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
The nurse is caring for a patient who is receiving warfarin (Coumadin) and notes bruising and petechiae on the patient™s extremities. The nurse will request an order for which laboratory test?
A. International normalized ratio (INR)
B. Platelet level
C. PTT and aPTT
D. Vitamin K level
Show answer and rationale
Correct answer: B — Platelet level
The nurse should request an order for a platelet level to assess the patient's platelet count. Warfarin (Coumadin) is an anticoagulant medication that works by interfering with the blood clotting process. Bruising and petechiae may be signs of decreased platelet count or impaired platelet function. Monitoring the platelet level will help determine if the patient's symptoms are related to thrombocytopenia (low platelet count). While the International Normalized Ratio (INR) is commonly used to monitor the effects of warfarin therapy, in this case, the presence of bruising and petechiae suggest a need to assess platelet levels specifically. PT and aPTT tests assess the clotting function of factors produced by the liver and are not directly related to platelet count. Vitamin K level may be tested in cases of suspected vitamin K deficiency, but it would not directly help in assessing
Question 2
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.
Show answer and rationale
Correct answer: B — increased concentration of neurotransmitter in the synaptic gap.
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.
Question 3
This graph shows the concentration-dependent effects of norepinephrine on arterial blood pressure, both alone, and in the presence of a fixed concentration of Drug X. Which type of antagonist is Drug X?
A. Silent
B. Non-competitive
C. Competitive
D. Chemical
Show answer and rationale
Correct answer: B — Non-competitive
The correct answer is B: Non-competitive antagonist. This is because a non-competitive antagonist binds irreversibly to a different site on the receptor compared to the agonist (norepinephrine in this case) and prevents its activation, leading to a decrease in response. In the graph, the presence of Drug X shifts the concentration-response curve of norepinephrine downward without affecting the maximum response, indicating non-competitive antagonism.
A: Silent antagonists do not affect the agonist's binding or activity on the receptor.
C: Competitive antagonists compete with the agonist for the same binding site on the receptor, affecting potency but not the maximum response.
D: Chemical antagonist is a broad term for any antagonist that binds to the agonist or receptor to prevent activation but does not specifically describe the mechanism like non-competitive antagonism does.
Question 4
The nurse educator on the unit receives a list of high- alert drugs. Which strategy is recommended to decrease the risk of errors? (Select all that apply.)
A. Store drugs on a shelf for quick retrieval.
B. Limit access to high-alert drugs.
C. Use special labels for high-alert drugs.
D. Provide increased training to staff.
Show answer and rationale
Correct answer: B — Limit access to high-alert drugs.
The correct answer is B: Limit access to high-alert drugs. This strategy is recommended to decrease the risk of errors because it restricts the availability of high-risk medications to only authorized personnel, reducing the likelihood of medication errors. By limiting access, only trained and qualified staff members will handle these drugs, minimizing the potential for mistakes.
Explanation for other choices:
A: Storing drugs on a shelf for quick retrieval may increase the risk of errors as it allows easier access to high-alert drugs, potentially leading to misuse or incorrect administration.
C: Using special labels for high-alert drugs can be helpful but may not be as effective as limiting access in preventing errors.
D: Providing increased training to staff is beneficial, but alone may not be sufficient to reduce errors if access to high-alert drugs is not restricted.
Question 5
A new nurse is completing an assessment on an 80-year-old patient who is alert and oriented. The patient’s daughter is present in the room. Which action by the nurse will require follow-up by the charge nurse?
A. The nurse makes eye contact with the patient.
B. The nurse speaks only to the patient’s daughter.
C. The nurse leans forward while talking with the patient.
D. The nurse nods periodically while the patient is speaking.
Show answer and rationale
Correct answer: B — The nurse speaks only to the patient’s daughter.
The correct answer is B because it is important for the nurse to communicate directly with the patient, especially when the patient is alert and oriented. Speaking only to the patient's daughter may undermine the patient's autonomy and dignity. It is crucial for the nurse to establish rapport and build a therapeutic relationship with the patient. Making eye contact with the patient (choice A) is a good nonverbal communication technique. Leaning forward while talking with the patient (choice C) shows attentiveness and engagement. Nodding periodically while the patient is speaking (choice D) demonstrates active listening and encourages the patient to continue sharing. However, speaking only to the patient's daughter (choice B) is the incorrect choice as it neglects the patient's role in the conversation and may lead to potential issues in communication and patient-centered care.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
A 55-year-old female with type 2 diabetes is prescribed canagliflozin. Canagliflozin works by:
A. Inhibiting the reabsorption of glucose in the kidneys
B. Stimulating the pancreas to release more insulin
C. Increasing the release of glucagon from the pancreas
D. Improving insulin sensitivity in peripheral tissues
Correct answer:
The correct answer is A: Inhibiting the reabsorption of glucose in the kidneys. Canagliflozin is a sodium-glucose cotransporter-2 (SGLT2) inhibitor that works by blocking the reabsorption of glucose in the kidneys, leading to increased urinary glucose excretion and lowering blood glucose levels. This mechanism of action is unique to SGLT2 inhibitors and helps improve glycemic control in patients with type 2 diabetes.
Choice B is incorrect because canagliflozin does not stimulate the pancreas to release more insulin. Choice C is incorrect as canagliflozin does not increase the release of glucagon from the pancreas. Choice D is incorrect because canagliflozin does not directly improve insulin sensitivity in peripheral tissues. The key mechanism of action of canagliflozin lies in its specific inhibition of glucose reabsorption in the kidneys, making choice A the correct answer.
The primary underlying disorder of pulmonary edema is:
A. Decreased left ventricular pumping
B. Increased left atrial contractility
C. Decreased right ventricular elasticity
D. Increased right atrial pressure
Correct answer:
Step 1: Pulmonary edema is caused by fluid accumulation in the lungs due to increased pressure in the pulmonary vasculature.
Step 2: Decreased left ventricular pumping leads to congestive heart failure, causing increased pressure in pulmonary circulation.
Step 3: This increased pressure forces fluid from the capillaries into the alveoli, causing pulmonary edema.
Step 4: Increased left atrial contractility (B) would not directly lead to pulmonary edema.
Step 5: Decreased right ventricular elasticity (C) and increased right atrial pressure (D) are not directly related to the pathophysiology of pulmonary edema.
Summary: The correct answer is A because decreased left ventricular pumping directly contributes to the increased pressure in the pulmonary circulation that leads to pulmonary edema. Choices B, C, and D do not align with the primary underlying disorder of pulmonary edema.
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
The physician has prescribed sertraline (Zoloft) for the patient who is anxious and depressed. The patient calls the nurse to report that he has experienced delayed ejaculation since being on this medication. What is the best response by the nurse?
A. I will let your doctor know, and he will most likely change your medication.'
B. This does happen, but treating your depression is a bigger priority.'
C. I am concerned that you will become suicidal if you stop the medication.'
D. Keep taking the medicine, as this usually goes away after a few months.'
Correct answer:
Sertraline, an SSRI, commonly causes sexual dysfunction, including delayed ejaculation, affecting up to 70% of patients due to increased serotonin levels impacting sexual response. This side effect can significantly affect quality of life, making it a valid concern warranting physician notification , as the doctor might adjust the dose or switch to a drug with fewer sexual side effects, like bupropion. Choice B minimizes the patient's experience, prioritizing depression over well-being, which could reduce compliance. Choice C assumes a drastic outcome (suicide) without evidence, escalating unnecessarily. Choice D inaccurately suggests spontaneous resolution, which is rare without intervention. The nurse's best action is to advocate for the patient by informing the physician, ensuring a tailored treatment plan, making choice A the most patient-centered and proactive response.
A 60-year-old female with hyperlipidemia is prescribed atorvastatin. Atorvastatin works primarily by:
A. Inhibiting the reabsorption of cholesterol in the intestines
B. Inhibiting HMG-CoA reductase in the liver
C. Increasing HDL cholesterol levels
D. Increasing the excretion of cholesterol in the bile
Correct answer:
The correct answer is B: Inhibiting HMG-CoA reductase in the liver. Atorvastatin is a statin drug that works by inhibiting the enzyme HMG-CoA reductase, which is involved in the production of cholesterol in the liver. By inhibiting this enzyme, atorvastatin reduces the synthesis of cholesterol in the liver, leading to lower levels of LDL cholesterol in the bloodstream.
A: Inhibiting the reabsorption of cholesterol in the intestines - This is incorrect because atorvastatin primarily works in the liver, not in the intestines.
C: Increasing HDL cholesterol levels - Atorvastatin is more effective at lowering LDL cholesterol levels rather than increasing HDL cholesterol levels.
D: Increasing the excretion of cholesterol in the bile - Atorvastatin does not directly increase the excretion of cholesterol in the bile, it primarily acts in the liver to reduce cholesterol production.
The nurse notes that a client’s wound has not improved despite consistent wound care as outlined in the care plan. What should the nurse do next?
A. Reassess the wound and client’s condition.
B. Discontinue the current care plan.
C. Increase the frequency of wound dressing changes.
D. Refer the client to a specialist immediately.
Correct answer:
Step 1: Reassessing the wound and client's condition allows the nurse to identify any factors contributing to the lack of improvement.
Step 2: It helps determine if the current care plan needs modifications or if there are underlying issues affecting healing.
Step 3: This step ensures a comprehensive evaluation before making any changes to the care plan, promoting evidence-based practice.
Step 4: Choosing this option aligns with the nursing process of assessment, which is crucial for making informed decisions in client care.
Summary:
Option A is correct as it emphasizes the importance of reassessment to gather more information and make informed decisions. Discontinuing the care plan (Option B) without assessment can be harmful. Increasing dressing changes (Option C) may not address the underlying issue. Referring immediately (Option D) may be premature without reassessment.
A nurse is evaluating a client who is HIV positive who is prescribed with pentamidine (Pentam) IV for
A. Which of the following assessment after the administration is the most important to relay to the physician?
B. Blood pressure of 100/62 mm/Hg.
C. Redness and pain at the site of the infusion.
D. Sudden sweating and hunger.
Correct answer:
Redness and pain at the site of the infusion are important signs of a potential infiltration or extravasation of the medication, in this case pentamidine (Pentam) IV. Pentamidine is an antimicrobial medication used to treat and prevent Pneumocystis jiroveci pneumonia (PCP) in patients who are immunocompromised, such as those with HIV. Infiltration or extravasation of IV medications can lead to significant tissue damage, necrosis, and other complications. Therefore, it is crucial to immediately address any signs of redness and pain at the infusion site to prevent further harm to the patient. This assessment finding should be promptly relayed to the physician for appropriate management, which may include discontinuation of the infusion, monitoring for complications, and providing alternative treatments if necessary. The other assessment findings (blood pressure of 100/62 mm/Hg
A patient comes to the ER with a painful stab wound. The ER resident administers pentazocine for the pain. Soon after administration the patient experiences sweating, restlessness, and an increase in pain sensations. What is the most likely explanation for his symptoms?
A. The patient is probably tolerant to pentazocine.
B. The patient is a heroin addict.
C. Pentazocine is an ineffective analgesic.
D. Pentazocine was used at the wrong dose.
Correct answer:
Pentazocine, a mixed opioid agonist-antagonist, acts as a kappa receptor agonist and a partial mu receptor agonist, providing analgesia in opioid-naive patients. However, in a heroin addict with high mu receptor tolerance, pentazocine's partial antagonism at mu receptors can displace full agonists like heroin, precipitating withdrawal symptoms—sweating, restlessness, and heightened pain perception. Tolerance to pentazocine itself wouldn't typically increase pain; it would reduce efficacy. Pentazocine is an effective analgesic in appropriate contexts, so ineffectiveness isn't the issue. Incorrect dosing might alter efficacy or toxicity but wouldn't specifically cause this withdrawal-like reaction. The patient's history of heroin use explains this response, as pentazocine's antagonist properties disrupt the opioid equilibrium, unmasking withdrawal in a dependent individual.
The nurse educator on the unit receives a list of high- alert drugs. Which strategy is recommended to decrease the risk of errors? (Select all that apply.)
A. Store drugs on a shelf for quick retrieval.
B. Limit access to high-alert drugs.
C. Use special labels for high-alert drugs.
D. Provide increased training to staff.
Correct answer:
The correct answer is B: Limit access to high-alert drugs. This strategy is recommended to decrease the risk of errors because it restricts the availability of high-risk medications to only authorized personnel, reducing the likelihood of medication errors. By limiting access, only trained and qualified staff members will handle these drugs, minimizing the potential for mistakes.
Explanation for other choices:
A: Storing drugs on a shelf for quick retrieval may increase the risk of errors as it allows easier access to high-alert drugs, potentially leading to misuse or incorrect administration.
C: Using special labels for high-alert drugs can be helpful but may not be as effective as limiting access in preventing errors.
D: Providing increased training to staff is beneficial, but alone may not be sufficient to reduce errors if access to high-alert drugs is not restricted.
A2-year-old boy was brought to the emergency department with high body temperature (104°F, 40°C), flushed and dry skin, and widely dilated pupils unresponsive to light. He was agitated and underwent a brief tonic-clonic convulsion. His mother stated that the boy apparently swallowed several tablets of her allergy medication. Which of the following drugs most likely caused the patient's poisoning?
A. Ibuprofen
B. Diphenhydramine
C. Phenylephrine
D. Celecoxib
Correct answer:
The correct answer is B: Diphenhydramine. Diphenhydramine is a first-generation antihistamine that can cause anticholinergic toxicity in overdose. The symptoms described in the question such as high body temperature, dry skin, dilated pupils, and agitation are consistent with anticholinergic poisoning. Diphenhydramine also has sedative effects which can lead to seizures in high doses.
A: Ibuprofen is a nonsteroidal anti-inflammatory drug and overdose typically presents with symptoms like gastrointestinal upset and kidney injury, not the symptoms described in the question.
C: Phenylephrine is a decongestant that can cause hypertension and tachycardia in overdose, not the symptoms described in the question.
D: Celecoxib is a selective COX-2 inhibitor used as an NSAID and overdose usually presents with gastrointestinal symptoms, not the symptoms described in the question.
RN exams pharmacology practice questions, set 16 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the RN exams exam guide.
The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
