NCLEX-RN : Pharmacology

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #93 : Drug Identification

The client prescribed cholestyramine has been given instructions for taking the medication. The nurse would recognize a need for further instructions if the client said:

Possible Answers:

A high fiber diet is important while taking this medication

I will store the medication at room temperature

This medication will help lower my cholesterol

This medication should only be taken with water

Correct answer:

This medication should only be taken with water

Explanation:

Cholestyramine should be taken with meals and water. The dosage should be administered once or twice daily, with a maximum of six times daily. Cholestyramine binds bile in the gastrointestinal tract to prevent its reabsorption.

Example Question #181 : Nclex

Which of the following is a potential side effect of prednisone?

Possible Answers:

All of these

Adrenal suppression

Weight gain

Hyperglycemia and diabetes

Correct answer:

All of these

Explanation:

There are many potential side effects of prednisone, including all those listed in the answer choices, headache, fatigue, acne, seizures, upset stomach, changes in mood, difficulty breathing, dry cough, vomiting, depression, heartburn, muscle weakness, irregular heart beat, tremors, inability to properly thermoregulate, and many others. 

Example Question #94 : Drug Identification

The nurse anticipates administration of milk of magnesia (magnesium hydroxide). Which of the following patient conditions may affect the nurse’s decision to administer magnesium hydroxide?

Possible Answers:

Reflex esophagitis

Indigestion

Constipation

Peptic ulcer

Stress ulcer

Correct answer:

Constipation

Explanation:

The nurse must consider potential side effects of medications before administering them. Constipation, diarrhea, metabolic acidosis, and acid rebound are potential side effects of magnesium hydroxide. A dose of magnesium hydroxide may potentially exacerbate the patient’s current condition if he is constipated. As an antacid, magnesium hydroxide is indicated for peptic ulcers, stress ulcers, indigestion, and reflex esophagitis.

Example Question #95 : Drug Identification

The psychiatric nurse cares for a patient with major depressive disorder admitted after a suicide attempt. The primary care provider has prescribed fluoxetine, which the patient has never taken before. Which of the following statements is important for the nurse to say to the patient?

Possible Answers:

“You should take this medication in the morning because it can cause insomnia.”

“You could begin to feel more anxious.”

“This medication takes at least 4 weeks to work.”

“You may experience changes in your bowel movements such as diarrhea or constipation.”

“You may experience changes in appetite and weight.”

Correct answer:

“This medication takes at least 4 weeks to work.”

Explanation:

Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) commonly prescribed to patients diagnosed with depression. It may cause changes in appetite and weight, increase anxiety and insomnia, or cause bradycardia or palpitations. It is most important for the nurse to educate the patient that the therapeutic effect of fluoxetine may take up to 4 weeks, as the patient has a previous suicide attempt, and may experience suicide ideation before the effect occurs.

Example Question #96 : Drug Identification

The nurse prepares to administer medications on the psychiatric unit. The patient is prescribed phenelzine sulfate for depression. Which of the following is the nurse’s priority education when administering this medication?

Possible Answers:

Avoid foods with tyramine

Avoid tricyclic medications until 3 weeks after stopping

Wear sunblock

Potentiates alcohol and other medications

Effect of medication takes 3-4 weeks to work

Correct answer:

Avoid foods with tyramine

Explanation:

Phenelzine is a monoamine oxidase inhibitor (MAOI) that treats depression. Patients who take MAOIs should avoid foods with tyramine due to an increased risk for hypertensive crisis. Tyramine-rich foods include those that are fermented, heavily marinated, pickled, smoked, or heavily marinated, also, chocolate and alcoholic beverages have significant amounts of tyramine. In addition to education about diet modification, nurses must educate patients of the signs of hypertensive crisis, which are headache, sweating, palpitations, stiff neck, and intracranial hemorrhage. All of the other listed patient educations are essential, but the priority is to avoid tyramine due to the risk for hypertensive crisis, which is life-threatening.

Example Question #185 : Nclex

A client being treated for type II diabetes has recently been prescribed an oral hyperglycemic medication and has inquired how the medications will keep his blood sugar levels under control. The nurse informs the patient the medication prescribed will reduce glucose production by the liver and increase insulin sensitivity but will not increase insulin production.

Based on this description, which diabetic medication has this client been prescribed?

Possible Answers:

Exenatide

Glyburide

Glipizide

Metformin

Sitagliptin

Correct answer:

Metformin

Explanation:

The only medication mentioned that does not actually stimulate insulin production is Metformin. This medication is a Biguanide, it's mechanism of action includes decreasing hepatic glucose production, and increases insulin sensitivity.

Example Question #186 : Nclex

A 26 year old pregnant client presents to labor and delivery in premature labor, the doctor has ordered a tocolytic medication to help in stopping the contractions.

Which of the following medications is effective in managing premature labor contractions?

Possible Answers:

Pitocin

Naprosyn

Terbutaline sulfate

Misoprostol

Calcium gluconate

Correct answer:

Terbutaline sulfate

Explanation:

Terbutaline sulfate is a tocolytic agent, as well as a bronchodilator effective in stopping premature labor contractions. Both Pitocin and Misoprostol are used to induce labor, calcium gluconate in labor is used to reverse magnesium sulfate another tocolytic. Naprosyn is an NSAID. 

Example Question #11 : Other Pharmacological Drugs

You are the nurse at a psychiatry clinic taking care of a 47-year old male who complains of three months of depressed mood and fatigue. His physician starts him on venlafaxine. Which of the following best describes the mechanism of action of venlafaxine?

Possible Answers:

GABA agonist

Beta-adrenergic blocker

Monoamine oxidase inhibitor (MAOI)

Selective serotonin reuptake inhibitor (SSRI)

Serotonin-norepinephrine reuptake inhibitor (SNRI)

Correct answer:

Serotonin-norepinephrine reuptake inhibitor (SNRI)

Explanation:

The correct answer is "Serotonin-norepinephrine reuptake inhibitor (SNRI)." This is correct because venlafaxine functions by blocking the reuptake of both serotonin and norepinephrine, and thus is classified as a serotonin-norepinephrine reuptake inhibitor (SNRI). Venlafaxine is used to treat a number of conditions including depression, anxiety, panic attacks, and social phobia, among others. In addition to its anti-depressant properties, it is also useful in that it can provide the benefit of increased energy in some patients due to the norepinephrine reuptake inhibition (effectively increasing the effect of norepinephrine). 

Selective serotonin reuptake inhibition (SSRI) is incorrect because venlafaxine is an SNRI, not an SSRI. An example of an SSRI is fluoxetine.

Monoamine oxidase inhibition (MAOI) is incorrect because venlafaxine is an SNRI, not an MAOI. An example of an MAOI is phenelzine. 

An example of a GABA agonist is phenobarbital, a barbiturate. 

An example of a beta-adrenergic blocker is propranolol.

Example Question #181 : Pharmacology

You are the nurse taking care of a 24-year old female with major depressive disorder. She is started on phenelzine, a monoamine oxidase inhibitor (MAOI). To avoid serious adverse effects, including hypertensive crisis, you should warn her to avoid which of the following foods?

Possible Answers:

Aged cheeses

Green, leafy vegetables

Beets

Grapefruit juce

Carrots

Correct answer:

Aged cheeses

Explanation:

The correct answer is "aged cheeses." This is the correct answer because MAOI's, when combined with food or drink products containing the metabolite, tyramine, have the potential to cause serious adverse effects including hypertensive crisis. Tyramine is found most commonly in aged cheeses and cured meats. Thus, since this patient is taking an MAOI, she should be advised to avoid aged cheeses.

Carrots, beets, grapefruit juice, and green, leafy vegetables do not need to be avoided in patients taking MAOI's. 

Example Question #104 : Drug Identification

You are the nurse taking care of a patient with schizophrenia. You administer the patient's medications and note that he is receiving haloperidol. Which of the following best describes the mechanism of action of haloperidol?

Possible Answers:

Dopamine D2 receptor antagonist

Selective serotonin reuptake inhibitor

Norepinephrine-dopamine reuptake inhibitor

Increased efficiency of GABA receptor binding

Serotonin-norepinephrine reuptake inhibitor

Correct answer:

Dopamine D2 receptor antagonist

Explanation:

The correct answer is "Dopamine D2 receptor antagonist." 

This is the correct answer, as haloperidol is a first-generation antipsychotic, also known as a typical antipsychotic medication, and functions by selectively antagonizing dopaminergic D2 receptors. Haloperidol is used to treat a number of conditions including schizophrenia, bipolar disorder (manic phase), acute psychosis, tics from Tourette syndrome, and delirium, among others. 

Increased efficiency of GABA receptor binding describes the mechanism of action of benzodiazepines, not haloperidol.

Selective serotonin reuptake inhibition does not describe the mechanism of action of haloperidol. This describes medications like fluoxetine and escitalopram.

Serotonin-norepinephrine reuptake inhibition does not describe the mechanism of action of haloperidol. This describes medications like venlafaxine and desvenlafaxine.

Norepinephrine-dopamine reuptake inhibition does not describe the mechanism of action of haloperidol. This describes medications like buproprion and methylphenidate.

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