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 33-year-old man spends the morning outside gardening in the sun on a warm spring day. He develops a tension headache, and the only medication he has at home is aspirin. After taking two regular-sized aspirin tablets, there was an increase in his respiration rate. What is the reason for the increased respirations?
A. Salicylates are agonists at the CO2 receptors in the carotid bodies
B. Salicylates at this dose directly stimulate the respiratory center of the brain
C. Salicylates shift the oxygen dissociation curve to the right
D. Salicylate uncoupling of oxidative phosphorylation
Show answer and rationale
Correct answer: B — Salicylates at this dose directly stimulate the respiratory center of the brain
Aspirin (salicylates) at standard doses (two tablets) can cause respiratory changes. Option , CO2 receptor agonism, is incorrect-salicylates don't target carotid bodies directly. Option , direct stimulation of the respiratory center, is correct-salicylates stimulate the medullary respiratory center, increasing respiration rate, a known early effect in salicylate toxicity. Option , shifting the oxygen dissociation curve, is unrelated to aspirin's action. Option , uncoupling oxidative phosphorylation, occurs in overdose, causing metabolic acidosis and compensatory hyperventilation, but not at this dose. Here, the mild increase in respiration aligns with central stimulation, not severe metabolic disruption. This reflects aspirin's pharmacological effect on brainstem respiratory control, distinct from overdose scenarios, explaining the observed hyperventilation in this otherwise healthy man.
Question 2
A patient has been taking the selective serotonin reuptake inhibitor (SSRI) sertraline (Zoloft) for about 6 months. At a recent visit, she tells the nurse that she has been interested in herbal therapies and wants to start taking St. John’s wort. Which response by the nurse is appropriate?
A. “That should be no problem.”
B. “Good idea! Hopefully you’ll be able to stop taking the Zoloft.”
C. “Be sure to stop taking the herb if you notice a change in side effects.”
D. “Taking St. John’s wort with Zoloft may cause severe interactions and is not recommended.”
Show answer and rationale
Correct answer: D — “Taking St. John’s wort with Zoloft may cause severe interactions and is not recommended.”
The correct response is D: “Taking St. John’s wort with Zoloft may cause severe interactions and is not recommended.”
Rationale:
1. St. John's wort is known to affect serotonin levels, similar to SSRIs like Zoloft.
2. Combining St. John's wort with SSRIs can lead to serotonin syndrome, a potentially life-threatening condition.
3. The nurse should advise against combining these medications due to the risk of adverse interactions.
4. This response prioritizes patient safety and provides clear guidance on the potential harm of the combination.
Summary:
A: Incorrect. This response is too casual and does not address the potential interactions between St. John's wort and Zoloft.
B: Incorrect. Encouraging the patient to stop Zoloft abruptly is not safe and overlooks the risk of interactions.
C: Incorrect. This response is vague and does not emphasize the seriousness of potential interactions.
Question 3
Before, during and after seizure. The nurse knows that the patient is ALWAYS placed in what position?
A. Low fowler’s
B. Modified trendelenburg
C. Side lying
D. Supine NERVOUS SYSTEM
Show answer and rationale
Correct answer: C — Side lying
The correct answer is C: Side lying position. This position helps prevent aspiration of secretions and promotes drainage from the mouth during and after a seizure. Placing the patient in a side lying position also helps prevent injury from falling and facilitates monitoring of the patient's airway.
Incorrect choices:
A: Low fowler's - This position does not provide optimal airway protection and may increase the risk of aspiration during a seizure.
B: Modified trendelenburg - This position may worsen the patient's airway patency and does not facilitate drainage of secretions.
D: Supine - Placing the patient in a supine position can lead to aspiration and compromise the airway, especially during a seizure.
Summary: The side lying position is the most appropriate choice as it ensures airway protection, facilitates drainage, and reduces the risk of aspiration during and after a seizure.
Question 4
A client has been severely depressed and suicidal. After admission to an inpatient psychiatric unit, antidepressant medication is administered. As the client becomes more energized and communicative, what should be the priority nursing intervention for this client?
A. Allowing the client to have unsupervised passes to his or her home
B. Encouraging the client to participate in group activities
C. Increasing the vigilance regarding the client's suicidal precautions
D. Recognizing that the client's suicidal potential has decreased
Show answer and rationale
Correct answer: C — Increasing the vigilance regarding the client's suicidal precautions
Correct Answer: C - Increasing the vigilance regarding the client's suicidal precautions
Rationale:
1. The client was admitted for severe depression and suicidal ideation, indicating a high suicide risk.
2. Antidepressants can initially increase energy before improving mood, potentially raising suicide risk.
3. As the client becomes more energized and communicative, the risk of impulsive actions, including suicide, may increase.
4. Therefore, increasing vigilance and maintaining strict suicidal precautions are crucial to ensure the client's safety.
Summary of Incorrect Choices:
A: Allowing unsupervised passes may expose the client to triggers or opportunities for self-harm.
B: Group activities can be beneficial but do not address the immediate safety concern of suicidal risk.
D: Assuming suicidal potential has decreased prematurely can be dangerous, as the client may still be at risk.
Question 5
A patient is started on a diuretic for antihypertensive therapy. The nurse expects that a drug in which class is likely to be used initially?
A. Loop diuretics
B. Osmotic diuretics
C. Thiazide diuretics
D. Potassium-sparing diuretics
Show answer and rationale
Correct answer: C — Thiazide diuretics
Thiazide diuretics are commonly used as first-line therapy for hypertension due to their effectiveness, safety profile, and affordability. They work by inhibiting sodium reabsorption in the distal convoluted tubule, leading to increased elimination of sodium and water, ultimately reducing blood volume and blood pressure. Thiazide diuretics are generally well-tolerated and have been shown to be effective in lowering blood pressure in patients with hypertension. Loop diuretics, such as furosemide, are more potent diuretics typically reserved for use in conditions where aggressive diuresis is needed, such as heart failure or renal disease. Osmotic diuretics, like mannitol, are primarily used for reducing intracranial pressure or preventing acute kidney injury. Potassium-sparing diuretics are often used in combination with other diuretics to prevent hypokalemia but are not typically used as
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Question 6
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.
Correct answer:
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.
Which of the following events best explains the patient's syndrome of weakness, paresthesias, constipation, and low potassium level in Addison disease?
A. Cortisol-induced hyperglycemia
B. Fludrocortisone excess
C. Inadequate therapy of adrenal insufficiency
D. Cortisol-induced myopathy
Correct answer:
The correct answer is B: Fludrocortisone excess. In Addison's disease, there is adrenal insufficiency leading to low levels of cortisol and aldosterone. Fludrocortisone is a synthetic mineralocorticoid used to replace aldosterone in the treatment of Addison's disease. Excess fludrocortisone can cause retention of sodium and water, leading to hypertension, hypokalemia, weakness, and paresthesias. Constipation can also occur due to altered electrolyte balance.
A: Cortisol-induced hyperglycemia is not the best explanation for the patient's symptoms as hyperglycemia is not a prominent feature of Addison's disease.
C: Inadequate therapy of adrenal insufficiency would not cause the specific symptoms mentioned.
D: Cortisol-induced myopathy is not the primary cause of weakness and paresthesias in Addison's disease; aldosterone deficiency leading to electrolyte imbalance is more relevant.
A depressed patient who is taking a tricyclic antidepressant tells the nurse, “I don’t think I can keep taking these pills. They make me very dizzy, especially when I stand up.†The best nursing response is:
A. “That is annoying, but it is something most patients are able to learn to live with as time goes on. You’ll get used to the medicine’s side effects.â€
B. “The medicine can slow the body’s adjustment of blood pressure when changing position; drinking more fluids and changing position slowly can help.â€
C. “Compared to the problems caused by the depression, it seems like a relatively small annoyance to have to put up with.â€
D. “All medicines have side effects, and this one is relatively mild. It could be that your depression is causing you to think negatively about the medicine.â€
Correct answer:
The correct answer is B. The nurse should educate the patient on orthostatic hypotension, a common side effect of tricyclic antidepressants that causes dizziness upon standing. By advising the patient to increase fluid intake and change positions slowly, the nurse is promoting safety and providing a practical solution to manage the side effect. This response addresses the patient's concern effectively and empowers them to take control of their symptoms.
Choice A is incorrect because dismissing the patient's symptoms as something to get used to does not address the potential risks of orthostatic hypotension. Choice C is incorrect as it minimizes the patient's discomfort and may invalidate their concerns. Choice D is incorrect as it dismisses the patient's symptoms by attributing them solely to negative thinking, rather than acknowledging the physiological effects of the medication.
You are managing a stable middle-aged adult with emphysema. In addition to reinforcing smoking cessation and medication schedules which annual intervention will you recommend?
A. Pneumococcal polysaccharide vaccine (PPSV23)
B. Pneumococcal conjugate vaccine (PCV13)
C. Quadrivalent inactivated influenza vaccine (QIV)
D. Live attenuated influenza vaccine (LAV)
Correct answer:
The correct answer is A: Pneumococcal polysaccharide vaccine (PPSV23). This vaccine is recommended for adults with chronic lung conditions like emphysema to prevent pneumococcal infections. It helps in reducing the risk of pneumonia and its complications.
Rationale:
1. PPSV23 is specifically indicated for adults with chronic medical conditions, including emphysema.
2. Emphysema puts the individual at a higher risk for respiratory infections, including pneumococcal infections.
3. PPSV23 provides protection against pneumococcal bacteria, which is a common cause of pneumonia.
4. Administering PPSV23 annually helps maintain immunity and reduces the likelihood of pneumococcal infections in high-risk individuals.
Summary:
B: Pneumococcal conjugate vaccine (PCV13) is primarily recommended for children, not for stable middle-aged adults with emphysema.
C: Quadrivalent inactivated
What part of the nursing diagnosis statement suggests the nursing interventions to be included in the plan of care?
A. Problem statement
B. Defining characteristics
C. Etiology of the problem
D. Outcomes criteria
Correct answer:
The correct answer is C: Etiology of the problem. In a nursing diagnosis statement, the etiology describes the underlying cause or contributing factors to the identified problem. This is crucial as it guides the selection of appropriate nursing interventions aimed at addressing the root cause of the issue. By addressing the etiology, nurses can implement interventions that will effectively treat the problem.
Choice A (Problem statement) simply identifies the issue without providing insight into its cause. Choice B (Defining characteristics) lists the signs and symptoms of the problem but doesn't directly inform the interventions needed. Choice D (Outcomes criteria) outlines the expected results of the interventions but doesn't directly suggest which interventions to implement. Thus, C is the correct choice as it directly influences the selection of appropriate nursing interventions.
The client is receiving warfarin (Coumadin) for a deep vein thrombosis. Which food should the nurse instruct the client to avoid in large amounts?
A. Spinach
B. Potatoes
C. Bananas
D. Chicken
Correct answer:
Warfarin, an anticoagulant, inhibits vitamin K-dependent clotting factors. Spinach is high in vitamin K, which can counteract warfarin's effect, reducing its efficacy and increasing clot risk if consumed in large amounts. The nurse must instruct avoidance to maintain therapeutic INR levels. Potatoes and bananas have minimal vitamin K and don't significantly affect warfarin. Chicken is protein-rich, not vitamin K-rich, posing no issue. Consistent vitamin K intake is key, but large amounts of spinach could destabilize anticoagulation, risking thrombus progression. This aligns with warfarin's pharmacodynamics, where dietary education prevents therapeutic failure. Potatoes, bananas, and chicken lack this interaction, making spinach the priority to limit. Thus, A is the correct choice, ensuring the client understands how to support treatment efficacy and safety through diet management.
The therapeutic action of neurotransmitter inhibitors that block reuptake cause:
A. decreased concentration of the neurotransmitter in the central nervous system.
B. increased concentration of neurotransmitter in the synaptic gap.
C. destruction of receptor sites.
D. limbic system stimulation.
Correct answer:
The correct answer is B: increased concentration of neurotransmitter in the synaptic gap. When neurotransmitter reuptake is blocked, it remains in the synaptic gap longer, leading to an increased concentration available for binding to postsynaptic receptors. This enhances neurotransmission and can help alleviate symptoms associated with neurotransmitter imbalances.
A: decreased concentration of the neurotransmitter in the central nervous system - This is incorrect because blocking reuptake leads to an increased concentration of neurotransmitter, not decreased.
C: destruction of receptor sites - This is incorrect as blocking reuptake does not lead to the destruction of receptor sites.
D: limbic system stimulation - This is incorrect as blocking reuptake affects neurotransmitter levels in the synaptic gap, not the stimulation of a specific brain region like the limbic system.
The patient has been receiving amitriptyline (Elavil) for 2 weeks. He tells the nurse he doesn't think this medicine is working, as he is still depressed. What is the best response by the nurse?
A. It is working, but it can take several weeks to have an effect.'
B. You might still feel depressed, but you are looking much better.'
C. This may not be the best medicine for you; I'll call your doctor.'
D. It is working, but it can take several months to have an effect.'
Correct answer:
Amitriptyline, a tricyclic antidepressant, typically requires 2 to 6 weeks to achieve full therapeutic effect, as it gradually increases neurotransmitter levels (e.g., serotonin, norepinephrine) in the brain to alleviate depression. After only 2 weeks, the patient's continued symptoms are expected, not indicative of failure, making choice A the best response: it educates the patient on the timeline, fostering adherence. Choice B dismisses the patient's feelings with subjective reassurance, undermining trust. Choice C prematurely suggests switching drugs without evidence, risking unnecessary changes. Choice D exaggerates the timeline to months, which is inaccurate and discouraging. The nurse's role is to provide accurate information and support, reinforcing that delayed onset is normal for this class of medication, thus making choice A the most therapeutic and evidence-based response.
A 79-year-old patient is taking a diuretic for treatment of hypertension. This patient is very independent and wants to continue to live at home. The nurse will know that which teaching point is important for this patient?
A. He should take the diuretic with his evening meal.
B. He should skip the diuretic dose if he plans to leave the house.
C. If he feels dizzy while on this medication, he needs to stop taking it and take potassium supplements instead.
D. He needs to take extra precautions when standing up because of possible orthostatic hypotension and resulting injury from falls.
Correct answer:
Step 1: Diuretics can cause orthostatic hypotension, leading to a drop in blood pressure upon standing.
Step 2: Orthostatic hypotension increases the risk of falling and injury, especially in older adults.
Step 3: By instructing the patient to take extra precautions when standing up, the nurse helps prevent falls and injuries.
Step 4: This teaching point is crucial for promoting the patient's safety and independence at home.
Summary:
Choice A is incorrect because the timing of diuretic intake with meals is not as critical as preventing falls. Choice B is incorrect as skipping doses can lead to uncontrolled hypertension. Choice C is incorrect because stopping the medication abruptly can have negative consequences and potassium supplements may not be necessary. Choice D is correct as it addresses the potential side effect of orthostatic hypotension and emphasizes safety measures.
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.
RN exams pharmacology practice questions, set 14 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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