WGU D116 ADVANCED PHARMACOLOGY
OA & PRE-ASSESSMENT EXAM STUDY
GUIDE, PRACTICE QUESTIONS & ANSWERS
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,A 30-year-old patient presents to a primary care clinic with a YES Influences receptor activity on target cells
history of anxiety. The advanced practice registered nurse
reviews the mechanism of action by which many Correct! This medication influences the activity in the receptors, and it targets cells.
neuropharmacological agents act and decides to prescribe
citalopram.
What is the mechanism of action of this medication?
A patient is admitted with a diagnosis of Huntington disease. NO Modulates the effects of glutamate at NMDA receptors
On admission, the patient exhibits uncontrolled twitching, YES Inhibits neurotransmitter GABA
difficulty walking, trouble swallowing, confusion, and memory NO Halts the breakdown of acetylcholine by acetylcholinesterase
loss. The advanced practice registered nurse (APRN) Alters the synthesis and release of norepinephrine, serotonin, and dopamine
prescribes baclofen. Incorrect. Cholinesterase inhibitors prevent the breakdown of acetylcholine by
What is the mechanism of action of this medication? acetylcholinesterase. They are used in patients with Alzheimer's.
Correct! Huntington's disease involves a deficiency of the neurotransmitters acetylcholine
and y-aminobutyric acid in the basal ganglia and extrapyramidal system.
A 21-year-old patient accompanied by a parent comes to a Atonic
clinic for an emergency visit with an advanced practice NO Myoclonic
registered nurse (APRN) following a seizure. Upon YES Tonic-clonic
interviewing the patient and the parent, the APRN determines Absence
that the seizure is classified by marked impairment of Incorrect. Myoclonic seizures consist of a sudden muscle contraction that lasts for just
consciousness and is followed by a period of central nervous one second.
system (CNS) depression. Correct! A tonic-clonic seizure is a type of seizure that is also called a convulsion. This
Which type of seizure is this patient experiencing? type of seizure can include muscle stiffness, loss of consciousness, and body jerking.
A patient has been taking oral oxycodone every six hours for YES Physical dependence
back pain during the past three years. The patient suddenly Correct! The patient suddenly stopping the medication will cause physical symptoms that
decides to stop taking the pain medication and is trying an can range from nausea to seizures.
alternative therapy without a clinician's approval.
Which risk is of clinical concern?
An advanced practice registered nurse has diagnosed a 44- YES Bupropion
year-old male with depression. A plan is developed to start
treatment with medication. The patient has a history of sexual Correct! Bupropion does not cause sexual dysfunction. This will help the patient with a
dysfunction and is concerned about taking medication that history of sexual dysfunction. This will enhance the patient's libido, which will help with
may worsen this condition. both depression and sexual dysfunction.
Which antidepressant has the benefit of enhancing libido?
,A patient is wheezing and short of breath. The nurse assesses YES Tachycardia
a heart rate of 88 beats per minute, a respiratory rate of 24
breaths per minute, and a blood pressure of 124/78 mm Hg. Correct! Beta-agonists are used for asthma because of their beta2 effects on bronchial
The prescriber orders a nonspecific beta-agonist medication. smooth muscle, causing dilation. Beta1 effects cause tachycardia and hypertension. Beta
Besides evaluating the patient for a reduction in respiratory receptors do not exert effects on the bladder.
distress, the nurse should monitor for which side effect?
A patient is experiencing toxic side effects from atropine, YES Physostigmine
including delirium and hallucinations. Which medication
should the provider administer? Correct! Physostigmine is the drug of choice for treating poisoning from atropine and
other drugs that cause muscarinic blockade. Donepezil is used to treat Alzheimer
disease. Edrophonium is used to distinguish between a myasthenic crisis and a
cholinesterase inhibitor overdose. Neostigmine does not cross the blood-brain barrier
and would not effectively treat this patient's central nervous system (CNS) symptoms.
A patient brought to the emergency department requires allow a reduced dose of the anesthetic
sutures. The prescriber orders a local anesthetic with
epinephrine. Correct! Epinephrine prolongs absorption of the anesthetic because it is an alpha1
The epinephrine is ordered to ___________. agonist. It is frequently combined with a local anesthetic for this purpose so the amount
of anesthetic required may be reduced. Local anesthetics do not induce hypertension;
therefore, epinephrine would not be needed to prevent it. Epinephrine does not act as an
antiemetic and would not reduce anesthetic-induced nausea. Epinephrine is not used to
reduce the pain of an injection.
A patient has been diagnosed with Parkinson disease (PD) and Increase the dose of carbidopa
begins treatment with carbidopa. After several months of Discuss the "on-off" phenomenon
therapy, the patient reports no change in symptoms. Reevaluate the diagnosis
As the provider, you should do which of the following? NO Add a dopamine agonist
Incorrect. Adding a dopamine agonist is not indicated.
A patient who is taking oral contraceptives begins taking YES Ask the patient if she is taking the valproic acid with food because taking the drug on
valproic acid for seizures. After a week of therapy with an empty stomach can cause gastrointestinal side effects
valproic acid, the patient tells the nurse that she is
experiencing nausea. Correct! Gastrointestinal effects, including nausea, vomiting, and indigestion, are
What should the nurse do? common with valproic acid and can be minimized by taking the drug with food or using
an enteric-coated product. Hyperammonemia can occur when valproic acid is combined
with topiramate. Signs of pregnancy usually do not occur within a week, so this is less
likely. Hepatotoxicity is a rare adverse effect.
, A patient with cerebral palsy who has been receiving baclofen YES Missed doses of baclofen
via gastrostomy tube for three months is admitted to the
hospital for evaluation of new-onset seizures. Correct! Baclofen does not appear to cause physical dependence, but abrupt
What might you suspect to be the cause of these seizures? discontinuation has been associated with adverse reactions. Abrupt withdrawal of oral
baclofen can cause visual hallucinations, paranoid ideation, and seizures and should be
considered when a patient develops these symptoms. Seizures are not a symptom of
baclofen toxicity.
A nurse is preparing a patient to go home from the YES Nervousness and tachycardia
emergency department after receiving sutures for a laceration Correct! Absorption of the vasoconstrictor can cause systemic effects, including
on one hand. The provider used lidocaine with epinephrine as nervousness and tachycardia. If severe, alpha- and beta-adrenergic antagonists can be
a local anesthetic. given. Local anesthetics are nonselective modifiers of neuronal function and can block
Which symptom in this patient causes the most concern? motor neurons, so it is expected that patients may have difficulty with movement. The
sensation of pressure also is affected and is an expected effect. As the local anesthetic
wears off, the sensation of pain will return.
A patient who has recurrent migraine headaches is prescribed Coronary artery disease
sumatriptan. Which aspect of this patient's history is of Adverse events include coronary vasospasm.
concern when taking this drug? Incorrect. There is no contraindication for asthma, diabetes, or renal disease.
A patient who has been taking a monoamine oxidase inhibitor YES "Stop taking the MAOI two weeks before starting the SSRI."
(MAOI) for depression for several months tells the provider
that the medication has not helped with symptoms. You plan Correct! MAOIs increase serotonin receptor (5-HT) availability, thus greatly increasing
to switch the patient to an SSRI. the risk of serotonin syndrome. MAOIs should be withdrawn at least 14 days before an
What should you instruct the nurse to teach this patient? SSRI is started. An SSRI should never be given at the same time as an MAOI. It is not
necessary to wait five weeks before starting an SSRI.
A patient is admitted to a hospital for treatment for first-time YES Lithium
symptoms of mania and is exhibiting euphoric mania. Correct! In almost all cases of mania, divalproex sodium is the drug of choice, except for
Which medication should you order? euphoric mania symptoms. Lithium is used to treat euphoric mania. Olanzapine and
risperidone are used to treat other symptoms that are associated with borderline
personality disorder (BPD).
OA & PRE-ASSESSMENT EXAM STUDY
GUIDE, PRACTICE QUESTIONS & ANSWERS
| NEWEST EXAM REVIEW MATERIALS
| GRADED A+ | GUARANTEED SUCCESS
UPDATED QUESTIONS AND ANSWERS
100% VERIFIED EXAM PREP
[EXAM• STUDY GUIDE • SUMMARY • ASSIGNMENT]
A clean, organized resource designed for easy revision and reference.
QUICK • CLEAR • PROFESSIONAL
,A 30-year-old patient presents to a primary care clinic with a YES Influences receptor activity on target cells
history of anxiety. The advanced practice registered nurse
reviews the mechanism of action by which many Correct! This medication influences the activity in the receptors, and it targets cells.
neuropharmacological agents act and decides to prescribe
citalopram.
What is the mechanism of action of this medication?
A patient is admitted with a diagnosis of Huntington disease. NO Modulates the effects of glutamate at NMDA receptors
On admission, the patient exhibits uncontrolled twitching, YES Inhibits neurotransmitter GABA
difficulty walking, trouble swallowing, confusion, and memory NO Halts the breakdown of acetylcholine by acetylcholinesterase
loss. The advanced practice registered nurse (APRN) Alters the synthesis and release of norepinephrine, serotonin, and dopamine
prescribes baclofen. Incorrect. Cholinesterase inhibitors prevent the breakdown of acetylcholine by
What is the mechanism of action of this medication? acetylcholinesterase. They are used in patients with Alzheimer's.
Correct! Huntington's disease involves a deficiency of the neurotransmitters acetylcholine
and y-aminobutyric acid in the basal ganglia and extrapyramidal system.
A 21-year-old patient accompanied by a parent comes to a Atonic
clinic for an emergency visit with an advanced practice NO Myoclonic
registered nurse (APRN) following a seizure. Upon YES Tonic-clonic
interviewing the patient and the parent, the APRN determines Absence
that the seizure is classified by marked impairment of Incorrect. Myoclonic seizures consist of a sudden muscle contraction that lasts for just
consciousness and is followed by a period of central nervous one second.
system (CNS) depression. Correct! A tonic-clonic seizure is a type of seizure that is also called a convulsion. This
Which type of seizure is this patient experiencing? type of seizure can include muscle stiffness, loss of consciousness, and body jerking.
A patient has been taking oral oxycodone every six hours for YES Physical dependence
back pain during the past three years. The patient suddenly Correct! The patient suddenly stopping the medication will cause physical symptoms that
decides to stop taking the pain medication and is trying an can range from nausea to seizures.
alternative therapy without a clinician's approval.
Which risk is of clinical concern?
An advanced practice registered nurse has diagnosed a 44- YES Bupropion
year-old male with depression. A plan is developed to start
treatment with medication. The patient has a history of sexual Correct! Bupropion does not cause sexual dysfunction. This will help the patient with a
dysfunction and is concerned about taking medication that history of sexual dysfunction. This will enhance the patient's libido, which will help with
may worsen this condition. both depression and sexual dysfunction.
Which antidepressant has the benefit of enhancing libido?
,A patient is wheezing and short of breath. The nurse assesses YES Tachycardia
a heart rate of 88 beats per minute, a respiratory rate of 24
breaths per minute, and a blood pressure of 124/78 mm Hg. Correct! Beta-agonists are used for asthma because of their beta2 effects on bronchial
The prescriber orders a nonspecific beta-agonist medication. smooth muscle, causing dilation. Beta1 effects cause tachycardia and hypertension. Beta
Besides evaluating the patient for a reduction in respiratory receptors do not exert effects on the bladder.
distress, the nurse should monitor for which side effect?
A patient is experiencing toxic side effects from atropine, YES Physostigmine
including delirium and hallucinations. Which medication
should the provider administer? Correct! Physostigmine is the drug of choice for treating poisoning from atropine and
other drugs that cause muscarinic blockade. Donepezil is used to treat Alzheimer
disease. Edrophonium is used to distinguish between a myasthenic crisis and a
cholinesterase inhibitor overdose. Neostigmine does not cross the blood-brain barrier
and would not effectively treat this patient's central nervous system (CNS) symptoms.
A patient brought to the emergency department requires allow a reduced dose of the anesthetic
sutures. The prescriber orders a local anesthetic with
epinephrine. Correct! Epinephrine prolongs absorption of the anesthetic because it is an alpha1
The epinephrine is ordered to ___________. agonist. It is frequently combined with a local anesthetic for this purpose so the amount
of anesthetic required may be reduced. Local anesthetics do not induce hypertension;
therefore, epinephrine would not be needed to prevent it. Epinephrine does not act as an
antiemetic and would not reduce anesthetic-induced nausea. Epinephrine is not used to
reduce the pain of an injection.
A patient has been diagnosed with Parkinson disease (PD) and Increase the dose of carbidopa
begins treatment with carbidopa. After several months of Discuss the "on-off" phenomenon
therapy, the patient reports no change in symptoms. Reevaluate the diagnosis
As the provider, you should do which of the following? NO Add a dopamine agonist
Incorrect. Adding a dopamine agonist is not indicated.
A patient who is taking oral contraceptives begins taking YES Ask the patient if she is taking the valproic acid with food because taking the drug on
valproic acid for seizures. After a week of therapy with an empty stomach can cause gastrointestinal side effects
valproic acid, the patient tells the nurse that she is
experiencing nausea. Correct! Gastrointestinal effects, including nausea, vomiting, and indigestion, are
What should the nurse do? common with valproic acid and can be minimized by taking the drug with food or using
an enteric-coated product. Hyperammonemia can occur when valproic acid is combined
with topiramate. Signs of pregnancy usually do not occur within a week, so this is less
likely. Hepatotoxicity is a rare adverse effect.
, A patient with cerebral palsy who has been receiving baclofen YES Missed doses of baclofen
via gastrostomy tube for three months is admitted to the
hospital for evaluation of new-onset seizures. Correct! Baclofen does not appear to cause physical dependence, but abrupt
What might you suspect to be the cause of these seizures? discontinuation has been associated with adverse reactions. Abrupt withdrawal of oral
baclofen can cause visual hallucinations, paranoid ideation, and seizures and should be
considered when a patient develops these symptoms. Seizures are not a symptom of
baclofen toxicity.
A nurse is preparing a patient to go home from the YES Nervousness and tachycardia
emergency department after receiving sutures for a laceration Correct! Absorption of the vasoconstrictor can cause systemic effects, including
on one hand. The provider used lidocaine with epinephrine as nervousness and tachycardia. If severe, alpha- and beta-adrenergic antagonists can be
a local anesthetic. given. Local anesthetics are nonselective modifiers of neuronal function and can block
Which symptom in this patient causes the most concern? motor neurons, so it is expected that patients may have difficulty with movement. The
sensation of pressure also is affected and is an expected effect. As the local anesthetic
wears off, the sensation of pain will return.
A patient who has recurrent migraine headaches is prescribed Coronary artery disease
sumatriptan. Which aspect of this patient's history is of Adverse events include coronary vasospasm.
concern when taking this drug? Incorrect. There is no contraindication for asthma, diabetes, or renal disease.
A patient who has been taking a monoamine oxidase inhibitor YES "Stop taking the MAOI two weeks before starting the SSRI."
(MAOI) for depression for several months tells the provider
that the medication has not helped with symptoms. You plan Correct! MAOIs increase serotonin receptor (5-HT) availability, thus greatly increasing
to switch the patient to an SSRI. the risk of serotonin syndrome. MAOIs should be withdrawn at least 14 days before an
What should you instruct the nurse to teach this patient? SSRI is started. An SSRI should never be given at the same time as an MAOI. It is not
necessary to wait five weeks before starting an SSRI.
A patient is admitted to a hospital for treatment for first-time YES Lithium
symptoms of mania and is exhibiting euphoric mania. Correct! In almost all cases of mania, divalproex sodium is the drug of choice, except for
Which medication should you order? euphoric mania symptoms. Lithium is used to treat euphoric mania. Olanzapine and
risperidone are used to treat other symptoms that are associated with borderline
personality disorder (BPD).
