West Coast University NURS 180 Exam 2 (pdf) | 2026/2027 |
Pharmacology Q&A | Pharmacology
1. A client is diagnosed with schizophrenia and is prescribed a first-
generation antipsychotic. The nurse understands that this medication
primarily targets which type of symptoms?
A) Negative symptoms
B) Positive symptoms
C) Cognitive symptoms
D) Mood symptoms
Correct Answer: Positive symptoms
Rationale: First-generation antipsychotics are most effective at targeting
positive symptoms of schizophrenia, such as hallucinations, delusions, and
disorganized thinking. They have limited effect on negative symptoms like
flat affect and avolition. Second-generation antipsychotics are more effective
for negative and cognitive symptoms.
2. A client is experiencing acute dystonia after receiving an antipsychotic
medication. Which medication should the nurse anticipate administering?
A) Haloperidol
B) Clozapine
C) Diphenhydramine (Benadryl)
D) Lorazepam
Correct Answer: Diphenhydramine (Benadryl)
Rationale: Acute dystonia is a severe muscle spasm that is an extrapyramidal
symptom (EPS). It requires immediate intervention and is typically treated
with anticholinergic medications such as diphenhydramine (Benadryl) or
,benztropine (Cogentin). Haloperidol is an antipsychotic that can cause EPS,
and clozapine is an atypical antipsychotic.
3. The nurse is caring for a client with schizophrenia who exhibits lip-
smacking, tongue protrusion, and facial grimacing. The nurse should suspect
which condition?
A) Acute dystonia
B) Akathisia
C) Tardive dyskinesia
D) Neuroleptic malignant syndrome
Correct Answer: Tardive dyskinesia
Rationale: Tardive dyskinesia is a late-onset side effect of antipsychotic
medications characterized by involuntary, repetitive movements, often of the
face and mouth (e.g., tongue protrusion, lip-smacking). It can be irreversible
and requires discontinuation of the offending medication. Acute dystonia is a
sudden muscle spasm, akathisia is a feeling of inner restlessness, and NMS is
a life-threatening reaction with fever and muscle rigidity.
4. A client with schizophrenia is experiencing akathisia. Which statement by
the client is most consistent with this condition?
A) "My muscles are stiff and rigid."
B) "I can't sit still; I feel like I have to keep moving."
C) "My tongue keeps sticking out involuntarily."
D) "I have a high fever and my muscles are very rigid."
Correct Answer: "I can't sit still; I feel like I have to keep moving."
,Rationale: Akathisia is an extrapyramidal symptom characterized by a
subjective feeling of inner restlessness and an uncontrollable need to be in
constant motion. Muscle stiffness is associated with drug-induced
parkinsonism, tongue protrusion with tardive dyskinesia, and fever with
rigidity are signs of NMS.
5. The nurse is assessing a client for negative symptoms of schizophrenia.
Which finding is consistent with negative symptoms?
A) Hallucinations
B) Delusions
C) Avolition
D) Disorganized speech
Correct Answer: Avolition
Rationale: Negative symptoms of schizophrenia represent a deficit in normal
functioning and include avolition (lack of motivation), flat affect, alogia
(poverty of speech), anhedonia (inability to experience pleasure), and
asociality. Hallucinations, delusions, and disorganized speech are positive
symptoms (excesses of normal function).
6. A client is experiencing neuroleptic malignant syndrome (NMS). Which
assessment finding is most characteristic of this condition?
A) Hypotension and bradycardia
B) Hyperthermia, muscle rigidity, and autonomic instability
C) Involuntary facial movements and lip-smacking
D) Restlessness and an inability to sit still
Correct Answer: Hyperthermia, muscle rigidity, and autonomic instability
, Rationale: Neuroleptic malignant syndrome (NMS) is a life-threatening
reaction to antipsychotic drugs characterized by hyperthermia, severe
muscle rigidity, autonomic instability (tachycardia, labile blood pressure),
and altered mental status. It requires immediate intervention, including
discontinuation of the antipsychotic and supportive care.
7. A client is prescribed disulfiram (Antabuse) for alcohol use disorder. Which
instruction is most important for the nurse to include in client teaching?
A) "Take this medication with food to prevent stomach upset."
B) "Avoid all products containing alcohol, including mouthwash and cough
syrup."
C) "This medication will reduce your cravings for alcohol."
D) "You can safely drink alcohol 24 hours after stopping this medication."
Correct Answer: "Avoid all products containing alcohol, including mouthwash
and cough syrup."
Rationale: Disulfiram is an alcohol deterrent that causes a severe adverse
reaction (flushing, nausea, vomiting, hypotension) when combined with
alcohol. Clients must avoid all alcohol-containing products, including
mouthwash, cough syrup, and even alcohol swabs. Naltrexone reduces
cravings.
8. A client is experiencing alcohol withdrawal. Which symptom is a priority
concern for the nurse?
A) Nausea and vomiting
B) Anxiety and insomnia
C) Seizures and delirium tremens
D) Diaphoresis and tachycardia
Correct Answer: Seizures and delirium tremens
Pharmacology Q&A | Pharmacology
1. A client is diagnosed with schizophrenia and is prescribed a first-
generation antipsychotic. The nurse understands that this medication
primarily targets which type of symptoms?
A) Negative symptoms
B) Positive symptoms
C) Cognitive symptoms
D) Mood symptoms
Correct Answer: Positive symptoms
Rationale: First-generation antipsychotics are most effective at targeting
positive symptoms of schizophrenia, such as hallucinations, delusions, and
disorganized thinking. They have limited effect on negative symptoms like
flat affect and avolition. Second-generation antipsychotics are more effective
for negative and cognitive symptoms.
2. A client is experiencing acute dystonia after receiving an antipsychotic
medication. Which medication should the nurse anticipate administering?
A) Haloperidol
B) Clozapine
C) Diphenhydramine (Benadryl)
D) Lorazepam
Correct Answer: Diphenhydramine (Benadryl)
Rationale: Acute dystonia is a severe muscle spasm that is an extrapyramidal
symptom (EPS). It requires immediate intervention and is typically treated
with anticholinergic medications such as diphenhydramine (Benadryl) or
,benztropine (Cogentin). Haloperidol is an antipsychotic that can cause EPS,
and clozapine is an atypical antipsychotic.
3. The nurse is caring for a client with schizophrenia who exhibits lip-
smacking, tongue protrusion, and facial grimacing. The nurse should suspect
which condition?
A) Acute dystonia
B) Akathisia
C) Tardive dyskinesia
D) Neuroleptic malignant syndrome
Correct Answer: Tardive dyskinesia
Rationale: Tardive dyskinesia is a late-onset side effect of antipsychotic
medications characterized by involuntary, repetitive movements, often of the
face and mouth (e.g., tongue protrusion, lip-smacking). It can be irreversible
and requires discontinuation of the offending medication. Acute dystonia is a
sudden muscle spasm, akathisia is a feeling of inner restlessness, and NMS is
a life-threatening reaction with fever and muscle rigidity.
4. A client with schizophrenia is experiencing akathisia. Which statement by
the client is most consistent with this condition?
A) "My muscles are stiff and rigid."
B) "I can't sit still; I feel like I have to keep moving."
C) "My tongue keeps sticking out involuntarily."
D) "I have a high fever and my muscles are very rigid."
Correct Answer: "I can't sit still; I feel like I have to keep moving."
,Rationale: Akathisia is an extrapyramidal symptom characterized by a
subjective feeling of inner restlessness and an uncontrollable need to be in
constant motion. Muscle stiffness is associated with drug-induced
parkinsonism, tongue protrusion with tardive dyskinesia, and fever with
rigidity are signs of NMS.
5. The nurse is assessing a client for negative symptoms of schizophrenia.
Which finding is consistent with negative symptoms?
A) Hallucinations
B) Delusions
C) Avolition
D) Disorganized speech
Correct Answer: Avolition
Rationale: Negative symptoms of schizophrenia represent a deficit in normal
functioning and include avolition (lack of motivation), flat affect, alogia
(poverty of speech), anhedonia (inability to experience pleasure), and
asociality. Hallucinations, delusions, and disorganized speech are positive
symptoms (excesses of normal function).
6. A client is experiencing neuroleptic malignant syndrome (NMS). Which
assessment finding is most characteristic of this condition?
A) Hypotension and bradycardia
B) Hyperthermia, muscle rigidity, and autonomic instability
C) Involuntary facial movements and lip-smacking
D) Restlessness and an inability to sit still
Correct Answer: Hyperthermia, muscle rigidity, and autonomic instability
, Rationale: Neuroleptic malignant syndrome (NMS) is a life-threatening
reaction to antipsychotic drugs characterized by hyperthermia, severe
muscle rigidity, autonomic instability (tachycardia, labile blood pressure),
and altered mental status. It requires immediate intervention, including
discontinuation of the antipsychotic and supportive care.
7. A client is prescribed disulfiram (Antabuse) for alcohol use disorder. Which
instruction is most important for the nurse to include in client teaching?
A) "Take this medication with food to prevent stomach upset."
B) "Avoid all products containing alcohol, including mouthwash and cough
syrup."
C) "This medication will reduce your cravings for alcohol."
D) "You can safely drink alcohol 24 hours after stopping this medication."
Correct Answer: "Avoid all products containing alcohol, including mouthwash
and cough syrup."
Rationale: Disulfiram is an alcohol deterrent that causes a severe adverse
reaction (flushing, nausea, vomiting, hypotension) when combined with
alcohol. Clients must avoid all alcohol-containing products, including
mouthwash, cough syrup, and even alcohol swabs. Naltrexone reduces
cravings.
8. A client is experiencing alcohol withdrawal. Which symptom is a priority
concern for the nurse?
A) Nausea and vomiting
B) Anxiety and insomnia
C) Seizures and delirium tremens
D) Diaphoresis and tachycardia
Correct Answer: Seizures and delirium tremens
