PN Pharmacology
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Answer all questions, then review your results with feedback at the end.
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Below are sample questions from this exam to help you understand the content and format.
Q1: A nurse is preparing to administer vaccines to an 11-year-old child who is up to date on immunizations. Which of the following vaccines should the nurse plan to administer?
Answer Choices:
✔️ Vaccination Schedule:
At age 11, the quadrivalent human papillomavirus (HPV) vaccine is recommended as part of routine immunization. The CDC recommends administering the HPV vaccine series starting at ages 11–12.
✔️ Primary Prevention:
The HPV vaccine helps prevent cervical cancer, genital warts, and other cancers related to the HPV virus, and is most effective when given before potential exposure to the virus (i.e., before sexual activity).
✔️ Clinical Guidelines:
The CDC and American Academy of Pediatrics (AAP) recommend that children receive the HPV vaccine at 11 or 12 years of age, with two doses given 6–12 months apart.
Educational Insight:
The CDC recommends that all adolescents, regardless of gender, receive the HPV vaccine to reduce the risk of certain cancers and genital warts caused by HPV types 6, 11, 16, and 18.
Incorrect Options:
"A. Hepatitis B"
Hepatitis B vaccine is typically administered in infancy, with a 3-dose series. By age 11, the child should already be up to date on this vaccine.
"B. Rotavirus"
Rotavirus vaccine is given during infancy (before 8 months of age), not at age 11.
"C. Pneumococcal conjugate"
The pneumococcal conjugate vaccine (PCV13) is recommended in early childhood and is not needed for an 11-year-old who is up to date on immunizations.
Q2: A nurse is giving a patient instructions.
Answer Choices:
✔️ Albuterol:
Albuterol is a short-acting beta agonist (SABA) used for quick relief of acute asthma symptoms, such as difficulty breathing, wheezing, and chest tightness. It should be taken when the client experiences difficulty breathing to provide rapid bronchodilation.
✔️ Salmeterol:
Salmeterol is a long-acting beta agonist (LABA) that should be taken regularly, twice a day, to help prevent asthma symptoms. It is not used for acute relief but rather as a maintenance treatment for long-term control.
✔️ Fluticasone:
Fluticasone is a steroid inhaler used for chronic asthma management. The nurse should instruct the client to rinse their mouth after use to prevent oral thrush (a fungal infection) and ensure proper hygiene. It is not intended for immediate relief of asthma attacks.
Educational Insight:
Albuterol provides quick relief for acute asthma symptoms, while salmeterol is used for long-term control. Fluticasone, a steroid, helps reduce inflammation in the airways, improving asthma management over time.
Incorrect Options:
"Hold your breath for 20 seconds when taking your albuterol."
Incorrect—While it's helpful to hold your breath after using an inhaler, holding for 20 seconds is too long. The recommended time is usually about 5-10 seconds to allow the medication to reach the lungs.
"Take the salmeterol 5 minutes before the albuterol when you need both medications."
Incorrect—Salmeterol is used for maintenance and should be taken regularly as prescribed, not based on immediate needs. Albuterol should be used first during an acute episode, and salmeterol is typically taken on a regular schedule, not immediately before or after albuterol.
"Take the fluticasone as needed for an asthma attack."
Incorrect—Fluticasone is not for acute relief but for long-term control of asthma. It should be taken regularly as prescribed, even when the client feels well, to maintain asthma control.
Q3: A nurse is caring for a client who is taking allopurinol. Which of the following laboratory findings indicates the medication has been effective?
Answer Choices:
✔️ Mechanism of Action:
Allopurinol works by inhibiting the enzyme xanthine oxidase, which reduces the production of uric acid in the body. A decreased uric acid level indicates the medication is effectively lowering uric acid, which is the goal in treating conditions like gout and hyperuricemia.
✔️ Clinical Purpose:
By reducing uric acid levels, allopurinol helps prevent gout attacks, kidney stones, and other complications related to hyperuricemia, which can cause joint pain and inflammation.
✔️ Laboratory Indicator:
The most direct marker of allopurinol's effectiveness is a decrease in serum uric acid levels, as this confirms that the drug is achieving its intended therapeutic effect.
Educational Insight:
According to the American College of Rheumatology (ACR), reducing serum uric acid levels to below 6 mg/dL is the primary treatment goal for patients with gout on allopurinol.
Incorrect Options:
"A. Decreased triglycerides"
Allopurinol does not affect triglyceride levels directly. This would not be a relevant marker for assessing the effectiveness of allopurinol.
"C. Increased albumin"
Albumin levels are primarily associated with liver function and protein status rather than being an indicator of allopurinol's effectiveness in reducing uric acid.
"D. Increased potassium"
Increased potassium is not related to allopurinol use. Potassium levels may change due to renal issues or other medications, but not due to allopurinol.
Q4: A nurse is reinforcing teaching with a newly licensed nurse about age-related changes that affect medication administration for older adult clients. Which of the following information should the nurse include?
Answer Choices:
✔️ Renal Function Decline:
As people age, renal function tends to decline, which affects the ability of the kidneys to excrete medications. Slower renal excretion means medications stay in the body longer, potentially leading to drug accumulation and increased risk for toxicity.
✔️ Pharmacokinetics in Older Adults:
The aging process often leads to a reduction in glomerular filtration rate (GFR), renal blood flow, and nephron function, which directly affects the metabolism and clearance of medications, requiring dosage adjustments.
✔️ Clinical Significance:
It is important to monitor kidney function (via creatinine clearance or GFR) in older adults and adjust medication dosages accordingly to avoid adverse drug reactions and toxicity.
Educational Insight:
The American Geriatrics Society (AGS) highlights the importance of renal function assessment when prescribing medications for older adults to avoid complications due to slower drug excretion.
Incorrect Options:
"B. Brain receptors become less sensitive to medications."
While brain receptors may become less sensitive to certain medications (like benzodiazepines), increased sensitivity to some medications (such as antipsychotics) can also occur in older adults, so this is not universally true.
"C. Gastric emptying rate increases."
Gastric emptying rate decreases with age, which can affect the absorption of certain medications. This slows down the onset of action for some drugs.
"D. Hepatic enzymes process medications more rapidly."
Hepatic metabolism generally slows down with aging due to a decrease in liver size and hepatic blood flow, which can result in slower drug processing and increased risk of drug buildup.
Q5: A nurse is collecting data from a client who has taken an overdose of oxycodone. Which of the following findings should the nurse expect?
Answer Choices:
✔️ Oxycodone Toxicity Effects:
Oxycodone is an opioid analgesic that causes CNS depression. An overdose of oxycodone typically results in sedation, drowsiness, and decreased alertness as the body's response to excessive opioid effects.
✔️ Opioid Effects:
In cases of opioid overdose, the primary effects are sedation and respiratory depression, with a reduced level of consciousness. This is in contrast to stimulants or other drug overdoses that may cause agitation or increased activity.
✔️ Clinical Observations:
According to opioid overdose protocols, sedation is one of the most common and early signs, along with respiratory depression and miosis (pinpoint pupils).
Educational Insight:
The National Institute on Drug Abuse (NIDA) highlights that opioid overdose, including that from oxycodone, causes respiratory depression, sedation, and decreased responsiveness, and that immediate administration of naloxone is essential in such cases.
Incorrect Options:
"A. Tachycardia"
Tachycardia is typically not associated with an opioid overdose; opioids usually cause bradycardia (slowed heart rate).
"B. Tachypnea"
Tachypnea (increased respiratory rate) is uncommon in opioid overdose. Instead, opioids cause hypoventilation or respiratory depression, leading to a slow or shallow breathing pattern.
"D. Dilated pupils"
Opioid overdose typically causes constricted pupils (miosis), not dilated pupils. Dilated pupils are more commonly associated with stimulant overdoses (e.g., cocaine, amphetamines).
