NR293 Exam 4 Actual Exam Style V3 | NR
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient with depression is prescribed fluoxetine. Which statement by the patient
indicates a correct understanding of the medication’s administration?
A. I will take this drug in the morning to avoid trouble sleeping.
B. I should expect to feel much better within the first two days.
C. I will take this medication right before I go to bed.
D. I can stop taking the medicine as soon as my mood improves.
Answer: A
Rationale: Fluoxetine is an SSRI that often causes CNS stimulation and insomnia, making
morning administration the preferred timing. It typically takes two to four weeks for the
full therapeutic effect to be felt by the patient. Patients must also be instructed never to
discontinue the medication abruptly to avoid withdrawal symptoms.
2. A nurse is monitoring a patient receiving lithium carbonate for bipolar disorder. The latest
lab result shows a lithium level of 1.9 mEq/L. Which action should the nurse take first?
A. Notify the provider and withhold the next dose.
B. Administer the next scheduled dose as prescribed.
C. Increase the patient’s daily fluid intake to 4 liters.
,D. Document the finding as being within the therapeutic range.
Answer: A
Rationale: The therapeutic range for lithium is narrow, typically between 0.6 and 1.2
mEq/L, making 1.9 mEq/L a toxic level. High levels of lithium can lead to severe
complications such as seizures, arrhythmias, and kidney failure. The nurse must withhold
the medication and alert the healthcare provider immediately to prevent further toxicity.
3. A patient is being started on phenelzine for treatment-resistant depression. Which food
choice requires intervention by the nurse?
A. Fresh grilled chicken with steamed broccoli.
B. Cottage cheese with sliced peaches.
C. An egg white omelet with fresh spinach.
D. A pepperoni pizza with aged cheddar cheese.
Answer: D
Rationale: Phenelzine is an MAO inhibitor that interacts dangerously with foods high in
tyramine, such as aged cheeses and cured meats. Consuming these foods while on an MAOI
can trigger a hypertensive crisis, which is a medical emergency. The patient should be
educated to stick to fresh foods and avoid fermented or aged products.
4. The nurse is preparing to administer haloperidol to a patient. Which assessment finding
would most likely indicate the development of Neuroleptic Malignant Syndrome (NMS)?
A. Muscle flaccidity and a temperature of 98.6°F.
, B. Muscle rigidity, diaphoresis, and sudden high fever.
C. Dry mouth, blurred vision, and urinary retention.
D. Increased appetite and significant weight gain.
Answer: B
Rationale: Neuroleptic Malignant Syndrome is a life-threatening reaction to antipsychotic
drugs like haloperidol characterized by high fever and ‘lead-pipe’ muscle rigidity. It is
considered a medical emergency that requires immediate cessation of the drug and
supportive care. Other signs include autonomic instability such as tachycardia and
fluctuating blood pressure.
5. A patient is prescribed chlorpromazine. The nurse notices the patient is experiencing
involuntary upward eye movements and neck spasms. Which medication should the nurse
expect to administer?
A. Lorazepam
B. Benztropine
C. Risperidone
D. Lithium
Answer: B
Rationale: The patient is exhibiting signs of an acute dystonic reaction, which is an
extrapyramidal side effect (EPS) associated with typical antipsychotics. Benztropine is an
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient with depression is prescribed fluoxetine. Which statement by the patient
indicates a correct understanding of the medication’s administration?
A. I will take this drug in the morning to avoid trouble sleeping.
B. I should expect to feel much better within the first two days.
C. I will take this medication right before I go to bed.
D. I can stop taking the medicine as soon as my mood improves.
Answer: A
Rationale: Fluoxetine is an SSRI that often causes CNS stimulation and insomnia, making
morning administration the preferred timing. It typically takes two to four weeks for the
full therapeutic effect to be felt by the patient. Patients must also be instructed never to
discontinue the medication abruptly to avoid withdrawal symptoms.
2. A nurse is monitoring a patient receiving lithium carbonate for bipolar disorder. The latest
lab result shows a lithium level of 1.9 mEq/L. Which action should the nurse take first?
A. Notify the provider and withhold the next dose.
B. Administer the next scheduled dose as prescribed.
C. Increase the patient’s daily fluid intake to 4 liters.
,D. Document the finding as being within the therapeutic range.
Answer: A
Rationale: The therapeutic range for lithium is narrow, typically between 0.6 and 1.2
mEq/L, making 1.9 mEq/L a toxic level. High levels of lithium can lead to severe
complications such as seizures, arrhythmias, and kidney failure. The nurse must withhold
the medication and alert the healthcare provider immediately to prevent further toxicity.
3. A patient is being started on phenelzine for treatment-resistant depression. Which food
choice requires intervention by the nurse?
A. Fresh grilled chicken with steamed broccoli.
B. Cottage cheese with sliced peaches.
C. An egg white omelet with fresh spinach.
D. A pepperoni pizza with aged cheddar cheese.
Answer: D
Rationale: Phenelzine is an MAO inhibitor that interacts dangerously with foods high in
tyramine, such as aged cheeses and cured meats. Consuming these foods while on an MAOI
can trigger a hypertensive crisis, which is a medical emergency. The patient should be
educated to stick to fresh foods and avoid fermented or aged products.
4. The nurse is preparing to administer haloperidol to a patient. Which assessment finding
would most likely indicate the development of Neuroleptic Malignant Syndrome (NMS)?
A. Muscle flaccidity and a temperature of 98.6°F.
, B. Muscle rigidity, diaphoresis, and sudden high fever.
C. Dry mouth, blurred vision, and urinary retention.
D. Increased appetite and significant weight gain.
Answer: B
Rationale: Neuroleptic Malignant Syndrome is a life-threatening reaction to antipsychotic
drugs like haloperidol characterized by high fever and ‘lead-pipe’ muscle rigidity. It is
considered a medical emergency that requires immediate cessation of the drug and
supportive care. Other signs include autonomic instability such as tachycardia and
fluctuating blood pressure.
5. A patient is prescribed chlorpromazine. The nurse notices the patient is experiencing
involuntary upward eye movements and neck spasms. Which medication should the nurse
expect to administer?
A. Lorazepam
B. Benztropine
C. Risperidone
D. Lithium
Answer: B
Rationale: The patient is exhibiting signs of an acute dystonic reaction, which is an
extrapyramidal side effect (EPS) associated with typical antipsychotics. Benztropine is an
