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Example Questions
Example Question #41 : Drug Identification
How does adalimumab function to reduce inflammation in rheumatoid arthritis?
Cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) inhibitor
Tumor necrosis factor-alpha inhibitor
Monoclonal antibody
More than one of these
More than one of these
Adalimumab is a tumor necrosis factor alpha (TNF-alpha) inhibitor. This class of drugs suppresses response to TNF-alpha, a potent pro-inflammatory cytokine. Inhibition of folic acid metabolism is the method of action of methotrexate. Reversible inhibition of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) is the mechanism of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen. Rheumatoid arthritis drugs such as rituximab, and almost all drugs that end in -mab, including adalimumab function as monoclonal antibodies.
Example Question #122 : Nclex
Which of the following analgesic medications should be used with caution in patients with hepatic disease?
Ketorolac
Naproxen
Meloxicam
Acetaminophen
Ibuprofen
Acetaminophen
The correct answer is "acetaminophen." This is the correct answer because acetaminophen, also known as Tylenol, is initially metabolized into a hepatotoxic intermediate (it transiently becomes a reactive oxygen species, which can cause liver hepatotoxicity). As such, in patients who already have pre-existing liver disease who are already more prone to liver injury from substances and diseases that affect the liver, it is prudent to avoid medications like acetaminophen that have a known potential to cause liver damage.
Meloxicam, ibuprofen, naproxen, and ketorolac are all examples of non-steroidal anti-inflammatory drugs (NSAIDs). These medications have the potential to cause renal damage or gastrointestinal damage if used in excess, but do not have the known hepatotoxic properties that acetaminophen does.
Example Question #42 : Drug Identification
You are the nurse taking care of a patient who is started on a two-week course of oral prednisone. Which of the following is a known side effect of oral steroids?
Decreased appetite
Insomnia
Hypotension
Hyponatremia
Hyperkalemia
Insomnia
The correct answer is "insomnia," as steroids are known to increase patients' vigilance and energy levels, thereby frequently making it difficult for patients to fall asleep and/or stay asleep while taking their steroid medication. The other choices are incorrect. Decreased appetite is not a side effect of taking steroid medications. Patients on steroids often have increased appetite. Hyponatremia and hyperkalemia both are not side effects of taking steroid medications. Hypernatremia and hypokalemia are more common side effects of steroids. Hypertension, rather than hypotension is a known side effect of steroid use.
Example Question #43 : Drug Identification
You are the nurse taking care of a patient with severe lower back pain. He is being treated with oxycodone and hydromorphone. Which of the following analgesic medications produces dilated pupils?
Morphine
Oxycodone
Acetaminophen
Meperidine
Hydromorphone
Meperidine
The correct answer is "meperidine." Meperidine, a potent opioid analgesic, also known as Demerol, is one of the only opioids that produces dilated pupils, rather than constricted, "pinpoint" pupils. A way to remember this is to remember the phrase, "Demerol Dilates." The other choices are incorrect. Acetaminophen has no known effect on pupil size. Morphine, oxycodone, and hydromorphone, all opioid analgesics, are known to constrict the pupils.
Example Question #41 : Drug Identification
You are the nurse taking care of a patient who is hospitalized for severe lower back pain. The patient also has a medical history significant for multiple gastrointestinal bleeds and peptic ulcer disease. Which of the following medications should be used with extreme caution in this patient given his medical history?
Hydromorphone
Acetaminophen
Morphine
Oxycodone
NSAIDs
NSAIDs
The correct answer is "NSAIDs." This is the correct answer because NSAIDs are known to be irritants of the gastrointestinal tract, and prolonged and/or extensive use of NSAIDs can increase the risk of developing gastrointestinal ulcers, as well as consequent gastrointestinal bleeds in the setting of ulcers. Given this patient's medical history, which already contains multiple gastrointestinal bleeds and peptic ulcer disease, NSAIDs should be used very, very carefully, if at all, in this patient.
The other choices are incorrect. Acetaminophen is not known to increase the risk of gastrointestinal bleeding or peptic ulcer formation. Morphine, oxycodone, and hydromorphone are all opioid analgesics and are not known to increase the risk of gastrointestinal bleeding or peptic ulcer formation.
Example Question #131 : Pharmacology
The home health nurse reviews the types of insulin prescribed to the client diagnosed with diabetes mellitus type 1. Which of the following insulins experiences peak action between 6-12 hours?
Glargine
Lispro
Regular
Aspart
Isophane (NPH)
Isophane (NPH)
It is essential for the nurse to know the onset, peak, and duration of actions for all types of insulin. Rapid-acting insulins lispro and aspart have an onset between 10-30 minutes, peak between 30 min to 3 hours, and have a duration of 3-6 hours. Regular insulin has an onset between 30-60 min, peaks between 1-5 hours, and lasts 6-10 hours. Intermediate-acting insulins isophane (NPH) has an onset between 1-2 hours, peaks between 6-12 hours, and lasts 16-24 hours. Very long-acting insulin glargine has an onset between 3-4 hours, does not peak because it works continuously, and lasts 24 hours.
Example Question #42 : Drug Identification
All of the following are examples of adrenergic agonists except __________.
salmeterol
tiotropium
terbutaline
albuterol
tiotropium
Albuterol, terbutaline, and salmeterol are all beta-2 adrenergic agonists. Beta-2 adrenergic agonists stimulate beta-2 adrenergic receptors, causing smooth muscle relaxation in the bronchial passages.
Tiotropium (trade name Spiriva) is an anticholinergic bronchodilators.
Example Question #2 : Respiratory Pharmacology
Which of the following is an example of an inhaled steroid used in the treatment of asthma?
Ipratropium
Salmeterol
Fluticasone
Fluticasone
Fluticasone (trade name Flovent) is a synthetic glucocorticoid used in the treatment of asthma and allergic rhinitis.
Example Question #3 : Respiratory Pharmacology
What class of drug is montelukast?
Corticosteroid
Leukotriene inhibitor
Anticholinergic bronchodilator
Long acting beta-2 agonist (LABA)
Leukotriene inhibitor
Montelukast is a leukotriene inhibitor. It acts by antagonism of the leukotriene receptor sites in bronchial wall smooth muscle to prevent wheezing, chest tightness, and coughing caused by asthma, and to treat other respiratory issues to promote proper ventilation.
Example Question #43 : Drug Identification
Each of the following antibiotics works by inhibition of the 50S subunit of bacterial ribosomes except __________.
tetracyclines
macrolides
streptogramin
clindamycin
tetracyclines
Macrolides, streptogramins, and clindamycin all work by inhibition of the 50S subunit of bacterial ribosomes. Tetracyclines have a similar mechanism of action, but instead affect the 30S unit of bacterial ribosomes.
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