NURS 251 Module 3 Exam V1 | NURS 251
Module 3 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 3 Exam)
1. A nurse is preparing to administer lidocaine with epinephrine to a patient for a minor
surgical procedure. What is the primary rationale for including epinephrine in this solution?
A. To increase the rate of systemic absorption of the lidocaine.
B. To act as a secondary anesthetic agent to block motor neurons.
C. To prevent the patient from developing malignant hyperthermia.
D. To cause vasoconstriction, thereby prolonging the local effect and reducing bleeding.
Answer: D
Rationale: Epinephrine is a vasoconstrictor that restricts blood flow to the injection site.
This restriction slows the systemic absorption of the local anesthetic, which prolongs the
duration of the numbing effect. Additionally, the decreased blood flow helps minimize
bleeding at the incision site during the procedure.
2. When assessing a patient for local anesthetic toxicity following a regional nerve block,
which clinical manifestation should the nurse prioritize?
A. Increased urine output and polyuria.
B. Gastrointestinal upset and hyperactive bowel sounds.
,C. Central nervous system excitation followed by depression.
D. Peripheral edema in the lower extremities.
Answer: C
Rationale: Systemic toxicity from local anesthetics primarily affects the CNS and
cardiovascular systems. Initial signs typically include CNS excitation such as tremors,
seizures, or irritability. This is often followed by profound CNS depression and potential
cardiac arrest if not managed promptly.
3. A patient is receiving morphine sulfate via a Patient-Controlled Analgesia (PCA) pump.
Which assessment finding requires the most immediate intervention by the nurse?
A. The patient reports a pain level of 3 on a scale of 0 to 10.
B. The patient reports feeling sleepy between doses.
C. The patient has not had a bowel movement in two days.
D. A respiratory rate of 8 breaths per minute.
Answer: D
Rationale: Respiratory depression is the most serious adverse effect of opioid analgesics
like morphine. A respiratory rate of 8 breaths per minute indicates significant depression
and requires immediate medical attention or the administration of a reversal agent. While
constipation and sedation are common, they are not life-threatening in the acute sense
compared to respiratory failure.
, 4. The nurse is educating a patient about the use of Naloxone (Narcan). Which statement
correctly describes the mechanism of action of this drug?
A. It acts as an agonist at the mu-opioid receptors to enhance analgesia.
B. It is a competitive antagonist that displaces opioids from their receptors.
C. It provides sedative effects to help the patient sleep during withdrawal.
D. It increases the metabolism of opioids in the liver to speed excretion.
Answer: B
Rationale: Naloxone is a pure opioid antagonist that has a high affinity for mu-receptors. It
works by competing with opioid molecules for receptor sites and displacing them, thereby
reversing the effects of the opioid. Because it has a shorter half-life than most opioids,
repeated doses may be necessary to prevent the return of respiratory depression.
5. Which of the following instructions is most important for a nurse to provide to a patient
prescribed an Aspirin regimen for cardiovascular protection?
A. Report any ringing in the ears or dark, tarry stools immediately.
B. Discontinue the medication if you experience a mild headache.
C. Take the medication on an empty stomach to ensure rapid absorption.
D. Increase your intake of vitamin K to prevent bleeding complications.
Answer: A
Module 3 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 3 Exam)
1. A nurse is preparing to administer lidocaine with epinephrine to a patient for a minor
surgical procedure. What is the primary rationale for including epinephrine in this solution?
A. To increase the rate of systemic absorption of the lidocaine.
B. To act as a secondary anesthetic agent to block motor neurons.
C. To prevent the patient from developing malignant hyperthermia.
D. To cause vasoconstriction, thereby prolonging the local effect and reducing bleeding.
Answer: D
Rationale: Epinephrine is a vasoconstrictor that restricts blood flow to the injection site.
This restriction slows the systemic absorption of the local anesthetic, which prolongs the
duration of the numbing effect. Additionally, the decreased blood flow helps minimize
bleeding at the incision site during the procedure.
2. When assessing a patient for local anesthetic toxicity following a regional nerve block,
which clinical manifestation should the nurse prioritize?
A. Increased urine output and polyuria.
B. Gastrointestinal upset and hyperactive bowel sounds.
,C. Central nervous system excitation followed by depression.
D. Peripheral edema in the lower extremities.
Answer: C
Rationale: Systemic toxicity from local anesthetics primarily affects the CNS and
cardiovascular systems. Initial signs typically include CNS excitation such as tremors,
seizures, or irritability. This is often followed by profound CNS depression and potential
cardiac arrest if not managed promptly.
3. A patient is receiving morphine sulfate via a Patient-Controlled Analgesia (PCA) pump.
Which assessment finding requires the most immediate intervention by the nurse?
A. The patient reports a pain level of 3 on a scale of 0 to 10.
B. The patient reports feeling sleepy between doses.
C. The patient has not had a bowel movement in two days.
D. A respiratory rate of 8 breaths per minute.
Answer: D
Rationale: Respiratory depression is the most serious adverse effect of opioid analgesics
like morphine. A respiratory rate of 8 breaths per minute indicates significant depression
and requires immediate medical attention or the administration of a reversal agent. While
constipation and sedation are common, they are not life-threatening in the acute sense
compared to respiratory failure.
, 4. The nurse is educating a patient about the use of Naloxone (Narcan). Which statement
correctly describes the mechanism of action of this drug?
A. It acts as an agonist at the mu-opioid receptors to enhance analgesia.
B. It is a competitive antagonist that displaces opioids from their receptors.
C. It provides sedative effects to help the patient sleep during withdrawal.
D. It increases the metabolism of opioids in the liver to speed excretion.
Answer: B
Rationale: Naloxone is a pure opioid antagonist that has a high affinity for mu-receptors. It
works by competing with opioid molecules for receptor sites and displacing them, thereby
reversing the effects of the opioid. Because it has a shorter half-life than most opioids,
repeated doses may be necessary to prevent the return of respiratory depression.
5. Which of the following instructions is most important for a nurse to provide to a patient
prescribed an Aspirin regimen for cardiovascular protection?
A. Report any ringing in the ears or dark, tarry stools immediately.
B. Discontinue the medication if you experience a mild headache.
C. Take the medication on an empty stomach to ensure rapid absorption.
D. Increase your intake of vitamin K to prevent bleeding complications.
Answer: A
