BIO 290 Exam 4 Actual Exam V1 | BIO 290 Pharmacology (BIO290
Exam 4) | Joyce University
1. A patient is prescribed gentamicin for a severe gram-negative infection. Which clinical
monitoring is the highest priority for this patient?
A. Monitoring of serum creatinine and urine output
B. Periodic assessment of visual acuity
C. Daily assessment of blood glucose levels
D. Observation for signs of hyperkalemia
Answer: A
Rationale: Gentamicin is an aminoglycoside known for significant nephrotoxicity and
ototoxicity risks. Monitoring serum creatinine and urine output is essential to detect early
signs of renal impairment. Unlike some other classes, aminoglycosides do not typically
affect blood glucose or potassium levels directly.
2. A nurse is preparing to administer vancomycin intravenously. What should the nurse do to
prevent ‘Red Man Syndrome’?
A. Infuse the medication slowly over at least 60 minutes
B. Dilute the medication in a small volume of 0.45% Saline
C. Administer the dose via rapid IV push over 2 minutes
D. Keep the patient in a supine position for 4 hours post-infusion
Answer: A
Rationale: Red Man Syndrome is a rate-dependent infusion reaction caused by the release
of histamine. To minimize this risk, vancomycin must be infused slowly, typically over 60
minutes or longer. Rapid administration can lead to severe hypotension and flushing of the
neck and face.
3. A patient taking tetracycline for acne expresses concern about side effects. Which teaching
point is most important for the nurse to include?
A. Expect your urine to turn a bright orange color
B. Take the medication with a full glass of milk
C. Avoid sun exposure and use high-SPF sunscreen
D. This medication is safe to take during the first trimester of pregnancy
Answer: C
,Rationale: Tetracyclines are known to cause significant photosensitivity, increasing the
risk of severe sunburn. Patients should also avoid dairy products during administration as
calcium interferes with absorption. Furthermore, tetracyclines are contraindicated in
pregnancy due to potential effects on fetal bone and tooth development.
4. A patient is receiving morphine sulfate via PCA pump. The nurse finds the patient lethargic
with a respiratory rate of 7 breaths per minute. Which medication should be administered?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Acetylcysteine
Answer: B
Rationale: Naloxone is the specific opioid antagonist used to reverse respiratory
depression caused by opioids like morphine. Flumazenil is used for benzodiazepine
reversal, while protamine sulfate is for heparin. Acetylcysteine is the antidote for
acetaminophen toxicity, not opioid overdose.
5. When teaching a patient about a new prescription for lithium carbonate, which dietary
instruction is critical?
A. Strictly limit sodium intake to less than 1 gram per day
B. Eliminate all caffeine-containing beverages
C. Maintain a consistent and adequate intake of sodium
D. Increase intake of green leafy vegetables high in Vitamin K
Answer: C
Rationale: Lithium is handled by the kidneys in a manner similar to sodium. If sodium
levels drop, the kidneys retain lithium, which can lead to toxic levels in the blood.
Therefore, maintaining a consistent sodium and fluid intake is vital for therapeutic stability
and safety.
6. A patient is prescribed phenelzine, an MAOI. The nurse instructs the patient to avoid which
of the following foods to prevent a hypertensive crisis?
A. Fresh apples and oranges
B. Whole grain breads and cereals
C. Aged cheeses and cured meats
D. Cooked white rice and steamed broccoli
Answer: C
, Rationale: Phenelzine inhibits the breakdown of tyramine in the body. Consumption of
tyramine-rich foods, such as aged cheeses, smoked meats, and red wine, can trigger a
massive release of norepinephrine. This results in a potentially fatal hypertensive crisis
characterized by extreme blood pressure elevation.
7. A nurse is caring for a patient receiving chemotherapy who has developed neutropenia.
Which nursing intervention is most appropriate?
A. Strictly implement handwashing and avoid large crowds
B. Encourage the patient to eat fresh salads and raw fruits
C. Administer aspirin for any low-grade fevers
D. Restrict all fluid intake to prevent edema
Answer: A
Rationale: Neutropenia significantly increases the risk of life-threatening infections
because the body lacks sufficient white blood cells to fight pathogens. Handwashing is the
single most effective way to prevent the spread of infection to the immunocompromised
patient. Fresh produce should generally be avoided because it may harbor bacteria or fungi
that the patient cannot fight off.
8. Which lab value must be monitored closely for a patient taking methotrexate for
rheumatoid arthritis?
A. Thyroid-stimulating hormone (TSH)
B. Serum calcium and magnesium levels
C. Complete Blood Count (CBC) and Liver Function Tests (LFTs)
D. Prothrombin Time (PT) and INR
Answer: C
Rationale: Methotrexate is a folate antagonist that can cause bone marrow suppression
and hepatotoxicity. Periodic CBCs are necessary to monitor for leukopenia, anemia, and
thrombocytopenia. LFT monitoring is required to detect early drug-induced liver injury or
fibrosis.
9. A patient is prescribed haloperidol for schizophrenia. The nurse notices the patient is
experiencing lip-smacking and tongue protrusion. How should the nurse document this
finding?
A. Akathisia
B. Pseudoparkinsonism
C. Neuroleptic Malignant Syndrome
D. Tardive Dyskinesia
Exam 4) | Joyce University
1. A patient is prescribed gentamicin for a severe gram-negative infection. Which clinical
monitoring is the highest priority for this patient?
A. Monitoring of serum creatinine and urine output
B. Periodic assessment of visual acuity
C. Daily assessment of blood glucose levels
D. Observation for signs of hyperkalemia
Answer: A
Rationale: Gentamicin is an aminoglycoside known for significant nephrotoxicity and
ototoxicity risks. Monitoring serum creatinine and urine output is essential to detect early
signs of renal impairment. Unlike some other classes, aminoglycosides do not typically
affect blood glucose or potassium levels directly.
2. A nurse is preparing to administer vancomycin intravenously. What should the nurse do to
prevent ‘Red Man Syndrome’?
A. Infuse the medication slowly over at least 60 minutes
B. Dilute the medication in a small volume of 0.45% Saline
C. Administer the dose via rapid IV push over 2 minutes
D. Keep the patient in a supine position for 4 hours post-infusion
Answer: A
Rationale: Red Man Syndrome is a rate-dependent infusion reaction caused by the release
of histamine. To minimize this risk, vancomycin must be infused slowly, typically over 60
minutes or longer. Rapid administration can lead to severe hypotension and flushing of the
neck and face.
3. A patient taking tetracycline for acne expresses concern about side effects. Which teaching
point is most important for the nurse to include?
A. Expect your urine to turn a bright orange color
B. Take the medication with a full glass of milk
C. Avoid sun exposure and use high-SPF sunscreen
D. This medication is safe to take during the first trimester of pregnancy
Answer: C
,Rationale: Tetracyclines are known to cause significant photosensitivity, increasing the
risk of severe sunburn. Patients should also avoid dairy products during administration as
calcium interferes with absorption. Furthermore, tetracyclines are contraindicated in
pregnancy due to potential effects on fetal bone and tooth development.
4. A patient is receiving morphine sulfate via PCA pump. The nurse finds the patient lethargic
with a respiratory rate of 7 breaths per minute. Which medication should be administered?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Acetylcysteine
Answer: B
Rationale: Naloxone is the specific opioid antagonist used to reverse respiratory
depression caused by opioids like morphine. Flumazenil is used for benzodiazepine
reversal, while protamine sulfate is for heparin. Acetylcysteine is the antidote for
acetaminophen toxicity, not opioid overdose.
5. When teaching a patient about a new prescription for lithium carbonate, which dietary
instruction is critical?
A. Strictly limit sodium intake to less than 1 gram per day
B. Eliminate all caffeine-containing beverages
C. Maintain a consistent and adequate intake of sodium
D. Increase intake of green leafy vegetables high in Vitamin K
Answer: C
Rationale: Lithium is handled by the kidneys in a manner similar to sodium. If sodium
levels drop, the kidneys retain lithium, which can lead to toxic levels in the blood.
Therefore, maintaining a consistent sodium and fluid intake is vital for therapeutic stability
and safety.
6. A patient is prescribed phenelzine, an MAOI. The nurse instructs the patient to avoid which
of the following foods to prevent a hypertensive crisis?
A. Fresh apples and oranges
B. Whole grain breads and cereals
C. Aged cheeses and cured meats
D. Cooked white rice and steamed broccoli
Answer: C
, Rationale: Phenelzine inhibits the breakdown of tyramine in the body. Consumption of
tyramine-rich foods, such as aged cheeses, smoked meats, and red wine, can trigger a
massive release of norepinephrine. This results in a potentially fatal hypertensive crisis
characterized by extreme blood pressure elevation.
7. A nurse is caring for a patient receiving chemotherapy who has developed neutropenia.
Which nursing intervention is most appropriate?
A. Strictly implement handwashing and avoid large crowds
B. Encourage the patient to eat fresh salads and raw fruits
C. Administer aspirin for any low-grade fevers
D. Restrict all fluid intake to prevent edema
Answer: A
Rationale: Neutropenia significantly increases the risk of life-threatening infections
because the body lacks sufficient white blood cells to fight pathogens. Handwashing is the
single most effective way to prevent the spread of infection to the immunocompromised
patient. Fresh produce should generally be avoided because it may harbor bacteria or fungi
that the patient cannot fight off.
8. Which lab value must be monitored closely for a patient taking methotrexate for
rheumatoid arthritis?
A. Thyroid-stimulating hormone (TSH)
B. Serum calcium and magnesium levels
C. Complete Blood Count (CBC) and Liver Function Tests (LFTs)
D. Prothrombin Time (PT) and INR
Answer: C
Rationale: Methotrexate is a folate antagonist that can cause bone marrow suppression
and hepatotoxicity. Periodic CBCs are necessary to monitor for leukopenia, anemia, and
thrombocytopenia. LFT monitoring is required to detect early drug-induced liver injury or
fibrosis.
9. A patient is prescribed haloperidol for schizophrenia. The nurse notices the patient is
experiencing lip-smacking and tongue protrusion. How should the nurse document this
finding?
A. Akathisia
B. Pseudoparkinsonism
C. Neuroleptic Malignant Syndrome
D. Tardive Dyskinesia
