Rehash

Question 1

1. The study of drugs and their interaction in general with living systems is known as:
   a. Pharmacokinetics
   b. Clinical pharmacology
   c. Pharmacotherapeutics
   d. Pharmacology

Answer 1

d. pharmacology

Question 2

In teaching a continuing education class in pharmacology, the instructor tests the class regarding concepts learned about pharmacodynamics. Which statement made by a student best demonstrates the understanding regarding these concepts:

a. “Routes of administration are components of pharmacodynamics.”
b. “Receptor binding is the main component of pharmacodynamics.”
c. “Metabolism is a component of pharmacodynamics.”
d. “Age and gender are components of pharmacodynamics.”

Answer 2

b. “Receptor binding is the main component of pharmacodynamics.”

Question 3

Among the characteristics for an “ideal drug”, what are the three important characteristics that are considered to be the most important for a drug?

a. Predictability, stability and effectiveness
b. Safety, reversibility and ease of administration
c. Safety, effectiveness and selectivity
d. Stability, safety and selectivity

Answer 3

c. Safety, effectiveness and selectivity

Question 4

A nurse is teaching a continuing education class on pharmacology. The nurse is evaluating the participants’ knowledge and poses the question, “When a disease process triggers increased metabolism of the drug, the disease has altered the drug’s ___________.”

a. Pharmacodynamics
b. Pharmacotherapeutics
c. Pharmacokinetics
d. Selectivity

Answer 4

c. Pharmacokinetics

Question 5

The intensity of any drug action is determined by

a. What dosage is administered
b. How the dosage is administered
c. How the drug is handled by the body
d. All of the above

Answer 5

d. All of the above

Question 6

A patient while being administered the drug questions the nurse, “What do you mean that most drug actions are reversible?” The nurse’s best response is that most drug effects _____________________________________.

a. Diminish when given in low doses
b. Diminish as it wears out from the system
c. Reverse when given in high doses
d. Reverse when given in low doses

Answer 6

b. Diminish as it wears out from the system

Question 7

A patient with type I diabetes mellitus arrives at the clinic with complaints of low blood sugar. The nurse questions the patient regarding compliance with medications. The patient states that she gives herself more insulin per dose so she doesn’t have to take it as often. Which of the following area does the nurse need to educate the patient on?

a. Pharmacokinetics
b. Pharmacodynamics
c. Administration
d. Chemical stability

Answer 7

c. Administration

Question 8

Which aspect of the baseline assessment would be the most important before a drug that is known to cause hepatotoxicity is to be administered to a patient?

a. The patient’s blood pressure measurement
b. The patient’s liver function tests
c. The patient’s electrocardiogram (EKG)
d. The patient’s mental status

Answer 8

b. The patient’s liver function tests

Question 9

The nurse is ready to administer an anti-hypertensive agent and on assessing finds out the blood pressure is 108/75 (normal 100/80). What action should the nurse take to determine if it is safe to administer the drug?
a. Note the current blood pressure levels and give the medication and monitor the patient
because he has hypertension
b. Hold the medication, as the patient’s blood pressure is too high to administer the drug.
c. Administer the medication because the medication is prescribed.
d. Assess the patients baseline blood pressure levels before and after the last dose of the medication, to determine if the medication should be administered.

Answer 9

d. Assess the patients baseline blood pressure levels before and after the last dose of the medication, to determine if the medication should be administered.

Question 10

A patient has been taking a brand-name drug and his insurance plan change requires the use of generic drugs since they are available and approved by the FDA. The patient asks if he should pay out of his pocket for the brand-name drug. The nurse’s response should be based on the fact that:
a. Trade name drugs contain active ingredients than generic drugs and he should
pay out of his pocket
b. Generic drugs have therapeutic equivalency to their brand-name counterparts and its ok to start with the generic drugs
c. Generic drugs usually are not the same dosage as brand-name drugs and he should
pay out of his pocket
d. Continuing to use the brand-name drug will prevent confusion and therefore he should
pay out of his pocket

Answer 10

b. Generic drugs have therapeutic equivalency to their brand-name counterparts and its ok to start with the generic drugs

Question 11

An adult patient is receiving antibiotics as drug therapy for an infection and has developed hearing loss. The nurse realizes that this is a side effect of the drug. This action has occurred during which step of the nursing process?

a. Baseline assessment
b. Evaluation
c. Planning
d. Implementation

Answer 11

b. Evaluation

Question 12

When discussing the types of drug names such as Ibuprofen / 2,4,(isobutylphenyl) propionic acid / Advil, it is because we are discussing their ________________ name.

a. Chemical / Generic / Trade
b. Generic / Chemical / Trade
c. Trade / Generic / Chemical
d. Trade/ Chemical/ Generic

Answer 12

b. Generic / Chemical / Trade

Question 13

The nurse is caring for several patients and prepares to administer morning medications. Which among the following is the most high-risk patient that the nurse should monitor after administering the drugs?

a. The pediatric patient admitted with a broken arm
b. The active elderly patient admitted with a right hip fracture
c. The young adult patient with a history of kidney disease
d. The 26-year-old female admitted with asthma

Answer 13

c. The young adult patient with a history of kidney disease

Question 14

All drugs have a chemical, a generic and a trade name. Learning the generic name for a drug is important for nurses/practitioners. Why?

a. The generic name is the same as trade name
b. Generic names are easy to recall and pronounce
c. The generic name of the drug will be the same no matter what the trade name is
d. There are several generic names for a drug with one given trade name

Answer 14

c. The generic name of the drug will be the same no matter what the trade name is

Question 15

Which legislation gives the power to the FDA, for the first time, to require drug companies to conduct pediatric clinical trials on new drugs that may be used in children?

a. Controlled Substance Act (1970)
b. Food and Drug Administration Modernization Act (FDAMA, 1997)
c. Pediatric Research Equity Act (PREA) of 2003
d. The Best Pharmaceutical for Children Act (BPCA) in 2002

Answer 15

c. Pediatric Research Equity Act (PREA) of 2003

Question 16

The Harris-Kefauver amendment that was created after the thalidomide tragedy sought to strengthen all aspects of drug regulation. It required

a. Proof of effectiveness before a new drug could be marketed
b. That drugs be free of adulterants
c. All new drugs undergo testing for toxicity
d. Testing procedures be done for adverse effects before a new drug is released

Answer 16

a. Proof of effectiveness before a new drug could be marketed

Question 17

The rationale for the 1992 changes in the Food and Drug Administration regulations to permit accelerated approval of drugs for the treatment of life-threatening or severely debilitating disease was to:

a. Allow for marketing before completion of Phase III in drug trials
b. Ensure that the unknown risks associated with early approval are balanced by the need for effective drugs
c. Change the rules because existing FDA regulations were too easy for potentially non-effective drugs
d. Accelerate approval of new drugs to give physicians the option of using them even before knowing their effectiveness

Answer 17

b. Ensure that the unknown risks associated with early approval are balanced by the need for effective drugs

Question 18

A researcher working for a pharmaceutical company is providing orientation to a new nurse researcher. The researcher determines that further education is needed when the nurse states that

a. Preclinical testing takes place in animals b. Phase I involves normal volunteers
c. Phase III involves patients
d. The manufacturer applies for FDA approval after phase II

Answer 18

d. The manufacturer applies for FDA approval after phase II

Question 19

When a new drug is subjected to clinical trial while there is an already existing drug in treatment for the condition, what would the control drug be in this clinical trial ?

a. A placebo sugar pill
b. A control sugar pill
c. The already existing drug
d. All of the above

Answer 19

c. The already existing drug

Question 20

The terminology used to describe the clinical trial drug study where both health professional and the patient do not know what drug they are receiving in the trial is a(n)
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ study.
a. Single blind					
b. Open label 
c. Cross over					
d. Double blind

Answer 20

d. Double blind

Question 21

The most common way through which drugs cross the membrane is via direct penetration. From the following list, identify the one that can cross the membrane more readily:

a. Molecules that are hydrophilic/lipophobic
b. Molecules that are hydrophobic/lipophilic
c. Small molecules that are charged
d. Large molecules that are charged

Answer 21

b. Molecules that are hydrophobic/lipophilic

Question 22

Select the accurate statement with regard to drugs and pH dependent ionization (ion trapping). Aspirin when taken with antacid will be ____________________________.

a. Absorbed more from the stomach at that pH because they are non-ionized
b. Trapped more in the stomach at that pH because they will ionize
c. Degraded more in the stomach at that pH
d. Absorbed normally as they don’t ionize

Answer 22

b. Trapped more in the stomach at that pH because they will ionize

Question 23

Under most circumstances, intramuscular (IM) injections are to be avoided; however, there are some advantages to this route. Identify the advantage in using IM from the following list:

a. IM route is the least painful
b. IM route is the least expensive
c. The IM route is superior when administering poorly soluble drugs
d. IM injections are safer than the other drug administration routes

Answer 23

c. The IM route is superior when administering poorly soluble drugs

Question 24

Some drugs under go first- pass effect where as others undergo enterohepatic recirculation. The first-pass effect primarily alters a drug’s _____________, whereas enterohepatic circulation alters a drugs’s ________________.

a. Absorption. metabolism
b. Distribution, metabolism
c. Metabolism, distribution
d. Metabolism, excretion.

Answer 24

c. Metabolism, distribution

Question 25

The nurse is reading research about a drug. The literature states that the drug is potent. This means the drug

a. Produces its maximal effects at low doses
b. Produces strong effects at only high doses
c. Produces toxic effects at even low doses
d. All of the above

Answer 25

a. Produces its maximal effects at low doses

Question 26

Grape fruit juice consumed along with certain drugs plays a major effect on the plasma levels of the drug. The “grape fruit juice effect” is most associated with:

a. Altered absorption in the stomach
b. Increased excretion in the urine
c. Decreased binding to plasma proteins
d. Effects on drug metabolism

Answer 26

d. Effects on drug metabolism

Question 27

A patient with a history of cardiac problems is admitted to a telemetry unit. The patient needs administration of digoxin (Lanoxin) immediately. The drug has a longer half- life. As a prescriber what would be your best action?

a. Administer the same amount every day (for 4 half lives) until it reaches plateau
b. Administer double the dose every day until it reaches the plateau
c. Administer high and low doses alternatively every day
d. Administer a high dose to reach plateau, followed by a lower dose for maintenance

Answer 27

d. Administer a high dose to reach plateau, followed by a lower dose for maintenance

Question 28

On Monday (Sep 1) a patient begins taking a daily dose of a drug with a half-life of 3 days. If the patient takes the same dose every day, on what day will the plasma drug levels reach a plateau?

a. Sep 4, Thursday
b. Sep 13, Saturday
c. Sep 7, Sunday
d. Sep 10, Wednesday

Answer 28

b. Sep 13, Saturday

Question 29

. A patient has been taking medication for his asthma condition. His condition has improved and the doctor has ordered him to stop taking his medication. How much of the drug will still remain in the patient at the end of three half-lives?

a. 50%
b. 6.25%
c. 25%
d. 12.5%

Answer 29

d. 12.5%

Question 30

When comparing a drug that has a strong attraction to albumin with one that has a weaker attraction, the nurse would anticipate that the distribution of the free drug with the strong attraction would be:

a. Higher than the distribution of the drug with the weaker attraction.
b. No different from the distribution of the drug with the weaker attraction
c. Lower than the distribution of the drug with the weaker attraction
d. Equal as far as free drug distribution goes

Answer 30

c. Lower than the distribution of the drug with the weaker attraction

Question 31

Select the accurate statement regarding competitive antagonists

a. They bind at a site different than the site where endogenous compounds bind
b. They produce pharmacologic effects by causing receptor activation
c. They are stronger in the absence of an agonist compound
d. They have a higher affinity than an agonist compound

Answer 31

c. They are stronger in the absence of an agonist compound

Question 32

Drug A has an ED50 of 10 mg & a LD50 of 20 mg. Drug B has an ED50 of 10 mg and a LD50 of 100 mg. Based on this information, which statement is TRUE about A & B?

a. A is more potent than B
b. A is more safer than B
c. B is more potent than A
d. B is more safer than A

Answer 32

d. B is more safer than A

Question 33

A scientist tests a new drug for pain relief and finds that it provides pain relief at a range of dosages. The overall pain relief (magnitude of response) produced by this drug is almost double of that of available medications at the same tested dosage. What can be said about this new drug?

a. The drug is very potent than the existing drugs
b. The drug is more efficient (more efficacy) than the existing drugs
c. The drug is less efficient (less efficacy) than the existing drugs
d. The drug is less potent than the existing drugs

Answer 33

b. The drug is more efficient (more efficacy) than the existing drugs

Question 34

Endogenous ligands such as acetylcholine and GABA act through receptors that are

a. Cell membrane embedded enzymes
b. G-Protein coupled receptors systems
c. Transcription factors
d. Ligand-gated ion channels

Answer 34

d. Ligand-gated ion channels

Question 35

Dose–response relationships can be explained by drug-receptor interaction theories. According to the modified occupancy theory differences in potency between two drugs can be explained by the

a. Difference in affinities towards the receptor
b. Difference in avidities towards the receptor
c. Difference in their intrinsic activity towards the receptor
d. Difference in desensitization of the receptor

Answer 35

a. Difference in affinities towards the receptor

Question 36

Education on pharmacology is taking place on the nursing unit. The discussion involves the receptor sensitivity of a medication. The presenter asks one nurse to provide an example situation for hyper-sensitization. The nurse’s response would be:

a. The degradation of more receptors
b. Continuous exposure to an agonist
c. Internalization and recycling of receptors
d. Continuous exposure to an antagonist

Answer 36

d. Continuous exposure to an antagonist

Question 37

The nurse is providing nursing education regarding receptor-less drugs to a group of college students. Which example of a receptor-less drug given by a student would indicate a need for further teaching?

a. Antiseptics
b. Chelating agents
c. Saline laxatives
d. morphine

Answer 37

d. morphine

Question 38

The following combination of drugs when taken together is a good example for reduced therapeutic (or adverse) effect that is detrimental

a. Morphine and Naloxone
b. Propanalol and albuterol
c. Sublactam and warfarin
d. all of the above

Answer 38

b. Propanalol and albuterol

Question 39

When one drug alters the absorption of a second drug taken at the same time for example: tetracyclines taken along with antacids or calcium tablets, the interaction would be classified as:

a. A direct chemical reaction.
b. Pharmacodynamic.
c. Pharmacokinetic.
d. Combined toxicity

Answer 39

c. Pharmacokinetic

Question 40

When one drug works to decrease acidity in the stomach by directly neutralizing the acid (antacid) and another drug decreases stomach acidity by preventing the production of acid in the stomach (Prilosec), how would the interaction be classified?

a. A direct chemical reaction
b. Pharmacodynamic
c. Pharmacokinetic
d. Combined toxicity

Answer 40

b. Pharmacodynamic

Question 41

When taking monoamine oxidase inhibitors for treating depression, consumption of food items such as fermented cheese, chianti wine etc., rich in the following compound should be avoided to prevent any potential hypertensive crisis:

a. Monoamine
b. Tyrosine
c. Tryptamine
d. Tyramine

Answer 41

d. Tyramine

Question 42

A patient who has taken antipsychotics for treatment develops “tardive dyskinesia” that resembles parkinson’s disease. This adverse drug reaction would be classified as:

a. An allergic reaction
b. An iatrogenic disease
c. An idiosyncratic effect
d. A teratogenic effect

Answer 42

b. An iatrogenic disease

Question 43

A nurse is providing patient education regarding the development of drug tolerance. Which statement made by the nurse is correct with regard to the development of drug tolerance?

a. “Drug tolerance is only seen with the use of opioids.”
b. “The patient will require a greater dosage of drug for the same effect to be achieved if tolerance has developed.”
c. “The patient needs a lower dose of the medication until the drug is discontinued.”
d. “Addiction is likely to develop if the drug is decreased, leading to tolerance.”

Answer 43

b. “The patient will require a greater dosage of drug for the same effect to be achieved if tolerance has developed.”

Question 44

Most people who receive succinylcholine as a muscle paralyzer have a brief response lasting only a few minutes. But a person who has a very prolonged effect from the drug at a standard dosage is experiencing:

a. An anaphylactic reaction.
b. An idiosyncratic effect.
c. An iatrogenic response.
d. A physical dependence.

Answer 44

b. An idiosyncratic effect.

Question 45

A patient’s unique genetic makeup can lead to variability in drug response. Which of the following is a good example of varied response due to different genetic makeup?

a. Digitalis treatment and increased mortality in women
b. Severe skin reactions in Asians due to consumption of anti-seizure medication Carbamazapine
c. Barbiturates and increased metabolism of drugs
d. all of the above

Answer 45

b. Severe skin reactions in Asians due to consumption of anti-seizure medication
Carbamazapine

Question 46

Repeated dosing within a short period of time with a drug may lead to a situation referred to as __________________, where the drug effect is lost. Nitroglycerin is a good example for this condition.

a. Idiosyncratic effect
b. Tachyphylaxis
c. Anaphylaxis
d. Iatrogenic effect

Answer 46

b. Tachyphylaxis`

Question 47

Neuropharmacologic agents can cause which of the following effects?

a. Decreased neurotransmitter synthesis
b. Increased neurotransmitter degradation
c. Direct activation of receptor
d. All of the above

Answer 47

d. All of the above

Question 48

A nurse is discussing the functions of the parasympathetic and the sympathetic nervous system with a group of nursing students. Which statement made by one of the student indicates a need for further teaching?

a. “The parasympathetic nervous system regulates the digestive functions of the body.”
b. “The sympathetic nervous system regulates the cardiovascular system.”
c. “The sympathetic nervous system implements the fight-or-flight response.”
d. “The parasympathetic nervous system regulates body temperature.”

Answer 48

d. “The parasympathetic nervous system regulates body temperature.”

Question 49

The receptor subtype and the neurotransmitter involved in sweat glands in the body:

a. Acetylcholine and nicotinic (Nm) receptors
b. Norepinephrine and beta1 receptors
c. Epinephrine and muscarinic receptors (M)
d. Acetylcholine and muscarinic receptors (M)

Answer 49

d. Acetylcholine and muscarinic receptors (M)

Question 50

Skeletal muscle contraction involves the following neurotransmitter and the receptor
subtype:
a. acetylcholine and nicotinic(Nn type)
b. acetyl choline and muscarinic (M) type
c. acetylcholine and nicotinic (Nm type)
d. norepinephrine and alpha 1 type

Answer 50

c. acetylcholine and nicotinic (Nm type)

Question 51

A prescriber has ordered bethanechol (Urecholine) for a postoperative patient who has urinary retention. The nurse reviews the patient’s chart before giving the drug. Which part of the patient’s history would be a contraindication to using this drug?

a) Asthma as a child
b) Intestinal obstruction
c) Hypertension
d) Hypothyroidism

Answer 51

b) Intestinal obstruction

Question 52

Acetylcholine (Miochol-E) has limited therapeutic indication due to its selectivity at cholinergic receptors. Miochol is indicated primarily for:

a) Reducing excessive secretions and mucus in a postoperative patients
b) Lowering intraocular pressure in patients with glaucoma
c) Inhibiting muscular activity in the bladder
d) Producing rapid miosis in cataract surgery

Answer 52

d) Producing rapid miosis in cataract surgery

Question 53

A prescriber has ordered pilocarpine (Pilocar). A nurse understands that the drug stimulates muscarinic receptors and would expect the drug to have which action?

a) Reduce excessive secretions in a postoperative patient
b) Lower intraocular pressure in patients with glaucoma
c) Inhibit muscular activity in the bladder
d) Prevent hypertensive crisis

Answer 53

b) Lower intraocular pressure in patients with glaucoma

Question 54

A patient has developed muscarinic antagonist toxicity from ingestion of an unknown chemical. The nurse should prepare to administer which medication?

a) Atropine (Sal-Tropine) IV
b) Physostigmine (Antilirium)
c) An acetylcholinesterase activator
d) Pseudoephedrine

Answer 54

b) Physostigmine (Antilirium)

Question 55

A nurse plans to administer atropine (Sal-Tropine) to a patient on multiple concurrent medications. The nurse feels confident that which class of drugs would be safe to administer with atropine?

a) Antihistamines
b) Tricyclic antidepressants
c) Phenothiazine antipsychotics
d) Narcotic analgesics

Answer 55

d) Narcotic analgesics

Question 56

Anticholinergic agents that are selective for M3 receptors are commonly used treat overactive bladders. Identify the anticholinergic agent below used for overactive bladder treatment and is highly M3 receptor selective :

a) Echothiopate (phospholine)
b) Darifinecin (Enablex)
c) Bethenachol (Urechol)
d) Atropine (Sal-tropine, Atropen)

Answer 56

b) Darifinecin (Enablex)

Question 57

A nurse working in the emergency department is assigned to a child who is arriving by ambulance after being involved in a spill of organophosphate insecticides. What will the nurse expect to be the initial priority for treating this child?

a) Administering diphenhydramine to control secretions
b) Giving beta blockers to prevent tachycardia
c) Providing mechanical ventilation and oxygen
d) Reporting the spill to the Environmental Protection Agency

Answer 57

c) Providing mechanical ventilation and oxygen

Question 58

A nurse has arrived at work late and missed report. While reviewing the patient’s medications, the nurse notes that the patient is on an irreversible cholinesterase inhibitor. The nurse understands that the only indication for an irreversible cholinesterase inhibitor would be:

a) Glaucoma.
b) Muscular dystrophy
c) Myasthenia gravis
d) Hypertension

Answer 58

a) Glaucoma.

Question 59

Acetylcholinesterase inhibitors are not only given for treatment of Mysthenia Gravis but four specific acetylcholinesterase inhibitors have been indicated for treatment for Alzheimer’s as well. Identify the one acetylcholinesterase inhibitor used for Alzheimer’s treatment from the list below:

a) Neostigamine (Prostigmin)
b) Physostigamine (Antilirium)
c) Edrophonium (Tensilon/Reversol/Enlon)
d) Rivastigamine (Exelon)

Answer 59

d) Rivastigamine (Exelon)

Question 60

A nurse is providing education to the other nurses on the unit on how to differentiate between a myasthenic crisis and a cholinergic crisis. To show that they understand the difference, the nurses could state that they should

a) ask the patient about occupation and family history
b) administer atrophine and monitor the patient
c) administer edrophonium (Tensilon/Reversol/enlon) and monitor the response
d) assess serum levels of succinyl choline

Answer 60

c) administer edrophonium (Tensilon/Reversol/enlon) and monitor the response

Question 61

While preparing a patient for a procedure in which a neuromuscular blocking agent such as tubocurarine will be used, the nurse reviews the patient’s preprocedure laboratory values. Which abnormality would cause the most concern?

a) Hyponatremia
b) Hypercalcemia
c) Hypomagnesemia
d) Hypokalemia

Answer 61

d) Hypokalemia

Question 62

A nurse is starting at a unit where short surgical procedures are done and muscle blockers are constantly being used. Which statement made by the nurse suggests more education regarding muscle blockers?
a) Succinyl choline and tubocurarine both can cause paralysis
b) Succinylcholine produces paralysis via constant depolarization whereas tubocurarine
via non-depolarization
c) Electrolyte levels (especially K levels) can alter responses to tubocurarine but has no
effect on succinly choline
d) Cholinesterase inhibitors potentiate the action of tubocurarine whereas they inhibit the action of succinyl choline

Answer 62

d) Cholinesterase inhibitors potentiate the action of tubocurarine whereas they inhibit the action of succinyl choline

Question 63

While preparing a patient for a second esophageal dilation procedure, the nurse explains that succinylcholine (Anectine) will be used for muscle relaxation. The patient is anxious and reports not being able to swallow for several hours after the previous procedure with the same muscle relaxant. What will the nurse do?

a) Be prepared to provide mechanical ventilation after the procedure
b) Have dantrolene available, because this patient is at increased risk for side effects
c) Reassure the patient that this is expected after neuromuscular blockade
d) Request an order for a pseudocholinesterase level

Answer 63

d) Request an order for a pseudocholinesterase level

Question 64

A patient is being prescribed a drug for treatment for primary hypertension. While reading the medical history the prescriber notices that he had been treated before for depression and decides not to prescribe the drug primarily because of its effect on promoting suicidal thoughts. Which of the following drug is it?

a) Ephedrine
b) Clonidine (catapres)
c) Methyldopa (aldomet)
d) Reserpine (Serpasil/Serpalan)

Answer 64

d) Reserpine (Serpasil/Serpalan)

Question 65

A patient brought to the emergency department requires sutures. The prescriber orders a local anesthetic with epinephrine. The nurse understands that epinephrine is ordered to:

a) prevent hypertension induced by the anesthetic
b) reduce anesthetic-induced nausea
c) prolong absorption of the anesthetic
d) reduce the pain of an injection

Answer 65

c) prolong absorption of the anesthetic

Question 66

A nursing student asks the nurse about receptor specificity of adrenergic agonist medications. What will the nurse say?

a) “As the dosage of these medications increases, drugs in this class are more selective.”
b) “Dopamine is selective for dopamine receptors and has no effects on alpha or beta receptors.”
c) “Epinephrine is the least selective alpha-adrenergic agonist medication.”
d) “Dobutamine activates both alpha receptors.”

Answer 66

c) “Epinephrine is the least selective alpha-adrenergic agonist medication.”

Question 67

This adrenergic agent has no major therapeutic effects on other organs other than the kidney. Diuretics taken along with this adrenergic agonist compliments its effect:

a) Norepinephrine (levophed)
b) Terbutaline (Brethine)
c) Isoproterenol (Isuprel)
d) Dopamine (intropin)

Answer 67

d) Dopamine (intropin)

Question 68

A nurse is providing education for a prescription drug for a patient with hypertension and explains: ”This drug is an alpha blocker and produces first dose effect where 1% of the patients are know to loose consciousness on taking their first dose. So take this drug before bedtime or while sitting on bed”. Which drug is the nurse referring to?

a) Phentolamine (Regitine)
b) Phenylephrine (Neo-synephrine)
c) Phenoxybenzamine
d) Prazosin (Minipres)

Answer 68

d) Prazosin (Minipres)

Question 69

The following adrenergic agonist is also referred to as a mixed acting drug because it acts on both alpha and beta- receptors and also causes release of norepinephrine:

a) Epinephrine (adrenalin)
b) Phenylephrine (Neo-synephrine)
c) Ephedrine
d) Dopamine (intropin)

Answer 69

c) Ephedrine

Question 70

A prescriber has ordered methyldopa for a patient with hypertension. The nurse teaches the patient about drug actions, adverse effects, and the ongoing blood tests necessary with this drug. The nurse is correct to tell the patient what?

a) “This drug may cause increased lipid levels so you may see weight gain”
b) “Malignant hypertermia and hypertension are serious side effects and indications for withdrawing the medication.”
c) “If you have a positive Coombs’ test result, you will need to discontinue the medication, because this means you have hemolytic anemia.”
d) “Methyldopa can be used for its analgesic effects and for its hypertensive effects.”

Answer 70

c) “If you have a positive Coombs’ test result, you will need to discontinue the
medication, because this means you have hemolytic anemia.”

Question 71

Pheochromocytoma is an adrenal tumor that releases large quantities of catecholamines into circulation. The physician has ordered a blocking agent listed below. Identify the one used specifically to treat pheochromocytoma:

a) Terazosin (Hytrin)
b) Phentolamine (Regitine)
c) Isoproterenol (Isupel)
d) Terbutline (Brethine)

Answer 71

b) Phentolamine (Regitine)

Question 72

A nurse notes that a patient who has come to the clinic has type I diabetes and takes insulin and is also taking Propranolol (inderal) for his high blood pressure. What education should the nurse provide to the patient? a) “Propranolol may potentiate the effects of the insulin so it is good to take them together”

b) “Propranolol has no effects on diabetes mellitus or on your insulin requirements.”
c) “Propranolol may mask the signs of hypoglycemia, so you need to monitor your blood glucose closely”
d) “You need to increase your insulin to allow for the agonist effects of propranolol.”

Answer 72

c) “Propranolol may mask the signs of hypoglycemia, so you need to monitor your blood glucose closely”

Question 73

A nurse is caring for a patient who requires treatment with a beta- blocker for hypertension. The patient has a history of asthma. The nurse should anticipate that the prescriber will order which of the following antihypertensive medications, taking into consideration the patient’s health history?

a) Propranolol (inderal)
b) Verapamil (calan)
c) Prazosin (minipress)
d) Metoprolol (Lopressor)

Answer 73

d) Metoprolol (Lopressor)

Question 74

Recent FDA warnings indicate using the following drug, a long acting beta2 agonist is associated with asthma related death as they mask the symptoms of a future asthma attack and therefore should be used cautiously:

a) albuterol (proventil)
b) Budenoside (Plumicort)
c) Pibuterol (Maxair)
d) Salmetrol (Serevent Diskus)

Answer 74

d) Salmetrol (Serevent Diskus)

Question 75

Leukotriene modifiers are the newer set of drugs being prescribed in the treatment of asthma. The following is a leukotriene modifier that works as a leukotriene receptor blocker and is being used in the treatment of both asthma and allergies. It works both in adults and children as young as year of age:

a) Zileuton (Zyflo)
b) Zafirlukast (Accolate)
c) Remicade (Infliximab)
d) Montelukast (Singulair)

Answer 75

d) Montelukast (Singulair)

Question 76

Mediators such as leukotrienes and interleukins that are released by mast cells can
ultimately affect allergen-induced inflammation and bronchospasm in which of the
following ways?
a) directly cause bronchodilation that leads to airway constriction
b) releases more mediators that inhibit bronchospasm
c) directly cause inflammation that leads to airflow limitation
d) makes the lungs immune to allergens

Answer 76

c) directly cause inflammation that leads to airflow limitation

Question 77

Sometimes asthma patients use two different types of asthma inhalers: a short-acting beta2 agonist and a corticosteroid. When a nurse is questioned by the patient as to why he is being prescribed beta 2 agonists, the nurse’s best response would be that beta2 agonists

a) are to be used only when no other drugs work
b) reduce symptoms of asthma by primarily suppressing leukotrienes
c) help prevent respiratory infections
d) work rapidly in asthma attacks

Answer 77

d) work rapidly in asthma attacks

Question 78

Cromlyn (Intal) is being prescribed for treatment for a child with asthma. The patient’s mother asks the nurse when and how this drug helps during an asthma attack? Select the nurse’s best response.

a) Cromolyn is used to abort an ongoing attack and suppresses inflammation.
b) Cromolyn is used for prophylaxis and is a leukotriene modifier
c) Cromolyn is used for prophylaxis and it suppresses inflammation
d) Cromolyn stabilizes inflammatory cells and promotes the release of histamine

Answer 78

c) Cromolyn is used for prophylaxis and it suppresses inflammation

Question 79

The following drug provides relief only to patients who suffer specifically from allergy related asthmas. The drug works by targeting the IgE antibodies that produce allergies. Which of the following drug is it?

a) Zafirlukast (Accolate)
b) Omalizumab (Xolair)
c) Montelukast (Singulair)
d) Infliximab (remicade)

Answer 79

b) Omalizumab (Xolair)

Question 80

A patient has been put on inhaled glucocorticoid therapy for his asthma. When educating this patient what common side effects should the nurse include?

a) fatigue and depression
b) anxiety and peripheral neuropathy
c) headache and rapid heart rate
d) oral candidiasis and dysphonia

Answer 80

d) oral candidiasis and dysphonia

Question 81

The following asthma drug is given as IV for emergencies and routinely used for maintenance therapy for chronic stable asthma. Even though the mechanism of action is not clear, it is said to act through adenosine receptors:

a) Cromolyn (intal)
b) Budenoside (pulmicort)
c) Theophylline
d) Ipratropium (atrovent)

Answer 81

c) Theophylline

Question 82

Which of the following antitussives, a non- opioid which binds to both the opioid mu receptor and NMDA receptor in order to elevate the cough threshold in the CNS? This drug is generally found in cough medications for that purpose:

a) codeine
b) dextromethorphan
c) diphenhydramine (Benadryl)
d) guaifenesin (mucinex)

Answer 82

b) dextromethorphan

Question 83

Allergy medications such as Claritin-D and Allegra-D are a new type of combination medications available for treating allergies and the symptoms such as congestion, associated with allergies. They contain the following drugs:

a) cholinergic agent + antihistamine
b) anticholinergic agent + sympathomimetic
c) sympathomimetic + antihistamine
d) antihistamine + leukotriene modifier

Answer 83

c) sympathomimetic + antihistamine

Question 84

Cold medications generally are combination medications that provide relief for the symptoms associated with cold. Which of the following combination could be found in a cold medication?

a) nasal decongestant + leukotriene modifier
b) antihistamine + decongestant
c) leukotriene modifier + sympathomimetic
d) leukotriene modifier + antihistamine

Answer 84

b) antihistamine + decongestant

Question 85

The health care provider is treating a patient with complaints of severe abdominal pain and confirmed infection with H. pylori. Which of the following combination of medications based on the FDA regimen would the nurse expect the health care provider to order?

a) Cimetidine (Tagamet), Tindamax, metronidazole (Flagyl) and esomeprazole (Nexium)
b) Cimetidine (Tagamet), tetracycline, and clarithomycin (Biaxin)
c) Clarithromycin (Biaxin), amoxicillin (Amoxil), metronidazole (flagyl) and esomeprazole (Nexium)
d) Amphotericin B, cimetidine (Tagamet), and bismuth (Pepto-Bismol)

Answer 85

c) Clarithromycin (Biaxin), amoxicillin (Amoxil), metronidazole (flagyl) and esomeprazole (Nexium)

Question 86

A patient is placed on a multidrug regimen including bismuth for peptic ulcer disease. The nurse should instruct the patient about the side effects of bismuth as follows:

a) “One week of therapy should heal ulcers and relieve symptoms.”
b) “When the symptoms resolve, the ulcer will be healed.”
c) “The tongue and stool may turn black on bismuth.”
d) “Single-drug therapy is preferable.”

Answer 86

c) “The tongue and stool may turn black on bismuth.”

Question 87

Which statement regarding omeprazole (Prilosec) & esomeprazole (Nexium) is correct?

a) Prilosec is a proton pump inhibitor (PPI)whereas Nexium is a histamine-R antagonist
b) Prilosec is an s-isomer of Nexium and metabolized slower than Nexium and thus its effects lasts longer
c) Nexium is an s-isomer of Prilosec and thereby metabolized slowly and thus its effects lasts longer
d) Nexium is a proton pump inhibitor whereas Prilosec is a histamine-R antagonist

Answer 87

c) Nexium is an s-isomer of Prilosec and thereby metabolized slowly and thus its effects lasts longer

Question 88

The nurse is prepping a patient for a surgical procedure that is scheduled within 4 hours and has to receive a bowel preparation for the procedure. The nurse would anticipate administration of which of the following laxative based on the classification of laxatives by therapeutic response?

a) Psyllium (Metamucil)
b) Castrol oil
c) Docusate sodium (Colace)
d) Bisacodyl (Dulcolax)

Answer 88

b) Castrol oil

Question 89

A 30-year-old female patient is to be started on misoprostol (Cytotec) for treatment of a gastric ulcer secondary to long-term ibuprofen (Motrin) use. Which of the following statements must the nurse include in the patient education?

a) “Start taking the drug at the end of the day when you are in bed.”
b) “Take the medication 1 hour before meals.”
c) “Use a reliable method of birth control to prevent pregnancy while on this drug.”
d) “Make sure to get liver function tests done while on the medication.”

Answer 89

c) “Use a reliable method of birth control to prevent pregnancy while on this drug.”

Question 90

A 30-year-old male patient will begin a three-drug regimen to treat peptic ulcer disease. The regimen will consist of bismuth subsalicylate, tetracycline, and cimetidine (Tagamet). The nurse will include which information when teaching this patient about this drug regimen?

a) Black discoloration of tongue and stools require immediate discontinuation
b) There are no central nervous system related side effects
c) Decreased libido, impotence, and gynecomastia are side effects that will happen during this drug
d) Staining of the teeth may occur and is an indication for discontinuation of drug

Answer 90

c) Decreased libido, impotence, and gynecomastia are side effects that will happen during this drug

Question 91

The nurse is providing patient education to an elderly patient being treated for duodenal ulcers. The prescriber has ordered sucralfate (Carafate). The patient asks the nurse how sucralfate helps heal ulcers. Which answer by the nurse is correct?

a) “It creates a protective barrier against pepsin and acid.”
b) “It irreversibly suppresses gastric acidity.”
c) “It inhibits the enzyme that generates gastric acid.”
d) “It enhances prostaglandin production.”

Answer 91

a) “It creates a protective barrier against pepsin and acid.”

Question 92

The nurse is preparing to administer Docusate sodium (Colace) per the doctor’s request for a laxative. The patient asks the nurse how this medication works. Which of the following would be a correct statement by the nurse?

a) “It draws water into the colon to soften the feces through osmosis”
b) “It decreases surface tension so it draws more water into the colon.”
c) “It increases bulk in the colon as it is a natural fiber.”
d) “It stimulates the nerves that regulate defecation”

Answer 92

b) “It decreases surface tension so it draws more water into the colon.”

Question 93

The following is a laxative that is unique and works at the small intestine and colon by opening up chloride channels in the intestinal epithelium and increasing secretion of fluid into the lumen. Which of the following laxative is it?

a) Lactulose
b) Polyethylene glycol
c) Bisacodyl (Dulcolax)
d) Lubiprostone

Answer 93

d) Lubiprostone

Question 94

The nurse is administering cisplatin, a chemotherapeutic agent to a patient with lung cancer and anticipates nausea and vomiting as a side effect. She plans to administer antiemetics. What category of antiemetics is the most effective in this situation?

a) Aprepitant (Amend)
b) Dexamethasone (Decadron)
c) Ondansetron (Zofran)
d) Lorezapam (Ativan)

Answer 94

c) Ondansetron (Zofran)

Question 95

The recovery room nurse is caring for a patient post surgery and administers an antiemetic agent for postoperative nausea and vomiting. The patient is transferred to the unit and begins to display extrapyramidal effects. Which agent does the nurse think is most likely responsible?

a) Ondansetron (Zofran)
b) Dronabinol (Marinol)
c) Lorezapam (Ativan)
d) Prochlorperazine (Compazine)

Answer 95

d) Prochlorperazine (Compazine)

Question 96

The nurse is preparing to administer an antiemetic to a newly admitted patient. Prior to administration, the nurse reviews the patient’s health history and sees he has a history of drug abuse. The nurse is concerned and wants to let the prescriber know the drug he has prescribed has temporal dissociation, depersonalization and dysphoria all as side effects. Which drug is it?

a) Dimenhydrinate (Dramamine)
b) Scopolamine
c) Dranabinol (marinol)
d) Aprepitant (Amend)

Answer 96

c) Dranabinol (marinol)

Question 97

A patient comes to the clinic for a checkup and shares upcoming plans to go on a vacation cruise. The patient asks for a medication to prevent sea sickness. The nurse practitioner orders scopolamine. The nurse provides education and tells the patient to be aware of the potential side effects, which include

a) nausea and vomiting
b) itching and diarrhea
c) blurred vision and drowsiness
d) hearing loss and salivation

Answer 97

c) blurred vision and drowsiness

Question 98

A patient with irritable bowel syndrome has received a prescription for Diphenoxylate (Lomotil). When asked about the rationale for this drug, the nurse should explain that it:

a) decrease GI motility & slow intestinal transit
b) increase intestinal motility & reduce abdominal pain
c) lifting depression is the goal for this condition
d) alter the dopaminergic effects in the gastrointestinal tract

Answer 98

a) decrease GI motility & slow intestinal transit

Question 99

Traveler’s diarrhea is common when you travel to foreign countries and consume water in unsanitary conditions where E,coli is most commonly the causative agent. What specific antibiotic would you expect to be prescribed in children and pregnant women with severe traveler’s diarrhea?

a) Ciprofloxacin
b) Azithromycin (Zithromax)
c) Levofloxacin
d) Doxycycline

Answer 99

b) Azithromycin (Zithromax)

Question 100

Inflammatory bowel disease such as crohn’s disease is treated with drugs that target and inactivates TNF- alpha factor involved in inflammation. Identify the drug specifically used to treat IBD by the above mechanism.

a) Sulfasalzine(Azulfidine)
b) Natalizumab (Tysabri)
c) Infliximab (Remicade)
d) Budesonide (Entocort)

Answer 100

c) Infliximab (Remicade)

Question 101

The instructor from a pharmacology class is reviewing material on CNS drugs.
Which statement is correct regarding the impact of drug exposure on the central nervous system?
a) Side effects or adverse effects generally increase over time.
b) When tolerance develops, drug dosage should be decreased and tapered off.
c) They act immediately to produce structural changes in the nervous system.
d) They may take some time to exert changes to produce the desired effects

Answer 101

d) They may take some time to exert changes to produce the desired effects

Question 102

The pharmacology instructor is providing instructions to a group of students about the goal of pharmacologic therapy in treating Parkinson’s disease. Which of the following statement made by the instructor would be true?

a) Increase the amount of acetylcholine at the presynaptic neurons.
b) Decrease the amount of dopamine available in the substantia nigra.
c) Balance cholinergic and dopaminergic activity in the brain.
d) Block dopamine receptors in both presynaptic and postsynaptic neurons

Answer 102

c) Balance cholinergic and dopaminergic activity in the brain.

Question 103

The following drug is used to treat Parkinson’s by increasing release of DA and blocking uptake of DA. This drug is also known to cause liverdo reticularis as a side effect. Which drug is it?

a) Atropine (Sal-tropine, Atropen)
b) Rivastigamine (Exalon)
c) Trihexyphenidyl (Artane)
d) Amantadine (Symmetrel)

Answer 103

d) Amantadine (Symmetrel)

Question 104

Selegiline (Eldepryl) is another drug used for Parkinson’s disease treatment. The mechanism of action of Selegiline is what? It inhibits

a) both MAO- A&B enzyme
b) dopamine synthesis
c) dopamine release
d) MAO –B enzymes

Answer 104

d) MAO –B enzymes

Question 105

Levadopa/ carbidopa combination is considered better than the Levadopa alone for treatment for Parkinson’s. It is available as a combination formulation under two trade names Sinamet and Paracopa. The reason the combination works better is because:

a) more carbidopa is absorbed in the brain
b) carbidopa prevents levadopa degradation in the periphery
c) levadopa prevents carbidopa degradation in the periphery
d) carbidopa inhibits monoamine oxidase enzymes in the neuron

Answer 105

b) carbidopa prevents levadopa degradation in the periphery

Question 106

A nurse is providing patient education on a dopaime agonist prescribed for his treatment with Parkinson’s disease. The nurse warns that the patient should not be driving while on this drug as it may produce sleepy attacks as a side effect. Which drug is this patient prescribed?

a) Levadopa (Dopar)
b) Pramipexole (Mirapex)
c) Apomorphine
d) Amantadine (Symmetrel)

Answer 106

b) Pramipexole (Mirapex)

Question 107

A nurse cares for four elderly patients, all are diagnosed with Alzheimer’s disease and all take a particular cholinesterase inhibitor. The physician has prescribed one particular type of cholinesterase inhibitor that is selective to the brain, well tolerated and taken only once a day. Identify the drug the nurse would choose from the following list of cholinesterase inhibitors:

a) Donepezil (Aricept)
b) Rivastigmine (Exelon)
c) Galantamine (Reminyl)
d) Tacrine (Cognex)

Answer 107

a) Donepezil (Aricept)

Question 108

A patient with severe Alzheimer’s disease presents for a follow-up visit. She has been responding adversely to the cholinesterase inhibitor that she has been taking and her physician would like to switch her to the new drug Memantine (Namenda). The patient asks the prescriber how the drug works. The prescriber would be correct to say:

a) it stabilize microtubules to prevent neurofibrillary tangles
b) it block chloride ion entry via GABA receptors when extracellular GABA is low
c) it prevents the breakdown of acetylcholine
d) it block calcium ion entry via NMDA receptors when extracellular glutamate is low

Answer 108

d) it block calcium ion entry via NMDA receptors when extracellular glutamate is low

Question 109

Which of the following drugs decreases neurologic disability and clinical relapses
associated with multiple sclerosis by binding to DNA and inhibiting topoisomeraseII?
a) Mitoxantrone (Novantrone)
b) Ginko biloba
c) Interferon beta (Avonex & Rebif)
d) Glatiramer acetate (Copaxone)

Answer 109

a) Mitoxantrone (Novantrone)

Question 110

The major difference between the two different types of interferons Avonex (interferon 1a) and betaseron (interferon 1b) used to treat multiple sclerosis.

a) Avonex is a natural peptide where as betasetron has a random peptide sequence
b) Avonex has a random polypeptide sequence and betaseron has the interferon sequence
c) Avonex and betasetron both are similar but avonex has the additional glycoprotein sequence
d) Avonex and betaseron both have a scrambled amino acid sequence but Avonex is given by IV

Answer 110

c) Avonex and betasetron both are similar but avonex has the additional glycoprotein sequence

Question 111

The immunomodulator that promotes “T cell shift” and is a synthetic polypeptide that is used to treat multiple sclerosis is:

a) Mitoxantrone (Novontrone)
b) Natalizumab (Tysabri)
c) Glatimier acetate (Copaxone)
d) Interferon beta 1b (Betaserone)

Answer 111

c) Glatimier acetate (Copaxone)

Question 112

Natalizumab (Tysabri) is a drug for multiple sclerosis that is available only through the TOUCH Prescribing Program. In most patients this drug is well tolerated with a significant reduction of relapses and brain lesions. Natalizumab works by:

a) Acting as a decoy for the antibodies produced against myelin proteins
b) Binding to integrins and blocking leucocytes from exiting the vasculature
c) Binding to sphingosine-1-phosphate (SIP-1) receptor and sequestering lymphocytes
d) Binding to TNF alpha and suppressing the inflammatory reaction that causes destruction.

Answer 112

b) Binding to integrins and blocking leucocytes from exiting the vasculature

Question 113

The following is a neurodegenerative disease that causes the destruction of neurons and appears to be due toxic level accumulations of alpha-synuclein which in turn is a results of abnormal levels of parkin and ubiquitin proteins. Which one is it?

a) Multiple Schlerosis
b) Depression
c) Parkinson’s disease
d) Alzhiemer’s disease

Answer 113

c) Parkinson’s disease

Question 114

The following is the first oral immunomdoulator that was introduced for treatment for multiple schlerosis. This drug works by sequestering lymphocytes in the lymph nodes by blocking Sphingosine -1 –phosphate (SIP-1 ) receptor. Which one of the following drug is it?

a) Natalizumab (Tysabri)
b) Glatimier acetate (Copaxone)
c) Fingolimod (Gilneya)
d) Interferon beta 1a (Avonex)

Answer 114

c) Fingolimod (Gilneya)

Question 115

Beta amyloid , neuritic plaques, neurofibrillary tangles, and reduced cholinergic transmission are all pathophysiological characteristics of which CNS disorder?

a) Alzheimer’s disease
b) Multiple Sclerosis
c) Bipolar disorder
d) Schizophrenia

Answer 115

a) Alzheimer’s disease

Question 116

A nurse is providing patient education to patients and their families who experience seizures. To evaluate their understanding, the nurse asks the group several questions about medications. Which statement from the group best demonstrates an understanding of antiepileptic medication therapy?

a) Seizure medications can be monitored by monitoring their drug levels in the urine.
b) Maintenance of a seizure frequency chart is essential.
c) The monitoring period is 10 days for most patients.
d) Patients can safely drive during the monitoring period

Answer 116

b) Maintenance of a seizure frequency chart is essential.

Question 117

The only drug prescribed for treatment of all types of seizure disorder. The drug also causes pancreatitis and used prophylactic treatment of migraines and bipolar disorder. Which drug is it?

a) Carbamazepine (Tegretol)
b) Valproic acid (Depakote)
c) Ethosuximide (Zarontin)
d) Phenytoin (Dilantin)

Answer 117

b) Valproic acid (Depakote)

Question 118

Which traditional anti-epileptic drug works by selectively inhibiting hyperactive neurons? This drug also causes side effects such as gingival hyperplasia, skin rashes & also fetal malformations such as cleft lip, heart defects etc. if taken during pregnancy

a) Ethosuximide (Zarontin)
b) Phenytoin (Dilantin)
c) Valproic acid (Depakene or Depakote)
d) Phenobarbital

Answer 118

b) Phenytoin (Dilantin)

Question 119

Absence seizures are characterized by loss of consciousness for a brief time. Which prescription drug would the nurse expect for this type of seizure that is the only seizure drug that does not work through inhibition of sodium channels or GABA enhancement but works by inhibiting slow calcium channels instead?

a) Phenytoin (Dilantin)
b) Carbamazepine (Tegretol)
c) Ethosuximide (Zarontin)
d) Phenobarbital

Answer 119

c) Ethosuximide (Zarontin)

Question 120

The newer antiepileptic drugs are well tolerated than the older traditional antiepileptics but most are prescribed for adjuvant therapy along with traditional antiepileptics and therefore not indicated for monotherapy. However 3 of the drugs listed below are indicated for monotherapy except:

a) Topiramate (Topomax)
b) Lamotrigine (Lamictal)
c) Oxycarbamazapine (Trileptal).
d) Levetiracetam (Keppra)

Answer 120

d) Levetiracetam (Keppra)

Question 121

A patient is diagnosed with epilepsy. Further review of their medical history reveals that this patient is on an ‘older’ AED that is also approved to treat BPD and trigeminal & glossopharyngeal neuralgias. Adverse effects include CNS disturbances, hematologic (bone marrow) effects, birth defects, water retention, and mild to severe dermatologic effects. Which is it?

a) Phenobarbitol
b) Valproic acid (Depakene, others)
c) Carbamazepine (Tegretol)
d) Levetiracetam (Keppra)

Answer 121

c) Carbamazepine (Tegretol)

Question 122

The following CNS agent is used to reduce muscle spasticity associated with MS and cerebral palsy. It resembles GABA structurally and known to work through activation of these receptors. Which of the following drug is it?

a) Diazepam (Valium)
b) Baclofen (Lioresal)
c) Dantrolene (Dantrium)
d) Tizanidine (zanaflex)

Answer 122

b) Baclofen (Lioresal)

Question 123

A nursing instructor asks a student about the difference between the 2 agents given for treatment for spasticity: Dantrolone and Diazepam (Valium). The student would be correct in saying:

a) Dantrolene acts on the GABA receptor while Diazepam at the skeletal muscles
b) both act directly on skeletal muscles, but diazepam is a weaker agent.
c) Dantrolene acts directly on the skeletal muscle while Diazepam at the GABA site.
d) Diazepam acts through changes in muscle potassium and hydrogen concentrations while Dantrolone does not

Answer 123

c) Dantrolene acts directly on the skeletal muscle while Diazepam at the GABA site.

Question 124

This drug is the only exception that is used for treating both muscle spasm and
spasticity. Sedation is common when used to treat spasticity with this drug. Beneficial
effects appear to derive from action through GABA receptors in the CNS. Which drug is
it?
a) Baclofen (Lioseral)
b) Diazepam (Valium)
c) Thiopental (Pentothal)
d) Dantrolene (Dantrium)

Answer 124

b) Diazepam (Valium)

Question 125

The first approved antiseizure medication for bipolar disorder that works equivalent to lithium and used for prophylactic treatment as well as to treat acute manic episodes. This drug produces side effects such as thrombocytopenia and pancreatitis:

a) Carbamazapine (Equetro)
b) Lamotrigine (Lamictol)
c) Valproic acid ( Depakane, Depakot)
d) Ethosuxamide(Zarontin)

Answer 125

c) Valproic acid ( Depakane, Depakot)

Question 126

Bipolar disorder is a cyclic disorder characterized by abnormal elevation or depression separated by periods in which mood is relatively normal. Which class of drug (s) is (are) given during a depressive episode?

a) mood stabilizers
b) antipsychotics
c) antidepressants
d) a and c

Answer 126

d) a and c

Question 127

A patient’s lithium level is 0.6mEq/L. The nurse’s accurate understanding of lithium
therapeutics is best reflected by which statement?
a) The patient’s plasma level is below the toxic level of 3.0mEq/L and is considered therapeutic.
b) The patient’s plasma level exceeds 0.5mEq/L and is therefore toxic.
c) The patient’s plasma level is between 0.4- 1.0mEq/L, the maintenance level and is considered therapeutic.
d) The patient’s plasma level is below the 2.5-mEq/L level that would indicate toxicity

Answer 127

c) The patient’s plasma level is between 0.4- 1.0mEq/L, the maintenance level and is considered therapeutic.

Question 128

When comparing the effects and efficacy of Valproic acid (Depakene) with those of
Lithium for treatment of bipolar disorders, the nurse should understand that Valproic acid
__________________________ than Lithium
a) does not have more GI side effects.
b) does not cause more weight gain.
c) is associated with unintentional weight loss.
d) has a greater therapeutic index.

Answer 128

d) has a greater therapeutic index.

Question 129

A nurse is caring for a patient who just started on an antipsychotic drug and who begins to complain of severe muscle spasms of the tongue, face, and back. The patient is confused, has fever, and develops “lead pipe” rigidity. Based on these manifestations, which antipsychotic drug should the nurse suspect that the prescriber may have ordered?

a) Haloperidol (Haldol)
b) Olanzapine (Zyprexa)
c) Clozapine (clozaril)
d) aripriprazole (abilify)

Answer 129

a) Haloperidol (Haldol)

Question 130

The following drug (s) if taken together can counteract the antipsychotic action of conventional antipsychotic drugs:

a) Diabetic drugs
b) antihypertensive drugs
c) Levadopa or direct acting dopamine agonists
d) all of the above

Answer 130

c) Levadopa or direct acting dopamine agonists

Question 131

The following is an atypical antipsychotic agent that is referred to as a dopamine system stabilizer because it blocks or activates the dopamine receptor based on the amount of neurotransmitter present and therefore has less EPS side effects. Which drug is it?

a) Risperidone ( Risperidol)
b) Aripiprazole (Abilify)
c) Olanazapine (Zyprexa)
d) Ziprasidone [geodon]

Answer 131

b) Aripiprazole (Abilify)

Question 132

Clozapine (clozaril)is prescribed for a patient with a schizophreniform disorder. Which information would be the most important to include in the teaching plan for this patient?

a) Strategies to manage their BP
b) The importance of promptly reporting flulike symptoms
c) Contraceptive measures and expected changes in menstruation
d) it can cause weight gain and diabetes and agranulocytosis

Answer 132

d) it can cause weight gain and diabetes and agranulocytosis

Question 133

Which agent is a tricyclic antidepressant that is used as a day- time antidepressant due to its less sedating property? Also this particular drug is indicated for the elderly due to its weak anticholinergic properties:

a) Sertralin (Zoloft)
b) Desipramine (Norpramin)
c) Fluoxetine (prozac)
d) Citalopram (Celexa)

Answer 133

b) Desipramine (Norpramin)

Question 134

Monoamine oxidase inhibitor antidepressants are:

a) used first-line in the treatment of depression.
b) reserved for patients who have not responded to SSRIs and TCAs.
c) used in patients who have developed serotonergic syndrome.
d) indicated for patients who have difficulty sleeping

Answer 134

b) reserved for patients who have not responded to SSRIs and TCAs.

Question 135

A nurse is reviewing a patient’s antidepressant medication. The nurse understands that the following drug is a selective serotonin re-uptake inhibitor. The drug also causes side effects such as altered mental status (serotonin syndrome), bruxism etc: Which drug is it?

a) Duloxetine (Cymbalta)
b) Desipramine (Norpramin)
c) Fluoxetine (Prozac)
d) Isocarboxazid (Marplan)

Answer 135

c) Fluoxetine (Prozac)

Question 136

The newer drug available for treatment Duloxetine (Cymbalta) achieves its effects by:

a) selectively inhibiting serotonin reuptake. ]
b) blocking the uptake of monoamines.
c) inhibiting MAO-A in nerve terminals.
d) selectively inhibiting both serotonin and NE reuptake

Answer 136

d) selectively inhibiting both serotonin and NE reuptake

Question 137

A nurse is acting as a preceptor to a graduate student. They are discussing the differences between various sedative medications. The nurse observes that the student has a clear understanding of the sedative drugs when she says in contrast to benzodiazepines, barbiturates:

a) cannot cross the blood-brain barrier.
b) potentiate GABA action.
c) mimic GABA action at high doses
d) are not lipid soluble

Answer 137

c) mimic GABA action at high doses

Question 138

A patient is diagnosed with depression and started on an atypical antidepressant. While the exact MOA of this drug is unclear; it acts as stimulant, suppresses appetite & does not cause weight gain. This drug actually increases sexual desire and pleasure. Adverse effects usually are not serious but agitation and seizures have been reported. Which of the following is this drug?

a) Bupropion (Wellbutrin)
b) Fluoxetine (Prozac)
c) Imipramine (Tofranil)
d) Trazodone (Desyrel)

Answer 138

a) Bupropion (Wellbutrin)

Question 139

The benodiazapene like drugs are not structurally similar to benzodiazepines but function similar to benzodiazapenes. These drugs are primarily indicated for insomnia. Identify the benzodiazapene like drug from the following list:

a) Triazolom (Halcion)
b) Diazepam (Valium)
c) Eszopiclone (Lunesta)
d) alprazolom (Xanax)

Answer 139

c) Eszopiclone (Lunesta)

Question 140

A patient reports awakening at 1 AM after only 2 hours of sleep and is unable to return to sleep for several hours. The patient is becoming increasingly anxious and requests a sleeping medication that will not cause a “hangover.” The nurse would anticipate the prescriber to order which one of the following drugs?

a) phenoarbitol
b) Flurazepam (Dalmane)
c) Zaleplon (Sonata)
d) Secobarbitol

Answer 140

c) Zaleplon (Sonata)

Question 141

This newer drug prescribed for insomnia and does not cause rebound insomnia or physical dependence and is FDA approved for sleeping disorders. This drug does not cause tolerance or dependence, and is not regulated as a controlled substance. However the drug increases prolactin levels and thus has side effects such as galactorrhea, amenorrhea etc. Which drug is it?

a) Triazolam (Halcion)
b) Zolpidem (Ambien)
c) Zaleplon (Sonata)
d) Ramelteon (Rozerem)

Answer 141

d) Ramelteon (Rozerem)

Question 142

You are doing a rotation in an ER where a patient is being treated for an overdose of benzodiazepines. The attending administers a specific drug and the patient recovers. What drug is the specific antidote for benzodiazepine overdose/toxicity?

a) Rozerem (Ramelteon)
b) Atomoxetine (Strattera)
c) Zolpidem (Ambien)
d) Flumazenil (Romazicon)

Answer 142

d) Flumazenil (Romazicon)

Question 143

ADHD treatment involves CNS stimulants. Identify the stimulant that also causes appetite suppression and thus indicated for treatment for obesity and further weight loss:

a) Amphetamine (Adderell)
b) Methylphenidate (Ritalin)
c) Pemoline (Cylert)
d) Modafinal (Provigil)
e) Zolpidem (Ambien)

Answer 143

a) Amphetamine (Adderell)

Question 144

Most of the drugs given for ADHD treatment involve CNS stiumlants. The following is the first and only non-stimulant approved for ADHD treatment for both children and adults and is:

a) Pemoline (Cylert)
b) Ramelteon (Rozerem)
c) Atomoxetine (Strattera)
d) Doxapram (Dopram)

Answer 144

c) Atomoxetine (Strattera)

Question 145

This particular drug works by blocking adenosine receptors in the CNS or by increasing levels of second messengers such as cAMP. It is given for treatment of ADHD and neonatal apnea but has side effects such as CNS stimulation and also sensory phenomena such as ringing in ears and flashing lights. What drug is it?

a) Doxapram (Dopram)
b) Methylxanthine
c) Methylphenidate (Ritalin)
d) Atomoxetine (Strattera)

Answer 145

b) Methylxanthine

Question 146

Molecular properties of local anesthetics are listed below. Which combination of characteristics in a local anesthetic would you predict to penetrate axon membranes the fastest?

a) larger size, high lipid solubility and low ionization
b) smaller size, high lipid solubility and high ionization
c) larger size, low lipid solubility, high ionization
d) smaller size, high lipid solubility and low ionization

Answer 146

d) smaller size, high lipid solubility and low ionization

Question 147

The difference between lidocaine and procaine (novocain) is:

a) Lidocaine can trigger allergic reactions whereas procaine does not
b) Lidocaine. is metabolized by liver enzymes whereas procaine by blood esterases
c) Lidocaine is metabolized by blood esterases whereas procaine by liver enzynes
d) Procaine is used most widely than lidocaine due to its rapid, intense and prolonged effect

Answer 147

b) Lidocaine. is metabolized by liver enzymes whereas procaine by blood esterases

Question 148

Nitrous oxide has an extremely high minimum alveolar concentration (MAC) and because of this nitrous oxide:

a) can be used at low doses to achieve adequate anesthesia.
b) cannot be used alone to achieve surgical anesthesia
c) will require an additional agent to produce analgesia
d) will make the patient responsive to painful stimuli

Answer 148

b) cannot be used alone to achieve surgical anesthesia

Question 149

Which sedative-hypnotic IV drug used for the induction and maintenance of anesthesia poses the highest risk for sepsis from bacterial contamination?

a) Midazolam (Versed)
b) Propofol (Diprivan)
c) Etomidate (Amidate)
d) Ketamine (Ketalar)

Answer 149

b) Propofol (Diprivan)

Question 150

A nurse has received a patient back on the unit shortly after a minor surgery. The patient complains of disturbing dreams and displays evidence of delirium and hallucinations. After reviewing the operative record, the nurse confirms that the patient is experiencing an adverse effect of which anesthetic medication?

a) Etomidate (Amidate)
b) Droperidol
c) Ketamine (Ketalar)
d) Propofol (Diprivan)

Answer 150

c) Ketamine (Ketalar)