Practice questions on Clinical Pharmacology

1.When a patient is taking gold compound therapy on an outpatient basis, the nurse advises the patient
to Inform the primary care provider if .

A.The appetite decreases

B A severe headache occurs

C.A metallic taste is noted

D.Hair loss occurs

2. When administering a skeletal muscle relaxant the nurse observes the patient for the most common
Adverse reaction, which is .

A.Drowsiness

B Gastrointestinal bleeding

C.Vomiting

D.Constipation

3. When a patient is prescribed a corticosteroid for Athritis and alternate-day therapy is used, the nurse
Administers the drug .

A With food or milk

B.On an empty stomach

C.Before 9:00 AM

D bedtime

4. When allopurinol (Zyloprim) is used for the treatment of gout, the nurse .

A Administers the drug with juice or milk

B.Administers the drug after the evening Meal

C.Restricts fluids during evening hours

D.Encourages a liberal fluid intake

5. What teaching points would the nurse include when Educating the patient prescribed risedronate?

A.The drug is administered once weekly.

B.Take a daily laxative because the drug will likely cause constipation.

C.Take the drug in the morning before breakfast and immediately lie down for 30 minutes to facillitate
absorption.

D After taking the drug, remain upright for at least 30 minutes.

6.The physician prescribes norepinephrine, a potent vasopressor, to be administered to a patient in

shock.The rate of the administration of the IV fluid containing the norepinephrine is

A. maintained at a set rate of infusion

B. adjusted accordingly to maintain the patient’s blood pressure

C. given at a rate not to exceed 5 mg/min

D. discontinued when the blood pressure is 100mm Hg systolic

7. At what intervals would the nurse monitor the blood pressure of a patient taking norepinephrine?

A. every 5 to 15 minutes

B. every 30 minute

C. every hour

D. every 4 hours

8. Which of the following are the common adverse reactions the nurse would expect with the
administration of the adrenergic drugs?

A. bradycardia, lethargy, bronchial constriction

B. increase in appetite, nervousness, drowsiness

C. nausea, vomiting, hypotension

D. insomnia, nervousness, anorexia

9. When dobutamine is administered with the -adrenergic blocking drugs the nurse is aware of an
increased risk for .

A. seizures

B. arrhythmias

C. hypotension

D. hypertension

10. Epinephrine is administered cautiously in patients with

Parkinson’s disease because the drug may .

A. precipitate congestive heart failure

B. temporarily increase rigidity and tremor

C. decrease the response to antiparkinsonism drugs

D. cause confusion

11. A patient is to receive a -adrenergic drug for hypertension. Before the drug is administered the most
important assessment the nurse performs is .

A. weighing the patient

B. obtaining blood for laboratory tests

C. taking a past medical history

D. taking the blood pressure on both arms

12. When an adrenergic blocking drug is given for a lifethreatening cardiac arrhythmia, which of the
following activities would the nurse expect to be a part of patient care?

A. daily ECGs

B. fluid restriction of 1000 mL per day

C. daily weights

D. cardiac monitoring

13. To prevent complications when administering a -adrenergic blocking drug to an elderly patient, the
nurse would be particularly alert for .

A. vascular insufficiency (eg, weak peripheral pulses and cold extremities)

B. complaints of an occipital headache

C. insomnia

D. hypoglycemia

14. The patient with glaucoma will likely receive a(n)

A. /-adrenergic blocking drug

B. -adrenergic blocking drug

C. -adrenergic blocking drug

D. antiadrenergic drug

15.A patient with glaucoma is prescribed pilocarpine eye drops. One adverse reaction that the nurse will
expect with the use of this drug is .

A. a temporary loss of visual acuity

B. pain in the affected eye

C. excessive tearing of both eyes

D. mydriasis of the eyes

16. The primary care provider allows the patient to keep pilocarpine eye drops at the bedside and to
selfadminister the eye drops 4 times daily. The nurse

A. need not check with the patient concerning the eye drops because the patient is a responsible adult

B. must check the patient to be sure the medication is used properly and at the right time

C. is not responsible for monitoring the patient’s response to the medication

D. does not record the administration of the drug in the patient’s chart

17. Ms. Martin has received a diagnosis of myasthenia gravis and begins a regimen of ambenonium. The
nursing assessment is important because the dose of the drug .

A. usually must be increased every 4 hours early in therapy

B. frequently is increased or decreased early in therapy

C. is titrated according to the patient’s blood pressure

D. is gradually decreased as a therapeutic response is achieved

18.A patient taking clidinium for a peptic ulcer complains of dry mouth. The nurse should .

A. consider this to be unusual and contact the primary care provider

B. encourage the patient to take frequent sips of water

C. give the patient salt-water mouth rinses

D. ignore this reaction because it is only temporary

19. Which of the following adverse reactions would the nurse expect after the administration of
atropine as part of a patient’s preoperative medication regimen?

A. enhance the action of anesthesia

B. reduce secretions of the upper respiratory tract

C. prolong the action of the preoperative narcotic

D. increase gastric motility

20. Because of the effect of cholinergic blocking drugs on intestinal motility, the nurse must monitor the
patient taking these drugs for the development of

A. esophageal ulcers

B.Diarrhoea

C. heartburn

D. constipation

21. Anticholinergic drugs are contraindicated in patients with .

A. gout

B. glaucoma

C. diabetes

D. bradycardia

22.Ms. Brown has arthritis in her lower back, and the pain keeps her awake at night. She asks if she can
have a “sleeping pill.” In considering her request the nurse must take into account that .

A. barbiturates, if given in the presence of pain, may cause excitement or delirium

B. a hypnotic may be given instead of an analgesic to relieve her pain

C. hypnotics often increase the pain threshold

D. a hypnotic plus an analgesic is best given in this situation

23. Which of these drugs can be given at bedtime or later during the night if the patient is unable to
sleep and has at least 4 hours left to sleep?

A. temazepam

B. estazolam

C. zaleplon

D. zolpidem

24. When giving a hypnotic to Ms. Green, age 82 years, the nurse is aware that .
A. smaller doses of the drug are usually given to older patients

B. elderly patients usually require larger doses of a hypnotic

C. older adults excrete the drug faster than younger adults

D. dosages of the hypnotic may be increased each night until the desired effect is achieved

25. Which of the following points should be included in a teaching plan for a patient taking a sedative or
hypnotic?

A. An alcoholic beverage may be served 1 to 2 hours before a sedative is taken without any ill effects.

B. Dosage of the sedative may be increased if sleep is not restful.

C. These drugs may safely be used for 6 months to 1 year when given for insomnia.

D. Do not use any over-the-counter cold, cough, or allergy medications while taking a sedative or
hypnotic.

26.Which of the following sedatives/hypnotics is a Pregnancy Category X drug?

A. zolpidem

B. amobarbital

C. temazepam

D. chloral hydrate

27.A patient is prescribed phenytoin for a recurrent convulsive disorder. The nurse informs the patient
that the most common adverse reactions are .

A. related to the gastrointestinal system

B. associated with the reproductive system

C. associated with kidney function

D. related to the CNS

28. Which of the following adverse reactions, if observed in a patient prescribed phenytoin, would
indicate that the patient may be developing phenytoin toxicity?

A. severe occipital headache

B. ataxia

C. hyperactivity

D. somnolence

29. When administering phenobarbital to an elderly patient the nurse should monitor the patient for
unusual effects of the drug such as .

A. marked excitement

B. excessive sweating

C. insomnia

D. agitation

30. When caring for a patient taking a succinimide for absent seizures, the nurse monitors the patient
for blood dyscrasias. Which of the following symptoms would indicate that the patient may be
developing a blood dyscrasia?

A. constipation, blood in the stool

B. diarrhea, lethargy

C. sore throat, general malaise

D. hyperthermia, excitement

31. Which statement would be included when educating the patient taking trimethadione for absence
seizures?

A. Take this drug with milk to enhance absorption.

B. Wear a sunscreen and protective clothing when exposed to sunlight.

C. To minimize adverse reactions, take this drug once daily at bedtime.

D. Visit a dentist frequently because this drug increases the risk of gum disease.

32.The most serious adverse reactions seen with levodopa include .

A. choreiform and dystonic movements

B. depression
C. suicidal tendencies

D. paranoia

33. Elderly patients prescribed one of the dopamine receptor agonists are monitored closely for which
of the following adverse reactions?

A. occipital headache

B. hallucinations

C. paralytic ileus

D. cardiac arrhythmias

34.When taking an anticholinergic drug for parkinsonism, the patient would mostly experience which of
the following adverse reactions?

A. constipation, urinary frequency

B. muscle spasm, convulsions

C. diarrhea, hypertension

D. dry mouth, dizziness

35. The patient taking tolcapone for Parkinson’s disease is monitored closely for .

A. kidney dysfunction

B. liver dysfunction

C. agranulocytosis

D. the development of an autoimmune disease

36.Alprazolam is contraindicated in patients with

A. a psychotic disorder

B. congestive heart failure

C. diabetes
D. hypertension

37. The three types of psychotherapeutic drugs include

A. antianxiety drugs, tranquilizers, and anxiolytics

B. antidepressants, psychotropic drugs, and

anticonvulsants

C. antipsychotic drugs, benzodiazepines, and tranquilizers

D. antianxiety drugs, antidepressants, and antipsychotic drugs

38. Which antianxiety drug must be taken regularly and is not effective on a PRN basis?

A. lorazepam

B. buspirone

C. oxazepam

D. hydroxyzine

39. The benzodiazepines are pregnancy category drugs that should not be taken while lactating because
the infant may .

A. B; seizure

B. C; develop the floppy infant syndrome

C. D; become lethargic and lose weight

D. X; become hypoglycemic

40. When administering an antidepressant to a patient contemplating suicide, it is most important for
the nurse to .

A. have the patient remain upright for at least 30 minutes after taking the antidepressant

B. assess the patient in 30 minutes for a therapeutic response to the drug

C. monitor the patient for an occipital headache

D. inspect the patient’s oral cavity to be sure the drug was swallowed

41. Which of the following adverse reactions would the nurse expect to find in a patient taking
amitriptyline?

A. constipation and abdominal cramp.

B. bradycardia and double vision

C. sedation and dry mouth

D. polyuria and hypotension

42. The nurse instructs the patient taking a monoamine oxidase inhibitor not to eat foods containing .

A. glutamine

B. sugar

C. tyramine

D. large amounts of iron

43. Which of the following antidepressants would be most likely to cause the patient to have a seizure?

A. amitriptyline

B. bupropion

C. sertraline

D. venlafaxine

44. A patient taking chlorpromazine (Thorazine) for schizophrenia is also prescribed the antiparkinson
drug benztropine. What is the best explanation for adding an antiparkinson drug to the drug regimen?

A. Antiparkinson drugs prevent symptoms of tardive diskinesia, such as involuntary movements of the
face and tongue.

B. Antiparkinson drugs promote the effects of chlorpromazine.

C. Antiparkinson drugs are given to reduce the possibility of symptoms such as fine tremors, muscle
rigidity, and slow movement.

D. Antiparkinson drugs help to decrease hallucinations and delusions in patients with schizophrenia.

45. Which of the following reactions would the nurse expect to see in a patient experiencing tardive
dyskinesia?

A. Muscle rigidity, dry mouth, insomnia

B. Rhythmic, involuntary movements of the tongue, face, mouth, or jaw

C. Muscle weakness, paralysis of the eyelids, diarrhea

D. Dyspnea, somnolence, muscle spasms

46. Which of the following symptoms would indicate to the nurse that a patient taking lithium is
experiencing toxicity?

A. Constipation, abdominal cramps, rash

B. Stupor, oliguria, hypertension

C. Nausea, vomiting, diarrhea

D. Dry mouth, blurred vision, difficulty swallowing

47. In giving discharge instructions to a patient taking

lithium the nurse stresses that the patient should

A. eat a diet high in carbohydrates and low in proteins

B. increase oral fluid intake to approximately 3000 mL/day

C. have blood drawn before each dose of lithium is administered

D. avoid eating foods high in amines

48. Adverse reactions that the nurse would assess for in a patient taking rivastigmine (Exelon) include .

A. occipital headache

B. vomiting
C. hyperactivity

D. hypoactivity

49. When administering tacrine (Cognex) to a patient with AD the nurse would expect which of the
laboratory

examinations most likely to be prescribed .

A. a complete blood count

B. cholesterol levels

C. transaminase levels

D. electrolytes

50. Which of the following nursing diagnoses would the nurse most likely place on the care plan of a
patient with AD that is related to adverse reactions of the cholinesterase inhibitors?

A. Imbalanced nutrition

B. Confusion

C. Risk for suicide

D. Bowel incontinence

51. The nurse correctly administers donepezil (Aricept)

A. three times daily around the clock.

B. twice daily 1 hour before meals or 2 hours after meals.

C. once daily in the morning.

D. once daily at bedtime.

52.Which of the following is a common adverse reaction seen when administering an antihistamine?

A. Sedation

B. Blurred vision
C. Headache

D. Hypertension

53.Antihistamines are not routinely given to patient with lower respiratory disorders because .

A. the depressant effects may cause a hypotensive crisis

B. stimulation of the central nervous system may occur, resulting in paradoxical excitement

C. the effects of these drugs on the respiratory tract may cause secretions to thicken

D. antihistamines may irritate the bronchi, causing bronchospasm

54. When antihistamines are administered to patients receiving central nervous system depressants, the
nurse monitors the patient for .

A. an increase in anticholinergic effects

B. excessive sedation

C. seizure activity

D. loss of hearing

55.A patient receives a prescription for phenylephrine (Neo-Synephrine). The nurse explains that
overuse of this drug may .

A. result in hypotensive episodes

B. decrease sinus drainage

C. cause rebound nasal congestion

D. dilate capillaries in the nasal mucosa

56.When would the nurse most correctly administer an antacid to a patient taking other oral
medications?

A. With the other drugs

B. 30 minutes before or after administration of other drugs

C. 2 hours befor dministration of other drugs

D. In early morning and at bedtime

57. The patient asks how fecal softeners relieve constipation. Which of the following would be the best
response by the nurse? Fecal softeners relieve constipation by .

A. stimulating the walls of the intestine

B. promoting the retention of sodium in the fecal mass

C. promoting water retention in the fecal mass

D. lubricating the intestinal walls

58. When an anticholinergic drug is prescribed for the treatment of a peptic ulcer, the nurse observes
the patient for which of the following adverse effects?

A. Dry mouth, urinary retention

B. Edema, tachycardia

C. Weight gain, increased respiratory rate

D. Diarrhea, anorexia

59. The nurse administers antidiarrheal drugs .

A. hourly until diarrhea ceases

B. after each loose bowel movement

C. with food

D. twice a day, in the morning and at bedtime

60. When an emetic is administered, the nurse must be

alert to the possibility that the patient may .

A. become violent

B. experience severe diarrhea

C. retain fluid

D. aspirate vomitus

61. A nurse is to administer nizatidine once daily. When would the nurse most correctly administer the
once daily dose of nizatidine?

A. At bedtime

B. With the noon meal

C. In the morning before eating

D. Any time of the day with 4 ounces of orange juice

62.Which of the following adverse reactions would the nurse expect with the administration of
clomiphene?

A. Edema

B. Vasomotor flushes

C. Sedation

D. Hypertension

63. Which of the following assessments would be most important for the nurse to make when a child
receiving the growth hormone comes to the primary care provider’s office?

A. Blood pressure, pulse, and respiration

B. Diet history

C. Height and weight

D. Measurement of abdominal girth

64. Which of the following adverse reactions would lead the nurse to suspect cushingoid appearance in
a patient taking a corticosteroid?

A. Moon face, hirsutism

B. Kyphosis, periorbital edema

C. Pallor of the skin, acne

D. Exophthalmos

65. Which of the following statements, if made by the patient, would indicate a possible adverse
reaction seen with the administration of vasopressin?

A. “I am unable to see well at night.”

B. “My stomach is cramping.”

C. “I have a sore throat.”

D. “I am hungry all the time.”

66. Adverse reactions seen with the administration of fludrocortisone include: .

A. hyperactivity and headache

B. sedation, lethargy

C. edema, hypertension

D. dyspnea, confusion

67. The nurse monitors the patient taking an anabolic steroid for the more severe adverse reactions,
which include .

A. anorexia

B. nausea and vomiting

C. severe mental changes

D. acne

68. The nurse must be aware that older men taking the androgens are .

A. prone to urinary problems

B. at greater risk for hypertension

C. at increased risk for confusion

D. at increased risk for prostate cancer

69. When monitoring a patient taking an oral contraceptive, the nurse would observe the patient for
signs of excess progestin. Which of the following reactions would indicate to the nurse that a patient has
an excess of progestin?

A. Increased appetite, hair loss

B. Virilization, constipation

C. Nausea, early breakthrough bleeding

D. Deepening of the voice, light-headedness

70. A patient calls the outpatient clinic and says that she missed one day’s dose of her “birth control
pills.”Which of the following statements would be most appropriate for the nurse to make to the
patient?

A. Do not take an additional tablet but resume the regular schedule today.

B. Discontinue use of the drug and use another type of contraceptive until after your next menstrual
period.

C. Take 2 tablets today; then resume the regular daily schedule.

D. Come into the office immediately for a pregnancy test.

71. When teaching the patient taking an oral contraceptive for the first time, the nurse emphasizes the
importance of taking ____

A. two tablets per day at the first sign of ovulation

B. the drug at the same time each day

C. the drug early in the morning before arising

D. the drug each day for 20 days beginning on the first of the month
72.When oxytocin is administered over a prolonged time, which of the following adverse reactions
would be most likely to occur?

A. Hyperglycemia

B. Renal impairment

C. Increased intracranial pressure

D. Water intoxication

73. When the patient is receiving oxytocin, the nurse would notify the primary health care provider in
which of the following conditions?

A. Uterine contractions occur every 5 to 10 minutes.

B. Uterine contractions last more than 60 seconds or contractions occur more frequently than every 2 to
3 minutes.

C. Patient experiences pain during a uterine contraction.

D. Patient experiences increased thirst.

74. Which of the following adverse reactions is most indicative of ergotism?

A. Numbness, tingling of the extremities

B. Headache, blurred vision

C. Tachycardia and cardiac arrhythmias

D. Diaphoresis, increased respirations

75. During administration of ritodrine, in what position would the nurse most probably place the
patient?

A. Supine

B. Prone

C. On the left side

D. On the right side

76.A nurse working in the clinic asks how muscle paralysis could be an occasional side effect of
aminoglycoside antibiotics. The most correct answer is that these drugs

A. Prevents sodium entry into the nerve junction and acetylcholine release

B. Induce potassium efflux into the nerve terminal that necessitating acetylcholine release.

C.Induce calcium efflux into the nerve terminal which is necessary for acetylcholine release

D. Prevents calcium entry into the the nerve terminal which is necessary for acetylcholine release

77.Botulinum toxin Type A is sometimes used to diminish

A.Tetanic fade

B.Wrinkles

C.Alopecia

D.Muscle relaxation

78. The nurse can use which of these drugs as an antidote for motor paralysis

A.Pancuronium

B.gallamine

C.Pyridostigmine

D.Vesamicol

79.As a nurse, a patient was said experience hypotension due to drug use, which of the following drug
would you suspect?

A.Succinylcholine

B.gallamine

C.physostigmine

D.none of the above

80. The nurse could sometimes co-administer atropine to block the effects of

A.Neostigmine

B.Pancuronium

C.Succinylcholine

D.Acetylcholine

81.Pyridostigmine can be administered orally for the treatment of

A.Tetanic fade

B.Rigo mortis

C.Muscle relaxation

D.Myasthenia gravis

82. ____ is not used therapeutically but rather as a diagnostic test in myasthenia gravis

A.Pyridostigmine

B.Edrophonium

C.Succinylcholine

D.Pancuronium

83.Which of the these drugs has the shortest duration of action

A.Edrohonium

B.Pyridostigmine

C.Neostigmine

D.Echothiophate
84. One of the side effect a nurse should watch out for if suxamethonium must be administered is

A.Reduced Plasma Muscle levels

B.Pre operative muscle pain

C.Tachycardia

D.Bradycardia

85. Neuromuscular blocking agents could be employed in___

A.post operative surgery

B. Mysthenia gravis

C. Anaesthesia

D.Post mortem

86. Which of the following is contraindicated in glaucoma

A. Neostigmine

B. Atropine

C.Pilocarpine

D.Carbachol

87. In a bid to treat bladder outlet obstruction with the prototype anticholinergic agents, the patient
may likely experience

A.Bradycardia

B.Renal colic

C.Hyperhidrosis

D.Xerostomia
88. When administering atropine as pre-anaesthetic medication to reduce the amount of secretion and
to prevent excessive vagal tone due to anaesthesia, the nurse assess the patient for the most common
side effect which are;

A. Urine retention, cycloplegia and tachycardia

B. Bronchoconstriction and hyperhidrosis

C. Increased voiding and hypotension

D. Constriction of the smooth muscle of the ureter and bladder wall and renal colic

89.Mr Ade was administered neostigmine to defuse post-operative urine retention.The nurse observes
him for signs of neurotoxicity which include;

A.Anorexia and abdominal pain

B. Decreased urinary output and dark, concentrated urine

C. Excitement, Vomiting, restless

D.Headache and Agitation

90.Patients with asthma are not encouraged to take a drug that may induce Bronchial Constriction and
Increase Bronchial Secretions such as;

A.gallamine

B.Atropine

C.Scopolamine

D.Carbachol Rx

1.C. 19.B. 37.D. 55.C

2.A. 20.D. 38.B. 56.C

3.C. 21.B. 39.C. 57.C

4.D. 22.A. 40.D. 58.A

5.D. 23.C. 41.C. 59.B

6.B. 24.A. 42.C. 60.D

7.A. 25.D. 43.B. 61.A

8.D. 26.C. 44.C 62.B

9.D. 27.D. 45.B. 63.C

10.B 28.B. 46.C. 64.A

11.D 29.A. 47.B 65.B

12.D 30.C. 48.B. 66.C

13.A. 31.B. 49.C 67.C

14.B. 32.A. 50.A 68.D

15.A. 33.B 51.D 69.C

16.B. 34.D. 52.A. 70.A

17.B. 35.B. 53.C 71.B

18.B. 36.A. 54.B 72.D 73.B 74.A 75.C