Pharmacology Quiz 2 NU 160
Pharmacology Quiz 2 – NU 160 Practice Questions With Answers
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Covers drug classifications, mechanisms of action, side effects, and safe administration practices
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Includes clinical scenarios and medication calculation problems
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Aligned with nursing pharmacology objectives for NU 160
Detailed rationales to boost comprehension, retention, and safe medication administration
Designed to build your confidence in:
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Dosage calculations and conversions
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Recognizing adverse effects and contraindications
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Applying the “Rights of Medication Administration” in real-world scenarios
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Free Pharmacology Quiz 2 NU 160 Questions
A nurse is teaching a client who has a new prescription for cyclobenzaprine. Which of the following information should the nurse include in the teaching
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Monitor for increased muscle spasms
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Discontinue medication if nausea occurs.
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Expect urine to turn orange
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Avoid driving until effects are known.
Explanation
Correct Answer D: Avoid driving until effects are known.
Explanation of the Correct Answer:
Cyclobenzaprine is a centrally acting skeletal muscle relaxant commonly prescribed to treat acute muscle spasms associated with musculoskeletal conditions. It works by depressing motor activity primarily in the brainstem, leading to muscle relaxation. One of the most important safety considerations when starting cyclobenzaprine is its sedative effect, which can cause drowsiness, dizziness, and impaired cognitive or motor performance.
Because of these central nervous system effects, clients are advised to avoid driving, operating heavy machinery, or engaging in hazardous activities until they understand how the drug affects them individually. This is particularly crucial during the initial stages of treatment or when the dose is increased, as sedation may be pronounced.
Why the Other Options Are Incorrect:
A. Monitor for increased muscle spasms
Incorrect. Cyclobenzaprine is used to reduce muscle spasms, not increase them. If spasms worsen, it may indicate an ineffective response, but it is not a common or expected adverse effect of the drug.
B. Discontinue medication if nausea occurs.
Incorrect. Nausea is a relatively mild and non-life-threatening side effect of cyclobenzaprine. It should not be a reason for abrupt discontinuation. Instead, clients should report persistent or severe nausea to their provider, who may adjust the dose or provide supportive measures.
C. Expect urine to turn orange
Incorrect. Orange discoloration of urine is associated with medications like phenazopyridine, not cyclobenzaprine. This is not an expected or typical side effect of this muscle relaxant.
Summary:
The nurse should teach the client to avoid driving until the effects of cyclobenzaprine are known, due to its potential to cause sedation and impair motor and cognitive function, especially during the initial treatment period.
Which of the following statements are true regarding patient teaching for clients taking azathioprine
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. Clients should avoid live vaccines while on immunomodulator therapy.
B.
C.
D.
E. Clients should report any signs of infection immediately, such as fever or unusual fatigue.
F. Clients can discontinue their medication if they feel well after a few weeks. -
It is safe to receive live vaccines if administered at least 30 days after starting the medication.
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Regular follow-up visits and bloodwork are essential for monitoring health status.
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Handwashing is not necessary if the client avoids sick individuals.
Explanation
Correct Answers:
A. Clients should avoid live vaccines while on immunomodulator therapy.
C. Regular follow-up visits and bloodwork are essential for monitoring health status.
E. Clients should report any signs of infection immediately, such as fever or unusual fatigue.
Explanation of the Correct Answers:
Azathioprine is an immunosuppressant often used to treat autoimmune conditions like inflammatory bowel disease (IBD) and rheumatoid arthritis, and to prevent organ transplant rejection. Because it suppresses the immune system, specific safety precautions and monitoring are essential.
A. Clients should avoid live vaccines while on immunomodulator therapy.
Correct. Live vaccines (such as MMR, varicella, and intranasal flu vaccine) can pose a serious risk of infection in immunosuppressed individuals. Clients should be instructed to avoid live vaccines unless cleared by their healthcare provider.
C. Regular follow-up visits and bloodwork are essential for monitoring health status.
Correct. Azathioprine can cause bone marrow suppression, liver toxicity, and increased infection risk. Regular CBCs and liver function tests are essential to monitor for leukopenia, anemia, or hepatotoxicity.
E. Clients should report any signs of infection immediately, such as fever or unusual fatigue.
Correct. Because azathioprine weakens the immune system, clients are at increased risk of infections. Fever, sore throat, or unexplained fatigue should be reported immediately, as they may indicate a serious infection.
Why the Other Options Are Incorrect:
B. It is safe to receive live vaccines if administered at least 30 days after starting the medication.
Incorrect. Live vaccines are generally contraindicated during immunosuppressive therapy regardless of timing, unless specifically advised by a specialist.
D. Handwashing is not necessary if the client avoids sick individuals.
Incorrect. Frequent handwashing is essential for infection prevention, especially when the immune system is compromised. Avoiding sick individuals is not a substitute for good hygiene practices.
F. Clients can discontinue their medication if they feel well after a few weeks.
Incorrect. Azathioprine must be taken consistently as prescribed. Stopping without medical guidance can lead to relapse or rejection in transplant patients. Always consult a healthcare provider before making changes.
Summary:
Correct patient teaching for azathioprine includes avoiding live vaccines, attending regular bloodwork appointments, and promptly reporting infection signs. Stopping the medication without medical advice or neglecting hygiene are unsafe practices.
A nurse is assessing a client who is on long-term omeprazole therapy. Which of the following findings should indicate to the nurse the medication is effective
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Regular bowel movements
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Increased appetite
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Reduced dyspepsia
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Absence of headache
Explanation
Correct Answer C: Reduced dyspepsia
Explanation of the Correct Answer:
Omeprazole is a proton pump inhibitor (PPI) that works by reducing gastric acid production. It is commonly prescribed to treat conditions like gastroesophageal reflux disease (GERD), peptic ulcers, and dyspepsia (indigestion). Reduced dyspepsia—which includes symptoms like heartburn, bloating, and discomfort after eating—is a clear indication that omeprazole is effective in decreasing gastric acid secretion and improving the client's symptoms.
Why the Other Options Are Incorrect:
A. Regular bowel movements
Incorrect. Omeprazole does not directly affect bowel movements. While it may help with stomach acid, it is not intended to regulate bowel function.
B. Increased appetite
Incorrect. Omeprazole does not typically cause increased appetite. If a client experiences changes in appetite, other factors should be considered, such as medication side effects or underlying conditions.
D. Absence of headache
Incorrect. Headaches are not a primary symptom of the conditions that omeprazole treats, and the absence of a headache is not a direct indicator of the medication's effectiveness.
Summary:
The most appropriate indicator of omeprazole's effectiveness in this case is reduced dyspepsia, as the drug is designed to alleviate symptoms related to excessive stomach acid.
A nurse is caring for a client who is receiving mydriatic eye drops. Which of the following manifestations indicates to the nurse that the client has developed a systemic anticholinergic effect
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Seizures
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Bradycardia
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Hypothermia
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Constipation
Explanation
Correct Answer D: Constipation
Explanation of the Correct Answer:
Mydriatic eye drops, which are often used to dilate the pupils, contain medications that can have anticholinergic effects on the body. These effects occur because the drug blocks acetylcholine, a neurotransmitter involved in the parasympathetic nervous system. Common systemic anticholinergic effects include dry mouth, blurred vision, urinary retention, and constipation. Constipation is a hallmark of anticholinergic toxicity due to reduced intestinal motility. If the client shows signs of constipation, it should be reported, as this could indicate an excessive systemic absorption of the drug.
Why the Other Options Are Incorrect:
A. Seizures:
Seizures are not a common systemic effect of anticholinergic medications like mydriatic drops. While severe toxicity could cause CNS symptoms, seizures are typically not the first sign.
B. Bradycardia:
Bradycardia (slow heart rate) is generally associated with cholinergic effects, which stimulate the parasympathetic nervous system. Mydriatic eye drops cause anticholinergic effects, which typically result in tachycardia (increased heart rate), not bradycardia.
C. Hypothermia:
Hypothermia is not typically a result of anticholinergic effects. Anticholinergic drugs might cause fever (hyperthermia) due to impaired sweating and thermoregulation, not hypothermia.
Summary:
The manifestation that indicates a systemic anticholinergic effect from mydriatic eye drops is constipation, as these medications can slow down gastrointestinal motility. If the client exhibits this symptom, the nurse should monitor for potential anticholinergic toxicity.
Which of the following statements is true about the adverse effects of isoniazid
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Isoniazid can cause ringing in the ears
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Isoniazid can cause pain in the joints.
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Isoniazid can cause tingling of the hands.
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Isoniazid can cause yellowing of the skin
Explanation
Correct Answer C: Isoniazid can cause tingling of the hands.
Explanation of the Correct Answer:
C. Isoniazid can cause tingling of the hands.
Isoniazid is an antibiotic used to treat tuberculosis (TB), and one of its known adverse effects is peripheral neuropathy, which causes tingling, numbness, or a "pins and needles" sensation in the hands and feet. This is a result of nerve damage, often due to the drug’s effects on vitamin B6 (pyridoxine) metabolism. Patients on isoniazid are sometimes given vitamin B6 supplements to help prevent this side effect.
Why the Other Options Are Incorrect:
A. Isoniazid can cause ringing in the ears.
Ringing in the ears, or tinnitus, is not a typical side effect of isoniazid. It is more commonly associated with ototoxic drugs, like certain antibiotics (e.g., aminoglycosides) or chemotherapy agents, but not isoniazid.
B. Isoniazid can cause pain in the joints.
While joint pain is not a common adverse effect of isoniazid, it may rarely cause arthralgia (joint pain). However, this is not one of the main or characteristic side effects of the drug.
D. Isoniazid can cause yellowing of the skin.
Yellowing of the skin (jaundice) is more often related to liver dysfunction. While isoniazid can affect liver function (causing hepatotoxicity), it typically causes elevated liver enzymes, but yellowing of the skin is not a typical presentation. Jaundice may occur in severe liver toxicity, but it’s not a direct or common adverse effect of isoniazid alone.
Summary:
The correct answer is C because tingling in the hands (peripheral neuropathy) is a known adverse effect of isoniazid. Other side effects, such as pain in the joints, tinnitus, and jaundice, are not typical for this drug, although liver toxicity (which can lead to jaundice) is a known, though less frequent, serious side effect.
Which of the following medications are classified as 5-Aminosalicylates for the treatment of inflammatory bowel diseases
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Infliximab
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Adalimumab
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Mesalamine
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Tofacitinib
- Sulfasalazine
Explanation
Correct Answer:
C. Mesalamine
E. Sulfasalazine
Explanation:
5-Aminosalicylates (5-ASAs) are a class of drugs commonly used to treat inflammatory bowel diseases (IBD) like ulcerative colitis and Crohn's disease. These drugs help to reduce inflammation in the intestines and are considered first-line therapies for managing mild to moderate IBD.
Mesalamine (also known as 5-ASA) is a primary medication in this class. It is used to reduce inflammation and treat symptoms of ulcerative colitis and other forms of IBD.
Sulfasalazine is also a 5-ASA medication. It is a prodrug that breaks down into sulfa (which has anti-inflammatory properties) and 5-ASA, which helps to reduce intestinal inflammation. Sulfasalazine is often used for ulcerative colitis and Crohn's disease.
Why the Other Options Are Incorrect:
A. Infliximab is not a 5-ASA. It is a biologic medication classified as a tumor necrosis factor (TNF) inhibitor. It works by targeting TNF-alpha, which plays a role in the inflammatory process of IBD. Infliximab is used for more moderate to severe cases of IBD, including Crohn’s disease and ulcerative colitis, but it is not a 5-ASA.
B. Adalimumab is also a TNF inhibitor and works in a similar way to infliximab. Like infliximab, it is used for moderate to severe IBD, but it is not classified as a 5-aminosalicylate.
D. Tofacitinib is a Janus kinase (JAK) inhibitor, which is used in ulcerative colitis and rheumatoid arthritis. It works by inhibiting the action of specific enzymes involved in the inflammatory process. It is not a 5-ASA.
Summary:
The medications classified as 5-Aminosalicylates (5-ASAs) for the treatment of inflammatory bowel diseases in the provided options are Mesalamine and Sulfasalazine.
A nurse at an ophthalmology clinic is providing teaching to a client who has open-angle glaucoma and a new treatment regimen of timolol and pilocarpine eye drops. Which of the following instructions should the nurse provide
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Hold pressure on the conjunctiva sac for 2 min following application of drops.
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It is not necessary to remove contact lenses before administering medications
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Administer the medications 5 minutes apart.
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Administer the medications by touching the tip of the dropper to the surface of the eye.
Explanation
Correct Answer C: Administer the medications 5 minutes apart.
Explanation of the Correct Answer:
It is important to administer timolol and pilocarpine eye drops at least 5 minutes apart to ensure that one medication does not dilute or interfere with the action of the other. By waiting between administrations, you maximize the effectiveness of each medication.
Why the Other Options Are Incorrect:
A. Hold pressure on the conjunctiva sac for 2 min following application of drops.
Incorrect. While punctal occlusion is often recommended with some eye medications to reduce systemic absorption, this is more critical with medications that have significant systemic side effects (e.g., timolol). However, this is not the best choice in this scenario as per standard practice.
B. It is not necessary to remove contact lenses before administering medications.
Incorrect. Contact lenses should be removed before administering eye drops, as some medications can adhere to the lenses, causing irritation or affecting the drug's effectiveness.
D. Administer the medications by touching the tip of the dropper to the surface of the eye.
Incorrect. The dropper tip should never touch the eye or eyelashes to avoid contamination and possible infection.
Summary:
The correct teaching for the client is to administer the medications 5 minutes apart to allow each medication to be effective without interference.
Which of the following statements regarding the side effects of adalimumab and self-injection technique are true
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The injection site should be kept moist to prevent infection.
B.
C.
D.
E. Adalimumab can lead to reactivation of tuberculosis.
F. The medication should be injected into the muscle of the upper arm. -
Redness or mild pain at the injection site is a common side effect.
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Patients should monitor for signs of infection after self-injection.
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Infections are not a concern with adalimumab treatment.
Explanation
Correct Answers:
B. Redness or mild pain at the injection site is a common side effect.
C. Patients should monitor for signs of infection after self-injection.
E. Adalimumab can lead to reactivation of tuberculosis.
Explanation of the Correct Answers:
B. Redness or mild pain at the injection site is a common side effect.
This is a well-known side effect of subcutaneous injections, including adalimumab. The injection can cause localized redness, mild pain, swelling, or itching at the site. This is usually temporary and resolves on its own.
C. Patients should monitor for signs of infection after self-injection.
Adalimumab, like other biologic medications, can increase the risk of infections. Because it suppresses the immune system, patients should be vigilant and monitor for symptoms such as fever, redness, or swelling at the injection site, or signs of systemic infection like chills or cough.
E. Adalimumab can lead to reactivation of tuberculosis.
Adalimumab can suppress the immune system and potentially reactivate latent tuberculosis (TB) infections. Patients are often screened for TB prior to starting adalimumab therapy to reduce the risk of reactivation.
Why the Other Options Are Incorrect:
A. The injection site should be kept moist to prevent infection.
Incorrect. The injection site should be kept clean and dry. Moisture can increase the risk of infection, and patients should follow proper cleaning techniques before administering the injection. Typically, alcohol wipes are used to clean the skin prior to injection.
D. Infections are not a concern with adalimumab treatment.
Incorrect. Infections are a significant concern with adalimumab therapy because it suppresses the immune system, increasing the risk of both local and systemic infections. This is why infection monitoring is crucial during treatment.
F. The medication should be injected into the muscle of the upper arm.
Incorrect. Adalimumab is typically administered subcutaneously, not intramuscularly. Common injection sites include the abdomen or the front of the thigh. Injecting into the muscle of the upper arm is not the recommended method.
Summary:
The true statements regarding adalimumab's side effects and self-injection technique are: redness or mild pain at the injection site is common, patients should monitor for signs of infection, and adalimumab can lead to reactivation of tuberculosis. Proper injection technique and infection monitoring are essential components of safe adalimumab use.
A nurse is teaching a client who has chronic obstructive pulmonary disease and is to start using fluticasone by MDI twice daily. Which of the following instructions should the nurse include
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Skip the morning dose if you do not have any symptoms.
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Inspect your mouth for lesions daily
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Use this medication to relieve an asthma attack.
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Check your heart rate before each dose
Explanation
Correct Answer B: Inspect your mouth for lesions daily.
Explanation of the Correct Answer:
Fluticasone is an inhaled corticosteroid (ICS) used for the long-term control of chronic obstructive pulmonary disease (COPD) and asthma. It helps reduce inflammation in the airways, making breathing easier over time.
One of the potential side effects of inhaled corticosteroids like fluticasone is the development of oral thrush, which is a fungal infection that can cause lesions in the mouth. It is important for the client to inspect their mouth daily for any signs of white patches, sores, or irritation. If these symptoms occur, the client should report them to their healthcare provider, as they may need treatment with antifungal medication. Rinsing the mouth with water after using the inhaler can help prevent this side effect.
Why the Other Options Are Incorrect:
A. Skip the morning dose if you do not have any symptoms.
This is not a recommended instruction. Fluticasone is a maintenance medication used regularly to control inflammation and symptoms over time. Even if the client does not have symptoms, it is important to use the medication as prescribed. Skipping doses could reduce its effectiveness in managing the condition.
C. Use this medication to relieve an asthma attack.
This is incorrect. Fluticasone is a preventive medication, not a rescue medication. It does not provide immediate relief during an asthma attack. For acute attacks, the client should use a short-acting beta-agonist (SABA), such as albuterol, which works quickly to open the airways.
D. Check your heart rate before each dose.
Checking the heart rate is not typically necessary for fluticasone use. Fluticasone does not have significant effects on heart rate. However, if the client is taking other medications that could affect the heart rate (such as certain bronchodilators), they might need to monitor their heart rate, but it is not required for fluticasone itself.
Summary:
The correct instruction is B because oral thrush is a common side effect of inhaled corticosteroids like fluticasone. Checking the mouth for lesions daily helps detect and prevent this issue early.
Which of the following are recommended treatments for TB
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Ethambuto
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Isoniazid
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Pyrazinamide
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Rifampicin
- Clindamycin
- Ciprofloxacin
Explanation
Correct Answer:
A. Ethambutol
B. Isoniazid
C. Pyrazinamide
D. Rifampicin
Explanation of the Correct Answer:
The treatment of tuberculosis (TB) usually involves a combination of drugs to effectively kill the bacteria and prevent resistance. The first-line medications commonly used for treating TB are:
A. Ethambutol :
This is an important drug in the treatment of TB. It works by inhibiting the synthesis of the mycobacterial cell wall. Ethambutol is typically used in combination with other TB drugs.
B. Isoniazid :
Isoniazid is a key antibiotic used to treat active TB. It works by inhibiting the synthesis of mycolic acids, which are essential components of the mycobacterial cell wall.
C. Pyrazinamide :
Pyrazinamide is used in the initial phase of treatment for TB, particularly effective against dormant bacteria within macrophages. It plays an important role in shortening the duration of therapy.
D. Rifampicin :
Rifampicin is a potent antibiotic that inhibits bacterial RNA synthesis. It is a cornerstone of TB treatment and is often used in combination with other drugs to prevent resistance.
These four drugs, when used together in combination, form the core treatment regimen for TB, typically for a duration of at least six months.
Why the Other Options Are Incorrect:
E. Clindamycin :
Clindamycin is an antibiotic, but it is not used to treat TB. It is typically used for treating infections caused by certain types of bacteria, such as Gram-positive cocci and some anaerobic bacteria, but it does not have efficacy against Mycobacterium tuberculosis, the bacterium responsible for TB.
F. Ciprofloxacin :
Ciprofloxacin is a fluoroquinolone antibiotic that can be used in drug-resistant TB in some cases. However, it is not part of the first-line treatment regimen for typical TB. It might be used as part of a second-line treatment in resistant TB strains, but it's not a routine treatment.
Summary:
The recommended treatments for TB are ethambutol, isoniazid, pyrazinamide, and rifampicin. These medications are typically used in combination as part of a first-line therapy for TB. Clindamycin and ciprofloxacin are not typically used for standard TB treatment, though ciprofloxacin may have a role in drug-resistant TB cases.
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1. Introduction
The NU 160 Pharmacology Quiz 2 Online Practice Guide equips nursing students with critical knowledge and practice questions to master safe and effective medication administration. This resource focuses on real-world application of pharmacological principles, preparing students to think critically about drug therapy, patient safety, and clinical responsibilities. All content is aligned with foundational pharmacology objectives for entry-level nurses and supports NCLEX-style preparation.
2. Medication Safety and Administration Principles
Safe medication administration is a cornerstone of nursing practice. Nurses must apply the “Six Rights” of medication administration—right patient, drug, dose, time, route, and documentation—consistently and carefully. High-alert medications such as anticoagulants and opioids require double-checking protocols. Look-alike/sound-alike (LASA) drugs and similar packaging also present safety risks, requiring heightened vigilance. This section covers the importance of accurate patient identification, bar-code scanning systems, and medication reconciliation during transitions of care.
3. Pharmacokinetics and Pharmacodynamics
Understanding how drugs work in the body is essential for predicting therapeutic effects and preventing adverse reactions. Students are introduced to key concepts such as absorption, distribution, metabolism, and excretion (ADME), along with half-life and onset of action.
Pharmacodynamics explores how drugs interact with cellular receptors to produce effects, including agonists, antagonists, and enzyme interactions. These principles are tied to patient case scenarios that emphasize age-related changes and polypharmacy in older adults.
4. Major Drug Classifications and Nursing Implications
This section focuses on commonly prescribed medication classes such as:
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Antihypertensives (e.g., ACE inhibitors, beta blockers)
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Antibiotics (e.g., penicillins, tetracyclines, aminoglycosides)
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Analgesics (non-opioid and opioid)
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Diuretics and antidiabetics
For each class, students review indications, common side effects, monitoring parameters, patient teaching points, and contraindications. Clinical reasoning is developed through case-based questions.
5. Parenteral and Non-Parenteral Routes
This section emphasizes proper technique and safety in administering medications via different routes:
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Oral (PO)—crushing tablets and assessing swallowing
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Intramuscular (IM)—injection sites and Z-track method
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Subcutaneous (SubQ)—insulin site rotation and angle of injection
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Intravenous (IV)—rate calculations and compatibility awareness
Emphasis is placed on sterile technique, prevention of needle-stick injuries, and recognizing complications such as infiltration or phlebitis.
Case Study Example:
Patient: Mr. Davis, 65 years old, diagnosed with hypertension and Type 2 diabetes. Recently prescribed lisinopril and metformin.
Scenario: Mr. Davis reports a dry cough and occasional dizziness. His fasting glucose is 145 mg/dL, and blood pressure is 92/58 mmHg.
Analysis:
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Assessment includes reviewing vitals, lab values, and patient complaints.
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Diagnosis might include "Risk for ineffective tissue perfusion" and "Knowledge deficit."
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Planning includes goals like maintaining BP within a safe range and understanding side effects.
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Implementation involves holding antihypertensives if systolic BP is < 90, monitoring renal function, and reinforcing metformin administration with meals.
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Evaluation measures patient understanding and symptom relief. This case highlights side effect recognition, drug interactions, and the importance of ongoing monitoring.
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