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QUESTION #1
Pharmacology Exam 2 Pharmacology
A nurse is conducting a preadministration assessment for a client recently diagnosed with urinary retention caused by an enlarged prostate. The provider is considering prescribing bethanechol. The nurse begins by gathering objective data from the client. Which action is the most appropriate in this scenario?
A Conduct a thorough assessment of the client’s pain level, including its location and aggravating factors.
B Perform a bladder scan and measure the residual urine.
C Inquire about the client’s medical history and prior urinary issues.
D Ask the client about their social support system and emotional well-being.

Explanations

A
Pain assessment is subjective, not objective, and bethanechol assessment focuses on urinary function.
B
Performing a bladder scan provides objective data about urinary retention and helps determine the need for bethanechol, which stimulates bladder contraction.
C
Medical history is subjective data that complements objective findings but is not the nurse’s immediate priority for this question.
D
Assessing emotional well-being is important but unrelated to the medication’s preadministration objective data.
When assessing before giving bethanechol, always collect measurable data such as bladder scan results or urine output to confirm true urinary retention before initiating therapy.
QUESTION #2
Pharmacology Exam 2 Pharmacology
A nurse is educating a client with Parkinson’s disease and the family about the potential effects of carbidopa-levodopa therapy. The nurse should emphasize that the client must be closely monitored for which adverse effect?
A Involuntary movements
B Increased perspiration
C Diarrhea
D Increased appetite

Explanations

A
Carbidopa-levodopa can cause dyskinesia, including involuntary facial grimacing, head bobbing, or jerking movements, which indicate excess dopamine levels or drug toxicity.
B
Sweating is not a common or dangerous adverse effect of this medication.
C
Gastrointestinal effects may occur, but diarrhea is not a typical reaction to carbidopa-levodopa.
D
Appetite is generally unaffected by this medication.
Monitor clients on carbidopa-levodopa for involuntary muscle movements, which may signal that the dose is too high or the body is developing a sensitivity to dopamine.
QUESTION #3
Pharmacology Exam 2 Pharmacology
A 59-year-old client with vascular disorders is prescribed cilostazol. The nurse explains that this medication is used for the treatment of which condition?
A Pulmonary embolism
B Deep-vein thrombosis
C Intermittent claudication
D Venous stasis

Explanations

A
Cilostazol does not dissolve or prevent emboli; anticoagulants like heparin are used instead.
B
DVT is treated with anticoagulants, not with vasodilators such as cilostazol.
C
Cilostazol is a phosphodiesterase III inhibitor that promotes vasodilation and increases blood flow to the extremities, reducing pain caused by peripheral arterial disease (PAD).
D
This condition is related to poor venous return and not treated with cilostazol.
Remember that cilostazol improves walking distance and reduces pain in peripheral artery disease (PAD) by increasing circulation to the legs, not by thinning the blood.
QUESTION #4
Pharmacology Exam 2 Pharmacology
A client with a long-standing history of angina has been prescribed nitroglycerin and diltiazem. In addition to monitoring the client’s heart rate, which assessment should the nurse prioritize?
A Blood pressure
B Level of consciousness
C Daily weights
D Respiratory status

Explanations

A
Both nitroglycerin and diltiazem are vasodilators, which can cause significant hypotension. Monitoring blood pressure ensures the client maintains adequate perfusion and helps prevent syncope or shock.
B
This may change with severe hypotension, but it’s a secondary indicator, not the first assessment priority.
C
Important for monitoring fluid retention in heart failure, but not the immediate concern with these medications.
D
These drugs primarily affect cardiac workload and vascular tone, not the respiratory system.
When patients are on vasodilators or calcium channel blockers, always monitor blood pressure closely to detect hypotension early and prevent fainting or falls.
QUESTION #5
Pharmacology Exam 2 Pharmacology
A patient with a history of anaphylaxis presents to the emergency department after using an epinephrine autoinjector following a bee sting. What is the priority nursing action?
A Check the patient’s blood glucose level.
B Ensure airway patency.
C Obtain an EKG.
D Assess for constipation.

Explanations

A
While epinephrine may cause transient hyperglycemia, airway management takes priority.
B
The primary concern in anaphylaxis is airway obstruction due to laryngeal edema or bronchospasm. Even after using epinephrine, the nurse must monitor breathing and oxygenation continuously.
C
Cardiac monitoring is important but not the first priority in a life-threatening allergic reaction.
D
This is unrelated to anaphylaxis or epinephrine use.
In any anaphylactic emergency, always prioritize airway, breathing, and circulation (ABCs). Even after epinephrine use, airway obstruction can recur—keep oxygen and emergency equipment ready.
QUESTION #6
Pharmacology Exam 2 Pharmacology
When a patient is taking an anticholinergic such as benztropine (Cogentin) as part of treatment for Parkinson’s disease, which information should the nurse include in the teaching plan?
A Minimize the amount of fluid taken while on this drug.
B Discontinue the medication if adverse effects occur.
C Take the medication on an empty stomach to enhance absorption.
D Use artificial saliva, sugarless gum, or hard candy to counteract dry mouth.

Explanations

A
Fluids should not be restricted; adequate hydration helps prevent constipation caused by anticholinergics.
B
The patient should never stop the medication abruptly; they must contact the provider first.
C
Anticholinergics can cause GI upset, so they are usually taken with food or milk.
D
Dry mouth is a common side effect of anticholinergic drugs due to decreased salivation. Sugarless gum or artificial saliva helps relieve discomfort.
Teach patients taking anticholinergics to manage dry mouth and constipation with hydration, oral care, and fiber intake, and to avoid overheating since these drugs inhibit sweating.
QUESTION #7
Pharmacology Exam 2 Pharmacology
The nurse is caring for a patient with myasthenia gravis (MG) who takes pyridostigmine 60 mg every 4 hours. The patient’s last dose was given 45 minutes ago. The nurse observes respiratory distress, excessive salivation, facial muscle twitching, and pupil constriction. Which action should the nurse take?
A Notify the provider to discuss an order for epinephrine.
B Request an order for an extra dose of pyridostigmine.
C Assess the patient for signs of ptosis.
D Obtain an order for atropine sulfate.

Explanations

A
Epinephrine treats allergic or anaphylactic reactions, not cholinergic crisis symptoms.
B
Giving more cholinergic medication would worsen toxicity and potentially lead to respiratory failure.
C
While ptosis is a sign of myasthenic crisis, the symptoms described (salivation, miosis, twitching) indicate cholinergic crisis.
D
These symptoms are classic signs of a cholinergic crisis due to overdose of pyridostigmine. Atropine, an anticholinergic, is the antidote that reverses muscarinic effects such as bradycardia, bronchospasm, and excessive secretions.
Remember the difference: Too little medication = myasthenic crisis, too much medication = cholinergic crisis. Atropine is the emergency antidote for the latter.
QUESTION #8
Pharmacology Exam 2 Pharmacology
The nurse is teaching a patient who will begin taking cyclobenzaprine to treat acute muscle spasms. Which statement by the patient indicates a need for further teaching?
A “I may experience dizziness and drowsiness when I take this drug.”
B “I should not consume alcohol while taking this medication.”
C “I should be careful driving with this medication because it can cause drowsiness.”
D “I will take this medication for 3 months and then stop taking it.”

Explanations

A
These are expected side effects due to CNS depression.
B
Alcohol intensifies sedative effects and should be avoided.
C
The drug impairs alertness and coordination.
D
Cyclobenzaprine is meant for short-term use (2–3 weeks) only. Prolonged use increases the risk of dependence and adverse effects.
Cyclobenzaprine should be used for acute, short-term muscle spasms—not chronic therapy. Reinforce that long-term use is unsafe and should only continue under medical supervision.
QUESTION #9
Pharmacology Exam 2 Pharmacology
The nurse is caring for a client who is receiving cyclobenzaprine for the relief of muscle spasms. Which adverse effect should the nurse assess for?
A Muscle spasms
B Insomnia
C Drowsiness
D Urinary incontinence

Explanations

A
Cyclobenzaprine is prescribed to relieve muscle spasms, not cause them.
B
The medication has a sedative effect, which makes insomnia unlikely.
C
Cyclobenzaprine is a centrally acting muscle relaxant that depresses the central nervous system, leading to drowsiness, dizziness, and fatigue as common adverse effects.
D
Cyclobenzaprine can cause urinary retention, not incontinence.
Advise patients taking cyclobenzaprine to avoid driving or operating machinery until they know how the drug affects them, as drowsiness and dizziness are frequent side effects.
QUESTION #10
Pharmacology Exam 2 Pharmacology
A nurse is teaching a client diagnosed with a pulmonary embolism about the prescribed heparin therapy. The nurse determines that teaching has been effective when the client states that heparin is given to:
A Dissolve the clot
B Break up the pulmonary embolism
C Slow the development of other clots
D Prevent clots from traveling to the lung

Explanations

A
Heparin does not dissolve existing clots; thrombolytics (e.g., alteplase) perform that function.
B
Heparin cannot break down clots already formed.
C
Heparin is an anticoagulant that prevents new clot formation and stops existing clots from growing larger.
D
Heparin prevents formation, not movement, of clots.
Heparin prevents new clots, it doesn’t dissolve old ones. It works by inhibiting clotting factors and keeping the clotting process under control.