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 RN exams exam guide or more RN 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
A 65-year-old male with hypertension is prescribed lisinopril. Lisinopril works by:
A. Inhibiting the conversion of angiotensin I to angiotensin II
B. Blocking beta-adrenergic receptors in the heart
C. Relaxing vascular smooth muscle
D. Increasing sodium excretion in the kidneys
Show answer and rationale
Correct answer: A — Inhibiting the conversion of angiotensin I to angiotensin II
The correct answer is A. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor, which works by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor that increases blood pressure. By inhibiting its production, lisinopril helps dilate blood vessels, reduce blood pressure, and improve blood flow. This mechanism is crucial in managing hypertension.
Choice B is incorrect because beta-blockers, not ACE inhibitors like lisinopril, block beta-adrenergic receptors in the heart to reduce heart rate and blood pressure. Choice C is incorrect because while lisinopril does relax vascular smooth muscle, the primary mechanism is through angiotensin II inhibition. Choice D is incorrect because lisinopril does not directly affect sodium excretion in the kidneys; instead, it primarily targets the renin-angiotensin-aldosterone system to regulate blood
Question 2
A patient had an orthopedic surgery and is prescribed enoxaparin. What would the nurse teach the patient and/or family members about this low–molecular-weight heparin before discharge?
A. Visual demonstration of intramuscular heparin administration is recommended.
B. Prothrombin time and international normalized ratio monitoring will be done weekly.
C. Avoidance of green leafy vegetables is recommended.
D. Watch for bleeding or excessive bruising.
Show answer and rationale
Correct answer: D — Watch for bleeding or excessive bruising.
The correct answer is D: Watch for bleeding or excessive bruising. Enoxaparin is an anticoagulant medication that helps prevent blood clots. The nurse should teach the patient and family members to monitor for signs of bleeding or excessive bruising, as these could indicate a potential complication of the medication. This is crucial for early detection and intervention to prevent serious consequences.
Explanation for incorrect choices:
A: Visual demonstration of intramuscular heparin administration is not applicable to enoxaparin as it is typically administered subcutaneously.
B: Prothrombin time and international normalized ratio monitoring are not usually required for enoxaparin as it works through a different mechanism compared to warfarin.
C: Avoidance of green leafy vegetables is not necessary for enoxaparin, unlike warfarin which interacts with vitamin K found in green leafy vegetables.
Question 3
A patient is prescribed ethinyl estradiol and norelgestromin transdermal contraceptive patch. Which statement, if made by the patient, indicates an understanding of the use of this drug?
A. The patch prevents pregnancy by acting as barrier.
B. I will experience minimal side effects because it is a progestin-only device.
C. I will remove the patch each month and replace it with a new patch 1 week later.
D. I will apply the patch in my vaginal area prior to having sexual intercourse.
Show answer and rationale
Correct answer: C — I will remove the patch each month and replace it with a new patch 1 week later.
Rationale for Correct Answer (C):
1. The patient stating "I will remove the patch each month and replace it with a new patch 1 week later" indicates understanding of the correct usage of the contraceptive patch.
2. Ethinyl estradiol and norelgestromin are combined hormonal contraceptives that require a once-weekly application for 3 weeks followed by a patch-free week to allow for menstruation.
3. This statement reflects proper adherence to the dosing schedule, ensuring continuous contraceptive efficacy and hormone levels.
Summary of Incorrect Choices:
A. The patch does not act as a physical barrier; it releases hormones to prevent pregnancy.
B. Ethinyl estradiol and norelgestromin are combined hormonal contraceptives, not progestin-only, so side effects may vary.
D. The patch should be applied to the skin, not in the vaginal area, and is not meant for immediate use before intercourse.
Question 4
A 65-year-old male with hypertension is prescribed lisinopril. Lisinopril works by:
A. Inhibiting the conversion of angiotensin I to angiotensin II
B. Blocking beta-adrenergic receptors in the heart
C. Relaxing vascular smooth muscle
D. Increasing sodium excretion in the kidneys
Show answer and rationale
Correct answer: A — Inhibiting the conversion of angiotensin I to angiotensin II
The correct answer is A. Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor, which works by inhibiting the conversion of angiotensin I to angiotensin II. Angiotensin II is a potent vasoconstrictor that increases blood pressure. By inhibiting its production, lisinopril helps dilate blood vessels, reduce blood pressure, and improve blood flow. This mechanism is crucial in managing hypertension.
Choice B is incorrect because beta-blockers, not ACE inhibitors like lisinopril, block beta-adrenergic receptors in the heart to reduce heart rate and blood pressure. Choice C is incorrect because while lisinopril does relax vascular smooth muscle, the primary mechanism is through angiotensin II inhibition. Choice D is incorrect because lisinopril does not directly affect sodium excretion in the kidneys; instead, it primarily targets the renin-angiotensin-aldosterone system to regulate blood
Question 5
A client diagnosed with bipolar I disorder: manic episode refuses to take lithium carbonate because he complains that it makes him feel sick. Which of the following medications might be alternatively prescribed for mood stabilization in bipolar disorders?
A. Sertraline (Zoloft)
B. Valproic acid (Depakote)
C. Trazodone (Desyrel)
D. Paroxetine (Paxil)
Show answer and rationale
Correct answer: B — Valproic acid (Depakote)
The correct answer is B: Valproic acid (Depakote). Valproic acid is commonly used as a mood stabilizer in bipolar disorder. It helps to control manic episodes and stabilize mood swings. It is effective in treating bipolar disorder and is well tolerated by many patients. It is an appropriate alternative to lithium carbonate for mood stabilization.
Explanation for why the other choices are incorrect:
A: Sertraline (Zoloft) is an antidepressant and not typically used as a primary treatment for bipolar disorder.
C: Trazodone (Desyrel) is primarily used as an antidepressant and not as a mood stabilizer for bipolar disorder.
D: Paroxetine (Paxil) is an antidepressant and is not indicated for mood stabilization in bipolar disorder.
In summary, Valproic acid (Depakote) is the most appropriate alternative medication for mood stabilization in bipolar disorder compared to the other choices provided.
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Question 6
Loosening of teeth, gingivitis and hemorrhage occur in the deficiency of:
A. Vitamin ?
B. Vitamin ?1
C. Vitamin B6
D. Vitamin C
Correct answer:
Step-by-step rationale for why Vitamin C (Choice D) is the correct answer:
1. Vitamin C is essential for collagen synthesis, which is crucial for maintaining the integrity of gum tissues.
2. Deficiency of Vitamin C leads to weakened collagen, causing symptoms like loosening of teeth, gingivitis, and hemorrhage.
3. Vitamin K (Choice A) is important for blood clotting, not directly related to gum health.
4. Vitamin B1 (Choice B) is essential for energy production, not directly linked to gum health.
5. Vitamin B6 (Choice C) is involved in various metabolic processes, but not specifically related to gum health.
Summary:
The correct answer is Vitamin C (Choice D) because it is directly linked to maintaining healthy gum tissues by supporting collagen synthesis. Choices A, B, and C are incorrect as they are not directly associated with the symptoms of loosening of teeth, gingivitis, and hemorrhage.
Which of the following is an appropriate nursing intervention to prevent infection in patients with AIDS?
A. Prohibiting patients who are severely immunodeficient from having any visitors.
B. Prohibiting visitors with a cough.
C. Wearing protective gear such as gown, mask, gloves, and goggles when entering the room.
D. Ensuring protective barrier isolation precautions are in place.
Correct answer:
The correct answer is C. Wearing protective gear such as gown, mask, gloves, and goggles when entering the room is crucial to prevent infection in patients with AIDS. This intervention helps to minimize the risk of transmitting pathogens to the patient and vice versa. The protective gear acts as a barrier to prevent the spread of infectious agents. It also protects healthcare workers from exposure to potentially harmful pathogens.
Prohibiting visitors who are severely immunodeficient (choice A) may be isolating for the patient and does not directly address preventing infection transmission. Prohibiting visitors with a cough (choice B) is important but does not cover all potential sources of infection. Ensuring protective barrier isolation precautions are in place (choice D) is a general statement and does not specify the practical steps needed to prevent infection transmission effectively.
A 50-year-old female with hypothyroidism is prescribed levothyroxine. Levothyroxine works by:
A. Increasing the production of thyroid-stimulating hormone (TSH)
B. Replacing deficient thyroid hormone
C. Inhibiting thyroid hormone synthesis
D. Increasing the metabolism of thyroid hormones
Correct answer:
The correct answer is B: Replacing deficient thyroid hormone. Levothyroxine is a synthetic form of the thyroid hormone thyroxine (T4). In hypothyroidism, the thyroid gland does not produce enough thyroid hormones, leading to various symptoms. By prescribing levothyroxine, we are supplying the body with the thyroid hormone it lacks, thereby replacing the deficient hormone and restoring normal thyroid function.
Explanation of other choices:
A: Increasing the production of thyroid-stimulating hormone (TSH) is incorrect because levothyroxine does not directly affect TSH production.
C: Inhibiting thyroid hormone synthesis is incorrect because levothyroxine does not inhibit thyroid hormone production.
D: Increasing the metabolism of thyroid hormones is incorrect because levothyroxine does not directly increase the metabolism of existing thyroid hormones; it simply replaces the deficient hormone.
A 64-year-old man suffering from benign prostatic hyperplasia presented to his physician complaining of generalized itching. The problem began 1 week earlier, after an afternoon of prolonged sun exposure. The patient reported that the itching was distressing, especially during the night. Physical examination showed an enlarged prostate and no other evidence of ongoing disease. Which of the following drugs would be appropriate for this patient?
A. Cyproheptadine
B. Diphenhydramine
C. Famotidine
D. Loratadine
Correct answer:
The correct answer is D: Loratadine. Loratadine is a second-generation antihistamine that is commonly used to relieve symptoms of allergies, including itching. In this case, the patient's generalized itching is likely due to an allergic reaction triggered by sun exposure. Loratadine can help alleviate the itching without causing excessive sedation, making it suitable for an elderly patient.
A: Cyproheptadine is a first-generation antihistamine that can cause significant sedation and anticholinergic side effects, making it less ideal for an elderly patient.
B: Diphenhydramine is also a first-generation antihistamine that can cause sedation and anticholinergic side effects, which may not be well-tolerated by the elderly patient.
C: Famotidine is a histamine-2 (H2) receptor antagonist used to reduce stomach acid production and treat ulcers, not itching related to allergic reactions.
A 45-year-old male with hyperlipidemia is prescribed pravastatin. Pravastatin works by:
A. Inhibiting the absorption of cholesterol in the intestines
B. Inhibiting the action of HMG-CoA reductase in the liver
C. Increasing HDL cholesterol levels
D. Blocking bile acid reabsorption
Correct answer:
The correct answer is B: Inhibiting the action of HMG-CoA reductase in the liver. Pravastatin is a statin medication that works by inhibiting the enzyme HMG-CoA reductase, which plays a key role in the liver's production of cholesterol. By blocking this enzyme, pravastatin reduces the liver's ability to produce cholesterol, leading to lower levels of LDL cholesterol in the bloodstream. This mechanism helps to lower the risk of cardiovascular events in patients with hyperlipidemia.
Choice A is incorrect because pravastatin does not inhibit the absorption of cholesterol in the intestines; it primarily acts in the liver. Choice C is incorrect because pravastatin primarily lowers LDL cholesterol levels rather than increasing HDL cholesterol levels. Choice D is incorrect because blocking bile acid reabsorption is not the primary mechanism of action of pravastatin in managing hyperlipidemia.
A patient who has had an MI is taking a beta blocker. What is the main benefit of beta blocker therapy for this patient?
A. Vasodilation of the coronary arteries
B. Increased force of cardiac contraction
C. Slowing of the heart rate
D. Maintaining adequate BP
Correct answer:
The main benefit of beta blocker therapy for a patient who has had a myocardial infarction (MI) is the slowing of the heart rate. Beta blockers work by blocking the action of adrenaline on beta-adrenergic receptors in the heart, which results in a decrease in heart rate. By slowing the heart rate, beta blockers help reduce the workload of the heart and decrease oxygen demand, which is beneficial in patients post-MI. This can help improve the heart's efficiency, decrease the risk of arrhythmias, and improve outcomes in patients with a history of MI. Vasodilation of the coronary arteries (choice A) is not the main mechanism of action of beta blockers. Increased force of cardiac contraction (choice B) is not a desired effect post-MI as it can increase oxygen demand and potentially worsen the patient's condition. Maintaining adequate blood pressure (choice D) can be a secondary benefit of beta
The newly licensed nurse is preparing to administer a high dose of androgen to the female client. The nurse manager asks for the rationale. What is the best response by the new nurse?
A. My client wants to improve athletic performance
B. My client has breast cancer
C. My client has brain cancer
D. My client is planning on sexual reassignment surgery
Correct answer:
High-dose androgen therapy in females is occasionally used as a palliative treatment for certain breast cancers, particularly hormone-sensitive types, where it suppresses estrogen-driven tumor growth, offering symptom relief in advanced stages. Using androgens for athletic performance enhancement, while possible due to their anabolic effects, isn't a clinical indication and is illegal in regulated settings. Brain cancer lacks evidence supporting androgen use, as it doesn't target neurological malignancies. Sexual reassignment involves testosterone for masculinization, but high doses in a clinical context typically align with cancer care, not transition protocols. The breast cancer rationale reflects a recognized, albeit niche, therapeutic use, leveraging androgens' anti-estrogenic properties to slow disease progression, making it the most defensible clinical justification in this scenario.
A 60-year-old male with hypertension is prescribed losartan. Losartan works by:
A. Blocking angiotensin II receptors
B. Inhibiting the reuptake of norepinephrine
C. Blocking calcium channels in the blood vessels
D. Inhibiting aldosterone secretion
Correct answer:
The correct answer is A: Blocking angiotensin II receptors. Losartan is an angiotensin II receptor blocker (ARB) that works by specifically blocking the angiotensin II receptor type 1 (AT1) receptors. Angiotensin II is a potent vasoconstrictor, and by blocking its action at the receptor level, losartan helps dilate blood vessels and reduce blood pressure. This mechanism is specific to ARBs and distinguishes them from other classes of antihypertensive medications.
Choice B: Inhibiting the reuptake of norepinephrine is incorrect as this mechanism is associated with drugs like tricyclic antidepressants and not losartan.
Choice C: Blocking calcium channels in the blood vessels is incorrect as this mechanism is associated with calcium channel blockers like amlodipine, not losartan.
Choice D: Inhibiting aldosterone secretion is incorrect as this mechanism is associated with drugs like
The LPN is caring for a patient in the preoperative period who, even after verbalizing concerns and having questions answered, states, “I know I am not going to wake up after surgery.” Which of the following actions should the nurse take?
A. Reassure patient everything will be all right
B. Explain national surgery death rate
C. Inform the registered nurse
D. Ask family to comfort the patient
Correct answer:
The correct answer is C: Inform the registered nurse. This is the best course of action as the LPN should escalate the situation to a higher level of care by involving the registered nurse who can further assess the patient's concerns and provide appropriate interventions.
A. Reassuring the patient may not address the underlying fear and may not be sufficient to alleviate their anxiety.
B. Providing statistics about surgery death rates may further escalate the patient's fears and anxiety, causing more harm than good.
D. Involving the family to comfort the patient may not address the patient's specific concerns and may not be within the family's scope of understanding or expertise to effectively address the situation.
Informing the registered nurse allows for a more comprehensive assessment and appropriate intervention to address the patient's fears and concerns in a holistic manner.
A 45-year-old male with hyperlipidemia is prescribed pravastatin. Pravastatin works by:
A. Inhibiting the absorption of cholesterol in the intestines
B. Inhibiting the action of HMG-CoA reductase in the liver
C. Increasing HDL cholesterol levels
D. Blocking bile acid reabsorption
Correct answer:
The correct answer is B: Inhibiting the action of HMG-CoA reductase in the liver. Pravastatin is a statin medication that works by inhibiting the enzyme HMG-CoA reductase, which plays a key role in the liver's production of cholesterol. By blocking this enzyme, pravastatin reduces the liver's ability to produce cholesterol, leading to lower levels of LDL cholesterol in the bloodstream. This mechanism helps to lower the risk of cardiovascular events in patients with hyperlipidemia.
Choice A is incorrect because pravastatin does not inhibit the absorption of cholesterol in the intestines; it primarily acts in the liver. Choice C is incorrect because pravastatin primarily lowers LDL cholesterol levels rather than increasing HDL cholesterol levels. Choice D is incorrect because blocking bile acid reabsorption is not the primary mechanism of action of pravastatin in managing hyperlipidemia.
RN exams pharmacology practice questions, set 13 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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