NCSBN - National Council of State Boards of Nursing Pharmacological Therapies Questions and Answers

Question 1

A nurse is providing discharge teaching to a client newly prescribed warfarin. Which statement by the client indicates a need for further education?

Accepted Answer

"I will start taking ibuprofen for my occasional headaches."

Answer

Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen increase the risk of bleeding when taken concurrently with warfarin. The nurse must instruct the client to use acetaminophen for pain relief instead. The other statements indicate a correct understanding of bleeding precautions and the required laboratory monitoring (INR/PT).

Question 2

A nurse is reviewing the laboratory results for a client receiving intravenous furosemide for acute heart failure. Which laboratory value requires the most immediate intervention?

Accepted Answer

Serum potassium 2.8 mEq/L

Answer

Furosemide is a potent loop diuretic that causes the excretion of potassium. A serum potassium level of 2.8 mEq/L is critically low (hypokalemia) and places the client at high risk for life-threatening cardiac dysrhythmias. This finding must be reported to the provider immediately. The other lab values are either within normal limits or not as immediately critical.

Question 3

A nurse assesses a client receiving morphine via a patient-controlled analgesia (PCA) pump. The client's respiratory rate is 7 breaths/min and they are difficult to arouse. After stopping the PCA infusion, what is the nurse's next priority action?

Accepted Answer

Administer naloxone as prescribed by standing order.

Answer

The client is exhibiting signs of severe opioid-induced respiratory depression, which is a life-threatening emergency. After stopping the opioid infusion to prevent further administration, the priority action is to reverse the respiratory depression by administering the opioid antagonist, naloxone. While checking oxygen saturation and notifying the provider are important, they are not the immediate priority over administering the life-saving antidote.

Question 4

A nurse is preparing to administer an intravenous infusion of vancomycin. To prevent the occurrence of vancomycin flushing syndrome ("Red Man Syndrome"), which nursing action is most appropriate?

Accepted Answer

Infuse the medication over at least 60 minutes.

Answer

Vancomycin flushing syndrome is a rate-dependent infusion reaction caused by histamine release, not a true allergic reaction. The primary strategy to prevent it is to infuse the medication slowly, over a period of at least 60 to 90 minutes. Administering it as a rapid bolus would cause the reaction. Pre-medication with antihistamines, not antiemetics, may also be ordered.

Question 5

A client who was prescribed lisinopril two weeks ago reports developing a persistent, nonproductive cough. Which of the following is the nurse's best response?

Accepted Answer

"This is an expected and common side effect. You should notify your provider to discuss potential medication changes."

Answer

A persistent, dry, hacking cough is a well-known and common side effect of ACE inhibitors like lisinopril, related to the accumulation of bradykinin. It is not an allergic reaction or a sign of infection. The most appropriate response is to validate the client's experience, identify it as a known side effect, and direct them to consult their provider, who may prescribe an alternative antihypertensive like an ARB.

NCSBN - National Council of State Boards of Nursing Practice Test

NCSBN - National Council of State Boards of Nursing Practice Test

NCSBN - National Council of State Boards of Nursing Pharmacological Therapies Questions and Answers