NCLEX-RN Pharmacology Neurological System Part
2 Exam Questions with Rationales |
20 ATI & NGN-Style Practice MCQs |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 28-year-old female client with generalized anxiety disorder
has been taking alprazolam for 6 months. During a clinic visit,
she reports, "I feel much better, so I stopped taking the
medication yesterday." The nurse notes mild tremors, anxiety,
and insomnia.
Question Stem
Which nursing response is most appropriate?
Options
A. "You can stop alprazolam abruptly once symptoms improve."
B. "You should take an extra dose today to eliminate withdrawal
symptoms."
,C. "Alprazolam should be tapered gradually under provider
supervision."
D. "Withdrawal symptoms indicate the medication is
ineffective."
Correct Answer
Correct Answer: C. "Alprazolam should be tapered gradually
under provider supervision."
Detailed Rationale
Alprazolam is a benzodiazepine that enhances the inhibitory
effects of GABA in the central nervous system. Long-term use
can lead to physical dependence. Abrupt discontinuation may
result in withdrawal manifestations including anxiety, tremors,
insomnia, agitation, tachycardia, and, in severe cases, seizures.
Therefore, gradual tapering under provider supervision is the
safest approach.
Option A is incorrect because abrupt discontinuation increases
the risk of serious withdrawal symptoms. Option B is incorrect
because clients should never independently adjust
benzodiazepine dosages. Increasing the dose may worsen
dependence and does not address the need for a structured
taper. Option D is incorrect because withdrawal symptoms
reflect physiological dependence, not treatment failure.
,Nurses should educate clients about medication adherence,
avoiding abrupt cessation, and reporting withdrawal symptoms
promptly. Monitoring includes assessment of anxiety
symptoms, sedation level, respiratory status, and signs of
misuse or dependence.
Learning Objective
After completing this question, the learner should be able to:
• Recognize benzodiazepine withdrawal manifestations.
• Identify safe discontinuation practices for alprazolam.
• Educate clients regarding medication adherence.
• Prioritize prevention of withdrawal-related complications.
Medication Safety Focus
Medication administration
Question 2
Clinical Scenario
A 74-year-old male client with Parkinson disease is prescribed
carbidopa/levodopa. The nurse is reviewing home medications
and dietary habits. The client reports taking the medication
with a high-protein breakfast every morning.
Question Stem
, Which teaching should the nurse provide?
Options
A. High-protein meals may decrease levodopa effectiveness.
B. Protein enhances absorption of levodopa.
C. Protein prevents orthostatic hypotension.
D. Levodopa should always be taken with dairy products.
Correct Answer
Correct Answer: A. High-protein meals may decrease levodopa
effectiveness.
Detailed Rationale
Levodopa crosses the blood-brain barrier and is converted to
dopamine in the CNS. Dietary protein competes with levodopa
for transport across the intestinal wall and blood-brain barrier,
potentially reducing therapeutic effectiveness. Clients may
experience worsening tremors, rigidity, and bradykinesia when
levodopa absorption is impaired.
Option B is incorrect because protein decreases—not
increases—availability of levodopa. Option C is incorrect
because dietary protein does not prevent orthostatic
hypotension, a common adverse effect of dopaminergic
therapy. Option D is incorrect because dairy products contain
protein and may contribute to reduced absorption.
2 Exam Questions with Rationales |
20 ATI & NGN-Style Practice MCQs |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 28-year-old female client with generalized anxiety disorder
has been taking alprazolam for 6 months. During a clinic visit,
she reports, "I feel much better, so I stopped taking the
medication yesterday." The nurse notes mild tremors, anxiety,
and insomnia.
Question Stem
Which nursing response is most appropriate?
Options
A. "You can stop alprazolam abruptly once symptoms improve."
B. "You should take an extra dose today to eliminate withdrawal
symptoms."
,C. "Alprazolam should be tapered gradually under provider
supervision."
D. "Withdrawal symptoms indicate the medication is
ineffective."
Correct Answer
Correct Answer: C. "Alprazolam should be tapered gradually
under provider supervision."
Detailed Rationale
Alprazolam is a benzodiazepine that enhances the inhibitory
effects of GABA in the central nervous system. Long-term use
can lead to physical dependence. Abrupt discontinuation may
result in withdrawal manifestations including anxiety, tremors,
insomnia, agitation, tachycardia, and, in severe cases, seizures.
Therefore, gradual tapering under provider supervision is the
safest approach.
Option A is incorrect because abrupt discontinuation increases
the risk of serious withdrawal symptoms. Option B is incorrect
because clients should never independently adjust
benzodiazepine dosages. Increasing the dose may worsen
dependence and does not address the need for a structured
taper. Option D is incorrect because withdrawal symptoms
reflect physiological dependence, not treatment failure.
,Nurses should educate clients about medication adherence,
avoiding abrupt cessation, and reporting withdrawal symptoms
promptly. Monitoring includes assessment of anxiety
symptoms, sedation level, respiratory status, and signs of
misuse or dependence.
Learning Objective
After completing this question, the learner should be able to:
• Recognize benzodiazepine withdrawal manifestations.
• Identify safe discontinuation practices for alprazolam.
• Educate clients regarding medication adherence.
• Prioritize prevention of withdrawal-related complications.
Medication Safety Focus
Medication administration
Question 2
Clinical Scenario
A 74-year-old male client with Parkinson disease is prescribed
carbidopa/levodopa. The nurse is reviewing home medications
and dietary habits. The client reports taking the medication
with a high-protein breakfast every morning.
Question Stem
, Which teaching should the nurse provide?
Options
A. High-protein meals may decrease levodopa effectiveness.
B. Protein enhances absorption of levodopa.
C. Protein prevents orthostatic hypotension.
D. Levodopa should always be taken with dairy products.
Correct Answer
Correct Answer: A. High-protein meals may decrease levodopa
effectiveness.
Detailed Rationale
Levodopa crosses the blood-brain barrier and is converted to
dopamine in the CNS. Dietary protein competes with levodopa
for transport across the intestinal wall and blood-brain barrier,
potentially reducing therapeutic effectiveness. Clients may
experience worsening tremors, rigidity, and bradykinesia when
levodopa absorption is impaired.
Option B is incorrect because protein decreases—not
increases—availability of levodopa. Option C is incorrect
because dietary protein does not prevent orthostatic
hypotension, a common adverse effect of dopaminergic
therapy. Option D is incorrect because dairy products contain
protein and may contribute to reduced absorption.
