NCLEX-RN Pharmacology Neurological System Part
2 Exam Questions with Detailed Rationales |
20 Original NGN Practice MCQs |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 78-year-old male is diagnosed with mild to moderate
Alzheimer’s disease. The healthcare provider prescribes
donepezil 5 mg orally once daily. The nurse is providing
discharge teaching to the patient and his daughter, who is the
primary caregiver.
Question Stem
Which statement by the daughter indicates an understanding of
the teaching regarding donepezil administration?
A. "I will give this medication with breakfast to prevent stomach
upset." B. "I should administer this medication at bedtime to
minimize daytime drowsiness." C. "I will crush the tablet and
mix it with applesauce if he has trouble swallowing." D. "I
,should expect his memory to completely return to normal
within two weeks."
Correct Answer: B. "I should administer this medication at
bedtime to minimize daytime drowsiness."
Detailed Rationale
Donepezil is a cholinesterase inhibitor used to treat mild to
moderate Alzheimer’s disease. It is typically administered at
bedtime to minimize common cholinergic side effects such as
drowsiness, dizziness, and gastrointestinal distress (nausea,
diarrhea). While it can be taken with or without food, bedtime
administration is preferred for tolerability. Option A is incorrect
because morning administration may exacerbate daytime
drowsiness and dizziness, increasing fall risk. Option C is
incorrect because standard tablets should not be crushed
without verifying specific formulation guidelines, and it does
not address the primary timing teaching point. Option D is
incorrect because donepezil does not cure Alzheimer’s disease
or restore memory completely; it only slows symptom
progression and may temporarily improve cognitive function.
The nurse must set realistic expectations for the caregiver
regarding the therapeutic goals of the medication.
Learning Objective
• Identify the optimal timing for administering
cholinesterase inhibitors to minimize adverse effects.
, • Educate caregivers on realistic therapeutic outcomes of
Alzheimer’s disease medications.
Medication Safety Focus
Patient education
====================================================
=
Question 2
Clinical Scenario
A 45-year-old female presents to the clinic with a severe,
unilateral, throbbing migraine headache accompanied by
nausea and photophobia. The provider prescribes sumatriptan
50 mg orally. The nurse is reviewing the patient’s medical
history before administering the first dose.
Question Stem
Which finding in the patient’s medical history is an absolute
contraindication to the administration of sumatriptan?
A. Seasonal allergic rhinitis B. Hypothyroidism C. Coronary
artery disease D. Osteoarthritis
Correct Answer: C. Coronary artery disease
Detailed Rationale
, Sumatriptan is a selective serotonin receptor agonist (triptan)
used for the acute treatment of migraine attacks. It works by
causing cranial vasoconstriction. Because of this mechanism, it
is absolutely contraindicated in patients with ischemic heart
disease, coronary artery vasospasm (Prinzmetal’s angina),
history of myocardial infarction, or uncontrolled hypertension,
as it can provoke coronary vasospasm and lead to myocardial
ischemia or infarction. Option A, seasonal allergic rhinitis, is not
a contraindication. Option B, hypothyroidism, does not preclude
the use of triptans. Option D, osteoarthritis, is also unrelated to
triptan contraindications. The nurse must thoroughly assess
cardiovascular history before administering any triptan
medication to ensure patient safety and prevent life-
threatening cardiac events.
Learning Objective
• Recognize absolute contraindications for triptan
medications.
• Understand the vasoconstrictive mechanism of action of
sumatriptan and its cardiovascular implications.
Medication Safety Focus
Contraindication
====================================================
=
2 Exam Questions with Detailed Rationales |
20 Original NGN Practice MCQs |
Nursing Pharmacology Study Guide
Question 1
Clinical Scenario
A 78-year-old male is diagnosed with mild to moderate
Alzheimer’s disease. The healthcare provider prescribes
donepezil 5 mg orally once daily. The nurse is providing
discharge teaching to the patient and his daughter, who is the
primary caregiver.
Question Stem
Which statement by the daughter indicates an understanding of
the teaching regarding donepezil administration?
A. "I will give this medication with breakfast to prevent stomach
upset." B. "I should administer this medication at bedtime to
minimize daytime drowsiness." C. "I will crush the tablet and
mix it with applesauce if he has trouble swallowing." D. "I
,should expect his memory to completely return to normal
within two weeks."
Correct Answer: B. "I should administer this medication at
bedtime to minimize daytime drowsiness."
Detailed Rationale
Donepezil is a cholinesterase inhibitor used to treat mild to
moderate Alzheimer’s disease. It is typically administered at
bedtime to minimize common cholinergic side effects such as
drowsiness, dizziness, and gastrointestinal distress (nausea,
diarrhea). While it can be taken with or without food, bedtime
administration is preferred for tolerability. Option A is incorrect
because morning administration may exacerbate daytime
drowsiness and dizziness, increasing fall risk. Option C is
incorrect because standard tablets should not be crushed
without verifying specific formulation guidelines, and it does
not address the primary timing teaching point. Option D is
incorrect because donepezil does not cure Alzheimer’s disease
or restore memory completely; it only slows symptom
progression and may temporarily improve cognitive function.
The nurse must set realistic expectations for the caregiver
regarding the therapeutic goals of the medication.
Learning Objective
• Identify the optimal timing for administering
cholinesterase inhibitors to minimize adverse effects.
, • Educate caregivers on realistic therapeutic outcomes of
Alzheimer’s disease medications.
Medication Safety Focus
Patient education
====================================================
=
Question 2
Clinical Scenario
A 45-year-old female presents to the clinic with a severe,
unilateral, throbbing migraine headache accompanied by
nausea and photophobia. The provider prescribes sumatriptan
50 mg orally. The nurse is reviewing the patient’s medical
history before administering the first dose.
Question Stem
Which finding in the patient’s medical history is an absolute
contraindication to the administration of sumatriptan?
A. Seasonal allergic rhinitis B. Hypothyroidism C. Coronary
artery disease D. Osteoarthritis
Correct Answer: C. Coronary artery disease
Detailed Rationale
, Sumatriptan is a selective serotonin receptor agonist (triptan)
used for the acute treatment of migraine attacks. It works by
causing cranial vasoconstriction. Because of this mechanism, it
is absolutely contraindicated in patients with ischemic heart
disease, coronary artery vasospasm (Prinzmetal’s angina),
history of myocardial infarction, or uncontrolled hypertension,
as it can provoke coronary vasospasm and lead to myocardial
ischemia or infarction. Option A, seasonal allergic rhinitis, is not
a contraindication. Option B, hypothyroidism, does not preclude
the use of triptans. Option D, osteoarthritis, is also unrelated to
triptan contraindications. The nurse must thoroughly assess
cardiovascular history before administering any triptan
medication to ensure patient safety and prevent life-
threatening cardiac events.
Learning Objective
• Recognize absolute contraindications for triptan
medications.
• Understand the vasoconstrictive mechanism of action of
sumatriptan and its cardiovascular implications.
Medication Safety Focus
Contraindication
====================================================
=
