Pharmacology revision Flashcards by Izabella Leach

What is the primary action of statins (e.g., atorvastatin)?
a. Lower blood glucose
b. Reduce platelet aggregation
c. Lower LDL cholesterol levels
d. Increase HDL cholesterol levels only

c. Lower LDL cholesterol levels

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Which lab value should be monitored with statin use?
a. Urea
b. Liver function tests (LFTs)
c. Platelets
d. Sodium

b. Liver function tests (LFTs)

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What is a common side effect of ACE inhibitors like enalapril?
a. Constipation
b. Persistent dry cough
c. Bradycardia
d. Increased appetite

b. Persistent dry cough

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Beta-blockers like metoprolol reduce blood pressure by:
a. Dilating veins
b. Inhibiting the RAAS system
c. Reducing heart rate and cardiac output
d. Increasing sodium excretion

c. Reducing heart rate and cardiac output

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What is a key nursing consideration when giving digoxin?
a. Check potassium levels after administration
b. Administer rapidly IV push
c. Monitor apical heart rate; hold if <60 bpm
d. Give with antacids

c. Monitor apical heart rate; hold if <60 bpm

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A toxic effect of digoxin is:
a. Hypertension
b. Visual disturbances (e.g., yellow halos)
c. Hypoglycemia
d. Rash

b. Visual disturbances (e.g., yellow halos)

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Which of the following is a strong opioid commonly used in New Zealand hospitals?
a. Paracetamol
b. Codeine
c. Morphine
d. Ibuprofen

c. Morphine

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What is the reversal agent for opioid overdose?
a. Flumazenil
b. Atropine
c. Naloxone
d. Protamine

c. Naloxone

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Which of the following is an appropriate use for NSAIDs like ibuprofen?
a. Severe neuropathic pain
b. Inflammatory conditions (e.g., arthritis)
c. Post-op anticoagulation
d. Migraine prophylaxis

b. Inflammatory conditions (e.g., arthritis)

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Paracetamol toxicity primarily affects which organ?
a. Heart
b. Liver
c. Kidney
d. Pancreas

b. Liver

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What type of insulin has a rapid onset (e.g., Novorapid)?
a. Intermediate-acting
b. Long-acting
c. Short-acting
d. Rapid-acting

d. Rapid-acting

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Which oral diabetic medication increases insulin sensitivity?
a. Gliclazide
b. Metformin
c. Sitagliptin
d. Glargine

b. Metformin

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Which of the following is a broad-spectrum antibiotic?
a. Amoxicillin-clavulanate (Augmentin)
b. Acyclovir
c. Nystatin
d. Metronidazole

a. Amoxicillin-clavulanate (Augmentin)

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Which IV fluid is isotonic and commonly used for fluid resuscitation?
a. 0.45% sodium chloride
b. Dextrose 5%
c. 0.9% sodium chloride (Normal saline)
d. 3% sodium chloride

c. 0.9% sodium chloride (Normal saline)

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What is an anticonvulsant commonly used for seizures?
a. Diazepam
b. Phenytoin
c. Clopidogrel
d. Gabapentin

b. Phenytoin

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Levodopa-carbidopa is used to treat which condition?
a. Epilepsy
b. Schizophrenia
c. Parkinson’s disease
d. Alzheimer’s disease

c. Parkinson’s disease

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Which class of drug is commonly used in the treatment of mood disorders like depression?
a. SSRIs (e.g., fluoxetine)
b. Antihistamines
c. Beta-blockers
d. Anticholinergics

a. SSRIs (e.g., fluoxetine)

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What is a major safety concern with SSRIs in the first few weeks?
a. Hypoglycemia
b. Hypertension
c. Increased suicide risk
d. Seizures

c. Increased suicide risk

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Donepezil is used to manage:
a. Parkinson’s disease
b. Alzheimer’s disease
c. Multiple sclerosis
d. Depression

b. Alzheimer’s disease

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A patient taking atorvastatin reports muscle pain and weakness. What should the nurse do first?
a. Reassure the patient it’s a common side effect
b. Encourage rest and hydration
c. Advise stopping the medication immediately
d. Notify the prescriber and assess for rhabdomyolysis

Notify the prescriber and assess for rhabdomyolysis

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A client on ramipril develops a persistent dry cough. What is the most appropriate action?
a. Check oxygen saturation
b. Continue the medication and monitor
c. Recommend switching to an angiotensin receptor blocker (ARB)
d. Administer salbutamol inhaler PRN

Recommend switching to an angiotensin receptor blocker (ARB)

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Which assessment is a priority before administering metoprolol?
a. Blood glucose
b. Apical pulse and blood pressure
c. Bowel sounds
d. Temperature

b. Apical pulse and blood pressure

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A patient is prescribed furosemide and digoxin. What is the nurse’s priority monitoring focus?
a. Respiratory rate and pain level
b. ECG changes and potassium level
c. GCS score and pupil response
d. BUN and creatinine only

b. ECG changes and potassium level

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Morphine is prescribed IV for post-operative pain. What is the nurse’s most important action before administration?
a. Monitor bowel sounds
b. Measure urine output
c. Count respirations and assess sedation level
d. Check electrolytes

c. Count respirations and assess sedation level

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What is the main reason paracetamol overdose is life-threatening? a. Causes acute renal failure b. Leads to metabolic alkalosis c. Irreversible liver damage due to toxic metabolites d. Suppresses respiratory drive

c. Irreversible liver damage due to toxic metabolites

A patient with type 1 diabetes receives rapid-acting insulin before a meal but refuses to eat. What is the nurse’s best action? a. Encourage a snack later b. Give IV dextrose immediately c. Notify the prescriber and monitor for hypoglycemia d. Administer long-acting insulin instead

c. Notify the prescriber and monitor for hypoglycemia

What is the correct nursing advice regarding metformin and contrast imaging procedures? a. Continue metformin but increase fluids b. Withhold metformin before and for 48 hours after contrast use c. Double the metformin dose d. Give IV fluids with contrast to flush the kidneys

Withhold metformin before and for 48 hours after contrast use

A patient is prescribed gentamicin IV. What lab value is most critical to monitor? a. ALT b. Creatinine c. INR d. Potassium

b. Creatinine

What is the nurse’s role when administering IV phenytoin? a. Administer quickly to prevent seizure b. Flush the line with glucose 5% after c. Use a separate IV line and monitor for bradycardia d. Shake the vial vigorously before use

c. Use a separate IV line and monitor for bradycardia

Levodopa-carbidopa is prescribed for a client with Parkinson’s disease. What dietary advice should the nurse give? a. Increase protein to support muscle strength b. Avoid high-protein meals around dosing time c. Take with iron supplements for synergy d. Limit fluid intake to prevent hypotension

b. Avoid high-protein meals around dosing time

What is a priority nursing intervention for a patient newly prescribed fluoxetine? a. Advise immediate effects within 24 hours b. Warn about addiction potential c. Monitor for suicidal ideation, especially in the first few weeks d. Encourage caffeine to offset drowsiness

c. Monitor for suicidal ideation, especially in the first few weeks

A patient on donepezil for Alzheimer’s disease is experiencing bradycardia and dizziness. What is the appropriate nursing response? a. Educate that this is expected b. Hold the dose and notify the provider c. Give atropine d. Administer with food to reduce symptoms

b. Hold the dose and notify the provider

A patient with sepsis is prescribed 0.9% NaCl at 500 mL/hr. What is the nurse’s priority assessment? a. Skin turgor b. Capillary refill c. Lung auscultation for crackles d. Colour of urine

c. Lung auscultation for crackles

What is a key nursing action when administering IV potassium chloride (KCl)? a. Ensure the line is patent and give undiluted b. Infuse rapidly over 15 minutes c. Mix with glucose 5% and give via bolus d. Administer diluted in IV fluid using a pump only

d. Administer diluted in IV fluid using a pump only

A patient with atrial fibrillation is prescribed digoxin. They complain of seeing yellow halos around lights. The nurse should: a. Administer the dose and reassess in one hour b. Encourage fluid intake c. Check serum digoxin and potassium levels d. Advise the patient to rest

c. Check serum digoxin and potassium levels

Which medication increases the risk of lithium toxicity when used concurrently? a. Ibuprofen b. Paracetamol c. Metoprolol d. Fluoxetine

a. Ibuprofen

The nurse is caring for a patient receiving gentamicin. Which assessment finding is most concerning? a. Mild nausea b. Temperature of 38°C c. Decreased urine output and tinnitus d. BP of 135/85 mmHg

c. Decreased urine output and tinnitus

A diabetic patient on insulin glargine (Lantus) and insulin aspart (NovoRapid) becomes NPO for surgery. The nurse should: a. Withhold both insulins completely b. Administer both as usual c. Administer glargine, but clarify aspart with the team d. Switch to oral hypoglycemics

c. Administer glargine, but clarify aspart with the team

A patient with heart failure is prescribed spironolactone. What is a key nursing consideration? a. Risk of hyponatremia b. Risk of hypokalemia c. Risk of hyperkalemia d. Monitor for tachycardia

c. Risk of hyperkalemia

A Parkinson’s patient taking levodopa-carbidopa reports involuntary movements. What is the most likely cause? a. Worsening of disease b. Anticholinergic overdose c. Peak-dose dyskinesia from levodopa d. Low dopamine levels

c. Peak-dose dyskinesia from levodopa

Clozapine is prescribed for a patient with schizophrenia. What lab value must be closely monitored? a. Liver function tests b. Neutrophil count c. INR d. Creatinine

b. Neutrophil count

What is a major nursing risk when administering tramadol for pain? a. Hypertension b. Bradycardia c. Serotonin syndrome d. Hyperkalemia

c. Serotonin syndrome

A patient has been prescribed metronidazole for a dental abscess. What discharge advice is essential? a. Take with dairy to prevent stomach upset b. Avoid sun exposure c. Avoid alcohol during and 48 hours after completion d. Increase potassium intake

c. Avoid alcohol during and 48 hours after completion

A post-op patient on morphine PCA becomes unresponsive with pinpoint pupils and a respiratory rate of 6. What is the priority action? a. Stop PCA and call the rapid response team b. Prepare to administer naloxone IV c. Increase IV fluid rate d. Stimulate the patient and recheck in 10 minutes

b. Prepare to administer naloxone IV

1. Which of the following is a typical effect of anticholinergic drugs? a. Increased salivation b. Diarrhoea c. Blurred vision d. Bradycardia

c. Blurred vision

2. A patient is prescribed atropine. The nurse expects which side effect? a. Increased GI motility b. Dry mouth c. Miosis d. Bradycardia

b. Dry mouth

3. Which of the following drugs is a cholinergic agonist? a. Atropine b. Bethanechol c. Epinephrine d. Propranolol

b. Bethanechol

4. Which nervous system does a beta-blocker like metoprolol primarily affect? a. Central nervous system b. Somatic nervous system c. Parasympathetic nervous system d. Sympathetic nervous system

d. Sympathetic nervous system

5. Which of the following medications is an ACE inhibitor? a. Amlodipine b. Simvastatin c. Ramipril d. Losartan

c. Ramipril

7. A known side effect of statins is: a. Hyperkalemia b. Muscle pain c. Constipation d. Bradycardia

b. Muscle pain

8. Which of the following is an antiplatelet drug? a. Warfarin b. Heparin c. Clopidogrel d. Enoxaparin

c. Clopidogrel

9. The nurse knows the antidote for heparin overdose is: a. Vitamin K b. Protamine sulfate c. Naloxone d. Atropine

b. Protamine sulfate

10. Before administering warfarin, which lab test must be checked? a. aPTT b. Platelet count c. INR d. Troponin

c. INR

1. A patient on a cholinergic agonist reports increased urination, sweating, and abdominal cramping. What is the most appropriate nursing action? a. Reassure the patient this is normal b. Discontinue the medication immediately c. Report possible cholinergic crisis to the provider d. Administer atropine

c. Report possible cholinergic crisis to the provider

2. Which drug may worsen asthma symptoms due to its anticholinergic activity? a. Pilocarpine b. Ipratropium c. Diphenhydramine d. Bethanechol

c. Diphenhydramine

3. Which of the following would most likely interfere with the effects of a beta-blocker? a. Salbutamol b. Digoxin c. Atorvastatin d. Clonidine

a. salbutamol

4. A patient taking lisinopril develops a persistent dry cough. What is the best next step? a. Administer cough suppressant b. Switch to a calcium channel blocker c. Switch to an angiotensin receptor blocker (ARB) d. Encourage fluid intake

c. Switch to an angiotensin receptor blocker (ARB)

5. Which electrolyte imbalance must be monitored in a patient taking spironolactone? a. Hypokalemia b. Hyperkalemia c. Hyponatremia d. Hypernatremia

b. Hyperkalemia

7. A patient on warfarin is found to have an INR of 4.5 with minor gum bleeding. What is the appropriate nursing action? a. Administer protamine sulfate b. Stop warfarin and give vitamin K c. Continue warfarin and monitor d. Hold the next dose and notify the provider

d. Hold the next dose and notify the provider

8. Which of the following drugs inhibits platelet aggregation by blocking ADP receptors? a. Aspirin b. Warfarin c. Clopidogrel d. Heparin

c. Clopidogrel

9. Which anticoagulant works by enhancing antithrombin III activity to inhibit thrombin and factor Xa? a. Warfarin b. Apixaban c. Heparin d. Dabigatran

c. Heparin

1. A 67-year-old male with a history of atrial fibrillation is started on warfarin. His INR is 5.2. He is not actively bleeding. What is the nurse’s best action? a. Administer vitamin K and continue warfarin b. Withhold the next dose and notify the prescriber c. Give protamine sulfate d. Administer the next dose with food

b. Withhold the next dose and notify the prescriber

2. A patient taking simvastatin complains of muscle pain and dark urine. What should the nurse suspect? a. Gastroenteritis b. Myocardial infarction c. Rhabdomyolysis d. UTI

c. Rhabdomyolysis

3. A patient with Parkinson’s disease is taking levodopa/carbidopa. She reports dizziness and light-headedness when standing. What is this likely due to? a. Increased dopamine in the brain b. Anticholinergic side effects c. Orthostatic hypotension d. CNS depression

c. Orthostatic hypotension

5. A diabetic patient taking metoprolol presents with fatigue and confusion. BGL = 2.9 mmol/L. Why might the hypoglycaemia not have been recognized earlier? a. Beta-blockers mask hypoglycaemia symptoms b. Metoprolol raises insulin levels c. The patient is insulin-resistant d. Metoprolol causes hyperglycaemia

a. Beta-blockers mask hypoglycaemia symptoms

7. A patient with epilepsy is prescribed phenytoin. What education is most important to give? a. Avoid foods high in vitamin C b. Stop medication if rash develops c. You can skip doses if you feel well d. Take it on an empty stomach

b. Stop medication if rash develops

9. An elderly client with Alzheimer’s is started on donepezil. What should the nurse monitor closely for? a. Insomnia and GI upset b. Weight gain and constipation c. Liver toxicity d. Bradycardia and hypotension

a. Insomnia and GI upset

10. A patient with schizophrenia is given haloperidol and develops high fever, rigidity, and altered mental status. What should the nurse do first? a. Reassess in 30 minutes b. Give PRN benzodiazepine c. Suspect neuroleptic malignant syndrome (NMS) and notify the prescriber d. Administer antipyretics

c. Suspect neuroleptic malignant syndrome (NMS) and notify the prescriber

1. What is the primary action of a cholinergic drug? a. Inhibits acetylcholine receptors b. Stimulates the parasympathetic nervous system c. Blocks sympathetic stimulation d. Stimulates dopamine production

b. Stimulates the parasympathetic nervous system

2. Which of the following is a common anticholinergic side effect? a. Diarrhoea b. Bradycardia c. Dry mouth d. Urinary frequency

c. Dry mouth

3. Which of these medications is considered anticholinergic? a. Atropine b. Bethanechol c. Pilocarpine d. Donepezil

a. Atropine

4. What is a key therapeutic use of cholinergic drugs like bethanechol? a. Treating urinary incontinence b. Treating bradycardia c. Stimulating bladder emptying d. Reducing gastric motility

c. Stimulating bladder emptying

5. A patient is experiencing blurred vision, dry mouth, urinary retention, and constipation. The nurse suspects: a. Cholinergic toxicity b. Sympathetic overstimulation c. Anticholinergic effects d. Opioid overdose

c. Anticholinergic effects

6. Why are anticholinergic medications like benztropine used in Parkinson’s disease? a. Increase dopamine b. Reduce acetylcholine activity to balance neurotransmitters c. Block serotonin d. Stimulate muscle movement

b. Reduce acetylcholine activity to

7. Which patient would most likely benefit from a cholinergic agonist? a. One with bradycardia b. One with asthma c. One with glaucoma d. One with urinary urgency

c. One with glaucoma

8. A major risk of using cholinergic drugs is: a. Tachycardia b. Respiratory depression c. Bronchospasm and bradycardia d. Constipation

c. Bronchospasm and bradycardia

9. Which of the following is a contraindication for anticholinergic use? a. Peptic ulcer disease b. Parkinson’s disease c. Glaucoma d. Motion sickness

c. Glaucoma

10. A nurse is giving a medication that causes “SLUDGE” symptoms: salivation, lacrimation, urination, diarrhoea, GI upset, and emesis. What type of drug is this? a. Anticholinergic b. Cholinergic c. Sympathomimetic d. Dopaminergic

b. Cholinergic

1. What lab test is used to monitor heparin therapy? a. INR b. PT c. PTT d. Bleeding time

c. PTT

2. What is the therapeutic INR range for most patients on warfarin? a. 0.5–1.0 b. 1.0–2.0 c. 2.0–3.0 d. 4.0–5.0

c. 2.0–3.0

3. What is the mechanism of action of warfarin? a. Directly dissolves clots b. Inhibits thrombin c. Blocks vitamin K–dependent clotting factors d. Enhances platelet activation

c. Blocks vitamin K–dependent clotting factors

4. Which of the following is an antiplatelet medication? a. Heparin b. Warfarin c. Alteplase d. Clopidogrel

d. Clopidogrel

5. A patient's INR is 5.2 while on warfarin. What is the priority action? a. Continue dose b. Administer protamine c. Hold dose and notify doctor d. Give aspirin

c. Hold dose and notify doctor

6. The antidote for heparin overdose is: a. Vitamin K b. Platelets c. Protamine sulfate d. Naloxone

c. Protamine sulfate

7. What is a major adverse effect of all anticoagulants? a. Hypotension b. Bleeding c. Seizures d. Bradycardia

b. Bleeding

8. Which medication should be held before surgery due to bleeding risk? a. Paracetamol b. Clopidogrel c. Statin d. Metoprolol

b. Clopidogrel

9. Why are thrombolytics like alteplase used only in emergencies? a. They are slow-acting b. They dissolve ALL clots, increasing bleeding risk c. They have no effect on clots d. They are expensive only

b. They dissolve ALL clots, increasing bleeding risk

10. Which is correct regarding low molecular weight heparin (LMWH) like enoxaparin? a. It requires PTT monitoring b. It is given orally c. It is given subcutaneously and does not require routine PTT d. It is an antiplatelet

c. It is given subcutaneously and does not require routine PTT

1. What is the mechanism of action of salbutamol (albuterol)? a. Blocks muscarinic receptors in bronchial smooth muscle b. Stimulates alpha-1 adrenergic receptors c. Stimulates beta-2 adrenergic receptors causing bronchodilation d. Inhibits histamine release from mast cells

c. Stimulates beta-2 adrenergic receptors causing bronchodilation

2. Which nervous system pathway does salbutamol mimic? a. Parasympathetic nervous system b. Enteric nervous system c. Somatic nervous system d. Sympathetic nervous system

d. Sympathetic nervous system

3. Ipratropium relieves bronchospasm by: a. Activating beta-2 receptors b. Inhibiting cholinergic stimulation c. Increasing histamine release d. Stimulating parasympathetic outflow

b. Inhibiting cholinergic stimulation

4. A common side effect of salbutamol is: a. Bradycardia b. Muscle weakness c. Tremor and tachycardia d. Constipation

c. Tremor and tachycardia

5. What type of drug is ipratropium? a. Cholinergic agonist b. Muscarinic antagonist c. Beta-1 blocker d. Histamine receptor antagonist

b. Muscarinic antagonist

Pharmacology revision Flashcards

NCNZ state exam revision (93 cards)