NSG 318 Exam 4 Pharmacology Review 2026 – GCU
1. A patient is prescribed Lithium Carbonate for Bipolar Disorder. Which serum
level should the nurse identify as within the therapeutic range?
A. 0.2 - 0.5 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.5 - 3.5 mEq/L
Answer: B
Rationale: The therapeutic serum range for lithium is 0.6 to 1.2 mEq/L. Levels above 1.5
mEq/L can indicate toxicity.
2. Which food item should a patient taking a Monoamine Oxidase Inhibitor
(MAOI) avoid to prevent a hypertensive crisis?
A. Fresh green beans
B. Cooked chicken breast
C. Whole grain bread
D. Aged cheddar cheese
Answer: D
Rationale: MAOIs interact with tyramine-rich foods, such as aged cheeses, cured meats,
and red wine, which can lead to a hypertensive crisis.
,3. A nurse is caring for a patient receiving Haloperidol. The patient develops a
high fever, muscle rigidity, and autonomic instability. What condition does the
nurse suspect?
A. Serotonin Syndrome
B. Extrapyramidal Symptoms (EPS)
C. Neuroleptic Malignant Syndrome (NMS)
D. Tardive Dyskinesia
Answer: C
Rationale: NMS is a life-threatening reaction to antipsychotic drugs characterized by fever,
altered mental status, muscle rigidity, and autonomic dysfunction.
4. What is the primary mechanism of action of Selective Serotonin Reuptake
Inhibitors (SSRIs)?
A. Blocking the reabsorption of serotonin into the neuron
B. Increasing the breakdown of serotonin in the synapse
C. Binding directly to serotonin receptors to mimic the neurotransmitter
D. Stimulating the release of dopamine and norepinephrine
Answer: A
Rationale: SSRIs work by blocking the reuptake of serotonin, making more of the
neurotransmitter available in the synaptic cleft.
5. A patient is brought to the emergency department with a suspected
benzodiazepine overdose. Which medication should the nurse anticipate
administering?
A. Naloxone
B. Acetylcysteine
C. Protamine Sulfate
D. Flumazenil
Answer: D
, Rationale: Flumazenil is the specific reversal agent (antidote) for benzodiazepine toxicity.
6. Which adverse effect is a primary concern for a patient starting Clozapine
therapy?
A. Agranulocytosis
B. Gingival hyperplasia
C. Ototoxicity
D. Hyperkalemia
Answer: A
Rationale: Clozapine carries a black box warning for agranulocytosis, necessitating weekly
WBC and ANC monitoring.
7. A nurse is teaching a patient about Levothyroxine. When should the patient
be instructed to take this medication?
A. With a large fatty meal
B. Immediately before bed
C. In the morning on an empty stomach
D. Only when feeling symptomatic of fatigue
Answer: C
Rationale: Levothyroxine should be taken in the morning on an empty stomach, 30-60
minutes before breakfast, to ensure optimal absorption.
8. Which assessment finding is the most significant risk when administering an
opioid analgesic like Morphine?
A. Respiratory rate of 8 breaths/min
B. Nausea and vomiting
C. Constipation
D. Urinary retention
Answer: A
1. A patient is prescribed Lithium Carbonate for Bipolar Disorder. Which serum
level should the nurse identify as within the therapeutic range?
A. 0.2 - 0.5 mEq/L
B. 0.6 - 1.2 mEq/L
C. 1.5 - 2.0 mEq/L
D. 2.5 - 3.5 mEq/L
Answer: B
Rationale: The therapeutic serum range for lithium is 0.6 to 1.2 mEq/L. Levels above 1.5
mEq/L can indicate toxicity.
2. Which food item should a patient taking a Monoamine Oxidase Inhibitor
(MAOI) avoid to prevent a hypertensive crisis?
A. Fresh green beans
B. Cooked chicken breast
C. Whole grain bread
D. Aged cheddar cheese
Answer: D
Rationale: MAOIs interact with tyramine-rich foods, such as aged cheeses, cured meats,
and red wine, which can lead to a hypertensive crisis.
,3. A nurse is caring for a patient receiving Haloperidol. The patient develops a
high fever, muscle rigidity, and autonomic instability. What condition does the
nurse suspect?
A. Serotonin Syndrome
B. Extrapyramidal Symptoms (EPS)
C. Neuroleptic Malignant Syndrome (NMS)
D. Tardive Dyskinesia
Answer: C
Rationale: NMS is a life-threatening reaction to antipsychotic drugs characterized by fever,
altered mental status, muscle rigidity, and autonomic dysfunction.
4. What is the primary mechanism of action of Selective Serotonin Reuptake
Inhibitors (SSRIs)?
A. Blocking the reabsorption of serotonin into the neuron
B. Increasing the breakdown of serotonin in the synapse
C. Binding directly to serotonin receptors to mimic the neurotransmitter
D. Stimulating the release of dopamine and norepinephrine
Answer: A
Rationale: SSRIs work by blocking the reuptake of serotonin, making more of the
neurotransmitter available in the synaptic cleft.
5. A patient is brought to the emergency department with a suspected
benzodiazepine overdose. Which medication should the nurse anticipate
administering?
A. Naloxone
B. Acetylcysteine
C. Protamine Sulfate
D. Flumazenil
Answer: D
, Rationale: Flumazenil is the specific reversal agent (antidote) for benzodiazepine toxicity.
6. Which adverse effect is a primary concern for a patient starting Clozapine
therapy?
A. Agranulocytosis
B. Gingival hyperplasia
C. Ototoxicity
D. Hyperkalemia
Answer: A
Rationale: Clozapine carries a black box warning for agranulocytosis, necessitating weekly
WBC and ANC monitoring.
7. A nurse is teaching a patient about Levothyroxine. When should the patient
be instructed to take this medication?
A. With a large fatty meal
B. Immediately before bed
C. In the morning on an empty stomach
D. Only when feeling symptomatic of fatigue
Answer: C
Rationale: Levothyroxine should be taken in the morning on an empty stomach, 30-60
minutes before breakfast, to ensure optimal absorption.
8. Which assessment finding is the most significant risk when administering an
opioid analgesic like Morphine?
A. Respiratory rate of 8 breaths/min
B. Nausea and vomiting
C. Constipation
D. Urinary retention
Answer: A
