NU 578 UNIT 2 EXAM | ADVANCED NURSING |
QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
UNIVERSITY OF SOUTH ALABAMA
1. A 68-year-old patient with chronic osteoarthritis pain is prescribed extended-
release morphine. The patient reports breakthrough pain at night. Which is the best
intervention?
A. Increase the total daily dose of extended-release morphine.
B. Prescribe an immediate-release opioid for breakthrough pain.
C. Switch the patient to a non-opioid analgesic only.
D. Recommend alternating doses every 2 hours.
Answer: B
Rationale: Breakthrough pain is best managed with immediate-release opioids
rather than increasing extended-release doses, which maintains baseline analgesia
without increasing toxicity.
2. A patient presents with respiratory depression, miosis, and decreased level of
consciousness. What is the most appropriate first-line intervention?
A. Administer intravenous Naloxone.
B. Increase oxygen supplementation only.
C. Give activated charcoal.
D. Administer Methylnaltrexone.
Answer: A
Rationale: The classic triad of opioid overdose is coma, miosis, and respiratory
depression. Naloxone, a mu-opioid antagonist, reverses opioid toxicity
immediately.
,3. Which of the following is a common side effect of chronic opioid therapy that
is not effectively managed with conventional laxatives?
A. Nausea
B. Sedation
C. Constipation
D. Pruritus
Answer: C
Rationale: Opioid-induced constipation often requires peripherally acting opioid
antagonists like Methylnaltrexone, as conventional laxatives may be insufficient.
4. A patient with Parkinson’s disease is taking Levodopa/Carbidopa. Which
symptom is most likely a side effect of this therapy?
A. Bradycardia
B. Livedo reticularis
C. Dyskinesias
D. Seizures
Answer: C
Rationale: Long-term Levodopa/Carbidopa use can lead to dyskinesias
(involuntary movements) due to fluctuating dopamine levels.
5. A 75-year-old patient with Alzheimer’s disease is started on Donepezil. The
nurse should monitor for:
A. Hypertension and tremors
B. Bradycardia and syncope
C. Hyperglycemia and weight gain
D. Insomnia and agitation
Answer: B
Rationale: Donepezil, a cholinesterase inhibitor, can enhance peripheral
cholinergic activity, causing bradycardia and increasing fall risk.
,6. Which drug is considered first-line for absence seizures?
A. Valproic acid
B. Ethosuximide
C. Phenytoin
D. Carbamazepine
Answer: B
Rationale: Ethosuximide is the drug of choice for absence seizures, specifically
targeting T-type calcium channels.
7. A patient taking Lithium reports nausea, tremor, and ataxia. Which action
should the nurse take immediately?
A. Advise the patient to drink more fluids and continue the medication.
B. Hold the medication and obtain a serum lithium level.
C. Increase the dose for therapeutic effect.
D. Add a loop diuretic to enhance excretion.
Answer: B
Rationale: These symptoms indicate potential lithium toxicity; serum levels must
be checked immediately, and the dose should be withheld until evaluation.
8. A patient with multiple sclerosis is starting Dimethyl Fumarate. What vaccine-
related precaution should the nurse teach?
A. All live vaccines are contraindicated during therapy.
B. Only influenza vaccines are contraindicated.
C. Vaccination is not affected by therapy.
D. Vaccines can be administered without timing considerations.
Answer: A
Rationale: Dimethyl Fumarate is immunomodulatory; live vaccines can cause
infection and should be avoided.
, 9. A 42-year-old patient experiences migraine headaches 3–4 times per month. The
provider prescribes Sumatriptan for abortive therapy. Which statement by the
patient indicates understanding?
A. “I should take this every day to prevent migraines.”
B. “I will take this as soon as I feel a migraine starting.”
C. “I should avoid using it for severe nausea only.”
D. “This medication is mainly for tension headaches.”
Answer: B
Rationale: Triptans like Sumatriptan are abortive therapy for acute migraine
attacks, not for prophylaxis.
10. Which statement about MAO-B inhibitors used in Parkinson’s disease is
accurate?
A. They are safe with any dietary intake of tyramine.
B. They increase dopamine levels by inhibiting its breakdown.
C. They are first-line for severe Alzheimer’s disease.
D. They are used for seizure disorders.
Answer: B
Rationale: MAO-B inhibitors (e.g., Selegiline, Rasagiline) prevent dopamine
breakdown, enhancing motor function in Parkinson’s disease.
11. A patient on an SSRI reports agitation, diaphoresis, and tremor after starting a
new medication. The nurse suspects:
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Lithium toxicity
D. Opioid overdose
Answer: B
Rationale: SSRIs combined with other serotonergic drugs can precipitate
serotonin syndrome, presenting with mental status changes, autonomic
hyperactivity, and neuromuscular abnormalities.
QUESTIONS AND 100% VERIFIED ANSWERS
WITH RATIONALES GRADED A+ LATEST
UNIVERSITY OF SOUTH ALABAMA
1. A 68-year-old patient with chronic osteoarthritis pain is prescribed extended-
release morphine. The patient reports breakthrough pain at night. Which is the best
intervention?
A. Increase the total daily dose of extended-release morphine.
B. Prescribe an immediate-release opioid for breakthrough pain.
C. Switch the patient to a non-opioid analgesic only.
D. Recommend alternating doses every 2 hours.
Answer: B
Rationale: Breakthrough pain is best managed with immediate-release opioids
rather than increasing extended-release doses, which maintains baseline analgesia
without increasing toxicity.
2. A patient presents with respiratory depression, miosis, and decreased level of
consciousness. What is the most appropriate first-line intervention?
A. Administer intravenous Naloxone.
B. Increase oxygen supplementation only.
C. Give activated charcoal.
D. Administer Methylnaltrexone.
Answer: A
Rationale: The classic triad of opioid overdose is coma, miosis, and respiratory
depression. Naloxone, a mu-opioid antagonist, reverses opioid toxicity
immediately.
,3. Which of the following is a common side effect of chronic opioid therapy that
is not effectively managed with conventional laxatives?
A. Nausea
B. Sedation
C. Constipation
D. Pruritus
Answer: C
Rationale: Opioid-induced constipation often requires peripherally acting opioid
antagonists like Methylnaltrexone, as conventional laxatives may be insufficient.
4. A patient with Parkinson’s disease is taking Levodopa/Carbidopa. Which
symptom is most likely a side effect of this therapy?
A. Bradycardia
B. Livedo reticularis
C. Dyskinesias
D. Seizures
Answer: C
Rationale: Long-term Levodopa/Carbidopa use can lead to dyskinesias
(involuntary movements) due to fluctuating dopamine levels.
5. A 75-year-old patient with Alzheimer’s disease is started on Donepezil. The
nurse should monitor for:
A. Hypertension and tremors
B. Bradycardia and syncope
C. Hyperglycemia and weight gain
D. Insomnia and agitation
Answer: B
Rationale: Donepezil, a cholinesterase inhibitor, can enhance peripheral
cholinergic activity, causing bradycardia and increasing fall risk.
,6. Which drug is considered first-line for absence seizures?
A. Valproic acid
B. Ethosuximide
C. Phenytoin
D. Carbamazepine
Answer: B
Rationale: Ethosuximide is the drug of choice for absence seizures, specifically
targeting T-type calcium channels.
7. A patient taking Lithium reports nausea, tremor, and ataxia. Which action
should the nurse take immediately?
A. Advise the patient to drink more fluids and continue the medication.
B. Hold the medication and obtain a serum lithium level.
C. Increase the dose for therapeutic effect.
D. Add a loop diuretic to enhance excretion.
Answer: B
Rationale: These symptoms indicate potential lithium toxicity; serum levels must
be checked immediately, and the dose should be withheld until evaluation.
8. A patient with multiple sclerosis is starting Dimethyl Fumarate. What vaccine-
related precaution should the nurse teach?
A. All live vaccines are contraindicated during therapy.
B. Only influenza vaccines are contraindicated.
C. Vaccination is not affected by therapy.
D. Vaccines can be administered without timing considerations.
Answer: A
Rationale: Dimethyl Fumarate is immunomodulatory; live vaccines can cause
infection and should be avoided.
, 9. A 42-year-old patient experiences migraine headaches 3–4 times per month. The
provider prescribes Sumatriptan for abortive therapy. Which statement by the
patient indicates understanding?
A. “I should take this every day to prevent migraines.”
B. “I will take this as soon as I feel a migraine starting.”
C. “I should avoid using it for severe nausea only.”
D. “This medication is mainly for tension headaches.”
Answer: B
Rationale: Triptans like Sumatriptan are abortive therapy for acute migraine
attacks, not for prophylaxis.
10. Which statement about MAO-B inhibitors used in Parkinson’s disease is
accurate?
A. They are safe with any dietary intake of tyramine.
B. They increase dopamine levels by inhibiting its breakdown.
C. They are first-line for severe Alzheimer’s disease.
D. They are used for seizure disorders.
Answer: B
Rationale: MAO-B inhibitors (e.g., Selegiline, Rasagiline) prevent dopamine
breakdown, enhancing motor function in Parkinson’s disease.
11. A patient on an SSRI reports agitation, diaphoresis, and tremor after starting a
new medication. The nurse suspects:
A. Neuroleptic malignant syndrome
B. Serotonin syndrome
C. Lithium toxicity
D. Opioid overdose
Answer: B
Rationale: SSRIs combined with other serotonergic drugs can precipitate
serotonin syndrome, presenting with mental status changes, autonomic
hyperactivity, and neuromuscular abnormalities.
