Exam Review

A nurse is explaining drug metabolism to a nursing student who asks about glucuronidation. The nurse knows that this is a process that allows drugs to be:
A)Excreted in hydrolyzed form in the feces to reduce drug toxicity.
B)Transported across the renal tubules to be excreted in the urine.
C)Recycled within the enterohepatic recirculation to remain in the body longer.
D)Reabsorbed from the urine into the renal circulation to minimize drug loss.
A patient tells the nurse that she takes aspirin for menstrual cramps, but she does not feel that it works well. What will the nurse suggest?
A)The patient should increase the dose until pain is controlled.
B)The patient should use a first-generation nonsteroidal anti-inflammatory medication instead.
C)The patient should use acetaminophen because of its anti-inflammatory effects.
D)The patient should avoid any type of COX inhibitor because of the risk of Reye’s syndrome.
A patient newly diagnosed with type 1 diabetes asks a nurse, “How does insulin normally work in my body?” The nurse explains that normal insulin has which action in the body?
A)It stimulates the liver to convert glycogen to glucose.
B)It promotes the synthesis of amino acids into glucose.
C)It stimulates the pancreas to reabsorb glucose.
D)It promotes the passage of glucose into cells for energy.
The healthcare provider orders Valium 8 mg IV now. The concentration available is 5 mg/mL. How many mL will the patient receive?
A)1.4 mL
B)1.8 mL
C)1.2 mL
D)1.6 mL

Page 1 of 21

A patient has had blood pressures of 150/95 and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient’s diagnostic tests are all normal. The nurse will expect this patient’s provider to order
A)An adrenergic neuron blocker
B)A beta blocker
C)Counseling on lifestyle changes
D)An ACE inhibitor
A patient receives a drug that has a narrow therapeutic range. The nurse administering this medication will expect to do what?
A)Monitor plasma drug levels
B)Administer this medication intravenously
C)Administer the drug at intervals longer than the drug half-life
D)Teach the patient that maximum drug effects will occur within a short period
A patient is taking a drug that has known toxic side effects. What will the nurse do?
A)Instruct patient on the importance of monitoring the function of all organs potentially affected by the drug
B)Ensure that complete blood counts are ordered periodically
C)Discontinue all the patient’s medications
D)Instruct the patient they should only follow-up if symptoms develop
A nurse teaches a patient who takes daily low-dose aspirin for protection against myocardial infarction and stroke to avoid also taking which medication?
A)Diphenhydramine [Benadryl]
B)Loratadine [Claritin]
C)Ibuprofen [Motrin]
D)Multivitamin

Page 2 of 21

A patient reports becoming “immune” to a medication because it no longer works to alleviate symptoms. The nurse recognizes that this decreased effectiveness is likely caused by:
A)Synthesis of more receptor sites in response to the medication
B)Decreased selectivity of receptor sites, resulting in a variety of effects
C)Desensitization of receptor sites by continual exposure to the drug
D)Antagonists produced by the body that compete with the drug for receptor sites
A patient with a history of hypertension is admitted for a procedure. If the patient’s blood pressure decreases, which clinical manifestation would the nurse expect to see?
A)Decreased heart rate
B)Erythema
C)Increased temperature
D)Increased heart rate
The nurse is caring for a patient who has jaundice, dark urine, malaise, light-colored stools, nausea, and vomiting. What is this patient most likely experiencing?
A)An allergic reaction
B)An idiosyncratic drug effect on the bone marrow
C)Iatrogenic disease of the skin
D)Drug toxicity of the liver
The healthcare provider orders Lasix 40 mg IV now. The concentration available is Lasix 20 mg/mL. How many mL will the patient receive?
A)5 mL
B)6 mL
C)4 mL
D)2 mL

Page 3 of 21

A patient has allergies and takes an antihistamine. The patient wants to know how the drug works. The nurse understands that antihistamines work because they are what?
A)Antidotes
B)Antagonists
C)Agonists
D)Activators
A patient who is taking morphine for pain asks the nurse how a pain medication can also cause constipation. What does the nurse know about morphine?
A)It binds to different types of receptors in the body
B)It can cause constipation in toxic doses
C)It is selective to receptors that regulate more than one body process
D)It causes only one type of response, and the constipation is coincidental
The nurse caring for a patient taking furosemide [Lasix] is reviewing the patient’s most recent laboratory results, which are: sodium, 136 mEq/L; potassium, 3.1 mEq/L; chloride, 100 mEq/L; blood urea nitrogen, 15 mg/dL. What is the nurse’s best action?
A)Administer Lasix as ordered
B)Place the patient on oxygen
C)Hold the Lasix and notify the physician
D)Begin a 24-hour urine collection
Name the imbalance using the following Arterial Blood Gas (ABG) values: pH 7.32, PaCO2 <37, HCO3- <24
A)Uncompensated metabolic acidosis
B)Uncompensated respiratory acidosis
C)Partially compensated respiratory acidosis
D)Partially compensated metabolic acidosis

Page 4 of 21

A patient who was in a motor vehicle accident sustained a severe head injury and is brought to the emergency department. The provider orders intravenous mannitol (Osmitrol). The nurse knows that this is given to:
A)Reduce intracranial pressure.
B)Reduce peripheral edema.
C)Restore extracellular fluid.
D)Reduce renal perfusion.
A patient who stops taking an ACE inhibitor because of its side effects will begin taking an angiotensin II receptor blocker (ARB) medication. Which side effect of ACE inhibitors will not occur with an ARB medication?
A)Dry cough
B)Hyperkalemia
C)Hypotension
D)Angioedema
A nurse is giving an enteral medication. The patient asks why this method is preferable for this drug. How will the nurse reply?
A)This route allows more rapid absorption of the drug
B)This route prevents inactivation of the drug by digestive enzymes
C)This route is the best way to control serum drug levels
D)This route is safer, less expensive, and more convenient
The nurse assesses a patient who takes ibuprofen [Advil] on a regular basis. Which finding would indicate a severe adverse effect of ibuprofen therapy?
A)Jaundice
B)Bloody emesis
C)Itching
D)Dysmenorrhea

Page 5 of 21

To achieve therapeutic effectiveness, a nurse teaches a patient with chronic asthma to use an inhaled glucocorticoid medication according to which schedule?
A)To abort an asthma attack
B)Only in an emergency
C)On a daily basis
D)2 weeks on, 2 weeks off
Name the imbalance using the following Arterial Blood Gas (ABG) values: pH 7.31, PaCO2 41, HCO3- 20
A)Respiratory alkalosis
B)Respiratory acidosis
C)Metabolic alkalosis
D)Metabolic acidosis
N-acetyl-para-aminophenol is an example of which type of drug name?
A)Trade
B)Proprietary
C)Generic
D)Chemical
A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide [Lasix]. The nurse notes an irregular heart rate of 86 beats/min, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern?
A)Sodium level of 140 mEq/L
B)Oxygen saturation of 95%
C)Potassium level of 3.0 mEq/L
D)Blood glucose level of 100 mg/dL

Page 6 of 21