NUR 2474 Pharmacology Final Exam: Practice Questions &
Answers (NCLEX)
A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by rest. The
provider administers one NG tablet which does not relieve the pain. What is the next action? -
ANSWER:Give the patient a beta blocker
A patient is brought to an emergency department with symptoms of acute ST segment elevation MI
(STEMI). The nearest hospiral that can perform a PCI is three hours away, what is the initial treatment for
this patient. - ANSWER:Initiate fibrinolytic therapy
A patient reports a feeling of fullness and pain in both ears and the practitioner elicits pain when
manipulating the ear structures, what is likely the diagnosis? - ANSWER:acute otitis externa
Which are risk factors for developing otitis externa? - ANSWER:having underlying DM, use of ear plugs or
hearing aids, vigorous external hygiene
A patient has an initial episode of otitis external associated with swimming. the patient's ear canal is
mildly inflamed and the TM is not involved. Which medication will be ordered? - ANSWER:Cipro HC
Which symptoms in children are evlauated using a parent-reported scoring system to determine the
severity of pain in children with OM? - ANSWER:Appetite, Difficulty sleeping, and tugging on ears.
Which patient may be given symptomatic treatment with 24 hours follow-up assessment without initial
antibiotic therapy? - ANSWER:A 36 month old with fever of 38.5, mild otalgia, and red, non-bulging TM
A pediatric patient has otalgia, fever of 38.8, and recent history of URI. the examiner is unable to
visualize the TM in the right ear because of the presence of cerumen. The left TM is dull gray with fluid
levels present. What is the correct action? - ANSWER:Remove the cerumen and visualize the TM
A patient reports ear pain and difficulty hearing. An otoscope examination reveals a small tear in the TM
of the affected ear with purulent d/c. What is the initial treatment for this patient? - ANSWER:Prescribe
antibiotic ear drops
A patient reports ear pain after being hit in the head with a baseball. The provider notes a perforated
TM. What is recommended treatment? - ANSWER:Refer the patient to an Otolaryngologist for eval
An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes foul-smelling
breath and a muffled voice with marked edema and erythema of the peritonsillar tissue. What should
you do? - ANSWER:Perform a rapid strep and throat culture.
A patient has a sore throat, and temp of 38.5, tonsillar exudates, and cervical lymphadenopathy. What
will the provider do next to manage this patient's symptoms. - ANSWER:Perform a RADT
A patient reports a sudden onset of sore throat, fever, malaise, and cough. the provider notes mild
erythema of the pharynx and clear rhinorrhea without cervical lymphadnopathy. what is most likely
cause? - ANSWER:viral pharyngitis
, A school-aged child has 5 episodes of tonsillitis in the past year and 2 episodes the previous year. The
child's parents ask the provider if the child needs a tonsillectomy. What will the provider say? -
ANSWER:Current recommendations do not support tonsillectomy for this child
A patient with EBV-IM also has GAS pharyngitis and is being treated with Amoxicillin. On the third day of
treatment, the patient develops a rash. A urinalysis is normal. what does this indicate? - ANSWER:A
reaction to the amoxicillin
An adolescent who plays football in high school is diagnosed with Infectious Mono and is noted to have
splenomegaly. What will the provider recommend to this patient about returning to sports? -
ANSWER:ABD US are recommended to determines safety
An adolescent patient has a fever, pharyngitis, and cervical lymphadenopathy and has negative GAS
culture. A cbc shows absolute lymphocytosis, but a heterophil antibody test is negative for EBV. What
will the provider tell the patient? - ANSWER:The likelihood of EBV is still high
A patient reports persistent nasal blockage, discharge and facial pain lasting on the right side for 4
months. There is no hx of sneezing or eye involvement, The patient has a hx of seasonal allergies and
takes a non-sedating antihistamine. What does the provider suspect is the cause of these symptoms? -
ANSWER:chronic rhinosinusitis
A provider determines that a patient has chronic rhinosinusitis without nasal polyps. What is first-line
treatment? - ANSWER:Intranasal corticosteroids
A patient has recurrent sneezing, alterations in taste and smell, watery, itchy eyes, and thin, clear nasal
secretions. The provider notes puffiness around the eyes. The patient;s vital signs are normal. What is
likely diagnosis? - ANSWER:allergic rhinitis
A patient has seasonal rhinitis symptoms and allergy testing reveals sensativity to trees and grasses.
What is first line treatment for this patient? - ANSWER:intranasal steroids
A patient is concerned about frequent nasal stuffiness and congestion that begins shortly after getting
out of bed in the morning. The patient denies itching and sneezing. A PE reveals erythematous nasal
mucosa with scant watery discharge. What treatment will the provider recommend? - ANSWER:daily
intranasal steroids
What are potential complications of chronic or recurrent sinusitis? - ANSWER:Meningitis, orbital
infection, and osteomyleitis.
A patient has nasal congestion, fever, purulent drainage, HA, and facial pain and begins treatment with
augmentin. At a follow up visit 10 days later after treatment, the patient continues to have symptoms.
What is next course of action? - ANSWER:A second course of augmentin
Which symptoms in a patient with abdominal pain are suggestive of appendicitis? - ANSWER:Abdominal
rigidity along with pain, pain accompanied by low grade fever, pain occurring prior to nausea and
vomiting.
A patient has sudden onset of RUQ pain and epigastric pain with fever, nausea, vomiting. The ED
provider notes yellowing of the sclera. What is probable cause of findings? - ANSWER:common bile duct
obstruction.
Answers (NCLEX)
A patient reports recurrent chest pain that occurs regardless of activity and is not relieved by rest. The
provider administers one NG tablet which does not relieve the pain. What is the next action? -
ANSWER:Give the patient a beta blocker
A patient is brought to an emergency department with symptoms of acute ST segment elevation MI
(STEMI). The nearest hospiral that can perform a PCI is three hours away, what is the initial treatment for
this patient. - ANSWER:Initiate fibrinolytic therapy
A patient reports a feeling of fullness and pain in both ears and the practitioner elicits pain when
manipulating the ear structures, what is likely the diagnosis? - ANSWER:acute otitis externa
Which are risk factors for developing otitis externa? - ANSWER:having underlying DM, use of ear plugs or
hearing aids, vigorous external hygiene
A patient has an initial episode of otitis external associated with swimming. the patient's ear canal is
mildly inflamed and the TM is not involved. Which medication will be ordered? - ANSWER:Cipro HC
Which symptoms in children are evlauated using a parent-reported scoring system to determine the
severity of pain in children with OM? - ANSWER:Appetite, Difficulty sleeping, and tugging on ears.
Which patient may be given symptomatic treatment with 24 hours follow-up assessment without initial
antibiotic therapy? - ANSWER:A 36 month old with fever of 38.5, mild otalgia, and red, non-bulging TM
A pediatric patient has otalgia, fever of 38.8, and recent history of URI. the examiner is unable to
visualize the TM in the right ear because of the presence of cerumen. The left TM is dull gray with fluid
levels present. What is the correct action? - ANSWER:Remove the cerumen and visualize the TM
A patient reports ear pain and difficulty hearing. An otoscope examination reveals a small tear in the TM
of the affected ear with purulent d/c. What is the initial treatment for this patient? - ANSWER:Prescribe
antibiotic ear drops
A patient reports ear pain after being hit in the head with a baseball. The provider notes a perforated
TM. What is recommended treatment? - ANSWER:Refer the patient to an Otolaryngologist for eval
An adolescent has fever, chills, and a severe sore throat. On exam, the provider notes foul-smelling
breath and a muffled voice with marked edema and erythema of the peritonsillar tissue. What should
you do? - ANSWER:Perform a rapid strep and throat culture.
A patient has a sore throat, and temp of 38.5, tonsillar exudates, and cervical lymphadenopathy. What
will the provider do next to manage this patient's symptoms. - ANSWER:Perform a RADT
A patient reports a sudden onset of sore throat, fever, malaise, and cough. the provider notes mild
erythema of the pharynx and clear rhinorrhea without cervical lymphadnopathy. what is most likely
cause? - ANSWER:viral pharyngitis
, A school-aged child has 5 episodes of tonsillitis in the past year and 2 episodes the previous year. The
child's parents ask the provider if the child needs a tonsillectomy. What will the provider say? -
ANSWER:Current recommendations do not support tonsillectomy for this child
A patient with EBV-IM also has GAS pharyngitis and is being treated with Amoxicillin. On the third day of
treatment, the patient develops a rash. A urinalysis is normal. what does this indicate? - ANSWER:A
reaction to the amoxicillin
An adolescent who plays football in high school is diagnosed with Infectious Mono and is noted to have
splenomegaly. What will the provider recommend to this patient about returning to sports? -
ANSWER:ABD US are recommended to determines safety
An adolescent patient has a fever, pharyngitis, and cervical lymphadenopathy and has negative GAS
culture. A cbc shows absolute lymphocytosis, but a heterophil antibody test is negative for EBV. What
will the provider tell the patient? - ANSWER:The likelihood of EBV is still high
A patient reports persistent nasal blockage, discharge and facial pain lasting on the right side for 4
months. There is no hx of sneezing or eye involvement, The patient has a hx of seasonal allergies and
takes a non-sedating antihistamine. What does the provider suspect is the cause of these symptoms? -
ANSWER:chronic rhinosinusitis
A provider determines that a patient has chronic rhinosinusitis without nasal polyps. What is first-line
treatment? - ANSWER:Intranasal corticosteroids
A patient has recurrent sneezing, alterations in taste and smell, watery, itchy eyes, and thin, clear nasal
secretions. The provider notes puffiness around the eyes. The patient;s vital signs are normal. What is
likely diagnosis? - ANSWER:allergic rhinitis
A patient has seasonal rhinitis symptoms and allergy testing reveals sensativity to trees and grasses.
What is first line treatment for this patient? - ANSWER:intranasal steroids
A patient is concerned about frequent nasal stuffiness and congestion that begins shortly after getting
out of bed in the morning. The patient denies itching and sneezing. A PE reveals erythematous nasal
mucosa with scant watery discharge. What treatment will the provider recommend? - ANSWER:daily
intranasal steroids
What are potential complications of chronic or recurrent sinusitis? - ANSWER:Meningitis, orbital
infection, and osteomyleitis.
A patient has nasal congestion, fever, purulent drainage, HA, and facial pain and begins treatment with
augmentin. At a follow up visit 10 days later after treatment, the patient continues to have symptoms.
What is next course of action? - ANSWER:A second course of augmentin
Which symptoms in a patient with abdominal pain are suggestive of appendicitis? - ANSWER:Abdominal
rigidity along with pain, pain accompanied by low grade fever, pain occurring prior to nausea and
vomiting.
A patient has sudden onset of RUQ pain and epigastric pain with fever, nausea, vomiting. The ED
provider notes yellowing of the sclera. What is probable cause of findings? - ANSWER:common bile duct
obstruction.
