NLN MEDICATION COMPREHENSIVE EXAM 2025/2026
QUESTIONS AND ANSWERS GRADED A++
✔✔Atropine Sulfate - ✔✔Anticholinergic (Parkinson's) and for ophthalmic use
Systemic effect is more pronounced in infants and children w/ blue eyes/blonde hair
Increased risk of toxicity w/ Down Syndrome
Used to increase HR, decreases involuntary movement/rigidity in PD
Given pre-op to decrease secretions and prevent aspiration of secretions while under
anesthesia
Used for inflammation of the iris and uveal tract
Side Effects: dry mouth, constipation, urinary retention/hesitancy, HA, dizziness
Adverse Effects/Toxicity: paralytic ileus
- Tx overdose (resp. depression and circulatory collapse) symptomatically
Adverse Effects w/ eye use: transient stinging, increases IOP, photophobia
Monitor dosage of meds carefully - overdoses easily
Assess constipation and urinary retention - increase fluids & bulk, exercise; assess
bowel sounds to r/o paralytic ileus
Avoid driving or other hazardous activities - drowsiness can occur
Acute glaucoma can be precipitated by papillary dilation - if not recognized and treated
acute glaucoma can --> blindness
Wear dark sunglasses and avoid bright light for photophobia
Monitor intraocular pressure and vision
✔✔Beclomethasone Diproprionate (Beclovent) - ✔✔Inhaled corticosteriod medication
(also nasal inhalant - Beconase)
Used in bronchial asthma and allergic rhinitis
Side Effects: pharyngeal irritation and sore throat, coughing, dry mouth, oral fungal
infections and sinusitis
- Increased susceptibility to infection, dermatological effects and osteoporosis, diarrhea,
N/V, HA, fever, dizziness, angioedema, rash, utricaria, and paradoxical bronchospasm
Adverse Effects/Toxicity: adrenocortical insufficiency, f/e disturbances, nervous system
effects and endocrine effects if absorbed systemically
Decrease dose if pt. is on systemic corticosteroid
Assess for impaired bone growth in children receiving inhaled corticsteroid
Monitor for hyperglycemia
Rinse mouth after use for med - oropharyngeal candidiasis and/or hoarseness can
occur
Use bronchodilator inhalant b/f corticosteroid when both are ordered
Do not abruptly stop meds - taper over 2 weeks
Be aware of steroid symptoms - moon face, acne, edema, increased fat pads
,Report weight gain
Contraindications: children, clients with known allergy; bronchospasm, status
asthmaticus
May require adjustment of antidaibetic agent - potential for elevated blood glucose
✔✔Benztropine Mesylate (Congentin) - ✔✔Anticholinergic and Anti-parkinson
Tx PD symptoms: suppresses tremors & rigidity, not tardive dyskinesia; decreases
hypersalivation and irregular movement; reduces EPS effects
Side Effects: dry mouth, urinary retention/hesitancy, HA, dizziness
Adverse Effects/Toxicity: paralytic ileus
Monitor dose carefully - overdoses easily
Monitor I/O
Avoid driving/hazardous activities - drowsiness
Avoid cough OTC meds unless prescribed
Contraindications: narrow-angle glaucoma, MG, GI obstruction
✔✔Buspirone (Buspar) - ✔✔Anxiolytic - for anxiety
Desired response may take 7-10 days and full effect takes 3-4 weeks
Side Effects: dizziness, HA, drowsiness
When switching to Buspar, taper of benzos
Less likely to have cognitive impairment than other CNS meds
Does not cause withdrawal s/s and thus does not need to be tapered off when stopping
Contraindications: MAOI's, lactation
Caution with moderate to severe renal impairment
✔✔Chlordiazepoxide Hydrochloride (Librium) - ✔✔Anxiolytic; sedative-hypnotic
benzodiazepine
IM and tablet form
Peak: 1-4 hrs PO and 15-30 min IM
Half-life = 5-30 hours
Relieves tension and/or anxiety; manages alcohol withdrawal
Do not abruptly stop taking drug - will have withdrawal symptoms (5-7 days)
Adverse Effects: respiratory distress, drowsy, dizziness, lethargy, orthostatic
hypotension, photosensitivity
Suicidal tendencies may occur
Monitor closely for paradoxical reactions - excitement, stimulation, and acute rage -
withhold drug and notify HCP
,Give w/ milk or food to prevent GI upset
Check BP and pulse early in tx
Monitor CBC, renal and hepatic enzymes
Watch for dependency
Avoid EtOH
No OTC meds unless prescribed
Avoid driving/hazardous activities until effects known
Contraindications: narrow-angle glaucoma, under 12 years old, and lactation
Caution with impending depression, impaired hepatic or renal function, COPD
✔✔Chloramphenicol (Chloromycetin) - ✔✔Anti-bacterial
Oral, Injection, Ophthalmic drops/ointment
Severe infection - for susceptible organisms when other anti-infectives are ineffective
Used for: sty, conjunctivitis, uveitis
Side Effects: dermatitis, itching, stinging, swelling
Adverse Effects/Toxicity: edema, super infection, aplastic anemia, & Stevens-Johnson
Syndrome
Obtain culture specimen from eye b/f initiation of treatment
Remove exudates
Monitor for pain, drainage, redness, swelling
Monitor for bleeding and bruising
Contraindications: hypersensitivity
✔✔Chlorothiazide (Diuril) - ✔✔Thiazide Diuretic (non-potassium sparing)
Antihypertensive
Increases urinary excretion Na+ & water by inhibiting Na+ reabsorptioin
Use for edema & HTN, HF, cirrhosis, corticosteroid & estrogen therapy, diabetes
insipidus
Side Effects: dizziness, vertigo, frequent urination, electrolyte imbalance, impaired
glucose tolerance, hyperuricemia, photosensitivity
Adverse Effects/Toxicity: renal failure, aplastic anemia, and anaphylaxsis
Take early in the morning to avoid nocturia
Give w/ food
Allow 3-4 weeks for max effect
Will not be effective if creatinine clearance is <30 mL/min
Contraindications: anuria and pregnancy
Use cautiously w/ impaired renal or hepatic function
Will increase lithium level
, ✔✔Chlorpromazine Hydrochloride (Thorazine) - ✔✔Antipsychotic med and anti-emetic
Block DA receptor in CNS
Uses: tx psychotic disorder (schizophrenia, bipolar, and other metnal illnesses);
prevents acute exacerbation and maintains highest level of function; Controls manic
phase; intractable hiccups, N/V
Low potency antipscyhotic which can reduce the risk of EPS effects
Side Effects: sedation, orthostatic hypotension, anticholinergic effect (dry mouth, blurred
vision, urinary retention, photophobia, constipation, tachycardia), liver damage, tremor
are 2 major side effects, photosensitivity
Adverse Effects/Toxicity: neuroleptic malignant syndrome (NMS), catatonia, rigidity,
stupor, unstable BP, profuse sweating, dyspnea
Get baseline ECG, thorough baseline elevation lab tests before treatment
Withdrawal of drug is necessary
Take measures to protect eyes exposed to sunlight
Contraindications: monitor diabetics closely for glucose intolerance
✔✔Cimetidine (Tagamet) - ✔✔H2 Receptor Antagonist
Works against histmaine receptors, decreases gastric secretion, and used short term for
duodenal ulcers, benign gastric ulcers, & acute upper GI bleeds
Side Effects: cardiac dysrhythmias, diarrhea, dry mouth, constipation
Adverse Effects/Toxicity: rare but may include agranulocytosis, neutropenia,
thrombocytopenia, aplastic anemia, and anaphylaxsis
May be given w/ meals & at bedtime
Avoid smoking which causes gastric simulation
Avoid use w/n 1 hour of dose
Contraindications: hypersensitivity
Use cautiously w/ impaired renal or hepatic function
✔✔Cisplatin (Platinol) - ✔✔Antineoplastic mediation; Alkylating agent
Major allergic rxn can occur w/n 15 min of amdin (anaphylaxsis w/n minutes)
Half-life 20-30 minutes
Treats ovaraina nd testicula rcancer by interfering with DNA replication
Side Effects: anorexia, uncontrolled N/V, fluid retention, weight gain
Adverse Effects/Toxicity:
- Major toxicities occur int he blood, GI, and reproductive system
- Watch urine output and specific gravity - nephrotoxcitiy w/n 2 weeks
- Ototoxicity
QUESTIONS AND ANSWERS GRADED A++
✔✔Atropine Sulfate - ✔✔Anticholinergic (Parkinson's) and for ophthalmic use
Systemic effect is more pronounced in infants and children w/ blue eyes/blonde hair
Increased risk of toxicity w/ Down Syndrome
Used to increase HR, decreases involuntary movement/rigidity in PD
Given pre-op to decrease secretions and prevent aspiration of secretions while under
anesthesia
Used for inflammation of the iris and uveal tract
Side Effects: dry mouth, constipation, urinary retention/hesitancy, HA, dizziness
Adverse Effects/Toxicity: paralytic ileus
- Tx overdose (resp. depression and circulatory collapse) symptomatically
Adverse Effects w/ eye use: transient stinging, increases IOP, photophobia
Monitor dosage of meds carefully - overdoses easily
Assess constipation and urinary retention - increase fluids & bulk, exercise; assess
bowel sounds to r/o paralytic ileus
Avoid driving or other hazardous activities - drowsiness can occur
Acute glaucoma can be precipitated by papillary dilation - if not recognized and treated
acute glaucoma can --> blindness
Wear dark sunglasses and avoid bright light for photophobia
Monitor intraocular pressure and vision
✔✔Beclomethasone Diproprionate (Beclovent) - ✔✔Inhaled corticosteriod medication
(also nasal inhalant - Beconase)
Used in bronchial asthma and allergic rhinitis
Side Effects: pharyngeal irritation and sore throat, coughing, dry mouth, oral fungal
infections and sinusitis
- Increased susceptibility to infection, dermatological effects and osteoporosis, diarrhea,
N/V, HA, fever, dizziness, angioedema, rash, utricaria, and paradoxical bronchospasm
Adverse Effects/Toxicity: adrenocortical insufficiency, f/e disturbances, nervous system
effects and endocrine effects if absorbed systemically
Decrease dose if pt. is on systemic corticosteroid
Assess for impaired bone growth in children receiving inhaled corticsteroid
Monitor for hyperglycemia
Rinse mouth after use for med - oropharyngeal candidiasis and/or hoarseness can
occur
Use bronchodilator inhalant b/f corticosteroid when both are ordered
Do not abruptly stop meds - taper over 2 weeks
Be aware of steroid symptoms - moon face, acne, edema, increased fat pads
,Report weight gain
Contraindications: children, clients with known allergy; bronchospasm, status
asthmaticus
May require adjustment of antidaibetic agent - potential for elevated blood glucose
✔✔Benztropine Mesylate (Congentin) - ✔✔Anticholinergic and Anti-parkinson
Tx PD symptoms: suppresses tremors & rigidity, not tardive dyskinesia; decreases
hypersalivation and irregular movement; reduces EPS effects
Side Effects: dry mouth, urinary retention/hesitancy, HA, dizziness
Adverse Effects/Toxicity: paralytic ileus
Monitor dose carefully - overdoses easily
Monitor I/O
Avoid driving/hazardous activities - drowsiness
Avoid cough OTC meds unless prescribed
Contraindications: narrow-angle glaucoma, MG, GI obstruction
✔✔Buspirone (Buspar) - ✔✔Anxiolytic - for anxiety
Desired response may take 7-10 days and full effect takes 3-4 weeks
Side Effects: dizziness, HA, drowsiness
When switching to Buspar, taper of benzos
Less likely to have cognitive impairment than other CNS meds
Does not cause withdrawal s/s and thus does not need to be tapered off when stopping
Contraindications: MAOI's, lactation
Caution with moderate to severe renal impairment
✔✔Chlordiazepoxide Hydrochloride (Librium) - ✔✔Anxiolytic; sedative-hypnotic
benzodiazepine
IM and tablet form
Peak: 1-4 hrs PO and 15-30 min IM
Half-life = 5-30 hours
Relieves tension and/or anxiety; manages alcohol withdrawal
Do not abruptly stop taking drug - will have withdrawal symptoms (5-7 days)
Adverse Effects: respiratory distress, drowsy, dizziness, lethargy, orthostatic
hypotension, photosensitivity
Suicidal tendencies may occur
Monitor closely for paradoxical reactions - excitement, stimulation, and acute rage -
withhold drug and notify HCP
,Give w/ milk or food to prevent GI upset
Check BP and pulse early in tx
Monitor CBC, renal and hepatic enzymes
Watch for dependency
Avoid EtOH
No OTC meds unless prescribed
Avoid driving/hazardous activities until effects known
Contraindications: narrow-angle glaucoma, under 12 years old, and lactation
Caution with impending depression, impaired hepatic or renal function, COPD
✔✔Chloramphenicol (Chloromycetin) - ✔✔Anti-bacterial
Oral, Injection, Ophthalmic drops/ointment
Severe infection - for susceptible organisms when other anti-infectives are ineffective
Used for: sty, conjunctivitis, uveitis
Side Effects: dermatitis, itching, stinging, swelling
Adverse Effects/Toxicity: edema, super infection, aplastic anemia, & Stevens-Johnson
Syndrome
Obtain culture specimen from eye b/f initiation of treatment
Remove exudates
Monitor for pain, drainage, redness, swelling
Monitor for bleeding and bruising
Contraindications: hypersensitivity
✔✔Chlorothiazide (Diuril) - ✔✔Thiazide Diuretic (non-potassium sparing)
Antihypertensive
Increases urinary excretion Na+ & water by inhibiting Na+ reabsorptioin
Use for edema & HTN, HF, cirrhosis, corticosteroid & estrogen therapy, diabetes
insipidus
Side Effects: dizziness, vertigo, frequent urination, electrolyte imbalance, impaired
glucose tolerance, hyperuricemia, photosensitivity
Adverse Effects/Toxicity: renal failure, aplastic anemia, and anaphylaxsis
Take early in the morning to avoid nocturia
Give w/ food
Allow 3-4 weeks for max effect
Will not be effective if creatinine clearance is <30 mL/min
Contraindications: anuria and pregnancy
Use cautiously w/ impaired renal or hepatic function
Will increase lithium level
, ✔✔Chlorpromazine Hydrochloride (Thorazine) - ✔✔Antipsychotic med and anti-emetic
Block DA receptor in CNS
Uses: tx psychotic disorder (schizophrenia, bipolar, and other metnal illnesses);
prevents acute exacerbation and maintains highest level of function; Controls manic
phase; intractable hiccups, N/V
Low potency antipscyhotic which can reduce the risk of EPS effects
Side Effects: sedation, orthostatic hypotension, anticholinergic effect (dry mouth, blurred
vision, urinary retention, photophobia, constipation, tachycardia), liver damage, tremor
are 2 major side effects, photosensitivity
Adverse Effects/Toxicity: neuroleptic malignant syndrome (NMS), catatonia, rigidity,
stupor, unstable BP, profuse sweating, dyspnea
Get baseline ECG, thorough baseline elevation lab tests before treatment
Withdrawal of drug is necessary
Take measures to protect eyes exposed to sunlight
Contraindications: monitor diabetics closely for glucose intolerance
✔✔Cimetidine (Tagamet) - ✔✔H2 Receptor Antagonist
Works against histmaine receptors, decreases gastric secretion, and used short term for
duodenal ulcers, benign gastric ulcers, & acute upper GI bleeds
Side Effects: cardiac dysrhythmias, diarrhea, dry mouth, constipation
Adverse Effects/Toxicity: rare but may include agranulocytosis, neutropenia,
thrombocytopenia, aplastic anemia, and anaphylaxsis
May be given w/ meals & at bedtime
Avoid smoking which causes gastric simulation
Avoid use w/n 1 hour of dose
Contraindications: hypersensitivity
Use cautiously w/ impaired renal or hepatic function
✔✔Cisplatin (Platinol) - ✔✔Antineoplastic mediation; Alkylating agent
Major allergic rxn can occur w/n 15 min of amdin (anaphylaxsis w/n minutes)
Half-life 20-30 minutes
Treats ovaraina nd testicula rcancer by interfering with DNA replication
Side Effects: anorexia, uncontrolled N/V, fluid retention, weight gain
Adverse Effects/Toxicity:
- Major toxicities occur int he blood, GI, and reproductive system
- Watch urine output and specific gravity - nephrotoxcitiy w/n 2 weeks
- Ototoxicity
