Pharmacology MCQs

1. Pharmacology MCQs

2. A child is receiving prednisolone. Which of the following statements makes the nurse know that the mother understands the teaching about her child’s prednisolone therapy? I’ll be sure to count my child’s pulse every day I can’t feed my child her favorite oatmeal for breakfast any more I’ll keep my child away from people with colds I’ll make sure my child rests in bed every afternoon The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

3. Isoniazid (INH) and rifampicin has been ordered for a patient with tuberculosis. Which comment by the patient indicates correct understanding of the medications regimen? I’ll take the medications until I regain my strength I’ll take the medications ass prescribed for over a year I’ll take the medications with citrus juice I’ll take the medications until my white blood cell count is normal The answer is B. The therapy for tuberculosis is usually taken for 6 months to 24 months depending on which type of TB it is or which organ is affected. The patient has to continue to take the medications even though they feel cured.

4. Erythromycin is instilled into the neonate’s eyes shortly after birth. This is to prevent : Ophthalmia neonatorum Retrolental fibroplasia Corneal keratitis Acute uveitis The answer is A. The antibiotic Erythromycin prevents ophthalmia neonatorum (Ocular Gonorrheal infection).

5. A patient is receiving Clonidine (Catapress). An appropriate nursing action is : Teach the patient to change position slowly Give the medication before meals Instruct the patient to take the medication with orange juice Offer the patient a cup of tea with meals The answer is A. When people take antihypertensives sudden change of position like sitting up or standing up will cause orthostatic hypotension and the patient may feel giddy. Clonidine can be taken before or after food It is not necessary to take with orange juice Offering tea which is a stimulant is not to be encouraged

6. While the nurse is teaching a patient about warfarin sodium (coumadin) medication which statement by the patient indicates that he has not understood the instructions well? I’ll use an electric razor when shaving I’ll need to have periodic blood coagulation tests I’ll expect my urine to be dark brown I’ll check my skin to see whether I am bruising more easily The answer is C. The patient is not supposed to have dark brown urine. Dark brown urine indicates overdose of an anticoagulant. Haematuria may be the cause of the discoloration. Using an electric razor reduces the chances of injury The patient should monitor the clotting time and hence needs periodic tests Bruising indicates that there is bleeding under the skin and hence the dose has to be reduced

7. The doctor has prescribed ibuprofen for a patient with osteoarthritis. The nurse should instruct the patient to take the drug with any of the following except : Food An antacid Milk Aspirin The answer is D. Simultaneous use fo aspirin is not needed. A.,B.,C. are all helpful in preventing gastric irritation and are recommended

8. One of the side effects of Ferrous Sulfate ( Fersolate) is : Tinnitus Ataxia Blurred vision Black stools The answer is D. The stools may be black or dark green after consumption of iron preparations.

9. A patient who has iron deficiency anemia has been prescribed ferrous gluconate. How is it administered? Undiluted, with a dropper Undiluted, from a teaspoon Diluted with milk, in a glass Diluted with water through a straw The answer is D. Ferrous gluconate should be well diluted and administered by a straw or placed on the back of the tongue with a dropper to prevent staining and to mask the taste. The preparation is not compatible with milk

10. Which one of the following is the side effect of Digoxin? Blurred vision Hand tremours Urinary retention Hearing loss The answer is A. The adverse effects of digoxin are nausea, vomiting, anorexia, and vision disturbances like blurred or yellow vision. B.,C., and D. are not the adverse effects of digoxin

11. Which of the following medicine counteracts the adverse effects of heparin sodium? Calcium gluconate Protamine sulphate Chlorambucil Lithium carbonate The answer is B. The specific antidote for Heparin sodium is Protamine sulphate. When given intravenously it binds with heparin and renders it ineffective within a few minutes.

12. Which one of the following is most likely to cause Peptic Ulcer? Taking ibuprofen daily for arthritis pain Working on a photocopy machine 8 hours a day, 5 days a week Strict vegetarian diet always Family history of severe psoriasis The answer is A. Ibuprofen is an NSAID. It can erode the gastric mucosal barrier predisposing to ulcer formation.

13. An intramuscular injection of iron dextran (Jectocos) is administered for iron deficiency. Which of the following nursing action is appropriate while administering Iron injection? Asking the patient whether he consumes alcoholic beverages daily Finding out if he is allergic to fish oil Administer the intramuscular injection by Z-track method Use a 1” 25G needle to inject to minimize the pain of the injection The answer is C. The IM injection has to be given by the Z-track method so that the drug will not leak out to the subcutaneous plane and cause staining of the subcutaneous tissues. A. & B. are irrelevant D. The drug has to be injected deep into the muscle. An one inch needle may deposit the drug in the subcutaneous tissue. It will not reach the muscle at all. A 2” 19G or 20G needle will be preferable

14. A patient has received two units of whole blood following an episode of GI bleeding. Which of the following laboratory reports would the nurse monitor most closely? Bleeding time Hemoglobin and hematocrit White blood cells Platelets The answer is B. Hemoglobin and hematocrit. The post transfusion haematocrit provides immediate information on red cell replacement and about continued blood loss

15. A patient of congestive heart failure has been prescribed Lanoxin (digoxin). What would the nurse expect to find when evaluating for therapeutic effectiveness of Lanoxin? Diaphoresis with decreased urinary output Increased heart rate with increased respiratory rate Improved respiratory status and increased urinary output Decreased chest pain and decreased blood pressure The answer is C. Digoxin is a cardiac glycoside. It is used in congestive cardiac failure to slow down the Heart Rate and to increase the strength of the cardiac contraction so that the cardiac output increases. Increased cardiac output will improve renal perfusion and increase urinary output Adverse effects of digoxin are : bradycardia, dysrhythmia, visual and GI disturbances. Patients receiving digoxin should have their apical pulse monitored for one full minute before and after administration of this drug

16. A child ir receiving prednisolone. Which following statement makes the nurse know that the mother understands the teaching about her child’s prednisolone therapy? I’ll be sure to count my child’s pulse every day I can’t feed my child her favorite oatmeal for breakfast any more I’ll keep my child away from people with colds I’ll make sure my child rests in bed every afternoon The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

17. A child ir receiving prednisolone. Which following statement makes the nurse know that the mother understands the teaching about her child’s prednisolone therapy? I’ll be sure to count my child’s pulse every day I can’t feed my child her favorite oatmeal for breakfast any more I’ll keep my child away from people with colds I’ll make sure my child rests in bed every afternoon The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

18. The nurse is caring for a patient receiving a blood transfusion who develops urticarial in 30 minutes. What is the first action to be taken by the nurse? Stop the infusion Slow the rate of infusion Take vital signs and observe for further deterioration Administer Benadryl and continue the infusion The answer is A. Stop the infusion that is the first action. Urticaria indicates an allergic reaction to the plasma protein.

19. A patient is receiving heparin therapy for Deep Vein Thrombosis. Which of the following laboratory values must be closely monitored? Bleeding time Platelet count Activated PTT Clotting time The answer is C. Activated PTT. Heparin is used to prevent further clots from being formed and to prevent the present clot from enlarging. The Activated Prothromboplastin Time (APTT) is a highly sensitive test to monitor the patient on heparin therapy.

20. A child ir receiving prednisolone. Which following statement makes the nurse know that the mother understands the teaching about her child’s prednisolone therapy? I’ll be sure to count my child’s pulse every day I can’t feed my child her favorite oatmeal for breakfast any more I’ll keep my child away from people with colds I’ll make sure my child rests in bed every afternoon The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

21. A child ir receiving prednisolone. Which following statement makes the nurse know that the mother understands the teaching about her child’s prednisolone therapy? I’ll be sure to count my child’s pulse every day I can’t feed my child her favorite oatmeal for breakfast any more I’ll keep my child away from people with colds I’ll make sure my child rests in bed every afternoon The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

22. A patient is being discharged with a prescription for chlorpromazine. Before leaving for home which of these findings should the nurse teach the patient to report? Change in libido, breast enargement Sore throat, fever Abdominal pain, nausea, diarrhea Dyspnoea, nasal congestion The answer is B. Sore throat and fever may be symptoms of agranulocytosis, a side effect of chlorpromazine.

23. While providing home care to a client with congestive heart failure, the nurse is asked how long diuretics must be taken. What is the nurse’s best response? As you urinate more, you will need less medication to control fluid. You will have to take this medication for about a year. The medication must be continued so the fluid problem is controlled Please talk to your health care provider about medications and treatments. The answer is C. The patient may have to continue the diuretics indefinitely. Hence the patient is informed that he has to continue the drug to control the fluid retention and prevent pulmonary oedema and pedal oedema.

24. Non Steroidal Anti-imflammatory drugs such as ibuprofen are beneficial in managing arthritis pain. But the nurse should caution the patients about which of the following common side effects? Urinary incontinence Constipation Nystagmus Occult bleeding The answer is D. NSAID taken for long perods of time may cause serios side effects including bleeding in the gastrointestinal tract. This can be looked for by doing an occult blood in stools test.

25. A mother asks the school nurse how to eliminate lice from her child. What is the most appropriate response by the nurse? Cut the child’s hair short to remove the nits. Apply warm soaks to the head twice daily. Wash the child’s linen and clothing ina bleach solution Apply pediculicides. The answer is D. Treatment of head lice consists of application of pediculicides. Pediculicides should be applied after carefully reading the directions given with the pack and should be followed carefully.

26. Why is it important for the nurse to monitor blood pressure in clients receiving antipsychotic drugs? Orthostatic hypotension is a common side effect Most antipsychotic drugs cause elevated blood pressure This provides information on the amount of sodium allowed in the diet It will indicate the need to institute anti parkinsonian drugs The answer is A. The nurse should monitor BP of the patient in sitting and standing positions because postural hypotension is common in patients in patients receiving antipsychotic drugs. The patient may have dizziness and vasovagal syncope on sudden changes of positions. The patient should be instructed to change positions slowly and to remain beside the bed for a few minutes.

27. The nurse is asked to give iron injection by deep intramuscular route to a patient. The reason for this special instruction is to : Enhance absorption of the medication Ensure that the entire dose of medication is given Provide more even distribution of the drug Prevent the drug from tissue irritation The answer is D. Deep intramuscular injection by Z-track or zigzag method of iron injection prevents oozing of the drug through the tract created by the needle into subcutaneous tissue. The ooze irritates the subcutaneous tissue and stains the skin.

28. The patient who is prescribed alprazolam (anxit, alprax) is informed that : Sedative hypnotics are effective anagesics Sudden cessation of alprazolam can cause rebound insomnia and nightmares Caffeine beverages can increase the effect of sedative hypnotics Avoidance of excessive exercise and high temperature is recommended The answer is B. Sudden cessation of alprazolam can cause rebound insomnia and nightmares.

29. A patient recovering from a hip replacement and is taking Tylenol#3 every 3 hours for pain. In checking the client, which finding suggests a side of the analgesic? Bruising at the operative site Elevated heart rate Decreased platelet count No bowel movement for 3 days The answer is D. While taking opioid analgesics respiratory depression, sedation and constipation may occur. Bruising is not related to Tylenol. But could be the result of corticosteroids or previously used anticoagulants. Elevated heart rate could be the result of bronchodilators. Some antibiotics may lower platelet counts.

30. A child ir receiving prednisolone. Which following statement makes the nurse know that the mother understands the teaching about her child’s prednisolone therapy? I’ll be sure to count my child’s pulse every day I can’t feed my child her favorite oatmeal for breakfast any more I’ll keep my child away from people with colds I’ll make sure my child rests in bed every afternoon The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

31. A child ir receiving prednisolone. Which following statement makes the nurse know that the mother understands the teaching about her child’s prednisolone therapy? I’ll be sure to count my child’s pulse every day I can’t feed my child her favorite oatmeal for breakfast any more I’ll keep my child away from people with colds I’ll make sure my child rests in bed every afternoon The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

32. A child ir receiving prednisolone. Which following statement makes the nurse know that the mother understands the teaching about her child’s prednisolone therapy? I’ll be sure to count my child’s pulse every day I can’t feed my child her favorite oatmeal for breakfast any more I’ll keep my child away from people with colds I’ll make sure my child rests in bed every afternoon The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

33. The nurse is teaching a patient about insulin injection to an Insulin Dependent Diabetic. Which statement by the patient indicates a need for further explanation? I use a sliding scale to adjust regular insulin to my sugar level Since my eye sight is so bad, I ask the nurse to fill several syringes. I keep my regular insulin bottle in the refrigerator I always make sure to shake the NPH bottle hard to mix it well The answer is D. The bottle should be rolled gently, not shaken.

34. A nurse is taking care of a patient with depression who is taking MAO inhibitors regularly. Which of the following precautions does the nurse insist upon? Avoid chocolate and cheese Take frequent naps Take the medication with milk Avoid walking without assistance The answer is A. Foods which are rich in tryptophan, tyramine and caffeine, such as chocolate and cheese may precipitate hypertensive crisis.

35. A patient of cirrhosis of the liver is taking spironolactone (Aldactone, lasilactone). This drug spares the elimination of which of the following? Sodium Potassium Phosphate Albumin The answer is B. If the patient is ascetic potassium sparing diuretics are prescribed such as aldactone. It inhibits the action of aldosterone on the kidneys and avoids hypokalemia.

36. A child is to be administered an IM injection of an antibiotic. The total volume of the injection is 2 ml. The correct action is to Administer the injection in 2 separate injections Give the medication in the dorsal gluteal site Call to get a smaller volume ordered Check with the pharmacy for a syrup form of the medication The answer is A. IM injections should not exceed a volume of 1 ml for small children. The injection should be split into 2 separate injections of 1 ml each. In adults the maximum volume that can be given by IM is 5 ml per site.

37. A patient with amyotrophic lateral sclerosis has a percutaneous endoscopic gastrostomy (PEG) tube for the administration of feedings and medications. Which nursing action is appropriate? Pulverize all medications to a powdery condition Squeeze the tube before using it to break up stagnant liquids Cleanse the skin around the tube daily with hydrogen peroxide Flush adequately with water before and after using the tube The answer is D. Flushing the tube before and after use not only provides for good flow and keeps the tube patent, it also provides water to maintain hydration. While medications should be crushed to pass through the tube, it is flushing that moves them through. Stagnant liquids are reduced by flushing after tube use. Cleansing the skin is important, but soap and water are sufficient without the added irritation of hydrogen peroxide.

38. The nurse has given discharge instructions to parent of a child on phenytoin sodium (Dilantin sodium). Which of the following statements suggests that the teaching was effective? We will call the health care provider if the child develops acne Our child should brush and floss carefully after every meal We will skip the next dose if vomiting or fever occur When our child is seizure-free for 6 months, we can stop the medication The answer is B. Phenytoin sodium causes lymphoid hyperplasia that is most noticeable in the gums. Frequent gum massage and careful attention to good oral hygiene may reduce the gingival hyperplasia.

39. A patient is receiving intravenous heparin therapy. What medication should the nurse have available in the event of an overdose of heparin? Protamine Amicar Imferon Diltiazem The answer is A. protamine binds heparin making it ineffective.

40. The nurse is teaching a patient about precautions with Coumadin therapy. The patient should be instructed to avoid which over-the-counter medication? Non-steroidal anti-inflammatory drugs Cough medicines with guaphenesin Histamine blockers Laxatives containing magnesium salts The answer is A. Medications with NSAIDs may increase the response to Coumadin (Warfarin) and increase the risk of bleeding.

41. A Cromolyn sodium (Intal ) inhaler is presctibed to a patient with asthma. A nurse provides instructions regarding the side effects of this medication. The nurse tells theclient that which undesirable effect is associated with this medication? Wheezing Insomnia Hypotension Constipation The answer is A. Cromolyn sodium is used to prevent asthma attacks in people with bronchial asthma. Undesirable side effects associated wwith the use of inhaler is wheezing, coough, nasal congestion, bronchospasmand throat irritation. Options B, C and D are not related to the medication

42. A cromolyn sodium (Intal) inhaler is prescribed to a patient with asthma. A nurse provides instructions regarding the side effects of this medication. The nurse tells the patient thet which undesirable effect is associated with this medication? Wheezing insomnia Hypotension. constipation The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

43. A child ir receiving prednisolone. Which following statement makes the nurse know that the mother understands the teaching about her child’s prednisolone therapy? I’ll be sure to count my child’s pulse every day I can’t feed my child her favorite oatmeal for breakfast any more I’ll keep my child away from people with colds I’ll make sure my child rests in bed every afternoon The answer is C. Prednisolone increases susceptibility to infections. The child should be protected from all infections.

44. A patient is prescribed Guaphenesin (Mucinex) . The nurse determines that the patient understands the proper administration of this medication if the patient states that he or she will: Drink extra fluids while taking this medication Take the medication with meals only Take an additional dose once fever and cough persist Limit orall fluid intake Guaphenesin is an expectorant. Drinking extra fluids helps to loosen the congestion and lubricates the throat while taking this medication. Option B : The medication does not have to be taken with meals. Option C: Additional doses should not be taken without the prescription of the doctor. Option D : Fluids are needed to loosen the secretions.

45. A nurse is about to administer Abuterol (Ventolin HFA) 2 puff and Budesonide (Pulmicort turbohaler) 2 puff by metered dose inhaler. The nurse plans to administer by? Alternating with a single puff each, starting with albuterol Alternating with a single puff each, starting with budesonide Budesonide inhaler first then the albuterol Albuterol inhaler first then the budesonide The answer is D. If two different inhaled medications are prescribed and one of the medications contains a corticosteroid, administer the bronchodilator (Albuterol) first and the corticosteroid (Budesonide) second. This will alloww for the wwidening of the air passages by the bronchodilator, making the corticosteroids more effective.

46. A nurse is about to administer Naloxone hydrochloride (Narcan) to a client with known opioid overdose. Which of the following equipment should be readily available at the bedside? Suction machine Resuscitative equipment Nasogastric tube Dressing tray The answer is B. While administering Narcan, resuscitation equipment, oxygen, mechanical ventilator should be readily available. Options A,C and D are not used during the medication therapy.

47. A patient is receiving theophylline intravenously. After seeral dosages, the patient started to become restless and complains of palpitations. The nurse determines that the client is experiencing theophylline toxicity in which of the following? Theophylline level of 10mc g/ ml Theophylline level of 15 mcg/ml Theophylline level of 20 mcg/ml Theophylline level of 25 mcg/ml The answer is D. Theophylline toxicity is likely to occur when the serum level is higher than 20 mcg/ml. Early signs of toxicity include restlessness, nervousness, tachycardia, tremors and palpitations.

48. A patient with a chronic obstructive pulmonary disease is prescribed with Ipratropium (Combivent). Upon reviewing the medical history of the patient, the nurse questions the prescription if which of the following is noted? History of smoking History of allergy to egg History of allergy to peanut History of a previous infection The answer is C. The patient with a peanut allergy should not take ipratropium because the product contains soy lecithin, which is in the same plant family as peanuts.

49. Montelukast (Singulair) is prescribed to a client with asthma. During the medication therapy, which of the following laboratories should be monitored? Complete blood count (CBC) Sodium and potassium Calcium and Platelet count ALT and AST The answer is D. Montelukastisa leukotriene receptor and is used with caution in patients with impaired renal function. Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) should be moitored while taking this medication. Options A, B and C are not related to the use of this medication.

50. The nurse is giving medication teachings to a patient receiving theophylline. The nurse instructs the patient to limit the intake of which of the following? Apple and banana Yogurt and cheese Tuna and oysters Cola and chocolate The answer is D. Theophylline is a methylxanthine bronchodilator. The nurse instructs the patient to limit the intake of xanthine-containing foods such as chocolate, cola and coffee.