carefully, noting the issue of the question and the keywords.In this question, the keywords are most appropriately and the issue is a toxic effect of themedication. Recalling that the therapeutic blood level of theophylline is 10 20 g/ mL willassist in determining that the client is experiencing toxicity. Remember, toxic effects arealways reported to the health care provider.

Medication Names

Do you Need to Memorize both the Generic and the Trade Name of aMedication?

No memorizing is necessary! When a pharmacology question appears on your test booklet,both the generic name and the trade/ brand name will appear. This will be helpful to assistyou in answering the question correctly. One medication name, perhaps generic name, maybe unfamiliar to you but you may recognize the trade name presented. For example, aquestion may ask about a medication named furosemide (Lasix). You may not be familiar

with the medication name furosemide, but it is very likely that you will be familiar with themedication name Lasix because it is a commonly administered medication.

How will Medical Terminology Skills help to Answer a Pharmacology Question?


THERAPEUTIC LEVELSAcetaminophen (Tylenol) 10 20 g/ mLCarbamazepine (Tegretol) 5 12 g/ mLDigoxin (Lanoxin) 0.5 - 2.0 g/ mLGentamicin (Garamycin) 5 10 g/ mLLithium (Lithobid) 0.5 1.3 g/ mLMagnesium sulfate 4 7 g/ mLPhenytoin (Dilantin) 10 20 g/ mLSalicylate 100 250 g/ mLTheophylline/ Aminophylline (Theo-Dur) 10 -20 g/ mL

Sample Question: Toxic EffectThe nurse reviews the results of a therapeutic blood level that was drawnfrom a client taking theophylline (Theo-Dur) and notes that the level is 20g/ mL. the nurse would most appropriately:

A. Administer the next scheduled dose of theophylline.B. Place the results of the blood test in the clients chart.C. Report the result to the health care provider.D. Ask the laboratory personnel to draw another blood specimen to

verify the result.


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Your examination may include pharmacology questions that contain the name of amedication with which you are unfamiliar, try to break the generic or trade name of themedication into parts and use medical terminology to assist in determining the medicationaction.

Answer: CTest-Taking Strategy:Remember to read the question carefully, noting the issue of the question and the keywords.

In this question, the keywords are most importantand the issue is an assessment. Focus onthe name of the medication; if you are unfamiliar with the medication, try to break the nameof the medication into parts and use medical terminology to assist in determining themedication action. For example, Lopressor lowers (lo) the blood pressure (pressor).

Medication Classifications

How will it Help to Identify a Medication by the Classification to Which itBelongs?Medications that belong to a particularclassification have similar medicationactions and usually have commonalities in

their side effects and nursinginterventions related to administration. Itis nearly impossible to learn every featureabout every individual medication.Learning medications by a classificationsystem method groups severalmedications wit similar propertiestogether and makes the amount ofinformation that needs to be learnedcondensed and manageable.

With regard to side effects andnursing interventions, do not try tomemorize every side effect and everynursing intervention for every medication.

It is best if you associate side effects withnursing interventions. Learn to recognizethe common side effects associated with

each medication classification, and thenrelate the appropriate nursinginterventions to each side effect. Forexample, if a side effect is hypertension,then the associated nursing intervention

would be to monitor blood pressure; if aside effects is hypokalemia, then theassociated nursing intervention s are tomonitor for signs and symptoms ofhypokalemia and to monitor the clientspotassium blood level. Again, this makesthe vast amount of information that youneed to remember manageable.

How can You Determine the Medication Classification if you are Unfamiliarwith the Medication?If you are presented with a pharmacology question that contains the name of a medication

with which you are unfamiliar, some of the strategies to use include the following:

Note whether the question identifies the clients diagnosis. For example, if thequestion states: Cyclophosphamide (Cytoxan) has been prescribed for a client with


Sample Question: Medical Terminology Skills

Metoprolol (Lopressor) has been prescribed for a client. The nurseperforms which most important assessment before administering themedication to the client?

A. Checks the clients lung soundsB. Checks the client for peripheral edemaC. Takes the clients blood pressureD. Takes the clients temperature


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metastatic breast cancer, focusing on the clients diagnosis will help you determinethat cyclophosphamide is an antineoplastic medication.

Break down the name of the medication (either the generic or trade name) into parts.

For example, if the question states: Terbutaline sulfate (Brethine) has beenprescribed for a client. Think about breath when you look at the medication nameBrethine to help you determine that it is a respiratory medication.

Note the letters in the medication name and look for those letters that identify aparticular medication classification (See Commonalities in Medication Names

below).

Commonalities in Medication NamesAndrogens: Most medication names end with terone such as testosterone (Andoderm,Testoderm).

Angiotensin-converting enzyme (ACE) inhibitors: Most medication names end withprilsuch as enalapril (Vasotec), captopril (Capoten)

Antidiuretic hormones: Most medication names end with pressin such asdesmopressin (DDAVP).

Antilipemic medications: Most medication names end with statin such as attorvastatin

(Lipitor), simvastatin.Antiviral medications: Most antiviral medications contain vir in their names such asacyclovir (Zovirax).Benzodiazepines: it includes alprazolam (Zanax), chlordiazepoxide (Librium), clorazepate(Tanxene), estazolam (ProSom) and triazolam (Halcion); most other benzodiazepines namesend with pam such as diazepam (Valium).Beta-adrenergic blockers: Most medication names end with lol such as atenolol(Tenormin), metoprolol (Lopresor).Calcium channel blockers: Most medication names end with pine such as amlodipine(Norvasc); some exceptions include diltiazem (Cardizem, Cardizem SR) and verapamil(Calan, Isoptin).Carbonic anhydrase inhibitors: Most medication names end with -mide such as

acetazolamide (Diamox).Estrogens: Most estrogen medications contain est in their names such as conjugatesestrogen (Premarin).Glucocorticoid and corticosteroids : Most emdication names end with sone such asprednisone (Deltasone).Histamine H2 receptor antagonists: Most medication names end with dine such ascimetidine (Tagamet), ranitidine (Zantac).Nitrates: Most medication names contain nitr in their names such as nitroglycerin(Nitrostat).Pancreatic enzyme replacements: Most medication names contain pancre in theirnames such as pancrelipase (Pancrease).Phenothiazines: Most phenothiazine medication names end with zine such as

chlorpromazine (Thorazine).Proton-pump inhibitors: Most medication names end with zole such as lansoprazole(Prevacid)Sulfonamides: Most medication names include sulfsuch as sulfasalazine (Azulfidine).Sulfonylureas: Most medication names end with mide such as chlorpropamide(Diabinese).Thiazide diuretics: Most medication names end with zide such as hydrochlorothiazide(HydroDIURIL).



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Thrombolytic medications: Most medication names end in ase such as alteplase(Activase).Thyroid hormones: Most medication names contain thy such as levothyroxine(Synthroid).Xanthine bronchodilators: Most medication names end with line such asaminophylline.

Answer: B

Test-Taking Strategy:Remember to read the question carefully, noting the issue of the question and the keywords.In this question, the keywords are is effective and relief of, and the issue is an intendedeffect. Remembering that most gastric acid pump inhibitor medication names end with thesuffix zolewill direct you to Option B.

Answer: CTest-Taking Strategy:Remember to read the question carefully, noting the issue of the question and the keywords.In this question, the keywords are suspects the presence of, and the issue is the nursesfinding. Remembering that many antiviral medication names contain the letters vir willdirect you to Option C. Also note the similarity in Options A, B and D. These options allrelate to gastrointestinal disorders.


Sample Question: Commonalities in Medication NamesNurse Lina is performing an assessment on Edwin who is takingpantoprazole (Protonix). Nurse Lina determines that the medication iseffective if the client states relief of which of the following symptoms?

A. A nighttime coughB. HeartburnC. ConstipationD. Migraine headache

Sample Question: Commonalities in Medication NamesNurse Jande is taking a health history of Zyra seen at the Mayondon HealthCenter for the first time. When Nurse Jande asks the client about currentprescribed medications, the client tells her that indinavir (Crixivan)) istaken twice daily. Based on this finding, Nurse Jande suspects the presenceof which condition?

A. Peptic ulcer disease (PUD)B. Inflammatory bowel disease (IBD)C. Human immunodeficiency virus (HIV)D. Diverticulitis


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Answer: CTest-Taking Strategy:Remember to read the question carefully, noting the issue of the question and the keywords.In this question, the keywords are before administering, and the issue is an assessment.Note the name of the medication atenolol. Recalling that most beta-blocker medicationnames end with loland these medications are used to control blood pressure will direct you

to Option C.

References:National Drug Handbook 2007 (NDH2007) PlusPharmacology: A Nursing Process ApproachPharmacology for Nursing CareSaunders Nursing Drug Handbook 2005Saunders Strategies for Success for the NCLEX-RN Examination


Sample Question: Commonalities in Medication NamesNurse Aikikee is preparing to administer atenolol (Tenormin) to a client.Nurse Aikikee checks which of the following before administering themedication?

A. Potassium levelB. Blood glucose levelC. Blood pressureD. Temperature

After learning the Strategies to crack down pharmacology questions,write down your goals here Remember that you are going nowherewithout a goal or a purpose of doing things. Learning the strategies isuseless if you will not apply it. YOU WILL PASS the BOARD EXAM!

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