Nursing Pharmacology Sample Exam Questions
Pharmacology is a critical component of nursing education and practice. Understanding medications, their actions, side effects, and proper administration is essential for safe patient care. Below are sample exam questions covering various pharmacological topics to help nursing students prepare for their examinations.
Cardiovascular Medications
1. A patient prescribed furosemide (Lasix) should be monitored for which electrolyte imbalance?
Answer: C. Hypokalemia
Furosemide is a loop diuretic that causes increased excretion of sodium, chloride, water, and potassium. Patients on furosemide are at risk for hypokalemia, which can lead to cardiac arrhythmias. Regular monitoring of potassium levels and potential potassium supplementation are important for patients on this medication.
2. Which medication is indicated for the treatment of acute angina pectoris?
Answer: B. Nitroglycerin
Nitroglycerin is a vasodilator that relaxes blood vessels, reducing cardiac workload and improving oxygen supply to the heart. It is the primary medication for immediate relief of acute angina pectoris. Sublingual nitroglycerin is typically administered for chest pain, providing rapid relief within 1-3 minutes.
Antibiotics
3. A patient receiving intravenous vancomycin should be monitored for which potential adverse effect?
Answer: A. Nephrotoxicity
Vancomycin can cause nephrotoxicity, particularly when administered intravenously at high doses or for prolonged periods. Nurses should monitor the patient's renal function, including serum creatinine and BUN levels, as well as urine output. Red Man Syndrome, a histamine-mediated reaction characterized by flushing and pruritus, is another important side effect to monitor for, especially if the drug is infused too quickly.
4. Which instruction should the nurse provide to a patient prescribed tetracycline?
Answer: B. Avoid exposure to sunlight while taking this medication
Tetracycline can cause photosensitivity, making patients more sensitive to sunlight and increasing the risk of sunburn. Patients should be instructed to use sunscreen, wear protective clothing, and avoid excessive sun exposure. Additionally, tetracycline should not be taken with dairy products, antacids, or iron supplements as they can decrease absorption, and it does not typically cause urine discoloration.
Central Nervous System Medications
5. Which neurotransmitter is primarily affected by selective serotonin reuptake inhibitors (SSRIs)?
Answer: C. Serotonin
SSRIs work by blocking the reabsorption (reuptake) of serotonin into neurons, increasing the amount of serotonin available in the synaptic cleft. This mechanism helps improve mood in depression and is also used in treating anxiety disorders, obsessive-compulsive disorder, and other conditions. Common SSRIs include fluoxetine, sertraline, and escitalopram.
6. A patient taking lithium for bipolar disorder should be instructed to:
Answer: A. Maintain consistent fluid and sodium intake
Lithium has a narrow therapeutic index, meaning the difference between therapeutic and toxic levels is small. Changes in hydration and sodium balance can significantly affect lithium levels. Dehydration or low sodium intake can lead to lithium accumulation and toxicity, while increased sodium intake can decrease lithium effectiveness. Regular blood level monitoring and consistent fluid and sodium intake are critical for safe lithium therapy.
Endocrine Medications
7. Which characteristic is most concerning in a patient who might be experiencing adrenal crisis?
Answer: B. Hypotension
Adrenal crisis is a life-threatening situation caused by insufficient adrenal cortex hormones, particularly cortisol. The hallmark signs include severe hypotension that may progress to shock, abdominal pain, vomiting, weakness, and confusion. While hyperglycemia, weight gain, and fluid retention can occur with adrenal insufficiency, acute hypotension is the most critical and immediately dangerous manifestation of adrenal crisis requiring emergency treatment with intravenous corticosteroids and fluids.
8. The nurse should instruct a patient taking oral hypoglycemic agents to:
Answer: B. Take the medication with meals
Most oral hypoglycemic agents should be taken with meals to reduce gastrointestinal side effects and to synchronize the drug's peak action with postprandial glucose elevations. Patients should never skip doses, change dosages, or discontinue medication without consulting their healthcare provider. If hypoglycemia occurs, patients should consume fast-acting carbohydrates and contact their provider if symptoms persist or are severe.
Respiratory Medications
9. Which medication would be most appropriate for a patient experiencing acute bronchospasm?
Answer: C. Albuterol
Albuterol is a short-acting beta-2 agonist that provides rapid relief of acute bronchospasm. It works by relaxing the smooth muscles of the airways, resulting in bronchodilation. For acute respiratory distress, albuterol is typically administered via inhaler or nebulizer. While ipratropium (an anticholinergic) may also be used in some cases, albuterol is more commonly used first for acute symptoms due to its faster onset of action.
10. A patient using a metered-dose inhaler (MDI) should be instructed to:
Answer: B. Hold breath for 5-10 seconds after inhalation
Proper MDI technique includes shaking the inhaler before use, exhaling completely, placing the mouthpiece in the mouth with lips sealed, pressing the canister while beginning a slow inhalation, holding breath for 5-10 seconds to allow medication deposition, and waiting if multiple puffs are prescribed (typically 30-60 seconds between puffs). Proper technique ensures medication delivery to the lungs rather than the oropharynx.
Gastrointestinal Medications
11. A patient receiving proton pump inhibitors should be monitored for which potential complication?
Answer: B. Hypomagnesemia
Long-term use of proton pump inhibitors (PPIs) such as omeprazole, pantoprazole, and esomeprazole has been associated with hypomagnesemia. In severe cases, this can lead to muscle spasms, arrhythmias, and seizures. Patients on long-term PPI therapy should have periodic magnesium level monitoring. Other potential long-term complications of PPIs include increased risk of fractures, Clostridium difficile infections, and vitamin B12 deficiency.
12. Which antiemetic works by blocking serotonin receptors?
Answer: C. Ondansetron
Ondansetron is a 5-HT3 receptor antagonist that prevents serotonin binding to its receptors, particularly in the gastrointestinal tract and the chemoreceptor trigger zone in the brain. It is commonly used to prevent and treat nausea and vomiting associated with chemotherapy, radiation therapy, and surgery. It is more selective for these receptors than other antiemetics, making it effective with fewer side effects.
Study Tips for Nursing Pharmacology
- Create medication cards: Include drug class, mechanism of action, indications, contraindications, side effects, and nursing considerations.
- Focus on drug classes: Learn characteristics of classes rather than memorizing individual drugs. This helps with understanding medications you may not have encountered before.
- Practice calculation problems: Dosage calculations are essential for safe medication administration. Practice regularly to build confidence.
- Learn suffixes and prefixes: Many medications have endings that indicate their class (e.g., "-lol" for beta-blockers, "-pril" for ACE inhibitors).
- Focus on high-alert medications: Pay special attention to medications with heightened risk of causing significant patient harm when used in error.
- Understand the nursing process: Pharmacology questions often require applying assessment, planning, implementation, and evaluation to medication scenarios.
- Use concept mapping: Connect pharmacological knowledge with pathophysiology, assessment findings, and nursing interventions.
Mastering pharmacology requires understanding not just what drugs do, but how they affect the body in both therapeutic and harmful ways. Regular review of medications and their clinical applications will help build the knowledge base needed for safe medication administration and successful completion of nursing pharmacology examinations.
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