NURS 251 — Pharmacology Module 8 Exam • Portage Learning / ABC Nursing / Geneva College
NURS 251 Module 8 Exam ()
Pharmacology — Portage Learning / ABC Nursing / Geneva College
Questions and Verified Answers, 100% Guarantee
85 Multiple-Choice Questions • 7 Competency-Aligned Sections
Instructions: This comprehensive practice exam assesses mastery of pharmacology content aligned with the NURS 251
Module 8 blueprint for the 2026/2027 academic year at Portage Learning, ABC Nursing, and Geneva College. Each
question presents four options (A–D) with exactly one verified correct answer. The correct option is flagged [CORRECT],
followed by a pharmacology-specific rationale integrating mechanism of action, adverse effects, nursing considerations,
and patient safety. Cognitive distribution: 35% recall, 45% application, 20% analysis. Question styles include drug
classification and mechanism of action, adverse effect recognition, patient counseling scenarios, dosage calculations with
common math error distractors, drug interaction and contraindication identification, assessment-before-administration
priorities, high-alert medication safety, laboratory monitoring (INR, K+, renal function, drug levels), and commonly
confused drug pairs (PPIs vs. H2RAs, Levothyroxine vs. Methimazole, Loperamide vs. Diphenoxylate/Atropine). Use this
exam for self-assessment, targeted review, and 100% competency verification.
Section Topic Questions
Section 1 Gastrointestinal Pharmacology Q1–Q14
Section 2 Peptic Ulcer Disease and GERD Pharmacotherapy Q15–Q26
Section 3 Anti-Infective Agents and Antimicrobial Therapy Q27–Q42
Section 4 Chemotherapy and Immunosuppressant Pharmacology Q43–Q54
Section 5 Endocrine Pharmacology Q55–Q66
Section 6 Musculoskeletal and Anti-Inflammatory Pharmacology Q67–Q76
Section 7 Medication Administration, Calculations, and Patient Safety Q77–Q85
Total All pharmacology competencies 85
Section 1: Gastrointestinal Pharmacology
Antiemetics, Antidiarrheals, Laxatives, & Antacids (Q1-Q14)
NURS 251 Module 8 Exam (2026/2027) — 85 Questions & Verified Answers Page 1
,NURS 251 — Pharmacology Module 8 Exam • Portage Learning / ABC Nursing / Geneva College
Q1: A patient receiving chemotherapy complains of nausea 30 minutes after the infusion begins. The
provider orders an antiemetic that blocks serotonin receptors in the chemoreceptor trigger zone (CTZ) and
GI tract. Which medication is MOST appropriate?
Competency: Antiemetics - Mechanism & Selection
A. Ondansetron (Zofran) [CORRECT]
B. Metoclopramide (Reglan)
C. Prochlorperazine (Compazine)
D. Diphenhydramine (Benadryl)
Correct Answer: A
Rationale: Ondansetron is a 5-HT3 receptor antagonist that blocks serotonin peripherally (GI tract) and centrally (CTZ), making
it first-line for chemotherapy-induced nausea and vomiting. Metoclopramide (B) is a prokinetic dopamine antagonist used for
delayed gastric emptying; prochlorperazine (C) is a phenothiazine dopamine antagonist used for less severe nausea;
diphenhydramine (D) is an antihistamine used for motion sickness or extrapyramidal side effects.
Q2: A nurse is preparing to administer metoclopramide to a patient with diabetic gastroparesis. Which
assessment finding is a CONTRAINDICATION to administration?
Competency: Antiemetics - Contraindications
A. Blood glucose 180 mg/dL
B. Bowel sounds absent in all four quadrants [CORRECT]
C. Patient reports nausea rated 4/10
D. Patient has a history of type 2 diabetes
Correct Answer: B
Rationale: Metoclopramide is a prokinetic agent that stimulates GI motility and is contraindicated in mechanical obstruction or
ileus (absent bowel sounds) because it could worsen the obstruction or cause perforation. Hyperglycemia (A) is expected in
diabetic gastroparesis; nausea (C) is a therapeutic indication; type 2 diabetes (D) is the underlying condition being treated.
Monitor for extrapyramidal symptoms and tardive dyskinesia with long-term use.
Q3: A patient who received prochlorperazine for nausea now reports involuntary lip smacking and tongue
thrusting. What is the nurse's PRIORITY action?
Competency: Antiemetics - Adverse Effects
A. Document as expected side effect and continue medication
B. Stop the medication and notify provider; suspect extrapyramidal symptoms [CORRECT]
C. Administer a second dose for breakthrough nausea
D. Switch to oral from IV route
Correct Answer: B
Rationale: Lip smacking and tongue thrusting are signs of tardive dyskinesia, a potentially irreversible extrapyramidal symptom
from dopamine antagonists like prochlorperazine; the medication must be stopped and provider notified. Continuing (A) or
repeating (C) worsens symptoms; route change (D) does not address the adverse effect. Diphenhydramine may be given for acute
dystonic reactions. Black box warning for elderly patients.
NURS 251 Module 8 Exam (2026/2027) — 85 Questions & Verified Answers Page 2
, NURS 251 — Pharmacology Module 8 Exam • Portage Learning / ABC Nursing / Geneva College
Q4: A patient with acute diarrhea is prescribed loperamide. The nurse should teach the patient to stop the
medication and notify the provider if which occurs?
Competency: Antidiarrheals - Patient Teaching
A. Stools become more formed within 24 hours
B. Diarrhea persists beyond 48 hours or if fever/blood in stool develops [CORRECT]
C. Patient experiences mild abdominal cramping
D. Bowel movements decrease to 2 per day
Correct Answer: B
Rationale: Loperamide is an antidiarrheal that should not be used for more than 48 hours without provider evaluation, and fever
or bloody stool suggest infectious cause requiring medical evaluation rather than symptomatic treatment. Formed stools (A), mild
cramping (C), and decreased bowel movements (D) indicate therapeutic effect. Avoid in C. difficile or bacterial enterocolitis due
to risk of toxic megacolon.
Q5: Diphenoxylate/atropine is prescribed for a patient with severe diarrhea. What is the purpose of the
atropine component?
Competency: Antidiarrheals - Mechanism
A. To enhance the antidiarrheal effect of diphenoxylate
B. To discourage recreational abuse by causing unpleasant anticholinergic effects at high doses [CORRECT]
C. To reduce nausea associated with diphenoxylate
D. To prevent respiratory depression from diphenoxylate
Correct Answer: B
Rationale: Diphenoxylate is an opioid agonist used for diarrhea; atropine is added in subtherapeutic doses to discourage abuse
because higher doses cause unpleasant anticholinergic effects (dry mouth, tachycardia, urinary retention). Atropine does not
enhance antidiarrheal effect (A), reduce nausea (C), or prevent respiratory depression (D). Monitor for opioid effects and
anticholinergic side effects especially in elderly.
Q6: A patient is prescribed bismuth subsalicylate for diarrhea and H. pylori therapy. The patient takes
warfarin daily. What is the PRIORITY nursing intervention?
Competency: Antidiarrheals - Drug Interactions
A. Administer both medications together for synergistic effect
B. Hold bismuth subsalicylate and notify provider; salicylate increases bleeding risk with warfarin [CORRECT]
C. Increase warfarin dose to compensate
D. Take bismuth with antacid to reduce interaction
Correct Answer: B
Rationale: Bismuth subsalicylate contains salicylate which increases anticoagulant effect of warfarin and risk of bleeding; the
provider should be notified for alternative therapy. Combining (A) increases bleeding risk; increasing warfarin (C) is dangerous;
antacid (D) does not prevent the salicylate-warfarin interaction. Also avoid in aspirin allergy, gout, and children with viral
infections (Reye syndrome risk).
NURS 251 Module 8 Exam (2026/2027) — 85 Questions & Verified Answers Page 3
NURS 251 Module 8 Exam ()
Pharmacology — Portage Learning / ABC Nursing / Geneva College
Questions and Verified Answers, 100% Guarantee
85 Multiple-Choice Questions • 7 Competency-Aligned Sections
Instructions: This comprehensive practice exam assesses mastery of pharmacology content aligned with the NURS 251
Module 8 blueprint for the 2026/2027 academic year at Portage Learning, ABC Nursing, and Geneva College. Each
question presents four options (A–D) with exactly one verified correct answer. The correct option is flagged [CORRECT],
followed by a pharmacology-specific rationale integrating mechanism of action, adverse effects, nursing considerations,
and patient safety. Cognitive distribution: 35% recall, 45% application, 20% analysis. Question styles include drug
classification and mechanism of action, adverse effect recognition, patient counseling scenarios, dosage calculations with
common math error distractors, drug interaction and contraindication identification, assessment-before-administration
priorities, high-alert medication safety, laboratory monitoring (INR, K+, renal function, drug levels), and commonly
confused drug pairs (PPIs vs. H2RAs, Levothyroxine vs. Methimazole, Loperamide vs. Diphenoxylate/Atropine). Use this
exam for self-assessment, targeted review, and 100% competency verification.
Section Topic Questions
Section 1 Gastrointestinal Pharmacology Q1–Q14
Section 2 Peptic Ulcer Disease and GERD Pharmacotherapy Q15–Q26
Section 3 Anti-Infective Agents and Antimicrobial Therapy Q27–Q42
Section 4 Chemotherapy and Immunosuppressant Pharmacology Q43–Q54
Section 5 Endocrine Pharmacology Q55–Q66
Section 6 Musculoskeletal and Anti-Inflammatory Pharmacology Q67–Q76
Section 7 Medication Administration, Calculations, and Patient Safety Q77–Q85
Total All pharmacology competencies 85
Section 1: Gastrointestinal Pharmacology
Antiemetics, Antidiarrheals, Laxatives, & Antacids (Q1-Q14)
NURS 251 Module 8 Exam (2026/2027) — 85 Questions & Verified Answers Page 1
,NURS 251 — Pharmacology Module 8 Exam • Portage Learning / ABC Nursing / Geneva College
Q1: A patient receiving chemotherapy complains of nausea 30 minutes after the infusion begins. The
provider orders an antiemetic that blocks serotonin receptors in the chemoreceptor trigger zone (CTZ) and
GI tract. Which medication is MOST appropriate?
Competency: Antiemetics - Mechanism & Selection
A. Ondansetron (Zofran) [CORRECT]
B. Metoclopramide (Reglan)
C. Prochlorperazine (Compazine)
D. Diphenhydramine (Benadryl)
Correct Answer: A
Rationale: Ondansetron is a 5-HT3 receptor antagonist that blocks serotonin peripherally (GI tract) and centrally (CTZ), making
it first-line for chemotherapy-induced nausea and vomiting. Metoclopramide (B) is a prokinetic dopamine antagonist used for
delayed gastric emptying; prochlorperazine (C) is a phenothiazine dopamine antagonist used for less severe nausea;
diphenhydramine (D) is an antihistamine used for motion sickness or extrapyramidal side effects.
Q2: A nurse is preparing to administer metoclopramide to a patient with diabetic gastroparesis. Which
assessment finding is a CONTRAINDICATION to administration?
Competency: Antiemetics - Contraindications
A. Blood glucose 180 mg/dL
B. Bowel sounds absent in all four quadrants [CORRECT]
C. Patient reports nausea rated 4/10
D. Patient has a history of type 2 diabetes
Correct Answer: B
Rationale: Metoclopramide is a prokinetic agent that stimulates GI motility and is contraindicated in mechanical obstruction or
ileus (absent bowel sounds) because it could worsen the obstruction or cause perforation. Hyperglycemia (A) is expected in
diabetic gastroparesis; nausea (C) is a therapeutic indication; type 2 diabetes (D) is the underlying condition being treated.
Monitor for extrapyramidal symptoms and tardive dyskinesia with long-term use.
Q3: A patient who received prochlorperazine for nausea now reports involuntary lip smacking and tongue
thrusting. What is the nurse's PRIORITY action?
Competency: Antiemetics - Adverse Effects
A. Document as expected side effect and continue medication
B. Stop the medication and notify provider; suspect extrapyramidal symptoms [CORRECT]
C. Administer a second dose for breakthrough nausea
D. Switch to oral from IV route
Correct Answer: B
Rationale: Lip smacking and tongue thrusting are signs of tardive dyskinesia, a potentially irreversible extrapyramidal symptom
from dopamine antagonists like prochlorperazine; the medication must be stopped and provider notified. Continuing (A) or
repeating (C) worsens symptoms; route change (D) does not address the adverse effect. Diphenhydramine may be given for acute
dystonic reactions. Black box warning for elderly patients.
NURS 251 Module 8 Exam (2026/2027) — 85 Questions & Verified Answers Page 2
, NURS 251 — Pharmacology Module 8 Exam • Portage Learning / ABC Nursing / Geneva College
Q4: A patient with acute diarrhea is prescribed loperamide. The nurse should teach the patient to stop the
medication and notify the provider if which occurs?
Competency: Antidiarrheals - Patient Teaching
A. Stools become more formed within 24 hours
B. Diarrhea persists beyond 48 hours or if fever/blood in stool develops [CORRECT]
C. Patient experiences mild abdominal cramping
D. Bowel movements decrease to 2 per day
Correct Answer: B
Rationale: Loperamide is an antidiarrheal that should not be used for more than 48 hours without provider evaluation, and fever
or bloody stool suggest infectious cause requiring medical evaluation rather than symptomatic treatment. Formed stools (A), mild
cramping (C), and decreased bowel movements (D) indicate therapeutic effect. Avoid in C. difficile or bacterial enterocolitis due
to risk of toxic megacolon.
Q5: Diphenoxylate/atropine is prescribed for a patient with severe diarrhea. What is the purpose of the
atropine component?
Competency: Antidiarrheals - Mechanism
A. To enhance the antidiarrheal effect of diphenoxylate
B. To discourage recreational abuse by causing unpleasant anticholinergic effects at high doses [CORRECT]
C. To reduce nausea associated with diphenoxylate
D. To prevent respiratory depression from diphenoxylate
Correct Answer: B
Rationale: Diphenoxylate is an opioid agonist used for diarrhea; atropine is added in subtherapeutic doses to discourage abuse
because higher doses cause unpleasant anticholinergic effects (dry mouth, tachycardia, urinary retention). Atropine does not
enhance antidiarrheal effect (A), reduce nausea (C), or prevent respiratory depression (D). Monitor for opioid effects and
anticholinergic side effects especially in elderly.
Q6: A patient is prescribed bismuth subsalicylate for diarrhea and H. pylori therapy. The patient takes
warfarin daily. What is the PRIORITY nursing intervention?
Competency: Antidiarrheals - Drug Interactions
A. Administer both medications together for synergistic effect
B. Hold bismuth subsalicylate and notify provider; salicylate increases bleeding risk with warfarin [CORRECT]
C. Increase warfarin dose to compensate
D. Take bismuth with antacid to reduce interaction
Correct Answer: B
Rationale: Bismuth subsalicylate contains salicylate which increases anticoagulant effect of warfarin and risk of bleeding; the
provider should be notified for alternative therapy. Combining (A) increases bleeding risk; increasing warfarin (C) is dangerous;
antacid (D) does not prevent the salicylate-warfarin interaction. Also avoid in aspirin allergy, gout, and children with viral
infections (Reye syndrome risk).
NURS 251 Module 8 Exam (2026/2027) — 85 Questions & Verified Answers Page 3
