BIO 290 Exam 3 Actual Exam V3 | BIO 290 Pharmacology (BIO290
Exam 3) | Joyce University
1. A patient is prescribed Omeprazole for the treatment of GERD. What is the primary
mechanism of action for this medication?
A. Neutralizing gastric acid already present in the stomach.
B. Blocking H2 receptors on parietal cells to reduce acid production.
C. Providing a protective barrier over the gastric mucosa.
D. Irreversibly inhibiting the H+/K+ ATPase enzyme system.
Answer: D
Rationale: Omeprazole is a proton pump inhibitor that works by irreversibly inhibiting the
H+/K+ ATPase enzyme system in the gastric parietal cells. This mechanism effectively
blocks the final step of acid production, leading to a significant increase in gastric pH. This
drug class is considered more potent than H2 receptor antagonists for long-term acid
suppression.
2. When administering Sucralfate to a patient with a duodenal ulcer, which timing is most
appropriate for the nurse to follow?
A. With meals to enhance absorption.
B. Only when the patient experiences epigastric pain.
C. Immediately following a dose of an antacid.
D. One hour before meals and at bedtime.
Answer: D
Rationale: Sucralfate requires an acidic environment to activate and form a protective
paste that adheres to the ulcer site. Administering it on an empty stomach, typically one
hour before meals, ensures the medication can coat the ulcer before food stimulates acid
production. Giving it with antacids or food would decrease its effectiveness by raising the
gastric pH or interfering with the coating process.
3. A patient taking Metoclopramide for diabetic gastroparesis reports involuntary movements
of the tongue and face. What is the nurse’s priority action?
A. Hold the medication and notify the healthcare provider immediately.
B. Administer the next dose as scheduled but monitor closely.
C. Reassure the patient that these are common side effects.
D. Suggest the patient take the medication with food to reduce symptoms.
,Answer: A
Rationale: Metoclopramide is a dopamine antagonist that can cause extrapyramidal
symptoms, including tardive dyskinesia, which may become irreversible. The nurse must
recognize these involuntary movements as a serious adverse reaction and stop the drug to
prevent further neurological damage. Healthcare providers should be notified to evaluate
the patient and consider alternative prokinetic therapies.
4. Which teaching point is essential for a patient starting Psyllium, a bulk-forming laxative?
A. Restricting fluid intake to prevent abdominal bloating.
B. Mixing the powder with at least 8 ounces of water and drinking it immediately.
C. Taking the medication only when stools are absent for three days.
D. Expecting a bowel movement within 30 minutes of administration.
Answer: B
Rationale: Psyllium works by absorbing water to increase the bulk of the stool, which
stimulates peristalsis. If taken without sufficient water, the powder can swell in the
esophagus and cause an obstruction or worsen constipation. Patients must be taught to
drink plenty of fluids throughout the day to ensure the safety and efficacy of bulk-forming
agents.
5. A patient is receiving Ondansetron for chemotherapy-induced nausea. Which electrolyte
abnormality or cardiac concern should the nurse monitor for?
A. Prolonged QT interval and potential dysrhythmias.
B. Hypocalcemia and shortened PR interval.
C. Hyperkalemia and bradycardia.
D. Hypernatremia and hypertension.
Answer: A
Rationale: Ondansetron is a 5-HT3 receptor antagonist that is generally well-tolerated but
carries a risk of prolonging the QT interval. This can lead to serious cardiac dysrhythmias,
such as Torsades de Pointes, especially in patients with existing heart conditions or
electrolyte imbalances. Nurses should perform baseline ECGs and monitor cardiac rhythm
in high-risk patients receiving this medication.
6. Why is Misoprostol contraindicated in a female patient who is pregnant?
A. It causes severe maternal hypertension.
B. It causes excessive maternal gastric acid secretion.
C. It is known to cause fetal renal failure in the first trimester.
D. It can induce uterine contractions and lead to miscarriage.
, Answer: D
Rationale: Misoprostol is a synthetic prostaglandin E1 analogue used to prevent NSAID-
induced ulcers, but it also stimulates uterine contractions. Because of its abortifacient
properties, it is classified as Pregnancy Category X and must not be used by pregnant
women. Female patients of childbearing age must have a negative pregnancy test before
starting therapy and use effective contraception.
7. A patient with hepatic encephalopathy is prescribed Lactulose. What is the desired
therapeutic outcome?
A. Reduction in ammonia levels through increased bowel movements.
B. Increase in serum potassium levels.
C. Prevention of gastric ulcers in high-stress environments.
D. Decreased frequency of loose stools.
Answer: A
Rationale: Lactulose works by drawing water into the colon and acidifying the
environment, which converts ammonia into ammonium. The ammonium is then trapped in
the gut and excreted through the stool, thereby lowering systemic ammonia levels.
Effectiveness is measured by the patient having 2 to 3 soft stools per day and improved
mental status.
8. Which medication is most appropriate for a patient requiring rapid-acting insulin to cover a
meal?
A. Insulin Lispro
B. Insulin Glargine
C. Insulin NPH
D. Regular Insulin
Answer: A
Rationale: Insulin Lispro is a rapid-acting insulin analog with an onset of action within 15
minutes. It is designed to be administered right before or after meals to manage
postprandial glucose spikes. Unlike long-acting insulins, rapid-acting versions have a
distinct peak and a short duration of action.
9. A patient is starting Metformin for Type 2 Diabetes. Which side effect is the nurse most
concerned about regarding the patient’s renal function?
A. Peripheral edema.
B. Urinary tract infections.
C. Hypoglycemia.
Exam 3) | Joyce University
1. A patient is prescribed Omeprazole for the treatment of GERD. What is the primary
mechanism of action for this medication?
A. Neutralizing gastric acid already present in the stomach.
B. Blocking H2 receptors on parietal cells to reduce acid production.
C. Providing a protective barrier over the gastric mucosa.
D. Irreversibly inhibiting the H+/K+ ATPase enzyme system.
Answer: D
Rationale: Omeprazole is a proton pump inhibitor that works by irreversibly inhibiting the
H+/K+ ATPase enzyme system in the gastric parietal cells. This mechanism effectively
blocks the final step of acid production, leading to a significant increase in gastric pH. This
drug class is considered more potent than H2 receptor antagonists for long-term acid
suppression.
2. When administering Sucralfate to a patient with a duodenal ulcer, which timing is most
appropriate for the nurse to follow?
A. With meals to enhance absorption.
B. Only when the patient experiences epigastric pain.
C. Immediately following a dose of an antacid.
D. One hour before meals and at bedtime.
Answer: D
Rationale: Sucralfate requires an acidic environment to activate and form a protective
paste that adheres to the ulcer site. Administering it on an empty stomach, typically one
hour before meals, ensures the medication can coat the ulcer before food stimulates acid
production. Giving it with antacids or food would decrease its effectiveness by raising the
gastric pH or interfering with the coating process.
3. A patient taking Metoclopramide for diabetic gastroparesis reports involuntary movements
of the tongue and face. What is the nurse’s priority action?
A. Hold the medication and notify the healthcare provider immediately.
B. Administer the next dose as scheduled but monitor closely.
C. Reassure the patient that these are common side effects.
D. Suggest the patient take the medication with food to reduce symptoms.
,Answer: A
Rationale: Metoclopramide is a dopamine antagonist that can cause extrapyramidal
symptoms, including tardive dyskinesia, which may become irreversible. The nurse must
recognize these involuntary movements as a serious adverse reaction and stop the drug to
prevent further neurological damage. Healthcare providers should be notified to evaluate
the patient and consider alternative prokinetic therapies.
4. Which teaching point is essential for a patient starting Psyllium, a bulk-forming laxative?
A. Restricting fluid intake to prevent abdominal bloating.
B. Mixing the powder with at least 8 ounces of water and drinking it immediately.
C. Taking the medication only when stools are absent for three days.
D. Expecting a bowel movement within 30 minutes of administration.
Answer: B
Rationale: Psyllium works by absorbing water to increase the bulk of the stool, which
stimulates peristalsis. If taken without sufficient water, the powder can swell in the
esophagus and cause an obstruction or worsen constipation. Patients must be taught to
drink plenty of fluids throughout the day to ensure the safety and efficacy of bulk-forming
agents.
5. A patient is receiving Ondansetron for chemotherapy-induced nausea. Which electrolyte
abnormality or cardiac concern should the nurse monitor for?
A. Prolonged QT interval and potential dysrhythmias.
B. Hypocalcemia and shortened PR interval.
C. Hyperkalemia and bradycardia.
D. Hypernatremia and hypertension.
Answer: A
Rationale: Ondansetron is a 5-HT3 receptor antagonist that is generally well-tolerated but
carries a risk of prolonging the QT interval. This can lead to serious cardiac dysrhythmias,
such as Torsades de Pointes, especially in patients with existing heart conditions or
electrolyte imbalances. Nurses should perform baseline ECGs and monitor cardiac rhythm
in high-risk patients receiving this medication.
6. Why is Misoprostol contraindicated in a female patient who is pregnant?
A. It causes severe maternal hypertension.
B. It causes excessive maternal gastric acid secretion.
C. It is known to cause fetal renal failure in the first trimester.
D. It can induce uterine contractions and lead to miscarriage.
, Answer: D
Rationale: Misoprostol is a synthetic prostaglandin E1 analogue used to prevent NSAID-
induced ulcers, but it also stimulates uterine contractions. Because of its abortifacient
properties, it is classified as Pregnancy Category X and must not be used by pregnant
women. Female patients of childbearing age must have a negative pregnancy test before
starting therapy and use effective contraception.
7. A patient with hepatic encephalopathy is prescribed Lactulose. What is the desired
therapeutic outcome?
A. Reduction in ammonia levels through increased bowel movements.
B. Increase in serum potassium levels.
C. Prevention of gastric ulcers in high-stress environments.
D. Decreased frequency of loose stools.
Answer: A
Rationale: Lactulose works by drawing water into the colon and acidifying the
environment, which converts ammonia into ammonium. The ammonium is then trapped in
the gut and excreted through the stool, thereby lowering systemic ammonia levels.
Effectiveness is measured by the patient having 2 to 3 soft stools per day and improved
mental status.
8. Which medication is most appropriate for a patient requiring rapid-acting insulin to cover a
meal?
A. Insulin Lispro
B. Insulin Glargine
C. Insulin NPH
D. Regular Insulin
Answer: A
Rationale: Insulin Lispro is a rapid-acting insulin analog with an onset of action within 15
minutes. It is designed to be administered right before or after meals to manage
postprandial glucose spikes. Unlike long-acting insulins, rapid-acting versions have a
distinct peak and a short duration of action.
9. A patient is starting Metformin for Type 2 Diabetes. Which side effect is the nurse most
concerned about regarding the patient’s renal function?
A. Peripheral edema.
B. Urinary tract infections.
C. Hypoglycemia.
