PHARMACOLOGY MASTERED 200
MODULE 8 PRACTICE QUESTIONS PAIN
PSYCH AND INFLAMMATION PORTAGE
LEARNING NURS 251
Pharmacology NURS 251: Module 8 Practice Exam
1. A patient with chronic osteoarthritis is prescribed Celecoxib
(Celebrex) for daily pain management. The nurse understands that
this medication is preferred over traditional NSAIDs because it
specifically targets which enzyme to reduce inflammation while
minimizing gastrointestinal upset?
A. COX-1 enzyme
B. COX-2 enzyme
C. Lipoxygenase
D. Prostaglandin E2
Rationale: Celecoxib is a selective COX-2 inhibitor, which reduces
inflammation and pain without inhibiting the protective COX-1
enzymes that maintain the gastric mucosa.
2. A 65-year-old male patient is taking low-dose Aspirin (81mg) daily
for cardiovascular prophylaxis. He asks why he must stop the
medication one week prior to his upcoming elective surgery. What
is the best explanation provided by the nurse?
A. Aspirin causes significant gastric ulceration during anesthesia.
B. Aspirin irreversibly inhibits platelet aggregation for
the lifespan of the platelet.
C. Aspirin interferes with the metabolism of paralytic agents.
D. Aspirin increases the risk of post-operative malignant
hyperthermia.
Rationale: Aspirin irreversibly binds to platelets (COX-1
inhibition), preventing clotting for 7–10 days, which is the typical
lifespan of a platelet.
3. A patient is admitted to the Emergency Department with a
suspected Acetaminophen overdose. The nurse anticipates the
administration of which specific antidote to prevent severe
hepatotoxicity?
A. Naloxone
, B. Flumazenil
C. Acetylcysteine
D. Vitamin K
Rationale: Acetylcysteine works by restoring hepatic glutathione,
which allows the body to metabolize the toxic byproduct of
acetaminophen safely.
4. A patient with severe postoperative pain is receiving Morphine
Sulfate via a Patient-Controlled Analgesia (PCA) pump. Which
assessment finding should the nurse prioritize as the most serious
adverse effect of this opioid agonist?
A. Constipation and decreased bowel sounds
B. Urinary retention
C. Respiratory rate of 8 breaths per minute
D. Generalized pruritus (itching)
Rationale: Respiratory depression is the most life-threatening
adverse effect of opioid agonists like Morphine.
5. A patient who has been taking high doses of Oxycodone for six
months for chronic back pain states that the medication "doesn't
seem to work as well as it used to." The nurse recognizes this
phenomenon as:
A. Physical dependence
B. Psychological addiction
C. Drug tolerance
D. Pseudo-addiction
Rationale: Tolerance occurs when the body requires a higher dose
of a drug to achieve the same therapeutic effect originally
produced by a lower dose.
6. During the administration of intravenous Naloxone (Narcan) to a
patient with an opioid overdose, the nurse should monitor for
which of the following immediate clinical responses?
A. Increased sedation and lethargy
B. Sudden onset of withdrawal symptoms and intense
pain
C. Severe hypotension and bradycardia
D. Prolonged QT interval on the ECG
Rationale: Naloxone is a competitive antagonist that displaces
opioids from receptors; if given to an opioid-dependent patient, it
triggers immediate and severe withdrawal.
,7. A patient is prescribed Allopurinol (Zyloprim) for the management
of chronic gout. The nurse explains to the patient that the primary
mechanism of action for this medication is to:
A. Increase the renal excretion of uric acid
B. Inhibit the enzyme xanthine oxidase to decrease uric
acid production
C. Provide immediate anti-inflammatory relief during an acute
attack
D. Prevent the migration of leucocytes to the inflamed joint
Rationale: Allopurinol is a maintenance drug that prevents the
formation of uric acid; it is not used for acute pain relief.
8. Which statement made by a patient recently prescribed Fluoxetine
(Prozac) for Major Depressive Disorder indicates a need for further
teaching regarding the timeline of therapeutic effects?
A. "I should avoid herbal supplements like St. John’s Wort."
B. "I expect to feel significantly less depressed by this
time tomorrow."
C. "I need to monitor for any increase in suicidal thoughts."
D. "It may take 4 to 6 weeks for the full effect of this drug to be
felt."
Rationale: SSRIs like Fluoxetine have a delayed therapeutic onset,
typically taking several weeks to reach steady state and full
clinical effect.
9. A patient taking an Monoamine Oxidase Inhibitor (MAOI) for
treatment-resistant depression must be educated on avoiding
foods high in tyramine, such as aged cheeses and red wine, to
prevent which life-threatening complication?
A. Serotonin Syndrome
B. Hypertensive Crisis
C. Neuroleptic Malignant Syndrome
D. Agranulocytosis
Rationale: MAOIs prevent the breakdown of tyramine; high
levels of tyramine cause a massive release of norepinephrine,
leading to dangerous hypertension.
10. A patient diagnosed with Bipolar Disorder is started on
Lithium Carbonate. The nurse advises the patient to maintain a
consistent intake of which dietary element to prevent Lithium
toxicity?
A. Potassium
, B. Sodium
C. Calcium
D. Magnesium
Rationale: The kidneys perceive Lithium and Sodium as the same;
if sodium levels drop (dehydration or low-salt diet), the kidneys
will retain Lithium, leading to toxicity.
11. A patient is brought to the clinic exhibiting signs of "Serotonin
Syndrome" after combining an SSRI with an OTC cough
suppressant. Which triad of symptoms would the nurse expect to
assess?
A. Bradycardia, hypotension, and constipation
B. Agitation, hyperreflexia, and hyperthermia
C. Hypothermia, miosis, and bradypnea
D. Lethargy, urinary retention, and dry mouth
Rationale: Serotonin syndrome is characterized by mental status
changes, autonomic hyperactivity (fever/tachycardia), and
neuromuscular abnormalities (tremor/clonus).
12.A patient with a history of alcohol use disorder is prescribed
Lorazepam (Ativan) for acute anxiety. The nurse should warn the
patient that combining benzodiazepines with alcohol significantly
increases the risk of:
A. Liver failure
B. Central Nervous System (CNS) depression
C. Hypertensive emergency
D. Tonic-clonic seizures
Rationale: Both alcohol and benzodiazepines enhance the effects
of GABA; combining them leads to additive and potentially fatal
respiratory and CNS depression.
13.When comparing Ibuprofen (Advil) to Acetaminophen (Tylenol),
the nurse knows that a key difference is that Ibuprofen possesses
which of the following properties that Acetaminophen lacks?
A. Antipyretic (fever-reducing)
B. Analgesic (pain-reducing)
C. Anti-inflammatory
D. Central nervous system action
Rationale: Acetaminophen has almost no anti-inflammatory
properties, whereas NSAIDs like Ibuprofen inhibit prostaglandins
in the periphery to reduce swelling.
MODULE 8 PRACTICE QUESTIONS PAIN
PSYCH AND INFLAMMATION PORTAGE
LEARNING NURS 251
Pharmacology NURS 251: Module 8 Practice Exam
1. A patient with chronic osteoarthritis is prescribed Celecoxib
(Celebrex) for daily pain management. The nurse understands that
this medication is preferred over traditional NSAIDs because it
specifically targets which enzyme to reduce inflammation while
minimizing gastrointestinal upset?
A. COX-1 enzyme
B. COX-2 enzyme
C. Lipoxygenase
D. Prostaglandin E2
Rationale: Celecoxib is a selective COX-2 inhibitor, which reduces
inflammation and pain without inhibiting the protective COX-1
enzymes that maintain the gastric mucosa.
2. A 65-year-old male patient is taking low-dose Aspirin (81mg) daily
for cardiovascular prophylaxis. He asks why he must stop the
medication one week prior to his upcoming elective surgery. What
is the best explanation provided by the nurse?
A. Aspirin causes significant gastric ulceration during anesthesia.
B. Aspirin irreversibly inhibits platelet aggregation for
the lifespan of the platelet.
C. Aspirin interferes with the metabolism of paralytic agents.
D. Aspirin increases the risk of post-operative malignant
hyperthermia.
Rationale: Aspirin irreversibly binds to platelets (COX-1
inhibition), preventing clotting for 7–10 days, which is the typical
lifespan of a platelet.
3. A patient is admitted to the Emergency Department with a
suspected Acetaminophen overdose. The nurse anticipates the
administration of which specific antidote to prevent severe
hepatotoxicity?
A. Naloxone
, B. Flumazenil
C. Acetylcysteine
D. Vitamin K
Rationale: Acetylcysteine works by restoring hepatic glutathione,
which allows the body to metabolize the toxic byproduct of
acetaminophen safely.
4. A patient with severe postoperative pain is receiving Morphine
Sulfate via a Patient-Controlled Analgesia (PCA) pump. Which
assessment finding should the nurse prioritize as the most serious
adverse effect of this opioid agonist?
A. Constipation and decreased bowel sounds
B. Urinary retention
C. Respiratory rate of 8 breaths per minute
D. Generalized pruritus (itching)
Rationale: Respiratory depression is the most life-threatening
adverse effect of opioid agonists like Morphine.
5. A patient who has been taking high doses of Oxycodone for six
months for chronic back pain states that the medication "doesn't
seem to work as well as it used to." The nurse recognizes this
phenomenon as:
A. Physical dependence
B. Psychological addiction
C. Drug tolerance
D. Pseudo-addiction
Rationale: Tolerance occurs when the body requires a higher dose
of a drug to achieve the same therapeutic effect originally
produced by a lower dose.
6. During the administration of intravenous Naloxone (Narcan) to a
patient with an opioid overdose, the nurse should monitor for
which of the following immediate clinical responses?
A. Increased sedation and lethargy
B. Sudden onset of withdrawal symptoms and intense
pain
C. Severe hypotension and bradycardia
D. Prolonged QT interval on the ECG
Rationale: Naloxone is a competitive antagonist that displaces
opioids from receptors; if given to an opioid-dependent patient, it
triggers immediate and severe withdrawal.
,7. A patient is prescribed Allopurinol (Zyloprim) for the management
of chronic gout. The nurse explains to the patient that the primary
mechanism of action for this medication is to:
A. Increase the renal excretion of uric acid
B. Inhibit the enzyme xanthine oxidase to decrease uric
acid production
C. Provide immediate anti-inflammatory relief during an acute
attack
D. Prevent the migration of leucocytes to the inflamed joint
Rationale: Allopurinol is a maintenance drug that prevents the
formation of uric acid; it is not used for acute pain relief.
8. Which statement made by a patient recently prescribed Fluoxetine
(Prozac) for Major Depressive Disorder indicates a need for further
teaching regarding the timeline of therapeutic effects?
A. "I should avoid herbal supplements like St. John’s Wort."
B. "I expect to feel significantly less depressed by this
time tomorrow."
C. "I need to monitor for any increase in suicidal thoughts."
D. "It may take 4 to 6 weeks for the full effect of this drug to be
felt."
Rationale: SSRIs like Fluoxetine have a delayed therapeutic onset,
typically taking several weeks to reach steady state and full
clinical effect.
9. A patient taking an Monoamine Oxidase Inhibitor (MAOI) for
treatment-resistant depression must be educated on avoiding
foods high in tyramine, such as aged cheeses and red wine, to
prevent which life-threatening complication?
A. Serotonin Syndrome
B. Hypertensive Crisis
C. Neuroleptic Malignant Syndrome
D. Agranulocytosis
Rationale: MAOIs prevent the breakdown of tyramine; high
levels of tyramine cause a massive release of norepinephrine,
leading to dangerous hypertension.
10. A patient diagnosed with Bipolar Disorder is started on
Lithium Carbonate. The nurse advises the patient to maintain a
consistent intake of which dietary element to prevent Lithium
toxicity?
A. Potassium
, B. Sodium
C. Calcium
D. Magnesium
Rationale: The kidneys perceive Lithium and Sodium as the same;
if sodium levels drop (dehydration or low-salt diet), the kidneys
will retain Lithium, leading to toxicity.
11. A patient is brought to the clinic exhibiting signs of "Serotonin
Syndrome" after combining an SSRI with an OTC cough
suppressant. Which triad of symptoms would the nurse expect to
assess?
A. Bradycardia, hypotension, and constipation
B. Agitation, hyperreflexia, and hyperthermia
C. Hypothermia, miosis, and bradypnea
D. Lethargy, urinary retention, and dry mouth
Rationale: Serotonin syndrome is characterized by mental status
changes, autonomic hyperactivity (fever/tachycardia), and
neuromuscular abnormalities (tremor/clonus).
12.A patient with a history of alcohol use disorder is prescribed
Lorazepam (Ativan) for acute anxiety. The nurse should warn the
patient that combining benzodiazepines with alcohol significantly
increases the risk of:
A. Liver failure
B. Central Nervous System (CNS) depression
C. Hypertensive emergency
D. Tonic-clonic seizures
Rationale: Both alcohol and benzodiazepines enhance the effects
of GABA; combining them leads to additive and potentially fatal
respiratory and CNS depression.
13.When comparing Ibuprofen (Advil) to Acetaminophen (Tylenol),
the nurse knows that a key difference is that Ibuprofen possesses
which of the following properties that Acetaminophen lacks?
A. Antipyretic (fever-reducing)
B. Analgesic (pain-reducing)
C. Anti-inflammatory
D. Central nervous system action
Rationale: Acetaminophen has almost no anti-inflammatory
properties, whereas NSAIDs like Ibuprofen inhibit prostaglandins
in the periphery to reduce swelling.
