NURS 430 Exam 1 Questions With Complete Solutions
A 12-year-old boy with a peanut allergy is brought to the
emergency room after accidental consumption of peanuts. He is
in anaphylactic shock. Which of the following drugs is most
appropriate to treat this patient?
A. Norepinephrine
B. Phenylephrine
C. Dobutamine
D. Epinephrine Correct Answer D. Epinephrine
Norepinephrine has more α agonistic effects and activates
mainly α1, α2, and β1 receptors. Epinephrine has more β
agonistic effects and activates mainly α1, α2, β1, and β2
receptors. Phenylephrine has predominantly α effects and
activates mainly α1 receptors. Dobutamine mainly activates β1
receptors and has no significant effects on β2 receptors. Thus,
epinephrine is the drug of choice in anaphylactic shock that can
both stimulate the heart (β1 activation) and dilate bronchioles
(β2 activation).
A 22-year-old male is brought to the emergency room with
suspected cocaine overdose. Which of the following symptoms
is most likely in this patient?
A. Hypertension
B. Bronchoconstriction
C. Bradycardia
D. Miosis (constriction of pupil) Correct Answer A.
Hypertension
,Cocaine is an indirect adrenergic agonist that prevents the
reuptake of norepinephrine intothe nerve terminals, thus
increasing the levels of NE in the synaptic cleft. The increase in
NE leads to an increasein blood pressure (hypertension),
tachycardia (not bradycardia), mydriasis (not miosis), and other
symptoms of sympathetic overactivity.
A 22-year-old woman requests emergency contraception after
unprotected intercourse that occurred 1 day ago. She has no
medical conditions. Which agent is most appropriate?
A. Ethinyl estradiol/norgestimate
B. Etonogestrel
C. Levonorgestrel
D. Mifepristone Correct Answer C. Levonorgestrel
A single dose of levonorgestrel is preferred for emergency
contraception and should be administered within 72 hours of
unprotected intercourse for best efficacy. Estrogen/progestin
regimens are less used for emergency contraception due to a
higher incidence of adverse effects such as nausea/vomiting.
Etonogestrel is a progestin used in the contraceptive ring and
implant. Mifepristone is a progesterone antagonist used to
terminate pregnancy once it has occurred.
A 25-year-old female is using injectable medroxyprogesterone
acetate as a method of contraception. Which of the following
adverse effects is a concern if she wishes to use this therapy
long-term?
,A. Hyperkalemia.
B. Male pattern baldness.
C. Osteoporosis.
D. Weight loss. Correct Answer C. Osteoporosis.
Medroxyprogesterone acetate may contribute to bone loss and
predispose patients to osteoporosis and/or fractures. Therefore,
the drug should not be continued for more than 2 years if
possible. The drug often causes weight gain, not weight loss.
The other adverse effects are not associated with
medroxyprogesterone.
A 29-year-old female has a TSH of 13.5 mIU/L (normal 0.5-4.7
mIU/L). Which agent is most appropriate to treat the TSH
abnormality?
A. Levothyroxine
B. Liothyronine
C. Liotrix
D. Propylthiouracil Correct Answer A. Levothyroxine
This patient presents with hypothyroidism as evidenced by high
TSH. Levothyroxine is preferred due to its long half-life and
better tolerability. Liothyronine (T3) and Liotrix (T3/T4) are not
as well tolerated. Propylthiouracil is used in the treatment of
hyperthyroidism.
A 30-year-old male patient was brought to the ER with
amphetamine overdose. He presented with high blood pressure
and arrhythmias. Which drug is the most appropriate to treat the
, cardiovascular symptoms of amphetamine overdose in this
patient?
A. Metoprolol
B. Prazosin
C. Labetalol
D. Nebivolol Correct Answer C. Labetalol
Amphetamine is an indirect adrenergic agonist that mainly
enhances the release ofnorepinephrine from peripheral
sympathetic neurons. Therefore, it activates all types of
adrenergic receptors (that is, α and β receptors) and causes an
increase in blood pressure. Since both α and β receptors are
activated indirectly by amphetamine, α-blockers (prazosin) or β-
blockers (metoprolol, nebivolol) alone cannot relieve the
cardiovascular effects of amphetamine poisoning. Labetalol
blocks both α1 and beta receptors and can minimize the
cardiovascular effects of amphetamine overdose.
A 35-year-old woman is experiencing infertility due to
anovulation. Which agent is most appropriate for this patient?
A. Clomiphene
B. Ospemifene
C. Raloxifene
D. Ulipristal Correct Answer A. Clomiphene
Clomiphene is a SERM that interferes with negative feedback of
estrogens on the hypothalamus, thereby increasing the secretion
of gonadotropin-releasing hormone and gonadotropins, and
leading to stimulation of ovulation. Ospemifene is a SERM
A 12-year-old boy with a peanut allergy is brought to the
emergency room after accidental consumption of peanuts. He is
in anaphylactic shock. Which of the following drugs is most
appropriate to treat this patient?
A. Norepinephrine
B. Phenylephrine
C. Dobutamine
D. Epinephrine Correct Answer D. Epinephrine
Norepinephrine has more α agonistic effects and activates
mainly α1, α2, and β1 receptors. Epinephrine has more β
agonistic effects and activates mainly α1, α2, β1, and β2
receptors. Phenylephrine has predominantly α effects and
activates mainly α1 receptors. Dobutamine mainly activates β1
receptors and has no significant effects on β2 receptors. Thus,
epinephrine is the drug of choice in anaphylactic shock that can
both stimulate the heart (β1 activation) and dilate bronchioles
(β2 activation).
A 22-year-old male is brought to the emergency room with
suspected cocaine overdose. Which of the following symptoms
is most likely in this patient?
A. Hypertension
B. Bronchoconstriction
C. Bradycardia
D. Miosis (constriction of pupil) Correct Answer A.
Hypertension
,Cocaine is an indirect adrenergic agonist that prevents the
reuptake of norepinephrine intothe nerve terminals, thus
increasing the levels of NE in the synaptic cleft. The increase in
NE leads to an increasein blood pressure (hypertension),
tachycardia (not bradycardia), mydriasis (not miosis), and other
symptoms of sympathetic overactivity.
A 22-year-old woman requests emergency contraception after
unprotected intercourse that occurred 1 day ago. She has no
medical conditions. Which agent is most appropriate?
A. Ethinyl estradiol/norgestimate
B. Etonogestrel
C. Levonorgestrel
D. Mifepristone Correct Answer C. Levonorgestrel
A single dose of levonorgestrel is preferred for emergency
contraception and should be administered within 72 hours of
unprotected intercourse for best efficacy. Estrogen/progestin
regimens are less used for emergency contraception due to a
higher incidence of adverse effects such as nausea/vomiting.
Etonogestrel is a progestin used in the contraceptive ring and
implant. Mifepristone is a progesterone antagonist used to
terminate pregnancy once it has occurred.
A 25-year-old female is using injectable medroxyprogesterone
acetate as a method of contraception. Which of the following
adverse effects is a concern if she wishes to use this therapy
long-term?
,A. Hyperkalemia.
B. Male pattern baldness.
C. Osteoporosis.
D. Weight loss. Correct Answer C. Osteoporosis.
Medroxyprogesterone acetate may contribute to bone loss and
predispose patients to osteoporosis and/or fractures. Therefore,
the drug should not be continued for more than 2 years if
possible. The drug often causes weight gain, not weight loss.
The other adverse effects are not associated with
medroxyprogesterone.
A 29-year-old female has a TSH of 13.5 mIU/L (normal 0.5-4.7
mIU/L). Which agent is most appropriate to treat the TSH
abnormality?
A. Levothyroxine
B. Liothyronine
C. Liotrix
D. Propylthiouracil Correct Answer A. Levothyroxine
This patient presents with hypothyroidism as evidenced by high
TSH. Levothyroxine is preferred due to its long half-life and
better tolerability. Liothyronine (T3) and Liotrix (T3/T4) are not
as well tolerated. Propylthiouracil is used in the treatment of
hyperthyroidism.
A 30-year-old male patient was brought to the ER with
amphetamine overdose. He presented with high blood pressure
and arrhythmias. Which drug is the most appropriate to treat the
, cardiovascular symptoms of amphetamine overdose in this
patient?
A. Metoprolol
B. Prazosin
C. Labetalol
D. Nebivolol Correct Answer C. Labetalol
Amphetamine is an indirect adrenergic agonist that mainly
enhances the release ofnorepinephrine from peripheral
sympathetic neurons. Therefore, it activates all types of
adrenergic receptors (that is, α and β receptors) and causes an
increase in blood pressure. Since both α and β receptors are
activated indirectly by amphetamine, α-blockers (prazosin) or β-
blockers (metoprolol, nebivolol) alone cannot relieve the
cardiovascular effects of amphetamine poisoning. Labetalol
blocks both α1 and beta receptors and can minimize the
cardiovascular effects of amphetamine overdose.
A 35-year-old woman is experiencing infertility due to
anovulation. Which agent is most appropriate for this patient?
A. Clomiphene
B. Ospemifene
C. Raloxifene
D. Ulipristal Correct Answer A. Clomiphene
Clomiphene is a SERM that interferes with negative feedback of
estrogens on the hypothalamus, thereby increasing the secretion
of gonadotropin-releasing hormone and gonadotropins, and
leading to stimulation of ovulation. Ospemifene is a SERM
