Question 1

Atropine is used to treat —?

Accepted Answer

Answer reason: Atropine is a competitive muscarinic antagonist that rapidly reverses muscarinic effects, especially airway secretions and bronchoconstriction, making it a key antidote. It does not treat the nicotinic manifestations (weakness/paralysis), which is why pralidoxime is often co-administered to reactivate acetylcholinesterase. Malaria, tuberculosis, and hepatitis require antimicrobial/antiviral therapies rather than antimuscarinic reversal of cholinergic excess.

Question 2

Which insulin is rapid acting?

Accepted Answer

Answer reason: Insulin aspart is a rapid-acting analog with onset in minutes and relatively short duration compared with basal preparations. Glargine and detemir are long-acting basal insulins intended for steady background coverage rather than meal coverage. NPH is intermediate-acting with a delayed onset and a pronounced peak, making it unsuitable as a rapid-acting choice.

Question 3

Calcium channel blockers reduce –?

Accepted Answer

Answer reason: This vasodilatory effect directly reduces arterial blood pressure, which is a primary therapeutic goal in hypertension and angina. While non-dihydropyridines (e.g., verapamil, diltiazem) can also slow AV-node conduction and decrease heart rate, that effect is not uniform across the class (dihydropyridines may cause reflex tachycardia). They do not primarily lower blood glucose or hemoglobin, making those options incorrect.

Question 4

Drug of choice for acute migraine attack –?

Accepted Answer

Answer reason: Triptans are 5-HT1B/1D agonists that cause cranial vasoconstriction and inhibit release of pro-inflammatory neuropeptides (e.g., CGRP), making them first-line for moderate to severe acute migraine. Simple analgesics/NSAIDs can help mild attacks but are not the classic single “drug of choice” when an acute migraine-specific agent is asked. Omeprazole is unrelated to migraine abortive treatment and is used for acid suppression.

Question 5

First-line drug for hypertension —?

Accepted Answer

Answer reason: A dihydropyridine calcium channel blocker lowers blood pressure by causing peripheral arteriolar vasodilation, making it an appropriate initial agent for many adults. A loop diuretic is typically reserved for hypertension with significant fluid overload (e.g., heart failure or reduced kidney function) rather than routine first-line use. A benzodiazepine and an antiplatelet agent do not treat chronic blood pressure elevation and are not appropriate initial antihypertensives.

Question 6

Which drug is nephrotoxic?

Accepted Answer

Answer reason: This risk is higher with prolonged therapy, elevated trough levels, dehydration, older age, and pre-existing kidney disease. The other listed antibiotics are not considered prototypically nephrotoxic in the same way; for example, ciprofloxacin more commonly causes tendinopathy and QT issues, with kidney injury being comparatively uncommon and usually specific (e.g., interstitial nephritis). Monitoring renal function and drug levels is a key safety step when using this medication.

Question 7

Which drug is used in Parkinson’s disease?

Accepted Answer

Answer reason: The most effective symptomatic therapy is to increase central dopamine, and levodopa is a dopamine precursor that crosses the blood–brain barrier and is converted to dopamine in the CNS. This directly improves core motor features such as bradykinesia and rigidity. In contrast, phenytoin treats seizures, diazepam is a benzodiazepine used for anxiety/seizures/spasm, and loratadine is an antihistamine—none address dopamine depletion.

Question 8

Which drug is used in angina pectoris?

Accepted Answer

Answer reason: Nitrates generate nitric oxide, producing venodilation that lowers preload and myocardial oxygen demand, and they also dilate coronary arteries to relieve ischemic chest pain. Omeprazole treats acid-related GI disorders, prednisolone is an anti-inflammatory steroid, and metformin is an antihyperglycemic; none address acute myocardial ischemia symptoms. Therefore the nitrate option is the most direct and clinically appropriate treatment for angina attacks.

Question 9

Which drug is used for motion sickness?

Accepted Answer

Answer reason: Dimenhydrinate is a first-generation H1 antihistamine commonly used to prevent and treat motion sickness–related nausea and vomiting. Paracetamol is an analgesic/antipyretic without antiemetic vestibular benefit, while cefixime is an antibiotic. Ranitidine is an H2 blocker for acid-related disorders and does not address vestibular-induced emesis.

Question 10

Bacterial diarrhea is treated with —?

Accepted Answer

Answer reason: This option is an antimicrobial with activity against anaerobic organisms and several protozoa (e.g., Giardia, Entamoeba) that can present with infectious diarrhea, making it the only plausible anti-infective choice among the options. The other options are symptomatic analgesics/NSAIDs or an antihypertensive and do not treat an infectious cause. While many cases of acute bacterial diarrhea are primarily managed with rehydration and only select pathogens require antibiotics, among the listed drugs this is the best match to the stated intent of treating an infectious diarrhea.

Question 11

UTI infection is commonly treated with –?

Accepted Answer

Answer reason: g., Enterobacterales). This choice is a fluoroquinolone antibiotic with activity against many gram-negative organisms and has been used for uncomplicated and complicated UTIs based on susceptibility patterns. Paracetamol can help with fever or dysuria pain but does not eradicate infection, while ranitidine is an H2 blocker and amlodipine is an antihypertensive, neither treating bacterial pathogens. In practice, antibiotic selection should also consider local resistance and safety concerns, but among the listed options this is the only appropriate antimicrobial.

Question 12

High blood pressure is controlled by –?

Accepted Answer

Answer reason: This drug is a dihydropyridine calcium-channel blocker that causes peripheral arterial vasodilation, making it a standard agent for hypertension control. Ciprofloxacin is an antibiotic, paracetamol is an analgesic/antipyretic, and loratadine is an antihistamine, so none of these are used to treat high blood pressure. A common distractor pattern is choosing a frequently used medication rather than one with a direct blood-pressure-lowering mechanism.

Question 13

Gastric acidity is relieved by —?

Accepted Answer

Answer reason: This mechanism directly targets hyperacidity symptoms and peptic ulcer/GERD-related acid production. The other options do not lower stomach acid: acyclovir is an antiviral, ciprofloxacin is an antibiotic, and losartan is an angiotensin receptor blocker for hypertension. Therefore the only option with an acid-suppressing action appropriate for relieving gastric acidity is the H2 blocker.

Question 14

Heartburn and acidity are treated with —?

Accepted Answer

Answer reason: Omeprazole is a proton pump inhibitor that irreversibly blocks the H+/K+ ATPase in gastric parietal cells, providing potent and sustained acid suppression for GERD and dyspepsia. Amlodipine is an antihypertensive calcium-channel blocker and does not treat acid-related symptoms. Paracetamol is an analgesic/antipyretic and azithromycin is an antibiotic, neither addressing the underlying acid production driving heartburn.

Question 15

Which drug is an antacid?

Accepted Answer

Answer reason: Aluminium hydroxide is a classic antacid that raises gastric pH by directly binding/neutralizing acid in the stomach lumen. In contrast, ciprofloxacin is a fluoroquinolone antibiotic, atorvastatin is an HMG-CoA reductase inhibitor for dyslipidemia, and paracetamol is an analgesic/antipyretic without acid-neutralizing action. Recognizing drug class by mechanism and therapeutic use identifies the antacid correctly.

Question 16

Which drug is used in emergency asthma?

Accepted Answer

Answer reason: This medication provides fast beta-2 mediated bronchodilation and also supports circulation via alpha/beta effects, making it particularly useful when asthma is associated with anaphylaxis or impending respiratory failure. The other options treat diabetes (metformin), acid suppression/GERD (omeprazole), and hypertension/angina (amlodipine) and do not address acute bronchospasm. In emergency care, this choice aligns with the need for immediate airway and ventilation support while definitive therapies (e.g., inhaled beta-agonists, steroids, oxygen) are administered.

Question 17

Asthma attack is relieved by —?

Accepted Answer

Answer reason: A short-acting beta-2 agonist relaxes bronchial smooth muscle within minutes and improves airflow and wheeze. Ranitidine is an H2 blocker for acid suppression, amlodipine is a calcium-channel blocker for hypertension/angina, and azithromycin is an antibiotic—none quickly reverse bronchospasm. Therefore the best agent to relieve an asthma attack is a SABA.

Question 18

Polio vaccine is given by?

Accepted Answer

Answer reason: Among the listed routes, oral delivery directly matches OPV administration and the public health practice used in many eradication programs. Intravenous, intradermal, and intranasal routes are not standard routes for polio vaccination. A common distractor is assuming all vaccines are injectable; however, OPV is specifically formulated for oral dosing.

Question 19

A nurse is caring for a burn patient. Which topical bacteriostatic medication can be applied to penetrate eschar?

Accepted Answer

Answer reason: This medication is a sulfonamide derivative that diffuses through eschar and provides broad antibacterial activity, including against many gram-negative organisms. In contrast, silver-based creams primarily act on the surface and have limited eschar penetration, making them less effective for infection beneath eschar. The other listed drugs are antifungals used for Candida/dermatophytes rather than standard topical antibacterial management of burn wounds.

Question 20

A nurse is caring for a patient who was recently diagnosed with anemia. The nurse receives an order for the patient to receive intranasal cyanocobalamin. Based on this treatment, which type of anemia does the patient likely have?

Accepted Answer

Answer reason: Intranasal and other non-oral routes help bypass gastrointestinal absorption problems, a key feature of pernicious anemia. Iron-deficiency anemia is treated with iron supplementation rather than B12. Aplastic and hemolytic anemias involve bone marrow failure or increased RBC destruction and are not corrected by vitamin B12 administration.

Question 21

During the initial assessment, a patient states they are allergic to penicillin. Which other medication should this patient not be given?

Accepted Answer

Answer reason: Cephalosporins share the beta-lactam ring with penicillins, so a patient with a true penicillin allergy (especially immediate/anaphylactic reactions) is at increased risk for hypersensitivity if given this class. In contrast, ciprofloxacin (fluoroquinolone), metronidazole (nitroimidazole), and sulfamethoxazole (sulfonamide) are not beta-lactams and do not have predictable cross-reactivity with penicillin. Clinically, the safest approach is to avoid cephalosporins unless allergy details and severity are clarified and an appropriate alternative or testing is used.

Question 22

Steroids, if used following kidney transplantation would cause which of the following side effects?

Accepted Answer

Answer reason: This effect is clinically important post-transplant because it can precipitate new-onset diabetes and increase infection and wound-healing risks. Orthostatic hypotension is not a typical steroid adverse effect; instead, steroids tend to cause sodium and water retention and can raise blood pressure. While dyslipidemia (including increased cholesterol) can occur with steroids, hyperglycemia is the most classic and consistently tested metabolic adverse effect.

Question 23

Vomiting (nausea) is treated with –?

Accepted Answer

Answer reason: Ondansetron is a 5-HT3 receptor antagonist commonly used for postoperative, chemotherapy-related, and other acute causes of nausea/vomiting. Paracetamol is an analgesic/antipyretic and does not treat emesis. Ranitidine reduces gastric acid and atorvastatin treats hyperlipidemia, so neither addresses the vomiting reflex directly.

Question 24

Nurse Claire is educating a patient who is prescribed Pyrazinamide. Which of the following statements is NOT accurate regarding this medication?

Accepted Answer

Answer reason: Pyrazinamide commonly causes hyperuricemia by reducing renal excretion of uric acid, which can precipitate gout. Because it raises uric acid, it may increase the need for urate-lowering therapy and can blunt the effectiveness of agents used to control hyperuricemia rather than potentiating them. Patient teaching also includes taking it with food to reduce GI upset and monitoring for hepatotoxicity and arthralgia. A common safety point is caution in patients with diabetes because it can affect glycemic control and complicate management during TB treatment.

Question 25

A patient reports muscle pain and is voiding dark tea-colored urine. They are taking atorvastatin, lisinopril, and hydrochlorothiazide. Labs show elevated creatine kinase (CK) AST, ALT, ALP, and myoglobinuria on urinalysis. Which medical condition may this patient be experiencing?

Accepted Answer

Answer reason: Rhabdomyolysis is characterized by skeletal muscle breakdown releasing CK and myoglobin, producing muscle pain and dark (tea-colored) urine from myoglobinuria. Statins such as atorvastatin are a classic medication trigger and can cause severe myopathy progressing to myoglobin-induced acute kidney injury. Associated transaminase elevations can occur because AST (and sometimes ALT) is present in muscle and rises with muscle necrosis, not only liver disease. Nephrotic syndrome would present with heavy proteinuria/edema rather than markedly elevated CK and myoglobinuria, and pyomyositis typically features focal infection signs (fever, localized swelling) rather than diffuse myoglobinuria.

Question 26

A 6-year-old boy with a history of congenital heart disease develops supraventricular tachycardia (SVT) with a heart rate of 210/min. He is hemodynamically stable after initial vagal maneuvers fail. Adenosine 0.1 mg/kg and then 0.2 mg/kg IV boluses are given with no response. What is the next best pharmacologic management?

Accepted Answer

Answer reason: This option fits recommended escalation for refractory narrow-complex tachycardia because it can suppress re-entrant supraventricular rhythms when AV-node blockade with adenosine is ineffective. Lidocaine is primarily for ventricular arrhythmias and is not appropriate for typical SVT. Verapamil carries important pediatric risks (notably hypotension and potential cardiovascular collapse in younger children and certain accessory-pathway scenarios), and digoxin is not used for acute termination of SVT.

Question 27

Which is a major concern when providing drug therapy for older adults?

Accepted Answer

Answer reason: This makes dosing and monitoring especially important for medications with significant first-pass metabolism or narrow therapeutic windows. Reduced clearance is a broad, high-impact safety issue compared with administration technique or tablet size, which are more easily mitigated by formulation changes. Alcohol use can be a concern in some individuals, but it is not a universal, physiology-driven determinant of altered pharmacokinetics in older adults like decreased hepatic clearance.

Question 28

A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer?

Accepted Answer

Answer reason: Phentolamine is a fast-acting, nonselective alpha blocker that acutely lowers blood pressure in catecholamine-driven crises. Methyldopa has a slower onset and is not used for urgent catecholamine surges, while felodipine is not the preferred targeted antidote in this specific etiology. Mannitol is an osmotic diuretic for intracranial pressure/edema and does not treat the pathophysiologic driver of pheochromocytoma hypertension.

Question 29

When caring for a female client with a history of hypoglycemia, nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description?

Accepted Answer

Answer reason: In a patient with a history of low blood sugar, this interaction is clinically important because it can trigger recurrent symptomatic episodes. By contrast, systemic corticosteroids like prednisone more typically raise blood glucose and can worsen hyperglycemia rather than cause hypoglycemia. Therefore, this medication is the one most associated with potentiating hypoglycemia and should be avoided or used with close monitoring and dose adjustment of antidiabetic therapy.

Question 30

A male client is recovering from a small bowel resection. To relieve pain, the physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours. How soon after administration should meperidine onset of action occur?

Accepted Answer

Answer reason: Meperidine given intramuscularly typically begins providing analgesia within about 10–30 minutes, so this time window best matches expected pharmacokinetics for onset. An onset of 5–10 minutes is more consistent with IV administration rather than IM. A 30–60 minute onset is generally too delayed for IM meperidine, while 2–4 hours reflects duration/peak considerations rather than onset.

Question 31

As a well-rounded health care provider, you know that corticosteroid therapy is indicated in all of the following conditions except?

Accepted Answer

Answer reason: Osteoarthritis is largely a degenerative, “wear-and-tear” joint disease rather than a systemic autoimmune inflammatory disorder, so routine systemic corticosteroid therapy is not an indicated disease treatment. In contrast, rheumatoid arthritis and systemic lupus erythematosus have inflammatory/autoimmune pathophysiology where corticosteroids can be used to control flares and reduce inflammatory injury. Acute spinal cord injury historically involved high-dose steroids to limit secondary injury from inflammation/edema (though practice has evolved and is controversial), making it a more plausible indication than osteoarthritis.

Question 32

A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following medications can you rule out as being the cause?

Accepted Answer

Answer reason: Sulfasalazine can cause orange-yellow urine discoloration, and phenolphthalein (a laxative) may cause pink to red urine. Levodopa can darken urine (brown/black) due to metabolite oxidation. Aspirin is not a classic or expected cause of benign urine color change; if urine looks red/brown while taking it, bleeding (e.g., hematuria) should be considered rather than harmless discoloration.

Question 33

The client with a testicular cancer is being treated with Etoposide (Etopophos). Which of the following side effect is specifically associated with this medication?

Accepted Answer

Answer reason: Hair follicle damage leads to chemotherapy-related hair loss, making this a classic, expected adverse effect for this agent. While etoposide can cause infusion-related hypotension (especially if infused too rapidly), that is not as characteristic a “signature” effect as alopecia among the listed choices. Chest pain and edema are not typical hallmark adverse effects used to identify etoposide in exam questions compared with alopecia and myelosuppression.

Question 34

Histamine2-receptor antagonists?

Accepted Answer

Answer reason: H2 receptor antagonists are competitive blockers of histamine at H2 receptors on gastric parietal cells, which reduces cAMP-mediated stimulation of acid secretion. This directly decreases basal and meal-stimulated gastric acid output. Irreversible binding to the H+/K+ ATPase describes proton pump inhibitors, not H2 blockers. They also increase (not decrease) gastric pH, and allergy symptom control is primarily via H1 receptor antagonism.

Question 35

The client with non-Hodgkin’s lymphoma is being managed with vincristine (Vincasar). Which of the following indicates a side effect specific to this medication?

Accepted Answer

Answer reason: This makes distal sensory changes such as toe numbness a particularly expected toxicity for this drug. Alopecia can occur with many chemotherapeutic agents and is not specific enough to vincristine. Chest heaviness and weight gain are not hallmark vincristine toxicities and should prompt evaluation for other causes or medications.

Question 36

Walter, a teenage patient is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?

Accepted Answer

Answer reason: As hepatic glutathione is depleted, NAPQI binds hepatocytes and leads to centrilobular hepatic necrosis, which can progress to acute liver failure with coagulopathy and encephalopathy. This makes the liver the key organ where life-threatening injury occurs and the focus of antidotal therapy with N-acetylcysteine. While renal injury can occur, it is less common and typically secondary compared with the dominant risk of fulminant hepatic failure in overdose.

Question 37

Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?

Accepted Answer

Answer reason: Clinically, this adverse interaction is monitored by closer INR surveillance and assessment for bleeding after glucagon use in patients on warfarin-type therapy. By contrast, thiazide diuretics and beta-blockers more commonly worsen glycemic control or blunt hypoglycemia symptoms rather than creating a direct adverse interaction with glucagon itself. Therefore the most specific adverse drug interaction listed is with oral anticoagulants.

Question 38

Estrogen antagonists are used to treat estrogen hormone-dependent cancer, such as breast carcinoma. Androgen antagonists block testosterone stimulation of androgen-dependent cancers. An example of an androgen-dependent cancer would be?

Accepted Answer

Answer reason: Androgen-dependent tumors rely on androgen receptor signaling for growth, so reducing testosterone effects (e.g., with androgen receptor blockers or androgen deprivation) helps control disease. Prostate malignancy classically exhibits androgen sensitivity, particularly in early and many advanced hormone-responsive stages. This is the prototypical cancer treated with antiandrogen therapy. In contrast, thyroid cancer, renal cell carcinoma, and neuroblastoma are not primarily driven by testosterone stimulation and are not standard indications for androgen antagonists.

Question 39

Methotrexate, the most widely used antimetabolite in cancer chemotherapy does not penetrate the central nervous system (CNS). To treat CNS disease this drug must be administered?

Accepted Answer

Answer reason: Medications that do not cross the blood–brain barrier cannot achieve therapeutic cerebrospinal fluid concentrations when given by systemic routes. Delivering the drug directly into the CSF via the intrathecal route bypasses this barrier and is a standard approach for CNS leukemia/lymphoma prophylaxis or treatment with this agent. Intravenous or subcutaneous administration mainly produces systemic exposure and still results in inadequate CNS levels for reliable treatment. Inhalation does not provide targeted CSF delivery and is not an indicated route for this purpose.

Question 40

Nurse Paul is educating a patient who is taking streptomycin about the potential nervous system side effects. He correctly informs the patient that this medication can cause damage to which cranial nerve?

Accepted Answer

Answer reason: Aminoglycosides (including streptomycin) are classically ototoxic due to injury of the vestibulocochlear apparatus, causing vestibular dysfunction and/or sensorineural hearing loss. This toxicity reflects damage involving cranial nerve VIII pathways, so patient teaching should emphasize early symptoms such as tinnitus, dizziness/vertigo, and imbalance. The risk increases with higher cumulative doses, prolonged therapy, and renal impairment because serum levels rise. Other listed cranial nerves are not the characteristic neurotoxicity target of streptomycin, making them less defensible choices on exam pattern recognition and mechanism.

Question 41

Nurse Davis is reviewing the interactions between medications and thyroid hormone therapy. Which of the following medications is known to have its action decreased when thyroid hormone is taken concurrently?

Accepted Answer

Answer reason: When levothyroxine is started in a patient stabilized on digoxin, diminished rate control/contractility effects may be seen unless the digoxin dose is adjusted and levels are monitored. In contrast, thyroid hormone tends to increase sensitivity to warfarin by increasing clotting factor turnover, which would raise bleeding risk rather than decrease anticoagulant action. Beta-blocker effects may be blunted in hyperthyroid states, but the classic interaction highlighted with thyroid hormone therapy is reduced digoxin effect.

Question 42

During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with the synthesis of which vitamin and may lead to hypoprothrombinemia?

Accepted Answer

Answer reason: Vitamin K is required for hepatic gamma-carboxylation of clotting factors II (prothrombin), VII, IX, and X, so deficiency prolongs PT/INR and can manifest as hypoprothrombinemia with bleeding risk. This is most relevant in bowel prep or prolonged antibiotic use where gut bacteria are significantly suppressed. Fat-soluble vitamins A, D, and E are not directly tied to prothrombin production, making them less consistent with the hypoprothrombinemia clue.

Question 43

Bismuth subsalicylate (Pepto-Bismol), as an absorbent, has which of the following mechanisms of action?

Accepted Answer

Answer reason: Absorbent antidiarrheals work by adsorbing water and irritating substances/toxins in the intestinal lumen, which reduces the watery component of stool. Bismuth subsalicylate also has antisecretory and antimicrobial effects, but the key “absorbent” action is decreasing stool liquidity via increased net fluid uptake/adsorption. Decreasing GI motility is more characteristic of opioids like loperamide rather than bismuth as an absorbent. “Binding to diarrhea-causing bacteria for excretion” is an oversimplification; bismuth mainly binds toxins and has antimicrobial activity rather than mechanically eliminating bacteria as its primary absorbent mechanism.

Question 44

Bismuth subsalicylate (Pepto-Bismol), as an absorbent, has which of the following mechanisms of action?

Accepted Answer

Answer reason: Adsorbents act primarily by binding toxins and microorganisms in the intestinal lumen, reducing their contact with the mucosa and limiting secretory diarrhea. Bismuth subsalicylate has an antisecretory and antimicrobial effect in the gut, and the bismuth component can bind bacterial enterotoxins and other irritants to facilitate elimination. Options describing decreased GI motility better match opioid antidiarrheals (e.g., loperamide), not bismuth’s primary “absorbent/adsorbent” action. Decreased gastric secretions is not the key therapeutic mechanism for treating diarrhea, and “increased fluid absorption” is less specific than luminal binding/adsorption of pathogens and toxins.

Question 45

Which of the following statements best describes the action of antacids?

Accepted Answer

Answer reason: They do not significantly reduce acid secretion from parietal cells; that mechanism is characteristic of H2-receptor antagonists and proton pump inhibitors, making the “block production” choice a common distractor. Dopamine blockade describes antiemetics like metoclopramide or prochlorperazine, not this drug class. Enhancing acetylcholine relates to prokinetic/cholinergic effects, which is a different therapeutic approach than acid neutralization.

Question 46

Methotrexate is a folate antagonist. It inhibits enzymes required for DNA base synthesis. To prevent harm to normal cells, a fully activated form of folic acid known as leucovorin (folinic acid; citrovorum factor) can be administered. Administration of leucovorin is known as?

Accepted Answer

Answer reason: Leucovorin provides reduced folate that bypasses dihydrofolate reductase inhibition, allowing normal cells to continue DNA synthesis despite methotrexate’s antifolate effects. This “antidote-like” strategy is specifically used after high-dose methotrexate to limit myelosuppression and mucositis while maintaining antitumor activity. The key concept is selective protection of healthy tissue without negating the therapeutic intent. Induction and consolidation refer to phases of chemotherapy regimens, not to pharmacologic reversal of toxicity, and pulse therapy describes intermittent high-dose dosing rather than folate replacement to prevent injury.

Question 47

A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following conditions is a major complication of this drug therapy?

Accepted Answer

Answer reason: In transplant recipients, this immunosuppression is an expected tradeoff to prevent rejection, making infection one of the most clinically important complications requiring surveillance and prophylaxis. Hemorrhage is not a primary adverse effect pattern of cyclosporine; instead, key toxicities more classically include nephrotoxicity and hypertension. Peptic ulcer disease is more associated with corticosteroids and NSAIDs than with calcineurin inhibitors, and depression is not a major hallmark complication of this agent.

Question 48

Aminophylline (theophylline) is prescribed for a client with acute bronchitis. A nurse administers the medication, knowing that the primary action of this medication is to?

Accepted Answer

Answer reason: Methylxanthines primarily act as bronchodilators by increasing intracellular cAMP (via phosphodiesterase inhibition and adenosine receptor antagonism), which decreases bronchial smooth muscle tone and improves airflow. This mechanism directly targets bronchospasm and airflow limitation that can accompany acute bronchitis symptoms such as wheeze or reactive airway narrowing. Promoting expectoration may occur indirectly with improved ventilation and mucociliary clearance, but it is not the primary pharmacologic action. Suppressing cough and preventing infection are handled by antitussives and antimicrobials when indicated, not by aminophylline/theophylline.

Question 49

Currently, there is no way to prevent myelosuppression. However, there are medications available to elicit a more rapid bone marrow recovery. An example is?

Accepted Answer

Answer reason: Myelosuppression reduces bone marrow production of blood cells, so therapies that stimulate hematopoiesis are used to speed count recovery and reduce transfusion needs. Epoetin alfa is an erythropoiesis-stimulating agent that promotes red blood cell production and is commonly used to treat anemia related to chemotherapy or other marrow-suppressing conditions. In contrast, glucagon treats severe hypoglycemia, fenofibrate lowers triglycerides, and lamotrigine is an anticonvulsant/mood stabilizer—none address bone marrow recovery. Therefore, the only option aligned with accelerating marrow-driven blood cell recovery is the erythropoietic growth factor.

Question 50

Beta-adrenergic agonists such as albuterol are given to Reggie, a child with asthma. Such drugs are administered primarily to do which of the following?

Accepted Answer

Answer reason: This produces bronchodilation and prompt relief of acute bronchospasm, which is the primary therapeutic goal in asthma for rescue therapy. They do not treat infection, so reducing secondary infections is not a direct effect. Airway inflammation is addressed primarily by anti-inflammatory controller medications such as inhaled corticosteroids rather than short-acting beta agonists.

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Atropine is used to treat —?

Which insulin is rapid acting?

Calcium channel blockers reduce –?

Drug of choice for acute migraine attack –?

First-line drug for hypertension —?

Which drug is nephrotoxic?

Which drug is used in Parkinson’s disease?

Which drug is used in angina pectoris?

Which drug is used for motion sickness?

Bacterial diarrhea is treated with —?

UTI infection is commonly treated with –?

High blood pressure is controlled by –?

Gastric acidity is relieved by —?

Heartburn and acidity are treated with —?

Which drug is an antacid?

Which drug is used in emergency asthma?

Asthma attack is relieved by —?

Polio vaccine is given by?

A nurse is caring for a burn patient. Which topical bacteriostatic medication can be applied to penetrate eschar?

A nurse is caring for a patient who was recently diagnosed with anemia. The nurse receives an order for the patient to receive intranasal cyanocobalamin. Based on this treatment, which type of anemia does the patient likely have?

During the initial assessment, a patient states they are allergic to penicillin. Which other medication should this patient not be given?

Steroids, if used following kidney transplantation would cause which of the following side effects?

Vomiting (nausea) is treated with –?

Nurse Claire is educating a patient who is prescribed Pyrazinamide. Which of the following statements is NOT accurate regarding this medication?

A patient reports muscle pain and is voiding dark tea-colored urine. They are taking atorvastatin, lisinopril, and hydrochlorothiazide. Labs show elevated creatine kinase (CK) AST, ALT, ALP, and myoglobinuria on urinalysis. Which medical condition may this patient be experiencing?

Which is a major concern when providing drug therapy for older adults?

A female client with a history of pheochromocytoma is admitted to the hospital in an acute hypertensive crisis. To reverse hypertensive crisis caused by pheochromocytoma, nurse Lyka expects to administer?

When caring for a female client with a history of hypoglycemia, nurse Ruby should avoid administering a drug that may potentiate hypoglycemia. Which drug fits this description?

A male client is recovering from a small bowel resection. To relieve pain, the physician prescribes meperidine (Demerol), 75 mg I.M. every 4 hours. How soon after administration should meperidine onset of action occur?

As a well-rounded health care provider, you know that corticosteroid therapy is indicated in all of the following conditions except?

A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following medications can you rule out as being the cause?

The client with a testicular cancer is being treated with Etoposide (Etopophos). Which of the following side effect is specifically associated with this medication?

Histamine2-receptor antagonists?

The client with non-Hodgkin’s lymphoma is being managed with vincristine (Vincasar). Which of the following indicates a side effect specific to this medication?

Walter, a teenage patient is admitted to the hospital because of acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?

Nurse Noemi administers glucagon to her diabetic client, then monitors the client for adverse drug reactions and interactions. Which type of drug interacts adversely with glucagon?

Estrogen antagonists are used to treat estrogen hormone-dependent cancer, such as breast carcinoma. Androgen antagonists block testosterone stimulation of androgen-dependent cancers. An example of an androgen-dependent cancer would be?

Methotrexate, the most widely used antimetabolite in cancer chemotherapy does not penetrate the central nervous system (CNS). To treat CNS disease this drug must be administered?

Nurse Paul is educating a patient who is taking streptomycin about the potential nervous system side effects. He correctly informs the patient that this medication can cause damage to which cranial nerve?

Nurse Davis is reviewing the interactions between medications and thyroid hormone therapy. Which of the following medications is known to have its action decreased when thyroid hormone is taken concurrently?

During preparation for bowel surgery, a male client receives an antibiotic to reduce intestinal bacteria. Antibiotic therapy may interfere with the synthesis of which vitamin and may lead to hypoprothrombinemia?

Bismuth subsalicylate (Pepto-Bismol), as an absorbent, has which of the following mechanisms of action?

Bismuth subsalicylate (Pepto-Bismol), as an absorbent, has which of the following mechanisms of action?

Which of the following statements best describes the action of antacids?

Methotrexate is a folate antagonist. It inhibits enzymes required for DNA base synthesis. To prevent harm to normal cells, a fully activated form of folic acid known as leucovorin (folinic acid; citrovorum factor) can be administered. Administration of leucovorin is known as?

A client has just received a renal transplant and has started cyclosporine therapy to prevent graft rejection. Which of the following conditions is a major complication of this drug therapy?

Aminophylline (theophylline) is prescribed for a client with acute bronchitis. A nurse administers the medication, knowing that the primary action of this medication is to?

Currently, there is no way to prevent myelosuppression. However, there are medications available to elicit a more rapid bone marrow recovery. An example is?

Beta-adrenergic agonists such as albuterol are given to Reggie, a child with asthma. Such drugs are administered primarily to do which of the following?

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