1.Parenteral anticoagulants work by disrupting: A) Conversion of prothombin to trombin B) Formation of thromboplastin C) Vitamin [K-] dependent clotting factors D) Conversion of prothrombinto fibrin ANSWER: A 2.Which of the following cardiac arrhythmias needs to be treated with anticoagulants? A) ARight bundle branch block B) second degree AV block C) Wandering atrial pacemaker D) atrial fibrillation ANSWER: D 3.SC heparin should be administered in the: A) Flank B) Abdominal fat C) Leg D) Gluteal area ANSWER: B 4.The half life of heparin is: A) 10 minutes B) 1 to 1.5 hours C) 8 to 12 hours D) 1 to 2 days ANSWER: B 5.Which of the following is an appropriate use of heparin? A) To dissolve thrombus formation in the legs B) To prevent extension of pulmonary emboli C) To remove fat emboli during long bone fractures D) Long term prevention of clots in prosthetic heart valve clients ANSWER: B 6.Heparin therapy is evaluated as effective if the coagulation profiles are: A) Within the baseline B) Lower than the baseline C) 1.5 times the baseline D) Over 2.5 times the baseline ANSWER: C 7.Which of the following is an appropriate diluent for a heparin drip? A) Dextrose 5percent water B) Dextrose 5percen and 0.9percent normal saline C) 0.9percent normal saline D) Ringer’s lactate ANSWER: C 8. Which drug is used to stop bleeding associated with heparin overdose? A) urokinase [Abbokinase] B) aminocaproic acid [Amicar] C) Vitamin K [AquaMEPHYTON] D) protamine sulfate [Protamine] ANSWER: D 9. During warfarin [Coumadin] administration, the the initial extension of PT occurs within ____ hours after therapy begins. A) 1 to 2 B) 4 to 6 C) 8 to 12 D) 12 to 24 ANSWER: D 10. Streptokinase (Streptase) lyses clots by: A) Increasing plasmin levels B) Inactivating plasminogen C) Decreasing plasmin levels D) Increasing erythrocyte aggregation ANSWER: A 11.Which category of drugs prevents treats constipation by the osmotic drawing of water from extravascular space to intestinal lumen.? A) Stimulants B) Bulk- forming agents C) Hyperosmotic agents D) Lubricants ANSWER: C 12.Which of the following intestinal stimulants may be habit forming? A) senna B) mineral oil C) lactulose D) psyllium ANSWER: A 13.Which of the following is bulk-forming agents? A) Glycerin B) Lactulose C) FiberCon D) Milk of Magnesia ANSWER: C 14 When rapid cleansing of the bowel is needed, which category is best used? A) Bacid B) Bulk-forming agents C) Saline laxatives with magnesium D) Intestinal flora modifiers ANSWER: C 15. Which of the following drugs contain salicylate? A) senna B) castor oil C) Pepto-Bismol D) Kaopectate ANSWER: C 16.Which of the following categories is used for diarrhea and constipation? A) Bulk-forming agents B) Intestinal flora modifiers C) Cascara B) Milk of Magnesia ANSWER: A 17.Which of the following may be used for a bowel preparation and is not recommended for treatment of constipation? A) Corrrectol B) Fiberall C) Mineral oil D) Castor oil ANSWER: D 18.Some benzodiazepines are contraindicated in whuch of the following conditions? A) Glaucoma B) Depression C) Seizures D) Musculoskeletal problems ANSWER: A 19.When administering lorazepam, it is essential for the nurse to A) Mpnitpr for symptoms of withdrawal B) Have emergency equipment available C) Check compatibility before to mixing in a syringe with other medications D) Assess for suicidal ideation before administering drug ANSWER: B 20.For which of the following medical conditions would the nurse anticipate that an emergency anxiety drug would not be indicated? A) Increased sedation B) Stress related anorexia C) GI distress D) Constipation and nausea ANSWER: C 21.When adsministering antianxiety medications to an elderly client, which of the following actions by the nurse is essential? A) Monitor vita signs B) Suggest reduce doses C) Taper dose before stopping D) Implement a full presentation protocol ANSWER: A 22.When monitoring a client who is taking benzodiazepines, the nurse should be alert for which of the following side effects? A) Blurred vision B) Seizures,tremors and diaphoresis C) Ataxia,sedation and dizziness D) Libido,changes,edema and dystonia ANSWER: C 23.Which of the following antianxiety agents would the nurse anticipate would be used in the treatment of acute alcohol withdrawal syndrome? A) Diazepam B) Alprazolam C) Lorazepam D) Chlordiazepoxide ANSWER: D 24.Which of the following drug is considered to be a sedative hypnotic? A) Alprazolam B) Phentobarbital C) Hydroxyzine D) Propranolol ANSWER: B 25.All narcotic,regardless of their origin,reduce pain by A) Stimulating opiate receptors B) Promoting the release of excitatory transmitters C) releasing large quantities of endorphin D) Blocking the mu receptors ANSWER: A 26.In addition to analgesics,narcotic effects include A) Euphoria,diarrhea, increased respiration B) Euphoria,miosis,nausea and vomiting C) Respiratory depression, increased blood pressure D) Dependence,seizures,muscle spasms ANSWER: B 27. The half life of morphine is A) 4-6 hours B) 2-4 hours C) 6-8 hours D) 30 minutes to 1 hour ANSWER: b 28.Monitoring parameters for narcotics include A) Pain relief,range of motion,blood pressure B) Heart rate ,blood pressure,muscle tone C) Pain relief,blood pressure,respiratory and menta status D) Dizziness,respiratory rate and range of motion ANSWER: C 29.Wich of the following actions of morphine does not develop tolerance? A) Respiratory depression B) Pinpoint pupils C) Euphoria D) Diarrhea ANSWER: B 30.Which of the following abot morphin is correct? A) Morphine is contraindicated in pain relief caused by head injuy B) Morphine’s withdrawal symptoms can nmpt be relieved by methadone C) Morphine is most effective by parenteral administration D) Morphine quickly enters all body tissues ANSWER: D 31.Which of the following is the drug of choice for acute myocardial infarction? A) Morphine B) Meperidine hydrochloride C) Codeine D) Oxycodeine ANSWER: A 32.Which of the following is true of Levorphanol? A) It is equally potent either P.O. orSC B) It is only soluble in thePO form C) It is not present in the po form D) It is onlyavailable ib the parenteral form ANSWER: A 33. Which narcotic is used for treatment of mild to moderate pain because it is not potent enough to treat severe pain? A) Morphine sulfate B) Hydromorphone C) Meperidine D) Prophoxyphene ANSWER: D 34.When administering codeine, the nurse should be aware that A) Codeine produces more sedatioon than other opiates B) Codeine is very constipating Codeine is an atitussive in high doses ANSWER: C 35.During surgery,there is an increased for arrhythmias when catecholamines are given with A) Halothane B) Digoxiin C) Bupicaine D) LIdocaine ANSWER: A 36.General anesthetics potentiate the effect of which of the following group of drugs? A) Depolarizing agents B) Skeletal muscle relaxants C) Volatile liquids D) Inhalation anesthetics ANSWER: B 37.The most dangerous metabolic side effect of general anesthesia that can occur during surgery is: A) Hyperglycemia B) Hyperthermia C) Hypoglycemia D) Hypothermia ANSWER: b 38.A client who will be undergoing surgery with general anesthesia should be given which of the following instructions perioperatively? A) Eat a big breakfast B) Expect to be incontinent of urine postoperatively C) double your medications doses D) Expect nausea,vomiting,shivering,and pain postoperatively ANSWER: D 39.Local and regional anesthetics act by A) inhibiting depolarization B) Increasing depolarization C) Producing a semiconscious state D) Inhibiting motor movement ANSWER: A 66.Which of the following laboratory tests should be monitored when when a client is receiving Azathioprine? A) CBC B) BUN C) Electrolytes D) Sedimentation rate ANSWER: A 67.When administering muromonab,nursing management will include A) IV push rapidly by a certified RN B) Keeping the client NPO during transfusion C) Neutropenic precations D) Premedication with steroids,Tylenol and Benadry ANSWER: D 68.When administering muromonab CD3, the nurse should identify that the client is at risk for which of the following nursing diagnosis? A) Altered protection related to anaphylaxis B) Altered cardiac output related to arrhythmias C) Impaired gas exchange related to bronchospasm D) Risk for altered body temperature related to fever ANSWER: A 69. When administering mychophenolate mofetil, the nurse should be sure to A) Keep emergency equipment available B) Monitor for Leukopenia C) Administer the drug with corticosteroid and cyclosporine D) Administer the drug during the immediate postoperative period to prevent hyperacute rejection ANSWER: C 70.In a transplant client, the action odf cyclosporine is to A) Defend the body against foreign antigens B) Inhibit the T-cells in response to antigens C) Inhibit B cells immunoglobulin D) Intensify the production of T lymphocytes ANSWER: B 71.Client teaching for mycophenolate mofetil must include instructions to A) Take with food B) Avoid use of corticosteroid C) Monitor for adverse effects D) Practice effective contraception ANSWER: D 72.Which of the following client comments demonstrates that teaching has been successful regarding cyclosporine therapy? A) I need to mix the medicine in styrofoam B) I should take the medication on an empty stomach C) I need to be consistent about when I take it and also monitor how much fat is in my food D) If I vomit I should take another dose” ANSWER: C 73.Antibacterials cause diarrhea because A) The drugs render food indigestible B) Gastric flora is disturbed C) Fluid is added into the intestine D) Normal intestinal bacteria are destroyed ANSWER: D 74.When a client with chronic obstructive pulmonary disease is taking theophylline also receives ciprofloxacin, which of the following interactions should occur? A) Ciprotoxicity B) Ineffectiveness of ciprofloxacin C) Theophylline toxicity D) Ineffective theophylline ANSWER: C 75.Which of the following is a caution when administering a cephalosporin? A) Cephalosporin allergy B) Cephalosporin sensitivity C) Macrolide allergy D) Penicillin allergy ANSWER: D 76.When a nurse must give aminoglycosides immediately after general surgery, the nurse is aware that the client may develop A) Neuromuscular blockade B) Cardiac arrest C) Hyperglycemia D) Arrhythmias ANSWER: A 77.Aminoglycosides work optimally under which of the following conditions? A) Low oxygen tension B) Acid environment C) Anaerobic environment D) Alkaline environment ANSWER: D 78.The client at highest risk for nepnrotoxicity with aminoglycoside use is a: A) Male with a creatinine of 1.7 and BUN of of 52 on a 10day regimen B) Female with [BUN of 12 qnd creatinine of 0.8] C) Female with past history cystitis on 5 days of therapy D) Male with istory of kidney stones on a 10 day therapy ANSWER: A 79.The aminoglycoside used in the management of tuberculosis is : A) tobramycin B) Streptomycin C) Isoniazid D) rifampicin ANSWER: B 80.Which aminoglycoside is recommended in the management of methicillin resistant staphylococcus A) Kefzol B) Amikacin C) Kanamycin D) Neomycin ANSWER: B 81.Aminoglycosides should not be administered concomitanty with: A) Diuretics B) Penicillins C) Cardiac glycosides D) Rifampicin ANSWER: A 82.When giving aminoglycosides and vancomycin, the nurse must monitor: A) Hearing B) Urine volume C) Serum creatinine D) ECG ANSWER: C 83.The primary mechanism of bacterial action of penicillin involves inhibition of: A) Cell wall synthesis B) Protein synthesis C) DNA replication D) Bacterial cell synthesis of folic acid ANSWER: A 84.Which of the following class drugs should be avoided in clients with a history of penicillin allergy? A) Aminoglycosides B) Tetracyclines C) Sulfonamides D) Cephalosporin ANSWER: D 85.Whe assessing clients for evidence of penicillin allergy, hich of the following symptoms may not be considered to be a true hypersensitivity reaction? A) Wheezing B) Nausea C) Urticaria D) Angioneurotic edema ANSWER: B 86.Which of the following penicillin is used most exclusively for infections caused by penicillinase producing staphylococcus aureus? A) Amoxicillin B) Methicillin C) Carbenicillin D) penicillin V ANSWER: B 87.Which of the following penicillins is effective against many gram-negative organisms including pseudomonas? A) Ampicillin B) Penicillin G C) ethicillin D) Carbenicillin ANSWER: D 88.Which of the fllowing statements is true of drug interactions with penicillins? A) The penicillins decrease the effect of aminoglycosides B) The penicillins increase the effect of oral contraceptives C) Probenicid increase the excretion of penicillin by increasing the renal elimination D) Antacids may increase the absorption of the PO penicikkin ANSWER: A 89.All of the following are evident of supper infection except: A) White oral plaques B) Creamy vaginal discharge C) Skin rash D) Darkened tongue ANSWER: C 90.Which of the following statements is true when educating clinets about penicillin therapy? A) The client must take medications at evenly spaced intervals B) The client may save leftover medications for future illness C) If signs of an allergic reaction, continue the medication and notify physician D) Clients taking oral contraceptives must be cautioned to use an alternate form form of birth control while being treated with penicillin ANSWER: D 91.The penicillins are effective against all of the following organisms except A) Neisseria gonorrhea B) Streptococcus pneumonia C) Viruses D) Neisseria meningitides ANSWER: C 92. The Penicillins may cause which urine test interference? A) False-positive clinitest B) Increased WBC lymphocytes C) Decreased serum alkaline phosphatase D) Decreased AST[SGOT],ALT [SGPT] ANSWER: A 93.The most common adverse effect of antituberculars is : A) Red-0orange discoloration of the urine B) Hypersensitivity C) Hepatotoxicity D) CHF ANSWER: C 94.In the treatment of tuberculosis, the therapeutic rationale for combination drug therapy is to: A) Decrease cost and improve complications B) Reduce the incidence of cumulative effects C) Increase blood dyscracias D) Decrease the emergence of drug resistant strains ANSWER: D 95.Changes in visual acuity and color perception are associated with treatment by which of the following agents? A) INH[Isoniazid] B) PZA [Pyrazinamide] C) Eth[Ethambutol] D) SM [Streptomycin] ANSWER: C 96.Which of the following groups of antitubercular agents includes first-line agents? A) INH,PZA,RIF B) SM,PAS,INH C) EMB, PAS, INH D) INH, Cycloserine,RIF ANSWER: A 97.For clients with active TB, direct client teaching toward all of the following except: A) Continuance of therapy despite resolution of symtoms B) Avoidance of alcohol C) Length of therapy D) Consumption of high protein diet ANSWER: D 98.Peripheral neuropathy associated within therapy may be prevented or treated with: A) Streptomycin 1 g IM daily B) Cyacobalamin 5 ug IM daily C) Ascorbic acid 500 mg PO daily D) Pyridoxine 50 mg PO daily ANSWER: D 99.Antitubercular therapy may be determined ineffective when: A) Sputums are negative B) Symptoms resolve C) Hepatitis results D) Drug resistant bacteria emerge ANSWER: D 100.A red-orange discoloration of body fluids is associated with which of the following drugs? A) Isoniazid B) Rifampicin C) Ethambutol D) Pyrazinamide ANSWER: B 101.Which first line antitubercular agent is associated with potentiating effects phenytoinin a drug Kinteraction? A) INH B) PAS C) EMB D) Streptomycin ANSWER: A 102.Fluconazole[Diflucan] can be administered to a client with A) Pneumococcal meningitis B) Oral thrush C) Cryotoccocal meningitis D) Pneumococcal pneumonia ANSWER: C 103.When administering phenytoin[Dilantin0 and Fluconazole] concurrently,which of the following must be monitored? A) ECG B) Phenytoin levels C) Prothrombin time D) Glucose ANSWER: B 104.When administering prothrombin B,which of the following must be used? A) A bron bag to protect the infusion from the light. B) A diluents of 5% dextrose with no preservatives C) A diluents of normal saline with alcohol D) A micrn filter with above 1 U ANSWER: B 105.A client has a throat infection that has been suspected as strep.The culture comes back as candida. Which of the following drugs is appropriate. A) Ketoconazole B) penicllin C) Nystatin D) Amphotericin B ANSWER: A 106.Client teaching for an epileptic taking antifungal medications should include: A) Increasing dosage of phenytoin B) Observing for side effects C) Checking vital signs D) Monitoring of serum phenytoin levels ANSWER: D 107.Which of the following might occur when administering large parenteral doses of amphotericin B with vancomycin A) Decreased cardiac output B) Ineffective airway clearance C) Ineffective breathing pattern D) Fluid volume excess ANSWER: D 108.Serious systemic fungal infections are treated with A) Amphotericin B B) Miconazole C) Ketoconazole D) griseofulvin ANSWER: A 109.Which drug may cause hypokalemia if given with steroids? A) Clotrimazole B) Miconazole C) Amphotericin b D) Fluconazole ANSWER: C 110.Which of the following must be always present before beginning antifungal therapy? A) Coagulation profile B) Confirmed diagnosis C) Biopsy of infected site D) Urinalysis ANSWER: B 111.Currently approved nucleoside compounds available to interfere with HIV replication include A) AZT,ddl,ddC,protease inhibitors B) AZT,ddl.ddC,stavudinesaquinqvir D) AZT,ddl,ddC,3TC,5-FU ANSWER: B 112.Which choice describes the action of nucleoside analogs? A) Exert anti-HIV activity at the reverse transcriptase level and cause premature termination of viral DNA chain synthesis B) Completely stop the replication of HIV virus C) Allow for a patient to become noncontagious after taking at least 3 days D) Are all equally effective and free of sideffects ANSWER: A 113. Which of the following is true about protease inhibitors? They A) Work better when used alone B) Are the same as nuxleoside analogs C) Affect replication of HIV at different stage than nucleoside analogs D) Have a high level of oxicity ANSWER: C 114.The human cells specifically affected by HIV are A) Gonadocytes B) CD4_T Lymphocytes C) Islet cells D) Red blood cells ANSWER: B 115.The immunodeficiency caused by HIV is a direct result of A) Loss of the critical CD4 B) Prolonged exposure to infectious diseases C) Chemotherapeutic agents D) Repeated exposure to HIV over time ANSWER: A 116.Monotherapy for the treatment of HIV diseaseAp A) Is the only FDA approved treatment for HIV B) Is able to effectively destroy all viral particles of HIV C) Interferes with the replication of HIV virus without causing any side effects D) Appears to cause rapid resistance ANSWER: D 117.Combination therapy for HIV diseaseAp A) Completely shuts off replication of HIV B) Is the only FDA approved treatment for HIV disease C) Appears to cause a sustained benefit achieved by drug no.1 preventing the emergence of resistance to drug [no.2] despite resistance to drug [n0.1] D) Is only effective if used alternating with pwriods of monotherapy ANSWER: C 118.Initiation of AZT [antiretroviral therapy] is often considered when t-cells are A) less than 50 B) greater than 500 C) less than 500 D) Between 500 and 1000 ANSWER: C 119.Common side effects of AZT include A) Itching ,dizziness and insomnia B) Vomiting and diarrhea C) Renal failure D) Anemia,headache and malaise ANSWER: D 120.When taking AZT , a client must be closely monitord for A) dementia B) Bone marrow suppression C) GI bleeding D) Phlebitis Opthalmic and otic agents ANSWER: B 121.When administering topical ophthalmic preparations,you must assess A) Visual acuity B) Intraocular movements C) Color of the sclera D) blinking reflex ANSWER: A 122.Which of the following drugs must be given to relieve pain from corneal abrasion A) Proparacaine B) Timolol maleate C) Betaxolol hydrochloride D) Levobunolol ANSWER: A 123.Drugs that lower intraocular pressure work by increasing A) the flow of aqueous humor through the anterior chamber B) fluid volume in the eye’s anterior chamber C) Pressure in the ete chambers D) Diameter in the eye chambers ANSWER: A 124.Whwn administering otic preparations, the nurse should observe the tympanic membrane for A) erythema B) Perforation C) Fluid D) All of the above ANSWER: D 125.A client has been diagnosed with scabies. His physician has orderd chrotamiton.After one week of treatment, the client reports that the pruritus has not stopped.You would advice the client to A) Dtop applying the medication B) Continue the treatment because pruritus may persist for 4 to 6 weeks C) Call the physician D) None of the above ANSWER: B 126.A client has psoriasis of the scalp.The physician has ordered Zetar shampoo. You would advise the clieny to A) Avoid sun exposure to the scalp B) Use the shampoo prn C) Report pruritus D) None of the above ANSWER: A 127.Topical antibiotics work by A) Inhibiting replication of the virus B) Blocking histamine 1 and 2 receptors C) Bibding to fungal cll membranes D) Inhibiting bacterial cell wall synthesis ANSWER: D 128.Pediculodicides are used to treat which of the following disorders? A) Scabies B) Fungal infections C) Viral infections D) Head lice ANSWER: D 129.A client is being treated to seborrheic dermatitis with a keratolastic agents. You woud advise him that all of the following side effects may occur except A) Photosensitivity B) Dermatitis C) Staining of the hair and skin D) Hair loss ANSWER: D 130.Topical antibiotic ointments are A) Absorbed systematically B) Used to treat systemic infections C) Are not used to prevent skin infections D) Absorbed poorly by intact or enuded skin ANSWER: D 131.Which of the following is a potential side effect of antivirl creams A) Vulvitis B) Headaches C) Dizziness D) Staining of the skin ANSWER: A 132.Antipruritic agents A) Often are combined with anti-inflammatory creams and ointments B) Aid in wound haling C) Increase in skin dryness D) Stain the skin ANSWER: A 133.Lindane a scabicide is contraindicated in what age group? A) Geriatric B) Pediaric C) Adult D) All of the above ANSWER: B 134.All of the following are considered dermatologic agents except A) Bacitracin B) Westcort C) A and D ointment D) Valproic acid ANSWER: D