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Pharmacology Worksheet: Desmopressin, Vasopressin, and Oxytocin

Total questions: 60

Worksheet time: 30mins

Name
Class
Date
1.

Desmopressin (DDAVP) is primarily indicated for which condition?

a)

Diabetes mellitus

b)

Diabetes insipidus

c)

Hypothyroidism

d)

Adrenal crisis

2.

The nurse should monitor for which adverse effect in a patient receiving vasopressin?

a)

Hypotension

b)

Hypertension

c)

Hypoglycemia

d)

Bradycardia

3.

Oxytocin (Pitocin) is used therapeutically to:

a)

Induce or enhance labor contractions

b)

Treat diabetes

c)

Reduce milk production

d)

Control hypertension

4.

Which nursing action is priority when administering oxytocin IV?

a)

Monitor fetal heart rate and uterine contractions

b)

Measure urine output hourly

c)

Restrict fluids

d)

Administer with food

5.

A patient taking desmopressin should be taught to report: Signs of water intoxication or hyponatremia.

a)

Headache and weight gain

b)

Dry skin

c)

Polyuria

d)

Tachycardia

6.

Vasopressin is contraindicated in patients with:

a)

Severe cardiovascular disease

b)

Diabetes insipidus

c)

Dehydration

d)

Septic shock

7.

The nurse explains that oxytocin promotes which physiological effect?

a)

Uterine contraction and milk ejection

b)

Water reabsorption

8.

Desmopressin differs from vasopressin because it:

a)

Has a longer duration and less vasoconstrictive effect

b)

Increases blood pressure more strongly

c)

Is used only for cardiac arrest

d)

Causes bradycardia

9.

Vasopressin may be used during cardiac arrest because it:

a)

Causes intense vasoconstriction to increase coronary perfusion

b)

Reduces heart rate

c)

Promotes urine production

d)

Increases thyroid function

10.

Which laboratory should be monitored for a patient taking desmopressin?

a)

Serum sodium

b)

Potassium

c)

Hemoglobin

d)

Calcium

11.

Levothyroxine (Synthroid) should be taken:

a)

Once daily in the morning on an empty stomach

b)

At bedtime with food

c)

With calcium supplements

d)

Twice daily with meals

12.

Which symptom indicates excessive levothyroxine dosage?

a)

Tachycardia and anxiety

b)

Constipation

c)

Weight gain

d)

Cold intolerance

13.

Propylthiouracil (PTU) treats hyperthyroidism by:

a)

Blocking synthesis and conversion of thyroid hormones

b)

Increasing iodine levels

c)

Stimulating TSH

d)

Enhancing T4 metabolism

14.

When should improvement be expected with PTU therapy?

a)

After 2 weeks of continuous treatment

b)

After 12 hours

15.

Which lab should the nurse monitor for a patient on PTU?

a)

Liver function tests

b)

Potassium

c)

Glucose

d)

Calcium

16.

A patient taking levothyroxine should avoid:

a)

Switching brands without provider approval

b)

Drinking milk with the dose

c)

Taking in the evening

d)

Combining with multivitamins

17.

Signs of hypothyroidism include:

a)

Weight gain and fatigue

b)

Tremors and heat intolerance

c)

Diarrhea and insomnia

d)

Tachycardia and sweating

18.

A nurse knows PTU therapy is effective when:

a)

Thyroid hormone levels normalize and symptoms improve

b)

The patient loses weight rapidly

c)

The pulse becomes irregular

d)

Serum sodium increases

19.

Myxedema coma is associated with:

a)

Severe hypothyroidism

b)

Hyperthyroidism

c)

Thyroid cancer

d)

Overdose of PTU

20.

Which medication may interact with levothyroxine?

a)

Anticoagulants (Warfarin)

b)

Insulin

c)

Cortisone

d)

Vasopressin

21.

Which insulin can be given IV for acute hyperglycemia?

a)

NPH

b)

Regular (Humulin R)

c)

Glargine

d)

Detemir

22.

Which insulin has no pronounced peak and provides 24-hour basal coverage?

a)

NPH

b)

Regular

c)

Glargine (Lantus)

d)

Lispro

23.

Approximate peak of NPH insulin is:

a)

30–60 min

b)

1–2 hr

c)

4–8 hr

d)

None

24.

Before starting metformin, the nurse should review:

a)

Potassium

b)

Renal function (eGFR/creatinine)

c)

CBC

d)

Magnesium

25.

A patient on metformin is scheduled for iodinated IV contrast. Best action? To reduce lactic acidosis risk.

a)

Double the dose

b)

Hold before and 48 hr after contrast (check renal function)

c)

Switch to glipizide

d)

Give with food only

26.

Thiazolidinediones (e.g., pioglitazone) carry which key risk?

a)

Hyperkalemia

b)

Fluid retention/heart failure exacerbation

c)

Pancreatitis

d)

Severe hypoglycemia

27.

Sitagliptin and linagliptin are:

a)

SGLT2 inhibitors

b)

DPP-4 inhibitors

c)

GLP-1 agonists

d)

Sulfonylureas

28.

Exenatide/dulaglutide/semaglutide most common adverse effect:

a)

Neutropenia

b)

Nausea/vomiting

c)

Hyperkalemia

29.

Long-term systemic glucocorticoid therapy increases risk for:

a)

Hyperkalemia

b)

Osteoporosis and infection

c)

Hypoglycemia

d)

Weight loss

30.

Best instruction for oral prednisone therapy:

a)

Stop when you feel better

b)

Taper to avoid adrenal crisis

c)

Take on empty stomach

d)

Double dose if stressed

31.

A patient on high-dose steroids develops black tarry stools. Priority action?

a)

Give antacid

b)

Notify provider (possible GI bleed)

c)

Continue therapy

d)

Start iron

32.

Fludrocortisone is primarily: Replaces aldosterone activity.

a)

Glucocorticoid

b)

Mineralocorticoid

c)

Androgen

d)

Estrogen

33.

Which combination insulin is correctly matched?

a)

Humalog 50/50 = Detemir/Lispro

b)

Humalog Mix 75/25 = NPL (protamine lispro)/Lispro

c)

Novolin 70/30 = Glargine/Regular

d)

Humulin 50/50 = Detemir/Regular

34.

Classic early sign of insulin-induced hypoglycemia:

a)

Warm, dry skin

b)

Tremor and diaphoresis

c)

Kussmaul respirations

d)

Flushed face

35.

Key monitoring with fludrocortisone:

a)

Bradycardia

b)

Blood pressure and edema

c)

Leukopenia

d)

Hypoglycemia

36.

Which lab abnormality is expected with chronic glucocorticoids?

a)

Hypernatremia & hyperkalemia

b)

Hyperglycemia

c)

Eosinophilia

d)

Elevated TSH

37.

Stress-dose steroids are needed when:

a)

Starting therapy

b)

During acute illness/surgery

c)

When tapering off

d)

With inhaled forms

38.

Morning dosing of glucocorticoids helps to:

a)

Reduce infection risk

b)

Mimic circadian rhythm & reduce HPA suppression

c)

Increase absorption

d)

Prevent ulcers

39.

Methylprednisolone (IV) is preferred for:

a)

Chronic maintenance

b)

Acute inflammatory/autoimmune exacerbations

c)

Addison’s maintenance

d)

Mineralocorticoid replacement

40.

Abrupt cessation after prolonged steroid use can cause:

a)

Cushing syndrome

b)

Adrenal insufficiency (hypotension, fatigue)

c)

Hypernatremia

d)

Hyperkalemia only

41.

Estrogen therapy carries a boxed warning for increased risk of:

a)

Hypoglycemia

b)

Thromboembolic events

c)

Nephrotoxicity

42.

Medroxyprogesterone (Depo-Provera) key counseling:

a)

Causes hyperkalemia

b)

May decrease bone mineral density with long-term use

c)

Always causes weight loss

d)

Take daily at bedtime

e)

Consider calcium/vitamin D and duration limits.

43.

Megestrol (Megace) is often used for:

a)

Osteoporosis prevention

b)

Appetite stimulation/weight gain (cachexia)

c)

Hypertension

d)

Uterine atony

e)

Progestin with orexigenic effects.

44.

Raloxifene (Evista) is a SERM used to:

a)

Treat hot flashes

b)

Prevent/treat postmenopausal osteoporosis

c)

Induce ovulation

d)

Treat VTE

e)

Estrogen agonist on bone, antagonist on breast/uterus; VTE risk.

45.

Clomiphene (Clomid) treats infertility by:

a)

Suppressing LH/FSH

b)

Inducing ovulation via increased FSH/LH

c)

Blocking progesterone receptors

d)

Replacing estrogen

e)

SERM that stimulates the HPO axis.

46.

Dinoprostone/misoprostol in obstetrics:

a)

Stop contractions

b)

Cervical ripening and labor induction

c)

Tocolysis

d)

Prevent eclampsia

e)

Prostaglandins for cervix and uterine activity.

47.

Methylergonovine (Methergine) is contraindicated in:

a)

Asthma

b)

Hypertension

c)

Hypothyroidism

d)

Diabetes

e)

Ergot increases BP/vasoconstriction.

48.

Oxytocin infusion priority monitoring: Prevent fetal distress/uterine rupture.

a)

Serum sodium

b)

Fetal heart rate & uterine tachysystole

c)

D-dimer

d)

Platelets

49.

Calcitonin (nasal) teaching: Local nasal effects common.

a)

Take with calcium chelators

b)

Alternate nostrils; monitor for nasal irritation

c)

Expect hypercalcemia

d)

Use PRN only

50.

Teriparatide vs. Denosumab—correct pairing:

a)

Teriparatide = RANKL inhibitor

b)

Denosumab = RANKL inhibitor; Teriparatide = PTH analog

c)

Both are SERMs

d)

Both cause VTE routinely

51.

Contraindication to testosterone therapy:

a)

BPH

b)

Prostate or male breast cancer

c)

Hyperlipidemia

d)

Hypothyroidism

52.

Key counseling for topical testosterone gel: Prevent secondary exposure (children/partners).

a)

Apply to scrotal skin

b)

Avoid skin-to-skin transfer; wash hands; cover application site

c)

Apply over open wounds

d)

Use as needed for energy

53.

Common adverse effect of testosterone:

a)

Hypernatremia only

b)

Edema/fluid retention

c)

Bradycardia

d)

Hypoglycemia

54.

4. Finasteride MOA:

(a)  

55.

Counseling for women handling finasteride tablets: DHT inhibition is teratogenic.

a)

Safe in pregnancy

b)

Avoid handling crushed/broken tablets (teratogenic to male fetus)

c)

Wear gloves only if breastfeeding

d)

No precautions needed

56.

Expected effect of finasteride on labs: Adjust PSA interpretation accordingly.

a)

↑ PSA 50%

b)

↓ PSA ~50% after months

c)

↑ Hematocrit

d)

↓ Creatinine

57.

Timeframe to symptom improvement in BPH with finasteride: Prostate shrinkage is gradual.

a)

48 hours

b)

1 week

c)

Several months

d)

Immediately

58.

Testosterone monitoring should include:

a)

Daily CBC

b)

LFTs and lipids; assess for edema, sleep apnea, PSA/prostate

c)

Daily ECG

d)

BNP only

59.

Finasteride adverse effects to discuss:

a)

Hypertension

b)

Decreased libido/ED/ejaculatory disorders

c)

Hypercalcemia

d)

Gynecomastia never occurs

60.

Indication for testosterone replacement: Treat only documented androgen deficiency.

a)

Fatigue of any cause

b)

Confirmed hypogonadism (clinical + low morning testosterone)

c)

Weight loss

d)

Erectile dysfunction alone

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