N316B Pharmacology Midterm Exam 2025
Questions and Answers
4) A client develops extrapyramidal effects after taking a neuroleptic medication, and the nurse
notes extrapyramidal effects. Which medication can limit these side effects?
Zolpidem
Hydroxyzine
Dantrolene
Benztropine mesylate - ANS benztropine mesylate
rationale
Benztropine mesylate, an anticholinergic, helps balance neurotransmitter activity in the central
nervous system (CNS) and helps control extrapyramidal tract symptoms. Zolpidem is a sedative-
hypnotic medication used for short-term insomnia. Hydroxyzine is a sedative that depresses
activity in the subcortical areas in the CNS; it is used to reduce anxiety. Dantrolene, a muscle
relaxant, has a direct effect on skeletal muscle by acting on the excitation-contraction coupling
of muscle fibers and not at the level of the CNS, unlike most other muscle relaxation
medications.
STUDY TIP: Becoming a nursing student automatically increases stress levels because of the
complexity of the information to be learned and applied and because of new constraints on
time. One way to decrease stress associated with school is to become very organized so that
assignment deadlines or tests do not come as sudden surprises. By following a consistent plan
for studying and completing assignments, you can stay on top of requirements and thereby
prevent added stress.
5) An 11-year-old client reports having bedwetting issues (enuresis). Which medication would
the nurse anticipate when developing a teaching plan ?
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,Alprazolam
Imipramine
Lithium salts
Clomipramine - ANS Imipramine
rationale
Certain conditions of pediatric clients necessitate the usage of tricyclic antidepressant
medications as an adjuvant. Childhood enuresis is one such condition that necessitates the
administration of imipramine. Alprazolam is the medication of choice for treating anxiety
disorders. Lithium salt is prescribed to treat bipolar disorders. Clomipramine is a tricyclic
antidepressant medication prescribed for treating obsessive-compulsive disorder.
Test-Taking Tip: Identifying content and what is being asked about that content is critical to
your choosing the response. Be alert for words in the stem of the item that are the same or
similar in nature to those in one or two of the options .
13) Which medication class includes amitriptyline?
Tricyclics
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs) - ANS Tricyclics
rationale
Amitriptyline is one of several tricyclic antidepressants used to treat anxiety disorders. It is not
an MAOI, SSRI, or SNRI.
Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under
ordinary circumstances and that the action can be carried out in the given situation.
48) A client with a history of methamphetamine use is admitted to the medical unit. Which
clinical manifestation would the nurse expect when assessing the client who is under the
influence on admission?
Constricted pupils
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,Intractable diarrhea
Increased heart rate
Decreased respirations
:rationale
Methamphetamine is a stimulant that causes the release of adrenaline, which activates the
sympathetic nervous system and causes increased heart rate. The pupils will dilate, not
constrict, because the sympathetic nervous system is activated. Clients withdrawing from
opioids, not methamphetamine, experience diarrhea. The respirations will increase, not
decrease, because of the activation of the sympathetic nervous system.
48) A client with a history of methamphetamine use is admitted to the medical unit. Which
clinical manifestation would the nurse expect when assessing the client who is under the
influence on admission?
Constricted pupils
Intractable diarrhea
Increased heart rate
Decreased respirations - ANS Increased heart rate
rationale
Methamphetamine is a stimulant that causes the release of adrenaline, which activates the
sympathetic nervous system and causes increased heart rate. The pupils will dilate, not
constrict, because the sympathetic nervous system is activated. Clients withdrawing from
opioids, not methamphetamine, experience diarrhea. The respirations will increase, not
decrease, because of the activation of the sympathetic nervous system.
#
60) Which conclusion would the nurse make about the development of loose stools and
increased salivation two days after a client with myasthenia gravis begins taking
pyridostigmine?
The client is experiencing a myasthenic crisis.
The medication is causing cholinergic side effects.
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, The medication is triggering a paradoxical reaction.
The client is exhibiting toxic effects of the medication. - ANS The medication is causing
cholinergic side effects
rationale
Because this medication inhibits the destruction of acetylcholine, parasympathetic activity may
increase, resulting in cholinergic side effects such as diarrhea and increased salivation. The signs
do not indicate a myasthenic crisis. Myasthenic crisis is characterized by difficulty breathing or
speaking, morning headaches, feeling tired during the daytime, waking up frequently at night,
not sleeping well, a weak cough with increased secretions (mucus or saliva), an inability to clear
secretions, a weak tongue, trouble swallowing or chewing, and weight loss. Side effects are not
temporary and not paradoxical; they continue as long as the medication is continued. The
dosage may be adjusted or an anticholinergic may be given to limit side effects. Toxicity or
cholinergic crisis is manifested by increased muscle weakness, including muscles of respiration.
68) Nortriptyline is prescribed for a depressed client. Which time period identifies when the
nurse would expect a therapeutic response?
1 to 3 days
12 to 24 hours
30 minutes to 2 hours
2 to 3 weeks - ANS 2-3 weeks
rationale
As with other tricyclics, optimal therapeutic effects take 2 to 3 weeks to occur. One to 3 days,
12 to 24 hours, and 30 minutes to 2 hours are all too soon to expect a response to nortriptyline.
Test-Taking Tip: Be aware that information from previously asked questions may help you
respond to other examination questions.
86) A client is admitted to the acute medical unit for severe amphetamine intoxication. Which
medications are indicated to counteract the effects of stimulant intoxication? Select all that
apply. One, some, or all responses may be .
Diazepam
Pg. 4 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
Questions and Answers
4) A client develops extrapyramidal effects after taking a neuroleptic medication, and the nurse
notes extrapyramidal effects. Which medication can limit these side effects?
Zolpidem
Hydroxyzine
Dantrolene
Benztropine mesylate - ANS benztropine mesylate
rationale
Benztropine mesylate, an anticholinergic, helps balance neurotransmitter activity in the central
nervous system (CNS) and helps control extrapyramidal tract symptoms. Zolpidem is a sedative-
hypnotic medication used for short-term insomnia. Hydroxyzine is a sedative that depresses
activity in the subcortical areas in the CNS; it is used to reduce anxiety. Dantrolene, a muscle
relaxant, has a direct effect on skeletal muscle by acting on the excitation-contraction coupling
of muscle fibers and not at the level of the CNS, unlike most other muscle relaxation
medications.
STUDY TIP: Becoming a nursing student automatically increases stress levels because of the
complexity of the information to be learned and applied and because of new constraints on
time. One way to decrease stress associated with school is to become very organized so that
assignment deadlines or tests do not come as sudden surprises. By following a consistent plan
for studying and completing assignments, you can stay on top of requirements and thereby
prevent added stress.
5) An 11-year-old client reports having bedwetting issues (enuresis). Which medication would
the nurse anticipate when developing a teaching plan ?
Pg. 1 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
,Alprazolam
Imipramine
Lithium salts
Clomipramine - ANS Imipramine
rationale
Certain conditions of pediatric clients necessitate the usage of tricyclic antidepressant
medications as an adjuvant. Childhood enuresis is one such condition that necessitates the
administration of imipramine. Alprazolam is the medication of choice for treating anxiety
disorders. Lithium salt is prescribed to treat bipolar disorders. Clomipramine is a tricyclic
antidepressant medication prescribed for treating obsessive-compulsive disorder.
Test-Taking Tip: Identifying content and what is being asked about that content is critical to
your choosing the response. Be alert for words in the stem of the item that are the same or
similar in nature to those in one or two of the options .
13) Which medication class includes amitriptyline?
Tricyclics
Monoamine oxidase inhibitors (MAOIs)
Selective serotonin reuptake inhibitors (SSRIs)
Serotonin-norepinephrine reuptake inhibitors (SNRIs) - ANS Tricyclics
rationale
Amitriptyline is one of several tricyclic antidepressants used to treat anxiety disorders. It is not
an MAOI, SSRI, or SNRI.
Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under
ordinary circumstances and that the action can be carried out in the given situation.
48) A client with a history of methamphetamine use is admitted to the medical unit. Which
clinical manifestation would the nurse expect when assessing the client who is under the
influence on admission?
Constricted pupils
Pg. 2 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
,Intractable diarrhea
Increased heart rate
Decreased respirations
:rationale
Methamphetamine is a stimulant that causes the release of adrenaline, which activates the
sympathetic nervous system and causes increased heart rate. The pupils will dilate, not
constrict, because the sympathetic nervous system is activated. Clients withdrawing from
opioids, not methamphetamine, experience diarrhea. The respirations will increase, not
decrease, because of the activation of the sympathetic nervous system.
48) A client with a history of methamphetamine use is admitted to the medical unit. Which
clinical manifestation would the nurse expect when assessing the client who is under the
influence on admission?
Constricted pupils
Intractable diarrhea
Increased heart rate
Decreased respirations - ANS Increased heart rate
rationale
Methamphetamine is a stimulant that causes the release of adrenaline, which activates the
sympathetic nervous system and causes increased heart rate. The pupils will dilate, not
constrict, because the sympathetic nervous system is activated. Clients withdrawing from
opioids, not methamphetamine, experience diarrhea. The respirations will increase, not
decrease, because of the activation of the sympathetic nervous system.
#
60) Which conclusion would the nurse make about the development of loose stools and
increased salivation two days after a client with myasthenia gravis begins taking
pyridostigmine?
The client is experiencing a myasthenic crisis.
The medication is causing cholinergic side effects.
Pg. 3 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
, The medication is triggering a paradoxical reaction.
The client is exhibiting toxic effects of the medication. - ANS The medication is causing
cholinergic side effects
rationale
Because this medication inhibits the destruction of acetylcholine, parasympathetic activity may
increase, resulting in cholinergic side effects such as diarrhea and increased salivation. The signs
do not indicate a myasthenic crisis. Myasthenic crisis is characterized by difficulty breathing or
speaking, morning headaches, feeling tired during the daytime, waking up frequently at night,
not sleeping well, a weak cough with increased secretions (mucus or saliva), an inability to clear
secretions, a weak tongue, trouble swallowing or chewing, and weight loss. Side effects are not
temporary and not paradoxical; they continue as long as the medication is continued. The
dosage may be adjusted or an anticholinergic may be given to limit side effects. Toxicity or
cholinergic crisis is manifested by increased muscle weakness, including muscles of respiration.
68) Nortriptyline is prescribed for a depressed client. Which time period identifies when the
nurse would expect a therapeutic response?
1 to 3 days
12 to 24 hours
30 minutes to 2 hours
2 to 3 weeks - ANS 2-3 weeks
rationale
As with other tricyclics, optimal therapeutic effects take 2 to 3 weeks to occur. One to 3 days,
12 to 24 hours, and 30 minutes to 2 hours are all too soon to expect a response to nortriptyline.
Test-Taking Tip: Be aware that information from previously asked questions may help you
respond to other examination questions.
86) A client is admitted to the acute medical unit for severe amphetamine intoxication. Which
medications are indicated to counteract the effects of stimulant intoxication? Select all that
apply. One, some, or all responses may be .
Diazepam
Pg. 4 Copyright © 2025 Jasonmcconell. ALL RIGHTS RESERVED.
