1
WGU
WGU D116 PHARMACOLOGY REVIEW EXAM
QUESTIONS AND ANSWERS UPDATED
(2024/2025) (VERIFIED ANSWERS)
A patient is wheezing and short of breath. The nurse assesses a heart rate of 88
beats per minute, a respiratory rate of 24 breaths per minute, and a blood
pressure of 124/78 mm Hg. The prescriber orders a nonspecific beta-agonist
medication.
Besides evaluating the patient for a reduction in respiratory distress, the nurse
should monitor for which side effect? - ANS ✓YES Tachycardia
Correct! Beta-agonists are used for asthma because of their beta2 effects on
bronchial smooth muscle, causing dilation. Beta1 effects cause tachycardia and
hypertension. Beta receptors do not exert effects on the bladder.
A patient is experiencing toxic side effects from atropine, including delirium and
hallucinations. Which medication should the provider administer? - ANS ✓YES
Physostigmine
Correct! Physostigmine is the drug of choice for treating poisoning from atropine
and other drugs that cause muscarinic blockade. Donepezil is used to treat
Alzheimer disease. Edrophonium is used to distinguish between a myasthenic
crisis and a cholinesterase inhibitor overdose. Neostigmine does not cross the
blood-brain barrier and would not effectively treat this patient's central nervous
system (CNS) symptoms.
An advanced practice registered nurse has diagnosed a 44-year-old male with
depression. A plan is developed to start treatment with medication. The patient
has a history of sexual dysfunction and is concerned about taking medication
that may worsen this condition.
Which antidepressant has the benefit of enhancing libido? - ANS ✓YES
Bupropion
WGU D116
, 2
WGU
Correct! Bupropion does not cause sexual dysfunction. This will help the patient
with a history of sexual dysfunction. This will enhance the patient's libido, which
will help with both depression and sexual dysfunction.
A patient has been diagnosed with Parkinson disease (PD) and begins treatment
with carbidopa. After several months of therapy, the patient reports no change in
symptoms.
As the provider, you should do which of the following? - ANS ✓Increase the dose
of carbidopa
Discuss the "on-off" phenomenon
Reevaluate the diagnosis
NO Add a dopamine agonist
Incorrect. Adding a dopamine agonist is not indicated.
A patient who is taking oral contraceptives begins taking valproic acid for
seizures. After a week of therapy with valproic acid, the patient tells the nurse
that she is experiencing nausea.
What should the nurse do? - ANS ✓YES Ask the patient if she is taking the valproic
acid with food because taking the drug on an empty stomach can cause
gastrointestinal side effects
Correct! Gastrointestinal effects, including nausea, vomiting, and indigestion, are
common with valproic acid and can be minimized by taking the drug with food
or using an enteric-coated product. Hyperammonemia can occur when valproic
acid is combined with topiramate. Signs of pregnancy usually do not occur within
a week, so this is less likely. Hepatotoxicity is a rare adverse effect.
A patient with cerebral palsy who has been receiving baclofen via gastrostomy
tube for three months is admitted to the hospital for evaluation of new-onset
seizures.
What might you suspect to be the cause of these seizures? - ANS ✓YES Missed
doses of baclofen
WGU D116
, 3
WGU
Correct! Baclofen does not appear to cause physical dependence, but abrupt
discontinuation has been associated with adverse reactions. Abrupt withdrawal
of oral baclofen can cause visual hallucinations, paranoid ideation, and seizures
and should be considered when a patient develops these symptoms. Seizures are
not a symptom of baclofen toxicity.
A nurse is preparing a patient to go home from the emergency department after
receiving sutures for a laceration on one hand. The provider used lidocaine with
epinephrine as a local anesthetic.
Which symptom in this patient causes the most concern? - ANS ✓YES
Nervousness and tachycardia
Correct! Absorption of the vasoconstrictor can cause systemic effects, including
nervousness and tachycardia. If severe, alpha- and beta-adrenergic antagonists
can be given. Local anesthetics are nonselective modifiers of neuronal function
and can block motor neurons, so it is expected that patients may have difficulty
with movement. The sensation of pressure also is affected and is an expected
effect. As the local anesthetic wears off, the sensation of pain will return.
A patient who has recurrent migraine headaches is prescribed sumatriptan.
Which aspect of this patient's history is of concern when taking this drug? - ANS
✓Coronary artery disease
Adverse events include coronary vasospasm.
Incorrect. There is no contraindication for asthma, diabetes, or renal disease.
A patient brought to the emergency department requires sutures. The prescriber
orders a local anesthetic with epinephrine.
The epinephrine is ordered to ___________. - ANS ✓allow a reduced dose of the
anesthetic
Correct! Epinephrine prolongs absorption of the anesthetic because it is an
alpha1 agonist. It is frequently combined with a local anesthetic for this purpose
so the amount of anesthetic required may be reduced. Local anesthetics do not
induce hypertension; therefore, epinephrine would not be needed to prevent it.
WGU D116
, 4
WGU
Epinephrine does not act as an antiemetic and would not reduce anesthetic-
induced nausea. Epinephrine is not used to reduce the pain of an injection.
A patient who has been taking a monoamine oxidase inhibitor (MAOI) for
depression for several months tells the provider that the medication has not
helped with symptoms. You plan to switch the patient to an SSRI.
What should you instruct the nurse to teach this patient? - ANS ✓YES "Stop
taking the MAOI two weeks before starting the SSRI."
Correct! MAOIs increase serotonin receptor (5-HT) availability, thus greatly
increasing the risk of serotonin syndrome. MAOIs should be withdrawn at least
14 days before an SSRI is started. An SSRI should never be given at the same
time as an MAOI. It is not necessary to wait five weeks before starting an SSRI.
A patient is brought to the emergency department with shortness of breath, a
respiratory rate of 30 breaths per minute, intercostal retractions, and frothy,
pink sputum.
Which drug should the provider administer for this patient? - ANS ✓YES
Furosemide
Correct! Furosemide, a potent diuretic, is used when rapid or massive
mobilization of fluids is needed. This patient shows severe signs of congestive
heart failure with respiratory distress and pulmonary edema and needs
immediate mobilization of fluid. Hydrochlorothiazide and spironolactone are not
indicated for pulmonary edema because their diuretic effects are less rapid.
Mannitol is indicated for patients with increased intracranial pressure and must
be discontinued immediately if signs of pulmonary congestion or heart failure
occur.
A patient with a recent onset of nephrosclerosis has been taking an ACE
inhibitor and a thiazide diuretic. The patient's initial blood pressure was 148/100
mm Hg. After one month of drug therapy, the patient's blood pressure is 130/90
mm Hg.
WGU D116
WGU
WGU D116 PHARMACOLOGY REVIEW EXAM
QUESTIONS AND ANSWERS UPDATED
(2024/2025) (VERIFIED ANSWERS)
A patient is wheezing and short of breath. The nurse assesses a heart rate of 88
beats per minute, a respiratory rate of 24 breaths per minute, and a blood
pressure of 124/78 mm Hg. The prescriber orders a nonspecific beta-agonist
medication.
Besides evaluating the patient for a reduction in respiratory distress, the nurse
should monitor for which side effect? - ANS ✓YES Tachycardia
Correct! Beta-agonists are used for asthma because of their beta2 effects on
bronchial smooth muscle, causing dilation. Beta1 effects cause tachycardia and
hypertension. Beta receptors do not exert effects on the bladder.
A patient is experiencing toxic side effects from atropine, including delirium and
hallucinations. Which medication should the provider administer? - ANS ✓YES
Physostigmine
Correct! Physostigmine is the drug of choice for treating poisoning from atropine
and other drugs that cause muscarinic blockade. Donepezil is used to treat
Alzheimer disease. Edrophonium is used to distinguish between a myasthenic
crisis and a cholinesterase inhibitor overdose. Neostigmine does not cross the
blood-brain barrier and would not effectively treat this patient's central nervous
system (CNS) symptoms.
An advanced practice registered nurse has diagnosed a 44-year-old male with
depression. A plan is developed to start treatment with medication. The patient
has a history of sexual dysfunction and is concerned about taking medication
that may worsen this condition.
Which antidepressant has the benefit of enhancing libido? - ANS ✓YES
Bupropion
WGU D116
, 2
WGU
Correct! Bupropion does not cause sexual dysfunction. This will help the patient
with a history of sexual dysfunction. This will enhance the patient's libido, which
will help with both depression and sexual dysfunction.
A patient has been diagnosed with Parkinson disease (PD) and begins treatment
with carbidopa. After several months of therapy, the patient reports no change in
symptoms.
As the provider, you should do which of the following? - ANS ✓Increase the dose
of carbidopa
Discuss the "on-off" phenomenon
Reevaluate the diagnosis
NO Add a dopamine agonist
Incorrect. Adding a dopamine agonist is not indicated.
A patient who is taking oral contraceptives begins taking valproic acid for
seizures. After a week of therapy with valproic acid, the patient tells the nurse
that she is experiencing nausea.
What should the nurse do? - ANS ✓YES Ask the patient if she is taking the valproic
acid with food because taking the drug on an empty stomach can cause
gastrointestinal side effects
Correct! Gastrointestinal effects, including nausea, vomiting, and indigestion, are
common with valproic acid and can be minimized by taking the drug with food
or using an enteric-coated product. Hyperammonemia can occur when valproic
acid is combined with topiramate. Signs of pregnancy usually do not occur within
a week, so this is less likely. Hepatotoxicity is a rare adverse effect.
A patient with cerebral palsy who has been receiving baclofen via gastrostomy
tube for three months is admitted to the hospital for evaluation of new-onset
seizures.
What might you suspect to be the cause of these seizures? - ANS ✓YES Missed
doses of baclofen
WGU D116
, 3
WGU
Correct! Baclofen does not appear to cause physical dependence, but abrupt
discontinuation has been associated with adverse reactions. Abrupt withdrawal
of oral baclofen can cause visual hallucinations, paranoid ideation, and seizures
and should be considered when a patient develops these symptoms. Seizures are
not a symptom of baclofen toxicity.
A nurse is preparing a patient to go home from the emergency department after
receiving sutures for a laceration on one hand. The provider used lidocaine with
epinephrine as a local anesthetic.
Which symptom in this patient causes the most concern? - ANS ✓YES
Nervousness and tachycardia
Correct! Absorption of the vasoconstrictor can cause systemic effects, including
nervousness and tachycardia. If severe, alpha- and beta-adrenergic antagonists
can be given. Local anesthetics are nonselective modifiers of neuronal function
and can block motor neurons, so it is expected that patients may have difficulty
with movement. The sensation of pressure also is affected and is an expected
effect. As the local anesthetic wears off, the sensation of pain will return.
A patient who has recurrent migraine headaches is prescribed sumatriptan.
Which aspect of this patient's history is of concern when taking this drug? - ANS
✓Coronary artery disease
Adverse events include coronary vasospasm.
Incorrect. There is no contraindication for asthma, diabetes, or renal disease.
A patient brought to the emergency department requires sutures. The prescriber
orders a local anesthetic with epinephrine.
The epinephrine is ordered to ___________. - ANS ✓allow a reduced dose of the
anesthetic
Correct! Epinephrine prolongs absorption of the anesthetic because it is an
alpha1 agonist. It is frequently combined with a local anesthetic for this purpose
so the amount of anesthetic required may be reduced. Local anesthetics do not
induce hypertension; therefore, epinephrine would not be needed to prevent it.
WGU D116
, 4
WGU
Epinephrine does not act as an antiemetic and would not reduce anesthetic-
induced nausea. Epinephrine is not used to reduce the pain of an injection.
A patient who has been taking a monoamine oxidase inhibitor (MAOI) for
depression for several months tells the provider that the medication has not
helped with symptoms. You plan to switch the patient to an SSRI.
What should you instruct the nurse to teach this patient? - ANS ✓YES "Stop
taking the MAOI two weeks before starting the SSRI."
Correct! MAOIs increase serotonin receptor (5-HT) availability, thus greatly
increasing the risk of serotonin syndrome. MAOIs should be withdrawn at least
14 days before an SSRI is started. An SSRI should never be given at the same
time as an MAOI. It is not necessary to wait five weeks before starting an SSRI.
A patient is brought to the emergency department with shortness of breath, a
respiratory rate of 30 breaths per minute, intercostal retractions, and frothy,
pink sputum.
Which drug should the provider administer for this patient? - ANS ✓YES
Furosemide
Correct! Furosemide, a potent diuretic, is used when rapid or massive
mobilization of fluids is needed. This patient shows severe signs of congestive
heart failure with respiratory distress and pulmonary edema and needs
immediate mobilization of fluid. Hydrochlorothiazide and spironolactone are not
indicated for pulmonary edema because their diuretic effects are less rapid.
Mannitol is indicated for patients with increased intracranial pressure and must
be discontinued immediately if signs of pulmonary congestion or heart failure
occur.
A patient with a recent onset of nephrosclerosis has been taking an ACE
inhibitor and a thiazide diuretic. The patient's initial blood pressure was 148/100
mm Hg. After one month of drug therapy, the patient's blood pressure is 130/90
mm Hg.
WGU D116
