NCLEX : Pharmacology

Study concepts, example questions & explanations for NCLEX

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Example Questions

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Example Question #1 : General Concepts

Which of the following is considered a schedule II drug?

Possible Answers:

Alprazolam

Ibuprofen

Hydrochlorothiazide (HCTZ)

Oxycodone/acetaminophen

Acetominophen

Correct answer:

Oxycodone/acetaminophen

Explanation:

Schedule II drugs are monitored drugs that have an accepted medical use and are highly addictive (both physically and psychologically). Schedule II drugs include oxycodone/acetaminophen, fentanyl, and hydromorphone.

Example Question #1 : Pharmacology

The nurse has just administered the first doses of the following medications. Which is most likely the cause of a new-onset headache?

Possible Answers:

Metoclopromide

Magnesium hydroxide

Pantoprazole

Sumatriptan

Sucralfate

Correct answer:

Pantoprazole

Explanation:

The development of a headache is most likely a side effect of pantoprazole (a proton-pump inhibitor). Sumatriptan is a medication that is commonly used to relieve migraine headaches. Metoclopromide may cause restlessness and anxiety. Sucralfate may cause constipation. Side effects are rarely seen with magnesium hydroxide, they include nausea, constipation, and aluminum deficiency due to overexcretion via binding phosphate in the stomach.

Example Question #2 : General Concepts

A nurse is preparing a client to receive pain medication to aid with the discomfort of labor. The client is being prepped to undergo a pudendal nerve block. The nurse will explain the affects of such a block. 

A pudendal block is responsible for which of the following pharmacological actions in regards to providing anesthesia during labor?

Possible Answers:

A block specifically formulated to block nerve impulses to the uterus to aid in mother to assist in pushing during the birth process.

A type of anesthesia block to provide total anesthesia to the entire area, injected into fifth lumbar space and may hinder the mother from pushing during the birth process. 

Provides relief of pain from an episiotomy, blocks nerve impulses associated with the vagina, the cervix as well as the perineum region. 

A local infiltration of the skin around the vaginal opening to provide superficial anesthesia to the skin.

Provides complete anesthesia with injection into the subarachnoid space of the lumbar region of the spine.

Correct answer:

Provides relief of pain from an episiotomy, blocks nerve impulses associated with the vagina, the cervix as well as the perineum region. 

Explanation:

A pudendal block is a useful type of anesthesia often utilized during the second stage of the labor process. It provides anesthesia for an episiotomy performed in the perineum area. 

Example Question #4 : Nclex

What is the purpose of Beer's criteria?

Possible Answers:

To list inappropriate laboratory tests for infants

To list inappropriate drugs for infants

To list inappropriate laboratory tests for the elderly

To list inappropriate drugs for the elderly

Correct answer:

To list inappropriate drugs for the elderly

Explanation:

Beer's criteria is used in medicine as a list of drugs that should not be prescribed in the elderly. These drugs can have potentially disastrous complications for older adults, including falls and other serious injuries. Older patients undergoing pallative care typically do not need to follow Beer's criteria.

Example Question #5 : Nclex

You are the nurse taking care of a patient who is being treated with oral vancomycin, an antibiotic, for Clostridium difficile diarrhea. Which of the following choices best describes the mechanism of action of vancomycin?

Possible Answers:

Inhibition of topoisomerase II

Inhibition of peptide elongation

Disruption of mycolic acid synthesis

Inhibition of integrase 

Disruption of peptidoglycan cross-linkage

Correct answer:

Disruption of peptidoglycan cross-linkage

Explanation:

The correct answer is "Disruption of peptidoglycan cross-linkage," as this is the mechanism of action of the antibiotic, vancomycin. Vancomycin has high clinical utility in medicine, as it can be administered orally to treat Clostridium difficile diarrhea, or intravenously to treat MRSA infections, among others. As such, it is important to be well aware of vancomycin in clinical practice.

Inhibition of topoisomerase II is the mechanism of action of fluroquinolone antibiotics, such as levofloxacin.

Disruption of mycolic acid synthesis is the mechanism of action of anti-fungal medications.

Inhibition of integrase is the mechanism of action of some anti-retroviral drugs, as would be used in the treatment of diseases like HIV.

Inhibition of peptide elongation is the mechanism of action of macrolide antibiotics, such as azithromycin.

Example Question #1 : Nclex

You are the nurse taking care of a patient who is receiving an antibiotic, clindamycin, for the treatment of an oral infection. Which of the following choices best describes the mechanism of action of clindamycin?

Possible Answers:

Inhibition of dihydrofolate reductase

Prevention of folic acid synthesis

Inhibition of RNA transcription

Blockage of peptide elongation by binding 50S ribosome site

Inhibition of DNA gyrase

Correct answer:

Blockage of peptide elongation by binding 50S ribosome site

Explanation:

The correct answer is "blockage of peptide elongation by binding 50S ribosome site," as this is the mechanism of action of the antibiotic, clindamycin.

Inhibition of DNA gyrase is one of the mechanisms of action of fluoroquinolone antibiotics, such as levofloxacin.

Inhibition of RNA transcription is one of the mechanisms of action of bacitracin, a topical antibiotic.

Inhibition of dihydrofolate reductase is the mechanism of action of trimethoprim, an antibiotic that is often combined with sulfamethoxazole to inhibit folic acid synthesis.

Prevention of folic acid synthesis is the ultimate mechanism of action of trimethoprim and sulfamethoxazole (both individually and when given together).

Example Question #1 : Pharmacology

The nurse is preparing to administer 250,000 units of medication to a patient. The ampule sent from the pharmacy contains 500,000 units/mL. How many mL should the nurse administer?

Possible Answers:

1.2 mL

0.5 mL

0 mL

2.5 mL

Correct answer:

0.5 mL

Explanation:

The medication dose formula is as follows: Milliliters to be administered = (Dose to be administered)/(Available solution). Thus, the calculation for this problem is (250,000 units)/(500,000 units/mL) = 0.5 mL

Example Question #1 : General Concepts

The nurse is preparing to administer 100,000 units of medication to a patient. The ampule sent from the pharmacy contains 600,000 units/mL. How many mL should the nurse administer?

Possible Answers:

0 mL

1.5 mL

2 mL

2.4 mL

Correct answer:

0 mL

Explanation:

The medication dose formula is as follows: Milliliters to be administered = (Dose to be administered)/(Available solution). Thus, the calculation for this problem is (100,000 units)/(600,000 units/mL) = 0 mL mL

Example Question #1 : Pharmacology

The nurse is preparing a bag of heparin sodium solution with a mix of 120,000 units/400 mL intravenously. At what rate should the nurse set the infusion pump if intending to deliver 1800 units/hr?

Possible Answers:

7.8 mL/hr

1.3 mL/hr

6.0 mL/hr

2.2 mL/hr

Correct answer:

6.0 mL/hr

Explanation:

The required rate can be calculated as follows: (Delivered units/hr x mL)/units. Thus, the answer can be calculated as (1800 units/hr x 400 mL)/120,000 units = 6.0 mL/hr

Example Question #2 : Nclex

Hayden is a 9-year-old boy who has been admitted to the emergency room with a fever. He weighs 71lbs. If the dosing guideline for acetaminophen is  at 4 hour intervals, how many milligrams of acetaminophen should the nurse administer?

Possible Answers:

Correct answer:

Explanation:

First convert Hayden's weight from pounds to kilograms. This is done by dividing Hayden's weight by 2.2 because 1 pound is 2.2 kilograms.

Next set up the equation as follows: 

Solve for :

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