NCLEX-RN : Drug Identification

Study concepts, example questions & explanations for NCLEX-RN

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Example Questions

Example Question #8 : Anti Inflammatory And Pain Treatments

How does adalimumab function to reduce inflammation in rheumatoid arthritis?

Possible Answers:

Cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) inhibitor

More than one of these

Monoclonal antibody

Tumor necrosis factor-alpha inhibitor

Correct answer:

More than one of these

Explanation:

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 #1 : Anti Inflammatory And Pain Treatments

Which of the following analgesic medications should be used with caution in patients with hepatic disease?

Possible Answers:

Ibuprofen

Ketorolac

Naproxen

Meloxicam

Acetaminophen

Correct answer:

Acetaminophen

Explanation:

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 #1 : Anti Inflammatory And Pain Treatments

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?

Possible Answers:

Hypotension

Decreased appetite

Hyponatremia

Insomnia

Hyperkalemia

Correct answer:

Insomnia

Explanation:

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 #41 : 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?

Possible Answers:

Meperidine

Acetaminophen

Hydromorphone

Oxycodone

Morphine

Correct answer:

Meperidine

Explanation:

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 #11 : Anti Inflammatory And Pain Treatments

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?

Possible Answers:

Morphine

Acetaminophen

Hydromorphone

Oxycodone

NSAIDs

Correct answer:

NSAIDs

Explanation:

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 #1 : Endocrine 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?

Possible Answers:

Lispro

Glargine

Aspart

Isophane (NPH)

Regular

Correct answer:

Isophane (NPH)

Explanation:

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 #41 : Drug Identification

All of the following are examples of adrenergic agonists except __________.

Possible Answers:

salmeterol 

albuterol

terbutaline

tiotropium

Correct answer:

tiotropium

Explanation:

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 #1 : Respiratory Pharmacology

Which of the following is an example of an inhaled steroid used in the treatment of asthma?

Possible Answers:

Salmeterol

Tiotropium

Ipratropium

Fluticasone

Correct answer:

Fluticasone

Explanation:

Fluticasone (trade name Flovent) is a synthetic glucocorticoid used in the treatment of asthma and allergic rhinitis. 

Tiotropium (trade name Spiriva) and Ipratropium (trade name Atrovent) are both anticholinergics, and Salmeterol (trade name Serevent) is a beta-2 adrenergic receptor agonist.

Example Question #41 : Drug Identification

What class of drug is montelukast?

Possible Answers:

Leukotriene inhibitor

Anticholinergic bronchodilator

Long acting beta-2 agonist (LABA)

Corticosteroid

Correct answer:

Leukotriene inhibitor

Explanation:

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 #1 : Antimicrobial Pharmacology

Each of the following antibiotics works by inhibition of the 50S subunit of bacterial ribosomes except __________.

Possible Answers:

macrolides

clindamycin

streptogramin

tetracyclines

Correct answer:

tetracyclines

Explanation:

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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