Question

A nurse is teaching a nursing student about the difference between an anticoagulant and a thrombolytic medication. Which statement by the student indicates correct understanding?

Answer 1

Correct Answers:

"Anticoagulants prevent clot formation or extension, while thrombolytics actively break down existing clots."

Rationale :

✨Anticoagulants (e.g., heparin, warfarin, enoxaparin) do not dissolve clots but work by interfering with the clotting cascade to prevent new clots from forming or existing clots from getting bigger. They are used in conditions like atrial fibrillation, DVT, or post-surgery prevention.

✨Thrombolytics (e.g., alteplase, streptokinase) are “clot-busting drugs” that actively lyse existing clots by converting plasminogen to plasmin, which breaks down fibrin. They are used in acute emergencies such as ischemic stroke, massive PE, or STEMI.

✨Thrombolytics are not used long-term due to their high risk of bleeding; anticoagulants are used for long-term management and prevention.

✨Platelet production is not directly increased by either class—both work on the clotting system, not bone marrow.

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Answer 2

Correct Answers:

20

Rationale :

Formula:

Dose ordered × Volume available

Strength on hand

Step 1: Identify the strength on hand → 5 mg in 5 mL

Step 2: Ordered dose → 20 mg

Step 3: Calculation → 20 mg × 5 mL

5 mg

Step 4: Simplify → 100 mLmg ÷ 5 mg = 20 mL

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Answer 3

Correct Answers:

Undetectable viral load in blood tests

Rationale :

✨The primary goal of antiretroviral therapy (ART) is to suppress viral replication to the point where HIV becomes undetectable in the blood.

✨An undetectable viral load indicates that ART is effective, the client’s immune system is better preserved, and the risk of disease progression and transmission is significantly reduced.

✨In contrast, increased viral load or low CD4 T-cell count suggests poor response or progression of HIV.

✨Drug resistance would also indicate therapy failure, often requiring a change in medication regimen.

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Answer 4

Correct Answers:

Take the medication on an empty stomach, at least 30 minutes before eating.

Rationale :

✨Levothyroxine is best absorbed in the small intestine when taken on an empty stomach. Food, especially those high in calcium, iron, or fiber, can significantly reduce its absorption.

✨Clients should take it in the morning, 30–60 minutes before breakfast, with a full glass of water for maximum effectiveness.

✨It should not be taken at bedtime after meals, nor should it be taken with calcium supplements, since these interfere with absorption.

✨Levothyroxine is given orally, not by injection, so site rotation does not apply.

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Answer 5

Correct Answers:

Take the missed pill as soon as possible and continue taking the remaining pills at the usual time, even if it means taking two pills in one day.

Rationale :

👩‍⚕️When one COC pill is missed (<24 hours late), contraceptive protection is not significantly reduced.

👩‍⚕️The correct guidance is to take the missed pill immediately and then continue the rest of the pack as scheduled, even if it requires taking two pills in one day.

👩‍⚕️No backup method is required for missing a single pill, as hormone levels remain sufficient to suppress ovulation.

👩‍⚕️Stopping the pills, skipping the dose, or discarding it would increase the risk of contraceptive failure.

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Answer 6

Correct Answers:

700

Rationale :

1 g = 1,000 mg

So:

0.7 g × 1,000 mg = 700 mg

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Answer 7

Correct Answers:

0.6

Rationale :

1 mg = 1,000 mcg

Divide micrograms by 1,000 to convert to milligrams.

600 ÷ 1,000 = 0.6 mg

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Answer 8

Correct Answers:

IM Epinephrine

Rationale :

⚡This client is experiencing anaphylaxis, a severe, life-threatening allergic reaction characterized by hypotension, airway compromise (throat tightness, swelling, wheezing), skin changes (hives, angioedema), and dizziness.

⚡The first-line treatment is intramuscular epinephrine, typically 0.3–0.5 mg in the mid-thigh, which rapidly reverses airway swelling, bronchospasm, and hypotension by stimulating α and β adrenergic receptors.

⚡Other medications—diphenhydramine (antihistamine), albuterol (bronchodilator), and methylprednisolone (corticosteroid)—can be given as adjuncts but do not act quickly enough to reverse airway obstruction and circulatory collapse.

⚡Immediate administration of IM epinephrine is lifesaving and should not be delayed.

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Answer 9

Correct Answers:

156

Rationale :

Step 1: Convert ordered dose to mg/hr

2.6 mg/min × 60 min = 156 mg/hr

Step 2: Since 1 mg = 1 mL → 156 mg/hr = 156 mL/hr

✅ Answer: 156

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Answer 10

Correct Answers

Increased RBC count and Hematocrit [ Testosterone ]
Increased risk of Endometrial Cancer [ Estrogen ]
Thrombosis (Blood Clots) [ Both ]
Hypertension [ Both ]

Rationale :

🩸 Increased RBC count and Hematocrit → Testosterone

💥Testosterone therapy stimulates erythropoiesis in the bone marrow, leading to increased red blood cell production and hematocrit levels.

💥This is why men receiving testosterone therapy are at risk for polycythemia, which can increase blood viscosity and thrombotic risk.

💥This effect is not typically associated with estrogen therapy.

🧬 Increased risk of Endometrial Cancer → Estrogen

💥Estrogen replacement therapy (ERT), when given without progesterone in women with an intact uterus, stimulates the endometrial lining.

💥Prolonged, unopposed estrogen exposure can cause endometrial hyperplasia, increasing the risk for endometrial carcinoma.

💥This adverse effect is unique to estrogen use and not linked to testosterone therapy.

🩹 Thrombosis (Blood Clots) → Both

💥Estrogen therapy increases liver production of clotting factors, raising the risk for deep vein thrombosis (DVT) and pulmonary embolism (PE).

💥Testosterone therapy can also increase clot risk indirectly through polycythemia and blood viscosity, though less pronounced than estrogen.

💥Thus, thromboembolic events are a shared risk of both therapies.

💉 Hypertension → Both

💥Both estrogen and testosterone can contribute to increased blood pressure.

💥Estrogen can cause fluid retention and alter the renin-angiotensin system, while testosterone increases sodium and water retention through its effects on the kidneys.

💥Therefore, hypertension is considered a possible adverse effect of both hormone therapies.

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Adverse Effects	Estrogen	Testosterone	Both
Increased RBC count and Hematocrit
Increased risk of Endometrial Cancer
Thrombosis (Blood Clots)
Hypertension

CUSTOM PHARMACOLOGY FINAL EXAM

No.

1 :
A nurse is teaching a nursing student about the difference between an anticoagulant and a thrombolytic medication. Which statement by the student indicates correct understanding?

2 : How many milliliters will you administer per dose? (Insert the numerical value only)

3 :
A nurse is evaluating the effectiveness of antiretroviral therapy (ART) in a client diagnosed with HIV. Which of the following findings would indicate that the treatment is effective?

4 :
A nurse is providing education to a patient who has been prescribed Levothyroxine. Which of the following instructions should the nurse provide to the patient regarding medication administration?

5 :
A 25-year-old patient calls the clinic and reports missing one dose of her combination oral contraceptive pill (COC) less than 24 hours ago. What is the most appropriate advice for the nurse to give this patient?

6 :
0.7 g =_

7 :
600 mcg =_
(Using the conversion: 1,000 mcg = 1 mg)

9 :
A medication is to infuse at 2.6 mg/min. The solution available is 250 mg/250 mL. What is the flow rate in mL/hr? (Fill in the blank with the numerical value only. Round to the nearest whole number.)

10 :
A nurse is reviewing the adverse effects of hormone therapies with a nursing student.

Correct Answers

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CUSTOM PHARMACOLOGY FINAL EXAM

No.

1 : A nurse is teaching a nursing student about the difference between an anticoagulant and a thrombolytic medication. Which statement by the student indicates correct understanding?

2 : How many milliliters will you administer per dose? (Insert the numerical value only)

3 : A nurse is evaluating the effectiveness of antiretroviral therapy (ART) in a client diagnosed with HIV. Which of the following findings would indicate that the treatment is effective?

4 : A nurse is providing education to a patient who has been prescribed Levothyroxine. Which of the following instructions should the nurse provide to the patient regarding medication administration?

5 : A 25-year-old patient calls the clinic and reports missing one dose of her combination oral contraceptive pill (COC) less than 24 hours ago. What is the most appropriate advice for the nurse to give this patient?

6 : 0.7 g =_

7 : 600 mcg =_(Using the conversion: 1,000 mcg = 1 mg)

9 : A medication is to infuse at 2.6 mg/min. The solution available is 250 mg/250 mL. What is the flow rate in mL/hr? (Fill in the blank with the numerical value only. Round to the nearest whole number.)

10 : A nurse is reviewing the adverse effects of hormone therapies with a nursing student.

Correct Answers

1 :
A nurse is teaching a nursing student about the difference between an anticoagulant and a thrombolytic medication. Which statement by the student indicates correct understanding?

3 :
A nurse is evaluating the effectiveness of antiretroviral therapy (ART) in a client diagnosed with HIV. Which of the following findings would indicate that the treatment is effective?

4 :
A nurse is providing education to a patient who has been prescribed Levothyroxine. Which of the following instructions should the nurse provide to the patient regarding medication administration?

5 :
A 25-year-old patient calls the clinic and reports missing one dose of her combination oral contraceptive pill (COC) less than 24 hours ago. What is the most appropriate advice for the nurse to give this patient?

6 :
0.7 g =_

7 :
600 mcg =_
(Using the conversion: 1,000 mcg = 1 mg)

9 :
A medication is to infuse at 2.6 mg/min. The solution available is 250 mg/250 mL. What is the flow rate in mL/hr? (Fill in the blank with the numerical value only. Round to the nearest whole number.)

10 :
A nurse is reviewing the adverse effects of hormone therapies with a nursing student.