NCLEX-RN Neurological System Part 2
Pharmacology Practice Questions |
20 Original NGN & ATI-Style MCQs with
Rationales
Question 1
Clinical Scenario
A 78-year-old female with mild Alzheimer’s disease is newly
prescribed donepezil. Her daughter, who is the primary
caregiver, is receiving discharge teaching regarding the
medication.
Question Stem
Which statement by the client's caregiver indicates
understanding of the medication teaching?
A. "I will administer this medication on an empty stomach for
best absorption."
B. "I should report any episodes of dizziness, fainting, or a slow
pulse."
C. "This medication will reverse the cognitive decline associated
with Alzheimer's disease within a few months."
,D. "I will discontinue the medication immediately if she
experiences mild nausea."
Correct Answer
B. "I should report any episodes of dizziness, fainting, or a slow
pulse."
Detailed Rationale
Donepezil is a reversible acetylcholinesterase inhibitor used to
manage symptoms of Alzheimer’s disease. By increasing
acetylcholine levels, it can cause parasympathetic (cholinergic)
adverse effects, most notably bradycardia and syncope. The
caregiver must be taught to monitor for and report dizziness,
fainting, or a slow heart rate, as these can lead to falls or
cardiovascular compromise. Option A is incorrect because
donepezil should be taken with food to minimize common
gastrointestinal side effects like nausea and diarrhea. Option C
is incorrect because cholinesterase inhibitors do not cure or
reverse Alzheimer’s disease; they only modestly slow symptom
progression. Option D is incorrect because mild nausea is a
common, often transient side effect that can be managed by
taking the medication with food; abrupt discontinuation should
only occur under a provider's guidance.
Learning Objective
After completing this question, the learner should be able to:
• Identify the primary cardiovascular adverse effects of
,cholinesterase inhibitors.
• Educate caregivers on safe administration and monitoring
parameters for donepezil.
• Differentiate between expected, manageable side effects and
those requiring immediate provider notification.
Medication Safety Focus
Adverse effect monitoring and fall prevention.
Question 2
Clinical Scenario
A 32-year-old male with relapsing-remitting multiple sclerosis
(MS) is prescribed subcutaneous interferon beta-1a. He
expresses concern about how he will tolerate the injections at
home.
Question Stem
Which nursing intervention is most appropriate to manage the
expected adverse effects of this medication?
A. Administer the injection on an empty stomach to enhance
systemic absorption.
B. Advise the client to avoid all sun exposure while on this
therapy.
C. Instruct the client to take acetaminophen or ibuprofen prior
to injection.
, D. Monitor the client for hypertensive crisis within the first hour
post-injection.
Correct Answer
C. Instruct the client to take acetaminophen or ibuprofen prior
to injection.
Detailed Rationale
Interferon beta-1a commonly causes flu-like symptoms,
including fever, chills, myalgia, fatigue, and headache, especially
during the initial weeks of therapy. Pre-medicating with an
antipyretic/analgesic (e.g., acetaminophen or ibuprofen) and
administering the injection at bedtime are evidence-based
strategies to minimize these expected adverse effects and
improve adherence. Option A is incorrect because food intake
does not significantly affect subcutaneous interferon
absorption. Option B is incorrect; while mild photosensitivity
can occur, absolute sun avoidance is not required, and flu-like
symptoms are the primary expected adverse effect to manage.
Option D is incorrect because interferon beta is not associated
with hypertensive crises; hypotension or no significant blood
pressure change is more typical.
Learning Objective
After completing this question, the learner should be able to:
• Recognize the expected flu-like adverse effects of interferon
beta therapy.
Pharmacology Practice Questions |
20 Original NGN & ATI-Style MCQs with
Rationales
Question 1
Clinical Scenario
A 78-year-old female with mild Alzheimer’s disease is newly
prescribed donepezil. Her daughter, who is the primary
caregiver, is receiving discharge teaching regarding the
medication.
Question Stem
Which statement by the client's caregiver indicates
understanding of the medication teaching?
A. "I will administer this medication on an empty stomach for
best absorption."
B. "I should report any episodes of dizziness, fainting, or a slow
pulse."
C. "This medication will reverse the cognitive decline associated
with Alzheimer's disease within a few months."
,D. "I will discontinue the medication immediately if she
experiences mild nausea."
Correct Answer
B. "I should report any episodes of dizziness, fainting, or a slow
pulse."
Detailed Rationale
Donepezil is a reversible acetylcholinesterase inhibitor used to
manage symptoms of Alzheimer’s disease. By increasing
acetylcholine levels, it can cause parasympathetic (cholinergic)
adverse effects, most notably bradycardia and syncope. The
caregiver must be taught to monitor for and report dizziness,
fainting, or a slow heart rate, as these can lead to falls or
cardiovascular compromise. Option A is incorrect because
donepezil should be taken with food to minimize common
gastrointestinal side effects like nausea and diarrhea. Option C
is incorrect because cholinesterase inhibitors do not cure or
reverse Alzheimer’s disease; they only modestly slow symptom
progression. Option D is incorrect because mild nausea is a
common, often transient side effect that can be managed by
taking the medication with food; abrupt discontinuation should
only occur under a provider's guidance.
Learning Objective
After completing this question, the learner should be able to:
• Identify the primary cardiovascular adverse effects of
,cholinesterase inhibitors.
• Educate caregivers on safe administration and monitoring
parameters for donepezil.
• Differentiate between expected, manageable side effects and
those requiring immediate provider notification.
Medication Safety Focus
Adverse effect monitoring and fall prevention.
Question 2
Clinical Scenario
A 32-year-old male with relapsing-remitting multiple sclerosis
(MS) is prescribed subcutaneous interferon beta-1a. He
expresses concern about how he will tolerate the injections at
home.
Question Stem
Which nursing intervention is most appropriate to manage the
expected adverse effects of this medication?
A. Administer the injection on an empty stomach to enhance
systemic absorption.
B. Advise the client to avoid all sun exposure while on this
therapy.
C. Instruct the client to take acetaminophen or ibuprofen prior
to injection.
, D. Monitor the client for hypertensive crisis within the first hour
post-injection.
Correct Answer
C. Instruct the client to take acetaminophen or ibuprofen prior
to injection.
Detailed Rationale
Interferon beta-1a commonly causes flu-like symptoms,
including fever, chills, myalgia, fatigue, and headache, especially
during the initial weeks of therapy. Pre-medicating with an
antipyretic/analgesic (e.g., acetaminophen or ibuprofen) and
administering the injection at bedtime are evidence-based
strategies to minimize these expected adverse effects and
improve adherence. Option A is incorrect because food intake
does not significantly affect subcutaneous interferon
absorption. Option B is incorrect; while mild photosensitivity
can occur, absolute sun avoidance is not required, and flu-like
symptoms are the primary expected adverse effect to manage.
Option D is incorrect because interferon beta is not associated
with hypertensive crises; hypotension or no significant blood
pressure change is more typical.
Learning Objective
After completing this question, the learner should be able to:
• Recognize the expected flu-like adverse effects of interferon
beta therapy.
