NURS 251 Module 3 Exam V3 | NURS 251
Module 3 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 3 Exam)
1. A patient is prescribed fluoxetine for the treatment of depression. Which statement by the
patient indicates a correct understanding of the medication’s onset of action?
A. I should feel much better within 2 to 4 days of starting this drug.
B. I will take this medicine only on days when I am feeling particularly low.
C. It may take up to 4 weeks before I notice a significant change in my mood.
D. I should stop the medication immediately if I don’t feel better in one week.
Answer: C
Rationale: Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine do not produce
immediate effects on mood. It typically takes 2 to 4 weeks, and sometimes longer, for the
therapeutic levels to stabilize and provide relief from depressive symptoms. Patients must
be educated to continue the regimen even if they do not feel an immediate improvement.
2. A patient taking Phenelzine (an MAOI) must be educated to avoid which of the following
foods to prevent a hypertensive crisis?
A. Fresh apples and oranges
B. Grilled chicken and white rice
,C. Aged cheddar cheese and red wine
D. Whole grain bread and skim milk
Answer: C
Rationale: Monoamine oxidase inhibitors (MAOIs) interact with tyramine-containing
foods, which can lead to a massive release of norepinephrine. This surge in norepinephrine
results in a hypertensive crisis characterized by dangerously high blood pressure and
severe headaches. Patients must avoid aged, fermented, or pickled foods like cheese, wine,
and cured meats.
3. What is the therapeutic serum level range for a patient receiving Lithium for bipolar
disorder?
A. 0.1 to 0.5 mEq/L
B. 2.0 to 3.5 mEq/L
C. 0.6 to 1.2 mEq/L
D. 5.0 to 10.0 mEq/L
Answer: C
Rationale: Lithium has a very narrow therapeutic window, meaning the difference
between a therapeutic dose and a toxic dose is small. The maintenance therapeutic range is
generally considered to be 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L can lead to significant
toxicity, requiring close monitoring of blood levels.
, 4. A nurse is caring for a patient experiencing an acute benzodiazepine overdose. Which
medication should the nurse anticipate administering as an antidote?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
Answer: B
Rationale: Flumazenil is a competitive benzodiazepine receptor antagonist used
specifically to reverse the sedative effects of benzodiazepines. While Naloxone is used for
opioid overdoses, Flumazenil is the standard of care for benzodiazepine-induced
respiratory depression or coma. The nurse must monitor for seizures after administration,
as Flumazenil can lower the seizure threshold in dependent patients.
5. Which adverse effect is a common and expected finding in a patient taking Phenytoin
(Dilantin) over a long period?
A. Extreme hypertension
B. Gingival hyperplasia
C. Excessive weight loss
D. Tinnitus
Answer: B
Module 3 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 3 Exam)
1. A patient is prescribed fluoxetine for the treatment of depression. Which statement by the
patient indicates a correct understanding of the medication’s onset of action?
A. I should feel much better within 2 to 4 days of starting this drug.
B. I will take this medicine only on days when I am feeling particularly low.
C. It may take up to 4 weeks before I notice a significant change in my mood.
D. I should stop the medication immediately if I don’t feel better in one week.
Answer: C
Rationale: Selective serotonin reuptake inhibitors (SSRIs) like fluoxetine do not produce
immediate effects on mood. It typically takes 2 to 4 weeks, and sometimes longer, for the
therapeutic levels to stabilize and provide relief from depressive symptoms. Patients must
be educated to continue the regimen even if they do not feel an immediate improvement.
2. A patient taking Phenelzine (an MAOI) must be educated to avoid which of the following
foods to prevent a hypertensive crisis?
A. Fresh apples and oranges
B. Grilled chicken and white rice
,C. Aged cheddar cheese and red wine
D. Whole grain bread and skim milk
Answer: C
Rationale: Monoamine oxidase inhibitors (MAOIs) interact with tyramine-containing
foods, which can lead to a massive release of norepinephrine. This surge in norepinephrine
results in a hypertensive crisis characterized by dangerously high blood pressure and
severe headaches. Patients must avoid aged, fermented, or pickled foods like cheese, wine,
and cured meats.
3. What is the therapeutic serum level range for a patient receiving Lithium for bipolar
disorder?
A. 0.1 to 0.5 mEq/L
B. 2.0 to 3.5 mEq/L
C. 0.6 to 1.2 mEq/L
D. 5.0 to 10.0 mEq/L
Answer: C
Rationale: Lithium has a very narrow therapeutic window, meaning the difference
between a therapeutic dose and a toxic dose is small. The maintenance therapeutic range is
generally considered to be 0.6 to 1.2 mEq/L. Levels above 1.5 mEq/L can lead to significant
toxicity, requiring close monitoring of blood levels.
, 4. A nurse is caring for a patient experiencing an acute benzodiazepine overdose. Which
medication should the nurse anticipate administering as an antidote?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
Answer: B
Rationale: Flumazenil is a competitive benzodiazepine receptor antagonist used
specifically to reverse the sedative effects of benzodiazepines. While Naloxone is used for
opioid overdoses, Flumazenil is the standard of care for benzodiazepine-induced
respiratory depression or coma. The nurse must monitor for seizures after administration,
as Flumazenil can lower the seizure threshold in dependent patients.
5. Which adverse effect is a common and expected finding in a patient taking Phenytoin
(Dilantin) over a long period?
A. Extreme hypertension
B. Gingival hyperplasia
C. Excessive weight loss
D. Tinnitus
Answer: B
