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
Which scenario best illustrates the nurse using data validation when making a nursing clinical decision for a patient? The nurse determines to remove a wound dressing when the patient reveals the time
A. of the last dressing change and notices old and new drainage. The nurse administers pain medicine due at 1700 at 1600 because the patient reports
B. increased pain and the family wants something done. The nurse immediately asks the health care provider for an order of potassium when a
C. patient reports leg cramps.
D. The nurse elevates a leg cast when the patient reports decreased mobility.
Show answer and rationale
Correct answer: A — of the last dressing change and notices old and new drainage. The nurse administers pain medicine due at 1700 at 1600 because the patient reports
The correct answer is A because the nurse is using data validation by comparing the time of the last dressing change with the appearance of old and new drainage. This process ensures that the decision to remove the wound dressing is based on accurate and relevant information. By assessing both the time of the last dressing change and the characteristics of the drainage, the nurse is validating the need for the intervention.
Option B is incorrect because administering pain medicine based solely on a patient's report of increased pain without further validation does not demonstrate data validation. Option C is incorrect as the nurse immediately requesting an order of potassium without further assessment of the patient's condition is not an example of data validation. Option D is incorrect as elevating a leg cast based solely on a patient's report of decreased mobility without further assessment does not involve data validation.
Question 2
Select the drug stimulating the protective function of the mucous barrier and the stability of the mucous membrane against damaging factors:
A. De-nol
B. Sucralfate
C. Misoprostol
D. Omeprazole
Show answer and rationale
Correct answer: A — De-nol
Step-by-step rationale for why "A: De-nol" is the correct answer:
1. De-nol contains the active ingredient bismuth subcitrate, which stimulates the protective function of the mucous barrier.
2. Bismuth subcitrate forms a protective layer on the mucous membrane, enhancing its stability against damaging factors.
3. This protective effect helps prevent damage to the mucous membrane from factors like acid, bile salts, and other irritants.
4. Sucralfate also forms a protective barrier but through a different mechanism, making it an incorrect choice.
5. Misoprostol and Omeprazole are not directly involved in stimulating the protective function of the mucous barrier, making them incorrect choices.
Summary:
De-nol is the correct choice because it directly stimulates the protective function of the mucous barrier and enhances the stability of the mucous membrane against damaging factors. Sucralfate, Misoprostol, and Omeprazole
Question 3
Which of the following drugs was most likely included in the therapeutic regimen of the patient with bilateral adrenal hyperplasia?
A. Hydrochlorothiazide
B. Mannitol
C. Furosemide
D. Fenoldopam
Show answer and rationale
Correct answer: C — Furosemide
The correct answer is C: Furosemide. In bilateral adrenal hyperplasia, excess production of aldosterone occurs, leading to fluid retention and hypertension. Furosemide is a loop diuretic that helps reduce blood volume and lower blood pressure by promoting the excretion of sodium and water in the urine. This drug is commonly used to manage hypertension associated with adrenal gland disorders.
Step-by-step rationale:
1. Identify the condition: bilateral adrenal hyperplasia.
2. Understand the pathophysiology: aldosterone excess leads to fluid retention and hypertension.
3. Choose the appropriate drug class: diuretics to reduce blood volume and lower blood pressure.
4. Select the specific drug: Furosemide, a loop diuretic, is effective in managing hypertension associated with adrenal gland disorders.
Summary:
A: Hydrochlorothiazide - Thiazide diuretic, not as effective in cases of aldosterone excess.
B: Mannitol - Osmotic diure
Question 4
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
Show answer and rationale
Correct answer: B — Replacing deficient thyroid hormone
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 hormone, leading to symptoms such as fatigue and weight gain. By prescribing levothyroxine, the deficient thyroid hormone levels can be restored to normal, alleviating the symptoms of hypothyroidism.
Explanation for why the other choices are incorrect:
A: Increasing the production of thyroid-stimulating hormone (TSH) - Levothyroxine does not directly affect TSH production; TSH is secreted by the pituitary gland to stimulate the thyroid gland.
C: Inhibiting thyroid hormone synthesis - Levothyroxine does not inhibit thyroid hormone synthesis; it provides the body with the thyroid hormone it lacks.
D: Increasing the metabolism of thyroid hormones - Levothyroxine does not increase the metabolism of thyroid hormones; it directly
Question 5
An older female adult patient who has been treated with clozapine (Clozaril) for 9 months calls to cancel a clinic appointment because of flulike symptoms, including a sore throat, fever, and tiredness. Which statement shows the best understanding regarding the management of the patient’s symptoms?
A. “I think you need to drink lots of juices and water and go to bed. Call me at the end of the week to reschedule your appointment.”
B. “I want you to please keep the appointment, and I will arrange for some blood work to be done while you are here.”
C. “It’s flu season all right. Get better soon, and call me to reschedule when you’re feeling better.”
D. “This may be something much more serious than the flu. Go to the hospital at once.”
Show answer and rationale
Correct answer: B — “I want you to please keep the appointment, and I will arrange for some blood work to be done while you are here.”
Step-by-step rationale for answer B:
1. Clozapine can cause agranulocytosis, a serious side effect characterized by a low white blood cell count.
2. The patient's symptoms of sore throat, fever, and tiredness may indicate a potential infection or agranulocytosis.
3. Blood work is necessary to monitor the patient's white blood cell count to rule out agranulocytosis.
4. Keeping the appointment and arranging for blood work allows for timely assessment and appropriate management.
Summary of other choices:
A: Incorrect. Advising the patient to drink juices and water and rest without further assessment may delay necessary medical intervention.
C: Incorrect. Merely acknowledging flu season without taking proactive steps to assess the patient's condition is inadequate.
D: Incorrect. Jumping to conclusions about the seriousness of the symptoms without proper evaluation through blood work is premature and may cause unnecessary alarm.
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Question 6
Which set of instructions will the nurse include in the teaching plan of a patient who is prescribed fluphenazine (Prolixin) and has developed a thickly white-coated tongue?
A. “Remember to avoid foods high in sugar, brush your teeth and tongue frequently, floss, and gargle with mouthwash. Check your tongue daily, and notify your physician if this happens again.â€
B. “Remember to avoid foods high in sugar, brush your teeth frequently, and gargle with mouthwash. Smoking can make the white coating on your tongue worse.â€
C. “I know this looks troubling, but it is not a problem. Continue taking your medication, and this will subside in about 3 weeks.â€
D. “Nasal inhalants can interact with your medication and cause an infection on your tongue.â€
Correct answer:
The correct answer is A because it provides comprehensive and appropriate instructions for managing the thickly white-coated tongue associated with fluphenazine. First, advising to avoid foods high in sugar helps prevent further irritation. Second, emphasizing good oral hygiene by brushing teeth and tongue, flossing, and gargling with mouthwash helps to reduce the coating. Third, encouraging daily tongue checks and prompt physician notification ensures monitoring and timely intervention if needed.
Choice B is incorrect because it lacks the comprehensive approach of Choice A, omitting the importance of flossing and daily tongue checks. Choice C is incorrect as it dismisses the issue without providing any guidance on how to manage the side effect. Choice D is incorrect as it introduces irrelevant information about nasal inhalants that can confuse the patient and is not directly related to managing the white-coated tongue.
The following anti-infective drugs are suitable as prophylaxis in the stated conditions:
A. Co-amoxiclav - human and animal bites
B. Ciprofloxacin - close adult contacts of meningococcal disease
C. Flucloxacillin - prevention of a secondary case of diphtheria
D. Erythromycin - whooping cough contact in an unvaccinated child under 1 year old
Correct answer:
Ciprofloxacin (B) is the correct answer as it's widely recommended for prophylaxis in close adult contacts of meningococcal disease caused by Neisseria meningitidis. A single dose effectively reduces nasopharyngeal carriage, preventing invasive disease spread. Co-amoxiclav (A) is appropriate for human and animal bites due to its coverage of anaerobes and skin pathogens like Pasteurella, but B is highlighted here. Flucloxacillin (C) isn't used for diphtheria prophylaxis; erythromycin or penicillin is preferred to eradicate Corynebacterium diphtheriae carriage. Erythromycin (D) is suitable for pertussis prophylaxis in unvaccinated infants exposed to Bordetella pertussis, reducing transmission. Aciclovir (original E) isn't standard for herpes labialis contact prophylaxis. Ciprofloxacin's efficacy, ease of administration, and alignment with public health protocols make it a critical tool in controlling meningococcal outbreaks.
A client is prescribed total parenteral nutrition (TPN). Which education should the nurse provide?
A. You will not be able to return home until the TPN is discontinued
B. Once you go home, you will come in twice a week for TPN
C. Since this is going to be a long-term treatment, your TPN will be given through a central line
D. Your TPN will be infused via an infusion pump
Correct answer:
Total parenteral nutrition (TPN) for long-term use requires a central line because it delivers high-concentration nutrients directly into large veins, like the subclavian, to avoid peripheral vein damage and ensure effective nutrient distribution. Clients can manage TPN at home with proper training, debunking the idea they must stay hospitalized until it's discontinued. It's also administered continuously or cyclically via an infusion pump for precise control, not on a twice-weekly outpatient schedule, which aligns with parenteral nutrition's complexity. The pump ensures steady delivery, critical for metabolic stability, while TPN's comprehensive nutritional support meets all dietary needs intravenously. This central line approach is standard for prolonged therapy, distinguishing it from short-term peripheral options, and supports home management, enhancing quality of life while addressing nutritional deficits effectively.
The following anti-infective drugs are suitable as prophylaxis in the stated conditions:
A. Co-amoxiclav - human and animal bites
B. Ciprofloxacin - close adult contacts of meningococcal disease
C. Flucloxacillin - prevention of a secondary case of diphtheria
D. Erythromycin - whooping cough contact in an unvaccinated child under 1 year old
Correct answer:
Ciprofloxacin (B) is the correct answer as it's widely recommended for prophylaxis in close adult contacts of meningococcal disease caused by Neisseria meningitidis. A single dose effectively reduces nasopharyngeal carriage, preventing invasive disease spread. Co-amoxiclav (A) is appropriate for human and animal bites due to its coverage of anaerobes and skin pathogens like Pasteurella, but B is highlighted here. Flucloxacillin (C) isn't used for diphtheria prophylaxis; erythromycin or penicillin is preferred to eradicate Corynebacterium diphtheriae carriage. Erythromycin (D) is suitable for pertussis prophylaxis in unvaccinated infants exposed to Bordetella pertussis, reducing transmission. Aciclovir (original E) isn't standard for herpes labialis contact prophylaxis. Ciprofloxacin's efficacy, ease of administration, and alignment with public health protocols make it a critical tool in controlling meningococcal outbreaks.
Which set of instructions will the nurse include in the teaching plan of a patient who is prescribed fluphenazine (Prolixin) and has developed a thickly white-coated tongue?
A. “Remember to avoid foods high in sugar, brush your teeth and tongue frequently, floss, and gargle with mouthwash. Check your tongue daily, and notify your physician if this happens again.”
B. “Remember to avoid foods high in sugar, brush your teeth frequently, and gargle with mouthwash. Smoking can make the white coating on your tongue worse.”
C. “I know this looks troubling, but it is not a problem. Continue taking your medication, and this will subside in about 3 weeks.”
D. “Nasal inhalants can interact with your medication and cause an infection on your tongue.”
Correct answer:
The correct answer is A because it provides comprehensive and appropriate instructions for managing the thickly white-coated tongue associated with fluphenazine. First, advising to avoid foods high in sugar helps prevent further irritation. Second, emphasizing good oral hygiene by brushing teeth and tongue, flossing, and gargling with mouthwash helps to reduce the coating. Third, encouraging daily tongue checks and prompt physician notification ensures monitoring and timely intervention if needed.
Choice B is incorrect because it lacks the comprehensive approach of Choice A, omitting the importance of flossing and daily tongue checks. Choice C is incorrect as it dismisses the issue without providing any guidance on how to manage the side effect. Choice D is incorrect as it introduces irrelevant information about nasal inhalants that can confuse the patient and is not directly related to managing the white-coated tongue.
A 68-year old client has been complaining of sleeping more, increased urination, anorexia, weakness, irritability, depression, and bone pain that interferes with her going outdoors. Based on these assessment findings, the nurse would suspect which of the following disorders?
A. Diabetes mellitus
B. Hypoparathyroidism
C. Diabetes insipidus
D. Hyperparathyroidism
Correct answer:
The correct answer is D: Hyperparathyroidism. This disorder is characterized by excessive secretion of parathyroid hormone, leading to increased calcium levels in the blood. The symptoms described in the question - bone pain, weakness, irritability, and depression - are all associated with hypercalcemia, a common manifestation of hyperparathyroidism. Additionally, the client's anorexia and increased urination can be attributed to the effects of hypercalcemia on the gastrointestinal and renal systems. Diabetes mellitus (choice A) involves high blood sugar levels and is not associated with the symptoms described. Hypoparathyroidism (choice B) is characterized by low levels of parathyroid hormone and calcium, leading to different symptoms such as muscle cramps and seizures. Diabetes insipidus (choice C) is a disorder of water balance characterized by excessive thirst and urination, not the symptoms presented in the question.
Individuals who are slow acetylators (i.e. have a relatively low activity of hepatic N-acetyltransferase):
A. Have a prevalence of 15-20 per cent in European caucasians
B. Are more likely to develop thrombocytopenia, nephrotic syndrome and rash during gold treatment
C. Are more likely to develop hepatotoxicity following halothane anaesthesia
D. Are more likely to develop antinuclear antibodies during hydralazine therapy
Correct answer:
Slow acetylators have reduced hepatic N-acetyltransferase (NAT2) activity, affecting metabolism of drugs like hydralazine, isoniazid, and procainamide. In European Caucasians, prevalence is actually 50-60%, not 15-20%, making that statement inaccurate. Gold treatment side effects like thrombocytopenia or nephrotic syndrome aren't strongly linked to acetylation status, but rather to immune responses, so that's less relevant. Halothane hepatotoxicity relates to immune-mediated reactions or metabolites, not acetylation speed. Hydralazine, metabolized by NAT2, accumulates in slow acetylators, increasing risk of drug-induced lupus with antinuclear antibodies (ANA), a well-documented association. Agranulocytosis with clozapine isn't tied to acetylation but to idiosyncratic reactions. The ANA risk with hydralazine is the most accurate, reflecting its pharmacogenetic implications, critical for personalized dosing and monitoring.
Which of the following drug classes is/are used in initial hypertension management of African American population?
A. Clonidine primary
B. Betablockers primary
C. Thiazide or calcium channel blocker primary
D. ACE-1 primary
Correct answer:
The correct answer is C: Thiazide or calcium channel blocker primary. This choice is correct because African Americans tend to respond better to thiazide diuretics and calcium channel blockers in managing hypertension. Thiazide diuretics are recommended as first-line treatment in this population due to their effectiveness and lower risk of adverse effects. Calcium channel blockers are also preferred as they have shown good efficacy and tolerability.
Choice A (Clonidine) is incorrect as it is not recommended as a primary treatment option for hypertension. Choice B (Betablockers) is also incorrect as they are not the preferred initial treatment in African American patients due to lower efficacy compared to other drug classes. Choice D (ACE-1 inhibitors) is incorrect as they are not recommended as first-line treatment in this population, as they may be less effective in African Americans compared to other drug classes.
A patient asks you how does the statin drugs work. How would you respond?
A. It inhibits the absorption of dietary cholesterol in the small intestine
B. It inhibits hydroxymethyl lutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver
C. It binds to bile in the intestinal track forming an insoluble complex that is excreted in the feces
D. It stimulates the biliary system to increase the excretion of dietary cholesterol
Correct answer:
The correct answer is B: It inhibits hydroxymethyl lutaryl-coenzyme A (HMG-CoA) reductase to reduce the biosynthesis of cholesterol in the liver. Statin drugs work by blocking the enzyme HMG-CoA reductase, which is involved in the synthesis of cholesterol in the liver. By inhibiting this enzyme, statins reduce the production of cholesterol in the body. This mechanism helps lower the levels of LDL (bad) cholesterol in the blood.
Incorrect choices:
A: It inhibits the absorption of dietary cholesterol in the small intestine - This is incorrect because statins do not affect the absorption of dietary cholesterol but rather target cholesterol synthesis in the liver.
C: It binds to bile in the intestinal track forming an insoluble complex that is excreted in the feces - This is incorrect as it describes the mechanism of bile acid sequestrants, not statins.
D: It stimulates the biliary system to increase the excretion of
A 68-year-old man was diagnosed with systolic heart failure with normal ejection fraction and normal sinus rhythm at rest. A treatment with captopril was started. Which of the following actions most likely mediated the therapeutic effect of captopril in this patient?
A. Increased cardiac contractility
B. Reduction of angiotensin-mediated vasoconstriction in the kidney
C. Reduction of preload and afterload
D. Stimulation of epinephrine release from adrenergic nerves
Correct answer:
The correct answer is B: Reduction of angiotensin-mediated vasoconstriction in the kidney. Captopril is an ACE inhibitor that works by blocking the conversion of angiotensin I to angiotensin II. In this patient with systolic heart failure, reducing angiotensin II levels will lead to vasodilation and decreased vasoconstriction in the kidney, improving renal blood flow and reducing fluid retention. This helps to alleviate symptoms of heart failure and improve overall cardiac function.
Incorrect choices:
A: Increased cardiac contractility - Captopril does not directly increase cardiac contractility.
C: Reduction of preload and afterload - While ACE inhibitors can reduce preload and afterload, the primary mechanism of captopril is through the renin-angiotensin-aldosterone system.
D: Stimulation of epinephrine release from adrenergic nerves - Captopril does not stimulate epinephrine release; it actually inhibits the
RN exams pharmacology practice questions, set 9 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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