Pharmacology Exam: Drug Interactions Scenarios
Study Guide 2026 PDF for Nursing Students and
Healthcare Professionals | Identifying Drug
Interactions, Adverse Effects, Medication Safety,
Clinical Decision-Making, Patient Monitoring, and
Nursing Interventions | Comprehensive
Pharmacology Exam Preparation to Strengthen
Critical Thinking, Clinical Judgment, and Safe
Medication Practices
,Question 1:
Scenario: A patient is prescribed warfarin for anticoagulation therapy. The patient starts
taking an over-the-counter medication containing ibuprofen for pain relief.
What potential interaction should the healthcare provider monitor?
• A) Increased effectiveness of ibuprofen
• B) Increased risk of bleeding due to warfarin
• C) Decreased effectiveness of warfarin
• D) Reduced pain relief from ibuprofen
Correct Option: B) Increased risk of bleeding due to warfarin
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can impair
platelet function and irritate the gastrointestinal tract, leading to higher risks of
bleeding. When taken with warfarin, an anticoagulant, the risk of major bleeding
increases significantly due to the additive effects on coagulation. Healthcare providers
should educate patients to avoid concurrent use of NSAIDs unless specifically directed.
Question 2:
Scenario: A patient with depression is being treated with fluoxetine. The patient is then
prescribed a medication containing phenelzine, an MAOI.
What is the most serious interaction that could occur?
• A) Increased serotonergic effects
• B) Serotonin syndrome
• C) Sedation
• D) Increased metabolism of fluoxetine
Correct Option: B) Serotonin syndrome
Rationale: The combination of fluoxetine, a selective serotonin reuptake inhibitor
(SSRI), and phenelzine, a monoamine oxidase inhibitor (MAOI), can lead to serotonin
syndrome, a potentially life-threatening condition characterized by excessive serotonin
levels in the brain. Symptoms include confusion, agitation, hyperreflexia, and
autonomic instability. It is crucial for healthcare providers to avoid prescribing these
drugs together and to monitor patients closely if switching from one type of
antidepressant to another.
Question 3:
, Scenario: A patient taking digoxin for heart failure begins a new regimen of azithromycin
for an infection.
What should the healthcare provider be most concerned about?
• A) Decreased effectiveness of azithromycin
• B) Increased risk of hypotension
• C) Increased levels of digoxin leading to toxicity
• D) No significant interaction
Correct Option: C) Increased levels of digoxin leading to toxicity
Rationale: Azithromycin can potentially increase digoxin levels due to the alteration of
gut flora that may affect digoxin metabolism and elimination. High digoxin levels can
lead to toxicity, presenting as nausea, vomiting, visual disturbances, and cardiac
arrhythmias. Physicians should ensure that digoxin levels are monitored closely when
starting azithromycin.
Question 4:
Scenario: A 70-year-old female with hypertension is taking lisinopril and starts taking
potassium supplements without consulting her physician.
What interaction should the healthcare provider monitor?
• A) Decreased antihypertensive effect of lisinopril
• B) Increased risk of renal impairment
• C) Hyperkalemia
• D) Increased blood pressure
Correct Option: C) Hyperkalemia
Rationale: Lisinopril is an ACE inhibitor that can cause potassium retention. When
combined with potassium supplements, the risk of hyperkalemia (elevated potassium
levels) significantly increases. Hyperkalemia can lead to serious cardiac arrhythmias
and other complications, making it vital for healthcare providers to monitor electrolyte
levels in patients taking both medications.
Question 5:
Scenario: A patient using oral corticosteroids long-term is prescribed a medication to
manage their diabetes.
What interaction should be considered regarding blood sugar levels?
Study Guide 2026 PDF for Nursing Students and
Healthcare Professionals | Identifying Drug
Interactions, Adverse Effects, Medication Safety,
Clinical Decision-Making, Patient Monitoring, and
Nursing Interventions | Comprehensive
Pharmacology Exam Preparation to Strengthen
Critical Thinking, Clinical Judgment, and Safe
Medication Practices
,Question 1:
Scenario: A patient is prescribed warfarin for anticoagulation therapy. The patient starts
taking an over-the-counter medication containing ibuprofen for pain relief.
What potential interaction should the healthcare provider monitor?
• A) Increased effectiveness of ibuprofen
• B) Increased risk of bleeding due to warfarin
• C) Decreased effectiveness of warfarin
• D) Reduced pain relief from ibuprofen
Correct Option: B) Increased risk of bleeding due to warfarin
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can impair
platelet function and irritate the gastrointestinal tract, leading to higher risks of
bleeding. When taken with warfarin, an anticoagulant, the risk of major bleeding
increases significantly due to the additive effects on coagulation. Healthcare providers
should educate patients to avoid concurrent use of NSAIDs unless specifically directed.
Question 2:
Scenario: A patient with depression is being treated with fluoxetine. The patient is then
prescribed a medication containing phenelzine, an MAOI.
What is the most serious interaction that could occur?
• A) Increased serotonergic effects
• B) Serotonin syndrome
• C) Sedation
• D) Increased metabolism of fluoxetine
Correct Option: B) Serotonin syndrome
Rationale: The combination of fluoxetine, a selective serotonin reuptake inhibitor
(SSRI), and phenelzine, a monoamine oxidase inhibitor (MAOI), can lead to serotonin
syndrome, a potentially life-threatening condition characterized by excessive serotonin
levels in the brain. Symptoms include confusion, agitation, hyperreflexia, and
autonomic instability. It is crucial for healthcare providers to avoid prescribing these
drugs together and to monitor patients closely if switching from one type of
antidepressant to another.
Question 3:
, Scenario: A patient taking digoxin for heart failure begins a new regimen of azithromycin
for an infection.
What should the healthcare provider be most concerned about?
• A) Decreased effectiveness of azithromycin
• B) Increased risk of hypotension
• C) Increased levels of digoxin leading to toxicity
• D) No significant interaction
Correct Option: C) Increased levels of digoxin leading to toxicity
Rationale: Azithromycin can potentially increase digoxin levels due to the alteration of
gut flora that may affect digoxin metabolism and elimination. High digoxin levels can
lead to toxicity, presenting as nausea, vomiting, visual disturbances, and cardiac
arrhythmias. Physicians should ensure that digoxin levels are monitored closely when
starting azithromycin.
Question 4:
Scenario: A 70-year-old female with hypertension is taking lisinopril and starts taking
potassium supplements without consulting her physician.
What interaction should the healthcare provider monitor?
• A) Decreased antihypertensive effect of lisinopril
• B) Increased risk of renal impairment
• C) Hyperkalemia
• D) Increased blood pressure
Correct Option: C) Hyperkalemia
Rationale: Lisinopril is an ACE inhibitor that can cause potassium retention. When
combined with potassium supplements, the risk of hyperkalemia (elevated potassium
levels) significantly increases. Hyperkalemia can lead to serious cardiac arrhythmias
and other complications, making it vital for healthcare providers to monitor electrolyte
levels in patients taking both medications.
Question 5:
Scenario: A patient using oral corticosteroids long-term is prescribed a medication to
manage their diabetes.
What interaction should be considered regarding blood sugar levels?
