West Coast University NURS180 Week 4 Quiz (pdf) |
2026/2027 | Pharmacology Q&A | Nursing
100 Practice Questions
1. Which class of drugs is associated with the FDA black box warning regarding increased
suicidal ideation in patients under 24 years of age?
A) Monoamine oxidase inhibitors
B) Tricyclic antidepressants
C) Selective serotonin reuptake inhibitors
D) Benzodiazepines
Correct Answer: Selective serotonin reuptake inhibitors
Rationale: The FDA requires a black box warning on all antidepressants, including SSRIs, highlighting
an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults up to
age 24. This risk is highest during the initial weeks of therapy and during dose adjustments. Close
monitoring by healthcare providers and family members is essential during this period. Other
antidepressant classes may also carry this warning, but SSRIs are a primary focus for this specific risk.
2. A patient taking phenelzine, an MAOI, reports consuming aged cheese and red wine. The
nurse should assess for which life-threatening condition?
A) Serotonin syndrome
B) Hypertensive crisis
C) Neuroleptic malignant syndrome
D) Respiratory depression
Correct Answer: Hypertensive crisis
Rationale: Monoamine oxidase inhibitors (MAOIs) block the breakdown of tyramine, a substance
found in aged cheeses, cured meats, and red wine. The resulting accumulation of tyramine can cause
a massive release of norepinephrine, leading to a severe hypertensive crisis characterized by a
throbbing headache, tachycardia, and diaphoresis. Patients on MAOIs must adhere to a strict low-
tyramine diet to prevent this potentially fatal reaction.
3. A patient is prescribed lithium carbonate for bipolar disorder. Which laboratory value should
the nurse monitor most frequently?
A) Hemoglobin A1C
B) Serum lithium levels
C) Liver function tests
D) Prothrombin time
Correct Answer: Serum lithium levels
Rationale: Lithium has a very narrow therapeutic index, meaning the difference between therapeutic
and toxic doses is small. The therapeutic range for serum lithium is typically 0.6 to 1.2 mEq/L. Regular
monitoring of serum lithium levels is crucial to prevent toxicity, which can manifest as severe
gastrointestinal, neurological, and cardiac symptoms. Renal and thyroid function must also be
monitored due to lithium's effects on these systems.
, 4. A patient taking sertraline is also prescribed tramadol for postoperative pain. The nurse
should be most concerned about the risk of which adverse effect?
A) Bleeding
B) Serotonin syndrome
C) Respiratory depression
D) Hypoglycemia
Correct Answer: Serotonin syndrome
Rationale: Both sertraline (an SSRI) and tramadol (a weak opioid with serotonin-norepinephrine
reuptake inhibitor properties) increase serotonin levels in the central nervous system. Concurrent use
significantly increases the risk of serotonin syndrome, a potentially life-threatening condition
characterized by mental status changes, autonomic instability, and neuromuscular abnormalities like
clonus and hyperreflexia. The nurse should monitor for these signs and consider alternative
analgesics.
5. Which term describes a well-understood model drug with which other drugs in a
pharmacologic class may be compared?
A) Chemical name
B) Generic name
C) Prototype drug
D) Trade name
Correct Answer: Prototype drug
Rationale: A prototype drug is the standard or original drug in a pharmacological class. It is well-
studied and serves as a reference point for comparing the actions, adverse effects, and interactions of
other drugs within the same class. For example, propranolol is a prototype for beta-blockers.
Understanding the prototype helps predict the behavior of newer medications in that category.
6. Which organ is primarily responsible for the biotransformation, or metabolism, of most
medications?
A) Kidneys
B) Liver
C) Lungs
D) Gastrointestinal tract
Correct Answer: Liver
Rationale: The liver is the primary site of drug metabolism, also known as biotransformation. It
contains enzymes, most notably the cytochrome P450 system, that chemically alter drugs to make
them more water-soluble for eventual excretion by the kidneys. Liver dysfunction can significantly
impair drug metabolism, leading to drug accumulation and toxicity. The kidneys are primarily
responsible for excretion, not metabolism.
7. What is the term for the movement of a drug from its site of administration into the
bloodstream?
A) Distribution
B) Metabolism
C) Absorption
D) Excretion
, Correct Answer: Absorption
Rationale: Absorption is the first step of pharmacokinetics and describes the process by which a drug
moves from its site of administration (e.g., gastrointestinal tract, muscle, skin) into the systemic
circulation. Factors affecting absorption include the route of administration, drug formulation, blood
flow to the site, and the presence of food in the stomach. Bioavailability refers to the fraction of the
drug that reaches systemic circulation unchanged.
8. A patient is prescribed an enteric-coated tablet. Which statement by the nurse accurately
explains the purpose of this formulation?
A) "It is designed to be crushed for faster absorption."
B) "It dissolves quickly in the stomach for rapid onset."
C) "It is meant to be chewed for extended release."
D) "It protects the drug from stomach acid or protects the stomach from irritation."
Correct Answer: "It protects the drug from stomach acid or protects the stomach from irritation."
Rationale: Enteric coatings are applied to tablets to prevent them from dissolving in the acidic
environment of the stomach. This serves two main purposes: to protect drugs that are acid-labile
(destroyed by stomach acid) and to protect the stomach lining from drugs that are irritating. Crushing
or chewing an enteric-coated tablet destroys this protective coating, leading to drug inactivation or
gastric irritation.
9. Which pregnancy safety category indicates that a medication poses a significant risk to the
fetus, and the risks clearly outweigh any potential benefits?
A) Category A
B) Category B
C) Category C
D) Category X
Correct Answer: Category X
Rationale: Pregnancy Category X is assigned to drugs for which studies in animals or humans have
demonstrated fetal abnormalities, or there is evidence of fetal risk based on human experience. The
risk of using the drug in pregnant women clearly outweighs any possible benefit. These medications
are contraindicated in women who are or may become pregnant.
10. A patient with a history of alcoholism is seeking relief from a headache. Which over-the-
counter medication should the nurse advise the patient to avoid due to an increased risk of
hepatotoxicity?
A) Ibuprofen
B) Acetaminophen
C) Aspirin
D) Naproxen
Correct Answer: Acetaminophen
Rationale: Acetaminophen is metabolized by the liver. Chronic alcohol consumption induces liver
enzymes and depletes glutathione, a substance that helps detoxify a toxic metabolite of
acetaminophen. This increases the risk of severe liver damage, even at therapeutic doses. Patients
with a history of alcohol abuse should avoid acetaminophen or use it with extreme caution and
medical supervision.
2026/2027 | Pharmacology Q&A | Nursing
100 Practice Questions
1. Which class of drugs is associated with the FDA black box warning regarding increased
suicidal ideation in patients under 24 years of age?
A) Monoamine oxidase inhibitors
B) Tricyclic antidepressants
C) Selective serotonin reuptake inhibitors
D) Benzodiazepines
Correct Answer: Selective serotonin reuptake inhibitors
Rationale: The FDA requires a black box warning on all antidepressants, including SSRIs, highlighting
an increased risk of suicidal thoughts and behaviors in children, adolescents, and young adults up to
age 24. This risk is highest during the initial weeks of therapy and during dose adjustments. Close
monitoring by healthcare providers and family members is essential during this period. Other
antidepressant classes may also carry this warning, but SSRIs are a primary focus for this specific risk.
2. A patient taking phenelzine, an MAOI, reports consuming aged cheese and red wine. The
nurse should assess for which life-threatening condition?
A) Serotonin syndrome
B) Hypertensive crisis
C) Neuroleptic malignant syndrome
D) Respiratory depression
Correct Answer: Hypertensive crisis
Rationale: Monoamine oxidase inhibitors (MAOIs) block the breakdown of tyramine, a substance
found in aged cheeses, cured meats, and red wine. The resulting accumulation of tyramine can cause
a massive release of norepinephrine, leading to a severe hypertensive crisis characterized by a
throbbing headache, tachycardia, and diaphoresis. Patients on MAOIs must adhere to a strict low-
tyramine diet to prevent this potentially fatal reaction.
3. A patient is prescribed lithium carbonate for bipolar disorder. Which laboratory value should
the nurse monitor most frequently?
A) Hemoglobin A1C
B) Serum lithium levels
C) Liver function tests
D) Prothrombin time
Correct Answer: Serum lithium levels
Rationale: Lithium has a very narrow therapeutic index, meaning the difference between therapeutic
and toxic doses is small. The therapeutic range for serum lithium is typically 0.6 to 1.2 mEq/L. Regular
monitoring of serum lithium levels is crucial to prevent toxicity, which can manifest as severe
gastrointestinal, neurological, and cardiac symptoms. Renal and thyroid function must also be
monitored due to lithium's effects on these systems.
, 4. A patient taking sertraline is also prescribed tramadol for postoperative pain. The nurse
should be most concerned about the risk of which adverse effect?
A) Bleeding
B) Serotonin syndrome
C) Respiratory depression
D) Hypoglycemia
Correct Answer: Serotonin syndrome
Rationale: Both sertraline (an SSRI) and tramadol (a weak opioid with serotonin-norepinephrine
reuptake inhibitor properties) increase serotonin levels in the central nervous system. Concurrent use
significantly increases the risk of serotonin syndrome, a potentially life-threatening condition
characterized by mental status changes, autonomic instability, and neuromuscular abnormalities like
clonus and hyperreflexia. The nurse should monitor for these signs and consider alternative
analgesics.
5. Which term describes a well-understood model drug with which other drugs in a
pharmacologic class may be compared?
A) Chemical name
B) Generic name
C) Prototype drug
D) Trade name
Correct Answer: Prototype drug
Rationale: A prototype drug is the standard or original drug in a pharmacological class. It is well-
studied and serves as a reference point for comparing the actions, adverse effects, and interactions of
other drugs within the same class. For example, propranolol is a prototype for beta-blockers.
Understanding the prototype helps predict the behavior of newer medications in that category.
6. Which organ is primarily responsible for the biotransformation, or metabolism, of most
medications?
A) Kidneys
B) Liver
C) Lungs
D) Gastrointestinal tract
Correct Answer: Liver
Rationale: The liver is the primary site of drug metabolism, also known as biotransformation. It
contains enzymes, most notably the cytochrome P450 system, that chemically alter drugs to make
them more water-soluble for eventual excretion by the kidneys. Liver dysfunction can significantly
impair drug metabolism, leading to drug accumulation and toxicity. The kidneys are primarily
responsible for excretion, not metabolism.
7. What is the term for the movement of a drug from its site of administration into the
bloodstream?
A) Distribution
B) Metabolism
C) Absorption
D) Excretion
, Correct Answer: Absorption
Rationale: Absorption is the first step of pharmacokinetics and describes the process by which a drug
moves from its site of administration (e.g., gastrointestinal tract, muscle, skin) into the systemic
circulation. Factors affecting absorption include the route of administration, drug formulation, blood
flow to the site, and the presence of food in the stomach. Bioavailability refers to the fraction of the
drug that reaches systemic circulation unchanged.
8. A patient is prescribed an enteric-coated tablet. Which statement by the nurse accurately
explains the purpose of this formulation?
A) "It is designed to be crushed for faster absorption."
B) "It dissolves quickly in the stomach for rapid onset."
C) "It is meant to be chewed for extended release."
D) "It protects the drug from stomach acid or protects the stomach from irritation."
Correct Answer: "It protects the drug from stomach acid or protects the stomach from irritation."
Rationale: Enteric coatings are applied to tablets to prevent them from dissolving in the acidic
environment of the stomach. This serves two main purposes: to protect drugs that are acid-labile
(destroyed by stomach acid) and to protect the stomach lining from drugs that are irritating. Crushing
or chewing an enteric-coated tablet destroys this protective coating, leading to drug inactivation or
gastric irritation.
9. Which pregnancy safety category indicates that a medication poses a significant risk to the
fetus, and the risks clearly outweigh any potential benefits?
A) Category A
B) Category B
C) Category C
D) Category X
Correct Answer: Category X
Rationale: Pregnancy Category X is assigned to drugs for which studies in animals or humans have
demonstrated fetal abnormalities, or there is evidence of fetal risk based on human experience. The
risk of using the drug in pregnant women clearly outweighs any possible benefit. These medications
are contraindicated in women who are or may become pregnant.
10. A patient with a history of alcoholism is seeking relief from a headache. Which over-the-
counter medication should the nurse advise the patient to avoid due to an increased risk of
hepatotoxicity?
A) Ibuprofen
B) Acetaminophen
C) Aspirin
D) Naproxen
Correct Answer: Acetaminophen
Rationale: Acetaminophen is metabolized by the liver. Chronic alcohol consumption induces liver
enzymes and depletes glutathione, a substance that helps detoxify a toxic metabolite of
acetaminophen. This increases the risk of severe liver damage, even at therapeutic doses. Patients
with a history of alcohol abuse should avoid acetaminophen or use it with extreme caution and
medical supervision.
