NCLEX Pharmacology Quiz: Exam!
(191).jpg "NCLEX Pharmacology Quiz: Exam! - Quiz")
.
Questions and Answers
- 1.
Walter, a teenage patient is admitted to the hospital because of an acetaminophen (Tylenol) overdose. Overdoses of acetaminophen can precipitate life-threatening abnormalities in which of the following organs?
- A.
Lungs
- B.
Liver
- C.
Adrenal Glands
- D.
Kidney
Correct Answer
B. LiverExplanation
Correct Answer B. Liver Acetaminophen is extensively metabolized by pathways in the liver. Toxic doses of acetaminophen deplete hepatic glutathione, resulting in accumulation of the intermediate agent, quinine, which leads to hepatic necrosis. Prolonged use of acetaminophen may result in an increased risk of renal dysfunction, but a single overdose does not precipitate life-threatening problems in the respiratory system, renal system, or adrenal glands.Rate this question:
-
- 2.
A contraindication for topical corticosteroid usage in a male patient with atopic dermatitis (eczema) is:
- A.
Parasite infection.
- B.
Viral infection.
- C.
Bacterial infection.
- D.
Spirochete infection.
Correct Answer
B. Viral infection.Explanation
Correct Answer B. Viral infection. Topical agents produce a localized, rather than systemic effect. When treating atopic dermatitis with a steroidal preparation, the site is vulnerable to invasion by organisms. Viruses, such as herpes simplex or varicella-zoster, present a risk of disseminated infection. Educate the patient using topical corticosteroids to avoid crowds or people known to have infections and to report even minor signs of an infection. Topical corticosteroid usage results in little danger of concurrent infection with these agents.Rate this question:
-
- 3.
In infants and children, the side effects of first-generation over-the-counter (OTC) antihistamines, such as diphenhydramine (Benadryl) and hydroxyzine (Atarax) include:
- A.
Reye’s syndrome.
- B.
Cholinergic effects.
- C.
Paradoxical CNS stimulation.
- D.
Nausea and diarrhea.
Correct Answer
C. Paradoxical CNS stimulation.Explanation
Answer C. Paradoxical CNS stimulation. Typically, first-generation OTC antihistamines have a sedating effect because of passage into the CNS. However, in some individuals, especially infants and children, paradoxical CNS stimulation occurs and is manifested by excitement, euphoria, restlessness, and confusion. For this reason, use of first generation OTC antihistamines has declined, and second generation product usage has increased. Reye’s syndrome is a systemic response to a virus. First generation OTC antihistamines do not exhibit a cholinergic effect. Nausea and diarrhea are uncommon when first generation OTC antihistamines are taken.Rate this question:
-
- 4.
Reye’s syndrome, a potentially fatal illness associated with liver failure and encephalopathy is associated with the administration of which over-the-counter (OTC) medication?
- A.
Acetaminophen (Tylenol)
- B.
Ibuprofen (Motrin)
- C.
Aspirin
- D.
Brompheniramine / Pseudoephedrine (Dimetapp)
Correct Answer
C. AspirinExplanation
Answer C. aspirin
Virus-infected children who are given aspirin to manage pain, fever, and inflammation are at an increased risk of developing Reye’s syndrome. Use of acetaminophen has not been associated with Reye’s syndrome and can be safely given to patients with fever due to viral illnesses. Ibuprofen adverse effects include GI irritation and bleeding, and in toxic doses, both renal and hepatic failure are reported. However, ibuprofen has not been associated with the onset of Reye’s disease. Brompheniramine/pseudoephedrine contains a first generation OTC antihistamine and a decongestant. Neither agent has been associated with the development of Reye’s syndrome.Rate this question:
-
- 5.
The nurse is aware that the patients who are allergic to intravenous contrast media are usually also allergic to which of the following products?
- A.
Eggs
- B.
Shellfish
- C.
Soy
- D.
Acidic fruits
Correct Answer
B. ShellfishExplanation
Answer B. Shellfish
Some types of contrast media contain iodine as an ingredient. Shellfish also contain significant amounts of iodine. Therefore, a patient who is allergic to iodine will exhibit an allergic response to both iodine containing contrast media and shellfish. These products do not contain iodine.Rate this question:
-
- 6.
A 13-month-old child recently arrived in the United States from a foreign country with his parents and needs childhood immunizations. His mother reports that he is allergic to eggs. Upon further questioning, you determine that the allergy to eggs is anaphylaxis. Which of the following vaccines should he not receive?
- A.
Hepatitis B
- B.
Inactivated polio
- C.
Diphtheria, acellular pertussis, tetanus (DTaP)
- D.
Mumps, measles, rubella (MMR)
Correct Answer
D. Mumps, measles, rubella (MMR)Explanation
Answer D. mumps, measles, rubella (MMR)
The measles portion of the MMR vaccine is grown in chick embryo cells. The current MMR vaccine does not contain a significant amount of egg proteins, and even children with dramatic egg allergies are extremely unlikely to have an anaphylactic reaction. However, patients that do respond to egg contact with anaphylaxis should be in a medically controlled setting where full resuscitation efforts can be administered if anaphylaxis results. The vaccines in options a,b and c do not contain egg protein.Rate this question:
-
- 7.
The cell and Coombs classification system categorizes allergic reactions and is useful in describing and classifying patient reactions to drugs. Type I reactions are immediate hypersensitivity reactions and are mediated by:
- A.
Immunoglobulin E (IgE).
- B.
Immunoglobulin G (IgG).
- C.
Immunoglobulin A (IgA).
- D.
Immunoglobulin M (IgM)
Correct Answer
A. Immunoglobulin E (IgE).Explanation
Answer A. immunoglobulin E (IgE).
IgE, the least common serum immunoglobulin (Ig) binds very tightly to receptors on basophils and mast cells and is involved in allergic reactions. Binding of the allergen to the IgE on the cells results in the release of various pharmacological mediators that result in allergic symptoms. IgG is the major Ig (75 percent of serum Ig is IgG). Most versatile Ig because it is capable of carrying out all of the functions of Ig molecules. IgG is the only class of Ig that crosses the placenta. It is an opsonin, a substance that enhances phagocytosis. IgA, the second most common serum Ig is found in secretions (tears, saliva, colostrum, and mucus). It is important in local (mucosal) immunity. IgM, the third most common serum Ig, is the first Ig to be made by the fetus and the first Ig to be made by a virgin B cell when it is stimulated by antigen. IgM antibodies are very efficient in leading to the lysis of microorganisms.Rate this question:
-
- 8.
Drugs can cause adverse events in a patient. Bone marrow toxicity is one of the most frequent types of drug-induced toxicity. The most serious form of bone marrow toxicity is:
- A.
Aplastic anemia.
- B.
Thrombocytosis.
- C.
Leukocytosis.
- D.
Granulocytosis.
Correct Answer
A. Aplastic anemia.Explanation
Answer A. aplastic anemia.
Aplastic anemia is the result of a hypersensitivity reaction and is often irreversible. It leads to pancytopenia, a severe decrease in all cell types: red blood cells, white blood cells, and platelets. A reduced number of red blood cells causes hemoglobin to drop. A reduced number of white blood cells make the patient susceptible to infection. And, a reduced number of platelets cause the blood not to clot as easily. Treatment for mild cases is supportive. Transfusions may be necessary. Severe cases require a bone marrow transplant. Option 2 is an elevated platelet count. Option 3 is an elevated white count. Option 4 is an elevated granulocyte count. A granulocyte is a type of white blood cell.Rate this question:
-
- 9.
Serious adverse effects of oral contraceptives include:
- A.
Increase in skin oil followed by acne.
- B.
Headache and dizziness.
- C.
Early or mid-cycle bleeding.
- D.
Thromboembolic complications.
Correct Answer
D. Thromboembolic complications.Explanation
Answer D. Thromboembolic complications.
Oral contraceptives have been associated with an increased risk of stroke, myocardial infarction, and deep vein thrombosis. These risks are increased in women who smoke. Increased skin oil and acne are effects of progestin excess. Headache and dizziness are effects of estrogen excess. Early or mid-cycle bleeding are effects of estrogen deficiency.Rate this question:
-
- 10.
The most serious adverse effect of Alprostadil (Prostin VR pediatric injection) administration in neonates is:
- A.
Apnea.
- B.
Bleeding tendencies.
- C.
Hypotension.
- D.
Pyrexia.
Correct Answer
A. Apnea.Explanation
Answer A. Apnea.
All items are adverse reactions of the drug. However, apnea appearing during the first hour of drug infusion occurs in 10-12 percent of neonates with congenital heart defects. Clinicians deciding to utilize alprostadil must be prepared to intubate and mechanically ventilate the infant. Careful monitoring for apnea or respiratory depression is mandatory. In some institutions, elective intubation occurs prior to initiation of the medication.Rate this question:
-
- 11.
Mandy, a patient calls the clinic today because he is taking atorvastatin (Lipitor) to treat his high cholesterol and is having pain in both of his legs. You instruct him to:
- A.
Stop taking the drug and make an appointment to be seen next week.
- B.
Continue taking the drug and make an appointment to be seen next week.
- C.
Stop taking the drug and come to the clinic to be seen today.
- D.
Walk for at least 30 minutes and call if symptoms continue.
Correct Answer
C. Stop taking the drug and come to the clinic to be seen today.Explanation
Answer C. Stop taking the drug and come to the clinic to be seen today.
Muscle aches, soreness, and weakness may be early signs of myopathy such as rhabdomyolysis associated with the HMG-CoA reductase class of antilipemic agents. This patient will need an immediate evaluation to rule out myopathy. Additional doses may exacerbate the problem. Exercise will not reverse myopathy and delays diagnosis.Rate this question:
-
- 12.
Which of the following adverse effects is associated with levothyroxine (Synthroid) therapy?
- A.
Tachycardia
- B.
Bradycardia
- C.
Hypotension
- D.
Constipation
Correct Answer
A. TachycardiaExplanation
Answer A. Tachycardia
Levothyroxine, especially in higher doses, can induce hyperthyroid-like symptoms including tachycardia. An agent that increases the basal metabolic rate would not be expected to induce a slow heart rate. Hypotension would be a side effect of bradycardia. Constipation is a symptom of hypothyroid disease.Rate this question:
-
- 13.
Which of the following adverse effects is specific to the biguanide diabetic drug metformin (Glucophage) therapy?
- A.
Hypoglycemia
- B.
GI distress
- C.
Lactic acidosis
- D.
Somnolence
Correct Answer
C. Lactic acidosisExplanation
Answer C. Lactic acidosis
Lactic acidosis is the most dangerous adverse effect of metformin administration with death resulting in approximately 50 percent of individuals who develop lactic acidosis while on this drug. Metformin does not induce insulin production; thus, administration does not result in hypoglycemic events. Some nausea, vomiting, and diarrhea may develop but is usually not severe. NVD is not specific for metformin. Metformin does not induce sleepiness.Rate this question:
-
- 14.
The most serious adverse effect of tricyclic antidepressant (TCA) overdose is:
- A.
Seizures
- B.
Hyperpyrexia.
- C.
Metabolic acidosis.
- D.
Cardiac arrhythmias.
Correct Answer
D. Cardiac arrhythmias.Explanation
Answer D. Cardiac arrhythmias
Excessive ingestion of TCAs result in life-threatening wide QRS complex tachycardia. TCA overdose can induce seizures, but they are typically not life-threatening. TCAs do not cause an elevation in body temperature. TCAs do not cause metabolic acidosis.Rate this question:
-
- 15.
The nurse is aware that the following solutions is routinely used to flush an IV device before and after the administration of blood to a patient is:
- A.
0.9 percent sodium chloride
- B.
5 percent dextrose in water solution
- C.
Sterile water
- D.
Heparin sodium
Correct Answer
A. 0.9 percent sodium chlorideExplanation
Answer A. 0.9 percent sodium chloride
0.9 percent sodium chloride is normal saline. This solution has the same osmolarity as blood. Its use prevents red cell lysis. The solutions given in options 2 and 3 are hypotonic solutions and can cause red cell lysis. The solution in option 4 may anticoagulate the patient and result in bleeding.Rate this question:
-
Quiz Review Timeline +
Our quizzes are rigorously reviewed, monitored and continuously updated by our expert board to maintain accuracy, relevance, and timeliness.
-
Current Version
-
Mar 22, 2023Quiz Edited by
ProProfs Editorial Team -
May 29, 2017Quiz Created by
Skymagic007
NCLEX Quiz: Childhood And Adolescent Psychiatric Disorders
NCLEX Quiz: Childhood And Adolescent Psychiatric Disorders
Personality, Mood Disorders, and Suicidal Behavior | NCLEX Quiz 210
Personality, Mood Disorders, and Suicidal Behavior | NCLEX Quiz 210
Personality, Mood Disorders, and Suicidal Behavior | NCLEX Quiz 209
Personality, Mood Disorders, and Suicidal Behavior | NCLEX Quiz 209
NCLEX Quiz: Schizophrenic Disorder Trivia Questions!
NCLEX Quiz: Schizophrenic Disorder Trivia Questions!
Back to top