NCLEX-RN/HAAD/Prometric Examinations Review Mr.

Henry who is taking Losartan

for his
Pharmacology Nursing hypertension. Which of the following should alert
the nurse?
Ramon Carlo T. Almirañez, RN, RM, USRN
a. Serum albumin 5 gm/dL

ACE Inhibitors
1. Which statement, if made by the hypertensive
client taking Lisinopril, indicates the need for further
teaching?
a. “I will take the medication with my Spironolactone.”
b. “I will inform the physician if my dizziness persists.” b. Calcium 8.5 mg/dL
c. “I will not stand up immediately after taking the c. Potassium 9 mEq/L
medication.” d. Hgb 18 gm/dL
d. “I will have my daughter take my blood pressure
from time to time.” 7. Which of the following statements made by the
client would alert the nurse to hold giving of the
2. The nurse correctly enumerates which of the drug Telmisartan:
following side effects in taking ACE Inhibitors. Select all a.“I have had my menstruation delayed for about 3
that apply:
1. Headache weeks now.”
2. Hypertension b. “I drink lots of fluids to compensate for my
3. Fatigue
excessive perspiration.”
4. Vomiting
5. Diarrhea c. “I elevate my legs whenever my blood pressure is
6. Cough low.”
7. Loss of consciousness
d. “I rise up from bed slowly until I don’t feel dizzy.”
3. A nurse is making her daily rounds. She remembers
that Mrs. Rose is taking Perindopril (Aceon); 8. Which of the following should the nurse instruct
which of the following statement, when made by the client to watch out for while taking ARBs?
Mrs. Rose, would warrant notification of the a. Decreased in level of consciousness
attending physician? b. Constipation
a. “The first time I took the medication, I had a c. Insomnia
d. Angioedema
headache.”
b. “I took my medication an hour before meals.” 9. A client taking Olmesartan develops a dry cough,
what is the appropriate action?
c. “I’ve had a blood extraction today to determine my a. Continue taking the medicine as it is an expected
potassium level.” side effect
b. Discontinue taking the medicine
d. “I have been feeling dizzy for three days now.”
c. Decrease the drug in half
d. Take the medicine with antihistamine
4. Mrs. Sommers, a 53-year-old female diagnosed
with Congestive Heart Failure is taking Fosinopril
10. A client with hypertension is to take an
(Monopril) 10 mg tablet once a day. Which of the
Angiotensin II Receptor Blocker. Which of the
following results would require the need to notify
following should be included in the health teaching?
the physician?
Select all that apply:
a. Creatinine 1.0 mg/dL
1. monitor BP daily
b. Potassium 7.8 mEq/L
2. avoid the use of NSAID
c. Albumin 5 U/L
3. Stop treatment if cough develops
d. BUN 10 mg/dL
4. Have blood drawn for potassium levels
5. You are the nurse caring for Mrs. Jones, a 44-year-
Anti-Anginals
old client with hypertension. An hour after taking
Ramipril (Altace), you took her blood pressure and
11. A client discharged with sublingual nitroglycerin
noted that it is 80/50. Which of the following
(Nitrostat) should be taught to:
nursing interventions should you do first?
a. take the medication with Sildenafil Citrate
a. Call the attending physician
b. avoid abrupt changes in posture
b. Elevate her legs by adjusting the bed and placing
c. take the medication 5 minutes after the pain has
her on a Trendelenburg position
started
c. Give her Furosemide (Lasix)
d. stop taking the medication if a burning sensation is
d. Give supplemental oxygen via nasal cannula at 3
present
lpm
12. How will the nurse evaluate the efficacy of
Angiotensin Receptor Blockers
Isordil?
6. The nurse receives the latest blood chemistry of
a. relief of chest pain in 3-5 minutes
b. relief of tremors at rest
c. asking for the fourth tablet of Isordil
d. increase in urine output
13. A home health nurse instructs a client on the use of
a nitrate patch. The nurse tells the client that the
following will prevent client tolerance to nitrates?
a. Never remove the patches
b. Have a 24-hour “no nitrate” period
c. Have a 12-hour “no nitrate” period
d. Keep nitrate patches on for 24 hours, then off for
24 hours
14. How should the nurse ensure that the potency of
nitroglycerin is not compromised?
a. Keep the medicine in a tightly closed, dark glass
container
b. A new supply of medication is purchased every
year
c. Sublingual tablets are swallowed for immediate
absorption
d. Take the 1st dose of nitroglycerin after 15 minutes
of observed pain
15. Which of the following statements, if made by the
client, indicates a need for further teaching?
a. “I can still drink wine occasionally.”
b. “I will notify my doctor if the dizziness does not
wear off."
c. “I shall wash my hands after applying the patch.”
d. “I shall rest while monitoring the effect of the
nitroglycerin.'
Anti Coagulants
16. In a client on Coumadin therapy, which of the
following nursing considerations should the nurse
implement? Select all that apply:
a. Consult with the physician before taking vitamins
b. Monitor complete blood count weekly
c. Monitor INR and Prothrombin time weekly
d. Do not take herbal medicines
17. Upon interview the nurse noted that Ms. Lionel has
had an embolic stroke. Which type of treatment
should the nurse expect?
a. Aspirin therapy
b. Cefepime Therapy
c. Heparin Therapy
d. Vitamin K Therapy
18. Which of the following discharge instructions
indicates that the client on Coumadin Therapy needs
additional teaching?
a. “I should shave with a manual razor.”
b. “I should use soft-bristled toothbrush.”
c. “I should return for my laboratory appointments.”
d. “I should monitor for signs of bleeding.”
19. Which nursing action would be appropriate for a
client on continuous infusion of heparin with a PTT
greater than 170 seconds?
a. Slow the heparin drip
b. Stop the heparin and notify the physician
c. Maintain the heparin at the current infusion rate
d. Increase the infusion rate and notify the physician
20. The doctor orders to start the client with Ventricular
dysrhythmia on Cordarone. Which of the following
should
the nurse prepare?
a. Pulse oximeter
b. Cardiac monitor
c. TENS machine
d. Electroencephalogram
21. A client with cardiac disease is on a monitor and
the nurse observes ventricular tachycardia at a rate of
140 bpm. The client is conscious with a GCS of 15/15.
What is the appropriate nursing action?
a. Obtain arterial blood gas values
b. Begin cardiopulmonary resuscitation
c. Administer Lidocaine IV push
d. Defibrillate the client
22. A client is reported to be in first-degree heart
block. What is a nursing measure to assess the status
of his dysrhythmia?
a. Evaluate ECG rhythm strip
b. Count the radial pulse for 1 full minute
c. Determine the cardiac rate at the PMI
d. Correlate blood pressure with hourly pulse checks
23. A client is being treated with Procainamide
(Pronestyl). After administration of the drug, the client
complains of dizziness. What nursing intervention
should be prioritized?
a. Administer oral nitroglycerin tablets
b. Auscultate the apical pulse then obtain the blood
pressure
c. Obtain a 12-lead ECG
d. Heart rate and rhythm on the rhythm strip
24.. The client taking Tocainide (Tonocard) complains of
dry mouth. What should the nurse do?
a. Refer to the attending physician
b. Taper the dosage of the medication
c. Decrease the frequency of the medication
d. Offer sugar-free gum
Cholinergics
25. A patient is to receive pilocarpine. The nurse
understands that this drug would be most likely used
to treat which of the following?
a. Myasthenia gravis
b. Neurogenic bladder
c. Glaucoma
d. Alzheimer disease
26. A patient with myasthenia gravis is no longer able
To swallow. Which of the following would the nurse
expect the physician to order?
a. Tacrine
b. Ambenonium
c. Pyridostigmine
d. Edrophonium
27. Adverse effects associated with the use of
Cholinergic drugs include
a. constipation and insomnia.
b. diarrhea and urinary urgency.
c. tachycardia and hypertension. b. Increased salivation
d. dry mouth and tachycardia. c. Hypotension
d. Apnea
28. Cholinergic (parasympathomimetic) drugs are
indicated for which situation? 35. The instructor determines that teaching about
a. Treating a postoperative patient who has adrenergic drugs has been successful when the class
Bradycardia identifies the drugs as also being called
b. Lowering intraocular pressure in patients with a. sympatholytic agents.
glaucoma b. cholinergic agents.
c. Inhibiting muscular activity in the bladder c. sympathomimetic agents.
d. Preventing salivation and sweating d. anticholinergic agents.

29 The nurse is administering neostigmine to a
client with myasthenia gravis. Which nursing
intervention should the nurse implement?
a. Give the medication on an empty stomach
b. Warn the client that he’ll experience mouth dryness
c. Schedule the medication before meals
d. Administer the medication for complaints of
muscle weakness or difficulty swallowing.
Anti Cholinergics
30. A home care nurse is visiting a client with a
diagnosis of Parkinson’s disease. The client is taking
benztropine mesylate (Cogentin) orally daily. The
nurse provides information to the spouse regarding
the side effects of this medication and tells the
spouse to report which side effect if it occurs?
a. inability to urinate
b. decrease appetite
c. shuffling gait
d. irregular bowel movement
31. A client has received atropine sulfate preoperatively.
The nurse monitors the client for which effect of the
medication in the immediate postoperative period?
a. Diarrhea
b. Bradycardia
c. Urinary retention
d. Excessive salivation
32. A client has been given a prescription for
propantheline as adjunctive treatment for peptic ulcer
disease. How should the nurse tell the client to take
this medication?
a. With meals
b. With antacids
c. Just after meals
d. 30 minutes before meals
36. The adrenergic agent of choice for treating the
signs and symptoms of allergic rhinitis is
a. norepinephrine.
b. phenylephrine.
c. dobutamine.
d. dopamine.
37. An adrenergic agent being used to treat shock
Infiltrates into the tissue with intravenous
administration. Which action by the nurse would be
most appropriate?
a. Watch the area for any signs of necrosis and
report it to the physician.
b. Notify the physician and decrease the rate of
infusion.
c. Remove the IV and prepare phentolamine for
administration to the area.
d. Apply ice and elevate the arm.
38. Phenylephrine, an alpha-specific agonist, is found in
many cold and allergy preparations. The nurse
Instructs the patient to be alert for which adverse
effects?
a. Urinary retention and pupil constriction
b. Hypotension and slow heart rate
c. Personality changes and increased appetite
d. Cardiac arrhythmias and difficulty urinating
39. Adverse effects associated with adrenergic
agonists are related to the generalized stimulation
of the sympathetic nervous system and could
include
a. slowed heart rate.
b. constriction of the pupils.
c. hypertension.
d. increased GI secretions.
Adrenergic Blockers

33. The nurse administers a dose of scopolamine 40. The physician is treating a client in the cardiac care
to a preoperative client. The nurse should monitor the unit for atrial arrhythmia and prescribes propranolol
client for which common side effect of the (Inderal), 10 mg PO three times a day. Propranolol
medication? inhibits the action of sympathomimetics at beta1-
a. Dry mouth receptor sites. Where are these site mainly located?
b. Diaphoresis a. Uterus
c. Excessive urination b. Blood vessels
d. Pupillary constriction c. Bronchi
d. Heart
Adrenergic Agonist
41. Adrenergic blocking drugs, because of their
34. A nurse is monitoring a client for adverse reaction to clinical effects, are also known as
Atropine eye drops. Systemic Absorption to atropine a. anticholinergics.
sulfate through the conjunctiva can cause which adverse b. sympathomimetics.
reaction? c. parasympatholytics.
a. Tachycardia d. sympatholytics.

42. Phentolamine (Regitine), an alpha-adrenergic
blocker, is most frequently used
a. to prevent cell death after extravasation of
Intravenous dopamine or norepinephrine.
b. to treat COPD in patients with hypertension or
arrhythmias.
c. to treat hypertension and BPH in male patients.
d. to block bronchoconstriction during acute
Asthma attacks.
43. Which of the following clients are not advised to
take Beta-Adrenergic blockers
a. Chronic obstructive pulmonary disease
b. Myocardial infarction
c. Angina pectoris
d. Chronic kidney disease
44. After suffering an acute myocardial infarction (Ml), a
client with a history of type 1 diabetes is prescribed
metoprolol (Lopressor) I.V. Which nursing interventions
are associated with I.V. metoprolol administration?
Select all that apply:
1. Monitor glucose level closely.
2. Monitor the client for heart block and bradycardia.
3. Monitor blood pressure closely.
4. Mix the drug in 50 ml of dextrose 5% in water and
infuse over 30 minutes.
5. Know that the drug isn’t compatible with morphine.
Chemotherapeutic Drugs
45. A nurse is caring for a client receiving
chemotherapy. Which assessment finding
places the client at the greatest risk for an infection?
a. White blood cell (WBC) count of 9,000
cells/mm3
b. Stage 3 pressure ulcer on the left heel
c. Temperature of 98.3° F (36.8° C)
d. Ate 75% of all meals during the day
46. A client is receiving chemotherapy to treat breast
cancer. Which assessment finding indicates a
chemotherapy-induced
complication?
a. Urine output of 400 ml in 8 hours
b. Serum potassium level of 2.6 mEq/L
c. Blood pressure of 120/64 to 130/72 mm Hg
d. Sodium level of 142 mEq/L
47. A nurse is caring for a client who is
receiving chemotherapy and has a platelet count of
30,000/mm3. Which statement by the client indicates a
need for additional teaching?
a. “I will floss my teeth every morning.”
b. “I use an electric razor to shave.”
c. “I take a stool softener every morning.”
d. “I removed all the throw rugs from the house.”
48. A client has just begun treatment with
bisulfan (Myleran), 4 mg by mouth daily, for
chronic myelogenous leukemia. The client
receives bisulfan until his white blood cell
(WBC) count falls to between 10,000/mm3
and 25,000/mm3, then the drug is stopped.
When should treatment resume?
a. When the WBC falls to 5,000/mm3
b. When lost hair begins to grow back
c. When the WBC count rises to 50,000/mm3
d. When the client displays anemia
49. A client who’s receiving chemotherapy for breast
cancer develops myelosuppression. Which
instructions should the nurse include in the client’s
discharge teaching plan? Select all that apply.
1. Avoid people who have recently received
attenuated vaccines.
2. Avoid actives that may cause bleeding.
3. Wash hands frequently.
4. Increase intake of fresh fruits and vegetables.
5. Avoid crowded places such as shopping malls.
6. Treat a sore throat with over-the-counter (OTC)
products.
50. A client with advanced breast cancer is
ordered tamoxifen (Nolvadex). When
teaching the client about this drug, the nurse should
emphasize the importance of reporting which adverse
reaction immediately?
a. Vision changes
b. Hearing loss
c. Skin rash
d. Anorexia
51. A client has been receiving chemotherapy to treat
cancer. Which assessment finding suggests that the
client has developed tomatitis?
a. White, cottage cheese—Ike patches on
the tongue
b. Yellow tooth discoloration
c. Red, open sores on the oral mucosa
d. Rust-colored sputum
52. During chemotherapy, an oncology client has a
nursing diagnosis of Impaired oral mucous membrane
related to decreased nutrition and inmunosuppression
secondary to the cytotoxic effects of chemotherapy.
Which nursing intervention is most likely to decrease
the pain of stomatitis?
a. Recommending that the client discontinue
chemotherapy
b. Providing a solution of viscous lidocaine for use as a
mouth rinse
c. Monitoring the client’s platelet and leukocyte counts
d. Checking regularly for signs and symptoms of
stomatitis
53. A client is receiving methotrexate (Trexall), 12 g/m²
I.V., to treat osteogenic carcinoma. During
methotrexate therapy, the nurse expects the client to
receive which other drug to protect normal cells?
a. Probenecid
b. Cytarabine
c. Thioguanine
d. Leucovorin
54. The nurse is teaching a client newly
diagnosed with cancer about chemotherapy.
The nurse tells the client he’ll receive an antitumor d. “This medicine needs to be taken with aspirin.”
antibiotic. The nurse knows that this type of
medications is: Diuretics
a. cell-cycle nonspecific.
b. cell-cycle specific in the S phase. 60. A nurse had just received the laboratory results of
c. cell-cycle specific in the M phase. Mr. Wyatt, a client with chronic kidney disease, who is
d. cell-cycle specific in the P phase. receiving Furosemide every 8 hours. Which of the
following laboratory results indicates a need to alert the
Anti-Platelet Drugs physician?
a. Creatinine 1.5 mg/dl
55. A 50-year-old woman comes into the outpatient b. Potassium 1.3 mEq/L
clinic for a check-up for echymosis around the toes. c. Sodium 130mEq/L
Upon interview she tells the nurse that she had been d. RBS 82 mg/dL
prescribed a new medication, namely Plavix, about a
week ago. Which of the following should the nurse tell 61. Upon discharge, the nurse explains to Mr. Wyatt
the client? how to take the prescribed Furosemide(Lasix) 40 mg
a.“It is a normal side effect of the medication and you once a day. What time of the day should the nurse
instruct the patient to take
should be fine.” the medication?
b. “It’s impossible that you got the echymosis from a. At bedtime
b. At noon
Plavix.”
c. After dinner
c. “With cases such as this, I’m afraid I have to refer you d. In the morning
to the infectious disease committee.”
62. Which of the following should the nurse monitor
d. “Please wait here for a while, the doctor will see you daily in a client receiving frequent doses of diuretics?
in a bit.” a. Weight
b. Calcium levels
56. A client is rushed at the emergency department for c. Lithium levels
taking almost a whole bottle Aspirin. Which of the d. Abdominal girth
following should the nurse monitor?
a. Tourniquet test 63. A client is on Acetazolamide and Digoxin. Which of
b. Shortened bleeding time the following statements by the client should be
c. Oxygen saturation reported for follow-ups?
d. ABG results a. “I noticed that my cough has been relieved.”
b. “I do early morning walks.”
57. A client with an acute pulmonary emboli is receiving
Pentoxifylline (Trental). Which of the following indicates c. “I sleep with three pillows at night.”
that the client is experiencing an adverse effect of the d. “I have lost weight.”
medication:
a. Hypertension 64. Which assessment finding is the nurse most likely to
b. Abdominal pain expect in a client who has received Mannitol 60cc IV
c. Bradycardia bolus?
d. Positive peripheral pulses a. Anuria
b. Hypoglycemia
58. The client is receiving high doses of aspirin to c. Hypoxemia
prevent the evolution of stroke. Which of the following d. Hypotension
is the most appropriate health teaching by the nurse?
a. Tell the client not to brush his teeth Corticosteroids
b. Provide active ROM exercises to prevent clot
formation 65. The nurse is caring for a client who is scheduled for n
c. Allow the client to sit at the bed side only adrenalectomy. The nurse plans to administer which
d. Tell the client to use an electric razor for shaving medication in the preoperative period to prevent
Addisonian crisis?
59. Ms. Cruz is prescribed with Ticlodipine (Ticlid) a. Prednisone orally
following a b. Fludrocortisone (Florinef) orally
thrombotic stroke. As the nurse provides instructions, c. Spironolactone (Aldactone) intramuscularly
which d. Methylprednisolone sodium succinate (Solu-Medrol)
client statement indicates that the client has intravenously
understood the
Instructions given? 66. The nurse is developing a discharge plan for a post
a. “I should not take this medicine on sick days.” operative client who had one adrenal gland removed.
b. “This medicine will cure the stroke.” What should the nurse include in the plan?
a. Teaching the client to maintain a diabetic diet
c. “I’ll take the medicine with meals.” b. Teaching proper application of an ostomy pouch
c. Providing a list of the early signs of a wound
infection
d. Explaining the need for lifelong replacement of all
adrenal hormones
67. A nurse ¡s caring for a client in addisonian crisis.
Which medication order should the nurse question?
a. Potassium chloride
b. Normal saline solution
c. Hydrocortisone (Cortefl
d. Fludrocortisone (Florinef)
68. A nurse is teaching a client recovering from
addisonian crisis about the need to take fiudrocortisone
acetate and hydrocortisone at home. Which statement
by the client indicates an understanding of the
instructions?
a. “I’ll take my hydrocortisone in the late afternoon,
before dinner.”
b. “I’ll take all of my hydrocortisone in the morning, right
after I wake up.”
c. “I’ll take two-thirds of the dose when I wake up and
one-third in the late afternoon.”
d. “I’ll take the entire dose at bedtime.”
69. The adrenal cortex is responsible for producing
which substances?
a. Glucocorticoicis and androgens
b. Catecholamines and epinephrine
c. Mineralocorticoids and catecholamines
d. Norepinephrine and epinephrine
Oral Hypoglycemic Agents
70. After administering Tolbutamide (Orinase), the
nurse instructs the client to avoid which of the following
food or drinks?
a. Carbonated beverages
b. Organ meats
c. Whole grain cereals
d. Alcohol
71. The nurse is explaining to the newly diagnosed DM 2
client his prescribed medicines. Which of the following
maintenance medicines of the client needs to be
reported to the physician?
a. Diltiazem
b. Atorvastatin
c. Amiodarone
d. Carvedilol
c. Improved condition in clients with inflammatory
bowel diseases
d. Liver function tests are within normal range
74. A client is taking glyburide (DiaBeta), 1.25 mg P.O.
daily, to treat type 2 diabetes. Which statement
indicates the need for further client teaching about
managing this disease?
a. “I always carry hard candy to eat in case my blood
sugar level drops.”
b. “I avoid exposure to the sun as much as possible.”
c. “I always wear my medical identification bracelet.”
d. “I skip lunch when I don’t feel hungry.”
Dobutamine/Dopamine Drug Computations
75. A man weighs 165 lb. and is being treated for shock.
The nurse is preparing a dopamine hydrochloride
infusion to start at 5 mcg/kg/min. The nurse has
prepared the following to infuse: dopamine 400 mg in
250 mL D5W. Which of the following rates of infusion
should the nurse choose?
a. 14 mL/hr
b. 16 mL/hr
c. 22.5 mL/hr
d. 37.5 mL/hr
76. A client with sepsis and hypotension is being treated
with dopamine (Inotropin). The nurse asks a colleague
to double-check the dosage that the client is
receiving. There are 400 mg of dopamine in 250 ml,
the infusion pump is running at 23 ml/hour, and the
client weighs 79.5 kg. How many micrograms per
kilogram per minute is the client receiving? Record
your answer using two decimal places.
77. Dopamine drip (400mg in 250 cc of IV fluid) is
infusing on your 80 kg patient at 20 cc/hour. How
many mcg/kg/min are infusing for this patient?
78. Infuse Dobutamine 500 mg in 250 ml D5W at 5
mcg/kg/min using microdrip tubing.The client weighs
182 lbs. Determine the ml/hr and the gtts/min.

72. In giving home instructions to the client on OHAs,

the following are side effects of Metformin, except?
a. Hypoglycemia
b. Dizziness
c. Hypertension
d. Nausea

73. Which of the following should be the expected

outcome on clients taking Biguanides?
a. Controlled blood glucose
b. Weight loss