NCLEX-RN : Drug Identification

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #91 : Nclex

You are a nurse in a primary care setting. One of your patients is diagnosed with hypercholesterolemia, and after failing to see cholesterol improvements with diet and exercise, is started on atorvastatin. Which of the following best describes the mechanism of action of atorvastatin?

Possible Answers:

Na-K-2Cl symporter inhibition

Alpha-adrenergic inhibition

Beta-adrenergic inhibition

Peroxisome proliferator-activated receptors (PPAR) activation

HMG-CoA reductase inhibition

Correct answer:

HMG-CoA reductase inhibition

Explanation:

The correct answer is "HMG-CoA reductase inhibition," as this is the accurate mechanism of action of atorvastatin, a commonly-prescribed lipid-lowering agent for patients with a number of medical conditions, including hypercholesterolemia. HMG-CoA reductase is an enzyme found within the liver that catalyzes a major reaction involved in cholesterol formation. By inhibiting this enzyme with a medication such as a statin, the new production of LDL cholesterol is decreased, and the number of LDL receptors is upregulated (which decreases circulating LDL, therefore lowering LDL cholesterol).

Atorvastatin is neither an alpha-adrenergic inhibitor, beta-adrenergic inhibitor, PPAR activator (fibrates), or Na-K-2Cl symporter inhibitor (loop diuretics). 

Example Question #92 : Nclex

You are a nurse working on an inpatient medicine floor. One of your patients is advised to discuss starting gemfibrozil, a fibrate medication, after he is discharged. Which of the following best describes the mechanism of action of gemfibrozil?

Possible Answers:

Vitamin-K-dependent clotting factor synthesis inhibition

Beta-adrenergic inhibition

Peroxisome proliferator-activated receptor (PPAR) activation

Alpha-adrenergic inhibition

HMG-CoA reductase inhibition

Correct answer:

Peroxisome proliferator-activated receptor (PPAR) activation

Explanation:

The correct answer is "Peroxisome proliferator-activated receptor (PPAR) activation," as this is the accurate mechanism of action for fibrate medications, such as gemfibrozil. Fibrates are commonly-used medications used to treat high cholesterol, as well as a number of other metabolic abnormalities in patients. Fibrates have the relatively unique property of lowering LDL (the "bad" cholesterol), increasing HDL (the "good" cholesterol), and lowering triglycerides, making them a popular choice when administered either alone, or with statin medications for patients with hypercholesterolemia. 

HMG-CoA reductase inhibition is the mechanism of action of statins.

Vitamin-K-dependent clotting factor synthesis inhibition is the mechanism of action of warfarin.

Alpha-adrenergic inhibition is the mechanism of action of phenoxybenzamine, among other medications.

Beta-adrenergic inhibition is the mechanism of action of propranolol, among other medications.

Example Question #93 : Nclex

You are the nurse taking care of a patient hospitalized for a deep vein thrombosis. You are reviewing his discharge medications, and counsel him about the benefits and risks associated with apixaban. Which of the following is a major possible adverse effect associated with apixaban?

Possible Answers:

Thrombosis

Bleeding

Ischemic stroke

Myocardial infarction

Constipation

Correct answer:

Bleeding

Explanation:

The correct answer is "bleeding." 

Apixaban is a novel anti-coagulant medication that functions by directly inhibiting factor Xa in the clotting cascade. You can remember this mechanism of action by noting the letters "Xa" in apiXaban. Apixaban is used with increasing frequency now in the treatment of deep vein thrombosis, pulmonary embolism, and atrial fibrillation. A very serious potential adverse effect of apixaban though is that since it is an anticoagulant agent, it can predispose to serious bleeding events. Furthermore, one of the biggest dangers of apixaban is that there is no readily available antidote for it yet, and as such if a bleeding event occurs, there is no simple way to reverse it, as there is with other anti-coagulants like warfarin or heparin. 

Thrombosis, myocardial infarction, and ischemic stroke are all typically thrombotic (e.g. clot-related) issues. Apixaban may be used in the treatment of conditions associated with clotting, but is not known to cause clots, as it is an anti-coagulant. 

Apixaban has no known association with bowel movement frequency. 

Example Question #94 : Nclex

You are a nurse taking care of a patient during a rapid response call. The patient is bradycardic and you are asked to administer atropine. Which of the following best describes the mechanism of action of atropine?

Possible Answers:

Beta-adrenergic blocker

Muscarinic acetylcholine receptor antagonist

Muscarinic acetylcholine receptor agonist

Alpha-adrenergic blocker

Monoamine oxidase inhibitor

Correct answer:

Muscarinic acetylcholine receptor antagonist

Explanation:

The correct answer is "Muscarinic acetylcholine receptor antagonist," as this accurately describes the mechanism of action of atropine. 

Atropine is an anticholinergic medication used for a number of reasons, including to treat bradycardia, various nerve agent poisonings, and intraoperatively at times to diminish the amount of saliva generated. Typical anticholinergic medication side effects can be associated with atropine including pupil dilation, urine retention, dry mouth, constipation, and tachycardia. 

Muscarinic acetylcholine receptor agonist is incorrect as this is the opposite of how atropine works. 

Beta-adrenergic blocker is incorrect. This class of medications would actually serve to decrease heart rate, which would be highly dangerous in a patient whose reason for intervention is bradycardia.

Neither alpha-adrenergic blockade nor monoamine oxidase inhibition describes the mechanism of action of atropine. 

Example Question #95 : Nclex

You are the nurse taking care of a 78-year old female who is in atrial fibrillation with rapid ventricular response. She is started on metoprolol and diltiazem. Which of the following best describes the mechanism of diltiazem?

Possible Answers:

Calcium-channel blocker

Alpha-adrenergic blocker

Beta-adrenergic blocker

Mu-opioid receptor agonist

Mu-opioid receptor antagonist

Correct answer:

Calcium-channel blocker

Explanation:

The correct answer is "Calcium-channel blocker." Diltiazem, which is more specifically a non-dihydropyridine calcium-channel blocker is a commonly given medication that functions to dilate both coronary and peripheral vessels (with a negligible reflex adrenergic response). It also is useful in reducing cardiac contractility, having negative inotropy, chronotropy, and dromotropy characteristics. 

The other choices are incorrect. Beta-adrenergic blocker is the mechanism of action of metoprolol. Alpha-adrenergic blocker is the mechanism of action of doxazosin. Mu-opioid receptor agonist is the mechanism of action of morphine. Mu-opioid receptor antagonist is the mechanism of action of naloxone.

Example Question #1 : Neural Pharmacology

A client has been taking daily doses of Paroxetine for 6 months and has asked for an information with the nurse about going off the medication. What should the nurse emphasize in the information session?

Possible Answers:

Advise the patient of probable weight gain after going off the medication

Stop taking the medication immediately, increase physical activity level for 2-3 weeks to counteract side effects

Taper the medication to avoid discontinuation syndrome

Urge the client to continue taking the medication until he consults a psychotherapist

Correct answer:

Taper the medication to avoid discontinuation syndrome

Explanation:

Clients taking Paroxetine may experience withdrawal and continuation syndrome. To minimize symptoms, taper the medication over a period of 3 or more weeks.

Example Question #2 : Neural Pharmacology

What type of antidepressant is fluoxetine?

Possible Answers:

Selective serotonin re-uptake inhibitor (SSRI)

Tetracyclic antidepressant

Monoamine oxidase inhibitors (MAOI) 

Norepinephrine reuptake inhibitor (NRI)

Correct answer:

Selective serotonin re-uptake inhibitor (SSRI)

Explanation:

Fluoxetine is an example of a selective serotonin re-uptake inhibitor (SSRI). SSRI's limit the amount of serotonin that the presynaptic cell that secreted it, cat re-uptake. This increases the time and amount that serotonin is in the synaptic cleft, and bound to postsynaptic receptors, leading to anti-depressant properties. The other drugs are all antidepressants, but are sold under other names.

Example Question #3 : Neural Pharmacology

What drug class is clomipramine?

Possible Answers:

Monoamine oxidase inhibitor (MAOI)

Tricyclic antidepressant

Serotonin modulator and stimulator (SMS)

Selective serotonin reuptake inhibitor (SSRI)

Correct answer:

Tricyclic antidepressant

Explanation:

Clomipramine is a tricyclic antidepressant. Drugs in this class function primarily by blocking serotonin and norepinephrine transporters, resulting in an increase in the levels of these neurotransmitters in the synapse, and thus an increase in their effects due to staying bound to postsynaptic receptors for longer. 

Example Question #4 : Neural Pharmacology

What class of drug is trazodone?

Possible Answers:

Norepinephrine reuptake inhibitor (NRI)

Tricyclic antidepressant

Tetracyclic antidepressant

Serotonin antagonist and reuptake inhibitor (SARI)

Correct answer:

Serotonin antagonist and reuptake inhibitor (SARI)

Explanation:

Trazodone is a serotonin antagonist and reuptake inhibitor (SARI). These drugs work by increasing the release and inhibiting the reuptake of serotonin in the synaptic space, thus increasing the effect of serotonin.

Example Question #5 : Neural Pharmacology

Aripiprazole is what class of drug? 

Possible Answers:

Atypical antipsychotic

Serotonin–norepinephrine reuptake inhibitor (SNRI)

Serotonin modulator and stimulator (SMS)

Selective serotonin re-uptake inhibitor (SSRI)

Correct answer:

Atypical antipsychotic

Explanation:

Aripiprazole is an atypical antipsychotic. It acts as a partial dopamine agonist and an agonist to multiple 5-HT (serotonin) receptors.

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