Pharmacology Final Exam Questions and Answers, Exams of Nursing

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PHARMACOLOGY Final Actual Exam Questions and Answers 2024

1. You administer an agonist drug that acts on postganglionic neurons of the sympathetic nervous system. Which response will you expect to see? a. Decreased sweating b. Bronchodilation c. Increased cardiac output d. Pinpoint pupils
2. You are administering dopamine to a patient. Which assessment finding would cause the most concern? a. Blood pressure of 100/ b. Increased urine output c. Edema at the IV site d. Headache
3. The majority of neuropharmacologic agents produce their effects in what way? a. Enhancing axonal reception c. Up-regulating axonal sensitivity d. Down-regulating transmitter receptivity
4. When drugs interfere with the process that terminates transmitter action, the result is: a. A significant alteration in the release of transmitter b. A decrease in the concentration of transmitters in the synaptic gap c. An increase in the concentration of transmitters in the synaptic gap d. An increase in transmitter reuptake
5. A patient is admitted to the ICU for treatment of shock. The prescriber orders isoproterenol (Isuprel). You expect this drug to increase tissue perfusion in this patient by: a. Alpha 1 receptors to cause vasoconstriction b. Alpha 1 receptors to raise BP c. Beta 1 receptors to cause a positive inotropic effect d. Beta 2 receptors to cause bronchodilation

6. You are called to a scene for the complaint of shortness of breath. Meds include a beta blocker for hypertension. Respirations are 28 bpm, BP 162/90, pulse 88 beats per minute. You auscultate crackles in all lung fields. You understand that these assessments are consistent with: a. Bronchoconstriction b. Left sided heart failure c. Rebound cardiac excitation d. Right heart failure
7. You are caring for a patient who has taken an overdose of a tricyclic antidepressant drug that has pronounced antimuscarinic properties. You should prepare to…(Select all that apply.) a. Support breathing b. Administer atropine c. Administer drugs for hypotension d. Administer drugs for hypertension e. Administer Haldol drugs to treat delirium f. Administer physostigmine
8. You administer drug A to a patient. You understand that the more types of receptors there are for the drug to work with, the greater the chance of producing which effect in the patient? a. Toxic levels b. Subtherapeutic levels c. Selective drug effects d. Minimal drug effects
9. A neuron contains a large amount of norepinephrine. How would this neuron be classified? a. Cholinergic b. Parasympathetic c. Synaptic d. Adrenergic
10. Jacob is taking an adrenergic agonist. Which of the following medications will likely cause him to have a hypertensive crisis? a. Metoprolol (Lopressor) b. Diuretics c. Alpha 1 adrenergic blockers d. MAO inhibitors
11. Drugs that increase receptor activation are those that: a. Antagonize any natural transmitter in the synapse b. Produce an effect equivalent to that produced by the natural transmitter c. Promote the use of excess transmitters to down-regulate activation d. Lack any effect at the synaptic cleft

a. The use of these medications during the first trimester is an indication for termination of the pregnancy b. Asthma medications pose no potential harm to a developing fetus and may be taken as needed c. The use of these medications is contraindicated throughout pregnancy d. Untreated asthma may be more detrimental to the developing fetus than drugs used to treat it

19. A patient is starting therapy with an alpha 1 antagonist for hypertension. Which of the following is the cause of the expected orthostatic blood pressure change? a. Parasympathetic effects on the CNS b. Dilation of the peripheral arterial walls c. Reduced smooth muscle tone in the venous walls d. Increased cardiac output from the sympathetic stimulation
20. Cholinergic drugs that stimulate muscarinic receptors are indicated for which situation? a. Treating a post-op patient who has bradycardia b. Lowering intra-ocular pressure in a patient with glaucoma c. Preventing salivation and diuresis d. Inhibiting muscular activity in the bowel
21. of epinephrine is administered IV to newborns whose heart rate is less than following adequate ventilations and chest compressions a. 0.01cc/kg 1:10,000; 60 b. 0.1 cc/kg 1:10,000; 60 c. 0.01 cc/kg 1:10,000; 100 d. 0.1 cc/kg 1:1000; 100
22. A patient is brought to the ED by friends who state that the patient was attacked by a bear and sustained a laceration to his leg 15 minutes ago. You would anticipate that the body would respond by a(n): a. Decrease in serum glucose b. Increase in serum glucose c. Heart rate of 72 beats/min d. Respirations of 16 breaths/min
23. Which of the following is a direct mechanism by which adrenergic agonists activate adrenergic receptors? a. Facilitation of norepinephrine inactivation b. Inhibition of norepinephrine release c. Direct receptor binding d. Promotion of norepinephrine reuptake
24. Ear drops are given to children younger than 3 years by: a. Pulling the lobe down and back b. Pulling the pinna up and back

c. Pulling the pinna out and up d. Pulling the lobe out and forward

25. All of the following are important steps in the management of a patient with pulseless electrical activity (PEA) except: a. Administering a rapid fluid challenge with normal saline b. Checking for muffled heart tones c. Administration of amiodarone d. Administration of epinephrine

26. In ED, you are ordered to prepare metoprolol (Lopressor) for a patient recovering from an MI. The patient’s HR is 50 bpm and the rhythm is regular. What action should you take next? a. Administer the drug as prescribed b. Inform the nurse so she can get an order for atropine c. Withhold the dose and document the HR d. Withhold the dose and inform the EDP prescriber
27. The most important cause of adverse drug reactions in the elderly is: a. Reduced renal excretion b. Retarded hepatic metabolism c. Low serum albumin levels d. Increased incidence of autoimmune disorders
28. You give a medication that inhibits acetylcholinesterase. How would this drug affect autonomic activity? a. Parasympathetic activity would increase b. Parasympathetic signals would be depressed c. Sympathetic activity would increase d. Respiratory activity would be increased
29. How do cholinergic (muscarinic) blockers, such as atropine, produce their therapeutic effects? a. They mimic the action of ACh at muscarinic receptor sites b. They block the action of ACh at nicotinic receptor sites c. They metabolize ACh at the postjunctional membrane d. They compete with ACh at muscarinic receptor sites
30. Based on the general principles of pharmacokinetics and relative specificity, patients with what chronic diseases would be at most risk for adverse effects from adrenergic agonists? a. Chronic obstructive pulmonary disease b. Hypotension

37. Which of the following patients needs immediate intubation? a. Unconscious diabetic patient with blood glucose of 28 b. Apneic patient whose chest does not rise and fall with BVM ventilations c. Elderly man with severe chest pain and a respiratory rate of 30/min d. Woman with sinus tachycardia with runs of ventricular tachycardia
38. Which of these findings would be most significant if a patient was prescribed Inderal (propranolol)? a. Apical pulse of 100 bpm b. Expiratory wheezing c. BP 160/ d. Urinary retention
39. Toxic doses of sarin gas would be expected to cause: a. Metabolic alkalosis b. Ketoacidosis c. Disseminated intravascular coagulation d. Cholinergic crisis
40. You have mixed Heparin 25,000 units in 500 cc 5% Dextrose/Water. The physician orders the drip to run at 800 units/ hr. How many drops per minute using a minidrip? a. 960 gtts/min b. 60 gtts/min c. 96 gtts/min d. 16 gtts/min
41. A patient who has been taking propranolol for 18 months reports, “ I stopped taking the medication because my BP has been normal for the past 3 months.” Which information should you give to the patient? a. Stop the medication, and keep an accurate record of your BPs. b. Stop the medication, and report any headaches or uncomfortable symptoms. c. The drug should be tapered over a 2 - week period to prevent rebound hypertension. d. Continue the medication until another can be started to avoid withdrawal symptoms.
42. A group of students go camping. One student finds some wild mushrooms and eats them with his lunch. Which of the following symptoms would you expect to find if he is experiencing muscarinic poisoning? (Select all that apply), a. Tachycardia b. Hypertension c. Profuse salivation d. Constipation e. Dilated pupils that do not respond to light f. Wheezing

g. Lacrimation h. Incontinence

43. You are caring for a newborn 1 day after delivery. The infant’s mother used metoprolol during her pregnancy. You will expect to monitor this infant for which conditions? a. Hyperglycemia b. Hyperthroidism c. Respiratory distress d. Tachycardia
44. Drug metabolizing capacity is markedly elevated until the age of : a. 6 months b. 2 years c. 12 years d. 25 years
45. Catecholamines cannot be administered orally because: a. They have a long half-life b. The effects would be excessively potent if the drugs were given by this route c. The side effect profile prevents the administration by this route d. They are quickly destroyed by MAO and COMT
46. How do adrenergic blockers work? a. By blocking epinephrine and norepinephrine b. By blocking acetylcholine c. By inactivating acetylcholinesterase d. By imitating epinephrine and norepinephrine
47. If the half-life of a drug changes from 3 hours to 6 hours, what plan could you make to maintain therapeutic levels? a. Increase the time interval between doses b. Decrease the time interval between doses c. Alter the method of administration (Give IV instead of PO) d. No change should be planned; the therapeutic levels would remain the same even if half-life changes
48. What effect can a beta 1 nonselective antagonist (such as propranolol) have on a beta 2 agonist (terbutaline)? a. It has no effect b. The beta 1 antagonist can increase the effects of the beta 2 agonist c. The beta 1 antagonist can reduce the beneficial responses to beta 2 agonist d. The beta 1 antagonist can potentiate both drugs
49. Most of the peripherally-acting sympathomimetics act directly on receptor activation. The one exception acts directly on receptor activation and promotion of norepinephrine release. This one drug is: a. Terbutaline

d. The drug is in the highest risk category

57. The physician orders Dopamine 8 mcg/kg/min by continuous IV infusion. The patient’s weight is 175 lbs. You have Dopamine 400 mg in 500 ml D 5 W. What is the correct infusion rate in gtts/min? 8mcg/kg/min x 80kg x 500ml x 60gtts/ml = 48 gtts/min 400,000mcg A. What dose is this? (Renal, Cardiac or Pressor) Cardiac
58. How would you distinguish between a patient who has diphenhydramine poisoning and one who is experiencing a psychotic episode when intervening in a situation in which the individual is agitated and fighting police and EMS. Give at least 2 symptoms you would use to differentiate the conditions. ( 2 points) Anticholinergic symptoms: Dry skin, dry mouth Dystonia 59. Michael Jones , 4 years old, is being transported a distance from his home, with acute asthma. Weight: 55 lbs. His pediatrician orders an Aminophylline bolus and drip. He requests that you add 160 mg Aminophylline to 50 ml of D5W and run it over 30 minutes. The bolus is to be followed by a drip of 355 mg in 250 ml D5W and is to be run at 1 mg/kg/hr. A Bolus Dose:

1. How many cc’s of Aminophylline will you add to the bolus bag if it is available in 500 mg/20 ml ampules? 6ml
2. What is the concentration of the bag? 160mg/ 56ml = 3mg/ml
3. How many gtts/min? 56ml x 60 gtts/ml = 112 gtts/min 30 mins
4. How many mg/min? 160/30 = 5mg/min B. Maintenance Drip :
5. How many cc’s to be added to bag? ( mg/20 ml ampule) 14ml
6. How many gtts/min? 1mg x 250ml x 25 kg x 60gtts/ml = 18gtt/min 355mg x 60min
7. In what types of over-the-counter drugs are you likely to find adrenergic agonist activity (sympathomimetic activity)? List at least 3. Sudafed Robitussin Caffeine Pills Interpret the following rhythms:

64. Sinus with 1 st^ degree HB
65. A Flutter 2:

PHARMACOLOGY Final Actual Exam Questions and Answers 2024

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