BSN Advanced Pharmacology | Exam 6 Practice Questions With
Answers and detailed Rationales
Question 1.
A patient receiving lithium carbonate for bipolar disorder presents with a lithium level of
2.1 mEq/L. Which clinical manifestation is most likely?
A. Mild thirst and polyuria
B. Fine hand tremors and nausea
C. Confusion, ataxia, and blurred vision
D. Hyperactivity and increased appetite
Correct Answer: C. Confusion, ataxia, and blurred vision
Explanation: A lithium level of 2.1 mEq/L indicates moderate to severe toxicity.
Symptoms include neurological changes like ataxia, confusion, and blurred vision, as well
as persistent GI distress.
Question 2.
A patient is started on fluoxetine (Prozac). Which symptom should the nurse instruct the
patient to report immediately as a potential sign of Serotonin Syndrome?
A. Dry mouth and constipation
B. Fever, agitation, and hyperreflexia
C. Weight gain and drowsiness
D. Decreased libido and sexual dysfunction
Correct Answer: B. Fever, agitation, and hyperreflexia
Explanation: Serotonin syndrome is a potentially life-threatening condition characterized
by mental status changes (agitation), autonomic hyperactivity (fever), and neuromuscular
abnormalities (hyperreflexia).
Question 3.
When teaching a patient about Monoamine Oxidase Inhibitors (MAOIs), which food should
the nurse advise the patient to avoid?
A. Fresh green leafy vegetables
B. Citrus fruits and juices
C. Pasteurized milk and yogurt
D. Aged cheeses and cured meats
Correct Answer: D. Aged cheeses and cured meats
Explanation: Foods high in tyramine, such as aged cheeses, cured meats, and fermented
products, can cause a hypertensive crisis when consumed by a patient taking MAOIs.
,Question 4.
A patient is brought to the emergency department with a suspected benzodiazepine
overdose. Which medication should the nurse anticipate administering?
A. Naloxone
B. Flumazenil
C. Physostigmine
D. Acetylcysteine
Correct Answer: B. Flumazenil
Explanation: Flumazenil is the specific competitive benzodiazepine receptor antagonist
used to reverse the sedative effects of benzodiazepines.
Question 5.
A patient taking haloperidol develops high fever, muscle rigidity, and autonomic instability.
Which condition does the nurse suspect?
A. Extrapyramidal symptoms (EPS)
B. Neuroleptic Malignant Syndrome (NMS)
C. Acute dystonic reaction
D. Tardive dyskinesia
Correct Answer: B. Neuroleptic Malignant Syndrome (NMS)
Explanation: NMS is a rare but fatal reaction to antipsychotics characterized by
‘lead-pipe’ rigidity, high fever, and unstable blood pressure.
Question 6.
Following the administration of morphine IV, a patient’s respiratory rate drops to 6
breaths/minute. What is the nurse’s priority action?
A. Perform a vigorous sternal rub
B. Apply 100% oxygen via non-rebreather mask
C. Administer naloxone (Narcan) IV
D. Call for a STAT chest X-ray
Correct Answer: C. Administer naloxone (Narcan) IV
Explanation: Severe respiratory depression (RR < 8) following opioid administration is a
medical emergency that requires the opioid antagonist naloxone.
, Question 7.
Which teaching point is most important for a patient prescribed celecoxib (Celebrex) for
osteoarthritis?
A. This drug will turn urine an orange-red color.
B. Report any black, tarry stools immediately.
C. Avoid taking aspirin while on this medication.
D. Take the medication on an empty stomach for better absorption.
Correct Answer: B. Report any black, tarry stools immediately.
Explanation: While celecoxib is a COX-2 inhibitor with lower GI risk than traditional
NSAIDs, it still carries a risk for GI bleeding, which manifest as black, tarry stools.
Question 8.
A patient is experiencing an acute gout attack. Which medication is most appropriate for
rapid relief of inflammation?
A. Allopurinol
B. Colchicine
C. Febuxostat
D. Probenecid
Correct Answer: B. Colchicine
Explanation: Colchicine is the anti-inflammatory drug of choice for acute gout flares,
whereas allopurinol and probenecid are for long-term prevention.
Question 9.
A patient on long-term corticosteroid therapy should be monitored for which electrolyte
imbalance?
A. Hypercalcemia
B. Hypokalemia
C. Hyponatremia
D. Hypoglycemia
Correct Answer: B. Hypokalemia
Explanation: Glucocorticoids have mineralocorticoid activity that can lead to sodium
retention and potassium excretion (hypokalemia).
Answers and detailed Rationales
Question 1.
A patient receiving lithium carbonate for bipolar disorder presents with a lithium level of
2.1 mEq/L. Which clinical manifestation is most likely?
A. Mild thirst and polyuria
B. Fine hand tremors and nausea
C. Confusion, ataxia, and blurred vision
D. Hyperactivity and increased appetite
Correct Answer: C. Confusion, ataxia, and blurred vision
Explanation: A lithium level of 2.1 mEq/L indicates moderate to severe toxicity.
Symptoms include neurological changes like ataxia, confusion, and blurred vision, as well
as persistent GI distress.
Question 2.
A patient is started on fluoxetine (Prozac). Which symptom should the nurse instruct the
patient to report immediately as a potential sign of Serotonin Syndrome?
A. Dry mouth and constipation
B. Fever, agitation, and hyperreflexia
C. Weight gain and drowsiness
D. Decreased libido and sexual dysfunction
Correct Answer: B. Fever, agitation, and hyperreflexia
Explanation: Serotonin syndrome is a potentially life-threatening condition characterized
by mental status changes (agitation), autonomic hyperactivity (fever), and neuromuscular
abnormalities (hyperreflexia).
Question 3.
When teaching a patient about Monoamine Oxidase Inhibitors (MAOIs), which food should
the nurse advise the patient to avoid?
A. Fresh green leafy vegetables
B. Citrus fruits and juices
C. Pasteurized milk and yogurt
D. Aged cheeses and cured meats
Correct Answer: D. Aged cheeses and cured meats
Explanation: Foods high in tyramine, such as aged cheeses, cured meats, and fermented
products, can cause a hypertensive crisis when consumed by a patient taking MAOIs.
,Question 4.
A patient is brought to the emergency department with a suspected benzodiazepine
overdose. Which medication should the nurse anticipate administering?
A. Naloxone
B. Flumazenil
C. Physostigmine
D. Acetylcysteine
Correct Answer: B. Flumazenil
Explanation: Flumazenil is the specific competitive benzodiazepine receptor antagonist
used to reverse the sedative effects of benzodiazepines.
Question 5.
A patient taking haloperidol develops high fever, muscle rigidity, and autonomic instability.
Which condition does the nurse suspect?
A. Extrapyramidal symptoms (EPS)
B. Neuroleptic Malignant Syndrome (NMS)
C. Acute dystonic reaction
D. Tardive dyskinesia
Correct Answer: B. Neuroleptic Malignant Syndrome (NMS)
Explanation: NMS is a rare but fatal reaction to antipsychotics characterized by
‘lead-pipe’ rigidity, high fever, and unstable blood pressure.
Question 6.
Following the administration of morphine IV, a patient’s respiratory rate drops to 6
breaths/minute. What is the nurse’s priority action?
A. Perform a vigorous sternal rub
B. Apply 100% oxygen via non-rebreather mask
C. Administer naloxone (Narcan) IV
D. Call for a STAT chest X-ray
Correct Answer: C. Administer naloxone (Narcan) IV
Explanation: Severe respiratory depression (RR < 8) following opioid administration is a
medical emergency that requires the opioid antagonist naloxone.
, Question 7.
Which teaching point is most important for a patient prescribed celecoxib (Celebrex) for
osteoarthritis?
A. This drug will turn urine an orange-red color.
B. Report any black, tarry stools immediately.
C. Avoid taking aspirin while on this medication.
D. Take the medication on an empty stomach for better absorption.
Correct Answer: B. Report any black, tarry stools immediately.
Explanation: While celecoxib is a COX-2 inhibitor with lower GI risk than traditional
NSAIDs, it still carries a risk for GI bleeding, which manifest as black, tarry stools.
Question 8.
A patient is experiencing an acute gout attack. Which medication is most appropriate for
rapid relief of inflammation?
A. Allopurinol
B. Colchicine
C. Febuxostat
D. Probenecid
Correct Answer: B. Colchicine
Explanation: Colchicine is the anti-inflammatory drug of choice for acute gout flares,
whereas allopurinol and probenecid are for long-term prevention.
Question 9.
A patient on long-term corticosteroid therapy should be monitored for which electrolyte
imbalance?
A. Hypercalcemia
B. Hypokalemia
C. Hyponatremia
D. Hypoglycemia
Correct Answer: B. Hypokalemia
Explanation: Glucocorticoids have mineralocorticoid activity that can lead to sodium
retention and potassium excretion (hypokalemia).
