Final Exam: NUR 1211C/ NUR1211 (Complete Latest Answered Mcq's updated fall 2025/26) | Answered 100% with Rationales | NUR 1211C : Basic Adult Healthcare - Keiser University.

Final Exam: NUR 1211C/ NUR1211 (Complete Latest Answered Mcq's updated fall 2025/26) | Answered 100% with Rationales | NUR 1211C : Basic Adult Healthcare - Keiser University. NUR 1211C Final Exam Bank Questions and Answers/ Rationales_ Latest Fall 2025-26. 1. Which of the following best describes a therapeutic class of drugs? A) The chemical structure of a drug B) The disease the drug treats C) The mechanism of action of a drug D) The brand name of a drug 2. Which of the following is an example of a pharmacologic class? A) Antihypertensive B) Antidiabetic C) ACE inhibitor D) Antiemetic 3. Which class describes drugs used for managing elevated blood glucose? A) Antiemetics B) Antihypertensives C) Antidiabetics D) Antibiotics 4. Beta-blockers belong to which drug classification? A) Therapeutic class B) Pharmacologic class C) Chemical class D) Biologic class 5. Which of the following is a therapeutic class? A) Diuretics B) Beta-2 agonists C) Proton pump inhibitors D) Angiotensin II receptor blockers 6. Which definition fits pharmacologic class? A) Treatment based grouping B) Disease based grouping C) MOA or chemical structure based grouping D) Symptom based grouping 7. A drug classified as an antipyretic would primarily be used to treat: A) Pain B) Fever C) Inflammation D) Infection 8. Which of the following is considered a therapeutic drug classification? A) Beta-adrenergic antagonist B) Anticoagulant C) Alpha-2 agonist D) Selective serotonin reuptake inhibitor (SSRI) 9. Which of the following would be grouped together primarily because of shared chemical structure? A) Analgesics B) NSAIDs C) Antibiotics D) Beta-lactams 10. Which describes therapeutic class best? A) Target receptor B) Body system affected C) Disease treated D) Chemical structure 11. ACE inhibitors belong to what type of classification? A) Therapeutic B) Chemical C) Pharmacologic D) Nutritional 12. What is a therapeutic class for beta-blockers? A) Antihypertensive B) Beta-adrenergic antagonist C) Cardio-protective agents D) Antiarrhythmic agent 13. A diuretic primarily treats: A) Infections B) Dehydration C) Fluid overload D) Hypotension 14. Proton pump inhibitors belong to which pharmacologic class? A) Gastric reducers B) Antiulcer agents C) Enzyme inhibitors D) Antacids 15. The classification of a drug based on receptor type is an example of: A) Therapeutic classification B) Pharmacologic classification C) Clinical classification D) Structural classification 16. Antidiabetics primarily aim to: A) Lower cholesterol B) Control blood glucose C) Prevent infection D) Reduce fever 17. A drug’s structure involving a beta-lactam ring is part of its: A) Therapeutic class B) Pharmacologic class C) Chemical classification D) Mechanism of action 18. Which best fits the therapeutic class of "analgesics"? A) Antihistamines B) Pain relievers C) Inflammatory reducers D) Antibiotics 19. A drug that lowers blood pressure by blocking calcium channels belongs to which classification? A) Antidiabetic, Pharmacologic B) Antihypertensive, Therapeutic C) Antidepressant, Therapeutic D) Diuretic, Pharmacologic 20. What distinguishes therapeutic from pharmacologic classification? A) Source of drug B) Body system affected C) Reason for drug use vs drug action mechanism D) Administration route 21. Which of the following are examples of therapeutic classes? (Select all that apply.) Antihypertensives Beta-blockers Antiemetics ACE inhibitors Antidiabetics 22. Which statements are true about pharmacologic classes? (Select all that apply.) Based on disease treated Based on mechanism of action Based on chemical structure Includes examples like beta-blockers Same as brand names 23. Therapeutic class names include which of the following? (Select all that apply.) Antibiotics Antihistamines SSRIs Diuretics NSAIDs 24. Pharmacologic class examples include: (Select all that apply.) Beta-blockers Calcium channel blockers Antivirals Proton pump inhibitors NSAIDs 25. A drug’s pharmacologic class can be determined by: (Select all that apply.) Its mechanism of action Its side effects Its chemical structure Its brand name Its generic name 1. Beta-lactam antibiotics kill bacteria by: A) Inhibiting protein synthesis B) Blocking DNA replication C) Disrupting folic acid synthesis D) Inhibiting cell wall synthesis 2. Which agent inhibits protein synthesis by binding the 30S ribosomal subunit? A) Azithromycin B) Ciprofloxacin C) Gentamicin D) Trimethoprim-sulfamethoxazole 3. Which class inhibits DNA gyrase, blocking bacterial replication? A) Fluoroquinolones B) Macrolides C) Tetracyclines D) Beta-lactams 4. Sulfonamides exert their antimicrobial effect by: A) Inhibiting DNA replication B) Inhibiting folic acid synthesis C) Damaging bacterial membranes D) Inhibiting protein synthesis 5. The primary mechanism of action of macrolides is: A) Disruption of ergosterol B) Inhibition of 50S ribosome C) DNA gyrase inhibition D) Cell wall lysis 6. Amphotericin B disrupts fungal cells by: A) Binding to ergosterol B) Inhibiting bacterial DNA C) Blocking protein synthesis D) Inhibiting DNA gyrase 7. Acyclovir primarily works by: A) Blocking viral release B) Inhibiting viral DNA synthesis C) Enhancing host immunity D) Destroying viral proteins 8. Which drug disrupts protozoal DNA or mitochondria? A) Chloroquine B) Oseltamivir C) Gentamicin D) Fluconazole 9. Mebendazole treats parasitic infections by: A) Blocking folic acid B) Inhibiting mitosis C) Paralyzing worms D) Inhibiting viral replication 10. Which antineoplastic agent mechanism is correct? A) Enhances bacterial cell wall production B) Inhibits mitosis in cancer cells C) Stimulates fungal replication D) Blocks ergosterol synthesis 11. Which class requires monitoring of CBC, renal function, and neutropenic precautions? A) Antifungal B) Antineoplastic C) Antiviral D) Antiprotozoal 12. What is the first step before administering any anti-infective? A) Administer test dose B) Hydrate patient C) Obtain culture and sensitivity D) Monitor peak/trough 13. To maintain therapeutic blood levels, anti-infectives should be administered: A) Only during the day B) Before meals only C) Around-the-clock D) When symptoms worsen 14. What should patients report immediately when taking antibiotics? A) Constipation B) Rash or difficulty breathing C) Mild fatigue D) Increased thirst 15. Hydration is essential during anti-infective therapy to prevent: A) Hypertension B) Nephrotoxicity C) Anemia D) Hyperkalemia 16. IV extravasation is a particular risk with which drugs? A) Macrolides B) Sulfonamides C) Vancomycin and aminoglycosides D) Beta-lactams 17. Which strategy prevents development of antibiotic resistance? A) Administer antibiotics before cultures B) Using broad-spectrum antibiotics for all infections C) Completing full antibiotic courses D) Discontinuing antibiotics once symptoms improve 18. Antibiotic stewardship includes: A) Using antibiotics to prevent colds B) Promoting narrow-spectrum drug use C) Avoiding culture testing D) Avoiding combination therapy 19. Combination antimicrobial therapy is appropriate for: A) Mild common colds B) HIV and tuberculosis infections C) Simple UTIs D) Mild otitis externa 20. In healthcare settings, antibiotic resistance prevention includes: A) Liberal use of antibiotics B) Isolation precautions for resistant organisms C) Delaying diagnosis D) Ignoring culture results 21. Which are mechanisms of action for antimicrobial classes? (Select all that apply.) Inhibiting cell wall synthesis Enhancing viral replication Blocking DNA gyrase Inhibiting folic acid synthesis Disrupting protein synthesis 22. Which nursing responsibilities apply before anti-infective administration? (Select all that apply.) Check allergy history Obtain cultures Delay therapy until results Hydrate patient if needed Administer with food immediately 23. Strategies to prevent antibiotic resistance include: (Select all that apply.) Complete full antibiotic courses Use antibiotics for viral infections Perform culture and sensitivity Avoid unnecessary antibiotics Use narrow-spectrum drugs when possible 24. Signs that require immediate attention during antibiotic therapy include: (Select all that apply.) Rash Difficulty breathing Mild headache Diarrhea Fever after several days of treatment 25. Common resistance-prevention strategies in hospitals include: (Select all that apply.) Antibiotic stewardship Isolation of resistant organisms Broad-spectrum use for minor infections Culture before antibiotics Combination therapy for serious infections 1. Which characteristic makes viruses particularly difficult to treat? A) They produce their own proteins independently. B) They mutate slowly. C) They replicate using host cellular machinery. D) They are living organisms with their own metabolism. 2. The action of Oseltamivir (Tamiflu) primarily targets which viral process? A) DNA replication B) Protein synthesis C) Viral entry D) Viral release from host cell 3. Which statement is true regarding oseltamivir (Tamiflu)? A) It can be started any time during infection with equal efficacy. B) It is most effective if initiated within 48 hours of symptom onset. C) It is contraindicated in all renal impairment cases. D) It is primarily excreted by the liver. 4. Acyclovir primarily treats which viruses? A) Influenza A/B B) HIV C) HSV and varicella-zoster D) Hepatitis B 5. What major adverse effect is associated with IV acyclovir? A) Hepatotoxicity B) Neurotoxicity C) Nephrotoxicity D) QT prolongation 6. Patients using topical acyclovir should be taught to: A) Apply liberally with bare hands B) Use gloves to prevent viral spread C) Take it orally for better absorption D) Mix it with moisturizer before use 7. Which virus is associated with fecal-oral transmission and self-limiting disease? A) Hepatitis B B) Hepatitis C C) Hepatitis A D) Cytomegalovirus 8. Which antiviral agent blocks viral DNA replication in hepatitis B? A) Oseltamivir B) Adefovir C) Acyclovir D) Zidovudine transcriptase in HBV. 9. Zidovudine (AZT) prevents HIV replication by: A) Blocking protease activity B) Inhibiting viral release C) Acting as a nucleotide analog to terminate DNA chain D) Disrupting viral capsid 10. Which lab value should be monitored frequently in a patient on zidovudine (AZT)? A) Electrolytes B) CBC (Complete Blood Count) C) INR D) Blood glucose 11. A major adverse effect of HAART therapy includes: A) Renal stones B) QT prolongation C) Lactic acidosis D) Hyperthyroidism 12. Which statement about HIV is correct? A) HIV is curable with HAART. B) CD4+ count increases as HIV progresses. C) Viral load monitoring occurs every 6 months. D) PrEP is ineffective in preventing HIV transmission. 13. Which antifungal binds directly to ergosterol, causing fungal cell death? A) Fluconazole B) Nystatin C) Amphotericin B D) Clotrimazole 14. Which adverse effect is common with systemic amphotericin B? A) Red-orange urine B) Renal toxicity C) Hyperkalemia D) Hypoglycemia B is nephrotoxic. 15. What should be pre-administered before amphotericin B infusion to reduce reactions? A) IV fluids only B) Antihistamines and antipyretics C) Antibiotics D) Loop diuretics 16. Which antifungal is typically used for oral thrush? A) Fluconazole B) Amphotericin B C) Nystatin D) Clotrimazole 17. When administering nystatin suspension for thrush, the nurse should: A) Tell patient to swallow immediately B) Have patient swish for 15–30 seconds C) Instruct to swish for at least 2 minutes D) Mix with mouthwash before swishing 18. Clotrimazole works by: A) Binding ergosterol directly B) Inhibiting ergosterol synthesis C) Blocking viral entry D) Killing bacteria 19. Fluconazole adverse effects include: A) Bone marrow suppression B) Hypokalemia C) Hepatotoxicity D) Gingival hyperplasia 20. Which patients should use caution with fluconazole therapy? A) Diabetics B) Liver disease patients C) Asthma patients D) COPD patients 21. Features of viral infections that complicate treatment include: (Select all that apply.) Use of host cell machinery Rapid mutation rates Large bacterial structure Protective capsid Slow replication target. 22. Oseltamivir (Tamiflu) nursing considerations include: (Select all that apply.) Start within 48 hours of symptoms Encourage annual flu vaccination Monitor for neuropsychiatric symptoms Administer with nephrotoxic agents Administer after live flu vaccine . 23. Amphotericin B adverse effects include: (Select all that apply.) Renal impairment Hypotension Infusion reaction (fever/chills) Anemia Electrolyte imbalances 24. HIV antiretroviral therapy goals include: (Select all that apply.) Increase viral load Increase CD4+ count Suppress viral replication Prevent AIDS progression Cure the infection 25. Important nursing education for patients taking antifungals includes: (Select all that apply.) Complete full course of treatment Report signs of liver dysfunction Expect drug to cure infection overnight Adhere to hygiene practices Expect mild side effects like GI upset 1. The mechanism of action for chloroquine involves: A) Inhibition of ergosterol synthesis B) Disruption of protozoal DNA and RNA synthesis C) Inhibition of bacterial ribosomes D) Promotion of antibody formation . 2. A patient receiving chloroquine should be monitored for: A) Signs of hepatotoxicity and retinal damage B) Bone marrow suppression C) Alopecia D) QT shortening 3. Cinchonism is a side effect associated with which drug? A) Metronidazole B) Mebendazole C) Amphotericin B D) Chloroquine 4. Metronidazole's mechanism of action is: A) Disruption of bacterial cell wall B) Inhibition of folic acid synthesis C) Disruption of DNA synthesis in anaerobic cells D) Inhibition of viral protease 5. A disulfiram-like reaction may occur if metronidazole is combined with: A) Dairy products B) Alcohol C) Antacids D) Proton pump inhibitors 6. Which is a harmless side effect of metronidazole therapy? A) Hyperkalemia B) Blue-green urine C) Dark-colored urine D) Jaundice 7. Which patient should NOT receive mebendazole? A) A 24-year-old male with roundworm infection B) A pregnant woman in her first trimester C) A 7-year-old child with pinworms D) A healthy adult with a tapeworm 8. Mebendazole acts by: A) Disrupting DNA replication in bacteria B) Paralyzing adult worms C) Inhibiting glucose uptake in helminths D) Enhancing protozoal apoptosis 9. Family-wide prophylaxis is recommended for which infection? A) Malaria B) Roundworm C) Hookworm D) Pinworm 10. A hallmark feature of malignant cells is: A) Slower cell division than normal cells B) Apoptosis after DNA damage C) Uncontrolled cell division D) Selective metabolic quiescence 11. Chemotherapy agents target: A) Only cancer cells B) All rapidly dividing cells C) Only dormant cancer cells D) Only cells in G1 phase 12. Which class of antineoplastic drugs cross-links DNA strands? A) Antimetabolites B) Alkylating agents C) Mitotic inhibitors D) Hormonal agents 13. Methotrexate exerts its cytotoxic effects by: A) Inhibiting dihydrofolate reductase B) Blocking protein synthesis C) Inhibiting microtubule formation D) Binding directly to DNA 14. An early sign of methotrexate toxicity is: A) Alopecia B) Bone marrow suppression C) Diarrhea D) Renal calculi 15. Which drug interaction can increase methotrexate toxicity? A) Warfarin B) Sulfonamides C) Statins D) Calcium channel blockers 16. Pulmonary fibrosis is a rare adverse effect of: A) Vincristine B) Methotrexate C) Doxorubicin D) Cyclophosphamide 17. A critical nursing intervention for chemotherapy is: A) Encouraging immediate live vaccines B) Monitoring for infection signs C) Holding fluids to prevent dilution D) Ignoring CBC results unless symptomatic 18. Tumor lysis syndrome can be prevented with: A) Daily diuretics B) Allopurinol and hydration C) Loop diuretics and potassium supplements D) Methotrexate pre-treatment 19. Antineoplastic antibiotics like doxorubicin primarily cause: A) Hepatotoxicity B) Cardiotoxicity C) Nephrotoxicity D) Neuropathy 20. Chemotherapy PPE includes: A) Surgical mask only B) Gloves and gown C) Mask, gloves, and hat D) Goggles only 21. Signs of cinchonism associated with chloroquine include: (Select all that apply.) Tinnitus Dizziness Visual changes Metallic taste Hair loss 22. Nursing considerations for metronidazole therapy include: (Select all that apply.) Avoid alcohol during and 48 hours after therapy Monitor CNS symptoms (seizures) Counsel on metallic taste Stop drug immediately if urine darkens Advise patient on completion of full course 23. Common adverse effects of chemotherapy include: (Select all that apply.) Alopecia Mucositis Myelosuppression Bone fractures GI upset 24. Important pre-treatment assessments before starting antineoplastic therapy include: (Select all that apply.) CBC Liver function tests Electrocardiogram Kidney function Sputum cultures 25. Infection prevention strategies for neutropenic patients include: (Select all that apply.) Private room if possible Frequent handwashing Live vaccines during neutropenia Monitoring for fever Use of crowds to build immunity 1. The body's first line of defense against pathogens is composed of: A) Cellular immunity B) Antibodies C) Barrier defenses D) Inflammatory response 2. Which of the following is part of the body's barrier defenses? A) Helper T cells B) Basophils C) Gastric acid D) Complement proteins 3. Which structure physically traps pathogens in the respiratory and GI tracts? A) Skin B) Mucous membranes C) Normal flora D) Bone marrow 4. What blood cell type is the first to respond during infection? A) Lymphocytes B) Basophils C) Neutrophils D) Eosinophils 5. Basophils primarily function to: A) Phagocytose bacteria B) Release histamine and mediate inflammation C) Kill parasites directly D) Suppress immune response 6. Eosinophils are most associated with combating: A) Viral infections B) Bacterial infections C) Parasites and allergies D) Cancer cells 7. Which cell type presents antigens to activate adaptive immunity? A) Neutrophils B) Basophils C) Macrophages D) Platelets 8. Which organ is the site of T-cell maturation? A) Bone marrow B) Lymph node C) Spleen D) Thymus 9. The spleen primarily functions to: A) Produce antibodies B) Filter blood and recycle RBCs C) Produce histamine D) Generate platelets 10. Which is a cardinal sign of inflammation? A) Hypertension B) Heat C) Bradycardia D) Hypothermia 11. Redness at an inflamed site is due to: A) Leukocyte infiltration B) Vasodilation C) Hypoperfusion D) Fibrosis 12. Which chemical mediator primarily increases pain during inflammation? A) Histamine B) Interleukin-1 C) Bradykinin D) Complement 13. Which chemical mediators enhance both inflammation and pathogen destruction? A) Prostaglandins B) Complement proteins C) Histamine D) Cytokines 14. The immune response characterized by specific memory is the: A) Inflammatory response B) Cellular defense C) Adaptive immune response D) Barrier defense 15. Helper T cells (CD4+) function to: A) Directly kill infected cells B) Suppress immune reactions C) Coordinate the immune response D) Secrete antibodies 16. Which cell produces antibodies? A) T cells B) Plasma cells C) Macrophages D) Natural killer (NK) cells 17. Which immunoglobulin crosses the placenta to provide fetal immunity? A) IgA B) IgM C) IgE D) IgG 18. IgE is primarily involved in: A) Mucosal immunity B) Allergic reactions and parasitic infections C) Secondary immune responses D) First-line defense 19. Which lab marker would most likely be elevated during active inflammation? A) Sodium B) CRP (C-reactive protein) C) Hemoglobin D) Platelets 20. Which is an important nursing consideration for an immunocompromised patient? A) Delay vaccinations B) Monitor WBC, CRP, ESR levels C) Encourage raw food consumption D) Ignore mild signs of infection 21. Which are considered barrier defenses? (Select all that apply.) Skin Cilia in the airway Neutrophils Tears Stomach acid 22. Signs of the inflammatory response include: (Select all that apply.) Pain Redness Bradycardia Swelling Heat 23. Functions of complement proteins include: (Select all that apply.) Enhancing phagocytosis Promoting cell lysis Opsonization Reducing inflammation 24. Helper T cells (CD4+) are responsible for: (Select all that apply.) Activating B cells Killing infected cells Coordinating immune responses Activating cytotoxic T cells Producing antibodies directly 25. Nursing interventions to protect immunocompromised patients include: (Select all that apply.) Monitoring infection markers Encouraging vaccines Promoting wound hygiene Delaying antibiotics until cultures are confirmed Educating about infection prevention 1. Aspirin inhibits inflammation primarily by: A) Blocking histamine receptors B) Irreversibly inhibiting COX enzymes C) Stimulating platelet aggregation D) Suppressing B-cell function 2. A patient on long-term aspirin therapy should be monitored for: A) Liver cirrhosis B) GI bleeding and tinnitus C) Hypokalemia D) Hyperglycemia 3. Reye's syndrome is associated with aspirin use in: A) Adults over 65 B) Children with viral infections C) Diabetic patients D) Asthmatic patients 4. Ibuprofen primarily exerts its effect by: A) Enhancing prostaglandin production B) Reversibly inhibiting COX enzymes C) Blocking T-cell activation D) Disrupting DNA synthesis 5. A major long-term risk of NSAID therapy is: A) Hepatitis B) GI ulcers and bleeding C) Hyperkalemia D) Osteoporosis 6. Acetaminophen is preferred over NSAIDs for patients with: A) Hypertension B) Liver disease C) Renal disease D) Peptic ulcer disease 7. What is the antidote for acetaminophen overdose? A) Naloxone B) Flumazenil C) Acetylcysteine D) Atropine 8. Which is a hallmark symptom of gold salt toxicity? A) Alopecia B) Gingivitis C) Tachycardia D) Hypertension 9. Auranofin is typically reserved for patients with: A) Mild osteoarthritis B) Severe, treatment-resistant rheumatoid arthritis C) Acute infections D) Hypertension 10. Interferons work by: A) Blocking prostaglandins B) Enhancing viral replication C) Enhancing immune response and inhibiting viral replication D) Blocking antibody production 11. Flu-like symptoms are a common side effect of: A) Methotrexate B) Cyclosporine C) Interferon alfa-2b D) Aspirin 12. A serious adverse effect of interleukin therapy is: A) Pulmonary embolism B) Capillary leak syndrome C) Hepatic cirrhosis D) Bone fractures 13. The mechanism of action for cyclosporine is: A) Blocking B-cell maturation B) Inhibiting T-helper cell activity C) Enhancing phagocytosis D) Increasing antibody production 14. Grapefruit juice is contraindicated with cyclosporine because it: A) Increases drug metabolism B) Decreases drug absorption C) Increases drug levels and toxicity D) Has no significant interaction 15. Passive immunity involves: A) Exposure to a live virus B) Injection of antibodies C) Activation of T cells D) Memory B-cell formation 16. A vaccine containing live, attenuated virus would include: A) Hepatitis A vaccine B) Influenza inactivated vaccine C) Varicella vaccine D) Tetanus toxoid 17. After administering a vaccine, the nurse must document: A) Blood pressure readings B) Injection site, lot number, and consent C) Blood glucose levels D) Medication reconciliation 18. Which is an adverse effect of immune sera administration? A) Anaphylaxis B) Hair loss C) Hyperglycemia D) Constipation 19. When are immune sera like Rho(D) immune globulin typically administered? A) Before vaccination B) During pregnancy in Rh-negative women C) Only during infection recovery D) In healthy newborns 20. A contraindication for receiving live attenuated vaccines is: A) History of asthma B) Mild fever C) Immunocompromised status D) Recent antibiotic use 21. Adverse effects of aspirin include: (Select all that apply.) GI ulcers Salicylism (tinnitus) Hepatotoxicity Reye's syndrome in children Constipation 22. Nursing considerations for acetaminophen include: (Select all that apply.) Max daily dose 4g Monitor liver enzymes with chronic use Monitor renal function primarily Educate on reading OTC labels Antidote is acetylcysteine 23. Common nursing monitoring points during cyclosporine therapy include: (Select all that apply.) Blood pressure Renal function Mood changes Signs of infection Liver enzymes 24. Symptoms of capillary leak syndrome include: (Select all that apply.) Hypotension Edema Hypertension Respiratory distress Fluid overload 25. Post-vaccination monitoring should include: (Select all that apply.) Observing for anaphylaxis Documenting lot number Watching for local reactions Scheduling immediate booster for all vaccines Educating about side effects 1. The central nervous system (CNS) includes: A) Brain and cranial nerves B) Brain and spinal cord C) Spinal cord and peripheral nerves D) Brainstem and somatic nerves 2. The sympathetic nervous system (SNS) is responsible for: A) Increasing GI motility B) Stimulating the "fight or flight" response C) Promoting relaxation and rest D) Decreasing heart rate 3. Acetylcholine (ACh) primarily affects: A) SNS activation B) PNS stimulation and muscle contraction C) Blood sugar levels D) Mood regulation 4. The neurotransmitter associated with mood regulation and appetite is: A) Dopamine B) Serotonin (5-HT) C) Norepinephrine D) GABA 5. Gamma-aminobutyric acid (GABA) is classified as: A) An excitatory neurotransmitter B) An inhibitory neurotransmitter C) A stress hormone D) A neuropeptide 6. Diazepam enhances the effects of: A) Dopamine B) Acetylcholine C) GABA D) Norepinephrine 7. A major concern with long-term benzodiazepine use is: A) Hypertension B) Tolerance and dependence C) Cardiotoxicity D) Kidney stones 8. The antidote for benzodiazepine overdose is: A) Naloxone B) Flumazenil C) Atropine D) Activated charcoal 9. Phenobarbital overdose is primarily managed by: A) Flumazenil B) Supportive care and airway management C) Naltrexone D) Beta-blockers 10. Which side effect is commonly associated with barbiturate use? A) Tachycardia B) Hypotension C) Insomnia D) Hyperactivity 11. Depression is primarily associated with deficiency of: A) GABA B) Serotonin, norepinephrine, dopamine C) Acetylcholine D) Histamine 12. The MOA of tricyclic antidepressants (TCAs) is to: A) Block serotonin receptors B) Inhibit reuptake of serotonin and norepinephrine C) Inhibit dopamine synthesis D) Block GABA activity 13. Fluoxetine (Prozac) belongs to which antidepressant class? A) SNRI B) MAOI C) SSRI D) TCA 14. A serious, life-threatening complication of SSRIs is: A) Neuroleptic malignant syndrome B) Hypertensive crisis C) Serotonin syndrome D) Capillary leak syndrome 15. Which symptom would alert the nurse to possible serotonin syndrome? A) Hypertension and diarrhea B) Fever, muscle rigidity, and confusion C) Bradycardia and hypothermia D) Jaundice and nausea 16. Duloxetine (Cymbalta) inhibits reuptake of: A) Dopamine and serotonin B) Serotonin and norepinephrine C) Norepinephrine only D) Serotonin only 17. A hypertensive crisis is most closely associated with: A) SSRIs B) TCAs C) MAOIs and tyramine-containing foods D) Benzodiazepines 18. Which antidepressant is least likely to cause sexual dysfunction? A) Fluoxetine B) Bupropion C) Duloxetine D) Phenelzine 19. Patients with seizure disorders should avoid which antidepressant? A) Duloxetine B) Bupropion C) Fluoxetine D) Imipramine 20. Key nursing action for a patient newly started on TCA therapy is: A) Encourage high-tyramine diet B) Monitor blood glucose C) Educate about orthostatic hypotension risk D) Administer with antacids 21. Common side effects of benzodiazepines include: (Select all that apply.) Drowsiness Respiratory depression Seizures Sedation Confusion 22. Symptoms of serotonin syndrome include: (Select all that apply.) Muscle rigidity Agitation Fever Hypotonia Diaphoresis 23. Important nursing education for patients taking MAOIs includes: (Select all that apply.) Avoid aged cheeses and fermented foods Monitor for signs of hypertensive crisis It’s safe to mix with SSRIs immediately Allow a 14-day washout period before switching antidepressants Carry medical alert identification 24. Nursing considerations for bupropion include: (Select all that apply.) Avoid use in seizure disorders Monitor for agitation and insomnia Avoid double dosing if a dose is missed Educate about risk of serotonin syndrome Take late at night to enhance sleep 25. Non-pharmacologic treatments for depression include: (Select all that apply.) Electroconvulsive therapy (ECT) Cognitive Behavioral Therapy (CBT) Stimulant therapy Exercise and sleep regulation Support groups 1. Lithium carbonate's therapeutic serum range is: A) 0.2–0.5 mEq/L B) 0.6–1.2 mEq/L C) 1.5–2.0 mEq/L D) 2.5–3.0 mEq/L 2. Early signs of lithium toxicity include: A) Bradycardia and hallucinations B) Nausea, vomiting, and tremors C) Respiratory depression D) Polycythemia and hypertension 3. Haloperidol (Haldol) is mainly used to treat: A) Negative schizophrenia symptoms B) Bipolar depression C) Positive schizophrenia symptoms D) Seizure disorders 4. Extrapyramidal symptoms (EPS) are treated with: A) Flumazenil B) Benztropine C) Naloxone D) Dantrolene 5. Which adverse effect requires immediate discontinuation of an antipsychotic? A) Drowsiness B) Neuroleptic Malignant Syndrome (NMS) C) Orthostatic hypotension D) Constipation 6. Clozapine requires regular monitoring of: A) Liver enzymes B) WBC/ANC C) Thyroid function D) Creatine kinase 7. A common side effect of methylphenidate (Ritalin) is: A) Hyperphagia B) Sedation C) Insomnia D) Bradycardia 8. Status epilepticus is initially treated with: A) Phenytoin B) Diazepam C) Phenobarbital D) Donepezil 9. A key adverse effect of phenytoin is: A) Gingival hyperplasia B) Hyperkalemia C) Tachycardia D) Increased urination 10. Therapeutic phenytoin levels are: A) 0.5–5 mcg/mL B) 5–10 mcg/mL C) 10–20 mcg/mL D) 15–30 mcg/mL 11. Patients on ethosuximide therapy should be monitored for: A) Liver cancer B) Blood dyscrasias and rash C) Vision changes D) Renal failure 12. Which neurotransmitter is deficient in Parkinson’s disease? A) Acetylcholine B) Serotonin C) GABA D) Dopamine 13. Levodopa should be administered: A) With high-protein meals B) With vitamin C C) On an empty stomach D) Just before bed 14. A harmless side effect of levodopa therapy is: A) Skin rash B) Blackened stools C) Darkened urine and sweat D) Hair loss 15. Anticholinergic side effects include: A) Diarrhea and salivation B) Dry mouth and blurred vision C) Insomnia and vomiting D) Bradycardia and sweating 16. Donepezil (Aricept) improves cognition in Alzheimer’s disease by: A) Stimulating dopamine production B) Inhibiting acetylcholinesterase C) Enhancing serotonin release D) Blocking NMDA receptors 17. Major adverse effects of donepezil include: A) Hyperkalemia and hypertension B) GI upset and bradycardia C) Seizures and hyperthermia D) Psychosis and hallucinations 18. Parkinson’s disease primary symptoms include all EXCEPT: A) Tremor B) Rigidity C) Bradykinesia D) Hyperreflexia 19. Neuroleptic Malignant Syndrome (NMS) treatment includes: A) Flumazenil B) Dantrolene C) Naloxone D) Diazepam 20. Seizure precautions for hospitalized patients include: A) Applying soft wrist restraints B) Turning patient on side during seizure C) Administering 100% oxygen immediately D) Holding down the patient’s limbs 21. Early signs of lithium toxicity include: (Select all that apply.) Nausea Muscle tremors Confusion Seizures Polyuria 22. Symptoms of Neuroleptic Malignant Syndrome include: (Select all that apply.) Fever Muscle rigidity Respiratory depression Confusion Bradycardia 23. Nursing actions for a patient on phenytoin include: (Select all that apply.) Monitor phenytoin levels Educate on oral hygiene Administer IV push rapidly Watch for rash (Stevens-Johnson syndrome) Monitor blood pressure 24. Anticholinergic side effects associated with benztropine include: (Select all that apply.) Dry mouth Blurred vision Constipation Hypotension Urinary retention 25. Key nursing considerations when administering donepezil include: (Select all that apply.) Give at bedtime Monitor for bradycardia Educate that it slows, not cures Alzheimer’s Monitor blood glucose Assess cognition regularly 1. Which condition is associated with muscle spasticity rather than muscle spasm? A) Low potassium B) Spinal cord injury C) Muscle strain D) Dehydration 2. Baclofen primarily acts by: A) Blocking sodium channels B) Acting at the spinal cord to reduce excitatory neurotransmitters C) Blocking calcium channels D) Stimulating dopamine release 3. A major concern when abruptly discontinuing baclofen is: A) Psychosis B) Seizures and hallucinations C) Cardiac arrhythmias D) Respiratory failure 4. Dantrolene is unique among muscle relaxants because it: A) Acts directly on skeletal muscle B) Is used only for psychiatric conditions C) Enhances serotonin release D) Blocks dopamine receptors 5. Dantrolene is the drug of choice for: A) Serotonin syndrome B) Malignant hyperthermia C) Neuroleptic malignant syndrome D) Status epilepticus 6. Which lab value must be closely monitored during dantrolene therapy? A) Hemoglobin B) LFTs (Liver Function Tests) C) Serum calcium D) Sodium levels 7. Which opioid receptor is primarily responsible for euphoria and analgesia? A) Delta B) Kappa C) Mu D) Beta 8. Morphine is contraindicated in patients with: A) Diarrhea B) Respiratory depression C) Hypertension D) Seizure disorders 9. Naloxone's mechanism of action is to: A) Activate mu receptors B) Block mu receptors C) Enhance serotonin release 10. A serious adverse effect of naloxone is: A) Permanent sedation B) Worsening respiratory depression C) Rapid withdrawal symptoms D) Hyperglycemia 11. Aspirin irreversibly inhibits: A) COX-1 only B) COX-2 only C) COX-1 and COX-2 enzymes D) Histamine receptors 12. The primary toxicity concern with acetaminophen overdose is: A) Renal failure B) Liver failure C) Rhabdomyolysis D) Pancreatitis 13. The antidote for acetaminophen toxicity is: A) Flumazenil B) Naloxone C) Acetylcysteine D) Atropine 14. Key nursing consideration when administering ibuprofen is monitoring for: A) Hyperkalemia B) GI bleeding and nephrotoxicity C) Hypoglycemia D) Bradycardia 15. A patient taking sumatriptan should be monitored for: A) Tachypnea B) Chest pressure or pain C) Polyuria D) Nystagmus 16. Triptans are contraindicated in patients with: A) Asthma B) Coronary artery disease (CAD) C) Diabetes D) COPD 17. Ergotamine must be avoided in pregnancy due to: A) Hypertension B) Uterine contractions C) Renal toxicity D) Weight loss 18. A major adverse effect of prolonged ergotamine use is: A) Liver cirrhosis B) Ergotism (severe vasospasm) C) Kidney stones D) Hearing loss 19. When administering opioids, the nurse must prioritize: A) Heart rate monitoring B) Respiratory rate monitoring C) Blood glucose monitoring D) Temperature monitoring 20. Key education for a patient using baclofen includes: A) Use alcohol to enhance effects B) Discontinue immediately if feeling better C) Taper slowly to avoid withdrawal D) Double dosing is safe if one dose is missed 21. Adverse effects of baclofen include: (Select all that apply.) Drowsiness Constipation Seizures if stopped abruptly Hypertension Weakness 22. Symptoms of opioid overdose include: (Select all that apply.) Pinpoint pupils Respiratory depression Bradycardia Seizures Confusion 23. Nursing actions when giving dantrolene include: (Select all that apply.) Monitor LFTs Educate about avoiding alcohol Assess for jaundice Administer with high-fat meals Monitor muscle strength 24. Non-opioid analgesics (like ibuprofen and acetaminophen) nursing considerations include: (Select all that apply.) Watch for GI bleeding with ibuprofen Max acetaminophen dose is 4g/day NSAIDs are renal protective Watch for hepatotoxicity with acetaminophen Enteric-coated aspirin reduces GI irritation 25. Education for patients prescribed sumatriptan should include: (Select all that apply.) Take at first sign of migraine Avoid using with ergotamine Report chest pain immediately Use daily for migraine prevention Avoid in patients with CAD 1. The "fight or flight" response is primarily mediated by which branch of the ANS? A) Parasympathetic B) Sympathetic C) Central D) Somatic 2. Stimulation of Alpha-1 receptors causes: A) Bronchodilation B) Vasoconstriction C) Decreased HR D) Bladder relaxation 3. Beta-1 receptor stimulation leads to: A) Decreased heart rate B) Bronchodilation C) Increased HR and contractility D) Vasodilation 4. Which neurotransmitter is primarily involved in parasympathetic nervous system signaling? A) Norepinephrine B) Dopamine C) Acetylcholine D) Epinephrine 5. A drug classified as a sympathomimetic would: A) Decrease blood pressure B) Slow heart rate C) Mimic norepinephrine/epinephrine effects D) Block acetylcholine 6. Dopamine, at moderate doses, primarily stimulates: A) Alpha-2 receptors B) Beta-1 receptors C) Beta-2 receptors D) Muscarinic receptors 7. Phenylephrine acts predominantly by stimulating: A) Alpha-1 receptors B) Beta-2 receptors C) Beta-1 receptors D) Dopamine receptors 8. A serious adverse effect of phenylephrine nasal spray is: A) Bronchospasm B) Hypotension C) Rebound congestion D) Diarrhea 9. Which drug stimulates both Beta-1 and Beta-2 receptors? A) Phenylephrine B) Isoproterenol C) Dopamine D) Labetalol 10. A common adverse effect of isoproterenol is: A) Bradycardia B) Hypotension C) Tachycardia D) Respiratory depression 11. Labetalol is best described as: A) Beta-2 agonist B) Alpha and beta blocker C) Cholinergic agonist D) Nicotinic antagonist 12. The nurse must be cautious giving labetalol to patients with: A) Diabetes B) Asthma C) Hypothyroidism D) Rheumatoid arthritis 13. Bethanechol is used to treat: A) Hypertension B) Urinary retention C) Tachycardia D) Asthma 14. Important side effects to monitor with bethanechol include: A) Tachycardia B) Hypertension C) Bradycardia and diarrhea D) Dry mouth 15. Pyridostigmine works by: A) Blocking muscarinic receptors B) Stimulating adrenergic receptors C) Inhibiting acetylcholinesterase D) Inhibiting norepinephrine uptake 16. A key sign of cholinergic crisis (SLUDGE) is: A) Dry mouth B) Urinary retention C) Lacrimation (excessive tearing) D) Constipation 17. What drug is the antidote for cholinergic crisis? A) Labetalol B) Bethanechol C) Atropine D) Naloxone 18. Donepezil improves cognitive symptoms in Alzheimer’s disease by: A) Blocking dopamine B) Enhancing serotonin C) Inhibiting acetylcholinesterase D) Stimulating GABA 19. Signs of anticholinergic toxicity include all EXCEPT: A) Dry mouth B) Confusion C) Hypothermia D) Blurred vision 20. In patients receiving atropine, the nurse must monitor for: A) Tachycardia and dry mucous membranes B) Bradycardia and sweating C) Diarrhea and nausea D) Excessive salivation 21. Common sympathetic nervous system effects include: (Select all that apply.) Pupil dilation Decreased heart rate Bronchodilation Vasoconstriction Increased blood glucose 22. Symptoms of a cholinergic crisis (SLUDGE) include: (Select all that apply.) Salivation Diarrhea Urinary retention Lacrimation GI cramping 23. Appropriate nursing considerations for patients receiving dopamine include: (Select all that apply.) Monitor ECG Monitor urine output Monitor respiratory rate closely Taper slowly when discontinuing Assess for angina 24. Expected effects of muscarinic stimulation (like bethanechol) include: (Select all that apply.) Increased GI motility Increased salivation Decreased heart rate Bronchodilation Pupil constriction 25. Signs of anticholinergic toxicity include: (Select all that apply.) Hyperthermia Dry skin Blurred vision Diarrhea Confusion 1. The anterior pituitary hormone responsible for stimulating cortisol release is: A) FSH B) TSH C) ACTH D) LH 2. Which hormone increases blood calcium levels? A) Calcitonin B) Insulin C) Aldosterone D) Parathyroid hormone (PTH) 3. The main role of ADH is to: A) Promote glucose uptake B) Conserve water in the kidneys C) Increase calcium absorption D) Stimulate uterine contractions 4. Deficiency of ADH results in: A) SIADH B) Addison’s disease C) Diabetes Insipidus D) Cushing's syndrome 5. Desmopressin should be used cautiously to avoid: A) Hyperkalemia B) Water intoxication and hyponatremia C) Hyperglycemia D) Hypocalcemia 6. Which finding would a nurse expect in a patient with SIADH? A) Polyuria B) Hypernatremia C) Hypotension D) Hyponatremia 7. Which drug is given to correct hypothyroidism? A) Methimazole B) Propylthiouracil C) Levothyroxine D) Hydrocortisone 8. How should levothyroxine be administered? A) With meals B) At bedtime C) In the morning on an empty stomach D) Anytime with water Answer: C) In the morning on an empty stomach 9. What is a concerning adverse effect of methimazole therapy? A) Hyperglycemia B) Agranulocytosis C) Hypertension D) Water retention 10. Which lab value is most concerning after starting methimazole? A) Low WBC B) High platelets C) High hemoglobin D) Low potassium 11. Symptoms of hypothyroidism include: A) Tachycardia and weight loss B) Heat intolerance and insomnia C) Fatigue and cold intolerance D) Nervousness and diarrhea 12. Thyroid storm is best treated initially with: A) Levothyroxine B) Propylthiouracil (PTU) C) Methimazole D) Prednisone 13. Key symptoms of Addison’s disease include: A) Moon face, weight gain B) Salt craving, hypotension C) Hyperglycemia, hypertension D) Exophthalmos 14. Hydrocortisone should be administered with caution because it can cause: A) Hypernatremia B) Hyperkalemia C) Hyperglycemia D) Hypercalcemia 15. A nurse would monitor which labs for a patient receiving hydrocortisone? A) WBC and platelets B) Sodium and calcium C) Glucose and electrolytes D) Hemoglobin and hematocrit 16. Hyperthyroidism results in: A) Cold intolerance B) Bradycardia C) Weight gain D) Heat intolerance 17. Which electrolyte is primarily regulated by aldosterone? A) Calcium B) Potassium C) Phosphorus D) Magnesium 18. The action of cortisol includes all EXCEPT: A) Raising blood glucose B) Promoting inflammation C) Suppressing the immune system D) Assisting in stress response 19. Which hormone directly promotes uterine contractions? A) Oxytocin B) ADH C) FSH D) TSH 20. Which of the following is a clinical sign of Cushing’s syndrome? A) Hyperpigmentation B) Weight loss C) Moon face D) Salt craving 21. Symptoms of Addison’s Disease include: (Select all that apply.) Hyperpigmentation Hypertension Salt craving Weight loss Hypoglycemia 22. Priority monitoring after administering desmopressin includes: (Select all that apply.) Blood pressure Serum sodium Urine output Blood glucose Level of consciousness 23. Signs of hypothyroidism include: (Select all that apply.) Weight gain Constipation Cold intolerance Tachycardia Fatigue 24. Clinical features of Cushing’s Syndrome include: (Select all that apply.) Buffalo hump Hyperglycemia Osteoporosis Moon face 25. Which are complications of untreated hyperthyroidism? (Select all that apply.) Thyroid storm Heart failure Bradycardia Osteoporosis Arrhythmias 1. A fasting blood glucose of 130 mg/dL would indicate: A) Normal glucose B) Hypoglycemia C) Prediabetes D) Diabetes Mellitus 2. Which finding is most characteristic of hypoglycemia? A) Fruity breath B) Sweating and tachycardia C) Polyuria D) Kussmaul respirations 3. The only insulin that can be given intravenously is: A) NPH B) Regular insulin C) Glargine D) Lispro 4. The peak effect of regular insulin occurs at: A) 15 minutes B) 2–4 hours C) 6–8 hours D) 12 hours 5. A patient with DKA would likely receive: A) Subcutaneous NPH insulin B) IV Regular insulin C) Oral Metformin D) Subcutaneous Glargine 6. Which insulin has no peak and lasts up to 24 hours? A) NPH B) Regular C) Lispro D) Glargine 7. What is the primary action of glyburide? A) Decreases hepatic glucose production B) Stimulates insulin release from pancreas C) Slows carbohydrate absorption D) Inhibits glucose reabsorption in kidneys 8. Glyburide is contraindicated in patients with: A) Penicillin allergy B) Sulfa allergy C) Peanut allergy D) Aspirin sensitivity 9. A serious adverse effect of metformin therapy is: A) Hypoglycemia B) Hepatotoxicity C) Lactic acidosis D) Pancreatitis 10. Which instruction should the nurse provide to a patient starting metformin? A) Take on an empty stomach B) Hold 24–48 hours before contrast dye C) Expect frequent hypoglycemia D) Stop if mild nausea develops 11. A patient on metformin should have which labs monitored? A) Liver enzymes B) Creatinine and GFR C) Hemoglobin and hematocrit D) Potassium 12. An appropriate food source for a hypoglycemic episode would be: A) 8 oz orange juice B) Chicken breast C) Peanut butter sandwich D) Green salad 13. After administering glucagon, the nurse should: A) Lay the patient flat on back B) Roll the patient onto their side C) Give aspirin D) Insert a urinary catheter 14. Glucagon primarily works by: A) Releasing insulin from beta cells B) Increasing liver glycogenolysis C) Stimulating pancreatic alpha cells to release insulin D) Decreasing glucose absorption in intestines 15. A patient asks why they must rotate insulin injection sites. The best response is: A) "It prevents bruising." B) "It avoids infection." C) "It prevents lipodystrophy and improves absorption." D) "It helps reduce pain." 16. Symptoms of diabetic ketoacidosis (DKA) include: A) Cold, clammy skin B) Slow, shallow breathing C) Fruity-smelling breath D) Bradycardia 17. What is a critical electrolyte to monitor when treating DKA? A) Calcium B) Potassium C) Sodium D) Magnesium 18. When should rapid-acting insulin (lispro) be administered? A) 30 minutes before meals B) Immediately after meals C) Within 15 minutes of meals D) At bedtime 19. A patient taking glyburide should avoid: A) Caffeine B) Grapefruit juice C) Alcohol D) Chocolate 20. Which patient statement indicates a need for further education about insulin? A) "I will rotate my injection sites." B) "I can mix my regular insulin and NPH insulin." C) "I can mix glargine insulin with my rapid insulin." D) "I will carry a snack for low blood sugar." 21. Which are symptoms of hypoglycemia? (Select all that apply.) Shakiness Bradycardia Sweating Confusion Fruity breath 22. Which insulins have a rapid onset of action? (Select all that apply.) Lispro Aspart Regular insulin Glargine 23. Priority nursing interventions for a patient on metformin include: (Select all that apply.) Monitor renal function Assess for GI upset Hold before contrast dye Monitor for signs of hypoglycemia 24. Important teaching for a patient on glyburide includes: (Select all that apply.) Avoid alcohol Watch for rash Report signs of hypoglycemia Expect frequent weight loss 25. Nursing priorities for a patient receiving glucagon include: (Select all that apply.) Turn patient to side Monitor blood glucose Administer oral carbohydrates when alert Administer aspirin 1. The right side of the heart is responsible for: A) Systemic circulation B) Coronary circulation C) Pulmonary circulation D) Peripheral resistance 2. What structure initiates the cardiac electrical impulse? A) AV node B) Purkinje fibers C) SA node D) Bundle of His 3. Which valve is located between the left atrium and left ventricle? A) Tricuspid valve B) Mitral valve C) Pulmonic valve D) Aortic valve 4. Which factor directly affects preload? A) Blood pressure B) Blood volume returning to heart C) Afterload D) Contractility 5. A normal cardiac output (CO) is approximately: A) 1–2 L/min B) 4–8 L/min C) 10–12 L/min D) 8–12 L/min 6. What happens during diastole? A) Ventricles contract B) Ventricles fill with blood C) Atria eject blood D) Blood flows to coronary arteries 7. Atrial fibrillation is characterized by: A) Rapid and regular atrial rhythm B) Chaotic atrial activity C) Slow heart rate D) No ventricular contraction 8. In heart failure, left-sided symptoms primarily include: A) Peripheral edema B) Jugular vein distention C) Pulmonary congestion and dyspnea D) Ascites 9. Which blood vessel effect would cause an increase in peripheral resistance? A) Vasodilation B) Vasoconstriction C) Diuresis D) Increased preload 10. The first-line medications for hypertension include all EXCEPT: A) Thiazide diuretics B) ACE inhibitors C) Beta-blockers D) Calcium channel blockers 11. A major side effect of ACE inhibitors is: A) Persistent dry cough B) Bradycardia C) Hypokalemia D) Hypernatremia 12. Which drug class blocks angiotensin II receptors? A) ACE inhibitors B) ARBs C) Beta blockers D) Calcium channel blockers 13. Which patient should NOT receive a calcium channel blocker like diltiazem? A) One with bradycardia B) One with hypertension C) One with angina D) One with tachycardia 14. What serious adverse effect is associated with nitroprusside infusion? A) Hyperkalemia B) Hypoglycemia C) Cyanide toxicity D) Angioedema 15. Which beta-blocker would be used to manage hypertension and heart failure? A) Propranolol B) Metoprolol C) Isoproterenol D) Diltiazem 16. What is the correct action before administering digoxin? A) Check blood pressure B) Assess respirations C) Check apical pulse for 1 full minute D) Assess capillary refill 17. Digoxin toxicity is increased in the presence of: A) Hyperkalemia B) Hypokalemia C) Hypernatremia D) Hyponatremia 18. Which symptom indicates digoxin toxicity? A) Weight gain B) Visual halos C) Flushing D) Diarrhea 19. Which heart failure drug increases the strength of heart contraction while slowing HR? A) Nitroprusside B) Captopril C) Digoxin D) Metoprolol 20. The antidote for severe digoxin toxicity is: A) Naloxone B) Flumazenil C) Digibind D) Atropine 21. Symptoms of left-sided heart failure include: (Select all that apply.) Crackles Edema Orthopnea Dyspnea Ascites 22. Nursing interventions for a patient on digoxin include: (Select all that apply.) Monitor apical pulse Check potassium levels Give with antacids Monitor for visual changes Educate on daily weight 23. Which are side effects of ACE inhibitors like captopril? (Select all that apply.) Dry cough Hyperkalemia Angioedema Bradycardia Hypokalemia 24. Which conditions are treated with calcium channel blockers? (Select all that apply.) Hypertension Bradycardia Angina Atrial fibrillation 25. Which assessments are critical during nitroprusside infusion? (Select all that apply.) Blood pressure monitoring Protect IV bag from light Watch for cyanide toxicity Monitor respiratory rate Monitor serum potassium 1. What is the main ion responsible for depolarization in cardiac muscle cells? A) Potassium (K⁺) B) Calcium (Ca²⁺) C) Sodium (Na⁺) D) Chloride (Cl⁻) 2. Which arrhythmia is characterized by chaotic, irregular atrial activity? A) Atrial flutter B) Atrial fibrillation C) PVC D) Ventricular tachycardia 3. Which antiarrhythmic drug class blocks sodium channels? A) Class II B) Class I C) Class III D) Class IV 4. What is the prototype drug for Class I antiarrhythmic agents? A) Lidocaine B) Propranolol C) Amiodarone D) Diltiazem 5. Propranolol is classified as which type of antiarrhythmic? A) Sodium channel blocker B) Beta blocker C) Potassium channel blocker D) Calcium channel blocker 6. What is a major adverse effect of amiodarone? A) Nephrotoxicity B) Pulmonary fibrosis C) Hyperkalemia D) Gastric ulcers 7. What key monitoring is needed for patients on amiodarone? A) Liver function tests B) Pulmonary function tests C) Thyroid tests D) All of the above 8. Which class of drugs slows AV node conduction by blocking calcium channels? A) Class I B) Class II C) Class III D) Class IV 9. What is the prototype drug for calcium channel blockers used for arrhythmias? A) Lidocaine B) Amiodarone C) Diltiazem D) Verapamil 10. Paroxysmal SVT is often treated with: A) Amiodarone B) Lidocaine C) Verapamil D) Propranolol 11. Stable angina is usually: A) Random and unpredictable B) Predictable and relieved with rest or nitrates C) Caused by artery spasms D) Only seen in diabetics 12. Which drug is given sublingually for acute angina attacks? A) Diltiazem B) Atenolol C) Nitroglycerin D) Amiodarone 13. Patients taking nitroglycerin should be taught to: A) Stand immediately after dosing B) Take it only after meals C) Sit or lie down before taking D) Avoid fluids after dosing 14. A major drug interaction warning for nitroglycerin is with: A) Beta-blockers B) Calcium channel blockers C) PDE-5 inhibitors (e.g., sildenafil) D) Statins 15. A common side effect of nitrates is: A) Constipation B) Bradycardia C) Headache D) Weight gain 16. Beta-blockers like metoprolol are used to: A) Increase HR B) Increase cardiac oxygen demand C) Decrease HR and workload D) Vasoconstrict coronary arteries 17. Which calcium channel blocker is useful for both angina and arrhythmias? A) Amiodarone B) Verapamil C) Metoprolol D) Nitroglycerin 18. What key side effect should nurses monitor in patients taking diltiazem? A) Tachycardia B) Hypotension C) Hyperkalemia D) Tachypnea 19. Which antiarrhythmic has a long half-life requiring weeks to clear from the body? A) Lidocaine B) Propranolol C) Amiodarone D) Diltiazem 20. A patient taking propranolol must be monitored closely for: A) Pulmonary fibrosis B) Hypotension and bradycardia C) Cyanide toxicity D) Angioedema 21. Which are signs of amiodarone toxicity? (Select all that apply.) Pulmonary fibrosis Thyroid dysfunction Corneal deposits Weight gain Severe nausea 22. Nursing priorities for patients on antiarrhythmics include: (Select all that apply.) Continuous ECG monitoring Monitor blood pressure Watch for bradycardia Encourage grapefruit juice intake Teach to report dizziness or syncope 23. Education for patients taking sublingual nitroglycerin includes: (Select all that apply.) Sit or lie down before taking Store in dark, original container Take up to 3 doses, 5 minutes apart if needed Swallow the tablet whole Check expiration date frequently 24. Beta-blockers help angina by: (Select all that apply.) Lowering heart rate Increasing myocardial oxygen demand Reducing contractility Reducing afterload Causing coronary vasospasm 25. Which antianginal drug classes may cause bradycardia? (Select all that apply.) Beta-blockers Nitrates Calcium channel blockers Vasodilators Potassium channel blockers 1. What is the primary goal of lipid-lowering therapy? A) Increase LDL B) Increase triglycerides C) Decrease HDL D) Decrease LDL and triglycerides, increase HDL 2. Which lipoprotein is considered “bad cholesterol”? A) HDL B) VLDL C) LDL D) Chylomicrons 3. Which of the following is a major risk factor for ASCVD? A) Low HDL B) Hypotension C) Female gender only D) Low blood sugar 4. Which medication class binds bile acids in the intestine? A) Statins B) Bile Acid Sequestrants C) Cholesterol Absorption Inhibitors D) Fibrates 5. What is the prototype drug for bile acid sequestrants? A) Atorvastatin B) Cholestyramine C) Ezetimibe D) Fenofibrate 6. What is a common adverse effect of cholestyramine? A) Muscle pain B) Constipation C) Liver failure D) Renal toxicity 7. What should cholestyramine powder be mixed with? A) Carbonated beverage B) Juice or water (non-carbonated) C) Milk D) Any soft food 8. Which class of drugs inhibits HMG-CoA reductase? A) Fibrates B) Statins C) Bile acid sequestrants D) Omega-3 fatty acids 9. What is the prototype statin drug? A) Simvastatin B) Ezetimibe C) Atorvastatin D) Cholestyramine 10. When should atorvastatin ideally be taken? A) In the morning B) At bedtime C) With a high-fat meal D) After exercise 11. What are two serious adverse effects of statins? A) Constipation and HTN B) Myopathy and hepatotoxicity C) Hyperkalemia and edema D) Nephrotoxicity and hypoglycemia 12. Which fruit should be avoided while on statins? A) Apples B) Grapefruit C) Bananas D) Blueberries 13. Ezetimibe works by: A) Blocking cholesterol synthesis B) Enhancing bile acid secretion C) Blocking cholesterol absorption in the intestine D) Increasing HDL production 14. Which lipid-lowering drug class is safest during pregnancy? A) Statins B) Cholestyramine C) Ezetimibe D) None – caution is advised 15. Before starting atorvastatin, the nurse should assess: A) Creatinine B) Blood pressure C) Liver function tests D) Thyroid panel 16. Which lab value indicates successful lipid-lowering therapy? A) LDL < 70–100 mg/dL B) LDL > 160 mg/dL C) HDL < 30 mg/dL D) Triglycerides > 200 mg/dL 17. What adverse effect must be reported immediately when taking statins? A) Dizziness B) Diarrhea C) Muscle pain or weakness D) Constipation 18. Cholestyramine should be administered: A) With carbonated beverages B) Mixed dry with food C) 1 hour before or 4–6 hours after other medications D) Only at bedtime 19. Which drug combination increases the risk of myopathy when used with statins? A) Bile acid sequestrants B) Calcium supplements C) Fibrates D) NSAIDs 20. Which hormone is directly affected by bile acid sequestrants leading to LDL reduction? A) Insulin B) Cortisol C) Bile acids D) Epinephrine 21. Which are adverse effects of statins? (Select all that apply.) Muscle pain Constipation Hepatotoxicity Hypokalemia GI upset 22. Nurses should monitor which labs when a patient is taking atorvastatin? (Select all that apply.) Liver function tests (AST/ALT) Creatine kinase (CK) Blood glucose Serum calcium LDL levels 23. Bile acid sequestrants like cholestyramine require what nursing considerations? (Select all that apply.) Administer with carbonated beverages Mix powder with water or juice Monitor for constipation Administer 1 hour before or 4–6 hours after other meds Give only via IV 24. ASCVD risk factors include: (Select all that apply.) Hypertension Obesity Family history of heart disease Low cholesterol Smoking 25. Common patient education points for lipid-lowering agents include: (Select all that apply.) Report unexplained muscle pain Avoid grapefruit juice Discontinue if you feel better without physician approval Use backup contraception with ezetimibe Monitor liver enzymes regularly 1. What is the primary concern immediately after surgery? A) Pain management B) Monitoring airway and breathing C) Assessing surgical incision D) Giving oral fluids 2. Which anesthetic stage is characterized by skeletal muscle relaxation and loss of reflexes? A) Stage I B) Stage II C) Stage III D) Stage IV 3. What is the prototype for local anesthetics? A) Nitrous oxide B) Lidocaine C) Propofol D) Dantrolene 4. What is the mechanism of action of lidocaine? A) Blocks potassium channels B) Blocks sodium channels C) Stimulates GABA receptors D) Blocks calcium channels 5. What is an early sign of lidocaine toxicity? A) Seizures B) Cardiac arrest C) Circumoral numbness and metallic taste D) Muscle paralysis 6. Which anesthetic is classified as an inhalation agent? A) Ketamine B) Lidocaine C) Nitrous oxide D) Propofol 7. What should be given after discontinuing nitrous oxide to prevent diffusion hypoxia? A) Intravenous fluids B) 100% oxygen C) Naloxone D) Epinephrine 8. Which condition is a life-threatening emergency associated with anesthesia? A) Anaphylaxis B) Malignant hyperthermia C) Rhabdomyolysis D) Diffusion hypoxia 9. What drug treats malignant hyperthermia? A) Succinylcholine B) Propofol C) Dantrolene D) Lidocaine 10. What key symptom suggests malignant hyperthermia? A) Hypotension B) Muscle rigidity C) Seizures D) Urinary retention 11. Which NMJ blocker is a depolarizing agent? A) Pancuronium B) Rocuronium C) Succinylcholine D) Vecuronium 12. What is a nursing priority when administering NMJ blockers? A) Monitor consciousness B) Ensure mechanical ventilation is available C) Administer pain medication only D) Push fluids rapidly 13. Which anesthetic agent can cause muscle fasciculations before paralysis? A) Pancuronium B) Succinylcholine C) Lidocaine D) Dantrolene 14. Which of the following are signs of systemic lidocaine toxicity? A) Hypertension and tachycardia B) Blurred vision and urinary retention C) Metallic taste and seizures D) Severe constipation 15. A nurse is preparing a patient for surgery. Which finding would require immediate notification of the provider? A) NPO for 8 hours B) Elevated WBC C) Consent signed D) Reported allergy to anesthetics 16. A patient undergoing general anesthesia is at risk for which complication if not monitored closely? A) Diffusion hypoxia B) Acute kidney injury C) Peptic ulcer disease D) Liver cirrhosis 17. What is a key action during the postoperative phase of care? A) Administer high-dose narcotics immediately B) Keep the patient NPO indefinitely C) Monitor airway, breathing, and consciousness D) Keep patient in Trendelenburg position 18. What medication should be administered if signs of malignant hyperthermia develop? A) Epinephrine B) Naloxone C) Dantrolene D) Dopamine 19. In the preoperative phase, which of the following is a nursing priority? A) Starting high-dose fluids B) Obtaining informed consent C) Giving pain medication D) Forcing oral intake 20. What electrolyte imbalance should be closely monitored in malignant hyperthermia? A) Hyperkalemia B) Hypocalcemia C) Hypoglycemia D) Hypernatremia 21. Signs of malignant hyperthermia include: (Select all that apply.) Rapid increase in temperature Jaw muscle rigidity Severe hypotension Slow heart rate Tachycardia 22. Important perioperative nursing actions include: (Select all that apply.) Confirming NPO status Monitoring oxygenation intraoperatively Providing early ambulation post-op Forcing oral fluids immediately post-op Educating about incentive spirometry 23. Local anesthetic systemic toxicity (LAST) symptoms include: (Select all that apply.) Metallic taste Seizures Constipation Bradycardia Dizziness 24. Appropriate nursing actions for patients receiving neuromuscular blockers include: (Select all that apply.) Ensuring sedation Providing airway support Monitoring consciousness closely Administering oxygen Avoiding mechanical ventilation 25. Early signs of lidocaine toxicity involve: (Select all that apply.) Numbness around the mouth Visual changes Rash Metallic taste Tinnitus 1. What lab test is monitored for patients receiving IV heparin therapy? A) INR B) aPTT C) Platelet count D) Blood glucose 2. Which medication is used as the antidote for heparin overdose? A) Vitamin K B) Protamine sulfate C) Desferal D) Alteplase 3. What is the therapeutic INR range for a patient on warfarin? A) 1–2 B) 2–3 C) 3–4 D) 4–5 4. What adverse effect is m