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Example Questions
Example Question #81 : Drug Identification
Which of the following drugs is useful in treating infections from mycobacteria, which is the drug of choice in treating M. leprae?
Dapsone
Isoniazid
Pyrazinamide
Cycloserine
Ethambutol
Dapsone
Dapsone has been the world wide standard for treatment of leprosy. The other agents listed are used in treatment of tuberculosis.
Example Question #82 : Drug Identification
A 30-year-old man with HIV is being treated with anti-viral agents. 4 weeks after initiating therapy, he presents with weakness and fatigue. Laboratory studies reveal anemia, leukopenia and thrombocytopenia indicating bone marrow suppression. What anti-viral agent is most likely the cause of his symptoms?
Acyclovir
Tenofovir
Nelfinavir
Lamivudine
Zidovudine
Zidovudine
Zidovudine (ZDV,) formerly called azidothymidine, is active orally and is distributed to most tissues. The primary toxic side effect of ZDV is bone marrow suppression leading to anemia and neutropenia, which may require transfusions. Additional side effects include thrombocytopenia, gastrointestinal distress, headache, myalgia, acute cholestatic hepatitis, agitation, and insomnia.
The other choices are incorrect. Acyclovir is commonly used for the treatment of mucocutaneous and genital herpes lesions and for prophylaxis in AIDS. Acyclovir has no significant toxicity on the bone marrow. Nelfinavir is a protease inhibitor that is characterized by a short half-life and has a number of drug interactions but its primary adverse effect is diarrhea and it has the most favorable safety profile in pregnancy. It is not associated with bone marrow suppression. Lamivudine is a nucleoside inhibitor and is an active inhibitor of HIV reverse transcriptase. It is used in the treatment of hepatitis B virus infection. The drug is remarkably nontoxic and adverse effects are mild. Tenofovir is a nucleoside reverse transcriptase inhibitor and anti-HIV drug that competitively inhibits reverse transcriptase and causes chain termination after incorporation into DNA. Adverse side effects include gastrointestinal distress, asthenia, and headache but not anemia, leukopenia, or thrombocytopenia.
Example Question #83 : Drug Identification
Which of the following is an analog of guanine (a purine) and is transformed by viral thymidine kinase before it can inhibit viral DNA polymerase in viruses that are actively replicating?
Interferon
Zalcitabine
Zidovudine
Idoxuridine
Acyclovir
Acyclovir
The chemical type of an antiviral compound is often important in determining its potential mechanisms and, therefore, its utility against specific types of viruses. Interferon is a glycoprotein produced by many types of mammalian cells. It stimulates host mechanisms to prevent viral penetration and also inhibits viral protein synthesis. Idoxuridine, as its name implies, is a pyrimidine, which inhibits viral DNA polymerase. Zidovudine and zalcitabine are also pyrimidines, but they inhibit reverse transcriptase and act as chain terminators. Only acyclovir is a purine that requires viral thymidine kinase to be converted to an active phosphorylated form, which then inhibits viral DNA polymerase.
Example Question #84 : Drug Identification
Which of the following anthelminthic drugs must be administered intravenously and may cause albuminuria due to accumulation in the kidney, photophobia, and papular eruption?
Suramin
Diethylcarbamazine
Ivermectin
Zidovudine
Praziquantel
Suramin
Suramin must be administered intravenously and should be used cautiously in patients with kidney disease. It inhibits protein kinases and dihydrofolate reductase and reduces ATP synthesis. It is used in the treatment of certain extra-intestinal nematodes and is probably one of the most toxic anthelminthic agents.
The other choices are incorrect. Diethylcarbamazine is rapidly absorbed following oral administration and increases the susceptibility of extra-intestinal nematodes to host antibodies. Ivermectin is used to treat O. volvulus in humans and is rapidly absorbed following oral administration. The primary use of praziquantel, which is rapidly absorbed orally, is in the treatment of infection from flat worms and flukes where it reduces the resistance of the parasite to host immune mechanisms. Zidovudine is also administered orally, but is used for treatment of AIDS, where most of its toxic symptoms are hematologic.
Example Question #85 : Drug Identification
A 42-year-old immigrant from Pakistan comes to your office after his wife noted hypopigmented anesthetic patches on his back. On further examination, you discover bilaterally thickened ulnar nerves. Skin biopsy reveals numerous acid-fast bacilli and a negative lepromin test. What combination of drugs would you recommend for this patient?
Dapsone, Clofazimine, Rifampin
Ethambutol, Isoniazid, Clofazimine
Pyrazinamide, Rifampin, Isoniazid
Isoniazid, Rifampin, Dapsone
Dapsone, Clofazimine, Ethambutol
Dapsone, Clofazimine, Rifampin
Leprosy is of two types namely lepromatous and tuberculoid.This patient is suffering from lepromatous leprosy on account of the symmetric nerve involvement, the abundant acid fast bacilli and the negative lepromin test. The course of this subtype is progressive and malignant. In case of tuberculoid leprosy the course is more benign with cellular immunity remaining intact. The skin biopsy shows few bacilli and there is a positive skin test. Combination therapy is recommended for all types of leprosy to avoid the emergence of resistance. Cases of lepromatous leprosy are treated with a combination therapy involving the use of the following:
- Dapsone
- Rifampin
- Clofazimine
This combination is given for 2 to 3 years, ideally till the skin biopsies are negative. Cases of indeterminate (borderline) and tuberculoid leprosy are treated with a combination therapy involving the use of the following:
- Dapsone
- Rifampin
Rifampin for 6 to 12 months followed by dapsone—alone—for 2 years.
Example Question #172 : Nclex
Foscarent is toxic to which of the following organs?
Bladder
Heart
Liver
Kidneys
Kidneys
Foscarent can cause damage to the kidneys. To reduce the damaging effect, the patient may be put on intravenous fluids.
Example Question #172 : Nclex
What is acyclovir's mechanism of action?
Neuraminidase inhibitor
Reverse transcriptase blocker
M2 channel inhibitor
Guanosine analog
Guanosine analog
Acyclovir is a guanosine analog, which works by inhibiting viral DNA polymerase. This slows down the rate at which viruses can replicate. Acyclovir is used primarily in the treatment of herpes simplex viruses 1 and 2, chickenpox, and shingles.
Example Question #1 : Other Pharmacological Drugs
Allopurinol is used for what condition?
Gout
Hypertension
Type II diabetes
Kidney stones
Gout
Allopurinol is a purine analog and xanthine oxidase inhibitor used in the treatment of chronic gout.
Example Question #1 : Other Pharmacological Drugs
Which of the following drugs is used in the treatment of osteoporosis?
Alendronic acid
Sitagliptin
Infliximab
Budesonide/formoterol
Alendronic acid
Alendronic acid (trade name Fosamax) is a bisphosphonate used in the treatment of osteoporosis. Bisphosphonates reduce bone loss by encouraging apoptosis in osteoclasts.
Infliximab is a tumor necrosis factor-alpha (TNF-alpha) blocker used in the treatment of rheumatoid arthritis and several other autoimmune conditions. Sitagliptin (trade name Januvia) is a diabetes medication. Budesonide/formoterol (trade name Symbicort) is a combination long acting beta agonist and corticosteroid used in the treatment of asthma.
Example Question #2 : Other Pharmacological Drugs
When Allopurinol is prescribed to a client, it is best for the nurse to include the following instructions:
That the effect of the medication will occur immediately
To take the medication on an empty stomach
To drink 3000 mL of fluid a day
That if swelling of the lips occurs, this is a normal expected response
To drink 3000 mL of fluid a day
The nurse should instruct a patient on Allopurinol to drink 3000 mL of fluid a day to reduce the risk of kidney stone formation.
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