NSG 100 EXAM 2 | NEWEST UPDATED ACTUAL | VERIFIED
ANSWERS AND COMPLETE EXAM PREP
• EX2-001 [Remembering] Define drug action, indication, adverse effect, and
antidote. -✓✓ANSWER: Answer: Action = what a medication does in the body
(pharmacodynamics); indication = the reason to give it; adverse effect =
unwanted harmful response; antidote = substance used to counter a toxic effect.
| Rationale: A drug may have the expected action and still create a dangerous
adverse response. | Strategy: Underline which term the stem asks for; do not
confuse purpose with mechanism. | Tags: Exam2::Pharmacology
Exam2::Drug_action Bloom::Remembering
• EX2-002 [Understanding] What are a drug peak and trough, and why check
them? -✓✓ANSWER: Answer: Peak = highest blood concentration after a dose;
trough = lowest level just before the next dose. Monitoring helps assess drug
exposure and toxicity for selected medications. | Rationale: Sample timing is
essential: a mistimed result can misrepresent drug exposure. | Strategy: If given a
level, confirm dose and draw times before interpreting. | Tags:
Exam2::Pharmacology Exam2::Peak_Trough Bloom::Understanding
• EX2-003 [Applying] PRIORITY: A vancomycin trough was drawn after the next
infusion began. Should the nurse use it to guide dosing? -✓✓ANSWER: Answer:
No. Identify the timing error, inform pharmacy/prescriber, and arrange a correctly
timed sample according to the facility protocol. | Rationale: A post-dose sample
cannot be interpreted as the intended pre-dose trough. | Strategy: First validate
specimen timing, not just whether the number is high. | Tags:
Exam2::Pharmacology Exam2::Peak_Trough Bloom::Applying
• EX2-005 [Applying] PRIORITY: A patient receiving IV vancomycin develops
wheezing, hypotension, and facial swelling. What first? -✓✓ANSWER: Answer:
Stop the infusion; activate emergency response, assess and support
airway/breathing, and prepare prescribed emergency treatment. | Rationale: This
,suggests a severe allergic reaction (anaphylaxis), not merely a rate-related
flushing reaction. | Strategy: ABCs beat a routine drug level or charting task. |
Tags: Exam2::Pharmacology Exam2::Vancomycin Bloom::Applying
• EX2-006 [Understanding] Which medication safety findings matter with
vancomycin? -✓✓ANSWER: Answer: Monitor serum creatinine/renal function,
urine output, infusion reaction, rash, and ordered drug exposure measurements.
Teach the patient to report hearing changes, rash, or reduced urination. |
Rationale: The drug is cleared mainly by kidneys; excessive exposure increases
toxicity risk. | Strategy: Trend renal function together with concentration data
rather than evaluating one value alone. | Tags: Exam2::Pharmacology
Exam2::Vancomycin Bloom::Understanding
• EX2-007 [Understanding] What is the action and common concern of
trimethoprim-sulfamethoxazole (TMP-SMX)? -✓✓ANSWER: Answer: It blocks two
steps of bacterial folate synthesis. Watch for rash/severe skin reaction,
hyperkalemia (high potassium), renal effects, and marrow suppression; check
allergies and relevant interactions. | Rationale: Blocking folate limits bacterial
growth; systemic adverse effects require nursing surveillance. | Strategy: A
blistering rash or breathing difficulty warrants urgent assessment. | Tags:
Exam2::Pharmacology Exam2::Sulfonamides Bloom::Understanding
• EX2-008 [Understanding] What is the action of penicillins, and what adverse
reaction has highest priority? -✓✓ANSWER: Answer: Penicillins block bacterial
cell-wall synthesis. Check allergy history; anaphylaxis with airway swelling,
wheeze, or hypotension is highest priority. Also monitor diarrhea and possible C.
diff. | Rationale: A severe immediate allergy threatens breathing and perfusion. |
Strategy: Ask what happened during the prior allergy rather than recording
"allergic" without details. | Tags: Exam2::Pharmacology Exam2::Penicillin
Bloom::Understanding
,• EX2-009 [Applying] INITIAL: A patient reports a previous penicillin reaction
involving throat swelling. An IV penicillin is due. What should the RN do? -
✓✓ANSWER: Answer: Hold the dose, verify allergy documentation, and promptly
contact the prescriber/pharmacist for a safe plan. | Rationale: Throat swelling is
concerning for an immediate severe allergy; do not administer first and observe. |
Strategy: The safest medication may be the one not given until verified. | Tags:
Exam2::Pharmacology Exam2::Penicillin Bloom::Applying
• EX2-010 [Understanding] What is broad-spectrum antibiotic therapy, and what
is a major tradeoff? -✓✓ANSWER: Answer: It covers many kinds of bacteria when
the organism is not yet known or severe infection requires empiric coverage;
unnecessary use can disrupt normal flora, cause C. diff, and promote resistance. |
Rationale: Broad coverage is not automatically better once culture data identify a
narrower choice. | Strategy: Watch for culture-guided de-escalation rather than
assuming the broadest drug is safest. | Tags: Exam2::Pharmacology
Exam2::Broad_spectrum Bloom::Understanding
• EX2-011 [Applying] A patient taking antibiotics develops frequent new watery
stools. Which complication requires follow-up? -✓✓ANSWER: Answer: Possible C.
diff infection: assess stool history, hydration, vitals, exposure, and notify provider;
start precautions according to policy. | Rationale: Antibiotics may disrupt
protective gut flora and allow C. diff to multiply. | Strategy: New-onset diarrhea
after antibiotics is not simply a harmless expected effect. | Tags:
Exam2::Pharmacology Exam2::Antibiotics Bloom::Applying
• EX2-012 [Remembering] What are the common reversal agents for opioid and
benzodiazepine toxicity? -✓✓ANSWER: Answer: Opioids: naloxone.
Benzodiazepines: flumazenil in carefully selected situations; it can provoke
seizures, particularly in dependent patients or mixed overdose. | Rationale:
Reversal requires supportive airway management and continued observation. |
Strategy: Do not equate having an antidote with unrestricted safe use. | Tags:
Exam2::Pharmacology Exam2::Antidote Bloom::Remembering
, • EX2-013 [Applying] PRIORITY: An adult receiving morphine becomes difficult to
arouse with RR 6/min. What actions come first? -✓✓ANSWER: Answer: Stop/hold
opioid; stimulate and assess airway and breathing, call rapid response, give
ventilation/oxygen support and naloxone per protocol/order. Reassess because
naloxone can wear off first. | Rationale: Respiratory depression is the immediate
threat, more urgent than pain reassessment. | Strategy: Prioritize airway and
ventilation; do not merely increase nasal oxygen while breathing remains
inadequate. | Tags: Exam2::Pharmacology Exam2::Opioid Bloom::Applying
• EX2-014 [Understanding] What reverses acetaminophen overdose and what
organ is at risk? -✓✓ANSWER: Answer: N-acetylcysteine (NAC) limits liver injury
(hepatotoxicity); assess total ingestion, time, acetaminophen concentration, and
liver tests. | Rationale: Acetaminophen metabolites can damage liver when
detoxification pathways are overwhelmed. | Strategy: Verify all combination
products; do not assume over-the-counter means harmless. | Tags:
Exam2::Pharmacology Exam2::Acetaminophen Bloom::Understanding
• EX2-015 [Understanding] Is there a single routine bedside antidote for NSAID
toxicity or aspirin overdose? -✓✓ANSWER: Answer: No universal direct reversal.
Treat supportively, evaluate bleeding/renal injury; severe salicylate poisoning may
require sodium bicarbonate and/or dialysis under specialist direction. | Rationale:
Aspirin overdose can disturb acid-base balance and cause tinnitus, rapid
breathing, and neurologic change. | Strategy: Know naloxone and NAC
specifically; do not incorrectly assign them to NSAIDs. | Tags:
Exam2::Pharmacology Exam2::NSAID Bloom::Understanding
• EX2-016 [Understanding] Which opioid and NSAID adverse effects are common
exam traps? -✓✓ANSWER: Answer: Opioids: respiratory depression, sedation,
constipation, urinary retention, falls. NSAIDs: GI bleeding/ulcer, acute kidney
injury, fluid retention, and bleeding risk. | Rationale: The highest-priority
ANSWERS AND COMPLETE EXAM PREP
• EX2-001 [Remembering] Define drug action, indication, adverse effect, and
antidote. -✓✓ANSWER: Answer: Action = what a medication does in the body
(pharmacodynamics); indication = the reason to give it; adverse effect =
unwanted harmful response; antidote = substance used to counter a toxic effect.
| Rationale: A drug may have the expected action and still create a dangerous
adverse response. | Strategy: Underline which term the stem asks for; do not
confuse purpose with mechanism. | Tags: Exam2::Pharmacology
Exam2::Drug_action Bloom::Remembering
• EX2-002 [Understanding] What are a drug peak and trough, and why check
them? -✓✓ANSWER: Answer: Peak = highest blood concentration after a dose;
trough = lowest level just before the next dose. Monitoring helps assess drug
exposure and toxicity for selected medications. | Rationale: Sample timing is
essential: a mistimed result can misrepresent drug exposure. | Strategy: If given a
level, confirm dose and draw times before interpreting. | Tags:
Exam2::Pharmacology Exam2::Peak_Trough Bloom::Understanding
• EX2-003 [Applying] PRIORITY: A vancomycin trough was drawn after the next
infusion began. Should the nurse use it to guide dosing? -✓✓ANSWER: Answer:
No. Identify the timing error, inform pharmacy/prescriber, and arrange a correctly
timed sample according to the facility protocol. | Rationale: A post-dose sample
cannot be interpreted as the intended pre-dose trough. | Strategy: First validate
specimen timing, not just whether the number is high. | Tags:
Exam2::Pharmacology Exam2::Peak_Trough Bloom::Applying
• EX2-005 [Applying] PRIORITY: A patient receiving IV vancomycin develops
wheezing, hypotension, and facial swelling. What first? -✓✓ANSWER: Answer:
Stop the infusion; activate emergency response, assess and support
airway/breathing, and prepare prescribed emergency treatment. | Rationale: This
,suggests a severe allergic reaction (anaphylaxis), not merely a rate-related
flushing reaction. | Strategy: ABCs beat a routine drug level or charting task. |
Tags: Exam2::Pharmacology Exam2::Vancomycin Bloom::Applying
• EX2-006 [Understanding] Which medication safety findings matter with
vancomycin? -✓✓ANSWER: Answer: Monitor serum creatinine/renal function,
urine output, infusion reaction, rash, and ordered drug exposure measurements.
Teach the patient to report hearing changes, rash, or reduced urination. |
Rationale: The drug is cleared mainly by kidneys; excessive exposure increases
toxicity risk. | Strategy: Trend renal function together with concentration data
rather than evaluating one value alone. | Tags: Exam2::Pharmacology
Exam2::Vancomycin Bloom::Understanding
• EX2-007 [Understanding] What is the action and common concern of
trimethoprim-sulfamethoxazole (TMP-SMX)? -✓✓ANSWER: Answer: It blocks two
steps of bacterial folate synthesis. Watch for rash/severe skin reaction,
hyperkalemia (high potassium), renal effects, and marrow suppression; check
allergies and relevant interactions. | Rationale: Blocking folate limits bacterial
growth; systemic adverse effects require nursing surveillance. | Strategy: A
blistering rash or breathing difficulty warrants urgent assessment. | Tags:
Exam2::Pharmacology Exam2::Sulfonamides Bloom::Understanding
• EX2-008 [Understanding] What is the action of penicillins, and what adverse
reaction has highest priority? -✓✓ANSWER: Answer: Penicillins block bacterial
cell-wall synthesis. Check allergy history; anaphylaxis with airway swelling,
wheeze, or hypotension is highest priority. Also monitor diarrhea and possible C.
diff. | Rationale: A severe immediate allergy threatens breathing and perfusion. |
Strategy: Ask what happened during the prior allergy rather than recording
"allergic" without details. | Tags: Exam2::Pharmacology Exam2::Penicillin
Bloom::Understanding
,• EX2-009 [Applying] INITIAL: A patient reports a previous penicillin reaction
involving throat swelling. An IV penicillin is due. What should the RN do? -
✓✓ANSWER: Answer: Hold the dose, verify allergy documentation, and promptly
contact the prescriber/pharmacist for a safe plan. | Rationale: Throat swelling is
concerning for an immediate severe allergy; do not administer first and observe. |
Strategy: The safest medication may be the one not given until verified. | Tags:
Exam2::Pharmacology Exam2::Penicillin Bloom::Applying
• EX2-010 [Understanding] What is broad-spectrum antibiotic therapy, and what
is a major tradeoff? -✓✓ANSWER: Answer: It covers many kinds of bacteria when
the organism is not yet known or severe infection requires empiric coverage;
unnecessary use can disrupt normal flora, cause C. diff, and promote resistance. |
Rationale: Broad coverage is not automatically better once culture data identify a
narrower choice. | Strategy: Watch for culture-guided de-escalation rather than
assuming the broadest drug is safest. | Tags: Exam2::Pharmacology
Exam2::Broad_spectrum Bloom::Understanding
• EX2-011 [Applying] A patient taking antibiotics develops frequent new watery
stools. Which complication requires follow-up? -✓✓ANSWER: Answer: Possible C.
diff infection: assess stool history, hydration, vitals, exposure, and notify provider;
start precautions according to policy. | Rationale: Antibiotics may disrupt
protective gut flora and allow C. diff to multiply. | Strategy: New-onset diarrhea
after antibiotics is not simply a harmless expected effect. | Tags:
Exam2::Pharmacology Exam2::Antibiotics Bloom::Applying
• EX2-012 [Remembering] What are the common reversal agents for opioid and
benzodiazepine toxicity? -✓✓ANSWER: Answer: Opioids: naloxone.
Benzodiazepines: flumazenil in carefully selected situations; it can provoke
seizures, particularly in dependent patients or mixed overdose. | Rationale:
Reversal requires supportive airway management and continued observation. |
Strategy: Do not equate having an antidote with unrestricted safe use. | Tags:
Exam2::Pharmacology Exam2::Antidote Bloom::Remembering
, • EX2-013 [Applying] PRIORITY: An adult receiving morphine becomes difficult to
arouse with RR 6/min. What actions come first? -✓✓ANSWER: Answer: Stop/hold
opioid; stimulate and assess airway and breathing, call rapid response, give
ventilation/oxygen support and naloxone per protocol/order. Reassess because
naloxone can wear off first. | Rationale: Respiratory depression is the immediate
threat, more urgent than pain reassessment. | Strategy: Prioritize airway and
ventilation; do not merely increase nasal oxygen while breathing remains
inadequate. | Tags: Exam2::Pharmacology Exam2::Opioid Bloom::Applying
• EX2-014 [Understanding] What reverses acetaminophen overdose and what
organ is at risk? -✓✓ANSWER: Answer: N-acetylcysteine (NAC) limits liver injury
(hepatotoxicity); assess total ingestion, time, acetaminophen concentration, and
liver tests. | Rationale: Acetaminophen metabolites can damage liver when
detoxification pathways are overwhelmed. | Strategy: Verify all combination
products; do not assume over-the-counter means harmless. | Tags:
Exam2::Pharmacology Exam2::Acetaminophen Bloom::Understanding
• EX2-015 [Understanding] Is there a single routine bedside antidote for NSAID
toxicity or aspirin overdose? -✓✓ANSWER: Answer: No universal direct reversal.
Treat supportively, evaluate bleeding/renal injury; severe salicylate poisoning may
require sodium bicarbonate and/or dialysis under specialist direction. | Rationale:
Aspirin overdose can disturb acid-base balance and cause tinnitus, rapid
breathing, and neurologic change. | Strategy: Know naloxone and NAC
specifically; do not incorrectly assign them to NSAIDs. | Tags:
Exam2::Pharmacology Exam2::NSAID Bloom::Understanding
• EX2-016 [Understanding] Which opioid and NSAID adverse effects are common
exam traps? -✓✓ANSWER: Answer: Opioids: respiratory depression, sedation,
constipation, urinary retention, falls. NSAIDs: GI bleeding/ulcer, acute kidney
injury, fluid retention, and bleeding risk. | Rationale: The highest-priority
