Pharmacology II Final
1. Oral contraceptives with an estrogen and a progesterone suppress the production of
which hormones of the pituitary resulting in no ovulation (Mark the Two that apply)
a. LH
b. TSH
c. FSH
d. TRH
2. The client is newly diagnosed with breast cancer that is estrogen receptor positive
(Hint estrogen is making the tumor grow). Which of the following medications is
likely to be prescribed and what is the common adverse effect of the medication?
a. Megestrol: weight gain
b. Prednisone: elevated blood sugar
c. Tamoxifen: hot flashes
d. Cyclosporin: immunosuppression
3. During a seminar the nurse explains to a group of clients that the most important
advantage of combination chemotherapy over single-dose regimens is which of the
following?
a. Spare normal cells from severe toxicity
b. Reduce the potential for tumor resistance
c. Decrease the likelihood of drug-induced gonadal sterility
d. Reduce the potential for nausea and vomiting
4. A mother calls explaining that her child is dosing more frequently the albuterol
(Proventil) nebulizer because symptoms have worsened. What cautions should the
nurse provide about the adverse effects?
a. Risk of fatigue and fevers
b. Risk of nervousness and tachycardia
c. Risk of lethargy bradycardia
d. Risk of decreased blood pressure and dizziness
5. Tacrolimus (Prograf) has been ordered for your client. Which of the following is the
most likely diagnosis related to the use for the drug?
a. Hyperthyroid
b. GERD
c. Allergic rhinitis
d. Liver transplant
6. Which of the following is classified as an antimetabolite chemotherapy drug?
a. Vincristine
b. Fluorouracil (5-FU)
c. Cyclophosphamide
d. Cisplatin
7. Which of the following drugs will have a negative chronotropic effect based off their
mechanism of action? (SATA)
a. Atropine
b. Epinephrine (Adrenalin)
c. Metoprolol (Lopressor)
d. Digoxin (Lanoxin)
e. Diltiazem (Cardizem)
8. Your client is scheduled to receive the first round of IV chemotherapy today inpatient.
Upon entering the patient’s room for the first time today, you find that there are a lot
of family visiting, including sick, young grandchildren of the client, lots of flowers
and a couple of fruit baskets. Select all the nursing interventions that are indicated
a. Educate the client and family about avoiding infection exposure from sick
visitors and small children
b. Thank the family for bringing raw fruits and vegetables for the client as these
are optimal for the client’s nutrition at this time
c. Teach the family about the importance of something as simple as hand
washing to prevent infection
d. Invite family members to take the flowers home
9. Match the following asthma drugs with their respective category:
a. Loratadine (claritan) -H1 antagonist
b. Theophylline (Theo-Dur) -xanthine derivative
c. Albuterol (Proventil) -beta 2 selective agonist
d. Ipratropium (Atrovent) -anticholinergic
10. Phenylephrine (NeoSynephrine) is used typically as a decongestant. When used
intravenously, it causes what effect?
a. Bradycardia
b. Somnolence
c. Decrease in blood pressure
d. Increase in blood pressure
11. You are about to administer adenosine (adenocard) 6mg IV rapid push to a client
whose ECG shows supraventricular tachycardia. What do you anticipate to see
temporarily on the telemetry monitor?
a. Ventricular dysrhythmia
b. Sinus rhythm
c. Asystole
d. No change
12. A patient of yours has been receiving several doses of quetiapine (Seroquel). On your
shift, you notice that the patients tongue is protruding and when he looks at you, his
eyes jerk from side to side, and his hands have a tremor. These symptoms are
suggestive of ____. (what is MOST LIKELY occurring)
a. Extrapyramidal (EPS) side effects
b. The development of Parkinson’s disease
c. Psychosis
d. Opiate over dose
13. MOA inhibitors are used to treat resistant depression. If patients taking MAO
inhibitors consume foods containing high levels of tyramine like beer and aged
cheeses or decongestants like pseudoephedrine, this can result in what adverse effect?
a. Hypertension
b. Drowsiness
c. Hypotension
d. Nausea and vomiting
14. Which of the following would be appropriate to assess prior to administering a dose
of hydrocodone to ensure safe, effective medication administration? SATA
a. Blood pressure and respirations
b. Current weight
c. Pain level
d. Level of consciousness
15. Antiepileptics may be used to treat which of the following disorders? (Mark all that
apply)
a. Ventricular tachycardia
b. Intractable hiccups
c. Neuropathic pain
d. Bipolar/mood disorders
e. Seizures
16. You have a new order to administer furosemide (Lasix) 40 mg stat. What items are
essential to assess before administering a drug? (SATA)
a. Serum potassium
b. Blood pressure
c. White count
d. Platelets
17. The primary neurotransmitter ________ is centrally involved in schizophrenia and
most of the traditional antipsychotics _________ that neurotransmitters’ receptors.
a. Dopamine, stimulate
b. Norepinephrine, stimulate
c. Serotonin, block
d. Dopamine, block
e. Norepinephrine, block
18. Allopurinol is useful for the management of elevated uric acid levels associated with
a. Muscle spasms
b. Rheumatoid arthritis
c. Gout
d. Cirrhosis
19. A patient will be discharged with a 1-week supply of oxycodone for pain
management after abdominal surgery. The nurse will include which information in the
teaching plan?
a. How to prevent constipation
b. How to prevent dehydration due to diarrhea
c. The importance of taking the drug on an empty stomach
d. The importance of taking the drug only when the pain becomes severe
20. Simvastatin (Zocor) drug therapy is prescribed for a patient and the nurse is providing
instructions to the patient about medication. Which instructions will the nurse
include? (SATA)
a. Limit fluid intake to prevent fluid overload
b. Repeat abnormal or unusual bleeding or yellow discoloration of the skin
c. Report the occurrence of muscle pain and/or changes in the color of your urine
immediately
d. Every 3 months we will be checking your kidney function while you are on
this medication due to the potential for hepatoxicity associated with this class
e. Eat extra servings of raw vegetables and fruit and incorporate physical activity
into your lifestyle
21. The nurse is assessing a patient who has been admitted to the emergency department
for a possible opioid overdose. Which assessment findings are characteristic of an
opioid drug overdose? Select all that apply
a. Respiration rate of 6 breaths/min
b. Restlessness
c. Hypotension
d. Lethargy
e. Dilated pupils
22. A patient has had recent mechanical heart valve surgery and is receiving
anticoagulant therapy. While monitoring the patients laboratory work, the nurse
interprets that the patient’s international normalized ratio (INR) level of 2.8 indicates
that:
a. The patient’s intravenous heparin dose is at therapeutic levels
b. The patient’s intravenous heparin dose is dangerously high
c. The patient is not receiving enough warfarin to have a therapeutic effect
d. The patient’s warfarin dose is at therapeutic levels
23. 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. Thiazide diuretics
b. Osmotic diuretics
c. Loop diuretics
d. Potassium-sparing diuretics
24. When a patient is receiving desmopressin (DDAVP) or vasopressin (Pitressin), the
nurse will monitor for which therapeutic response?
a. Decreased urinary output and increase in blood pressure
b. Increased cervical ripening and contractions
c. Increased urinary output and decreased blood pressure
d. Improved appetite and energy levels
25. A patient in the emergency department was showing signs of hypoglycemia and had a
fingerstick glucose level of 44 mg/dL. The patient is still conscious. What is the
nurse’s next action?
a. Administer IM glycogen
b. Administer intravenous glucose (50% dextrose) and recheck the blood sugar in
15 minutes
c. Have the patient consume fruit juice, a non-diet soft drink, or glucose tablets
and recheck the blood sugar in 15 minutes.
d. Call the lab to order a fasting blood glucose level
26. The nurse is counseling a woman who will be starting rifampin (Rifadin) as part of
antitubercular therapy. The patient is currently taking oral contraceptives. Which
statement is true regarding rifampin therapy for this patient?
a. The incidence of adverse effects is greater if the two drugs are taken together
b. Oral contraceptives are less effective while the patient is taking rifampin
c. A higher dose of rifampin will be necessary because of the contraceptive
d. Women have a high risk for thrombophlebitis while on this drug
27. During an infusion of lactated ringers and/or 0.9% normal saline, the nurse monitors
the patient closely for the development of which potential adverse effect?
a. Fluid volume overload
b. Transfusion reaction
c. Fluid volume deficit
d. Hypernatremia
28. The nurse should include management of pulmonary toxicity in the plan of care for
clients receiving which of the following antineoplastic agents
a. Mercaptopurine (6-MP)
b. Vincristine
c. 5-fluorouracil (5-FU)
d. Bleomycin (blenoxane)
29. A client with adrenal insufficiency is prescribed to take hydrocortisone (Cortef) 3
times daily on a long term basis. What points should the nurse include during client
teaching? Select all that apply
a. Report any wound that will not heal or is healing very slowly
b. Increase your intake of calcium and Vitamin D intake as osteoporosis may
occur with long term care
c. Immediately stop taking the medication if weight gain or diarrhea occurs
d. Alcohol, excess sodium and caffeine should be avoided while taking this
medication
e. You will likely notice an improvement in your daily blood glucose levels and
hemoglobin A1C
30. A 79-year-old patient is receiving a fluoroquinolone as treatment for a complicated
incision infection. The nurse will monitor for which adverse effect that is associated
with these drugs?
a. Tendonitis and tendon rupture
b. Double vision
c. Hypotension
d. Neuralgia
31. The US Food and Drug administration has issued a black box warning for users of
antiepileptic drugs. Based on this report, the nurse will monitor for which potential
problems with this class of drugs?
a. Signs of bone marrow stimulation
b. Increased risk of cardiovascular events, such as strokes
c. Indications of drug addiction and dependency
d. Increased risk of suicidal thoughts and behaviors
32. During drug therapy for pneumonia, a female patient develops a vaginal
superinfection. The nurse explains that this infection is caused by:
a. The infection spreading from her lungs to the new site of infection
b. Resistance of the pneumonia-causing bacteria of the drugs
c. Large doses of antibiotics that kill normal flora
d. An allergic reaction to the antibiotics
33. On entering the room, a nurse finds the patient sitting upright in bed with the upper
torso resting on the over-bed table. The nurse assesses that this patient is experiencing
acute hypoxemia. Which of the following are symptoms of hypoxemia? (Select all
that apply- early and late signs of hypoxia)
a. Cyanosis
b. Restlessness
c. Eupnea
d. Intercostal retractions
e. Dysrhythmias
34. A patient with a Pseudomonas species urinary infection will be receiving amikacin
(Amikin) 15 mg/kg once daily via intravenous infusion. The patient weighs 198
pounds and the medication is available in an injection solution strength of 250
mg/mL. Identify how many milliliters of medication will be drawn up for this
injection. (record answer using one decimal place to the nearest tenth; do not include
units) _______ mL
35. A patient with a tracheostomy has difficulty removing excessive, thick mucus from
the respiratory tract. The nurse expects which drug will be ordered to aid in the
thinning and removal of mucus?
a. Dextromethorphan (Robitussin DM)
b. Benzonatate (Tessalon Perles)
c. Guaifenesin (Mucinex)
d. Diphenhydramine (Benadryl)
36. The nurse has just administered a dose of hydralazine (Apresoline) intravenously to a
client. After the initial dose, which of the following assessments is the priority?
a. Blood pressure
b. Oxygen saturation
c. Respiratory rate
d. Cardiac rhythm
37. The nurse is reviewing medications for the treatment of asthma. Which drugs are used
for acute asthma attacks? (Select all that apply)
a. Montelukast (Singulair)
b. Epinephrine nebulizer IM or IV infusion
c. Albuterol (Proventil) nebulizer solution
d. Fluticasone (Flovent) rotadisk inhaler
e. Salmeterol (Serevent) inhaler
38. Methotrexate is ordered for a patient with a malignant tumor, and the nurse is
providing education about self-care after the chemotherapy is given. Which
statements by the nurse are appropriate for the patient receiving methotrexate? SATA
a. Fevers are to be expected with chemotherapy and do not need to be reported
b. Avoid areas with large crowds or gatherings
c. Avoid foods that are too hot, too cold, too spicy or with rough edges to avoid
aggravation of stomatitis/mucocytis pain
d. Prepare for hair loss
e. Report unusual bleeding or bruising
39. A patient is receiving doxorubicin (Adriamycin) as part of treatment for ovarian
cancer. Which nursing diagnosis is most related to this antineoplastic drug?
a. Risk for injury related to the effects of neurotoxicity (ataxia, numbness of
hands and feet)
b. Decreased cardiac output related to the adverse effect of cardiotoxicity
c. Ineffective breathing pattern related to the adverse effect of pulmonary toxicity
d. Impaired urinary elimination pattern related to kidney stone
40. A patient in a rehabilitation center is beginning to experience opioid withdrawal
symptoms due to his recent cessation of heroin abuse. The patient is anxious and
hypertensive. The nurse expects to administer which drug/drugs as the mainstay of
treatment?
a. Disulfiram (Antabuse)
b. Bupropion (Zyban)
c. Methadone and clonidine (Catapres)
d. Diazepam (valium) and zolpidem (Ambien)
41. The nurse is monitoring a patient who is experiencing severe ethanol withdrawal.
Which are signs and symptoms of acute ethanol withdrawal? (SATA)
a. Pulse rate 120
b. Hypothermia
c. Tremors
d. Drowsiness
e. Agitation
f. Elevated systolic BP
42. Which of the following pharmacologic interventions are appropriate for a patient
experiencing acute alcohol withdrawal, dehydration, and malnourishment? SATA
a. Thiamine and folic acid replacement
b. 5% hypertonic saline IV
c. Electrolyte replacement (k+ and Mg+)
d. Chlordiazepoxide (Librium)
43. Which of the following drugs would NOT potentially be used to assist with a patient
withdrawing from nicotine?
a. Varenicline (Chantix)
b. Disulfiram (Antabuse)
c. Nicotine transdermal system (patch)
d. Bupropion (Zyban)
44. A patient is admitted for a pulmonary embolus and is started on a IV heparin gtt. The
prescriber monitors which of the following to determine the appropriate therapeutic
levels of heparin?
a. Platelet levels
b. aPTT
c. Red blood cell count
d. PT/INR
45. A patient is receiving digoxin 0.25 mcg/day as part of treatment for HF. The nurse
assesses the patient before medication administration. Which assessment finding
would be of most concern?
a. Apical heart rate of 70 bpm
b. Ankle edema +1 bilaterally
c. Serum digoxin level 1.2 ng/mL
d. Serum potassium level of 2.6 mEq/L
46. A patient has prescriptions for two inhalers. One inhaler is a bronchodilator and the
other is a corticosteroid. Which instruction regarding these inhalers will the nurse
give to the patient?
a. “Take the bronchodilator inhaler first”
b. “It does not matter which inhaler you use first”
c. “Take the corticosteroid inhaler first”
d. “Take these two drugs at least 2 hours apart”
47. When reviewing the antiviral medications oseltamivir (Tamiflu) and zanamivir
(Relenza) used for the treatment of the flu, which of the following statements should
the nurse include?
a. These drugs allow the patient to form antibodies to the flu to help them mount
a proper immune response to the future
b. They have been shown to reduce the symptoms and duration of influenza
infections by a few days
c. These drugs are effective only for influenza A
d. The most commonly reported adverse events with oseltamivir are palpitations,
sterility, diarrhea, nausea, and sinusitis
48. Which substance does the nurse identify as useful in the treatment of hyperlipidemia?
a. Vitamin K
b. Magnesium
c. Vitamin B3 (Niacin)
d. Calcium
49. When patients are taking selective SSRIs for the first time for depression, which is
most important to monitor for during the first few weeks of therapy?
a. Hypertensive crisis
b. Orthostatic hypotension
c. Suicidal thoughts
d. Convulsions
50. True or False: Overdose on tricyclic antidepressants are often lethal and fatal which is
one of the reasons why they have been largely replaced by the SSRI’s.
51. Treatment of extrapyramidal (EPS) symptoms is treated with which class of
medications?
a.
b.
c.
d.
Anticholinergics
Antihypertensives
Antispasmodics
Antiemetics
52. Match the following drug with the appropriate mechanism of action:
a. Nifedipine - Cause vasodilation because of relaxation of smooth muscles
venous> arterial (decreasing preload and afterload)
b. Atenolol - reduction of the heart rate through beta1 receptor blockade
c. Hydrochlorothiazide - decrease plasma and extracellular fluid volumes,
d. Enalapril - blocks ACE thus preventing the formation of angiotensin II
preventing potent vasoconstriction and aldosterone secretion
e. Nitroglycerine - slows calcium influx into smooth muscle causing vascular
relaxation and prevents spasm,
53. Your patient has just been prescribed naproxen for arthritis pain. The nurse would
monitor for all the following adverse effects associated with this NSAID except:
a. Fevers
b. GI bleeding
c. Tinnitus
d. Thromboembolic events (MI and CVA symptoms)
54. The nurse knows that the adverse effects of a nonselective beta blocker are likely to
be the most immediately life threatening in which patient?
a. Patient with gastroesophageal reflux disease
b. Patient with asthma
c. Patient with type I diabetes
d. Patient with hypertension
55. All of the following statements are true regarding the administration of metformin
EXCEPT?
a. Side effects of metformin include GI upset and rare potential for lactic acidosis
b. Metformin will need to be discontinued if the patient is to undergo studies
with contrast dye because of possible renal effects
c. Metformin stimulates the beta cells to increase insulin secretion from the
pancreas thereby decreasing blood glucose levels
d. Metformin is the first-line drug to treat type 2 DM and is the most commonly
used
56. Match the following drug with their appropriate class:
a. Zidovudine (Retrovir) -antiretroviral
b. Terazosin (Hytrin) – alpha 1 blocker
c. Carbamazepine (Tegretol) -antiepileptic
d. Baclofen (Liorsal) -antispasmodic
e. Sertraline (Zoloft) -antidepressant
57. The nurse recognizes that use of estrogen drugs is contraindicated in which patient?
a. A woman with a history of a thromboembolic event
b. A woman who has just given birth and wants to prevent postpartum lactation
c. A patient who has atrophic vaginitis
d. A patient who has inoperable prostate cancer
58. Match the following insulin with their appropriate category:
a. Regular insulin (Humulin R) -short acting
b. Insulin detemir (Levemir) -long acting
c. Insulin isophane suspension (NPH) -intermediate acting
d. Insulin lispro (Humalog) -rapid acting
59. Which of the following medications require serum drug monitoring to ensure the
therapeutic window is appropriate to avoid potential toxicity? SATA
a. Lithium
b. Antiepileptics (AEDs)
c. Digoxin
d. Methylprednisone
e. Aminoglycosides
60. A patient with a history of alcohol abuse has been admitted for severe weakness and
malnutrition. The nurse will prepare to administer which vitamin preparation to
prevent Wernicke’s encephalopathy?
a. Vitamin B1 (thiamine)
b. Folic Acid
c. Vitamin b6 (pyridoxine)
d. Vitamin b3 (niacin)
61. Lorazepam (Ativan) may be used in all of the following scenarios EXCEPT
a. Alcohol withdrawal
b. Anesthesia adjunct
c. Seizures
d. Migraines
62. All of the following medications are used to ease symptoms of Parkinson’s disease
except?
a. Selegiline (Eldepryl)- selective MAO-B inhibitors
b. Carbidopa-levodopa (Sinemet)- direct acting dopaminergic drugs
c. Phenelzine (Nardil)- nonselective MAO inhibitors
d. Benztropine (Cogentin)- anticholinergic
63. A patient has been receiving total parenteral nutrition. Upon assessment, the nurse
notes these assessment findings: blood pressure 150/92 Hg (elevated from previous
readings), pulse rate 110 bpm and weak, pitting edema on both ankles, new onset
confusion, coarse crackles and shortness of breath. The nurse suspects that the patient
is experiencing which condition?
a. Infection
b. Hyperglycemia
c. Fluid overload
d. Hypoglycemia
64. True or false. Administration of 3-5% hypertonic saline is considered a HIGH
ALERT drug because of its potential to cause irreversible brain stem damage if
administered erroneously
65. Histamine ___one______ antagonists/blockers such as diphenhydramine have several
properties including antihistamines effects, sedative effects, anticholinergic effects
and antipruritic effects (fill in the blank with number 1 or 2)
66. A patient is taking diphenoxylate with atropine (Lomotil). What does the nurse
monitor when assessing for therapeutic effects?
a. Decrease in loose, watery stools
b. Reduction in dry mouth
c. Increased bowel sounds
d. Minimal passage of flatus
67. The prescriber has changed the patient’s medication regimen to include the
leukotriene receptor antagonist (LTRA) montelukast (Singulair) PO to treat asthma.
The nurse will emphasize which point about this medication?
a. The patient needs to keep it close by at all times to treat acute asthma attacks
b. When the asthma symptoms improve, the dosage schedule can be tapered and
eventually discontinued
c. It needs to be taken every day on a continuous schedule, even if symptoms
improve
d. The proper technique for inhalation must be followed
68. Donepezil (Aricept) use to treat memory problems by increasing the amount of
acetylcholine in the synapses. The adverse effects likely from this drug include:
SATA
a. Urinary urgency
b. Increased salivation
c. Diarrhea
d. Decreased sweating
e. Constipation
69. When administering an alpha blocker for the first time, it is most important for the
nurse to assess the patient for the development of
a. Dysrhythmias
b. Blood dyscrasia
c. Hypotension
d. Renal failure
70. You have a patient that was admitted is hyperkalemic and in acute renal failure and is
now being started on emergent hemodialysis. Which of the following medications
should be avoided with this patient? Select all that apply
a. Ketorolac (Toradol)
b. Atenolol
c. Lisinopril
d. Magnesium hydroxide (Milk of Magnesia)
e. Potassium supplements
71. A patient wants to prevent problems with constipation and asks the nurse for advice
about which type of laxative is safe to use for this purpose. Which class of laxative is
considered safe to use on long-term basis?
a. Emollient laxatives
b. Bulk-forming laxatives
c. Hyperosmotic laxatives
d. Stimulant laxatives
72. Your client with erectile dysfunction is being evaluated for the use of sildenafil
(Viagra). Which of the following questions should the nurse ask before initiating
therapy with sildenafil?
a. “Have you ever been treated for migraine headaches?”
b. “Have you ever had an allergic reaction to dairy products?”
c. “Do you have a history of diabetes?”
d. “Are you currently taking medications for angina?”
73. What neurotransmitters are known to be involved with depression? (mark all that are
correct)
a. Norepinephrine
b. Dopamine
c. GABA
d. Acetylcholine
e. Serotonin
74. Which atypical antipsychotic agent requires routine monitoring of the CBC and
reporting to a registry to prescribe safely?
a. Haloperidol (Haldol)
b. Aripiprazole (Abilify)
c. Chlorpromazine (Thorazine)
d. Clozapine (Clozaril)
75. A bipolar patient of yours has been receiving several doses of risperadol. On your
shift, you notice that the patient’s tongue is protruding and when he looks at you, his
eyes jerk from side to side and his hands have a tremor. These symptoms are
suggestive of __________.
a. The development of Parkinson’s disease
b. Extrapyramidal side effects
c. Psychosis
d. Opiate over-dose
76. Lithium salts are used as a _________ in the treatment of bipolar disorder
a. Atypical antipsychotic
b. Typical antipsychotic
c. Mood stabilizer
d. Antidepressant