Question 1

Which of the following classes of medications maximizes cardiac performance in clients with heart failure by increasing ventricular contractility?

Accepted Answer

Answer reason: This mechanism is the most direct way among the options to “maximize cardiac performance” by boosting ventricular pumping strength. Diuretics primarily reduce preload and congestion rather than enhancing contractility, and beta-blockers are not used for acute contractility augmentation because they decrease inotropy initially. Many calcium channel blockers can also depress myocardial contractility and are generally avoided in HFrEF for this reason.

Question 2

Dr. Grey prescribes norfloxacin (Noroxin), 400 mg P.O. twice daily, for a client with a urinary tract infection (UTI). The client asks the nurse how long to continue taking the drug. For an uncomplicated UTI, the usual duration of norfloxacin therapy is?

Accepted Answer

Answer reason: Uncomplicated lower UTIs are typically treated with a short, fixed antibiotic course long enough to eradicate common uropathogens while minimizing resistance and adverse effects. Norfloxacin is a fluoroquinolone historically dosed for about a week for uncomplicated cystitis, making a 7–10 day duration the best match among the choices. A 3–5 day course is more characteristic of other first-line agents (e.g., TMP-SMX in selected settings) and is not the classic teaching for norfloxacin regimens. Courses extending to 12–14 days or 10–21 days are more consistent with complicated infection, upper-tract involvement, or special populations rather than routine uncomplicated cystitis.

Question 3

A client is taking Cyclophosphamide (Cytoxan) for the treatment of lymphoma. The nurse is very cautious in administering the medication because this drug poses the fatal side effect of?

Accepted Answer

Answer reason: This risk is clinically significant because it may progress to clot retention, obstruction, anemia, and shock if not prevented and treated promptly. Nursing caution focuses on prevention with aggressive hydration, frequent voiding, and use of mesna when indicated, along with monitoring for hematuria and dysuria. Sterility and alopecia are expected toxicities but are not typically the immediately fatal toxicity being emphasized here, and myeloma is not a typical direct adverse effect.

Question 4

A nurse is giving discharge instructions to a client who is receiving a bulk-forming laxative as part of the home medications. All of which are examples of bulk-forming laxative, except?

Accepted Answer

Answer reason: Methylcellulose, polycarbophil, and psyllium are classic bulk-forming products used for chronic constipation with adequate fluid intake. Docusate is not a fiber/bulk agent; it is a stool softener (surfactant) that lowers stool surface tension to allow water and fats to penetrate the stool. Because the question asks for the exception among bulk-forming laxatives, the surfactant stool softener is the best choice.

Question 5

The mechanism of action of diphenoxylate (Lotomil) is?

Accepted Answer

Answer reason: Diphenoxylate is an opioid agonist that acts primarily on intestinal μ-receptors to slow gastrointestinal smooth muscle activity. By reducing propulsive peristalsis and increasing intestinal transit time, it allows more fluid and electrolyte absorption, decreasing stool frequency and liquidity. Options describing increased motility or increased water excretion would worsen diarrhea, which is opposite of the drug’s antidiarrheal effect. The water-handling change is secondary to slowed motility rather than a primary decrease in reabsorption.

Question 6

Sucralfate (Carafate) achieves a therapeutic effect by?

Accepted Answer

Answer reason: Sucralfate is a locally acting cytoprotective agent that polymerizes in an acidic environment and adheres to ulcerated or eroded mucosa. This creates a viscous protective coating that shields the lesion from acid, pepsin, and bile salts, promoting healing. It does not directly neutralize existing acid (antacids do) and does not suppress acid production (H2 blockers/PPIs do). A key implication is that it can also bind other medications in the gut, so dosing often needs separation.

Question 7

A 45-year-old female client with a history of Graves' disease presents to the clinic for a follow-up appointment. Her latest laboratory results show elevated free T4 levels and TSH levels are suppressed. The client reports feeling anxious, having difficulty sleeping, and has lost weight unintentionally despite an increased appetite. Which of the following medications is the nurse most likely to expect this client to be taking to treat her hyperthyroidism?

Accepted Answer

Answer reason: Hyperthyroidism from Graves’ disease is treated by reducing thyroid hormone synthesis. Methimazole is a thionamide that inhibits thyroid peroxidase, decreasing iodination/coupling steps and thereby lowering T3/T4 over time, which matches the patient’s elevated free T4 with suppressed TSH and classic hypermetabolic symptoms. Levothyroxine would worsen hyperthyroidism because it replaces thyroid hormone and is used for hypothyroidism. Insulin and glucagon are pancreatic hormones used to manage blood glucose, not thyroid overactivity.

Question 8

"METFORMIN" Is a Drug used to Treat which Disease?

Accepted Answer

Answer reason: Metformin is a first-line oral antihyperglycemic for type 2 diabetes that lowers blood glucose primarily by decreasing hepatic gluconeogenesis and improving insulin sensitivity in peripheral tissues. It does not stimulate insulin release, so it has a low risk of hypoglycemia when used alone. It is also associated with modest weight neutrality/weight loss, supporting its use in type 2 diabetes management. In contrast, hyperthyroidism is treated with antithyroid drugs (e.g., methimazole/propylthiouracil) and beta-blockers, not biguanides.

Question 9

The healthcare provider prescribes losartan for a client with hypertension. When the client questions how this medication works, the nurse explains that it promotes vasodilation by which action?

Accepted Answer

Answer reason: Angiotensin II is a potent vasoconstrictor within the renin–angiotensin–aldosterone system; reducing its effect leads to arterial vasodilation and lower blood pressure. Losartan is an angiotensin II receptor blocker (ARB) that prevents angiotensin II from activating AT1 receptors, thereby decreasing vasoconstriction and aldosterone-mediated volume expansion. Option a describes calcium channel blockers, not ARBs. Options b and c would increase sympathetic tone or fluid retention, which would worsen hypertension rather than promote vasodilation.

Question 10

A client with hypertension has been given a prescription to treat the disorder. The nurse should explain that cough and loss of taste are side effects if which antihypertensive agent has been prescribed?

Accepted Answer

Answer reason: They can also cause dysgeusia (altered or reduced taste), a recognized adverse effect with this drug class. By contrast, propranolol more commonly causes bradycardia and bronchospasm, and diltiazem tends toward constipation and edema rather than cough. Furosemide’s key adverse effects relate to volume depletion and electrolyte losses, not taste changes with cough.

Question 11

A nurse is reviewing pharmacokinetic principles related to fluoxetine (Prozac). Which statement by a nursing student indicates an understanding of the drug’s unique pharmacologic profile?

Accepted Answer

Answer reason: " Fluoxetine is distinctive among SSRIs for its long half-life and the presence of an active metabolite (norfluoxetine) that extends drug exposure. This supports convenient once-daily dosing and contributes to a slower onset/offset of clinical effect, with antidepressant benefit typically taking weeks rather than days. A common misconception is that SSRIs like fluoxetine have short half-lives leading to rapid discontinuation symptoms; fluoxetine is actually less likely than many SSRIs to cause abrupt-withdrawal symptoms because of its prolonged elimination. It is also extensively hepatically metabolized and not primarily excreted unchanged in urine, so the liver/renal claims in the other options do not match its pharmacokinetic profile.

Question 12

Capillary glucose monitoring is being performed every 4 hours for a female client diagnosed with diabetic ketoacidosis. Insulin is administered using a scale of regular insulin according to glucose results. At 2 p.m., the client has a capillary glucose level of 250 mg/dl for which he receives 8 U of regular insulin. Nurse Vince should expect the dose’s?

Accepted Answer

Answer reason: Regular insulin is a short-acting insulin with an onset typically around 30 minutes (often cited 30–60 minutes) and a peak about 2–4 hours after subcutaneous administration. Given at 2 p.m., the earliest reasonable onset time among the choices is about 2:15–2:30 p.m., and the earliest plausible peak in the options is 3 p.m. Options suggesting immediate onset at exactly 2 p.m. align more with rapid-acting insulins and are too early for regular insulin. Options with onset at 4 p.m. reflect intermediate/longer acting profiles and are not consistent with regular insulin kinetics.

Question 13

After taking glipizide (Glucotrol) for 9 months, a male client experiences secondary failure. Which of the following would the nurse expect the physician to do?

Accepted Answer

Answer reason: Secondary failure to a sulfonylurea reflects progressive pancreatic beta-cell dysfunction such that the drug can no longer stimulate sufficient endogenous insulin release to maintain glycemic control. Glipizide’s mechanism depends on functioning beta cells, so loss of response after months of therapy indicates the need to provide insulin exogenously. Changing to another oral agent within the same general strategy may not overcome the core problem of inadequate insulin secretion. Dietary carbohydrate restriction alone is not an appropriate corrective step for medication secondary failure and would not reliably restore euglycemia.

Question 14

A 26-year-old female client seeks care for a possible infection. Her symptoms include burning on urination and frequent, urgent voiding of small amounts of urine. She’s placed on trimethoprim-sulfamethoxazole (Bactrim) to treat possible infection. Another medication is prescribed to decrease the pain and frequency. Which of the following is the most likely medication prescribed?

Accepted Answer

Answer reason: Phenazopyridine provides local analgesia to the urinary mucosa, reducing burning and discomfort and thereby improving perceived urgency/frequency. Nitrofurantoin is an antibiotic alternative (not an adjunct for pain relief when already on TMP-SMX). Systemic analgesics like ibuprofen or acetaminophen with codeine may reduce general pain but do not specifically target urinary mucosal irritation and are not the classic add-on for UTI dysuria relief.

Question 15

A 33-year-old patient with a history of seizures and medication compliance of phenytoin (Dilantin) and carbamazepine (Tegretol) is brought to the ED by the MS personnel for repetitive seizure activity that started 45 minutes prior to arrival. You anticipate that the physician will order which drug for status epilepticus?

Accepted Answer

Answer reason: IV lorazepam is a preferred first-line agent in status epilepticus because it has fast onset and a longer duration in the brain than diazepam, improving seizure control early. Oral maintenance agents are too slow for an emergency and do not reliably stop active status. Magnesium sulfate is primarily indicated for eclamptic seizures rather than typical adult status epilepticus.

Question 16

A female client complains of periorbital aching, tearing, blurred vision, and photophobia in her right eye. Ophthalmologic examination reveals a small, irregular, nonreactive pupil – a condition resulting from acute iris inflammation (iritis). As part of the client’s therapeutic regimen, the physician prescribes atropine sulfate (Atropisol), two drops of 0.5% solution in the right eye twice daily. Atropine sulfate belongs to which drug classification?

Accepted Answer

Answer reason: In acute iritis/uveitis, this decreases painful ciliary muscle spasm and helps prevent or break posterior synechiae by keeping the pupil dilated. A parasympathomimetic would instead cause miosis and accommodation, worsening pain and adhesions risk in this setting. The other listed options describe drugs affecting adrenergic signaling, which is not atropine’s primary mechanism.

Question 17

Orlando who has been taking steroids for rheumatoid arthritis over several years presents with a compression vertebral fracture. This fracture is due to?

Accepted Answer

Answer reason: Chronic systemic glucocorticoid therapy accelerates bone resorption and suppresses osteoblast activity, producing secondary osteoporosis. Vertebral bodies are rich in trabecular bone, so they are particularly prone to fragility compression fractures in steroid-induced osteoporosis. Rheumatoid arthritis itself can contribute to bone loss, but long-term steroids are a classic, high-yield cause of atraumatic vertebral compression fractures. The key clue is “over several years,” which points to cumulative adverse effects rather than an acute excessive dose.

Question 18

A client has a wound infection that is resistant to treatment with several antiseptics. The nurse expects that the wound infection will most likely respond to treatment with which antiseptic?

Accepted Answer

Answer reason: Dilute sodium hypochlorite (Dakin’s) provides broad-spectrum killing, including organisms that may persist despite other common topical agents, and is used for infected, necrotic, or malodorous wounds. Hydrogen peroxide has limited sustained antimicrobial effect and can damage healthy granulation tissue, making it less ideal for ongoing wound management. Isopropyl alcohol is primarily for intact skin and is too irritating/cytotoxic for open wounds, and phenolic agents are also generally too toxic/irritating for routine open-wound care.

Question 19

A client is receiving anthracycline chemotherapy agents. The oncology nurse should assess this client for what most well-known and common manifestation of chronic cardiac toxicity?

Accepted Answer

Answer reason: g., doxorubicin) cause dose-dependent, chronic cardiotoxicity primarily through free-radical injury leading to progressive left ventricular dysfunction. The classic presentation is dilated cardiomyopathy with reduced ejection fraction that can manifest as heart failure symptoms and is monitored with baseline and serial echocardiography. Bradycardia is not the hallmark chronic toxicity pattern for this drug class, and coronary vasospasm is more characteristic of agents like 5-FU. Myocardial necrosis is not the typical common chronic manifestation described for anthracyclines in clinical monitoring and exam frameworks.

Question 20

Nausea and vomiting is an expected side effect of chemotherapeutic drug use. Which of the following drugs should be administered to a client on chemotherapy to prevent nausea and vomiting?

Accepted Answer

Answer reason: Metoclopramide is a dopamine (D2) receptor antagonist with prokinetic effects, making it effective for preventing and treating nausea/vomiting associated with chemotherapy. In contrast, busulfan is an alkylating antineoplastic (and can itself cause nausea), succimer is a chelating agent for heavy metal poisoning, and anastrozole is an aromatase inhibitor used in hormone-sensitive breast cancer—none are antiemetics. Therefore, the best choice for prevention of nausea/vomiting in this context is the antiemetic agent listed.

Question 21

What type of renal failure would the nurse expect to see in a client who accidentally self-administered an excessive dose of tobramycin?

Accepted Answer

Answer reason: This is an intrinsic (intrarenal) cause of acute kidney injury, characterized by impaired tubular function and rising BUN/creatinine after toxic exposure. Prerenal failure would be driven by decreased renal perfusion (e.g., hypovolemia, shock), and postrenal failure by urinary outflow obstruction, neither of which is the primary mechanism of aminoglycoside overdose. “Extrarenal” is not a standard renal failure classification in this context and does not describe the toxic tubular injury expected here.

Question 22

Nurse Thompson assesses a client in the emergency room who is experiencing hallucinations, agitation, and has an irritated nasal septum, as reported by his friends who mentioned he ingested a substance about an hour ago. Which substance is most likely responsible for these symptoms?

Accepted Answer

Answer reason: Stimulant intoxication classically causes agitation, paranoia, and hallucinations due to excess catecholamine signaling in the CNS. An irritated nasal septum strongly points to intranasal use, which is commonly associated with mucosal irritation and can progress to septal damage. The reported onset about an hour ago aligns with a recent use window in which acute sympathomimetic and psychotic symptoms are prominent. In contrast, heroin typically produces CNS and respiratory depression, and LSD may cause hallucinations but does not explain nasal septum irritation as a characteristic finding.

Question 23

A patient unable to tolerate oral medications may be prescribed which of the following proton pump inhibitors to be administered intravenously?

Accepted Answer

Answer reason: Pantoprazole is widely available as an IV preparation and is routinely used in hospitalized patients for stress ulcer prophylaxis and for upper GI bleeding protocols. In contrast, lansoprazole is primarily administered orally (including ODT/suspension forms) and is not the standard IV PPI used in most inpatient settings. Selecting the IV-available agent ensures timely acid suppression when enteral administration is not feasible.

Question 24

When reviewing a lists of drugs in a drug handbook, a nurse can identify the generic name for a drug in which of the following ways?

Accepted Answer

Answer reason: This capitalization rule is widely used in drug handbooks and clinical documentation to reduce confusion between proprietary and nonproprietary naming. Parentheses usage varies by publisher and format, so it is not a reliable identifier across resources. The presence of letters and numbers is more typical of investigational codes or product identifiers rather than a standard naming convention for generics.

Question 25

A nurse is reviewing a drug reference. The nurse should identify that drugs in the same class share which of the following similarities?

Accepted Answer

Answer reason: This shared mechanism leads to similar therapeutic effects and characteristic adverse-effect profiles across the class. Half-life can vary widely within a class due to differences in metabolism, active metabolites, and elimination pathways. Likewise, route of administration and bioavailability are formulation- and drug-specific properties, so they are not reliable defining similarities of a drug class.

Question 26

A nurse is caring for a client who is receiving methohexital Sodium. The nurse monitor the client for which of the following adverse effects?

Accepted Answer

Answer reason: Methohexital is an ultra–short-acting barbiturate used for induction/sedation and, like other CNS depressants, can suppress the respiratory drive and protective airway reflexes. The most clinically important adverse effect to monitor is hypoventilation or apnea, especially after IV administration and when combined with other sedatives/opioids. Barbiturates more commonly cause hypotension (from vasodilation and myocardial depression) rather than hypertension. Hyperthermia is not a typical expected adverse effect of methohexital; the priority is close respiratory and airway monitoring.

Question 27

A nurse is caring for a client who has been taking selegiline to treat parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which the following?

Accepted Answer

Answer reason: Selegiline inhibits monoamine breakdown, and meperidine has serotonergic properties, so the combination can trigger serotonin syndrome–like toxicity. A key exam finding of this reaction is marked muscle rigidity (often with agitation, hyperthermia, and diaphoresis). The other options do not reflect the expected acute neurotoxic presentation of this contraindicated interaction.

Question 28

A client with diabetes and coronary heart disease is being evaluated for treatment. In light of the heart condition, which medication option is more likely to be an issue?

Accepted Answer

Answer reason: This makes the drug a concern when a patient has significant cardiac disease compared with many other glucose-lowering options. Metformin is generally cardiovascular-favorable unless contraindicated by severe renal impairment or hypoxia-related states. DPP-4 inhibitors and insulin do not have the same characteristic fluid-retention risk profile that drives the cardiac caution for this class.

Question 29

A patient is admitted with bipolar affective disorder. The nurse acknowledges that which medication is used to treat this disorder for some patients in place of lithium?

Accepted Answer

Answer reason: Valproate formulations are established alternatives to lithium, particularly for acute mania, rapid cycling, or when lithium is not tolerated or contraindicated. An SSRI like fluvoxamine targets depression/OCD and can worsen bipolar illness by precipitating mania if not paired with a mood stabilizer. Thiopental is an anesthetic agent and ginkgo biloba is an herbal supplement, neither of which is an evidence-based primary treatment for bipolar disorder.

Question 30

The nurse realizes that some herbs interact with selective serotonin reuptake inhibitors. Which herb interaction may cause serotonin syndrome?

Accepted Answer

Answer reason: St. John's wort Serotonin syndrome results from excessive serotonergic activity, most often when multiple agents that increase serotonin are combined. This herb has serotonergic properties and can add to an SSRI’s effect, increasing risk for agitation, hyperreflexia, diaphoresis, tremor, and hyperthermia. It is also a strong inducer of drug-metabolizing enzymes, creating additional clinically significant interactions, but the key danger here is serotonergic excess. In contrast, ma-huang primarily has sympathomimetic effects (stimulant-like) rather than directly increasing serotonin to the same clinically important degree.

Question 31

A selective serotonin reuptake inhibitor (SSRI) is prescribed for a patient. The nurse knows that which drug is an SSRI?

Accepted Answer

Answer reason: Paroxetine is a prototypical SSRI used for depression and anxiety disorders. Amitriptyline is a tricyclic antidepressant, divalproex is an anticonvulsant/mood stabilizer, and bupropion primarily affects norepinephrine and dopamine rather than serotonin. Therefore, the only SSRI listed is the correct choice.

Question 32

Which statement is true concerning lithium?

Accepted Answer

Answer reason: Lithium is cleared almost entirely by the kidneys, and anything that reduces renal lithium clearance can raise serum concentrations and toxicity risk. NSAIDs decrease renal prostaglandin synthesis, which lowers renal blood flow and GFR and promotes increased proximal tubular reabsorption of sodium and lithium. This interaction can lead to clinically significant rises in lithium levels, so patients need monitoring and sometimes dose reduction when NSAIDs are started. A common distractor is the therapeutic range: typical maintenance targets are around 0.6–1.2 mEq/L (higher for acute mania), so the listed 2.5–3.5 mEq/L would be in the toxic range rather than therapeutic.

Question 33

A nurse should identify that timolol is contraindicated for a client who has which of the following disorders?

Accepted Answer

Answer reason: Patients with asthma are at increased risk for bronchospasm and worsening airflow obstruction when exposed to nonselective beta-blockers, including ophthalmic preparations due to systemic absorption. This makes asthma a clear contraindication or strong precaution depending on severity and clinical context. Diabetes is not an absolute contraindication but requires caution because beta-blockers can mask hypoglycemia symptoms. Seizure disorder and rheumatoid arthritis are not typical contraindications for timolol.

Question 34

A nurse is caring for a client who is taking interferon beta-1a. The nurse should identify which of the following findings indicates a potential serious adverse effect of this drug?

Accepted Answer

Answer reason: New or worsening fatigue can signal significant liver injury or clinically important anemia/leukopenia and warrants prompt evaluation (e.g., LFTs, CBC) rather than reassurance. The other options are not characteristic sentinel findings of interferon beta-1a toxicity and are more suggestive of unrelated medication effects or conditions. Because serious adverse effects may present subtly, a systemic symptom like fatigue is a higher-yield warning sign to recognize and escalate.

Question 35

Which of the following treatments may be used to dissolve a thrombus that is lodged in the pulmonary artery?

Accepted Answer

Answer reason: This directly matches the question’s goal of dissolving a thrombus lodged in the pulmonary artery. Heparin prevents further clot propagation by enhancing antithrombin activity but does not lyse the formed thrombus. Aspirin primarily inhibits platelet aggregation and is not an effective treatment to dissolve an acute pulmonary arterial thrombus, while embolectomy removes the clot mechanically rather than dissolving it.

Question 36

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use?

Accepted Answer

Answer reason: Therefore, checking this section is the most direct way to see whether the drug treats more than one condition. Adverse effects focus on harmful or unintended outcomes rather than therapeutic purposes. Pharmacokinetics explains absorption, distribution, metabolism, and excretion, while nursing implications focus on administration and monitoring considerations rather than listing all uses.

Question 37

Which risk is significantly increased in patients diagnosed with liver disease?

Accepted Answer

Answer reason: Decreased albumin synthesis can increase the free (active) fraction of highly protein-bound drugs, further increasing toxicity risk at standard doses. Altered biliary excretion and impaired hepatic biotransformation also reduce elimination of many medications and their metabolites. While infection risk can rise in advanced cirrhosis, the most directly and consistently increased risk across liver disease is medication-related toxicity due to impaired drug handling.

Question 38

A nurse should identify that a client who has diabetes and is taking etanercept is at increased risk for which of the following adverse effects?

Accepted Answer

Answer reason: This immunosuppression increases the risk of serious bacterial, fungal, and opportunistic infections, including reactivation of latent tuberculosis. Diabetes further raises infection susceptibility due to impaired neutrophil function and microvascular changes, compounding the medication-related risk. The other options are not characteristic primary adverse effects of TNF-alpha blockade compared with infection risk.

Question 39

A nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include?

Accepted Answer

Answer reason: Because liver injury may be asymptomatic early, patients require periodic monitoring of hepatic transaminases to detect toxicity and guide continuation or discontinuation. An instruction focused on pulse monitoring fits drugs with significant chronotropic effects, not this agent’s primary safety concern. “As needed before exercising” aligns with short-acting bronchodilators, and mouth rinsing is a key teaching point for inhaled corticosteroids rather than zileuton tablets.

Question 40

A nurse is teaching a client about the use of anti histamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions?

Accepted Answer

Answer reason: By blocking histamine’s ability to bind to its receptors, they reduce sneezing, itching, watery eyes, and rhinorrhea. H2 blockade is related to gastric acid secretion rather than nasal allergy symptoms. Nasal congestion is driven more by vasodilation and mucosal edema and is often less responsive to antihistamines than to decongestants or intranasal corticosteroids.

Question 41

A nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage of alprazolam for anxiety. Which of the following findings should indicate to the nurse the reason for the prescription modification?

Accepted Answer

Answer reason: Impaired renal function can decrease elimination of alprazolam and/or its metabolites and increase risk for oversedation, confusion, and respiratory depression, so a lower dose is a safety adjustment. Cataracts and recent weight loss are not typical reasons to reduce benzodiazepine dosage. Smoking more commonly alters hepatic enzyme activity and may reduce effect in some drugs rather than prompt a routine dose reduction for safety.

Question 42

Nurse Marty is monitoring a client for adverse reactions to dantrolene (Dantrium). Which adverse reaction is most common?

Accepted Answer

Answer reason: Because it depresses excitation–contraction coupling in skeletal muscle, generalized weakness and fatigue are common and expected dose-related adverse effects. This is more characteristic than anticholinergic-type effects like urinary retention, which are typical of some centrally acting agents rather than dantrolene. Ocular tearing and slurred speech are not typical common adverse reactions for this medication in standard pharmacology teaching.

Question 43

The nurse is monitoring a male client for adverse reactions to atropine sulfate (Atropine Care) eyedrops. Systemic absorption of atropine sulfate through the conjunctiva can cause which adverse reaction?

Accepted Answer

Answer reason: Systemic atropine produces antimuscarinic effects by blocking parasympathetic (vagal) input to the heart, which increases SA node firing and AV conduction. Even when given as eye drops, some medication can enter systemic circulation via the conjunctiva/nasolacrimal drainage and lead to clinically meaningful effects. The expected cardiovascular adverse effect is an increased heart rate rather than a decrease. A common distractor is increased salivation, but atropine typically reduces secretions and causes dry mouth instead.

Question 44

Which of the following agents would increase sedation caused by morphine?

Accepted Answer

Answer reason: Alcohol potentiates opioid-induced sedation through additive CNS depression. Diazepam (a benzodiazepine) and chlorpromazine (a sedating antipsychotic) both further reduce CNS arousal and can worsen opioid-related somnolence and respiratory depression. Clomipramine, a tricyclic antidepressant with strong antihistaminic/anticholinergic sedating effects, can also add to opioid sedation, making the combined effect clinically significant.

Question 45

A nurse is teaching a client with a new diagnosis for parkinson’s disease about how levodopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects?

Accepted Answer

Answer reason: Levodopa is a dopamine precursor that crosses the blood–brain barrier and is converted to dopamine in the CNS, improving motor symptoms such as bradykinesia and rigidity. Carbidopa inhibits peripheral dopa decarboxylase, reducing peripheral conversion of levodopa so more reaches the brain and limiting nausea, vomiting, and hypotension. The alternative neurotransmitter pathways listed (acetylcholine, norepinephrine, serotonin metabolism) are not the key therapeutic target of this combination for Parkinson motor symptom control.

Question 46

A nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. The nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects?

Accepted Answer

Answer reason: Stopping alprazolam abruptly can lead to anxiety, tremor, insomnia, autonomic hyperactivity, and in severe cases seizures, which is why tapering is required. The other options describe adverse effects that can occur during active benzodiazepine use (e.g., respiratory depression with high doses or when combined with other CNS depressants). The key cue is “abruptly stopping” after “extended period,” which points specifically to dependence-related withdrawal.

Question 47

The nurse is working with a patient who has been experiencing multiple episodes of chest pain. The patient has a strong family history of heart disease. The patient is prescribed a medication to prevent myocardial infarction. Which of the following medications is appropriate for this disease?

Accepted Answer

Answer reason: This fits a patient with recurrent angina symptoms and elevated cardiovascular risk. NSAIDs such as ibuprofen and indomethacin do not prevent myocardial infarction and can increase cardiovascular risk and worsen blood pressure control. Loperamide is an antidiarrheal with no role in cardiac ischemia prevention.

Question 48

The nurse realizes that some herbs interact with selective serotonin reuptake inhibitors. Which herb interaction may cause serotonin syndrome?

Accepted Answer

Answer reason: St. John’s wort Serotonin syndrome results from excessive serotonergic activity, most often when serotonergic agents are combined. This herb has serotonergic effects and can increase serotonin signaling, so taking it with an SSRI raises the risk of toxicity (e.g., agitation, hyperreflexia/clonus, diaphoresis, fever). In contrast, ma-huang primarily has sympathomimetic (adrenergic) effects and is more associated with hypertension/tachyarrhythmias than serotonergic toxicity. Feverfew and ginkgo are mainly linked to antiplatelet/bleeding risks and do not typically precipitate serotonin syndrome with SSRIs.

Question 49

A nurse is teaching a client about montelukast. Which the following instruction should the nurse include?

Accepted Answer

Answer reason: It is typically administered once daily, and evening dosing is recommended for asthma because symptoms often worsen at night and to align with circadian variation in airway inflammation. A spacer is used with inhaled metered-dose bronchodilators or inhaled corticosteroids, not with an oral tablet. Mouth rinsing is a teaching point for inhaled corticosteroids to reduce oropharyngeal candidiasis, which does not apply to montelukast.

Question 50

A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects?

Accepted Answer

Answer reason: This directly improves airway clearance and can make a productive cough more effective. Cough suppressants (antitussives) act on the cough reflex rather than changing mucus consistency, so they are a different therapeutic class. “Dry up secretions” is more consistent with anticholinergic effects or some antihistamines, which can overly thicken secretions and potentially worsen clearance.

Train with a large NCLEX question bank and jump into a full exam-style simulator

Pharmacology NCLEX Practice Test

Continue Learning

Which of the following classes of medications maximizes cardiac performance in clients with heart failure by increasing ventricular contractility?

Dr. Grey prescribes norfloxacin (Noroxin), 400 mg P.O. twice daily, for a client with a urinary tract infection (UTI). The client asks the nurse how long to continue taking the drug. For an uncomplicated UTI, the usual duration of norfloxacin therapy is?

A client is taking Cyclophosphamide (Cytoxan) for the treatment of lymphoma. The nurse is very cautious in administering the medication because this drug poses the fatal side effect of?

A nurse is giving discharge instructions to a client who is receiving a bulk-forming laxative as part of the home medications. All of which are examples of bulk-forming laxative, except?

The mechanism of action of diphenoxylate (Lotomil) is?

Sucralfate (Carafate) achieves a therapeutic effect by?

"METFORMIN" Is a Drug used to Treat which Disease?

The healthcare provider prescribes losartan for a client with hypertension. When the client questions how this medication works, the nurse explains that it promotes vasodilation by which action?

A client with hypertension has been given a prescription to treat the disorder. The nurse should explain that cough and loss of taste are side effects if which antihypertensive agent has been prescribed?

A nurse is reviewing pharmacokinetic principles related to fluoxetine (Prozac). Which statement by a nursing student indicates an understanding of the drug’s unique pharmacologic profile?

After taking glipizide (Glucotrol) for 9 months, a male client experiences secondary failure. Which of the following would the nurse expect the physician to do?

Orlando who has been taking steroids for rheumatoid arthritis over several years presents with a compression vertebral fracture. This fracture is due to?

A client has a wound infection that is resistant to treatment with several antiseptics. The nurse expects that the wound infection will most likely respond to treatment with which antiseptic?

A client is receiving anthracycline chemotherapy agents. The oncology nurse should assess this client for what most well-known and common manifestation of chronic cardiac toxicity?

Nausea and vomiting is an expected side effect of chemotherapeutic drug use. Which of the following drugs should be administered to a client on chemotherapy to prevent nausea and vomiting?

What type of renal failure would the nurse expect to see in a client who accidentally self-administered an excessive dose of tobramycin?

Nurse Thompson assesses a client in the emergency room who is experiencing hallucinations, agitation, and has an irritated nasal septum, as reported by his friends who mentioned he ingested a substance about an hour ago. Which substance is most likely responsible for these symptoms?

A patient unable to tolerate oral medications may be prescribed which of the following proton pump inhibitors to be administered intravenously?

When reviewing a lists of drugs in a drug handbook, a nurse can identify the generic name for a drug in which of the following ways?

A nurse is reviewing a drug reference. The nurse should identify that drugs in the same class share which of the following similarities?

A nurse is caring for a client who is receiving methohexital Sodium. The nurse monitor the client for which of the following adverse effects?

A nurse is caring for a client who has been taking selegiline to treat parkinson's disease. The provider is considering the use of analgesics for the client but should be aware that a drug interaction between selegiline and meperidine can result in which the following?

A client with diabetes and coronary heart disease is being evaluated for treatment. In light of the heart condition, which medication option is more likely to be an issue?

A patient is admitted with bipolar affective disorder. The nurse acknowledges that which medication is used to treat this disorder for some patients in place of lithium?

The nurse realizes that some herbs interact with selective serotonin reuptake inhibitors. Which herb interaction may cause serotonin syndrome?

A selective serotonin reuptake inhibitor (SSRI) is prescribed for a patient. The nurse knows that which drug is an SSRI?

Which statement is true concerning lithium?

A nurse should identify that timolol is contraindicated for a client who has which of the following disorders?

A nurse is caring for a client who is taking interferon beta-1a. The nurse should identify which of the following findings indicates a potential serious adverse effect of this drug?

Which of the following treatments may be used to dissolve a thrombus that is lodged in the pulmonary artery?

A nurse is preparing to administer a drug to a client. In which of the following sections of a drug handbook should the nurse look to determine if the drug has more than one use?

Which risk is significantly increased in patients diagnosed with liver disease?

A nurse should identify that a client who has diabetes and is taking etanercept is at increased risk for which of the following adverse effects?

A nurse is teaching a client who has a prescription for zileuton. Which of the following instructions should the nurse include?

A nurse is teaching a client about the use of anti histamines to treat allergic rhinitis. The nurse should explain that these drugs are effective because they perform which of the following actions?

A nurse is reviewing the medical history of a client who has a new prescription for a reduced dosage of alprazolam for anxiety. Which of the following findings should indicate to the nurse the reason for the prescription modification?

Nurse Marty is monitoring a client for adverse reactions to dantrolene (Dantrium). Which adverse reaction is most common?

The nurse is monitoring a male client for adverse reactions to atropine sulfate (Atropine Care) eyedrops. Systemic absorption of atropine sulfate through the conjunctiva can cause which adverse reaction?

Which of the following agents would increase sedation caused by morphine?

A nurse is teaching a client with a new diagnosis for parkinson’s disease about how levodopa/carbidopa can help control symptoms. The nurse should identify that the drug has which of the following pharmacologic effects?

A nurse is caring for a client who has been taking alprazolam for an extended period of time to treat anxiety. The nurse should identify that abruptly stopping alprazolam therapy can result in which of the following adverse effects?

The nurse is working with a patient who has been experiencing multiple episodes of chest pain. The patient has a strong family history of heart disease. The patient is prescribed a medication to prevent myocardial infarction. Which of the following medications is appropriate for this disease?

The nurse realizes that some herbs interact with selective serotonin reuptake inhibitors. Which herb interaction may cause serotonin syndrome?

A nurse is teaching a client about montelukast. Which the following instruction should the nurse include?

A nurse is teaching a client about the use of a mucolytic to treat a cough. The nurse should include that a mucolytic has which of the following therapeutic effects?

Think you’re ready for the NCLEX?

Leave a Reply Cancel reply