NUA 285 Pharmacotherapeutics at Georgian Court University

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Free NUA 285 Pharmacotherapeutics at Georgian Court University Questions

1.

What is a potential serious complication of abrupt cessation of beta-blockers like metoprolol?

  • Rebound hypertension​

  • Sedation​

  • Hypoglycemia​

  • Hyperkalemia

Explanation

Correct Answer Is:
A. Rebound hypertension
Explanation
Abruptly stopping beta-blockers such as metoprolol can cause rebound hypertension, tachycardia, and even angina or myocardial infarction in patients with heart disease. This occurs because beta-blockers suppress sympathetic nervous system activity; sudden withdrawal leads to overstimulation of beta receptors. To prevent this dangerous effect, beta-blockers should always be tapered gradually under medical supervision while monitoring blood pressure and heart rate closely.
2.

A patient diagnosed with diabetes is being discharged to home with regular insulin and insulin glargine (Lantus). During discharge teaching, the patient asks what is the difference between the two types of insulin. What is your best response?

  • "Insulin glargine will only be given if your blood sugars are higher than 200 mg/dL."​

  • "Insulin glargine is the same as regular insulin, and you will require several injections during the day."​

  • "Insulin glargine helps to manage elevated blood sugars after you eat, and you will require injections three times a day."​

  • "Insulin glargine will help control your blood sugar for 24 hours and will need to be given one time per day."

Explanation

Correct Answer Is:
D. "Insulin glargine will help control your blood sugar for 24 hours and will need to be given one time per day."
Explanation
Insulin glargine (Lantus) is a long-acting basal insulin that provides steady blood glucose control for approximately 24 hours with once-daily administration. It maintains consistent insulin levels, reducing the risk of peaks and hypoglycemia between meals and overnight. In contrast, regular insulin is short-acting, used to manage blood sugar spikes after meals. Educating the patient about the timing and purpose of each type of insulin ensures safe and effective diabetes management.
3.

A nurse is monitoring a client who received epinephrine for angioedema after a first dose of losartan. Which of the following data indicates a therapeutic response to the epinephrine?

  • Client reports decreased groin pain of 3 on a 1 to 10 scale.​

  • The client tolerates a second dose of medication with no greater than 1+ peripheral edema.​

  • The client’s blood pressure when arising from resting position is at premedication levels.​

  • Respirations are unlabored.

Explanation

Correct Answer Is:
D. Respirations are unlabored.
Explanation
Epinephrine is administered during angioedema to counteract severe allergic reactions that cause airway swelling and respiratory distress. A therapeutic response is demonstrated by improved airway patency, reduced swelling, and unlabored respirations, indicating that the airway obstruction has resolved. The nurse should continue to monitor oxygen saturation, respiratory rate, and breath sounds. Other options, such as pain relief or changes in peripheral edema, are unrelated to the effectiveness of epinephrine in reversing life-threatening airway compromise.
4.

A patient comes to the ER with complaints of shortness of breath, wheezing, an O₂ saturation of 92%, respiratory rate of 28, and heart rate of 110. The patient took a short-acting beta₂ agonist prior to coming to the ER. Which drug will the nurse anticipate administering to the patient first?

  • Albuterol​

  • Theophylline​

  • Epinephrine​

  • Dexamethasone

Explanation

Correct Answer Is:
D. Dexamethasone
Explanation
Because the patient has already used a short-acting beta₂ agonist (such as albuterol) with persistent symptoms, the next step is to administer a systemic corticosteroid, such as dexamethasone. Corticosteroids reduce airway inflammation, decrease mucus production, and enhance the effectiveness of beta₂ agonists. This helps restore airway patency and improve oxygenation. Epinephrine is typically reserved for severe allergic reactions (anaphylaxis), and theophylline is not used for acute asthma exacerbations due to its slow onset and narrow therapeutic range.
5.

A patient with angina has been given 0.4 mg of nitroglycerin SL. The patient reports continued chest pain 5 minutes later. The nurse assesses a heart rate of 84 beats per minute and a blood pressure of 88/68 mm Hg. The nurse will take which action?

  • Notify the provider of the patient’s vital signs​

  • Give nitroglycerin by translingual spray​

  • Administer 0.4 mg of nitroglycerin SL​

  • Administer 0.3 mg of nitroglycerin SL

Explanation

Correct Answer Is:
A. Notify the provider of the patient’s vital signs
Explanation
Nitroglycerin causes vasodilation, which can lead to significant hypotension. Since the patient’s blood pressure is already 88/68 mm Hg, administering another dose could cause severe cardiovascular collapse. The nurse should withhold additional nitroglycerin and notify the healthcare provider immediately. The provider may order IV fluids or other interventions to stabilize the patient’s blood pressure.
If the systolic BP were above 90 mm Hg, another SL dose could be safely administered every 5 minutes (up to three total doses). However, in this case, the hypotension makes further dosing unsafe.
6.

What is the primary purpose of levodopa in Parkinson's disease treatment?

  • To decrease acetylcholine levels​

  • To cure Parkinson's disease​

  • To reduce symptoms of anxiety​

  • To increase dopamine levels in the brain

Explanation

Correct Answer Is:
D. To increase dopamine levels in the brain
Explanation
Levodopa is a precursor of dopamine that crosses the blood–brain barrier, where it is converted into dopamine. Parkinson’s disease is characterized by dopamine deficiency in the basal ganglia, leading to tremors, rigidity, and bradykinesia. By restoring dopamine levels, levodopa improves motor function and reduces symptoms but does not cure the disease or stop its progression. It is often combined with carbidopa to prevent peripheral breakdown and enhance its effectiveness.
7.

Order: Ascorbic Acid 200 mg IM every day.​ Available: Ampule containing Ascorbic Acid 500 mg/2 mL.​ How many mL will be given?

  • 0.5 mL​

  • 0.6 mL​

  • 0.8 mL​

  • 1 mL

Explanation

Correct Answer Is:
C. 0.8 mL
Explanation
Use the formula:
(Desired dose ÷ Available dose)×Volume=(200÷500)×2=0.8 mL
The nurse will administer 0.8 mL IM of Ascorbic Acid to deliver the ordered 200 mg dose safely and accurately.
8.

The nurse is teaching a client about sucralfate. Which statement made by the patient requires additional teaching?

  • "I need to take sucralfate 30 minutes after meals."​

  • "I need to report pain or vomiting of blood."​

  • "I need to take my antacid 30 minutes before or 30 minutes after sucralfate."​

  • "I need to increase my fluid intake."

Explanation

Correct Answer Is:
A. "I need to take sucralfate 30 minutes after meals."
Explanation
Sucralfate is a mucosal protectant that forms a barrier over ulcers, protecting them from stomach acid and promoting healing. It must be taken on an empty stomach, typically 1 hour before meals and at bedtime, to be effective. Therefore, the statement about taking it after meals shows a misunderstanding and requires further teaching. Patients should also be instructed to separate sucralfate from antacids by at least 30 minutes, report pain or signs of GI bleeding (vomiting blood, black stools), and increase fluid intake to prevent constipation, a common side effect.
9.

A patient is prescribed diltiazem for hypertension. What should the nurse monitor the patient for?

  • Gout​

  • Chronic kidney disease​

  • Heart failure​

  • Hyperthyroidism

Explanation

Correct Answer Is:
C. Heart failure
Explanation
Diltiazem is a calcium channel blocker (CCB) that lowers blood pressure by reducing myocardial contractility and causing vasodilation. Because it decreases the force of cardiac contraction and slows conduction through the AV node, it can worsen or precipitate heart failure, especially in patients with preexisting ventricular dysfunction.
The nurse should monitor for signs of heart failure, including shortness of breath, peripheral edema, weight gain, and crackles in the lungs. Blood pressure and heart rate should also be regularly assessed to detect hypotension or bradycardia.
10.

A patient who has pain with urination associated with cystitis will be discharged home with a prescription for phenazopyridine (Pyridium). What instruction will the nurse include when teaching the patient about this drug?

  • "Report reddish-brown urine to the provider immediately."​

  • "The drug provides symptomatic relief of pain."​

  • "Do not take this drug concurrently with an antibiotic."​

  • "This drug has antiseptic and analgesic properties."

Explanation

Correct Answer Is:
B. "The drug provides symptomatic relief of pain."
Explanation
Phenazopyridine (Pyridium) is a urinary tract analgesic used to relieve pain, burning, urgency, and discomfort caused by irritation of the urinary tract mucosa, commonly seen in cystitis. It does not treat the infection itself—antibiotics are required for that purpose—but it provides symptomatic relief until the infection resolves. The nurse should inform the patient that reddish-orange or reddish-brown urine discoloration is a normal, harmless side effect, not something to report as an emergency. Patients should also take the drug after meals to reduce gastrointestinal discomfort and use it only for short-term relief (typically 1–2 days) while antibiotic therapy takes effect.

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