Pharmacology

All but one are Nursing teachings for patients taking

Allopurinol:
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 Instruct patient to take the drug after meals
 Educate the patient that he may experience these side
effects: nausea, vomiting, loss of appetite (take after meals
or eat frequent small meals); drowsiness (use caution while
driving or performing hazardous tasks)

 Encourage patient to report unusual bleeding or bruising,

fever, chills, gout attack; numbness or tingling; flank pain,
skin rash
 Caution patient to chew medication

Correct answer
Caution patient to chew medication

What advice do you need to give to a patient taking Allopurinol?

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 Drink 8 to 10 full glasses of fluid every day, unless your
doctor tells you otherwise

 Store allopurinol at room temperature away from moisture

and heat
 Avoid being near people who are sick or have infections
  Skin rash is a common side effect, it will pass after a few
days

John is also prescribed some medications for his Gout. Which of

the following health teaching will you advise him to do?
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 Increase fluid intake 2 - 3 liters per day
 Have enough sunshine
 Avoid paracetamol (first line analgesic)
 Avoid dairy products

Correct answer
Increase fluid intake 2 - 3 liters per day

Mild pain after surgery and pain is reduced by taking which

medicine
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 Paracetamol
 Ibuprofen
 Paracetamol with codeine
 Paracetamol with morphine

Correct answer
Paracetamol

A Ibuprofen 200mg tablet has been prescribed. You only have a

400mg coated ibuprofen tablet. What should you do?
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 Give half of the tablet
  Crush the tablet and give half of the amount
 Order the different dose of tablet from pharmacy
 Omit

Correct answer
Order the different dose of tablet from pharmacy

Dennis was admitted because of acute asthma attack. Later on in

your shift, he complained of abdominal pain and vomited. He
asked for pain relief. Which of the following prescribed
analgesia will you give him?
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 Fentanyl buccal patch

 Ibuprofen enteric coated capsules

 Paracetamol suppositories
 Oromorphine

Correct answer
Paracetamol suppositories

What to teach a young patient when he is taking antibiotics

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 Take it during morning and complete the dose
 Don’t take it with alcohol
 Take it with food or after meal and complete dose

 Medication may cause hypotension

Correct answer
Don’t take it with alcohol

John, 18 years old is for discharge and will require further dose
of oral antibiotics. As his nurse, which of the following will you
advise him to do?
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 Take with food or after meals and ensure to take all
antibiotics as prescribed

 Take all antibiotics and as prescribed

 Take medicine during the day and ensure to finish the
course of medication
 Take medicine and stop when he feels better

Correct answer
Take all antibiotics and as prescribed

What instructions should you give a client receiving oral

Antibiotics?
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 Consume it all at once
 Take the antibiotic with glass of water

 Take the medication with meals and consume all the

antibiotics
 Take the medication as prescribed and complete the course
Correct answer
Take the medication as prescribed and complete the course

When should prescribed antibiotics be administered to a

septicaemic patient?
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 Immediately after admission
 After getting blood culture result

 Immediately following blood drawn for culture

Correct answer
Immediately following blood drawn for culture

When will the doctor prescribe a broad-spectrum antibiotic?

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 On admission

 When septicemia is suspected

 When the blood culture shows positive growth of organism

Correct answer
When septicemia is suspected

Which of the following should be considered before giving

digoxin?
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 Allergies
 Drug interactions
  Other interactions with food or substances like alcohol and
tobacco
 Medical problems (thyroid problems, kidney disease, etc )

 All of the above

Correct answer
All of the above

Before administering Digoxin, you must check specifically for

what?
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 Breathing

 Heart Rate
 Temperature
 LOC

Correct answer
Heart Rate

Tony is prescribed Lanoxin 500 mcg PO. What vital sign will
you assess prior to giving the drug?
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 Heart rate and rhythm

 Respiration rate and depth

 Temperature
 Urine output
Which medicine does digoxin interact with?
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 NSAID
 Rasagiline

 Amoxicillin
 Anticoagulants

Correct answer
NSAID

Which drug to be avoided by a patient on digoxin?

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 Corticosteroid

 NSAID

Correct answer
NSAID

Which of these medications is not administered with digoxin?

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 Diuretics

 Corticosteroids
 Antibiotics
 NSAIDs

Correct answer
NSAIDs
The nurse monitors the serum electrolyte levels of a client who
is taking digoxin (Lanoxin). Which of the following electrolyte
imbalances is common cause of digoxin toxicity?
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 Hypocalcemia
 Hyponatremia
 Hypomagnesemia

 Hypokalemia

Correct answer
Hypokalemia

Patient has next dose of Digoxin but has a CR=58

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 Omit dose, record why, and inform the doctor
 Give dose and tell the doctor
 Give dose as prescribed

Correct answer
Omit dose, record why, and inform the doctor

An adult who has gastroenteritis and is on digitalis has lab

values of ; K 3.2 mEq/L , Na 136 mEq/L, Ca 4.8 mEq/L , and Cl
98 mEq/L. The nurse puts which of the following on patient’s
plan of care?
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 Monitor for hyperkalemia
  Avoid foods rich in potassium
 Observe for digitalis toxicity
 Observe for Trousseau’s and Chvostek’s signs

Correct answer
Observe for digitalis toxicity

Mrs X has been admitted in the hospital due to oedema of her

thighs. One of her medications was Furosemide 40 mg tablets to
be administered once daily. What should be done prior to
administering Furosemide?
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 Check patient’s blood pressure, and withhold Furosemide if
it is low

 Check patient’s pupils, and withhold Furosemide if it is

constricted
 Swab your patient’s wound and send the sample to
pathology
 Assess each of your patient’s thighs by measuring its girth

Hypokalemia can occur in which situation?

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 Addissons disease

 When use spironolactone

 When use furosemide

Correct answer
When use furosemide
A patient receiving Lasix daily is admitted with a diagnosis of
dehydration and hypokalaemia. The patient's IV fluid is 1000
mL 0.9% normal saline with 20 mEq of potassium chloride
infusing at 125 mL/hour. What is most important for the nurse to
assess?
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 Food intake
 Intravenous site
 Intake and output

 Pulse and respirations

A patient is receiving a potassium-sparing diuretic. For which

non-therapeutic effect should the nurse assess the patient?
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 Muscle weakness
 Hypoactive reflexes

 Respiratory depression
 Dry sticky mucous membranes

Correct answer
Muscle weakness

Loop diuretics are used in pulmonary oedema due to left

ventricular failure (BNF 2015). How long should furosemide be
administered intravenously?
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  Intravenous administration rate should not exceed 1
mg/minute
 Intravenous administration rate should not exceed 2
mg/minute

 Intravenous administration rate should not exceed 3

mg/minute
 Intravenous administration rate should not exceed 4
mg/minute

Correct answer
Intravenous administration rate should not exceed 4 mg/minute

In which of the following situations might nitrous oxide

(Entonox) be considered?
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 A wound dressing change for short term pain relief or the
removal of a chest drain for reduction of anxiety

 Turning a patient who has bowel obstruction because there

is an expectation that they may have pain from pathological
fractures

 For pain relief during the insertion of a chest drain for the
treatment of a pneumothorax

 For pain relief during a wound dressing for a patient who

has had radical head and neck cancer that involved the jaw
A patient with burns is given anesthesia using 50% oxygen and
50% nitrous oxide to reduce pain during dressing. how long this
gas is to be inhaled to be more effective?
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 30 sec
 60 sec

 1-2 min
 3-5 min

Correct answer
1-2 min

Select which is not a proper way of administering eye drops?

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 Ask the patient to sit back with neck slightly hyoerextended
or lie down

 Ask the patient to close their eyes and keep them closed for
1-2mins

 If administering both drops and ointment, administer

ointment first

 Administer the prescribed number of drops, holding the eye

dropper 1-2cm above the eye If the patient blinks or closes
their eye, repeat the procedure
What is the best position in applying eye medications?
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 Sitting position with head tilt to the right
 Sitting position with head tilt backwards
 Prone position with head tilt to the left

Correct answer
Sitting position with head tilt backwards

Jim is to receive his eyedrops after his cataract operation. What

is the best position for Jim to assume when instilling the
eyedrops?
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 Sitting position, head tilted backwards

 Supine position for comfort

 Standing position to facilitate drainage
 Recovery position

How should eye drops be administered?

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 Pulling on the lower eyelid and administering the eye drops
 Pulling on the upper eyelid and administering the eye drops
 Tip the patients head back and administer the eye drops
into the cornea
 Tip the patients head to the side and administer the eye
drops into the nasolacrimal system
Correct answer
Pulling on the lower eyelid and administering the eye drops

What fluid should ideally be used when irrigating eyes?

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 Sterile 0.9% sodium chloride
 Sterile water
 Chloramphenicol drops

 Tap water

Correct answer
Sterile 0.9% sodium chloride

What is the most important health teaching that the nurse should
give to a patient taking glycerine tri-nitrate (GTN)?
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 Keep the tablets in a glass airtight container with a rubber-
lined cap and away from sunlight

 Keep the tablets in a glass airtight container with a foil-

lined cap, protected from sunlight and carry them in your
pockets in case of emergency

 Keep the tablets in a glass airtight container, protected from

sunlight, and should be used for not more than 8 weeks of
first opening of the bottle as the tablets can get old

 Keep the tablets in a glass airtight container, stored away

from sunlight and should be used for not more than 8
 weeks of first opening of the bottle as the tablets can
become too concentrated for use

Correct answer
Keep the tablets in a glass airtight container, protected from
sunlight, and should be used for not more than 8 weeks of first
opening of the bottle as the tablets can get old

What angle to inject via subcutaneous route?

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90
40
45

15

What is not a good route for IM injection?

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Upper arm
Thigh
Stomach

Buttocks

Which is the most dangerous site for intramuscular injection?

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 Ventrogluteal
 Deltoid

 Rectus femoris
  Dorsogluteal

Correct answer
Dorsogluteal

Which of the following is the most dangerous site for IM

injection?
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 Deltoid

 Thigh
 Abdominal area
 Buttocks

Correct answer
Buttocks

What is the best site of buttock injections?

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 Ventrogluteal site
 Dorsogluteal site

 Rectus Femoris
 Greater trochanter area

Correct answer
Ventrogluteal site
The degree of injection when giving subcutaneous insulin
injection on a site where you can grasp 1 inch of tissue?
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 45 degrees
 40 degrees
 25 degrees

 90 degrees

Correct answer
90 degrees

When administering injection in the buttocks, it should be given:

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 Right upper quadrant
 Left upper quadrant
 Right lower quadrant

 Left lower quadrant

Correct answer
Right upper quadrant

Which is the best site for giving IM injection on buttocks

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 Upper outer quadrant

 Upper inner quadrant

 Lower outer quadrant
  Lower inner quadrant

Levothyroxine causes sleep pattern changes, which should be

advised to the patient?
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 Levothyroxine is best taken one hour before breakfast

 Levothyroxine is best taken in the morning during meals

 Levothyroxine is best taken in the evening before bed to

promote sleep

 Levothyroxine is best taken in the evening before dinner

Correct answer
Levothyroxine is best taken one hour before breakfast

You are the night nurse in a nursing home. Maxine, 81 years

old, has been prescribed with Lorazepam PRN. You have
assessed her to be wandering and talking to staff. When do you
administer the Lorazepam?
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 Immediately due to wandering
 As soon as possible so she can go to bed

 When you see signs of confusion

 When you see signs of agitation

Correct answer
When you see signs of agitation
A patient is prescribed Metformin 1000 mg twice a day for his
diabetes. While taking with the patient he states “I never eat
breakfast so I take ½ tablet at lunch and a whole tablet at supper
because I don’t want my blood sugar to drop.” As his primary
care nurse you:
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 Tell him he has made a good decision and to continue
 Tell him to take a whole tablet with lunch and with supper
 Tell him to skip the morning dose and just take the dose at
supper
 Tell him to take one tablet in the morning and one tablet in
the evening as ordered

Hypoglycaemia in patients with diabetes is more likely to occur

when the patients take the following except:
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 Insulin
 Sulphonylureas

 Prandial glucose regulators

 Metformin

Correct answer
Metformin
Alone, metformin does not cause hypoglycemia (low blood
sugar). However, in rare cases, you may develop hypoglycemia
if you combine metformin with:
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 A poor diet
 Strenuous exercise
 Excessive alcohol intake

 Other diabetes medications

Correct answer
Other diabetes medications

Describe the breathing pattern when a patient is suffering from

Opioid toxicity:
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 Slow and shallow
 Fast and shallow

 Slow and deep

 Fast and deep

Correct answer
Slow and shallow

A patient was on morphine at hospital. On discharge doctor

prescribes fentanyl patches. At home patient should be observed
for which sign of opiate toxicity?
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  Shallow, slow respiration, drowsiness, difficulty to walk,
speak and think

 Rapid, shallow respiration, drowsiness, difficulty to walk,

speak and think
 Rapid wheezy respiration, drowsiness, difficulty to walk,
speak and think

A patient is on Fentanyl skin patch common side effect of the

fentanyl overdose is
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 Fast and deep breathing, dizziness, sleepiness
 Slow and shallow breathing, dizziness, sleepiness
 Noisy and shallow breathing, dizziness, sleepiness

 Wheeze and shallow breathing, dizziness, sleepiness

Correct answer
Slow and shallow breathing, dizziness, sleepiness

All but one are signs of opioid toxicity:

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 CNS depression (coma)
 Respiratory depression (cyanosis)

 Pupillary miosis
 Tachycardia

Correct answer
Tachycardia
What are the key nursing observations needed for a patient
receiving opioids frequently?
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 Respiratory rate, bowel movement record and pain
assessment and score
 Checking the patent is not addicted by looking at their
blood pressure
 Lung function tests, oxygen saturations and addiction levels
 Daily completion of a Bristol stool chart, urinalysis, and a
record of the frequency with which the patient reports
breakthrough pain

Correct answer
Respiratory rate, bowel movement record and pain assessment
and score

Which of the following drugs will require two nurses to check

during preparation and administration?
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 Oral antibiotics
 Glycerine suppositories

 Morphine tablet
 Oxygen

Correct answer
Morphine tablet

Which is not a sign or symptom of speed shock?

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 Headache
 A tight feeling in the chest
 Irregular pulse

 Cyanosis

Correct answer
Cyanosis

Which of the following are not signs of a speed shock?

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 Flushed face
 Headache and dizziness

 Tachycardia and fall in blood pressure

 Peripheral oedema

Correct answer
Peripheral oedema

While giving an IV infusion your patient develops speed shock.

What is not a sign and symptom of this?
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 Circulatory collapse
 Peripheral oedema

 Facial flushing
 Headache
Oral corticosteriods side effect
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 Mood variation
 Edema

What medications would most likely increase the risk for fall?
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 Loop diuretic
 Hypnotics

 Betablockers
 NSAIDs

Maisie is 86 years old, and has been in the nursing home for 5
years now. She has been complaining of burning sensation in
her chest and sour taste at the back of her throat. What would
she most likely to be prescribed with?
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 Ranitidine
 Zantac
 Paracetamol
 Levothyroxine

a and b
b and d

Correct answer
a and b
Mrs Z has been very chesty the last few days. She has been
having difficulty with breathing. You have referred her to the
GP, and requested for a home visit. What would probably be
prescribed by the GP?
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 Stalevo 200
 Digoxin 40 mg
 Trimethoprim 100 mg
 Simvastatin 100 mg

Correct answer
Trimethoprim 100 mg

Mr Jones has been having Type 6 and 7 stools today. As you are
doing his medications, which of the following would you not
omit?
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 Docusate Sodium 2 Capsules
 Lactulose 5 mL

 Senna 10 mL
 Simvastatin 100 mg

Correct answer
Simvastatin 100 mg

Pharmacokinetics can be described as:

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  The study of the effects of drugs on the function of living
systems

 The absorption, distribution, metabolism and excretion of

drugs within the body: what the body does to drug

 The studyof mechanism of the action of drugs and other

biochemical physiological effects: ‘what the drug does to
the body’

 All of the above

The Medicine and Healthcare Products Regulatory Agency

(MHRA) is responsible for what?
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 Licensing medicinal products

 Regulating the manufacture, distribution and importation of

medicines

 Regulating which medicine require a prescription and

which can be available without a prescription and under
what circumstances

 All of the above

Correct answer
All of the above
Medication errors account for around a quarter of the incidents
that threaten patient safety. In a study published in 2000 it was
found that 10% of all patients admitted to hospital suffer an
adverse event (incident. How much of these incidents were
preventable?
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 20%

 30%
 50%
 60%

Correct answer
50%