NR-293 Pharmacology for Nursing Practice - Set 1 - Part 3

Correct Answer: Dry mouth with a faster pulse

Atropine blocks muscarinic receptors on glands and on the sinus node, so saliva and airway secretions fall while the heart rate climbs. A dry mouth with mild tachycardia is expected. Option a is incorrect because tearing increases when acetylcholine reaches the lacrimal glands. Atropine shuts that pathway down, and clients often complain that their eyes feel gritty and uncomfortably dry after a dose. Option b is incorrect because a slower pulse is the reason atropine is given to clients with symptomatic bradycardia. Blocking vagal input on the sinus node raises the rate rather than dropping it. Option c is incorrect because gut motility falls under muscarinic blockade. Bowel sounds grow quiet, constipation follows, and the nurse assesses for the paralytic ileus that can develop when peristalsis stops altogether.

Correct Answer: An idiosyncratic reaction unique to this child

Paradoxical excitation instead of sedation is an unpredictable response tied to the individual, often genetic, and not driven by dose or immune memory. Children on this antihistamine show it classically. Option a is incorrect because that term covers harm from giving or failing to give a prescribed drug, including missed doses and errors. This child received the medication exactly as ordered. Option b is incorrect because poisoning follows overdose, accumulation, or a narrow margin between help and harm. Nothing suggests the dose was excessive, and the strange behaviour appeared at an ordinary amount. Option d is incorrect because hypersensitivity requires prior sensitising exposure and shows itself through hives, swelling, or bronchospasm. Agitation is a central nervous system effect with no antibody involvement whatsoever.

Correct Answer: Hold the dose and notify the prescriber

Standard practice is to withhold a beta blocker when the apical rate counted for a full minute falls below sixty, then inform the prescriber. Giving it would deepen the bradycardia already present. Option a is incorrect because administering the drug at this rate can drive conduction lower still, producing heart block or syncope. Rechecking afterwards does not undo a dose already swallowed. Option b is incorrect because splitting a prescribed amount is an unauthorized change to the order and still delivers beta blockade to a slow heart. Nurses hold and report rather than improvise. Option c is incorrect because the volume of fluid used has no bearing on whether the drug is safe at this heart rate. Hold parameters, not administration technique, govern the decision here.

Correct Answer: It carries high potential for severe dependence

Schedule II covers drugs with high abuse potential that can lead to severe physical or psychological dependence, and these prescriptions cannot be refilled. Opioids such as oxycodone, morphine, and fentanyl sit here. Option a is incorrect because agents with no recognised therapeutic role fall into Schedule I, a group that includes heroin and LSD. Oxycodone is prescribed daily for pain across the country. Option c is incorrect because the schedules run backward, placing the least dangerous products at the bottom of the list. Codeine cough preparations and diphenoxylate carry that lowest ranking, not a strong opioid. Option d is incorrect because federal law forbids refills on this tier entirely, so a new prescription is required each time. Nurses also count these drugs with a second licensed nurse.

Correct Answer: Recording how much the client drinks and voids

Measuring and recording intake and output is a routine task with a predictable outcome, well within the scope of assistive personnel. Teaching, assessment and judgments about holding a drug stay with the nurse. Option a is incorrect because client education requires the nurse to assess understanding and adjust the message. Assistive personnel may reinforce what was already taught, yet they cannot deliver the instruction itself. Option b is incorrect because palpating for retention is an assessment skill demanding clinical interpretation. A distended bladder in this client signals a dangerous adverse effect, and that judgment cannot be handed off. Option d is incorrect because withholding a medication is a nursing decision built on assessment data and knowledge of the drug. Unlicensed staff carry neither the scope nor the training for that call.

Correct Answer: "Reporting this helps us find the system problem."

A just culture treats reporting as the route to safer systems rather than an invitation to blame. Timing failures usually trace to staffing, interruptions, or scheduling design that the unit can then repair. Option b is incorrect because threatening a disciplinary record drives events underground, and hidden events cannot be analysed. Punitive handling of honest mistakes is precisely what the just culture model was built to replace. Option c is incorrect because harm is not the threshold for reporting. An event that injures nobody still exposes a weakness in the process, and near miss data are among the most useful safety information collected. Option d is incorrect because dismissing a timing deviation as trivial ignores drugs where the interval matters, such as insulin or antibiotics. Deciding on the spot which events count defeats the purpose of a reporting system.

Correct Answer: Insulin, a glucose lowering hormone

Insulin sits on the standard high alert list because a dosing slip produces profound hypoglycemia within minutes. A second licensed provider independently verifies the order, the concentration, and the units drawn before it is given. Option a is incorrect because this anticonvulsant needs serum level monitoring and blood count surveillance rather than a witnessed dose check. Narrow therapeutic index and high alert status are separate safety categories. Option b is incorrect because nonsteroidal agents carry gastrointestinal and renal cautions, not a heightened error consequence profile. Harm from them builds over repeated exposure, which no bedside second signature would prevent. Option c is incorrect because allergy screening, not double checking, is the safeguard attached to this antibiotic. Its main danger is an immunologic reaction in a sensitised client rather than a wrong number on a syringe.

Correct Answer: Ask the client to state name and birth date

Two approved identifiers are required, and the client stating name plus date of birth, matched to the armband and the record, meets that standard. A whiteboard is neither approved nor reliably current. Option b is incorrect because location has never served as an identifier. Clients change beds for isolation, telemetry, or bed flow, and room based matching is a classic route to giving a drug to the wrong person. Option c is incorrect because a colleague's recollection is secondhand and carries the same risk as familiarity. Verification belongs at the bedside with the client and the armband, not through another nurse's memory. Option d is incorrect because checking one unapproved source against another unapproved source multiplies nothing. Neither posting is tied to the client's body, so both can remain stale after a transfer or a discharge.

Correct Answer: Contact the prescriber to request an appropriate route

Changing the route on a written order falls outside nursing scope even when the drug is identical. The nurse reports the fever and the NPO status and asks the prescriber for a usable order. Option a is incorrect because a suppository is a different route, and substituting one requires a prescriber order. Rectal absorption is also erratic, so the decision is not the nurse's to make alone. Option b is incorrect because giving anything by mouth violates the surgical fasting order and risks aspiration under anesthesia. A sip of water does not make an oral dose acceptable here. Option d is incorrect because an untreated fever before an operation can delay the case and stress the client. Waiting passively ignores an available solution, which is a quick call to the prescriber.

Correct Answer: Using tall man lettering on both names

Tall man lettering capitalises the differing internal letters so the eye separates two similar names at a glance. Separate storage and stating the indication on the order reinforce the same protection. Option a is incorrect because shelving confusable products side by side is the opposite of the recommended safeguard. Similar names sitting next to one another invite the very grab that causes these mix ups. Option c is incorrect because brand names multiply across manufacturers and are themselves a leading source of name confusion. Documentation and communication use the generic name for exactly that reason. Option d is incorrect because altering an ordered amount is prescribing, and it addresses arithmetic rather than nomenclature. The hazard described here lives in two drug names that read alike, not in a decimal.