,NU 150 Exam 4 | Pharmacology (2026/2027) PDF |
Nursing | Galen College
1. The nurse is administering a drug that is highly protein-bound to a patient
with hypoalbuminemia. Which effect is most likely to occur?
A) Decreased drug effect due to increased metabolism
B) Increased free drug levels and risk of toxicity
C) Decreased absorption due to low protein
D) No change in drug levels
Correct Answer: B) Increased free drug levels and risk of toxicity
Rationale: Hypoalbuminemia reduces protein-binding sites, leading to an
increase in the unbound, pharmacologically active fraction of the drug. With
fewer binding sites, more free drug is available, increasing the risk of toxicity,
especially for drugs with a narrow therapeutic index. The nurse should monitor
the patient closely for signs of toxicity and may need to adjust the dose.
2. A patient is prescribed amitriptyline for depression. What is an essential
teaching point for the nurse to include?
A) "Take this medication in the morning to boost energy levels."
B) "Take this medication with meals to improve absorption."
C) "Avoid consuming alcohol while taking this medication."
D) "This medication has no specific timing requirements."
Correct Answer: C) "Avoid consuming alcohol while taking this medication."
,Rationale: Amitriptyline is a tricyclic antidepressant (TCA). Patients should be
taught to avoid consuming alcohol while taking this medication, as it can
potentiate the central nervous system depressant effects. Amitriptyline is often
prescribed at bedtime to minimize daytime drowsiness and to enhance sleep
quality.
3. A client was prescribed citalopram and is in the emergency department with
mental changes and hyperreflexia. Which item on the home-medication list may
be causing these symptoms?
A) Garlic
B) Alprazolam
C) St. John's Wort
D) Ibuprofen
Correct Answer: C) St. John's Wort
Rationale: Citalopram is an SSRI antidepressant. When combined with other
serotonergic agents such as St. John's Wort, it can cause serotonin syndrome.
Signs of serotonin syndrome include mental changes, hyperreflexia, and
autonomic instability. St. John's Wort is an herbal supplement that can interact
with antidepressants and increase the risk of serotonin syndrome.
4. The nurse is caring for a client who has been prescribed levodopa and
carbidopa. Which of the following findings indicates a therapeutic effect of
these medications?
A) Improved motor control
B) Decreased heart rate
C) Increased blood pressure
, D) Improved appetite
Correct Answer: A) Improved motor control
Rationale: Levodopa/carbidopa is used to treat Parkinson's disease. Carbidopa
prevents the breakdown of levodopa in the periphery, allowing more levodopa
to reach the brain. The therapeutic effect of these medications is indicated by
improved motor control.
5. What condition does allopurinol primarily help to manage?
A) Dementia
B) Rheumatoid arthritis
C) Gout
D) Hypertension
Correct Answer: C) Gout
Rationale: Allopurinol is primarily used to manage gout by reducing uric acid
production. It works by inhibiting the enzyme xanthine oxidase, which is
responsible for the production of uric acid.
6. A drug has a half-life of 6 hours. Approximately how many hours will it take
to reach steady state?
A) 12 hours
B) 24 hours
C) 30 hours
Nursing | Galen College
1. The nurse is administering a drug that is highly protein-bound to a patient
with hypoalbuminemia. Which effect is most likely to occur?
A) Decreased drug effect due to increased metabolism
B) Increased free drug levels and risk of toxicity
C) Decreased absorption due to low protein
D) No change in drug levels
Correct Answer: B) Increased free drug levels and risk of toxicity
Rationale: Hypoalbuminemia reduces protein-binding sites, leading to an
increase in the unbound, pharmacologically active fraction of the drug. With
fewer binding sites, more free drug is available, increasing the risk of toxicity,
especially for drugs with a narrow therapeutic index. The nurse should monitor
the patient closely for signs of toxicity and may need to adjust the dose.
2. A patient is prescribed amitriptyline for depression. What is an essential
teaching point for the nurse to include?
A) "Take this medication in the morning to boost energy levels."
B) "Take this medication with meals to improve absorption."
C) "Avoid consuming alcohol while taking this medication."
D) "This medication has no specific timing requirements."
Correct Answer: C) "Avoid consuming alcohol while taking this medication."
,Rationale: Amitriptyline is a tricyclic antidepressant (TCA). Patients should be
taught to avoid consuming alcohol while taking this medication, as it can
potentiate the central nervous system depressant effects. Amitriptyline is often
prescribed at bedtime to minimize daytime drowsiness and to enhance sleep
quality.
3. A client was prescribed citalopram and is in the emergency department with
mental changes and hyperreflexia. Which item on the home-medication list may
be causing these symptoms?
A) Garlic
B) Alprazolam
C) St. John's Wort
D) Ibuprofen
Correct Answer: C) St. John's Wort
Rationale: Citalopram is an SSRI antidepressant. When combined with other
serotonergic agents such as St. John's Wort, it can cause serotonin syndrome.
Signs of serotonin syndrome include mental changes, hyperreflexia, and
autonomic instability. St. John's Wort is an herbal supplement that can interact
with antidepressants and increase the risk of serotonin syndrome.
4. The nurse is caring for a client who has been prescribed levodopa and
carbidopa. Which of the following findings indicates a therapeutic effect of
these medications?
A) Improved motor control
B) Decreased heart rate
C) Increased blood pressure
, D) Improved appetite
Correct Answer: A) Improved motor control
Rationale: Levodopa/carbidopa is used to treat Parkinson's disease. Carbidopa
prevents the breakdown of levodopa in the periphery, allowing more levodopa
to reach the brain. The therapeutic effect of these medications is indicated by
improved motor control.
5. What condition does allopurinol primarily help to manage?
A) Dementia
B) Rheumatoid arthritis
C) Gout
D) Hypertension
Correct Answer: C) Gout
Rationale: Allopurinol is primarily used to manage gout by reducing uric acid
production. It works by inhibiting the enzyme xanthine oxidase, which is
responsible for the production of uric acid.
6. A drug has a half-life of 6 hours. Approximately how many hours will it take
to reach steady state?
A) 12 hours
B) 24 hours
C) 30 hours
