1.Safety of drug is determined by the degree between: A) Therapeutic and toxic doses B) Potency and efficacy C) Subtherapeutic and toxic levels D) Side and adverse effects ANSWER: A 2.The name selected by the original manufacturer based on the chemical structure of the drug is the: A) Chemical name B) Generic C) Trade name D) Drug name ANSWER: B 3.When a drug binds to a receptor to produce a pharmacologic effect, the drug may be called a: A) Agonist B) Antagonist C) Blocker D) Accelerator ANSWER: A 4.The interaction of one drug increased by the presence of a second drug is known as: A) Synergism B) Additive effect C) Antagonism D) Potentiation ANSWER: D 5.The extent to which a drug is absorbed and transported to target tissue is known as: A) Steady-state accumulation B) Therapeutic drug levels C) Bioavailability D) Distribution ANSWER: C 6.When two drugs given together have an effect equal to the sum of their respective effects, the interaction is known as: A) Potentiated B) Antagonized C) Agonist D) Additive ANSWER: D 7.Distribution is affected by: A) Bioitransformation B) Excretion C) Protein binding D) Lipid binding ANSWER: C 8.Absorption, distribution, and excretion may be increased by which of the following diceases? A) Hyperthyroidism B) Renal insufficiency C) Liver disease D) Hypothyroidism ANSWER: A 9.An unexpected effect from a drug is known as a: A) Side effect B) Adverse effect C) Toxic reaction D) Allergic reaction ANSWER: B 10.When a drug is 50percent protein bound, it means that: A) 50percent of the drug destroys protein B) 50percent of the dose is at work C) 50percent of the drug is excreted in the kidneys D) Protein must be restricted in the diet ANSWER: B 11.When performing an assessment to determined which medications can be used, which of the following elements is most important? A) Physical examination B) Allergies C) Presence of illness D) weight ANSWER: B 12.Which of the following will determine nursing interventions for a client on medications? A) Assessment B) Diagnosis C) Implementations D) Evaluation ANSWER: B 13.The client's ability to take oral medications will be hindered by: A) Dental caries B) Dysphagia C) Age D) Lifestyle ANSWER: B 14.When deciding on what time of day to give medications, the nurse pays closest attention to the client's habits regarding: A) Sleeping B) Eating C) Elimination D) Activity ANSWER: B 15.Which of the following muscles is possible site for IM injections? A) Outer aspect of hip B) Shoulder C) Vastus lateralis D) Vastus gluteus ANSWER: D 16.The volume of SC medications must be no more than: A) 0.5mL B) 1.0mL C) 1.5mL D) 3.0mL ANSWER: B 17.When performing an assessment about medications, the drug history should include: A) Complete vital signs B) Client's goal of therapy C) Reason for medications D) Administration of OTC medications ANSWER: D 18.Which of the following is not one of the five rights? A) Right dose B) Right route C) Right drug D) Right room ANSWER: D 19.The Action of a medication is inotropic when it: A) Decreased afterload B) Increased heart rate C) Increased the force of contraction D) Is used to treat CHF ANSWER: C 20.Which is the MOST appropriate action for the nurse to take before administering digoxim? A) Monitor potassium level B) Assess blood pressure C) Evaluate urinary output D) Avoid giving with thiazide diuretiC) ANSWER: A 21.Which of the following clients is at greatest risk for digitalis toxicity? A) A 50-year-old client with CHF B) An 85-year-old client with CHF C) A 25-year-old client with congenital heart disease D) A 60-year-old client after myocardial infarction ANSWER: B 22.Amrinone ( Inocor ) is used for short-term therapy for CHF and acts by which of the following mechanisms? A) Increasing stroke volume and heart rate B) Slowing ventricular rate and increasing cardiac output C) Vasodilating and increasing peripheral vascular resistance D) Increasing cardiac output and enhancing renal perfusion ANSWER: A 23.Before giving milrinone ( Primacor ) by an IV infusion to a client with symptoms of CHF, which of the following nursing actions is necessary? A) Record sodium level. B) Administer loading dose over 15 minutes. C) Asses CV status D) Review medications regimen to identify if client is on IV furosemide ( Lasix ) ANSWER: D 24.Which of the following is a contraindication for digoxin administration? A) Blood pressure of 140/90 B) Heart rate above 80 C) Heart rate below 60 D) Respiratory above 20 ANSWER: C 25.Blurred vision of halos are signs of: A) Subtherapeutic digoxin levels B) Digoxin toxicity C) Nothing related to digoxin D) Corneal side effects of digoxin ANSWER: B 26.The therapeutic drug level for digoxin is: A) 0.1-2.0ng/mg B) 1.0-2.0 ng/mg C) 0.1-0.5 ng/mg D) 0.5-2.0 ng/mg ANSWER: D 27.Which of the following drugs is the first line used to treat ventricular ectopy? A) Quinidine ( Cardioquin ) B) Digoxin ( Lanoxin ) C) Procainamide ( Pronestyl ) D) lidocaine ( Xylocaine ) ANSWER: D 28.Class IA antiarrhythmic agents have little effect on: A) AV node B) SA node C) Purkinje fibers D) Bundle of His ANSWER: B 29.Which of the following drugs can cause severe hematologic disorders? A) Digoxin ( Lanoxin ) B) Quinidine ( Cardioquin ) C) Disopyramide ( Norpace ) D) Procainamide ( Pronestyl ) ANSWER: D 30.Which of the following ECG findings alerts the nurse that the clients needs an antiarrhythmic? A) Normal sinus Rhythm B) Sinus bradycardia C) Sinus arrhythmia D) Frequent ventricular ectopy ANSWER: D 31.When administering an antiarrhythmic agent, which of the following assessment parameters is the most important for the nurse to evaluate? A) ECG B) Pulse rate C) Respiratory D) Blood pressure ANSWER: A 32.Which of the following blood test will tell the nurse that an adequate amount of drug is present in the blood to prevent arrhythmias? A) Serum chemistries B) Complete blood counts C) Drug levels D) None of the above ANSWER: C 33.Which of the following drug should be used only in situations in which the client can be very closely monitored such as critical care unit? A) Bretylium ( Bretylol ) B) Digoxin ( Lanoxin ) C) Quinidine ( Cardioquin ) D) Inderal ( Propanolol ) ANSWER: A 34.The most toxic antiarrhythmic agents is: A) Digoxin ( Lanoxin ) B) Lidocaine ( Xylocaine ) C) Amiodarone ( Cordorone ) D) Quinidine ( Cardioquin ) ANSWER: C 35.Which of the following is the priority for the nurse to assess before administering digoxin A,Auscultate the apical pulse for one full minute B) Palpate the radial pulse for 60 seconds C) Monitor the renal function tests D) Assess the serum potassium ANSWER: A 36. Upon finding a client in cardiac arrest nurse should administer which of the following drug first? A) Atropine B) Epinephrine C) Lidocaine D) Atenolol ANSWER: B 37.After medication teaching on atenolol, which of the following statements by a client with diabetes mellitus demonstrates the understanding of the atenolol? It may A) Cause hyperglycemia B) Mask an early indication of hypoglycemia C) Increase the action of insulin D) Diminish the action of insulin ANSWER: B 38.The nurse is caring for for a client with hypertension. Which of the following drugs should the nurse administer? A) Mexiletene B) Triamterene and hydrochlorthiazide C) Digoxin D) Warfarin ANSWER: B 39.Based on an understanding of nitroglycerin, the nurse administers it for which of the following reasons for a client with angina? A) Increase afterload B) Increase preload C) Constrict the arteries D) Dilate the veins ANSWER: D 40. The nurse is caring for a client with atrial fibrillation who is being treated with a variety of drugs. The nurse administers which of the following drugs in combination with quinidine that may result in increased level of the drug? A) Furosemide B) Digoxin C) Propranolol D) Triamteren and hydrochlorothiazide ANSWER: B 41.The nurse should administer amiodarone to teat which of the following arrhythmias? A) Sinus bradycadia B) Bubdle branch block C) Sinus tachycardia D) Junctional rhythym ANSWER: C 42. Which of the following is the priority nursng intervention for a client who is receiving adenosine for supraventricular tachycardia? A) Document the presence of peripheral pulses B) Monitor pulse oximetry C) Assure a patient IV in the antecubital vein D) Prepare for emergency defibrillation ANSWER: C 43.A client has been taking Viagra and is now experiencing anginA) The physician has prescribed nitroglycerin p.r.n. for the anginA) Which of the following should the nurse include in the discharge instructions? A) Viagra should not be used within 24 hours of taking nitroglycerin B) Nitroglycerin and Viagra should be taken at the same time C) Viagra is not effective when used in combination with nitroglycerin D) The effect of nitroglycerin is impaird by concurrent use with Viagra ANSWER: A 44.Which of the following adverse reactions should the nurse assess in in a 70 year old adult who is receiving a continuous infusion of lidocaine? A) Hypertension B) Osteoarthritis C) Confusion D) Decreased visual acuity ANSWER: C 45.Based on an understanding of beta blockers used for unstable angina, the nurse administers a beta blocker because of which of the following actions? A) To Increase myocardial contractility B) To decrease heart rate C) To promote cardiovascular fluid shift D) Coronary artery vasodilation ANSWER: B 46.Which of the following interventions should the nurse include in the plan of care for a client taking ACE inhibitor? A) Monitor the blood pressureclosely for two hours after the first dose B) Begin with a high dose and gradually decrease the dose C) Administer potassium supplements to the client D) Begin with daily dosing followed by dosing every other day ANSWER: A 47. The nurse administraters what drug to the client Who is experiencing symptomatic bradycardia? A) Digoxin B) Furosemide C) Beta blocker D) Atropine Sulfate ANSWER: D 48. A client's family member asks the nurse how to know if the client is improving while receiving furosemide for congestive heart failure.The nurse response should be based on the understanding that improvement in the client's condition is characterized by A) Diminishing oxygen needs B) Increased thirst C) Weight gain D) Intake greater than output ANSWER: A 49. A client with congestive heart disease returns in the clinic with muscle aching. The physician orders a potassium level,which shows hypokalemiA) The drug regimen includes furosemide, a potassium supplement, the nurse administers which of the following prescribed drugs\/ A) Bumetanide B) Torsemide C) Spironolactone D) Clonidine ANSWER: C 50.While providing care to a client on cholestyramine, the nurse should monitor the client for A) Urinary retention B) Bradycardia C) Constipation D) Confusion ANSWER: C 51.The nurse is caring for a client on a heparin infusion when the client expresses conern over a progressively painful headache. Which of the following is the priority nusing action? A) Stop the heparin infusion B) Admiister protamine C) Notify the physician D) Administer morphine ANSWER: C 52.A client has been taking warfarin sodium for the prevention of deep vein thrombosis.When the home care nurse arrives for a weekly visit, the client reports having been using acetylsalicylic acid daily for arthritic pain since hearing a commercial on television bolstering its benefits. Which of the following is the most appropriate response by the nurse,based on an understanding of the effect of combining Coumadin with aspirin A) As long as you use aspirin only once a day , there will be no problems B) Comadin and asprin used in combination increase the potential for bleeding C) Aspirin and Coumadin may be used with aspirin may be used safely together D) Coumadin may be used with aspirin without problem if Vitamin K is taken with each dose ANSWER: B 53. The nurse is instructing a client on clopedogrel bisulfate. Which of the following statements by the client indicates an understanding of the effect of this drug? A) I should ambulate slowly B) I may experience hypotension C) I should use caution taking other drugs that cause bleeding D) I should take a stool softener while on this drug ANSWER: C 54. The nurse should monitor a client wih an acute myocardial infarction who is receiving intravenous streptokinase for which of the following serious adverse reactions? A) Intracranial hemorrhage B) Intractable nausea C) extension of myocardial damage D) Pulmonary embolus ANSWER: A 55.The nurse is caring for a client taking atorvastatin(Lipitor). The client admits to consuming 6 to 12 hours daily. The nurse should monitor the client for what potentially serious reaction to Lipitor A) 20 minutes before a meal B) With meals C) At bedtime D) Early in the morning ANSWER: C 56.The nurse is caring for a client receiving gemfibrozil. The nurse understand this medication is given for what purpose A) To lower levels of plasma triglycerides B) To lower levels of HDL-cholesterol C) To lower levels of LDL-Cholesterol D) To lower levels of total cholesterol ANSWER: A 57. The nurse is caring for a client admitted with severe rectal bleeding who is receiving warfarin therapy. Which of the following interventions should have priority in the plan of care/ A) Acurate intake and output B) Discontinue the warfarin C) Assure a ptent 18 gauge IV D) Administer Vitamin K ANSWER: C 58.The registered nurse is prepring to delegate assignments for the day. Which of the following assignments would be appropriate to delegate to a licensed practical nurse? A) Contact a client's physician when the blood pressure is lower than 100 mmHg before pressure before administering a beta-adrenergic blocker B) Monitor the heparin level daily before administering heparin C) Question administration of streptokinase in a client admitted and suspected of intracranial; hemorrhage D) Take the blood pressure before administering a dose of verapamil ANSWER: D 59.The nurse is collecting a medication history.Which of the following questions would not elicit the most accurate informaion? A) Do you take any herbal supplements B) What tim of the day do you go to bed C) WWhat is the higest education you completed D) Do you have a vision or hearing problem ANSWER: B 60.Which of the following should the nurse include when administering drugs by a nasogastric tube ? A) Crush the drug before administering through a feeding tube B) Flush between drugs with 10 ml of water C) Administer one drug with 30 ml of water D) Maintain the client in an upright position for 15 minutes followwing drug administration ANSWER: C 61.The nurse is preparing the client assignments for the day.which of the following assignments would be appropriate for the registered nurse(RN)to assign to a licensed practical nurse(LPN)? A) Administer drug to a clientwho has an implantable intravenous infusion port B) Insert an angiocath into the medial antebrachial vin of the ciient with thrombocytopenia C) Instruct a client on the advantages of an autologous blood trnasfusion D) Discontinue a client's peripheral IV site ANSWER: D