Nursing Pharmacology Final Exam at Fox Valley Technical College

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Free Nursing Pharmacology Final Exam at Fox Valley Technical College Questions

1.

A client with epilepsy has been taking phenytoin daily and has been seizure free for months. The client asks, "Why do I still need to get blood testing if I'm not having seizures?" Which of the following is the best response by the nurse?

  • "Phenytoin can cause blood-thinning in some patients."
  • "Phenytoin can deplete your system of sodium."
  • "Phenytoin has a very narrow range between a therapeutic dose and a toxic dose."
  • "Phenytoin can cause a decrease in calcium, which can be detected through blood testing."

Explanation

Explanation
Phenytoin is a antiepileptic drug with a narrow therapeutic index, meaning that the difference between a therapeutic dose and a toxic dose is small. Blood tests are necessary to monitor phenytoin levels to ensure the drug remains within the therapeutic range to effectively prevent seizures while avoiding potential toxicity, which can lead to side effects like nystagmus, ataxia, or more severe complications.
Correct Answer Is:
C. "Phenytoin has a very narrow range between a therapeutic dose and a toxic dose."
2.

The nurse is administering medications to clients on the medical unit. Using the knowledge of pharmacodynamics and pharmacokinetics, which medication does the nurse expect to reach therapeutic effect quickest? (Select 4 that apply)

  • Bisacodyl Suppository
  • Ketorolac IM
  • Levothyroxine Tablet
  • Sertraline Capsule
  • Ferrous sulfate tablet
  • Nitroglycerin sublingual tablet
  • Albuterol meter dose inhaler
  • Allopurinol tablet

Explanation

Explanation
Explanation of Correct Answers:

A. Bisacodyl Suppository
Suppositories are absorbed quickly through the rectal mucosa, bypassing the digestive system and liver metabolism, leading to rapid absorption. Bisacodyl acts directly in the colon and produces a quick therapeutic effect in relieving constipation.

B. Ketorolac IM
Intramuscular injections are rapidly absorbed into the bloodstream compared to oral medications. Ketorolac administered via the IM route provides quick analgesic effects, making it effective for pain management, especially in an acute setting.

F. Nitroglycerin sublingual tablet
Sublingual tablets are absorbed directly into the bloodstream through the mucous membranes under the tongue. This provides a rapid onset of action, especially in treating angina, as the medication bypasses the digestive tract and liver, reaching systemic circulation quickly.

G. Albuterol meter dose inhaler
Inhaled medications, such as albuterol, are rapidly absorbed through the lungs, providing almost immediate therapeutic effects in the airways. This makes inhalation therapy the quickest method for relief in conditions like asthma or COPD.


Correct Answer Is:
A. Bisacodyl Suppository
B. Ketorolac IM
F. Nitroglycerin sublingual tablet
G. Albuterol meter dose inhaler
3.

The client is admitted for pneumonia and was having difficulty breathing. After receiving an albuterol nebulizer treatment for the first time, the patient tells the nurse they can breathe better but feels like their heart is racing. The client is feeling anxious and wondering if their infection is getting worse. What is the nurse's best response?

  • "We will skip the next scheduled albuterol nebulizer."
  • "This is to be expected, but I will continue to monitor your breathing and pulse."
  • "I will notify the physician, because you are right, this may be a sign that your condition is worsening."
  • "These symptoms are more likely to be an allergy to the albuterol so I will notify your physician."

Explanation

Explanation
Explanation of Correct Answer:
B. "This is to be expected, but I will continue to monitor your breathing and pulse."
Albuterol is a bronchodilator used to treat breathing difficulties. One of its common side effects is tachycardia (increased heart rate), as it stimulates beta-2 receptors in the heart. The nurse should reassure the client that this is a known side effect, but still continue to monitor their breathing and pulse to ensure their condition is stable. This response is appropriate for a first-time treatment with albuterol.
Correct Answer Is:
B. "This is to be expected, but I will continue to monitor your breathing and pulse."
4.

The mechanism of action for cephalosporins is to disrupt the bacterial cell wall. What other antimicrobial drug class has a similar mechanism of action and may have cross sensitivity with cephalosporins?

  • Penicillin
  • Fluoroquinolones
  • Aminoglycosides
  • Sulfonamides

Explanation

Explanation
Explanation of Correct Answer:
Cephalosporins and penicillins both belong to the beta-lactam class of antibiotics, which work by disrupting the bacterial cell wall. Due to their structural similarities, there is a potential for cross-sensitivity between these two drug classes, meaning that patients who are allergic to penicillin may also have an allergic reaction to cephalosporins.
Correct Answer Is:
A. Penicillin
5.

Who is the client's last line of defense in preventing medication errors in the acute care and long-term care setting?

  • Pharmacist
  • Health Care Provider
  • Nurse
  • Pharmacy technician

Explanation

Explanation
The nurse is the final professional to assess, administer, and evaluate medications before they reach the client. This role includes verifying the five rights of medication administration, assessing the client for contraindications, allergies, and current status, clarifying unclear orders, and monitoring for adverse effects after administration. Because the nurse directly administers medications and observes the client’s response, they serve as the last safeguard against medication errors.
Correct Answer Is:
C. Nurse
6.

Which of the following statements are true regarding antipsychotic drugs? (Select 4 that apply.)

  • Antipsychotic drugs reverse mental illness
  • Antipsychotic drugs may cause neuroleptic malignant hyperthermia
  • Many symptoms of psychosis, like hallucinations, can be controlled with medication
  • Almost all clients are compliant with medications
  • Antipsychotic drugs may cause extrapyramidal symptoms
  • Antipsychotic drugs work by blocking dopamine receptors in the brain
  • Antipsychotic drugs may cause Cushing's disease
  • Antipsychotic drugs are reversed by Acetylcysteine

Explanation

Explanation
Explanation of Correct Answers:

B. Antipsychotic drugs may cause neuroleptic malignant hyperthermia
Neuroleptic malignant hyperthermia (NMS) is a rare but life-threatening condition that can occur with the use of antipsychotic medications. It is characterized by fever, muscle rigidity, and autonomic dysregulation. Immediate intervention is required if NMS is suspected.

C. Many symptoms of psychosis, like hallucinations, can be controlled with medication
Antipsychotic medications are effective in controlling symptoms of psychosis, including hallucinations, delusions, and disorganized thinking. These medications help manage these symptoms by modulating neurotransmitter activity, particularly dopamine.

E. Antipsychotic drugs may cause extrapyramidal symptoms
Extrapyramidal symptoms (EPS) include movement disorders like tremors, rigidity, bradykinesia, and tardive dyskinesia. These side effects can occur with antipsychotic medications, especially older first-generation antipsychotics.

F. Antipsychotic drugs work by blocking dopamine receptors in the brain
Antipsychotics primarily work by blocking dopamine receptors (D2 receptors) in the brain. This action helps to control dopaminergic overactivity, which is thought to contribute to the symptoms of psychosis, such as hallucinations and delusions.


Correct Answer Is:
B. Antipsychotic drugs may cause neuroleptic malignant hyperthermia
C. Many symptoms of psychosis, like hallucinations, can be controlled with medication
E. Antipsychotic drugs may cause extrapyramidal symptoms
F. Antipsychotic drugs work by blocking dopamine receptors in the brain
7.

What is the mechanism of action of the H1-receptor blockers such as diphenhydramine (Benadryl)?

  • They block the leukotriene receptors in the nasal passages.
  • They block catecholamines in the respiratory tract.
  • They block histamine in smooth muscle found in the respiratory tract.
  • They are primarily blocking histamine in the gastric parietal cells.

Explanation

Explanation
Explanation of Correct Answer:
C. They block histamine in smooth muscle found in the respiratory tract.
H1-receptor blockers, such as diphenhydramine (Benadryl), are antihistamines that work by blocking histamine receptors (specifically H1 receptors) in various tissues, including the respiratory tract. Histamine is a chemical released during allergic reactions that causes symptoms like bronchoconstriction, nasal congestion, and swelling. By blocking these receptors, antihistamines help relieve symptoms like sneezing, runny nose, and congestion associated with allergic reactions.
Correct Answer Is:
C. They block histamine in smooth muscle found in the respiratory tract.
8.

The provider orders a parenteral dose of steroids for the client with an acute exacerbation of chronic obstructive pulmonary disease (COPD). The nurse recognizes and monitors for which of the following adverse effects of steroids? (Select 4 that apply)

  • Hyperglycemia
  • Red Man's syndrome
  • Increased risk for infection
  • Decreased HDL levels
  • Behavioral changes
  • Fluid retention and weight gain
  • Hypotension
  • Decreased appetite

Explanation

Explanation
Explanation of Correct Answers:

A. Hyperglycemia
Steroids, especially when administered for longer periods or in high doses, can increase blood sugar levels, leading to hyperglycemia. This occurs because steroids can induce insulin resistance, affecting the body's ability to regulate blood sugar.

C. Increased risk for infection
Steroids suppress the immune system, which can lead to an increased risk for infections. This is especially important for clients on long-term or high-dose steroid therapy, as their ability to fight off infections is reduced.

D. Decreased HDL levels
Steroids can lead to a decrease in HDL (high-density lipoprotein), which is known as "good cholesterol." A reduction in HDL levels increases the risk for cardiovascular issues, especially with long-term steroid use.

F. Fluid retention and weight gain
Steroids promote fluid retention by causing the kidneys to retain sodium and water. This can lead to weight gain due to increased fluid volume, contributing to edema, particularly in the lower extremities.


Correct Answer Is:
A. Hyperglycemia
C. Increased risk for infection
D. Decreased HDL levels
F. Fluid retention and weight gain
9.

A client with Parkinson's Disease is prescribed benztropine (Cogentin), an anticholinergic medication structurally similar to Atropine. Which adverse drug effect limits the usefulness of anticholinergic agents?

  • Urinary retention
  • Hypotension
  • Bradycardia
  • Increased salivation

Explanation

Explanation
Anticholinergic medications, like benztropine, block the action of acetylcholine, which can lead to several adverse effects. One significant side effect is urinary retention, as these medications can decrease bladder contractility, leading to difficulty urinating. This side effect limits the usefulness of anticholinergics, particularly in patients who are prone to urinary retention, as it can worsen their symptoms.
Correct Answer Is:
A. Urinary retention
10.

The nurse administers a dose of 4mg ondansetron (Zofran) to a client receiving chemotherapy. Which following assessment finding would indicate that the medication was effective for the client?

  • The client reports a decrease in pain
  • The client has improved oral intake
  • The client's white blood cell count increases
  • The client has decreased diarrhea

Explanation

Explanation
Explanation of Correct Answer:
Ondansetron (Zofran) is an antiemetic commonly used to prevent and treat nausea and vomiting, particularly in clients receiving chemotherapy. If the client is able to improve oral intake, it indicates that the nausea and vomiting have been effectively managed, as they are common side effects of chemotherapy. This suggests that the medication has been effective in controlling these symptoms.
Correct Answer Is:
B. The client has improved oral intake

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