NUR 210 Exam 4 V3 | NUR 210 Pharmacology |
Actual Q&A with Rationale (NUR 210 Exam 4) |
Galen
1. A patient is prescribed Lithium carbonate for the treatment of bipolar disorder. Which of
the following serum lithium levels should the nurse identify as indicating lithium toxicity?
A. 0.6 mEq/L
B. 1.8 mEq/L
C. 1.1 mEq/L
D. 0.9 mEq/L
Correct Answer: B
Explanation: Lithium has a narrow therapeutic index, typically ranging from 0.6 to 1.2
mEq/L for maintenance therapy. A level of 1.8 mEq/L is significantly above the therapeutic
range and indicates moderate to severe toxicity. The nurse must immediately notify the
provider and monitor for symptoms such as coarse tremors, confusion, and ataxia.
2. A nurse is preparing to administer Haloperidol to a patient with schizophrenia. The patient
develops a high fever, muscle rigidity, and autonomic instability. What condition does the
nurse suspect?
A. Serotonin Syndrome
B. Tardive Dyskinesia
,C. Extrapyramidal Symptoms (EPS)
D. Neuroleptic Malignant Syndrome (NMS)
Correct Answer: D
Explanation: Neuroleptic Malignant Syndrome is a rare but life-threatening adverse effect
of antipsychotic medications like Haloperidol. Key clinical manifestations include ‘lead-
pipe’ muscle rigidity, hyperpyrexia, and fluctuations in blood pressure. Treatment involves
immediate discontinuation of the drug and supportive care such as cooling and
administration of dantrolene.
3. A patient is brought to the emergency department following an overdose of Alprazolam.
Which medication should the nurse anticipate the provider will order as an antidote?
A. Naloxone
B. Acetylcysteine
C. Flumazenil
D. Protamine Sulfate
Correct Answer: C
Explanation: Flumazenil is a benzodiazepine receptor antagonist used specifically to
reverse the sedative effects of benzodiazepines like Alprazolam. The nurse must monitor
for seizures during administration, especially in patients with long-term benzodiazepine
use. It is important to note that Naloxone is the reversal agent for opioids, not
benzodiazepines.
, 4. A patient taking Fluoxetine for depression presents with agitation, hallucinations,
tachycardia, and hyperreflexia. Which condition should the nurse suspect?
A. Hypertensive Crisis
B. Serotonin Syndrome
C. Anticholinergic Toxicity
D. Hypoglycemia
Correct Answer: B
Explanation: Serotonin syndrome occurs when there is an over-accumulation of serotonin
in the body, often due to SSRIs or interactions with other serotonergic drugs. Symptoms
include mental status changes, autonomic hyperactivity, and neuromuscular abnormalities
like hyperreflexia. The nurse should advocate for the discontinuation of the offending agent
and provide supportive interventions.
5. A nurse is teaching a patient about taking Phenelzine, an MAOI. Which food choice
indicates that the patient understands the dietary restrictions?
A. Pepperoni pizza
B. Grilled chicken breast
C. Aged cheddar cheese
D. Red wine
Correct Answer: B
Actual Q&A with Rationale (NUR 210 Exam 4) |
Galen
1. A patient is prescribed Lithium carbonate for the treatment of bipolar disorder. Which of
the following serum lithium levels should the nurse identify as indicating lithium toxicity?
A. 0.6 mEq/L
B. 1.8 mEq/L
C. 1.1 mEq/L
D. 0.9 mEq/L
Correct Answer: B
Explanation: Lithium has a narrow therapeutic index, typically ranging from 0.6 to 1.2
mEq/L for maintenance therapy. A level of 1.8 mEq/L is significantly above the therapeutic
range and indicates moderate to severe toxicity. The nurse must immediately notify the
provider and monitor for symptoms such as coarse tremors, confusion, and ataxia.
2. A nurse is preparing to administer Haloperidol to a patient with schizophrenia. The patient
develops a high fever, muscle rigidity, and autonomic instability. What condition does the
nurse suspect?
A. Serotonin Syndrome
B. Tardive Dyskinesia
,C. Extrapyramidal Symptoms (EPS)
D. Neuroleptic Malignant Syndrome (NMS)
Correct Answer: D
Explanation: Neuroleptic Malignant Syndrome is a rare but life-threatening adverse effect
of antipsychotic medications like Haloperidol. Key clinical manifestations include ‘lead-
pipe’ muscle rigidity, hyperpyrexia, and fluctuations in blood pressure. Treatment involves
immediate discontinuation of the drug and supportive care such as cooling and
administration of dantrolene.
3. A patient is brought to the emergency department following an overdose of Alprazolam.
Which medication should the nurse anticipate the provider will order as an antidote?
A. Naloxone
B. Acetylcysteine
C. Flumazenil
D. Protamine Sulfate
Correct Answer: C
Explanation: Flumazenil is a benzodiazepine receptor antagonist used specifically to
reverse the sedative effects of benzodiazepines like Alprazolam. The nurse must monitor
for seizures during administration, especially in patients with long-term benzodiazepine
use. It is important to note that Naloxone is the reversal agent for opioids, not
benzodiazepines.
, 4. A patient taking Fluoxetine for depression presents with agitation, hallucinations,
tachycardia, and hyperreflexia. Which condition should the nurse suspect?
A. Hypertensive Crisis
B. Serotonin Syndrome
C. Anticholinergic Toxicity
D. Hypoglycemia
Correct Answer: B
Explanation: Serotonin syndrome occurs when there is an over-accumulation of serotonin
in the body, often due to SSRIs or interactions with other serotonergic drugs. Symptoms
include mental status changes, autonomic hyperactivity, and neuromuscular abnormalities
like hyperreflexia. The nurse should advocate for the discontinuation of the offending agent
and provide supportive interventions.
5. A nurse is teaching a patient about taking Phenelzine, an MAOI. Which food choice
indicates that the patient understands the dietary restrictions?
A. Pepperoni pizza
B. Grilled chicken breast
C. Aged cheddar cheese
D. Red wine
Correct Answer: B
