WorksheetsPharm Final
Total questions: 131
Worksheet time: 1hrs 6mins
Which statement best describes ondansetron’s mechanism of action?
Inhibits histamine receptors in the stomach lining
Neutralizes gastric acid with aluminum hydroxide salts
Blocks dopamine receptors in CTZ to reduce vomiting
Blocks serotonin receptors in CTZ and vagal terminals
A patient on ondansetron develops constipation and dizziness. Which additional adverse effect requires ECG monitoring?
Prolonged QT interval with torsades risk
Hyperkalemia causing peaked T waves
Bradycardia from vagal overactivity
Hypertension from alpha stimulation
Which counseling point is most appropriate for over-the-counter laxatives?
They increase gut motility and frequency indefinitely
Daily long‑term use prevents stool impaction safely
Overuse can cause dehydration and electrolyte imbalances
They are preferred in suspected bowel obstruction
Which statement reflects the primary action of antidiarrheals?
Increase water secretion into intestinal lumen
Chelate toxins to neutralize infectious agents
Stimulate peristalsis and increase stool output
Slow gut motility and decrease bowel movements
Which clinical scenario best supports using a dopamine antagonist antiemetic such as prochlorperazine?
Mild motion sickness after short car trip
Severe nausea with migraine-associated vomiting
Irritable bowel syndrome with constipation
GERD with nocturnal acid breakthrough
Which patient should avoid a specific class of antacids due to contraindication?
Heart failure patient avoiding sodium-containing antacids
Asthma patient avoiding aluminum-containing antacids
Diabetes patient avoiding calcium-containing antacids
Hypothyroid patient avoiding magnesium-containing antacids
Which adverse effect profile is most characteristic of metoclopramide requiring patient education?
Extrapyramidal symptoms and tardive dyskinesia risk
Photosensitivity with irreversible vision loss
Ototoxicity and nephrotoxicity with long use
Severe hyperglycemia with acute pancreatitis
How should a patient time metoclopramide dosing to reduce nausea and improve gastric emptying?
Take once weekly with fatty meals
Take 30 minutes before meals consistently
Take only after meals for peak effect
Take at bedtime only on empty stomach
Which best describes famotidine’s pharmacologic class?
H2 receptor antagonist
Proton pump inhibitor
Antacid neutralizing agent
Mucosal barrier agent
A patient takes calcium carbonate daily. When should famotidine be scheduled to avoid interaction?
One to two hours before antacids
Only at bedtime with food
Together with the antacid dose
Four hours after antacids
Which counseling point is most appropriate for lansoprazole?
Take only with fatty meals
Chew tablets thoroughly
Use only as needed daily
Take on an empty stomach
An older adult on famotidine develops acute confusion. What is the best initial action?
Suspect a drug adverse effect
Increase the famotidine dose
Add an over-the-counter antacid
Stop hydration until evaluation
What is the primary mechanism of action of sucralfate?
Forms a protective ulcer coating
Blocks gastric H2 receptors
Neutralizes gastric acidity
Inhibits proton pump activity
Which is an appropriate indication for initiating sucralfate therapy?
Eradication of H. pylori
Prevention of gallstones
Chronic constipation relief
Duodenal ulcer treatment
A patient using lansoprazole for heartburn asks about dosing frequency. Which guidance is best?
Take daily rather than as needed
Limit use to bedtime doses
Use only after symptoms occur
Alternate days with antacids
Which is a common risk factor for fluid volume deficit?
Daily intake of balanced oral fluids
Improved gastrointestinal absorption
Reduced diuretic use in older adults
Excessive sweating during heat exposure
Which sign best indicates fluid volume deficit at the bedside?
Moist oral mucous membranes
Generalized pitting edema present
Bounding peripheral pulses bilaterally
Flattened neck veins when supine
Which vital sign change is most consistent with fluid volume deficit?
Irregular pulse without pressure change
Afebrile with stable blood pressure
Bradycardia with hypertension
Tachycardia with orthostatic hypotension
Which laboratory pattern supports fluid volume deficit?
Elevated hematocrit and elevated BUN
Decreased hematocrit and low BUN
Normal hematocrit with low creatinine
Low hematocrit and high WBC count
Select the normal adult serum sodium range.
120–130 mEq/L
135–145 mEq/L
145–155 mEq/L
100–110 mEq/L
Which value is within the normal range for potassium?
1.2 mEq/L
5.8 mEq/L
4.2 mEq/L
2.8 mEq/L
A patient’s labs show creatinine 1.1 mg/dL and BUN 28 mg/dL. What is the best interpretation?
Both values are elevated above normal
BUN is elevated; creatinine is normal
Creatinine is low; BUN is normal
Both values are within normal limits
Which magnesium value falls in the normal adult range?
0.4 mg/dL
3.2 mg/dL
1.0 mg/dL
2.0 mg/dL
Which adverse effect most specifically aligns with hypernatremia in adults?
Extravasation risk with parenteral medications
Nausea with muscle cramps and confusion
Bradycardia with respiratory depression
Hypertension with dysrhythmias predominating
A patient presents with lethargy, confusion, focal brain hemorrhage, and seizures. Which electrolyte imbalance is most likely?
Hypernatremia causing cerebral edema
Hypomagnesemia causing tachycardia
Hypercalcemia causing hypertension
Hyponatremia causing cerebral complications
Which clinical picture best matches hyperkalemia?
Tachycardia with neuromuscular irritability
Bradycardia with coma and hypoventilation
Cardiac arrest with muscle weakness and paresthesias
Hypertension with ventricular dysrhythmias
Increased ectopy with premature ventricular contractions and arrhythmias most strongly suggests which imbalance?
Hyponatremia with cerebral edema
Hypercalcemia with bradycardia
Hypermagnesemia with heart block
Hypokalemia with ventricular irritability
Which finding is most consistent with hypomagnesemia?
Bradycardia with muscle weakness and coma
Hypotension with bleeding risk and confusion
Tachycardia with neuromuscular irritability and seizures
Hypertension with broad dysrhythmias
A patient has hypertension and dysrhythmias with elevated calcium. Which label fits best?
Hypercalcemia with cardiovascular changes
Hyponatremia with focal hemorrhage
Hypocalcemia with bleeding risk mainly
Hypermagnesemia with respiratory failure
Choose the most appropriate IV fluid for symptomatic hyponatremia with sodium less than 120 mEq/L.
Balanced crystalloids such as lactated Ringer’s
Hypotonic saline such as 0.45 percent NaCl
Isotonic saline such as 0.9 percent NaCl
Hypertonic saline such as 3 percent NaCl
Which fluid strategy best addresses hypernatremia with sodium above 160 mEq/L?
Hypotonic saline like 0.45 percent NaCl
Colloid solutions like albumin infusion
Hypertonic saline like 3 percent NaCl
Isotonic saline like 0.9 percent NaCl
Which statement best describes prednisone in clinical practice?
Prednisone is a synthetic ADH analog
Prednisone is an antithyroid medication
Prednisone is a mineralocorticoid hormone
Prednisone is a glucocorticoid medication
Which is a serious adverse effect associated with prednisone therapy?
Severe hypothyroidism symptoms
Agranulocytosis with neutropenia
Bradycardia with heart block
Immunosuppression with infection risk
Stopping long-term prednisone abruptly places a patient at highest risk for which complication?
Hyponatremia from SIADH recurrence
Thyroid storm from rebound TSH
Acute kidney injury from dehydration
Adrenal crisis due to cortisol suppression
Which description accurately defines adrenal insufficiency/crisis?
Sudden surge of catecholamines causing tachycardia
Transient excess of aldosterone causing hypertension
Autoimmune destruction of thyroid follicular cells
Life-threatening inability to make enough cortisol
A patient on chronic prednisone presents with weakness, fatigue, severe vomiting, diarrhea, and sudden lower back pain. Which additional finding most strongly supports adrenal crisis?
Hyperthermia with flushing and polyuria
Hyperglycemia with weight gain and edema
Hypertension with bradycardia and bradypnea
Hypotension with tachycardia and tachypnea
Which nursing action best prevents adrenal crisis in a patient requiring long-term prednisone?
Give levothyroxine concurrently to protect cortisol
Taper the dose gradually instead of stopping abruptly
Double the dose during periods of stress indefinitely
Restrict sodium and fluids to reduce edema
Which mechanism best describes methimazole’s primary action?
Inhibits thyroid hormone synthesis enzymes
Blocks peripheral T4 to T3 conversion
Stimulates thyroid hormone receptor activity
Enhances iodine uptake into follicles
A patient on methimazole develops fever and sore throat. Which adverse effect is most concerning?
Ototoxicity causing hearing loss
Photosensitivity causing skin burning
Agranulocytosis causing infection risk
Nephrotoxicity causing proteinuria
Which patient is an appropriate candidate for levothyroxine therapy?
Adult with primary hypothyroidism symptoms
Adult preparing for thyroidectomy
Child with acute thyrotoxic crisis
Pregnant patient with Graves disease
Which monitoring parameter is most appropriate to guide levothyroxine dose adjustments?
Serum TSH concentration trends
Random serum cortisol level
Creatine kinase isoenzymes
Erythrocyte sedimentation rate
Which adverse profile is most consistent with excessive levothyroxine dosing?
Anxiety, heat intolerance, weight loss
Hypotension, confusion, hyponatremia
Bradycardia, cold intolerance, weight gain
Constipation, dry skin, alopecia
For a patient receiving desmopressin, which labs and assessments are priorities to detect complications?
Serum glucose and HbA1c trends
Liver transaminases and bilirubin
Serum calcium and bone density scan
Serum sodium and fluid balance intake
Which finding best indicates effective vasopressin therapy in diabetes insipidus?
Decreased urine output with stable electrolytes
Increased urine output with rising sodium
Polyuria with improved mental status
Unchanged urine output with low BP
A patient on methimazole with elevated liver enzymes and rash asks about risks. Which counseling point is most accurate?
Hepatotoxicity and rash are known adverse effects
Dose increases will prevent these reactions
These effects indicate improved thyroid control
Stopping methimazole eliminates all infection risk
Which contraindication requires avoiding methimazole or using extreme caution?
History of nephrolithiasis only
Pregnancy and significant liver disease
Controlled hypertension and insomnia
Mild asthma and seasonal allergies
A nurse evaluates a patient on desmopressin who is increasingly drowsy with headache and nausea. Urine output is falling. Which complication is most likely?
Water intoxication with hyponatremia
Thyroid storm with hyperthermia
Osmotic diuresis with hypernatremia
Adrenal crisis with hyperkalemia
Which sign most specifically indicates hypoglycemia during an episode?
Persistent constipation without nausea
Dry skin with bradycardia at rest
Gradual weight gain over two weeks
Shakiness with sweating and tachycardia
A patient starting metformin asks how to take it. What is the best instruction?
Take with food and avoid alcohol
Take on empty stomach with alcohol
Skip meals to prevent side effects
Double dose if a meal is skipped
Which statement about oral hypoglycemics is accurate?
They stabilize glucose and need diet changes
They cure diabetes without lifestyle change
They cannot be combined with other agents
They always cause severe hypoglycemia alone
Regular insulin timing: when should it be administered relative to meals?
Only at bedtime regardless of meals
Immediately after finishing a meal
Two hours after beginning a meal
Thirty minutes before eating a meal
Which feature best characterizes regular insulin?
Short-acting with IV administration possible
Intermediate-acting with 24-hour duration
Ultra-long acting with no clear peak
Rapid-acting with five-minute onset
A client on insulin glargine asks about peaks. What should the nurse explain?
It peaks quickly and lasts four to six hours
It has multiple peaks and variable duration
It peaks at two hours and ends by noon
It has no peak and lasts twenty-four hours
Which instruction is correct for insulin glargine administration?
Shake the vial vigorously before use
Administer it right before each meal
Always give it intravenously only
Do not mix it with other insulins
A patient using only metformin reports sweating, shakiness, and dizziness. What is the most likely explanation?
Normal adaptation that requires no assessment
Insulin overdose due to metformin interaction
Expected hypoglycemia caused by metformin alone
Symptoms likely from another cause, not metformin alone
Which best describes the primary mechanism of action of digoxin?
Stimulates alpha-1 receptors producing vasoconstriction
Opens potassium channels causing membrane hyperpolarization
Inhibits Na+/K+ ATPase increasing intracellular calcium
Blocks beta-1 receptors reducing heart contractility
A key therapeutic use of digoxin is the management of which condition?
Hyperlipidemia with high triglycerides
Atrial fibrillation with rate control
Stable angina during exertion
Primary hypertension in adolescents
Which adverse effect is most characteristic of digoxin toxicity?
Green or yellow visual halos around lights
Photosensitivity with blistering rash
Severe gingival hyperplasia of the gums
Tinnitus with progressive hearing loss
Which nursing action is essential before administering digoxin to an adult?
Obtain peak blood glucose after meals
Assess pupillary response to bright light
Measure apical pulse for one full minute
Evaluate capillary refill in both hands
Which is the normal therapeutic serum level range for digoxin (ng/mL)?
0.5 to 2.0
2.5 to 4.0
4.5 to 6.0
6.5 to 8.0
Which medication serves as the specific antidote for severe digoxin toxicity?
Digoxin immune Fab antibody fragments
Naloxone opioid receptor antagonist
Protamine sulfate cationic polypeptide
Flumazenil GABA-A receptor blocker
Which patient factor increases the risk of digoxin toxicity when combined with diuretics?
Hypomagnesemia from antacids
Hypercalcemia from vitamin D use
Hypernatremia from sodium retention
Hypokalemia from potassium loss
Which contraindication would most strongly argue against initiating digoxin therapy?
Second-degree heart block with bradycardia
Mild renal impairment with hydration
Chronic anemia with iron deficiency
Controlled type 2 diabetes on metformin
Which adverse effect profile aligns with propranolol?
Bradycardia, hypotension, bronchospasm, fatigue
Tachycardia, hypertension, dry mouth, tremor
Constipation, urinary retention, mydriasis
Hyperglycemia, polyuria, blurred vision
Which condition is a contraindication for propranolol use?
Hypothyroidism under treatment
Asthma with reactive airway disease
Peptic ulcer without bleeding
Migraine with aura symptoms
Norepinephrine is most appropriately indicated for managing which situation?
Atrial flutter with rapid response
Stable angina with exertional pain
Septic shock with severe hypotension
Chronic hypertension in pregnancy
Which dosing effect pairing for dopamine is correct?
High dose: beta-1 selective chronotropy
Low dose: dopaminergic renal vasodilation
Any dose: pure beta-2 bronchodilation
Moderate dose: alpha-1 vasoconstriction
At moderate doses, dopamine primarily stimulates which receptor effect?
Histamine receptors causing vasodilation
Muscarinic receptors slowing AV conduction
Alpha-2 receptors decreasing norepinephrine release
Beta-1 receptors increasing contractility and HR
At high doses, dopamine predominantly causes which physiologic change?
Beta-2 mediated bronchodilation improving airflow
Alpha-1 mediated vasoconstriction raising blood pressure
Calcium channel blockade reducing afterload
D2 receptor blockade reducing nausea and vomiting
Which statement about adenosine administration is accurate?
Give subcutaneously with repeated small boluses
Administer intramuscularly for faster systemic uptake
Infuse slowly over ten minutes to avoid asystole
Give as a rapid IV push followed by rapid NS flush
Which rhythm is an appropriate indication for adenosine therapy?
Paroxysmal supraventricular tachycardia
Sinus bradycardia with pauses
Atrial fibrillation with stable rate
Monomorphic ventricular tachycardia
Which transient effect commonly follows adenosine administration?
Persistent hypertension with blurred vision
Brief asystole with flushing and chest discomfort
Profound bradycardia with miosis and salivation
Severe hyperkalemia with muscle weakness
Which statement best captures the dual actions of digoxin on the heart?
Negative dromotropy with alpha-1 block
Positive inotropy with negative chronotropy
Negative inotropy with positive dromotropy
Positive chronotropy with beta-2 agonism
A patient on digoxin and antacids develops subtherapeutic levels. What is the most likely mechanism?
Enhanced renal tubular secretion of drug
Displacement from plasma protein binding
Decreased gastrointestinal absorption of digoxin
Accelerated hepatic induction of metabolism
A septic patient remains hypotensive after fluids. Which first-line vasopressor should be started?
Phenylephrine intermittent IV boluses
Epinephrine subcutaneous injection
Norepinephrine continuous IV infusion
Dobutamine intra-arterial infusion
Which clinical situation most appropriately indicates starting amiodarone therapy?
Diabetic neuropathy with burning foot pain
Chronic hyperlipidemia requiring LDL reduction
Stable essential hypertension without tachycardia
New-onset atrial fibrillation with rapid ventricular rate
A patient on lisinopril reports a persistent dry cough. What is the best next medication change?
Switch to an angiotensin receptor blocker instead
Increase lisinopril dose by one tablet
Add a loop diuretic for cough relief
Stop all antihypertensives immediately
Which statement best describes diltiazem’s mechanism of action?
Blocks calcium entry in cardiac and vascular smooth muscle
Stimulates beta-1 receptors to increase contractility
Inhibits angiotensin-converting enzyme in the lungs
Blocks sodium channels in ventricular myocardium
Which is a common adverse effect profile associated with diltiazem?
Tinnitus, photosensitivity, polyuria
Flushing, transient asystole, dyspnea
Hyperkalemia, dry cough, angioedema
Bradycardia, hypotension, edema, dizziness
Which patient instruction is most appropriate when prescribing warfarin?
Avoid vitamin K–rich foods and take at same time
Take with grapefruit juice to improve absorption
Double the dose if a pill is missed the day before
Combine with other blood thinners for better control
What is the specific antidote for excessive anticoagulation caused by warfarin?
Fresh frozen plasma without vitamin K
Vitamin K administration by appropriate route
Protamine sulfate infusion over one hour
Desmopressin to increase vWF levels
A hospitalized patient on therapeutic heparin develops bleeding. Which reversal agent should be administered?
Vitamin K oral dose that evening
Activated charcoal with sorbitol
Protamine sulfate in an appropriate dose
Idarucizumab intravenous bolus
A 68-year-old with angina and supraventricular tachycardia requires rate control and vasodilation. Which single agent addresses both needs?
Heparin for rate control and vasodilation
Diltiazem for rate control and vasodilation
Amiodarone for rate control and vasodilation
Lisinopril for rate control and vasodilation
Which drug class does lorazepam belong to?
Tricyclic antidepressant
Atypical mood stabilizer
Benzodiazepine anxiolytic
Typical antipsychotic agent
A major adverse effect to monitor with lorazepam is which outcome?
Respiratory depression
Photosensitivity rash
Hyponatremic seizures
Renal crystalluria
Which medication is the antagonist for benzodiazepines in overdose management?
Naloxone opioid blocker
Protamine sulfate binder
Flumazenil reversal agent
Physostigmine cholinesterase
Fluoxetine’s primary mechanism of action is best described as which process?
Inhibits MAO enzymes
Increases GABA release
Inhibits serotonin reuptake
Blocks dopamine receptors
Which is an approved indication for SSRIs such as fluoxetine?
Obsessive–compulsive disorder
Acute manic psychosis
General anesthesia induction
Hypertensive emergencies
Which concurrent therapy is contraindicated with fluoxetine due to interaction risk?
MAOI use like phenelzine
Beta blockers like metoprolol
Loop diuretics like furosemide
Antacids like calcium carbonate
A patient starting fluoxetine should be advised to take it at what time and monitor for what?
With meals and hypoglycemia
Morning dosing and mood changes
With milk and constipation
Bedtime dosing and bradycardia
Use of St. John’s wort with SSRIs increases the risk of which condition?
Tardive dyskinesia onset
Serotonin syndrome event
Neuroleptic malignant syndrome
Lithium toxicity episode
Serotonin syndrome most commonly results from which cause?
Excess serotonergic medications
Abrupt benzodiazepine withdrawal
Acetylcholine depletion by anticholinergics
Dopamine blockade from haloperidol
Which symptom cluster is most consistent with serotonin syndrome?
Ataxia, jaundice, hypoglycemia
Agitation, hyperreflexia, hypertension
Bradykinesia, flat affect, hypotension
Miosis, hypothermia, constipation
Phenelzine is classified in which drug class?
Atypical antipsychotic medication
Tricyclic antidepressant agent
Selective serotonin reuptake inhibitor
Monoamine oxidase inhibitor
Which clinical scenario best fits an indication for phenelzine?
Schizophrenia negative symptoms
Bipolar mania maintenance
Acute panic attack in ED
Treatment‑resistant depression
Patients taking phenelzine should avoid foods high in tyramine for what reason?
Reduce serotonin syndrome
Prevent hypertensive crisis
Prevent agranulocytosis
Avoid lithium toxicity
Which is a contraindication to starting phenelzine therapy?
Severe liver disease
Mild seasonal rhinitis
Borderline personality
Uncomplicated cystitis
Haloperidol is best described as which type of medication?
Anticonvulsant agent
Sedative hypnotic
Atypical antidepressant
Typical antipsychotic drug
Which adverse effect is characteristically associated with haloperidol?
Extrapyramidal symptoms
Severe hypoglycemia
Hyperkalemic paralysis
Nephrotic syndrome
Elderly patients with dementia‑related psychosis taking haloperidol face what serious risk?
Thrombotic stroke cure
Irreversible blindness
Increased mortality rate
Fulminant hepatitis
A patient on haloperidol develops sudden high fever, severe muscle rigidity, confusion, and unstable blood pressure. What is the immediate nursing action?
Stop antipsychotics and support ABCs
Administer naloxone immediately
Give oral fluids and ambulate
Apply restraints and continue drug
Which movement disorder presents with lip smacking and facial twitching and can be irreversible after long‑term antipsychotic use?
Acute dystonia
Parkinsonian tremor
Tardive dyskinesia
Akathisia syndrome
Combining lorazepam with opioids is discouraged primarily due to which risk?
Acute renal failure risk
Additive respiratory depression
Serotonergic overstimulation
Hypertensive urgency crisis
A patient on multiple antidepressants develops agitation, diaphoresis, tachypnea, and muscle rigidity. Which prior medication change most likely precipitated this?
Stopping caffeine abruptly
Reducing a beta blocker
Adding a thiazide diuretic
Starting an MAOI while on SSRI
Which finding most strongly suggests Neuroleptic Malignant Syndrome after starting an antipsychotic?
Gradual tremor without fever or rigidity
Sudden high fever with severe muscle rigidity
Intermittent lip smacking without confusion
Mild sedation with stable vital signs
A patient on long-term antipsychotics shows lip smacking and facial twitching. What complication is most likely?
Tardive dyskinesia with possible irreversibility
Akathisia that resolves when resting
Acute dystonia with airway compromise
Serotonin syndrome with hyperreflexia
Which immediate nursing action is priority when Neuroleptic Malignant Syndrome is suspected?
Obtain cultures before interventions
Give antipyretics and continue antipsychotic
Stop antipsychotics and maintain ABCs
Increase IV fluids and monitor later
Which lithium level indicates toxicity requiring intervention?
1.1 mEq/L with mild tremor
0.4 mEq/L with no symptoms
0.8 mEq/L and stable status
1.7 mEq/L with nausea
Which teaching best reduces risk for lithium toxicity?
Maintain consistent salt and fluid intake
Double dose after missed tablets
Restrict salt to prevent edema risk
Increase caffeine to reduce sedation
Which patient condition heightens the risk of lithium toxicity and requires close monitoring?
Hypernatremia after salt tablets
Hyponatremia from heavy sweating
Hypocalcemia from low dairy intake
Hypermagnesemia from supplements
Which adverse effect profile most aligns with valproic acid?
Ototoxicity and nephrolithiasis risk
Cardiotoxicity and thyroiditis risk
Hepatotoxicity and pancreatitis risk
Agranulocytosis and nephrotoxicity risk
Which education is correct for a patient starting valproic acid?
Take with food and avoid aspirin use
Stop if stools become dark and tarry
Avoid food to improve absorption rate
Take on empty stomach to avoid nausea
For what indication is dantrolene most appropriately prescribed?
Prevention of neuroleptic malignant syndrome
Control of focal seizures with aura only
First-line therapy for essential tremor
Treatment and prophylaxis of malignant hyperthermia
Which serious adverse effect requires stopping dantrolene and evaluation?
Photosensitivity with mild rash
Persistent cough with mild fever
Orthostatic dizziness on standing
Jaundice with elevated liver enzymes
Which statement best describes the mechanism of action of carbidopa/levodopa?
Both agents inhibit MAO; dopamine levels fall peripherally
Levodopa converts to dopamine in CNS; carbidopa blocks peripheral breakdown
Levodopa blocks dopamine receptors; carbidopa enhances central reuptake
Carbidopa converts to dopamine; levodopa reduces acetylcholine
What is the primary indication for prescribing carbidopa/levodopa?
Huntington disease with choreiform movements
Acute dystonia after antipsychotic use
Parkinson’s disease with bradykinesia and rigidity
Essential tremor with anxiety features
Which adverse effect is most commonly associated with carbidopa/levodopa therapy?
Orthostatic hypotension with dizziness
Severe hepatotoxicity with jaundice
Hyperkalemia with arrhythmia
Profound bradycardia with syncope
Which contraindication requires avoiding carbidopa/levodopa?
History of malignant melanoma
Benign prostatic hyperplasia
Controlled hypothyroidism
Mild intermittent asthma
A patient on carbidopa/levodopa reports dark urine and sweat. What is the best response?
Stop immediately and go to emergency care
This is harmless and an expected effect
Increase fluids to flush the pigments
Skip doses until color returns to normal
Which instruction optimizes ferrous sulfate absorption for iron deficiency anemia?
Take with antacids and dairy products
Take on an empty stomach with vitamin C
Take only at bedtime with a snack
Take with high‑calcium foods every dose
Which hormone primarily stimulates production of red blood cells in bone marrow?
Prolactin from the anterior pituitary
Thrombopoietin from the liver and spleen
Erythropoietin from the kidneys
Cortisol from the adrenal cortex
Which adverse effect is most characteristic of tamoxifen therapy?
Hot flashes and thromboembolism risk
Ototoxicity with tinnitus episodes
Photosensitivity with sunburn blisters
Gingival hyperplasia and hirsutism
Severe hypoglycemia with tremors
A patient starting methotrexate should be screened for which contraindication before the first dose?
History of peptic ulcer only
Mild essential hypertension
Benign positional vertigo
Seasonal allergic rhinitis
Severe hepatic or renal disease
Which laboratory tests should be routinely monitored during methotrexate therapy?
CBC, liver enzymes, renal function, platelets
TSH, fasting insulin, uric acid
Serum calcium, lipase, amylase
ABGs, serum ammonia, CK-MB levels
CSF protein, lactate, beta-2 transferrin
A key teaching point to reduce methotrexate toxicity includes which recommendation?
Take with antacids for gastric comfort
Delay reporting signs of infection
Use leucovorin rescue as prescribed
Increase high-protein meal frequency
Drink alcohol with evening doses
Leuprolide is most appropriately used as treatment for which condition?
Primary testicular torsion relief
Advanced prostate cancer management
Estrogen receptor–positive breast cysts
Benign prostatic hyperplasia cure
Acute bacterial prostatitis cure
Which adverse effect profile best matches sildenafil?
Ototoxicity, nephrotoxicity, neuromuscular blockade
Headache, flushing, hypotension, visual hue change
Constipation, dry skin, urinary retention
Hyperglycemia, polyuria, ketoacidosis risk
Severe leukopenia, mucositis, pulmonary fibrosis
Which patient instruction is essential when prescribing sildenafil?
Take with high-fat meals to speed onset time
Use with alcohol to enhance medication effect
Combine with decongestants for better response
Avoid nitrates and alpha-blockers due to hypotension
Double dose if initial effect is inadequate
Which adverse effect of methotrexate requires immediate evaluation due to infection risk?
Myelosuppression with neutropenia signs
Transient flushing after first dose
Mild dyspepsia after large meals
Blue-green vision during bright light
Orthostatic dizziness upon standing
A woman on tamoxifen reports abnormal vaginal bleeding. What complication should be prioritized?
Iron deficiency anemia relapse
Pelvic inflammatory disease flare
Endometrial cancer development risk
Functional ovarian cyst rupture
Ovarian torsion with ischemia
Which action best minimizes oral mucositis risk in a patient taking methotrexate?
Practice gentle oral care consistently
Use alcohol-based mouthwash nightly
Chew tobacco to numb oral pain
Increase citrus intake aggressively
Avoid all fluids for twelve hours
