NU 150 Exam 4 | NU 150 Pharmacology |
Questions and Answers with Rationales
2026/2027 Update
QUESTION 1
What is the primary mechanism of action of nonsteroidal anti-inflammatory drugs
in the body?
A. Irreversible inhibition of cyclooxygenase enzymes to block prostaglandin
synthesis
B. Direct stimulation of central opioid mu receptors in the thalamus
C. Inhibition of histamine release from mast cells in peripheral tissues
D. Stimulation of beta-2 adrenergic receptors in vascular smooth muscle
ANSWER: A
RATIONALE: Nonsteroidal anti-inflammatory drugs act primarily by inhibiting
cyclooxygenase enzymes, which prevents the conversion of arachidonic acid into
prostaglandins, thereby reducing pain, inflammation, and fever.
QUESTION 2
Which gastrointestinal adverse effect is commonly associated with chronic
systemic use of nonsteroidal anti-inflammatory drugs?
A. Constipation and paralytic ileus
B. Gastric mucosal irritation, erosion, and peptic ulcer formation
C. Hypertrophic gastritis and increased acid production
D. Rapid absorption and decreased gastric motility
ANSWER: B
,RATIONALE: Prostaglandins normally protect the gastric mucosa by stimulating
mucus and bicarbonate production and regulating blood flow. Nonsteroidal anti-
inflammatory drugs inhibit these protective prostaglandins, increasing the risk of
mucosal injury and ulcers.
QUESTION 3
Which organ system is at highest risk for toxicity with long-term high-dose
therapy of acetaminophen?
A. Renal system
B. Hepatic system
C. Pulmonary system
D. Cardiovascular system
ANSWER: B
RATIONALE: Acetaminophen is metabolized in the liver, where a toxic
intermediate metabolite is normally neutralized by glutathione. In overdose,
glutathione stores are depleted, leading to centrilobular hepatic necrosis and liver
failure.
QUESTION 4
What is the specific pharmacological antidote administered for an acute
acetaminophen overdose?
A. Naloxone hydrochloride
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
ANSWER: C
RATIONALE: Acetylcysteine acts as a glutathione substitute that binds to toxic
acetaminophen metabolites, preventing them from binding to hepatic cells and
causing liver damage.
,QUESTION 5
Which medication classification is considered the gold standard for acute
moderate-to-severe pain management by binding to central nervous system
receptors?
A. Nonsteroidal anti-inflammatory drugs
B. Opioid analgesics
C. Skeletal muscle relaxants
D. Serotonin receptor agonists
ANSWER: B
RATIONALE: Opioid analgesics bind to specific opioid receptors in the central
nervous system to alter the perception of and emotional response to painful
stimuli.
QUESTION 6
Which classic adverse effect requires continuous nursing surveillance in patients
receiving opioid analgesics?
A. Severe hypertension and tachycardia
B. Respiratory depression and sedation
C. Hyperactivity and insomnia
D. Excessive salivation and diarrhea
ANSWER: B
RATIONALE: Opioid agonists depress the respiratory center in the brainstem,
leading to decreased respiratory rate and depth, which can progress to life-
threatening respiratory depression and profound sedation.
QUESTION 7
What is the primary pharmacological antidote used to reverse opioid-induced
respiratory depression and sedation?
A. Flumazenil
, B. Naloxone hydrochloride
C. Protamine sulfate
D. Vitamin K phytonadione
ANSWER: B
RATIONALE: Naloxone is a competitive opioid antagonist that displaces opioid
molecules from their receptor sites, rapidly reversing respiratory depression,
sedation, and analgesia.
QUESTION 8
Which laxative classification acts by drawing water into the intestinal lumen
through osmotic pressure to soften stool and stimulate peristalsis?
A. Bulk-forming laxatives
B. Osmotic and saline laxatives
C. Stimulant laxatives
D. Stool softeners
ANSWER: B
RATIONALE: Osmotic and saline laxatives contain poorly absorbed ions or sugars
that draw water into the intestinal tract by osmosis, increasing stool volume and
stimulating peristalsis.
QUESTION 9
What is the primary mechanism of action of bulk-forming laxatives such as
psyllium?
A. Irritating the intestinal mucosa to increase peristalsis
B. Absorbing water into the intestine to increase fecal bulk and stimulate
peristalsis, requiring adequate fluid intake
C. Lubricating the fecal mass to ease passage
D. Drawing water out of the intestinal wall into the bloodstream
Questions and Answers with Rationales
2026/2027 Update
QUESTION 1
What is the primary mechanism of action of nonsteroidal anti-inflammatory drugs
in the body?
A. Irreversible inhibition of cyclooxygenase enzymes to block prostaglandin
synthesis
B. Direct stimulation of central opioid mu receptors in the thalamus
C. Inhibition of histamine release from mast cells in peripheral tissues
D. Stimulation of beta-2 adrenergic receptors in vascular smooth muscle
ANSWER: A
RATIONALE: Nonsteroidal anti-inflammatory drugs act primarily by inhibiting
cyclooxygenase enzymes, which prevents the conversion of arachidonic acid into
prostaglandins, thereby reducing pain, inflammation, and fever.
QUESTION 2
Which gastrointestinal adverse effect is commonly associated with chronic
systemic use of nonsteroidal anti-inflammatory drugs?
A. Constipation and paralytic ileus
B. Gastric mucosal irritation, erosion, and peptic ulcer formation
C. Hypertrophic gastritis and increased acid production
D. Rapid absorption and decreased gastric motility
ANSWER: B
,RATIONALE: Prostaglandins normally protect the gastric mucosa by stimulating
mucus and bicarbonate production and regulating blood flow. Nonsteroidal anti-
inflammatory drugs inhibit these protective prostaglandins, increasing the risk of
mucosal injury and ulcers.
QUESTION 3
Which organ system is at highest risk for toxicity with long-term high-dose
therapy of acetaminophen?
A. Renal system
B. Hepatic system
C. Pulmonary system
D. Cardiovascular system
ANSWER: B
RATIONALE: Acetaminophen is metabolized in the liver, where a toxic
intermediate metabolite is normally neutralized by glutathione. In overdose,
glutathione stores are depleted, leading to centrilobular hepatic necrosis and liver
failure.
QUESTION 4
What is the specific pharmacological antidote administered for an acute
acetaminophen overdose?
A. Naloxone hydrochloride
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
ANSWER: C
RATIONALE: Acetylcysteine acts as a glutathione substitute that binds to toxic
acetaminophen metabolites, preventing them from binding to hepatic cells and
causing liver damage.
,QUESTION 5
Which medication classification is considered the gold standard for acute
moderate-to-severe pain management by binding to central nervous system
receptors?
A. Nonsteroidal anti-inflammatory drugs
B. Opioid analgesics
C. Skeletal muscle relaxants
D. Serotonin receptor agonists
ANSWER: B
RATIONALE: Opioid analgesics bind to specific opioid receptors in the central
nervous system to alter the perception of and emotional response to painful
stimuli.
QUESTION 6
Which classic adverse effect requires continuous nursing surveillance in patients
receiving opioid analgesics?
A. Severe hypertension and tachycardia
B. Respiratory depression and sedation
C. Hyperactivity and insomnia
D. Excessive salivation and diarrhea
ANSWER: B
RATIONALE: Opioid agonists depress the respiratory center in the brainstem,
leading to decreased respiratory rate and depth, which can progress to life-
threatening respiratory depression and profound sedation.
QUESTION 7
What is the primary pharmacological antidote used to reverse opioid-induced
respiratory depression and sedation?
A. Flumazenil
, B. Naloxone hydrochloride
C. Protamine sulfate
D. Vitamin K phytonadione
ANSWER: B
RATIONALE: Naloxone is a competitive opioid antagonist that displaces opioid
molecules from their receptor sites, rapidly reversing respiratory depression,
sedation, and analgesia.
QUESTION 8
Which laxative classification acts by drawing water into the intestinal lumen
through osmotic pressure to soften stool and stimulate peristalsis?
A. Bulk-forming laxatives
B. Osmotic and saline laxatives
C. Stimulant laxatives
D. Stool softeners
ANSWER: B
RATIONALE: Osmotic and saline laxatives contain poorly absorbed ions or sugars
that draw water into the intestinal tract by osmosis, increasing stool volume and
stimulating peristalsis.
QUESTION 9
What is the primary mechanism of action of bulk-forming laxatives such as
psyllium?
A. Irritating the intestinal mucosa to increase peristalsis
B. Absorbing water into the intestine to increase fecal bulk and stimulate
peristalsis, requiring adequate fluid intake
C. Lubricating the fecal mass to ease passage
D. Drawing water out of the intestinal wall into the bloodstream
