You choose the safer drug action, the vital sign to check, and the teaching that belongs at the bedside. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five pharmacology questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Which of the following is not a required element of the written prescription?
A. Quantity of a drug to be dispensed
B. Number of refills
C. Disease state being treated
D. Route of administration
Show answer and rationale
Correct answer: C — Disease state being treated
The correct answer is C: Disease state being treated. This is because the written prescription should include essential information such as the drug name, strength, dosage form, quantity to be dispensed, directions for use, patient information, prescriber information, and date. The disease state being treated is not a required element as it is typically part of the diagnosis and treatment plan discussed between the healthcare provider and the patient, but not necessarily explicitly stated on the prescription.
The other choices, A, B, and D, are required elements of a written prescription. Quantity of a drug to be dispensed ensures proper dosing, number of refills indicates how many times the prescription can be refilled, and route of administration specifies how the medication should be administered. These elements are crucial for the pharmacist to accurately dispense and the patient to safely use the medication.
Question 2
When educating a client with a new prescription for nitroglycerin, which of the following instructions should the nurse include?
A. Store the medication in a cool, dark place.
B. Take the medication before bedtime.
C. Take the medication with food.
D. Take the medication at the first sign of chest pain.
Show answer and rationale
Correct answer: D — Take the medication at the first sign of chest pain.
The correct instruction for a client with a new prescription for nitroglycerin is to take the medication at the first sign of chest pain. Nitroglycerin is a vasodilator used to relieve chest pain associated with angina. Taking it at the onset of chest pain ensures prompt relief by dilating blood vessels and increasing blood flow to the heart muscle. Storing nitroglycerin in a cool, dark place helps maintain its potency, while taking it with food can alter its absorption. Timing the medication with bedtime is not necessary, but prompt administration at the first sign of chest pain is crucial for effective management of angina. Choices A, B, and C are incorrect because storing the medication in a cool, dark place, taking it before bedtime, and taking it with food are not essential instructions for nitroglycerin use. The priority is to administer it promptly when chest pain occurs to achieve optimal therapeutic effects.
Question 3
A 2-year-old presents to the clinic with otalgia and fever. The left tympanic membrane (TM) is erythematous and bulging; The right TMs is perforated and draining. The child's parents states, “this is the fifth ear infection this year. What can we do?†What action will the provider take to address the child's ear problems?
A. Prescribe both high dose amoxicillin and the influenza vaccine
B. Discuss beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole
C. Prescribe both ceftriaxone (Rocephin) IVI with benzocaine ear drops for pain
D. Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist
Show answer and rationale
Correct answer: D — Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist
The correct answer is D: Prescribe amoxicillin/clavulanate and refer the child to an otolaryngologist.
Rationale:
1. Amoxicillin/clavulanate is a recommended first-line antibiotic for recurrent otitis media due to its broad spectrum coverage.
2. Referring the child to an otolaryngologist is necessary for further evaluation and management of recurrent ear infections, as this child has had multiple episodes in a year.
Summary of other choices:
A: Prescribing both high dose amoxicillin and the influenza vaccine is not the best option as the child already has recurrent ear infections and needs a more comprehensive approach.
B: Beginning prophylactic antibiotic therapy with trimethoprim/sulfamethoxazole is not recommended as a first-line treatment for recurrent otitis media.
C: Prescribing ceftriaxone IV with benzocaine ear drops is not the optimal choice for managing recurrent ear infections in a 2-year-old.
Question 4
A 79-year-old man with end-stage Alzheimer's disease and dysphagia is taking multiple medications. Physical examination reveals xerostomia and a limited gag reflex. Which of the following routes of medication administration would provide the lowest serum drug concentration?
A. Enteral
B. Intramuscular
C. Intrathecal
D. Intravenous
Show answer and rationale
Correct answer: A — Enteral
Enteral (A) administration would provide the lowest serum drug concentration in this patient due to the challenges posed by his dysphagia and limited gag reflex, which impair swallowing and gastrointestinal absorption. Enteral routes (e.g., oral) rely on GI uptake, which can be erratic or reduced in such conditions, further complicated by xerostomia reducing dissolution. Intramuscular (B) and intravenous (D) routes deliver drugs directly into systemic circulation, yielding higher concentrations. Intrathecal (C) targets the CSF, not serum, but still achieves systemic levels. Transdermal (original E) offers steady absorption but higher serum levels than enteral in this context. Given his swallowing difficulties, enteral drugs face significant barriers (e.g., incomplete absorption, first-pass metabolism), making it the least effective for systemic delivery, critical in managing polypharmacy in Alzheimer's patients.
Question 5
The nurse is preparing to administer an intravenous dose of furosemide (Lasix) to a client with heart failure. The nurse should monitor for which potential side effect?
A. Hypertension
B. Hyperkalemia
C. Hypokalemia
D. Hypoglycemia
Show answer and rationale
Correct answer: C — Hypokalemia
Furosemide is a loop diuretic that works by promoting the excretion of water and electrolytes, including potassium. This loss of potassium can lead to hypokalemia, which can be a potential side effect of furosemide administration. Hypokalemia can result in cardiac dysrhythmias and other complications, especially in clients with heart failure who may already have compromised cardiac function. Therefore, monitoring for signs of hypokalemia, such as muscle weakness, cardiac irregularities, and fatigue, is essential when administering furosemide. Choice A, hypertension, is incorrect because furosemide is actually used to treat hypertension by reducing excess fluid in the body. Choice B, hyperkalemia, is incorrect as furosemide causes potassium loss, leading to hypokalemia. Choice D, hypoglycemia, is unrelated to the mechanism of action of furosemide and is not a common side effect associated with its administration.
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Question 6
A66-year-old man suffering from benign prostatic hyperplasia was admitted to the hospital because of severe suprapubic pain and an inability to pass urine for the past 24 hours. On questioning, he said he had been taking diphenhydramine for a few days to relieve itching. Which of the following actions most likely mediated the adverse effect of the drug in this patient?
A. Relaxation of the detrusor muscle
B. Constriction of the bladder external sphincter
C. Constriction of the prostate capsule
D. Relaxation of the bladder internal sphincter
Correct answer:
The correct answer is A: Relaxation of the detrusor muscle. Diphenhydramine, an anticholinergic drug, causes relaxation of the detrusor muscle, leading to urinary retention. In benign prostatic hyperplasia, the enlarged prostate already causes obstruction, exacerbating the urinary retention. Therefore, the relaxation of the detrusor muscle due to diphenhydramine worsens the situation by further impairing bladder emptying.
Explanation for other choices:
B: Constriction of the bladder external sphincter - This would lead to urinary retention, not relieve it.
C: Constriction of the prostate capsule - Constriction of the prostate capsule would not relieve urinary retention in benign prostatic hyperplasia.
D: Relaxation of the bladder internal sphincter - Relaxation of the bladder internal sphincter would promote bladder emptying, which is opposite to the clinical presentation of urinary retention in this case.
Which of the following disorders most likely caused the patient's tachycardia?
A. Hypertrophic cardiomyopathy
B. Atrial fibrillation
C. Mitral regurgitation
D. Mitral stenosis
Correct answer:
The correct answer is B: Atrial fibrillation. Atrial fibrillation is a common arrhythmia characterized by rapid, irregular heartbeats that can lead to tachycardia. In atrial fibrillation, the atria quiver instead of contracting effectively, leading to an irregular heart rhythm and increased heart rate. This condition can cause tachycardia due to the ineffective pumping of blood by the heart.
Incorrect choices:
A: Hypertrophic cardiomyopathy - This disorder can cause heart muscle thickening, leading to decreased ventricular filling and potentially causing arrhythmias, but it is not directly associated with tachycardia.
C: Mitral regurgitation - This condition can lead to an enlarged left atrium and decreased cardiac output, but tachycardia is not a direct result of mitral regurgitation.
D: Mitral stenosis - This condition can cause increased pressure in the left atrium and pulmonary congestion, but t
A 30-year-old primipara woman had visible vaginal bleeding within a few hours after delivering her baby. Uterine massage and infusion of oxytocin did not control the bleeding. Upon examination, it was felt that the hemorrhage was due to uterine atony. An intramuscular injection of ergonovine was given. Which of the following actions most likely mediated the therapeutic effect of the drug in this patient?
A. Selective constriction of uterine arteries
B. Endothelin release in the uterine vascular bed
C. Platelet aggregation in the uterine vascular bed
D. Induction of powerful uterine contracture
Correct answer:
The correct answer is D: Induction of powerful uterine contracture. Ergonovine is a uterotonic agent that works by stimulating uterine contractions, which helps control postpartum hemorrhage due to uterine atony. The drug acts directly on the smooth muscle of the uterus, leading to increased tone and decreased bleeding.
A: Selective constriction of uterine arteries is incorrect because ergonovine primarily acts on the uterine muscle itself, not the blood vessels supplying the uterus.
B: Endothelin release in the uterine vascular bed is incorrect as ergonovine does not directly affect endothelin release.
C: Platelet aggregation in the uterine vascular bed is incorrect as ergonovine's action is not related to platelet aggregation but rather to uterine muscle contraction.
In summary, the therapeutic effect of ergonovine in this patient is mediated by its ability to induce powerful uterine contr
A patient has been taking the selective serotonin reuptake inhibitor (SSRI) sertraline (Zoloft) for about 6 months. At a recent visit, she tells the nurse that she has been interested in herbal therapies and wants to start taking St. John’s wort. Which response by the nurse is appropriate?
A. “That should be no problem.â€
B. “Good idea! Hopefully you’ll be able to stop taking the Zoloft.â€
C. “Be sure to stop taking the herb if you notice a change in side effects.â€
D. “Taking St. John’s wort with Zoloft may cause severe interactions and is not recommended.â€
Correct answer:
The correct response is D: “Taking St. John’s wort with Zoloft may cause severe interactions and is not recommended.â€
Rationale:
1. St. John's wort is known to affect serotonin levels, similar to SSRIs like Zoloft.
2. Combining St. John's wort with SSRIs can lead to serotonin syndrome, a potentially life-threatening condition.
3. The nurse should advise against combining these medications due to the risk of adverse interactions.
4. This response prioritizes patient safety and provides clear guidance on the potential harm of the combination.
Summary:
A: Incorrect. This response is too casual and does not address the potential interactions between St. John's wort and Zoloft.
B: Incorrect. Encouraging the patient to stop Zoloft abruptly is not safe and overlooks the risk of interactions.
C: Incorrect. This response is vague and does not emphasize the seriousness of potential interactions.
A patient with asthma is prescribed fluticasone. Fluticasone is classified as:
A. A beta-agonist
B. A corticosteroid
C. A leukotriene modifier
D. An anticholinergic agent
Correct answer:
The correct answer is B: A corticosteroid. Fluticasone is a corticosteroid that works by reducing inflammation in the airways, which is crucial in managing asthma. Corticosteroids are the mainstay of asthma treatment as they help to decrease airway inflammation and prevent asthma symptoms.
Choice A, a beta-agonist, is incorrect because beta-agonists work by relaxing the muscles around the airways and are usually used as rescue inhalers for quick relief of asthma symptoms.
Choice C, a leukotriene modifier, is incorrect as leukotriene modifiers work by blocking the action of certain immune system chemicals that cause asthma symptoms, but they are not the classification for fluticasone.
Choice D, an anticholinergic agent, is incorrect as anticholinergics work by blocking acetylcholine, a neurotransmitter that causes airway constriction, and are typically used in conditions like COPD, not as the
Loosening of teeth, gingivitis and hemorrhage occur in the deficiency of:
A. Vitamin К
B. Vitamin Ð’1
C. Vitamin B6
D. Vitamin C
Correct answer:
Step-by-step rationale for why Vitamin C (Choice D) is the correct answer:
1. Vitamin C is essential for collagen synthesis, which is crucial for maintaining the integrity of gum tissues.
2. Deficiency of Vitamin C leads to weakened collagen, causing symptoms like loosening of teeth, gingivitis, and hemorrhage.
3. Vitamin K (Choice A) is important for blood clotting, not directly related to gum health.
4. Vitamin B1 (Choice B) is essential for energy production, not directly linked to gum health.
5. Vitamin B6 (Choice C) is involved in various metabolic processes, but not specifically related to gum health.
Summary:
The correct answer is Vitamin C (Choice D) because it is directly linked to maintaining healthy gum tissues by supporting collagen synthesis. Choices A, B, and C are incorrect as they are not directly associated with the symptoms of loosening of teeth, gingivitis, and hemorrhage.
A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate because he complains that it makes him feel sick. Which of the following medications might be alternatively prescribed for mood stabilization in bipolar disorders?
A. Sertraline (Zoloft)
B. Valproic acid (Depakote)
C. Trazodone (Desyrel)
D. Paroxetine (Paxil)
Correct answer:
The correct answer is B: Valproic acid (Depakote). Valproic acid is commonly used as a mood stabilizer in bipolar disorder. It helps to control manic episodes and stabilize mood swings. It is effective in treating bipolar disorder and is well tolerated by many patients. It is an appropriate alternative to lithium carbonate for mood stabilization.
Explanation for why the other choices are incorrect:
A: Sertraline (Zoloft) is an antidepressant and not typically used as a primary treatment for bipolar disorder.
C: Trazodone (Desyrel) is primarily used as an antidepressant and not as a mood stabilizer for bipolar disorder.
D: Paroxetine (Paxil) is an antidepressant and is not indicated for mood stabilization in bipolar disorder.
In summary, Valproic acid (Depakote) is the most appropriate alternative medication for mood stabilization in bipolar disorder compared to the other choices provided.
A patient had an orthopedic surgery and is prescribed enoxaparin. What would the nurse teach the patient and/or family members about this low–molecular-weight heparin before discharge?
A. Visual demonstration of intramuscular heparin administration is recommended.
B. Prothrombin time and international normalized ratio monitoring will be done weekly.
C. Avoidance of green leafy vegetables is recommended.
D. Watch for bleeding or excessive bruising.
Correct answer:
The correct answer is D: Watch for bleeding or excessive bruising. Enoxaparin is an anticoagulant medication that helps prevent blood clots. The nurse should teach the patient and family members to monitor for signs of bleeding or excessive bruising, as these could indicate a potential complication of the medication. This is crucial for early detection and intervention to prevent serious consequences.
Explanation for incorrect choices:
A: Visual demonstration of intramuscular heparin administration is not applicable to enoxaparin as it is typically administered subcutaneously.
B: Prothrombin time and international normalized ratio monitoring are not usually required for enoxaparin as it works through a different mechanism compared to warfarin.
C: Avoidance of green leafy vegetables is not necessary for enoxaparin, unlike warfarin which interacts with vitamin K found in green leafy vegetables.
A client has been severely depressed and suicidal. After admission to an inpatient psychiatric unit, antidepressant medication is administered. As the client becomes more energized and communicative, what should be the priority nursing intervention for this client?
A. Allowing the client to have unsupervised passes to his or her home
B. Encouraging the client to participate in group activities
C. Increasing the vigilance regarding the client's suicidal precautions
D. Recognizing that the client's suicidal potential has decreased
Correct answer:
Correct Answer: C - Increasing the vigilance regarding the client's suicidal precautions
Rationale:
1. The client was admitted for severe depression and suicidal ideation, indicating a high suicide risk.
2. Antidepressants can initially increase energy before improving mood, potentially raising suicide risk.
3. As the client becomes more energized and communicative, the risk of impulsive actions, including suicide, may increase.
4. Therefore, increasing vigilance and maintaining strict suicidal precautions are crucial to ensure the client's safety.
Summary of Incorrect Choices:
A: Allowing unsupervised passes may expose the client to triggers or opportunities for self-harm.
B: Group activities can be beneficial but do not address the immediate safety concern of suicidal risk.
D: Assuming suicidal potential has decreased prematurely can be dangerous, as the client may still be at risk.
A 50-year-old female with hypothyroidism is prescribed levothyroxine. Levothyroxine works by:
A. Increasing the production of thyroid-stimulating hormone (TSH)
B. Replacing deficient thyroid hormone
C. Inhibiting thyroid hormone synthesis
D. Increasing the metabolism of thyroid hormones
Correct answer:
The correct answer is B: Replacing deficient thyroid hormone. Levothyroxine is a synthetic form of the thyroid hormone thyroxine (T4). In hypothyroidism, the thyroid gland does not produce enough thyroid hormones, leading to various symptoms. By prescribing levothyroxine, we are supplying the body with the thyroid hormone it lacks, thereby replacing the deficient hormone and restoring normal thyroid function.
Explanation of other choices:
A: Increasing the production of thyroid-stimulating hormone (TSH) is incorrect because levothyroxine does not directly affect TSH production.
C: Inhibiting thyroid hormone synthesis is incorrect because levothyroxine does not inhibit thyroid hormone production.
D: Increasing the metabolism of thyroid hormones is incorrect because levothyroxine does not directly increase the metabolism of existing thyroid hormones; it simply replaces the deficient hormone.
LPN exams pharmacology practice questions, set 4 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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