NUR
213
Professional Issues in
Nursing
Sample Pharm Math Test for Hiring Agencies
Complete the
following calculations:
1. The physician orders 1000 ml of 0.9% saline over 16 hours. You decide to use microtubing. If the IV is hung at 0500, what time will the IV be discontinued?
2. What is the rate of flow in ml/hr of the previous IV?
3. What is the rate of flow in gtts/min for the above IV?
4. The physician orders Demerol 50 mg and Phenergan 25 mg IM q 4h post-op. You have available Demerol 100 mg/ml and Phenergan 15mg/ml. What will the total volume be?
5. The physician orders Gentamycin 50mg IVPB. It is sent from the pharmacy in 100ml NSS. The drop factor of the tubing is 15. The drug reference book indicates the medication should infuse over 45 minutes. What is the rate of flow in gtts/min?
6. You need to give Emet-e-con 35 mg. The vial is labeled “Emet-e-con 50mg/vial; add 2.2 ml of appropriate diluent to equal 2.5 ml. How many ml will you administer?
7. You need to administer Heparin 3000 units. The vial is labeled Heparin 10,000 units per ml. How many ml will you administer?
8. There is an initial order of Gantrisan 4g. You receive Gantrisan 500mg/tablet from the pharmacy. How many tablets will you give the patient?
9. You need to give codeine sulfate 60mg. You have available codeine ˝ g. How many tablets will you give?
For the following questions select the most
appropriate answer:
10. While completing the admission history on Mrs. H, she tells you she is allergic to Erythromycin. You ask her to describe her reaction. Which of the following responses would indicate a possible allergic response?
a. Diarrhea
b. Yeast infection
c. Rash ****
d. Photosensitivity
11. The therapeutic anticoagulant effect of Heparin is monitored by which of the following laboratory tests?
a. PT
b. PTT ****
c. INR
d. CPK
12. Should the anticoagulant effect of Heparin be excessive the physician will most likely order which of the following as an antidote?
a. Vit C
b. Vit K
c. Protamine ****
d. Amandadine
13. Your patient has black bowel movements which hemetest negative. He is on the following medications. Which one could attribute to the patient’s stool color?
a. Ferrous Sulfate ****
b. Folinic Acid
c. Protamine Sulfate
d. Sulfate
14. Your patient is receiving phenytoin/Dilantin three times a day. Which of the following statements made by the patient may indicate toxicity?
a. “My gums bleed when I brush my teeth.” ****
b. I see green shadows around everything.
c. I feel sick to my stomach.
d. “My breath smells.”
15. Which of the following may indicate digoxin/Lanoxin toxicity?
a. I see green shadows around everything. ****
b. I have this rash on my stomach.
c. I have a severe headache.
d. I am always sick to my stomach.
16. You need to administer an injection using Z track technique. Which of the following best describes Z track technique?
a. Use a short needle and administer the medicine subcutaneously.
b. Inject the needle and medicine intramuscularly; pause for 10 seconds before removing needle. ****
c. Inject the medicine intradermally.
d. Inject the medicine intravenously over 2 minutes.
17. A patient is receiving Colace twice a day. He questions you as to why he needs this medication. You would respond that Colace is a (n)
a. medicine that acts as a laxative.
b. drug to soften the stool making it easier to pass. ****
c. anti-diarrheal.
d. drug that provides fiber to ease passage of the stool.
18. A patient was given 35 units of NPH insulin at 0730. At what time would the patient be most likely to exhibit symptoms of hypoglycemia?
a. 0930
b. 1200 ****
c. 1600
d. 2000
19. In the event of a hypoglycemic reaction, which nursing action should occur first?
a. Contact the physician
b. Give 2 units of insulin
c. Administer peanut butter crackers
d. Contact the lab to recheck the level ****
20. After receiving Lasix daily for 1 week, a patient complains of leg cramps and muscle weakness. This is most likely the result of
a. hypocalcemia
b. hypokalemia ****
c. hypercalcemia
d. hyperkalemia
21. Your patient is to receive “Heparin 5000 units SC q 12h”. Which of the following statements best describes the proper technique for administering the SQ Heparin?
a. Use a 22g 1 inch needle
b. Administer at a 90° angle ****
c. Massage following injection
d. Give 1 ml
22. Following abdominal surgery, Mr. W returns to your unit at 1500. At 1515 he requests pain medication. Prior to administering this narcotic analgesic, which of the following assessments would be most appropriate?
a. Respiratory rate and blood pressure
b. Level of consciousness
c. Pain level
d. Time of previous sedation ****
23. The physician orders Pepcid/femotidine IV for Mrs. Jones. Which of the following statements applies to the administration of this drug?
a. Dilute with NSS to 10ml ****
b. Do not mix with Dextrose
c. Give early in the morning
d. Stop if the patient develops diarrhea
24. Mr. Smith has an order for Carafate. He is also to receive Maalox. At what time should he receive the Carafate?
a. ˝ h before the antacid ****
b. with the antacid
c. with meals
d. with milk
25. Mrs. S. is taking Haldol. The nurse should assess for which of the following side effects?
a. Visual disturbances
b. Pain
c. Diarrhea
d. Extrapyramidal symptoms ****
26. You are preparing to administer the initial dose of Epogen to Mrs. Brown. She asks you what the drug is for. You tell her to stimulate production of
a. red blood cells ****
b. neutrophils
c. platelets
d. white blood cells
27. Mr. Jones has an order for Zinacef/cefuroxime. Which of the following instructions should be included in his patient teaching?
a. Take with orange juice
b. Report the development of an upset stomach
c. Complete the entire course of drugs ****
d. Have the antidote nearby
28. The physician orders Dilantin IV for Mr. Brown. Prior to administering the Dilantin you assess Mr. Brown’s
a. mouth for bleeding gums
b. past seizure history
c. IV solution ****
d. reaction to other medication
29. When reviewing orders for the patient receiving Solu-medrol 35 mg q 6 hours IV, the nurse should
a. remember to check for development of pettichiae
b. instruct patient to avoid individuals with infections ****
c. schedule the drug for
d. tell the patient to expect a decrease in appetite
30. Which information is most important for the nurse to include in a teaching plan for a patient receiving Nitroglycerin?
a. Check pulse daily
b. Store Nitroglycerine in refrigerator
c. Take 1 tablet every 5 minutes x 3 ****
d. Contact the physician prior to taking Nitroglycerine
31. Mrs. Smith is taking Theodur (theophylline) 150 mg po BID for her COPD. Which of the following indicates the development of toxicity?
a. Stevens-Johnson Syndrome
b. Drug level > 20 mg/ml ****
c. Development of a rash
d. Development of fear and anxiety
32. When administering Nitro paste, the nurse should
a. Wash hands after applying
b. leave the old patches on until totally absorbed
c. instruct patient to avoid washing areas where past Nitro has been applied
d. place Nitro paste along identified length of paper measure ****
33. Mrs. Lincoln has an order for a Lidocaine drip 2 g in 500 ml D5W at 2 mg/min on volumetric pump after Lidocaine bolus. The expected outcome of this therapy is:
a. a decrease in the number of PVCs ****
b. an increase in the heart rate
c. a reduction in PACs
d. an improvement in mental status
34. Which statement made by the patient receiving Pronestyl indicates a knowledge deficit?
a. “I’ll take my pill every 8 hours.”
b. “I’ll set my alarm to be sure I take my pill on time.”
c. “I don’t need to see the doctor for at least a year.” ****
d. “I’m going to spread my meals out to allow for snacks.”
35. Mr. Jones is scheduled to receive Ampicillin. He tells you he has an allergy to it. Which statement would most support this belief?
a. “I had trouble breathing when I took it.” ****
b. “ It made me very sick to my stomach.”
c. “It gave me diarrhea.”
d. “ I developed a slight rash on my arm.”
36. Ms. R has been medicated with Vasotec IV. Which of the following actions is most appropriate?
a. Assess her pulse rate before administering
b. Give via Z track
c. Give with a diuretic
d. Monitor BP ****
37. Mr. Smith has an order for Lactulose. You know that it
a. decreases the ammonia level of the patient in liver failure ****
b. causes constipation
c. should be given with a laxative
d. should not be mixed with anything
38. Mr. Brown has an order for 2 units of PRBCs. Which of the following actions should occur first?
a. Prime tubing with saline
b. Crosscheck blood bank number with patient ID number
c. Confirm physician & patient have signed blood permit ****
d. Assess patient for first 15 minutes
39. Mrs. Nichols is receiving Vancomycin IV via a PICC line. Which of the following statements concerning administration is true?
a. Use a tuberculin syringe to flush the catheter
b. Flush the catheter with 500 units of Heparin
c. Measure upper arm circumference prior to use
d. Confirm tip placement in central circulation ****
40. Mrs. Blough is scheduled to receive Ativan as part of her chemotherapy. The purpose of this drug is to
a. produce an amnesic effect
b. control nausea and vomiting ****
c. increase RBCs
d. decrease effect on blood
41. Which of the following information should the nurse obtain before administering Roxanol?
a. Previous response to pain medications
b. Family history
c. Respiratory rate and blood pressure ****
d. Diagnosis
42. In planning a teaching program for Mrs. D. who is receiving Rocephin, the nurse should consider
a. what foods the patient likes
b. the possible development of superinfections ****
c. the need to administer the drug via a centrally placed device
d. the patient’s biorhythm to determine dosing
43. Which of the following would indicate that Ms P’s Ancef regimen is effective?
a. a decrease in her platelet count
b. a decrease in her WBC count ****
c. an increase in her RBC count
d. an increase in her neutrophil count
44. Mr. Haines is scheduled to receive Mannitol prior to his chemotherapy. The purpose of this drug is to:
a. induce diuresis ****
b. decrease the effect on the blood
c. increase the effect on the cancerous cells
d. rescue normal cells
45. What lab value would need to be reported prior to administering chemotherapy?
a. 25000 platelets ****
b. HgB 14
c. AGC 1500
d. WBC 5000
46. Atropine is given preoperatively for the purpose of
a. restoring cardiac rhythm
b. acting as an antidote to anesthesia
c. drying secretions ****
d. reduce post-op tremors
47. Which of the following orders is written correctly?
a. Erythromycin 250 mg TID
b. Erythromycin 250 mg IV q6h ****
c. Same IV
d. D5NS over 8h
48. Mr. F’s orders include Gentamycin. Which assessment should occur prior to initiating the drug?
a. Hearing test ****
b. Vision test
c. Hemoglobin level
d. Iron level
49. Mrs. J is admitted for cholelithiass. Which of the following is the drug of choice for pain control?
a. Meperidine
b. Morphine ****
c. Codeine
d. Oxycontin
50. The RN is determining staff assignments for the evening shift. Which of the following patients should not be assigned to the LPN?
a. Mr. Jones, an 88 year old patient with pneumonia, IV Ancef
b. Mrs. Smith, a 24 year old trauma patient with Oxycontin for pain management
c. Mrs. Gill, a 45 years old cancer patient with a SQ port for chemotherapy ****
d. Mr. Dole, a 65 year old patient with COPD on a theophylline drip
51. Which of the following orders is written correctly?
a. Serax, 15 mg, po, daily
b. Patient Bob Jones, Serax, 15 mg po daily, Dr. Jones ****
c. Patient Bob Jones, Serax 1 tablet daily
d. Serax, 1 tablet daily, Dr. Jones