WGU D116 ADVANCED PHARMACOLOGY OBJECTIVE
ASSESSMENT"
A patient presents to an emergency room complaining of palpitations and irregular
heartbeat. The APRN places the patient on a cardiac monitor and observes atrial
fibrillation. The APRN orders dofetilide. How should the APRN recommend this
medication be taken? - Answers -YES With food or an empty stomach
A 70-year-old male calls a clinic complaining of chest pain that started after sexual
activity. He took sildenafil 50 mg about eight hours ago. He has nitroglycerin 0.3 mg on
hand. How should the APRN respond? - Answers -Do not take the nitroglycerin and call
911
Taking the medications together can cause what? - Answers -A serious drop in blood
pressure leading to cardiovascular collapse.
A patient with bipolar disorder is discussing beginning lithium. The APRN wants
baseline labs. The patient asks why. Which explanation should be provided? - Answers
-A baseline BUN and creatinine is needed to assess kidney function because lithium
can decrease renal function.
A new nurse is reviewing sildenafil use. Which patient may take sildenafil safely? -
Answers -YES A 54-year-old male with controlled hypertension, mild eczema, and past
urolithiasis without complications
A 30-year-old patient with anxiety is prescribed citalopram. What is its mechanism of
action? - Answers -YES Influences receptor activity on target cells
Correct explanation of citalopram's mechanism - Answers -This medication influences
the activity in the receptors, and it targets cells.
A Huntington disease patient has twitching, dysphagia, confusion, memory loss. APRN
prescribes baclofen. Mechanism of action? - Answers -YES Inhibits neurotransmitter
GABA
NO Modulates the effects of glutamate at NMDA receptors - Answers -Incorrect.
NO Halts breakdown of acetylcholine by acetylcholinesterase - Answers -Incorrect.
Cholinesterase inhibitors prevent ACh breakdown and are used for Alzheimer's.
Alters synthesis and release of norepinephrine, serotonin, and dopamine - Answers -
Incorrect.
,Correct explanation - Answers -Baclofen enhances GABA; Huntington involves
deficiency of acetylcholine and GABA.
A 21-year-old patient has a seizure with impaired consciousness followed by CNS
depression. Type of seizure? - Answers -YES Tonic-clonic
Atonic - Answers -NO
Myoclonic - Answers -NO — consists of sudden 1-second contractions
Absence - Answers -NO
Correct explanation - Answers -A tonic-clonic seizure involves convulsions, stiffening,
loss of consciousness, jerking.
A patient taking oxycodone every 6 hrs for 3 years suddenly stops. What is the clinical
concern? - Answers -YES Physical dependence
Correct explanation - Answers -Stopping abruptly causes withdrawal and can cause
symptoms from nausea to seizures.
A 44-year-old male with depression and sexual dysfunction history needs an
antidepressant that enhances libido. - Answers -YES Bupropion
Explanation - Answers -Bupropion does not cause sexual dysfunction and may improve
libido.
A wheezing patient receives a nonspecific beta-agonist. Besides respiratory relief, what
side effect should the nurse monitor? - Answers -YES Tachycardia
Explanation - Answers -Beta1 stimulation causes tachycardia and hypertension.
A patient has toxic atropine effects (delirium, hallucinations). Which medication should
the provider administer? - Answers -YES Physostigmine
Explanation - Answers -Physostigmine treats atropine poisoning and crosses the BBB.
A patient requires sutures. Provider orders local anesthetic with epinephrine.
Epinephrine is used to ________. - Answers -Allow a reduced dose of the anesthetic
Explanation - Answers -Epinephrine (alpha1 agonist) prolongs absorption and reduces
anesthetic needed.
A Parkinson patient on carbidopa reports no change after months. What should the
provider do? - Answers -Reevaluate the diagnosis
, Increase the dose of carbidopa - Answers -Option but less correct
Discuss "on-off" phenomenon - Answers -Possible but not primary
NO Add a dopamine agonist - Answers -Incorrect
A woman taking oral contraceptives starts valproic acid and reports nausea. What
should the nurse do? - Answers -YES Ask if she is taking valproic acid with food
Explanation - Answers -GI symptoms are common and reduced by taking with food.
A cerebral palsy patient receiving baclofen via G-tube has new seizures. Cause? -
Answers -YES Missed doses of baclofen
Explanation - Answers -Abrupt withdrawal may cause hallucinations, paranoia, and
seizures.
A patient received lidocaine with epinephrine for sutures. Which symptom is most
concerning? - Answers -YES Nervousness and tachycardia
Explanation - Answers -Systemic absorption of epinephrine can cause nervousness,
tachycardia.
A patient with migraine is prescribed sumatriptan. Which history finding is concerning? -
Answers -Coronary artery disease
Explanation - Answers -Risk of coronary vasospasm.
A patient on an MAOI is switching to an SSRI. What instruction should be given? -
Answers -YES "Stop the MAOI two weeks before starting the SSRI."
Explanation - Answers -To prevent serotonin syndrome.
A patient admitted with euphoric mania. Which medication should be ordered? -
Answers -YES Lithium
Explanation - Answers -Lithium is preferred for euphoric mania.
A patient with pulmonary edema and frothy pink sputum. Which drug to administer? -
Answers -YES Furosemide
Explanation - Answers -Rapid diuresis needed to treat pulmonary edema.
A patient with nephrosclerosis, BP 130/90 after ACE inhibitor + thiazide. What should
the nurse discuss? - Answers -YES Adding a calcium channel blocker
ASSESSMENT"
A patient presents to an emergency room complaining of palpitations and irregular
heartbeat. The APRN places the patient on a cardiac monitor and observes atrial
fibrillation. The APRN orders dofetilide. How should the APRN recommend this
medication be taken? - Answers -YES With food or an empty stomach
A 70-year-old male calls a clinic complaining of chest pain that started after sexual
activity. He took sildenafil 50 mg about eight hours ago. He has nitroglycerin 0.3 mg on
hand. How should the APRN respond? - Answers -Do not take the nitroglycerin and call
911
Taking the medications together can cause what? - Answers -A serious drop in blood
pressure leading to cardiovascular collapse.
A patient with bipolar disorder is discussing beginning lithium. The APRN wants
baseline labs. The patient asks why. Which explanation should be provided? - Answers
-A baseline BUN and creatinine is needed to assess kidney function because lithium
can decrease renal function.
A new nurse is reviewing sildenafil use. Which patient may take sildenafil safely? -
Answers -YES A 54-year-old male with controlled hypertension, mild eczema, and past
urolithiasis without complications
A 30-year-old patient with anxiety is prescribed citalopram. What is its mechanism of
action? - Answers -YES Influences receptor activity on target cells
Correct explanation of citalopram's mechanism - Answers -This medication influences
the activity in the receptors, and it targets cells.
A Huntington disease patient has twitching, dysphagia, confusion, memory loss. APRN
prescribes baclofen. Mechanism of action? - Answers -YES Inhibits neurotransmitter
GABA
NO Modulates the effects of glutamate at NMDA receptors - Answers -Incorrect.
NO Halts breakdown of acetylcholine by acetylcholinesterase - Answers -Incorrect.
Cholinesterase inhibitors prevent ACh breakdown and are used for Alzheimer's.
Alters synthesis and release of norepinephrine, serotonin, and dopamine - Answers -
Incorrect.
,Correct explanation - Answers -Baclofen enhances GABA; Huntington involves
deficiency of acetylcholine and GABA.
A 21-year-old patient has a seizure with impaired consciousness followed by CNS
depression. Type of seizure? - Answers -YES Tonic-clonic
Atonic - Answers -NO
Myoclonic - Answers -NO — consists of sudden 1-second contractions
Absence - Answers -NO
Correct explanation - Answers -A tonic-clonic seizure involves convulsions, stiffening,
loss of consciousness, jerking.
A patient taking oxycodone every 6 hrs for 3 years suddenly stops. What is the clinical
concern? - Answers -YES Physical dependence
Correct explanation - Answers -Stopping abruptly causes withdrawal and can cause
symptoms from nausea to seizures.
A 44-year-old male with depression and sexual dysfunction history needs an
antidepressant that enhances libido. - Answers -YES Bupropion
Explanation - Answers -Bupropion does not cause sexual dysfunction and may improve
libido.
A wheezing patient receives a nonspecific beta-agonist. Besides respiratory relief, what
side effect should the nurse monitor? - Answers -YES Tachycardia
Explanation - Answers -Beta1 stimulation causes tachycardia and hypertension.
A patient has toxic atropine effects (delirium, hallucinations). Which medication should
the provider administer? - Answers -YES Physostigmine
Explanation - Answers -Physostigmine treats atropine poisoning and crosses the BBB.
A patient requires sutures. Provider orders local anesthetic with epinephrine.
Epinephrine is used to ________. - Answers -Allow a reduced dose of the anesthetic
Explanation - Answers -Epinephrine (alpha1 agonist) prolongs absorption and reduces
anesthetic needed.
A Parkinson patient on carbidopa reports no change after months. What should the
provider do? - Answers -Reevaluate the diagnosis
, Increase the dose of carbidopa - Answers -Option but less correct
Discuss "on-off" phenomenon - Answers -Possible but not primary
NO Add a dopamine agonist - Answers -Incorrect
A woman taking oral contraceptives starts valproic acid and reports nausea. What
should the nurse do? - Answers -YES Ask if she is taking valproic acid with food
Explanation - Answers -GI symptoms are common and reduced by taking with food.
A cerebral palsy patient receiving baclofen via G-tube has new seizures. Cause? -
Answers -YES Missed doses of baclofen
Explanation - Answers -Abrupt withdrawal may cause hallucinations, paranoia, and
seizures.
A patient received lidocaine with epinephrine for sutures. Which symptom is most
concerning? - Answers -YES Nervousness and tachycardia
Explanation - Answers -Systemic absorption of epinephrine can cause nervousness,
tachycardia.
A patient with migraine is prescribed sumatriptan. Which history finding is concerning? -
Answers -Coronary artery disease
Explanation - Answers -Risk of coronary vasospasm.
A patient on an MAOI is switching to an SSRI. What instruction should be given? -
Answers -YES "Stop the MAOI two weeks before starting the SSRI."
Explanation - Answers -To prevent serotonin syndrome.
A patient admitted with euphoric mania. Which medication should be ordered? -
Answers -YES Lithium
Explanation - Answers -Lithium is preferred for euphoric mania.
A patient with pulmonary edema and frothy pink sputum. Which drug to administer? -
Answers -YES Furosemide
Explanation - Answers -Rapid diuresis needed to treat pulmonary edema.
A patient with nephrosclerosis, BP 130/90 after ACE inhibitor + thiazide. What should
the nurse discuss? - Answers -YES Adding a calcium channel blocker
