Question 1

What is the route of BCG vaccine administration?

Accepted Answer

Answer reason: BCG (bacille Calmette-Guérin) vaccine is administered into the dermis, typically over the deltoid area, to produce a characteristic local immune response and small wheal/bleb. Giving it by subcutaneous or intramuscular routes increases the risk of improper immune response and local complications (e.g., abscess). Oral administration is used for some vaccines (e.g., OPV/rotavirus) but not for BCG.
Category reason: This tests vaccine administration route knowledge, which is part of medication/vaccine fundamentals and is best categorized under Pharmacology rather than nursing prioritization or patient-care decision-making.

Question 2

Which of the following is NOT part of the 4-drug intensive phase regimen for new TB patients?

Accepted Answer

Answer reason: The standard 4-drug intensive phase for drug-susceptible pulmonary tuberculosis is HRZE: isoniazid, rifampicin, pyrazinamide, and ethambutol. Streptomycin is not routinely included in the first-line 4-drug regimen and is reserved for specific situations (e.g., certain retreatment regimens or drug resistance patterns). Current guidelines generally avoid streptomycin due to injectable administration requirements and notable toxicities such as ototoxicity and nephrotoxicity.
Category reason: This question tests knowledge of standard first-line anti-tuberculosis drug regimens, which is primarily pharmacology-focused rather than nursing care decision-making.

Question 3

Dana chooses to use COC as her family planning method. What is the danger sign of COC you would ask her to report?

Accepted Answer

Answer reason: D. Migraine headache New or worsening severe headache in a combined oral contraceptive user is a warning sign for serious vascular complications, including thromboembolism and stroke risk, particularly if migraine with aura develops. Such symptoms warrant prompt evaluation and usually discontinuation until assessed. In contrast, nasal congestion, mild weight gain, and nonspecific arthralgia are not classic “danger signs” that indicate an acute, life-threatening adverse effect of COCs.
Category reason: This question tests adverse effect warning signs of combined oral contraceptives, which is primarily medication safety/side-effect knowledge under Pharmacology.

Question 4

What is the main purpose of administering nitroglycerin in angina?

Accepted Answer

Answer reason: Nitroglycerin is a nitrate that relaxes vascular smooth muscle, producing venodilation and some arterial/coronary vasodilation. In angina, its key therapeutic aim is to relieve myocardial ischemia by improving coronary blood flow (including relief of coronary spasm) and reducing myocardial oxygen demand via preload reduction. Among the options given, coronary artery dilation most directly represents the intended anti-anginal effect. It does not primarily work by lowering heart rate, and “increase oxygen delivery” is not its direct mechanism.
Category reason: This question tests the mechanism and therapeutic purpose of a medication (nitroglycerin) used for angina, which is primarily a Pharmacology concept rather than a nursing judgment/intervention scenario.

Question 5

The nurse is caring for a client receiving IV heparin. What is the antidote for heparin overdose?

Accepted Answer

Answer reason: It directly neutralizes heparin by forming a stable inactive complex, rapidly reversing anticoagulation and helping control bleeding. It is used specifically for heparin toxicity (including post–cardiopulmonary bypass or excessive IV dosing). Vitamin K reverses warfarin, naloxone reverses opioids, and atropine is used for symptomatic bradycardia or organophosphate poisoning—none counteract heparin.
Category reason: This item tests knowledge of drug reversal agents (antidotes) and mechanism-based selection, which is core Pharmacology rather than nursing judgment or prioritization.

Question 6

A client is prescribed enalapril. What side effect should the nurse watch for?

Accepted Answer

Answer reason: ACE inhibitors like enalapril can increase bradykinin levels, which commonly triggers a persistent, nonproductive cough. This adverse effect is notable because it may lead to discontinuation and switching to an ARB if bothersome. The other options are not typical for ACE inhibitors: they more often cause hypotension, hyperkalemia, and (rarely) angioedema rather than hypoglycemia, constipation, or tachycardia.
Category reason: This item tests knowledge of a medication class (ACE inhibitors) and its characteristic adverse effects, which is primarily Pharmacology rather than nursing process or prioritization.

Question 7

Which of the following medications is administered to prevent Wernicke's encephalopathy in patients with Delirium Tremens?

Accepted Answer

Answer reason: Patients with delirium tremens are at high risk for thiamine (vitamin B1) deficiency due to chronic alcohol use and poor nutrition. Thiamine deficiency can precipitate Wernicke’s encephalopathy, classically with confusion, ophthalmoplegia, and ataxia. Prophylactic thiamine is given (often before glucose) to prevent worsening neurologic injury. Benzodiazepines treat withdrawal symptoms, and antipsychotics may help agitation, but neither prevents this deficiency-related encephalopathy.
Category reason: This item tests knowledge of which medication prevents a specific alcohol-related neurologic complication, focusing on drug/vitamin therapy rather than nursing prioritization or interventions, so it best fits Pharmacology under NursingScience.

Question 8

_____ drug which is used as a first line treatment of acute mania?

Accepted Answer

Answer reason: First-line pharmacologic options for acute mania commonly include mood stabilizers such as lithium and valproate, especially for classic manic episodes and for ongoing mood stabilization. Antipsychotics like haloperidol can rapidly control agitation and psychosis but are generally considered adjuncts/alternatives rather than core “first-line mood stabilizer” choices across standard teaching. When a single best choice is offered that captures first-line mood stabilizers, selecting the combination of lithium and sodium valproate best fits accepted practice.
Category reason: This item tests knowledge of medication classes and their indications in bipolar disorder (acute mania), which is primarily pharmacology rather than nursing intervention or prioritization.

Question 9

Antipsychotic which was first of all discovered?

Accepted Answer

Answer reason: A) Chlorpromazine Chlorpromazine was the first antipsychotic introduced into clinical practice in the early 1950s and became the prototype “typical” (first-generation) antipsychotic. Haloperidol was developed later, and olanzapine and risperidone are second-generation agents that appeared decades afterward. Therefore, the earliest discovered among the listed drugs is chlorpromazine.
Category reason: This question tests historical and classification knowledge of antipsychotic medications, which falls under Pharmacology rather than nursing care decision-making.

Question 10

Dose of atropine given before ECT is?

Accepted Answer

Answer reason: Atropine is used as a premedication in ECT to reduce vagal-mediated bradycardia and to decrease salivary and bronchial secretions during anesthesia and the seizure. Standard adult pre-ECT dosing is typically around 0.5 mg IM/IV (often cited as 0.4–0.6 mg), which matches this option. The other options are either subtherapeutic for this indication or excessively high and would raise risk of anticholinergic toxicity (e.g., tachyarrhythmias, hyperthermia, delirium).
Category reason: This item tests a specific medication dose used as premedication for a procedure, which is a core Pharmacology knowledge question rather than a nursing judgment/prioritization scenario.

Question 11

In oculogyrie crisis:

Accepted Answer

Answer reason: Oculogyric crisis is an acute dystonic reaction classically causing sustained, involuntary upward deviation of the eyes, often with associated neck muscle spasm and abnormal head posture (torticollis). It is most commonly triggered by dopamine-blocking drugs (e.g., antipsychotics, metoclopramide). Downward gaze is not typical for this reaction, and inability to talk/watch/hear describes an altered level of consciousness rather than a focal dystonia. Recognition is important because it responds rapidly to anticholinergics (e.g., benztropine) or antihistamines (e.g., diphenhydramine).
Category reason: This question tests recognition of an acute dystonic (extrapyramidal) adverse drug reaction and its characteristic presentation, which is primarily a Pharmacology concept.

Question 12

If a depressive patient is prescribed to take the antidepressant medicine once in a day. The patient should take it?

Accepted Answer

Answer reason: Many commonly used antidepressants (e.g., SSRIs, SNRIs, activating TCAs) can cause insomnia or increased alertness, so dosing in the morning helps reduce sleep disruption. Once-daily dosing is typically scheduled at the same time each day to maintain steady drug levels and improve adherence. If a particular antidepressant is sedating, bedtime dosing may be preferred, but the general teaching for once-daily antidepressants is morning unless otherwise directed.
Category reason: This question tests general medication administration timing and expected effects of antidepressants (activation vs insomnia), which is core Pharmacology rather than nursing-priority decision-making in a patient scenario.

Question 13

Which is a common side effect of opioid analgesics?

Accepted Answer

Answer reason: Opioids activate μ-receptors in the gastrointestinal tract, reducing peristalsis and increasing fluid absorption, which commonly leads to decreased bowel motility. This effect occurs in many patients and often persists without tolerance, so prophylactic bowel regimens are frequently needed. Diarrhea is not typical, and opioids more commonly cause hypotension/bradycardia and respiratory depression rather than hypertension or tachypnea.
Category reason: This item tests knowledge of medication adverse effects and mechanisms of opioids, which is primarily Pharmacology rather than a nursing judgment/prioritization scenario.

Question 14

Disinfectant for superficial fungal infection

Accepted Answer

Answer reason: It is a strong oxidizing antiseptic used topically in dilute solutions for superficial infections, including certain fungal skin infections (e.g., weeping/oozing lesions), by reducing microbial load and drying the area. Phenol is too caustic for routine superficial skin use and is not preferred for fungal infections. Chlorine and hypochlorite compounds are primarily environmental disinfectants/bleaches and are generally irritating and unsafe for direct application to skin/mucosa at disinfectant concentrations. Therefore, this is the best choice among the options for superficial fungal infection.
Category reason: This question tests knowledge of common antiseptics/disinfectants and their appropriate clinical uses, which is primarily pharmacology (agents, indications, and safety for topical use) rather than a nursing decision-making scenario.

Question 15

Rifampin:

Accepted Answer

Answer reason: Rifampin inhibits bacterial DNA-dependent RNA polymerase, which blocks transcription and prevents formation of mRNA. This halts protein production and leads to bacterial death, making it a key drug in tuberculosis therapy and some staphylococcal infections. Resistance develops rapidly if used alone, so it is typically combined with other antimicrobials. Important clinical considerations include strong CYP450 induction causing drug interactions and potential hepatotoxicity.
Category reason: This item tests the mechanism of action of a specific antimicrobial drug, which is a core Pharmacology concept rather than a nursing intervention or prioritization scenario.

Question 16

Transacetylase inactivate:

Accepted Answer

Answer reason: A common bacterial resistance mechanism to this drug is enzymatic inactivation by chloramphenicol acetyltransferase, which acetylates the molecule and prevents it from binding the 50S ribosomal subunit. This acetylation (sometimes loosely referred to as a transacetylation reaction) renders the antibiotic inactive. Aminoglycosides are more classically inactivated by different modifying enzymes (acetyltransferases, adenyltransferases, phosphotransferases), while penicillins and cephalosporins are typically inactivated by beta-lactamases.
Category reason: This item tests an antibiotic resistance mechanism and drug inactivation enzyme, which is core Pharmacology content rather than a nursing care decision.

Question 17

Which medication is contraindicated in postpartum hemorrhage if the client has hypertension?

Accepted Answer

Answer reason: It is an ergot alkaloid uterotonic that causes potent vasoconstriction and can significantly increase systemic blood pressure. In patients with hypertension (or preeclampsia), this raises the risk of severe hypertension, stroke, and other cardiovascular complications. Other common uterotonics used for postpartum hemorrhage (e.g., oxytocin, misoprostol) do not have the same strong hypertensive/vasoconstrictive contraindication.
Category reason: This question tests contraindications of specific postpartum hemorrhage uterotonic medications, which is primarily pharmacology knowledge rather than nursing prioritization or care-planning.

Question 18

A client with postpartum hemorrhage has hypertension. Which medication should be avoided?

Accepted Answer

Answer reason: B) Methylergonovine (Methergine) It is an ergot alkaloid uterotonic that causes strong vasoconstriction and can markedly raise blood pressure, so it is contraindicated in clients with hypertension or preeclampsia. Oxytocin and misoprostol are uterotonics without the same hypertensive risk and are commonly used in postpartum hemorrhage. Carboprost is avoided mainly in asthma due to bronchospasm risk rather than hypertension.
Category reason: This question tests contraindications and adverse cardiovascular effects of uterotonic medications used for postpartum hemorrhage, which is primarily pharmacology knowledge.

Question 19

A client is receiving atorvastatin. Which complaint should the nurse report immediately?

Accepted Answer

Answer reason: This suggests statin-associated myopathy, which can progress to rhabdomyolysis. Rhabdomyolysis can cause acute kidney injury due to myoglobin release, making early recognition and prompt provider notification critical. The nurse should expect evaluation of creatine kinase and renal function and may anticipate holding the medication per provider order.
Category reason: This question tests recognition of a serious adverse effect of a medication (atorvastatin), which is primarily pharmacologic knowledge.

Question 20

Plasminogen is converted to plasmin by ?

Accepted Answer

Answer reason: Urokinase is a fibrinolytic agent that directly activates plasminogen to form plasmin, which then degrades fibrin clots. This mechanism underlies its use in thrombolysis for selected thromboembolic conditions. Heparin acts by potentiating antithrombin to inhibit clotting factors rather than generating plasmin. Histamine and serotonin are vasoactive mediators without plasminogen-activating activity.
Category reason: This question tests drug mechanism of action in the fibrinolytic system, which is primarily a Pharmacology concept rather than a nursing care decision.

Question 21

Which of the following drugs is used for radical treatment of P. vivax malaria?

Accepted Answer

Answer reason: P. vivax has dormant liver hypnozoites that can cause relapses after the blood-stage parasites are cleared. Radical cure requires an agent active against these hepatic forms, which is an 8-aminoquinoline. Primaquine eradicates hypnozoites, preventing relapse, whereas chloroquine, quinine, and artemether primarily treat blood-stage infection.
Category reason: This question tests knowledge of antimalarial drug selection and specific stage activity (hypnozoites vs blood stages), which is primarily pharmacology rather than nursing care decision-making.

Question 22

A patient with osteoporosis is started on calcitonin. Which route is most appropriate for administration?

Accepted Answer

Answer reason: B. Subcutaneous or intranasal Calcitonin is a peptide hormone that is not effective orally because it is degraded in the gastrointestinal tract. For osteoporosis, it is commonly administered as an intranasal spray for convenience and tolerability, or by subcutaneous injection when needed. Intradermal administration is not a standard therapeutic route, and IV use is not the routine route for osteoporosis management.
Category reason: This question tests knowledge of medication formulation and appropriate routes of administration for calcitonin, which is primarily a pharmacology concept rather than a nursing-judgment scenario.

Question 23

Which medication should the nurse question in a client with a hip fracture and a history of osteoporosis?

Accepted Answer

Answer reason: B. Prednisone Systemic glucocorticoids accelerate bone loss by decreasing osteoblast activity, increasing osteoclast-mediated resorption, and reducing intestinal calcium absorption, which increases fracture risk and impairs bone healing. In a client with osteoporosis and a hip fracture, this medication can worsen underlying low bone density and contribute to delayed recovery. The other options are used to prevent/treat osteoporosis by improving bone mineralization or reducing bone resorption.
Category reason: This question tests knowledge of medication effects on bone metabolism and osteoporosis risk, which is primarily pharmacology rather than a nursing process/prioritization scenario.

Question 24

What is the therapeutic classification of Atropine?

Accepted Answer

Answer reason: Atropine is an anticholinergic (muscarinic antagonist) that increases heart rate by inhibiting vagal effects on the SA and AV nodes. Clinically it is used to treat symptomatic bradycardia and certain AV nodal conduction blocks, which places it under therapeutic use for dysrhythmia management. Antipsychotics, antidepressants, and anticonvulsants do not describe atropine’s primary clinical indications or mechanism. The option that best matches its therapeutic use in cardiac rhythm control is the antiarrhythmic category.

Question 25

All benzodiazepines reduce and produce .

Accepted Answer

Answer reason: A. anxiety, sedation Benzodiazepines are GABA-A positive allosteric modulators that increase inhibitory neurotransmission in the CNS. Clinically, this produces anxiolysis as a primary therapeutic effect and sedation/drowsiness as a common dose-related effect. The other options invert the direction of anxiolysis or include effects that are not characteristic or are contradictory to CNS depression. Therefore the option pairing reduced anxiety with sedation best matches the pharmacologic class effects.

Question 26

Lithium is used to treat?

Accepted Answer

Answer reason: Lithium is a mood stabilizer that helps prevent and treat manic episodes and reduces mood cycling. It is a first-line maintenance medication in bipolar disorder and is also effective for acute mania in many patients. It is not primarily used as monotherapy for unipolar depression or anxiety, where antidepressants and anxiolytics are typical first-line choices. Schizophrenia is primarily treated with antipsychotic medications rather than mood stabilizers.

Question 27

Which drug used into hemodialysis to prevent blood clot?

Accepted Answer

Answer reason: Systemic anticoagulation is commonly required during hemodialysis to prevent clotting in the extracorporeal circuit. This option directly fits because it rapidly potentiates antithrombin III, inhibiting thrombin and factor Xa, which helps keep the dialysis tubing and filter patent. Warfarin has a delayed onset and is not used for immediate circuit anticoagulation, and aspirin primarily affects platelets rather than providing reliable circuit anticoagulation. Protamine is used to reverse heparin’s effects, not to prevent clot formation during dialysis.

Question 28

Ondansetron, 8 mg IV given before chemotherapy is to prevent?

Accepted Answer

Answer reason: Ondansetron is a 5-HT3 receptor antagonist that blocks serotonin-mediated stimulation of the vagal afferents and the chemoreceptor trigger zone, which are central pathways for chemotherapy-induced nausea and vomiting. Giving it before chemotherapy is a prophylactic antiemetic strategy to reduce acute emesis. Hair loss is related to cytotoxic effects on rapidly dividing hair follicles and is not prevented by antiemetics. Fatigue and pain are managed with other supportive or analgesic interventions rather than serotonin receptor blockade.

Question 29

A nurse is teaching a client who is about to begin sumatriptan therapy to treat migraine headaches. The nurse should instruct the client to monitor for which the following adverse effects?

Accepted Answer

Answer reason: Sumatriptan is a selective 5-HT1B/1D agonist that can cause vasoconstriction in coronary vessels as well as cranial vessels. This can produce chest pressure/tightness or chest pain and may signal clinically significant ischemia, especially in patients with underlying cardiovascular risk. The client should be taught to promptly report these symptoms rather than dismissing them as benign. The other options are not characteristic key adverse effects associated with triptans and would be less safety-critical to prioritize in teaching.

Question 30

A nurses caring for a client who has a new prescription for amphetamine sulfate. The nurse should monitor the client for which of the following adverse effects?

Accepted Answer

Answer reason: Amphetamine is a central nervous system stimulant with sympathomimetic effects that increase norepinephrine activity. This raises heart rate and blood pressure, making increased pulse a common and clinically important adverse effect to monitor. In contrast, hypotension is opposite of the expected adrenergic response, and bronchospasm is not a typical direct adverse effect of amphetamines. Monitoring should include vital signs and assessment for palpitations, chest pain, and other signs of excessive stimulation.

Question 31

Which drug is used in leprosy?

Accepted Answer

Answer reason: Leprosy (Hansen disease) is treated with multidrug therapy to prevent resistance and to effectively eradicate Mycobacterium leprae. Standard WHO regimens combine rifampicin with dapsone, and clofazimine is included particularly for multibacillary disease and for its anti-inflammatory benefit in lepra reactions. Each listed medication is a recognized component of recommended leprosy therapy depending on classification and regimen duration. Options listing single agents are incomplete because monotherapy risks resistance and is not standard of care.

Question 32

Which is the first line drug in hypertension?

Accepted Answer

Answer reason: First-line pharmacologic therapy for uncomplicated primary hypertension commonly includes thiazide-type diuretics because they reliably lower blood pressure and reduce cardiovascular morbidity and mortality. This option directly matches standard guideline-based initial treatment choices (often alongside ACE inhibitors/ARBs or calcium channel blockers). Digoxin is used for heart failure and certain tachyarrhythmias rather than primary BP control. Diazepam is an anxiolytic/sedative, and warfarin is an anticoagulant, neither indicated as initial antihypertensive therapy.

Question 33

Which of the following is an example of a colloid solution?

Accepted Answer

Answer reason: Colloid solutions contain large molecules (e.g., proteins) that remain primarily within the intravascular space and exert oncotic pressure, drawing water into the circulation. Albumin is a plasma protein preparation and is therefore a classic colloid used for volume expansion. In contrast, D5W, Lactated Ringer’s, and normal saline are crystalloids composed of small solutes that distribute more freely into the interstitial space. This difference is clinically important because colloids tend to produce more sustained intravascular volume expansion per infused volume.

Question 34

Which is the antidote of heparin?

Accepted Answer

Answer reason: Heparin overdose is reversed by a specific antagonist that neutralizes its anticoagulant effect. Protamine is a positively charged protein that binds to negatively charged heparin to form an inactive complex, rapidly reducing anticoagulation. Vitamin K reverses warfarin (by restoring vitamin K–dependent clotting factor activation) and therefore would not correct heparin toxicity. Calcium gluconate treats calcium-channel blocker toxicity or hypocalcemia, and atropine treats symptomatic bradycardia, so neither addresses heparin’s mechanism.

Question 35

A nurse is teaching a client about raloxifene therapy to prevent osteoporosis. The nurse should instruct the client to monitor for which the following indications of an adverse reaction to the drug?

Accepted Answer

Answer reason: Raloxifene (a SERM) increases the risk of venous thromboembolism due to procoagulant effects similar to estrogen in some tissues. New unilateral calf pain can signal deep vein thrombosis, a serious adverse reaction that requires prompt medical evaluation. Patients should also be taught to watch for swelling, warmth, and redness of the leg and symptoms of pulmonary embolism (e.g., sudden dyspnea, chest pain). The other options are not characteristic sentinel findings of raloxifene-related complications and are less clinically urgent in this context.

Question 36

Which of the following is a therapeutic action of raloxifene?

Accepted Answer

Answer reason: Raloxifene is a selective estrogen receptor modulator (SERM) that acts as an estrogen agonist in bone, decreasing bone resorption and helping prevent/treat osteoporosis. This therapeutic goal is achieved by promoting estrogen-like effects on osteoblast/osteoclast signaling and improving bone mineral density. It is not used to stimulate menstrual cycling and does not work by increasing parathyroid hormone secretion. A key safety distinction is that it is an estrogen antagonist in breast and endometrial tissue, which helps avoid endometrial stimulation while still benefiting bone.

Question 37

A nurse is teaching a client about the use of cromolyn sodium to prevent bronchospasm. The nurse explained that the drug has which of the following therapeutic effects?

Accepted Answer

Answer reason: Cromolyn sodium is a mast cell stabilizer that prevents degranulation and subsequent release of histamine and other inflammatory mediators. By blocking this mediator release, it decreases airway hyperresponsiveness and helps prevent bronchospasm when used prophylactically. It does not produce acute bronchodilation, so it is not useful for immediate relief during an asthma attack. It also is not an anticholinergic drug, so muscarinic receptor blockade is not its mechanism. The overall therapeutic benefit is reduction of airway inflammation-driven bronchoconstrictive responses.

Question 38

A nurse should identify that dextromethorphan can have which the following effects when combined with morphine?

Accepted Answer

Answer reason: Combining centrally acting cough suppressants with opioids can produce additive central nervous system depressant effects. Morphine causes dose-dependent sedation and respiratory depression, and dextromethorphan can also cause CNS depression at therapeutic or higher doses. When used together, the key nursing concern is enhanced sedation with increased risk of respiratory compromise, especially in opioid-naive patients or when other sedatives are present. The renal absorption option is not a clinically relevant interaction mechanism, and morphine does not typically reduce the cough-suppressant action of dextromethorphan.

Question 39

When does regular insulin generally have peak action after application?

Accepted Answer

Answer reason: Insulin preparations have characteristic onset, peak, and duration profiles that guide timing of meals and hypoglycemia monitoring. Regular insulin (short-acting) typically peaks around 2–4 hours after subcutaneous administration, making 2–3 hours the best match among the choices. The 30–60 minute windows align more closely with onset rather than peak for regular insulin. Recognizing the peak window is clinically important because hypoglycemia risk is highest during peak effect and meal timing should account for it.

Question 40

Which of the following symptoms may occur with a phenytoin level of 32 mg/dl?

Accepted Answer

Answer reason: Phenytoin has a narrow therapeutic index, and toxicity commonly presents with dose-related CNS depression and cerebellar dysfunction. A level around 32 mg/dL is above the usual therapeutic range (about 10–20 mg/L), making neurologic findings such as ataxia, nystagmus, dysarthria, and confusion expected. This directly matches the option describing impaired coordination and altered mental status. Electrolyte depletion and urinary incontinence are not typical hallmark effects of phenytoin toxicity, and seizures would be more consistent with subtherapeutic anticonvulsant effect rather than supratherapeutic toxicity.

Question 41

Contraindication for metabolic therapy in patients with painful bone metastases is?

Accepted Answer

Answer reason: Systemic metabolic (radioisotope) therapy for painful bone metastases delivers radiation that can suppress bone marrow function. Baseline marrow reserve must be adequate because treatment commonly worsens cytopenias, increasing risks of infection, bleeding, and inability to tolerate further cancer therapy. Therefore, pre-existing marked myelosuppression is a key contraindication or requires deferral until counts recover. Advanced disease stage alone is not an absolute contraindication if the goal is palliation and marrow function is acceptable.

Question 42

Which drug is bronchodilator?

Accepted Answer

Answer reason: Bronchodilators relieve bronchospasm by relaxing airway smooth muscle, most commonly via beta-2 adrenergic receptor stimulation. Salbutamol (albuterol) is a short-acting beta-2 agonist used for acute asthma/COPD symptom relief and wheeze. Diazepam is a benzodiazepine used for anxiety, seizures, and sedation, not airway dilation. Furosemide is a loop diuretic for fluid overload, and warfarin is an anticoagulant; neither directly opens the bronchi.

Question 43

What is the expected outcome of thrombolytic drug therapy?

Accepted Answer

Answer reason: Thrombolytics activate plasminogen to plasmin, which breaks down fibrin within an existing clot, restoring perfusion. The desired therapeutic effect is lysis of the thrombus/embolus rather than vessel constriction or changes in permeability. Bleeding is a major adverse effect of this therapy, so it does not “prevent hemorrhage” and instead increases hemorrhage risk. Therefore the expected outcome is clot dissolution with improved blood flow.

Question 44

A nurse is providing teaching to a client who has a prescription for bus-irons. Which of the following instructions should the nurse include?

Accepted Answer

Answer reason: Buspirone is an anxiolytic that does not provide immediate relief and requires consistent dosing for clinical benefit. Because its therapeutic effect builds gradually, clients should be taught to expect a delayed onset over several weeks rather than rapid symptom control. It is not intended for PRN use in acute anxiety, which is a common misunderstanding compared with benzodiazepines. Grapefruit juice can increase buspirone levels via CYP3A4 inhibition and is generally avoided rather than recommended to “increase absorption.” Consistency with food (always with or always without) may be advised, but taking it specifically on an empty stomach is not the key teaching point.

Question 45

A nurse is caring for a client who was admitted to the er department with a head injury. The nurse notes that the client has an existing prescription for bupropion hydrochloride to treat depression. For which of the following adverse effects is the client at an increased risk?

Accepted Answer

Answer reason: Bupropion lowers the seizure threshold, and the risk is dose-related and increased in patients with predisposing factors. A recent head injury is a key risk factor because CNS trauma can increase neuronal excitability and susceptibility to seizures. Therefore, this client has heightened risk for seizures as an adverse effect while taking this medication. Drowsiness and respiratory depression are not typical prominent adverse effects for this agent compared with sedatives/opioids, and ischemic stroke is not a characteristic medication-related risk.

Question 46

Vitamin K is given to newborn to prevent –?

Accepted Answer

Answer reason: b) Bleeding Newborns have low vitamin K stores and limited gut flora, leading to reduced hepatic synthesis of vitamin K–dependent clotting factors (II, VII, IX, X). Prophylactic vitamin K supports normal coagulation and prevents vitamin K deficiency bleeding (including potentially catastrophic intracranial hemorrhage). This intervention targets impaired clotting rather than red cell production, so it does not primarily prevent anemia. It also does not provide antimicrobial protection or address glucose regulation, making infection and hypoglycemia incorrect.

Question 47

The provider orders an antihypertensive medication for a client whose blood pressure is 205/110 mm Hg. The nurse reviews the medication administration record and sees an order for which of the following blood pressure medications?

Accepted Answer

Answer reason: This drug is a potent direct vasodilator used in hypertensive emergencies because it has immediate onset and can be continuously infused with close BP monitoring. The other options are not antihypertensives: one is an opioid analgesic, and two are antimicrobials. Therefore, this is the only option that fits the ordered blood pressure medication for this presentation.

Question 48

All the following drugs can cross placenta EXCEPT.?

Accepted Answer

Answer reason: Unfractionated heparin is a large, negatively charged polysaccharide and therefore does not cross the placenta in clinically meaningful amounts. In contrast, phenytoin, diazepam, and morphine are sufficiently lipophilic/small to cross and can affect the fetus. This is why heparin is preferred for anticoagulation in pregnancy compared with agents that readily cross and pose fetal risks.

Question 49

Drug of choice for generalized anxiety?

Accepted Answer

Answer reason: Buspirone (a 5-HT1A partial agonist) is effective for chronic GAD and avoids the tolerance, withdrawal, and misuse risks seen with benzodiazepines. Alprazolam can relieve acute anxiety but is not preferred as a drug of choice for ongoing GAD due to dependence and sedation. Beta-blockers are mainly for performance/situational anxiety symptoms, and phenytoin is an anticonvulsant with no primary role in anxiety treatment.

Question 50

Dose of Vitamin K in term baby is…..?

Accepted Answer

Answer reason: Standard prophylaxis for a term newborn is phytonadione 1 mg IM given soon after birth to support hepatic synthesis of clotting factors II, VII, IX, and X. The 0.5 mg dose is typically used for preterm or very low birth weight infants, not term babies. Higher doses such as 2 mg are not the routine IM prophylactic dose for term newborns in standard protocols.

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