Pharmacology
A nurse is teaching a client about a newly prescribed oral medication. The nurse explains that the drug will be significantly metabolized by the liver before it reaches systemic circulation. Which term is the nurse describing?
A) First-pass effect B) Bioavailability C) Half-life D) Therapeutic index
a) first pass effect
A nursing instructor asks a student to differentiate innate and adaptive immunity. Which statement is correct?
A) Innate is slower but has memory; adaptive is immediate but nonspecific B) Innate is immediate and nonspecific; adaptive is slower but has memory for faster future responses C) Both have memory capability D) Innate only involves antibodies produced by B cells E) Adaptive doesn't require prior activation of innate immunity
Innate is immediate and nonspecific; adaptive is slower but has memory
A nurse is caring for a client having an acute asthma exacerbation. Which pathophysiologic changes explain the airflow limitation?
A) Bronchospasm, airway edema, and mucus hypersecretion B) Destruction of alveolar walls and loss of elastic recoil C) Hypertrophy of the left ventricle D) Increased surfactant production
Bronchospasm, airway edema, and mucus secretion
A client newly prescribed lisinopril develops a persistent dry cough. This occurs because:
A) ACE inhibitors cause bronchospasm directly B) ACE inhibitors increase bradykinin levels, which can cause cough and angioedema C) The client is developing pneumonia D) ACE inhibitors cause fluid overload in the lungs
ACE inhibitors increase bradykinin causing cough/angioedema
A client is given 800 mg of a medication with a half-life of 6 hours. How much of the drug remains in the body 6 hours after administration?
A) 800 mg B) 400 mg C) 200 mg D) 100 mg
400mg
A client develops hives, throat swelling, and wheezing within minutes of eating shellfish. Which type of hypersensitivity reaction is this?
A) Type I – IgE mediated B) Type II – Tissue specific C) Type III – Immune complex mediated D) Type IV – Cell mediated
type 1 IgE mediated
A client uses an albuterol inhaler for an acute asthma attack. Which adverse effect should the nurse monitor for?
A) Bradycardia and hypotension B) Tachycardia and tremors C) Dry mouth and urinary retention D) Hyperkalemia and metallic taste
tachycardia and tremors
A nurse is preparing to administer metoprolol. The client's apical heart rate is 48 bpm. What is the priority action?
A) Administer as scheduled B) Hold the medication and notify the provider C) Give IV push instead of orally D) Double the dose to compensate
hold the medication and notify the provider
A nurse is drawing a blood sample to determine the lowest serum concentration of an antibiotic before the next scheduled dose. Which level is being measured?
A) Peak level B) Trough level C) Half-life D) Bioavailability
trough level
A client with rheumatoid arthritis asks why her body seems to be "attacking itself." The nurse should explain that autoimmune disease occurs when:
A) The immune system fails to respond to any pathogens B) The body recognizes self-tissue as foreign and mounts an immune response against it C) White blood cell production stops completely D) The innate immune system is permanently activated
the body recognizes self-tissue as foreign
A nurse is teaching about ipratropium (Atrovent) inhaler use. Which client statement indicates a need for further teaching?
A) "I will drink extra water and suck on hard candy for dry mouth." B) "I will schedule regular eye exams to monitor for glaucoma." C) "I will use this as my rescue inhaler during an acute attack because it works within seconds." D) "I will report any difficulty urinating to my provider."
I will use this as my rescue inhaler during an acute attack because it works within seconds
A client taking amlodipine reports swollen, overgrown gums. The nurse recognizes this as:
A) An expected adverse effect called gingival hyperplasia B) A sign of anaphylaxis requiring epinephrine C) An indication the drug is not working D) A sign of digoxin toxicity
gingival hyperplasia
Which route of administration bypasses the first-pass effect?
A) Intravenous B) Oral tablet C) Enteric-coated tablet D) Extended-release capsule
intravenous (IV)
In the chain of infection, a nurse washing her hands before touching a client is intervening at which link?
A) Reservoir B) Portal of exit C) Mode of transmission D) Portal of entry
Mode of transmission
A client taking theophylline reports nausea, vomiting, and restlessness. The nurse should be most concerned about:
A) Therapeutic drug effect B) Theophylline toxicity, which can progress to seizures and dysrhythmias C) Normal expected adverse effect requiring no action D) Hypoglycemia E) Anaphylaxis
theophylline toxicity
A client taking digoxin reports nausea, fatigue, and seeing yellow halos around lights. These findings are signs of:
A) Expected therapeutic effect B) Digoxin toxicity C) Hyperkalemia unrelated to the medication D) An allergic reaction requiring epinephrine
digoxin toxicity
A client asks why they were prescribed low-dose aspirin instead of another pain reliever after their heart attack. The nurse explains this is an example of which concept?
A) A secondary therapeutic effect B) An adverse drug reaction C) A toxic effect D) Drug tolerance
Secondary therapeutic effect
A client asks why they need a booster vaccine years after their initial vaccination series. The nurse's best response:
A) "Boosters are given because immunity from the original vaccine can decrease over time." B) "Boosters are needed because the first vaccine didn't produce any immunity." C) "Boosters convert innate immunity into adaptive immunity." D) "Boosters are only needed if you develop an active infection."
immunity from the original vaccine can decrease over time
A nurse is caring for a client with emphysema. Which clinical finding is most consistent with this diagnosis?
A) Chronic productive cough with cyanosis, B) Barrel chest and pink complexion with dyspnea, C) Peripheral edema and normal chest shape D) Clubbing absent and AP:lateral ratio of 1:2
Barrel chest and pink complexion with dyspnea
A nurse is administering furosemide IV to a client with heart failure. Which action is most important to prevent a serious adverse effect?
A) Infuse rapidly for quick diuresis B) Infuse slowly and monitor for tinnitus or hearing changes C) Administer with a high-potassium IV bolus simultaneously D) Restrict the client's fluid intake
infuse slowly and monitor for tinnitus/hearing changes