NURS 1150 Exam 4 Actual Exam V3 | NURS 1150 Nurse Pharmacology
I (NURS1150 Exam 4) | Northwest College (NWC)
1. A patient is prescribed phenytoin (Dilantin) for the treatment of tonic-clonic seizures.
Which of the following findings would indicate a common side effect of this medication?
A. Urinary retention
B. Severe hypertension
C. Excessive growth of gum tissue
D. Increased appetite and weight gain
Answer: C
Rationale: Gingival hyperplasia is a well-known side effect of long-term phenytoin
therapy. Patients should be taught the importance of frequent dental checkups and
meticulous oral hygiene. The nurse must assess the oral cavity regularly for signs of gum
overgrowth.
2. A nurse is preparing to administer lithium carbonate to a patient with bipolar disorder.
Which laboratory value is most critical to monitor before administration?
A. Serum sodium level
B. Serum calcium level
C. Hemoglobin A1c
D. Platelet count
Answer: A
Rationale: Lithium has a narrow therapeutic index and is handled by the kidneys similarly
to sodium. Low sodium levels can lead to decreased lithium excretion and subsequent
toxicity. The nurse must ensure the patient maintains adequate salt and fluid intake.
3. A patient has just been started on fluoxetine (Prozac) for depression. What information
should the nurse include in the discharge teaching?
A. The medication will work immediately to improve mood.
B. It may take 4 to 6 weeks to feel the full therapeutic effect.
C. Stop taking the drug if you experience dry mouth.
D. Avoid all dairy products while taking this medication.
Answer: B
,Rationale: SSRIs like fluoxetine often require several weeks of consistent dosing before the
patient experiences a significant improvement in symptoms. This is a critical point for
patient compliance and safety. Nurses should monitor for increased suicidal ideation
during the initial phase of therapy.
4. Which of the following is the reversal agent for a benzodiazepine overdose?
A. Flumazenil
B. Protamine sulfate
C. Naloxone
D. Vitamin K
Answer: A
Rationale: Flumazenil is a benzodiazepine receptor antagonist used to reverse sedation
and respiratory depression. Naloxone is used for opioids, while Protamine sulfate is for
heparin. The nurse must monitor for seizures after administering flumazenil, especially in
chronic benzodiazepine users.
5. A patient with Type 1 Diabetes is prescribed Lispro (Humalog) insulin. When should the
nurse instruct the patient to take this insulin?
A. 30 to 45 minutes before a meal
B. Only at bedtime
C. Immediately before eating or with the first bite
D. Once daily in the morning
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes. It must be
administered in close proximity to a meal to prevent hypoglycemia. The nurse should
ensure the meal tray is present before the injection is given.
6. A patient is taking levothyroxine (Synthroid) for hypothyroidism. Which statement by the
patient indicates a need for further teaching?
A. I will take this medicine every morning on an empty stomach.
B. I will wait 30 to 60 minutes after taking it before eating.
C. I should report any heart palpitations to my doctor.
D. I can stop taking this once my energy levels return to normal.
Answer: D
, Rationale: Hypothyroidism usually requires lifelong replacement therapy, and the
medication should not be stopped abruptly. Taking the medication on an empty stomach
improves absorption. Heart palpitations can indicate an excessive dose or toxicity.
7. Which medication is most likely to be held for 48 hours before and after a procedure
involving intravenous contrast dye?
A. Glipizide
B. Metformin
C. Pioglitazone
D. Acarbose
Answer: B
Rationale: Metformin is withheld to prevent the risk of lactic acidosis if renal failure
occurs due to contrast dye. Renal function should be verified before resuming the
medication. This is a critical safety intervention for patients undergoing CT scans with
contrast.
8. A patient taking an MAO inhibitor (MAOI) for depression must avoid which of the following
foods to prevent a hypertensive crisis?
A. Leafy green vegetables
B. Aged cheeses and red wine
C. Citrus fruits
D. Whole grain breads
Answer: B
Rationale: Foods high in tyramine, such as aged cheeses, cured meats, and red wine, can
trigger a dangerous release of norepinephrine in patients on MAOIs. This can lead to a
severe, life-threatening hypertensive crisis. The nurse must provide a comprehensive list of
restricted foods to the patient.
9. Which of the following is a potential life-threatening side effect of clozapine (Clozaril) that
requires weekly blood monitoring?
A. Hepatotoxicity
B. Agranulocytosis
C. Ototoxicity
D. Nephrotoxicity
Answer: B
I (NURS1150 Exam 4) | Northwest College (NWC)
1. A patient is prescribed phenytoin (Dilantin) for the treatment of tonic-clonic seizures.
Which of the following findings would indicate a common side effect of this medication?
A. Urinary retention
B. Severe hypertension
C. Excessive growth of gum tissue
D. Increased appetite and weight gain
Answer: C
Rationale: Gingival hyperplasia is a well-known side effect of long-term phenytoin
therapy. Patients should be taught the importance of frequent dental checkups and
meticulous oral hygiene. The nurse must assess the oral cavity regularly for signs of gum
overgrowth.
2. A nurse is preparing to administer lithium carbonate to a patient with bipolar disorder.
Which laboratory value is most critical to monitor before administration?
A. Serum sodium level
B. Serum calcium level
C. Hemoglobin A1c
D. Platelet count
Answer: A
Rationale: Lithium has a narrow therapeutic index and is handled by the kidneys similarly
to sodium. Low sodium levels can lead to decreased lithium excretion and subsequent
toxicity. The nurse must ensure the patient maintains adequate salt and fluid intake.
3. A patient has just been started on fluoxetine (Prozac) for depression. What information
should the nurse include in the discharge teaching?
A. The medication will work immediately to improve mood.
B. It may take 4 to 6 weeks to feel the full therapeutic effect.
C. Stop taking the drug if you experience dry mouth.
D. Avoid all dairy products while taking this medication.
Answer: B
,Rationale: SSRIs like fluoxetine often require several weeks of consistent dosing before the
patient experiences a significant improvement in symptoms. This is a critical point for
patient compliance and safety. Nurses should monitor for increased suicidal ideation
during the initial phase of therapy.
4. Which of the following is the reversal agent for a benzodiazepine overdose?
A. Flumazenil
B. Protamine sulfate
C. Naloxone
D. Vitamin K
Answer: A
Rationale: Flumazenil is a benzodiazepine receptor antagonist used to reverse sedation
and respiratory depression. Naloxone is used for opioids, while Protamine sulfate is for
heparin. The nurse must monitor for seizures after administering flumazenil, especially in
chronic benzodiazepine users.
5. A patient with Type 1 Diabetes is prescribed Lispro (Humalog) insulin. When should the
nurse instruct the patient to take this insulin?
A. 30 to 45 minutes before a meal
B. Only at bedtime
C. Immediately before eating or with the first bite
D. Once daily in the morning
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of 15 minutes. It must be
administered in close proximity to a meal to prevent hypoglycemia. The nurse should
ensure the meal tray is present before the injection is given.
6. A patient is taking levothyroxine (Synthroid) for hypothyroidism. Which statement by the
patient indicates a need for further teaching?
A. I will take this medicine every morning on an empty stomach.
B. I will wait 30 to 60 minutes after taking it before eating.
C. I should report any heart palpitations to my doctor.
D. I can stop taking this once my energy levels return to normal.
Answer: D
, Rationale: Hypothyroidism usually requires lifelong replacement therapy, and the
medication should not be stopped abruptly. Taking the medication on an empty stomach
improves absorption. Heart palpitations can indicate an excessive dose or toxicity.
7. Which medication is most likely to be held for 48 hours before and after a procedure
involving intravenous contrast dye?
A. Glipizide
B. Metformin
C. Pioglitazone
D. Acarbose
Answer: B
Rationale: Metformin is withheld to prevent the risk of lactic acidosis if renal failure
occurs due to contrast dye. Renal function should be verified before resuming the
medication. This is a critical safety intervention for patients undergoing CT scans with
contrast.
8. A patient taking an MAO inhibitor (MAOI) for depression must avoid which of the following
foods to prevent a hypertensive crisis?
A. Leafy green vegetables
B. Aged cheeses and red wine
C. Citrus fruits
D. Whole grain breads
Answer: B
Rationale: Foods high in tyramine, such as aged cheeses, cured meats, and red wine, can
trigger a dangerous release of norepinephrine in patients on MAOIs. This can lead to a
severe, life-threatening hypertensive crisis. The nurse must provide a comprehensive list of
restricted foods to the patient.
9. Which of the following is a potential life-threatening side effect of clozapine (Clozaril) that
requires weekly blood monitoring?
A. Hepatotoxicity
B. Agranulocytosis
C. Ototoxicity
D. Nephrotoxicity
Answer: B
