You choose the safer drug action, the vital sign to check, and the teaching that belongs at the bedside. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five pharmacology questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Sertraline (Zoloft) has been prescribed for a client complaining of poor appetite, fatigue, and anhedonia. Which consideration should the nurse recognize as influencing this prescriptive choice?
A. Zoloft is less expensive for the client.
B. Zoloft is extremely sedating and will help with sleep disturbances.
C. Zoloft has less adverse side effects than other antidepressants.
D. Zoloft begins to improve depressive symptoms quickly.
Show answer and rationale
Correct answer: C — Zoloft has less adverse side effects than other antidepressants.
The correct answer is C: Zoloft has less adverse side effects than other antidepressants. This is because Zoloft is a selective serotonin reuptake inhibitor (SSRI) known for having a favorable side effect profile compared to other antidepressants. SSRIs are generally well-tolerated and have fewer side effects such as sedation, weight gain, and sexual dysfunction. This makes Zoloft a suitable choice for clients experiencing poor appetite and fatigue.
A: Zoloft being less expensive is not a primary consideration when choosing an antidepressant for a client as efficacy and side effect profile are more crucial.
B: Zoloft is not extremely sedating, so it may not be the best choice for addressing sleep disturbances.
D: While Zoloft may start to improve depressive symptoms relatively quickly, this is not the main influencing factor in this prescriptive choice.
Question 2
Which intervention, related to this medication, should be initiated to maintain this client’s safety upon discharge?
A. Provide a 6-month supply of Elavil to ensure long-term compliance.
B. Provide a 1-week supply of Elavil, with refills contingent on follow-up appointments.
C. Provide pill dispenser as a memory aid.
D. Provide education regarding the avoidance of foods containing tyramine.
Show answer and rationale
Correct answer: B — Provide a 1-week supply of Elavil, with refills contingent on follow-up appointments.
Correct answer: B. Providing a 1-week supply of Elavil with refills contingent on follow-up appointments is the best intervention to maintain the client's safety upon discharge. This approach ensures proper monitoring of the medication's effectiveness and any potential side effects.
Incorrect choices:
A. Providing a 6-month supply of Elavil may lead to non-compliance and potential misuse of the medication.
C. Providing a pill dispenser as a memory aid may help with medication organization but does not address the need for proper monitoring.
D. Providing education on avoiding tyramine-containing foods is not directly related to ensuring the client's safety with the medication.
Summary: Choice B is the most appropriate as it promotes responsible medication management through regular follow-up appointments, ensuring the client's safety and well-being.
Question 3
The nurse is preparing to administer adenosine (Adenocard) to a patient who is experiencing an acute episode of paroxysmal supraventricular tachycardia. When giving this medication, which is important to remember?
A. The onset of action occurs in 5 minutes.
B. The medication must be given as a slow intravenous (IV) push.
C. Asystole may occur for a few seconds after administration.
D. The medication has a long half-life, and therefore duration of action is very long.
Show answer and rationale
Correct answer: C — Asystole may occur for a few seconds after administration.
The correct answer is C. After administering adenosine, asystole may occur for a few seconds due to its rapid action on the heart's conduction system. Here's the rationale:
1. Adenosine works by slowing down conduction through the AV node, interrupting reentry pathways causing tachycardia.
2. This brief pause in electrical activity can cause a temporary stop in the heart's pumping action, resulting in asystole.
3. Asystole is expected and normal after adenosine administration, as it helps reset the heart's electrical activity and may terminate the tachycardia.
In contrast, options A and D are incorrect because adenosine has a rapid onset of action within seconds and a very short half-life of less than 10 seconds, leading to a quick duration of action. Option B is incorrect as adenosine should be given as a rapid IV push to ensure its effectiveness.
Question 4
A 70-year-old female with osteoarthritis is prescribed celecoxib. Celecoxib works by:
A. Inhibiting COX-1 and COX-2 enzymes
B. Inhibiting COX-2 enzymes selectively
C. Binding to opioid receptors in the brain
D. Inhibiting the synthesis of leukotrienes
Show answer and rationale
Correct answer: B — Inhibiting COX-2 enzymes selectively
The correct answer is B: Inhibiting COX-2 enzymes selectively. Celecoxib is a selective COX-2 inhibitor, meaning it specifically targets and inhibits the cyclooxygenase-2 enzyme, which is responsible for producing prostaglandins involved in inflammation and pain. By selectively inhibiting COX-2, celecoxib reduces inflammation and pain without affecting COX-1, which helps maintain the stomach lining and platelet function.
Choice A (Inhibiting COX-1 and COX-2 enzymes) is incorrect because celecoxib primarily targets COX-2, not COX-1.
Choice C (Binding to opioid receptors in the brain) is incorrect as celecoxib does not bind to opioid receptors but works through a different mechanism.
Choice D (Inhibiting the synthesis of leukotrienes) is incorrect as celecoxib does not directly inhibit leukotriene synthesis; it primarily inhibits COX-2 enzymes
Question 5
The client with atrial fibrillation is receiving warfarin (Coumadin). Which laboratory test should be monitored to determine the effectiveness of the therapy?
A. Prothrombin time (PT) and international normalized ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Complete blood count (CBC)
D. Fibrinogen level
Show answer and rationale
Correct answer: A — Prothrombin time (PT) and international normalized ratio (INR)
Monitoring Prothrombin time (PT) and international normalized ratio (INR) is crucial when a client is on warfarin therapy. These tests assess the clotting ability of the blood and help determine the appropriate dosage of warfarin to prevent complications such as bleeding or clotting events. PT and INR values within the therapeutic range indicate the effectiveness of warfarin in managing atrial fibrillation. Choice B, activated partial thromboplastin time (aPTT), is not typically used to monitor warfarin therapy; it is more commonly used to assess the effectiveness of heparin therapy. Choice C, complete blood count (CBC), does not directly assess the anticoagulant effect of warfarin. Choice D, fibrinogen level, is not a primary test for monitoring warfarin therapy; it is more relevant in assessing conditions like disseminated intravascular coagulation.
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Question 6
A 70-year-old female with osteoporosis is prescribed alendronate. Alendronate works by:
A. Inhibiting osteoclast-mediated bone resorption
B. Increasing calcium absorption from the intestine
C. Promoting osteoblast activity
D. Increasing parathyroid hormone levels
Correct answer:
The correct answer is A: Inhibiting osteoclast-mediated bone resorption. Alendronate is a bisphosphonate drug that works by inhibiting osteoclasts, which are responsible for breaking down bone tissue. By inhibiting osteoclast activity, alendronate helps to reduce bone resorption and increase bone density. This is particularly beneficial for patients with osteoporosis, as it helps to slow down bone loss and reduce the risk of fractures.
Choice B is incorrect because alendronate does not directly affect calcium absorption from the intestine. Choice C is incorrect because alendronate does not promote osteoblast activity, which is responsible for building new bone tissue. Choice D is incorrect because alendronate does not increase parathyroid hormone levels; in fact, it can actually decrease parathyroid hormone levels by affecting calcium homeostasis.
Main agents for acute migraine attack treatment are Ergot and indol derivatives and NSAID’s. The consideration is:
A. TRUE
B. FALSE
C. Null
D. All
Correct answer:
The correct answer is A: TRUE. Ergot and indol derivatives, along with NSAIDs, are indeed main agents for acute migraine attack treatment. Ergot derivatives like ergotamine and dihydroergotamine are vasoconstrictors that help alleviate migraine symptoms by reducing blood flow in the brain. Indol derivatives like sumatriptan are serotonin receptor agonists that also help relieve migraines. NSAIDs like ibuprofen can help reduce inflammation and pain associated with migraines. Therefore, the statement is true.
Summary of other choices:
B: FALSE - This choice is incorrect as the statement in the question is true.
C: Null - This choice is incorrect as it does not provide any relevant information to the question.
D: All - This choice is incorrect as it implies that all agents are main agents for acute migraine attack treatment, which is not accurate.
Effects of morphine on CNS include all of the following EXCEPT:
A. Miosis
B. Respiratory depression
C. Anticonvulsant effect
D. Depression of cough reflex
Correct answer:
Morphine, a mu-opioid receptor agonist, exerts profound CNS effects. Miosis (pinpoint pupils) results from parasympathetic stimulation via the Edinger-Westphal nucleus. Respiratory depression, a life-threatening effect, occurs due to reduced sensitivity of brainstem respiratory centers to CO2, a hallmark of opioid overdose. Depression of the cough reflex is mediated by medullary suppression, making morphine an antitussive. However, morphine lacks an anticonvulsant effect (choice C); it can lower the seizure threshold in overdose, potentially inducing convulsions, unlike drugs like benzodiazepines. This exception highlights morphine's CNS depressant profile, lacking the GABAergic enhancement needed for seizure control. Understanding these effects is vital for safe use, monitoring for overdose, and distinguishing morphine from anticonvulsant therapies.
Effects of morphine on CNS include all of the following EXCEPT:
A. Miosis
B. Respiratory depression
C. Anticonvulsant effect
D. Depression of cough reflex
Correct answer:
Morphine, a mu-opioid receptor agonist, exerts profound CNS effects. Miosis (pinpoint pupils) results from parasympathetic stimulation via the Edinger-Westphal nucleus. Respiratory depression, a life-threatening effect, occurs due to reduced sensitivity of brainstem respiratory centers to CO2, a hallmark of opioid overdose. Depression of the cough reflex is mediated by medullary suppression, making morphine an antitussive. However, morphine lacks an anticonvulsant effect (choice C); it can lower the seizure threshold in overdose, potentially inducing convulsions, unlike drugs like benzodiazepines. This exception highlights morphine's CNS depressant profile, lacking the GABAergic enhancement needed for seizure control. Understanding these effects is vital for safe use, monitoring for overdose, and distinguishing morphine from anticonvulsant therapies.
A healthcare provider is providing discharge instructions to a client who has a new prescription for digoxin. Which of the following instructions should the healthcare provider include?
A. Take the medication at bedtime.
B. Avoid taking antacids with this medication.
C. Monitor your pulse rate daily.
D. Increase your intake of potassium-rich foods.
Correct answer:
The correct answer is C: 'Monitor your pulse rate daily.' Monitoring the pulse rate daily is crucial when taking digoxin as it helps in early detection of digoxin toxicity. Digoxin can cause toxicity, which may manifest as changes in the heart rate, making monitoring the pulse rate an essential part of managing the medication. It is important for the client to be aware of their normal pulse rate and report any significant changes to their healthcare provider promptly. Choices A, B, and D are incorrect. Taking digoxin at bedtime is not a specific instruction related to monitoring its effects. Avoiding antacids is relevant for some medications, but not a key concern with digoxin. Increasing potassium-rich foods may interact with digoxin due to its effect on potassium levels, but monitoring the pulse rate is a more direct and immediate need for safety.
A 50-year-old female with asthma is prescribed albuterol. Albuterol works by:
A. Inhibiting the release of histamine from mast cells
B. Stimulating beta-2 adrenergic receptors in the lungs
C. Increasing acetylcholine release in the lungs
D. Blocking leukotriene receptors
Correct answer:
The correct answer is B: Stimulating beta-2 adrenergic receptors in the lungs. Albuterol is a beta-2 adrenergic agonist, which means it binds to and activates beta-2 adrenergic receptors in the lungs. By stimulating these receptors, albuterol causes smooth muscle relaxation, leading to bronchodilation and improved airflow in the lungs. This mechanism of action is beneficial in treating asthma by relieving bronchospasms and symptoms of shortness of breath.
Choice A is incorrect because albuterol does not inhibit histamine release from mast cells. Choice C is incorrect as albuterol does not increase acetylcholine release in the lungs; in fact, it has the opposite effect by promoting bronchodilation. Choice D is incorrect as albuterol does not block leukotriene receptors; leukotriene receptor antagonists like montelukast are used for that purpose.
A client with myocardial infarction suddenly becomes tachycardic, shows signs of air hunger, and begins coughing frothy, pink-tinged sputum. The nurse listens to breath sounds, expecting to hear which breath sounds bilaterally?
A. Rhonchi
B. Crackles
C. Wheezes
D. Diminished breath sounds
Correct answer:
In this scenario, the client is exhibiting signs of pulmonary edema, which can occur as a complication of myocardial infarction. Crackles are typically heard in cases of pulmonary edema, characterized by fluid accumulation in the lungs. These crackling sounds are heard during inspiration and sometimes expiration and are an indication of fluid-filled alveoli. Therefore, when assessing the client with these symptoms, the nurse would expect to hear crackles bilaterally. Rhonchi, which are coarse rattling respiratory sounds, are typically associated with conditions like bronchitis or pneumonia, not pulmonary edema. Wheezes are high-pitched musical sounds heard in conditions like asthma or COPD, not commonly present in pulmonary edema. Diminished breath sounds suggest decreased airflow or lung consolidation, not typical findings in pulmonary edema.
Which of the following best explains the primary reason for careful adjustment of the levothyroxine dose during pregnancy?
A. Longer half-life
B. Less frequent adverse effects
C. Higher affinity for thyroid receptors
D. Better gastrointestinal absorption
Correct answer:
The correct answer is D: Better gastrointestinal absorption. During pregnancy, there are physiological changes that affect drug absorption. Levothyroxine requires careful adjustment because gastrointestinal absorption can be altered, leading to fluctuations in serum levels. Ensuring optimal absorption helps maintain stable thyroid hormone levels for maternal and fetal health.
Rationale for why the other choices are incorrect:
A: Longer half-life is not the primary reason for dose adjustment during pregnancy, as the concern lies more with absorption changes.
B: Less frequent adverse effects do not drive the need for dose adjustment in pregnancy; it is about maintaining stable hormone levels.
C: Higher affinity for thyroid receptors is not the primary factor driving dose adjustments; absorption is key to ensuring adequate hormone levels.
Lovastatin (Mevacor) plus a bile-acid binding resin causes regression of coronary lesions in about one third of treated patients. This consideration is:
A. TRUE
B. FALSE
C. All
D. None
Correct answer:
The correct answer is A: TRUE. Lovastatin combined with a bile-acid binding resin has been shown to cause regression of coronary lesions in about one third of treated patients. This is supported by clinical studies and research, demonstrating the effectiveness of this combination therapy in improving coronary health. The other choices are incorrect because they do not accurately reflect the evidence and outcomes of this specific treatment approach. Choice B (FALSE) is incorrect because there is evidence to support the regression of coronary lesions with this treatment. Choice C (All) is incorrect because not all patients treated with this combination therapy experience regression of coronary lesions. Choice D (None) is incorrect as there is a significant proportion of patients who do benefit from this treatment in terms of lesion regression.
The wife of a patient who has been diagnosed with depression calls the office and says, “It’s been an entire week since he started that new medicine for his depression, and there’s no change! What’s wrong with him?†What is the nurse’s best response?
A. “The medication may not be effective for him. He may need to try another type.â€
B. “It may take up to 4 weeks to notice any therapeutic effects. Let’s wait a little longer to see how he does.â€
C. “It sounds like the dose is not high enough. I’ll check about increasing the dosage.â€
D. “Some patients never recover from depression. He may not respond to this therapy.â€
Correct answer:
The correct answer is B. The nurse should explain that it may take up to 4 weeks to notice any therapeutic effects of the new medication for depression. This is because antidepressants typically require time to build up in the patient's system and start producing the desired effects. By advising to wait a little longer, the nurse is providing accurate information and managing the wife's expectations appropriately.
Incorrect Choices:
A: This answer prematurely suggests changing the medication without allowing sufficient time for the current medication to take effect.
C: Increasing the dosage without waiting for the full therapeutic effect to manifest can lead to unnecessary side effects and risks.
D: This answer is pessimistic and does not offer constructive guidance or hope for improvement, which is not appropriate in this situation.
LPN exams pharmacology practice questions, set 7 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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