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WorksheetsNUR 334 Pharmacology Final EXAM Study Guide
Total questions: 111
Worksheet time: 56mins
In drug naming, which description correctly distinguishes generic from trade/brand names?
Generic names are official, lower case, and singular; trade/brand names are commercial, capitalized, and may be several
Generic names are commercial and capitalized; trade/brand names are scientific, lower case, and singular
Both generic and trade/brand names are commercial and may have several versions
Trade/brand names are official and singular; generic names are commercial and may be several
Which statement best separates side effects from allergic reactions?
Side effects are expected; allergic reactions are not expected
Side effects are not expected; allergic reactions are expected
Both side effects and allergic reactions are expected
Both side effects and allergic reactions are not expected
Which description defines adverse effects compared with side effects?
Adverse effects are unintended and severe or life‑threatening at therapeutic doses; side effects are unintended and commonly occur at therapeutic doses
Adverse effects are intended effects at therapeutic doses; side effects are severe or life‑threatening
Adverse effects only occur at toxic doses; side effects only occur at therapeutic doses
Adverse effects are expected; side effects are unexpected
What is a loading dose intended to accomplish?
Reach plateau drug levels faster by giving a higher amount once or twice to prime the bloodstream
Avoid first‑pass metabolism by using parenteral routes
Prevent adverse effects by starting with the lowest possible dose
Increase drug distribution time by delaying absorption
Which statement describes the first‑pass effect for orally administered drugs?
Oral drugs are metabolized to an inactive form before reaching target cells; sublingual, rectal, and parenteral routes bypass this
Oral drugs bypass hepatic metabolism and reach target cells unchanged
Sublingual and rectal routes increase first‑pass metabolism compared with oral
Parenteral routes cause drugs to be inactivated before reaching target cells
Which pharmacokinetic phase is defined as the movement of a drug from the site of administration to various tissues of the body?
Absorption
Distribution
Metabolism
Excretion
Which pharmacokinetic phase is the movement of a drug by the circulatory system to the intended site of action?
Distribution
Absorption
Metabolism
Excretion
Which pharmacokinetic phase is the biotransformation that changes a drug into a more or less potent, soluble, or inactive form?
Metabolism
Absorption
Distribution
Excretion
Which pharmacokinetic phase eliminates a drug or its metabolites from the body to the external environment via kidneys, gastrointestinal tract, skin, or lungs?
Excretion
Absorption
Distribution
Metabolism
For intramuscular medications, which arm injection site is identified?
Deltoid
Biceps brachii
Triceps tendon
Forearm extensor
According to onset, which route is fastest and which is slowest?
Fastest IV; slowest extended release
Fastest oral; slowest IV
Fastest subcutaneous; slowest intramuscular
Fastest extended release; slowest IV
Which type of medication should not be crushed?
Extended release
Immediate release tablets
Sublingual tablets
Liquid formulations
How should dosing be adjusted for a patient with renal disease?
Decrease dose because the patient cannot excrete effectively
Increase dose to overcome reduced absorption
Keep the same dose and increase frequency
Switch all medications to oral route
For a patient with absent bowel sounds, which route of administration should be avoided?
PO
IV
IM
Subcutaneous
Organ failure most directly increases the risk of which medication outcome listed?
Toxicity
Enhanced first‑pass metabolism
Improved distribution
Reduced receptor affinity
Which is a listed indication for ibuprofen (an NSAID)?
Mild‑moderate pain, inflammation, fever
Neuropathic pain only
Bipolar disorder
Seizure prophylaxis
Which patient history represents a contraindication for ibuprofen noted in the material?
Peptic ulcer or gastrointestinal bleeding, or chronic kidney disease
Asthma without bronchospasm
Type 2 diabetes only
History of seasonal allergies only
Which is a listed indication for ketorolac (an NSAID)?
Mild‑moderate pain, inflammation, fever
Chronic cough
Seizure disorders
Psychosis
Which is a listed indication for acetaminophen (a nonopioid analgesic)?
Fever in children and relief of mild‑moderate pain when aspirin is contraindicated
Severe pain requiring opioid therapy
Treatment of peptic ulcer disease
Prophylaxis for stroke
Which indication is noted for aspirin?
Mild‑moderate pain, inflammation, fever; cardio protection from myocardial infarction, stroke, and clots
Exclusive treatment for severe pain
Primary therapy for chronic kidney disease
Sedation for procedures
Concomitant use of which medication class increases bleeding risk with aspirin per the material?
Anticoagulants such as heparin or warfarin
Anticonvulsants
Antipsychotics
Bronchodilators
Across NSAIDs (e.g., ibuprofen, ketorolac, naproxen, celecoxib, meloxicam, aspirin), which mechanism of action is stated?
Inhibition of prostaglandin synthesis via cyclooxygenases (COX)
Direct activation of opioid receptors
Blockade of histamine receptors H1
Enhancement of serotonin reuptake
Which condition is a general contraindication for NSAIDs listed in the material?
Peptic ulcer and gastrointestinal bleeding
Bipolar disorder
Hypothyroidism
Bacterial infection
Which is an indication for naloxone (an opioid antagonist) described?
Acute opioid toxicity with respiratory depression due to opioid overdose
Prevention of mild fever
Treatment of chronic pain
Sedation for procedures
What clinical change signals effectiveness of naloxone according to the material?
Reversal of respiratory depression with respirations returning to 12–20 per minute
Onset of sedation and drowsiness
Development of hypotension
Persistent apnea
Opioid agonists such as morphine, hydromorphone, fentanyl, and methadone share which indication listed?
Moderate to severe pain
Fever reduction in children
Anticoagulation
Treatment of peptic ulcer disease
When administering opioids, which statement from the material directs action based on respiratory rate?
Stop opioids if respirations are less than 12 per minute
Increase dose if respirations are less than 12 per minute
Continue opioids regardless of respiratory rate
Switch to extended‑release formulation if respirations are low
Which administration routes are listed for morphine?
Oral, subcutaneous, IM, IV, epidural
Inhaled only
Transdermal only
Rectal only
Which listed effect is associated with morphine use?
Constipation and respiratory depression
Increased urine output and insomnia
Diarrhea and tachypnea
Photosensitivity only
Which indication is listed for codeine (a weaker opioid agonist)?
Moderate to severe pain
Anticoagulation
Fever reduction
Anxiolysis
Which contraindication is noted for codeine in the material?
Concomitant anticonvulsants (seizures)
Use of bronchodilators
Concurrent NSAIDs
Vitamin supplementation
Which indication is listed for lithium (a mood stabilizer)?
Bipolar disorder
Moderate pain
Acute opioid toxicity
Peptic ulcer disease
Diazepam – Benzodiazepines: Which listed item is the antidote referenced for benzodiazepine toxicity?
Naloxone
Flumazenil
Physostigmine
N-acetylcysteine
Diazepam – Benzodiazepines: According to the indications listed, which condition is treated short-term with diazepam?
Chronic insomnia
Anxiety disorder
Bipolar disorder
Hypertension
Tricyclic Antidepressants (TCAs): Which drugs are named in the examples list?
Amitriptyline
Sertraline
Imipramine
Fluoxetine
Tricyclic Antidepressants (TCAs): Based on the indications provided, which is an appropriate therapeutic use?
Generalized seizure prophylaxis
Bed wetting in children
Hyperthyroidism
Migraine aura reversal
Risperidone – Second Gen Antipsychotic: The indication stated targets which symptom group in schizophrenia?
Only positive symptoms
Only negative symptoms
Both positive and negative symptoms
Cognitive symptoms only
Risperidone – Second Gen Antipsychotic: The patient education note flags which severe adverse reaction abbreviation?
SJS
NMS
DIC
TIA
Sertraline – Selective Serotonin Reuptake Inhibitors (SSRIs): Which indication is listed for sertraline?
Obsessive–compulsive disorder
Mania
Schizophrenia
Tourette syndrome
Antibiotics – Superinfection: What adverse effect is described for anti‑infective therapy?
Primary infection resolution
Appearance of secondary infections
Immediate hypersensitivity only
Electrolyte imbalance
Antibiotics – Superinfection: The specific superinfection identified with a unique smell is caused by which organism?
Staphylococcus aureus
Clostridioides difficile (C. Diff)
Escherichia coli
Candida albicans
Bacteriostatic vs Bactericidal: Which description matches bactericidal action?
Prevents the growth of bacteria
Kills bacteria directly
Enhances immune memory
Neutralizes toxins
Aminoglycosides: Which suffix cue is noted for examples in this class?
-floxacin
-cillin
"cin"
-azole
Aminoglycosides: Which drug appears in the examples list?
Erythromycin
Gentamicin
Ciprofloxacin
Metronidazole
Vancomycin – Glycopeptides: Which indication is listed?
MRSA
Influenza
Tuberculosis
Candida sepsis
Vancomycin – Glycopeptides: Which adverse effect list includes the syndrome described with flushing and a red rash?
Stevens–Johnson syndrome
Red man syndrome
Toxic epidermal necrolysis
Serotonin syndrome
Sulfamethoxazole – Sulfonamides: Which patient group is highlighted under pregnancy considerations as not appropriate?
Men over 65 years old
Pregnant women or nursing women
Adolescents
Patients with gout
Sulfamethoxazole – Sulfonamides: Which indication is included?
Viral meningitis
Ulcerative colitis prophylaxis only
Urinary tract infections (UTIs)
Helminth infections
Trimethoprim–Sulfamethoxazole (Bactrim) – Sulfonamides: Which listed condition is an indication?
Migraine
UTIs
Hepatitis B
Hyperlipidemia
Metronidazole – Nitroimidazole: What effect is noted when taken with alcohol?
Euphoria
Severe vomiting
Constipation
Bronchospasm
Fluoroquinolones: Which drug name in the list belongs to this class?
Levofloxacin
Amoxicillin
Nystatin
Azithromycin
Fluoroquinolones: Which indication is stated?
Uncomplicated UTIs
Type 2 diabetes
Psoriasis
Gout flares
Ciprofloxacin – Fluoroquinolones: Which patient education point is included?
Safe for children under 12 years
Take with milk and antacids
Not for children under 18 years old
Crush tablets for faster absorption
Ciprofloxacin – Fluoroquinolones: According to the administration guidance, when should dosing occur relative to antacids or iron?
With antacids or iron
At least 4 hours before antacids or iron
Immediately after antacids or iron
Only at bedtime
Macrolides: Which drugs are listed among macrolides?
Erythromycin
Azithromycin
Clarithromycin
Gentamicin
Macrolides: What mechanism of action is stated?
Inhibit cell wall synthesis
Inhibit protein synthesis
Disrupt DNA replication
Block folate production
Nystatin – Antifungals: Which routes of administration are mentioned?
Intravenous only
Topical and oral (oropharyngeal candidiasis)
Intramuscular only
Rectal suppository only
Zidovudine – Antiretrovirals: Which indication is listed?
HIV
Hepatitis A
Influenza
Malaria
Zidovudine – Antiretrovirals: Which administration instruction is noted?
Take with a heavy meal
Empty stomach with a full glass of water
Chew tablets
Take only in the evening
Gentamicin – Aminoglycoside: Which pathogen is included among the indications?
Streptococcus pyogenes
Pseudomonas
Plasmodium falciparum
Clostridioides difficile
Fluticasone (Flovent) – Inhaled Corticosteroids: What indication is stated?
Terminate acute asthma attacks
Preferred therapy for preventing asthma attacks
Relieve allergic rhinitis only
Treat bacterial pneumonia
Fluticasone (Flovent) – Inhaled Corticosteroids: Which patient education point is listed?
Use only when wheezing starts
Rinse mouth after use
Avoid bone mineral density tests
Stop once asymptomatic
Beclomethasone – Inhaled Corticosteroids: What mechanism of action is provided?
Stimulates bronchodilation directly
Reduces inflammation in the lungs by suppression of the immune system
Blocks histamine receptors
Inhibits bacterial protein synthesis
Formoterol – LABA (Long‑Acting Beta 2 Agonists): Which indication is listed?
Rescue therapy for acute asthma
Long term asthma control
Treats COPD infections
Antihistamine for allergic rhinitis
Spacer for MDI: What is the stated indication for using a spacer?
Less drug into the lungs
More drug into the lungs
Reduce dose frequency
Prevent oral thrush
Diphenhydramine (Benadryl) – 1st Gen Antihistamines: Which indication is described?
Treat minor symptoms of allergy and the common cold
Antibiotic therapy for pneumonia
Antiviral therapy for HIV
Antifungal therapy for candidiasis
Diphenhydramine (Benadryl) – 1st Gen Antihistamines: Which effect is listed among the adverse reactions?
Bradycardia
Photosensitivity to UV light
Hyperkalemia
Tinnitus
Albuterol – SABA (Short Acting Beta 2 Agonist): The section heading lists which drug class and agent name.
LABA – Formoterol
SABA – Albuterol
Inhaled corticosteroid – Beclomethasone
Antifungal – Nystatin
Acute asthma attack management uses the mnemonic "AIM" listing the immediate medications to administer. Select all drugs included in "AIM" for an acute asthma attack.
Albuterol
Ipratropium
Steroids
Montelukast
Ipratropium (Atrovent) is an inhaled anticholinergic bronchodilator used to prevent bronchospasm (including off-label use for asthma). Which contraindication is specifically noted for its inhaler formulation?
Allergy to soy lecithin or peanuts used as the inhaler propellant
Concurrent use of beta-agonists
History of hypertension
Use with inhaled corticosteroids
Montelukast (Singulair), a leukotriene receptor antagonist, is used for asthma prophylaxis as a second-line medication to reduce inflammation and ease bronchoconstriction. Which adverse effect is highlighted in the worksheet?
Suicidal ideation
Tachycardia
Hypokalemia
Oral thrush
Theophylline (a methylxanthine) is indicated for long-term management of asthma unresponsive to beta agonists or inhaled corticosteroids. Which adverse effect listed indicates severe toxicity risk?
Tremors
Nausea
Seizures
Throat irritation
Codeine, an opioid antitussive, is indicated for a dry, non-productive, or harmful cough. Which concurrent medication class is noted as a contraindication due to additive central nervous system effects?
Central nervous system depressants
Inhaled beta agonists
Inhaled corticosteroids
Leukotriene receptor antagonists
Over-the-counter allergy medications: To prevent overdose, what purchasing strategy is recommended?
Choose single-ingredient drugs targeted to specific symptoms
Prefer multi-symptom combination products
Alternate doses of different antihistamines
Double the dose of a single agent if symptoms persist
Inhaler use instructions include proper device handling. Select the steps that are part of the recommended technique.
Shake the inhaler for 3–5 seconds
Insert the inhaler fully before actuating
Use a spacer to help prevent thrush
Exhale immediately after actuation without holding breath
Isotonic fluids (examples include Lactated Ringers and 0.9% NaCl) are indicated for dehydration. Which statement best describes their mechanism of action relative to fluid shifts?
Water is equal with the cell—no net fluid shift
Water enters the cell causing a net shift into intracellular space
Water leaves the cell causing a net shift into the intravascular space
They rapidly draw fluid from interstitial to intracellular compartments
Hypotonic fluids (example: 0.45% NaCl) are noted to move water into cells and hydrate them. Which clinical indication is specified for their use?
Hypernatremia
Hyponatremia
Pulmonary edema
Hemorrhagic shock
Colloid solutions (e.g., 5% albumin, dextran 40 in NS, hetastarch 6% in NS) pull fluid into blood vessels and act as volume expanders. What is their primary clinical use listed in the worksheet?
Treat hypovolemic shock and expand intravascular volume
Correct chronic hypernatremia
Relieve bronchospasm in asthma
Suppress non-productive cough
Potassium (IV): The worksheet notes safe IV rates and monitoring requirements. When infusion rates exceed 20 mEq/hr, what monitoring is required to reduce the risk of cardiac arrest?
Continuous cardiac monitoring
Continuous electroencephalography
Peak flow monitoring
Serial liver enzyme panels
Hypovolemia: According to the worksheet, what is the treatment of choice?
Isotonic fluids
Hypotonic fluids
Hypertonic fluids
Colloid solutions only
From the slide titled TPN – Total Parenteral Nutrition (Nutritional Supplements), which clinical situation most appropriately indicates starting TPN: when the gastrointestinal tract cannot be used for enteral nutrition and the solution provides complete nutritional needs in a hypertonic mixture with amino acids, lipids, carbohydrates (dextrose), electrolytes, vitamins, and minerals?
Yes, initiate TPN when the GI tract cannot be used and full nutrition must be provided intravenously
No, TPN is only for patients who need additional electrolytes but can eat normally
No, TPN is primarily for short-term hydration without macronutrients
No, TPN is reserved for patients with mild nausea who can still tolerate oral intake
According to the TPN slide, which adverse effect is a recognized risk of TPN therapy requiring monitoring?
Hyperglycemia or infection
Bradycardia
Hypothyroidism
Hearing loss
From the Psyllium – Bulk Forming Laxatives slide, what is the first-line indication for psyllium?
Constipation
Diarrhea due to infection
Peptic ulcer disease
Gastroparesis
Based on the Psyllium patient education bullets, which administration statement is accurate?
Several doses over 1–3 days may be needed for a therapeutic effect
Take only once; effects occur within minutes
Avoid daily use because it cannot be used as a fiber supplement
Must be taken exclusively with meals to work
From the Sulfasalazine – 5-Aminosalicylates slide, which condition is a listed indication?
Ulcerative colitis
Gastric cancer
Irritable bowel syndrome only
Pseudomembranous colitis
According to the Sulfasalazine patient education, which allergy warrants avoiding this medication?
Allergy to sulfonamide antibiotics or furosemide
Allergy to penicillin only
History of seasonal allergies
Allergy to acetaminophen
From the Ondansetron "Zofran" – Serotonin Antagonist slide, what is the primary indication?
Antiemetic (anti‑nausea)
Antidiarrheal
Prokinetic for gastroparesis
H2 receptor blockade
From the Omeprazole – PPI (Proton Pump Inhibitors) slide, which condition is listed as an indication?
GERD
Migraine headaches
Anemia
Asthma
From the Metoclopramide – Prokinetics slide, which long‑term effect carries a boxed warning?
Tardive dyskinesia
Hypoglycemia
Nephrolithiasis
Photosensitivity
According to the Metoclopramide indications, in which scenario is it used?
Gastroparesis with nausea and vomiting
Chronic constipation requiring bulk laxatives
C. difficile colitis
Gastric acid suppression
From the Loperamide – Antidiarrheal slide, which is a contraindication to using loperamide?
Suspected C. difficile infection (want to get toxins out)
Traveler’s diarrhea without fever
IBS with mild diarrhea
Post‑cholecystectomy diarrhea
Which additional contraindication for loperamide is listed on the slide?
Bowel obstruction
Gastritis
Lactose intolerance
GERD
From the Famotidine – H2 Blockers slide patient education, which administration advice is correct?
Can take with or without food; food slows absorption and may prolong beneficial effects
Must be taken only on an empty stomach to avoid reduced efficacy
Should not be taken at bedtime due to insomnia risk
Take with high‑fat meals to accelerate absorption
According to the Famotidine indications, which condition is included?
Duodenal ulcers treated for 6–8 weeks
Acute pancreatitis
Irritable bowel syndrome
Celiac disease
From the Peptic Ulcer Disease slide, which statement reflects the pathophysiology described?
Erosion occurs from gastric juices when insufficient mucus is produced to protect from acid
Ulcers result from excessive fiber intake irritating the mucosa
Ulcers primarily arise from pancreatic enzyme deficiency
Ulcers occur when gastric acid is absent
Based on the Peptic Ulcer Disease treatment bullets, which therapy set is listed?
Proton pump inhibitors, pain medications, and H2 receptor agents
High‑dose laxatives and antidiarrheals
Only antibiotics
Only antacids as monotherapy
From the Oxytocin – L&D Stimulant slide, what is a listed indication?
Promotes labor and manages post‑partum bleeding
Treats ovarian cysts
Prevents preeclampsia
Acts as a contraceptive
According to the Oxytocin effects list on the slide, which serious risk may occur with use?
Uterine rupture
Renal failure
Thyroid storm
Pulmonary embolism
From the Finasteride – 5 Alpha Reductase Inhibitors slide, which indication is described?
Benign prostatic hyperplasia with reduction/shrinkage of enlarged prostates
Erectile dysfunction
Acute prostatitis
Male infertility
From the Sildenafil (Viagra) – Phosphodiesterase Type 5 Inhibitor slide, which contraindicated medication combination is highlighted as potentially fatal?
Concurrent nitrates
Concurrent beta‑blockers
Concurrent calcium channel blockers
Concurrent acetaminophen
From the Testosterone – Androgens slide, which adverse effect is listed?
Sodium and water retention with elevated blood pressure and peripheral edema
Severe hypoglycemia
Profound bradycardia
Photosensitivity
According to the Testosterone indications, which clinical use is shown on the slide?
Hypogonadism
Hyperthyroidism
Migraine prophylaxis
Osteoarthritis
From the Estradiol – Hormonal Contraceptives slide, which lifestyle contraindication is specified?
Heavy smokers (more than 15 cigarettes a day)
Vegetarian diet
Low‑salt diet
Occasional caffeine use
Which medical condition listed on the Estradiol slide is a contraindication to its use?
History of DVT or PE, stroke, or coronary artery disease
Irritable bowel syndrome
Mild seasonal allergies
Benign prostatic hyperplasia
According to the Estradiol slide, which interaction increases the chance of pregnancy?
Use with certain antibiotics
Use with antihistamines
Use with calcium supplements
Use with proton pump inhibitors
From the Allopurinol – Xanthine Oxidase Inhibitors slide, what indication is listed?
Gout
Hypertension
GERD
Migraine prevention
The health care provider prescribes 250 mL normal saline to be administered over 8 hours. The nurse is using IV tubing with a drop factor of 15 gtt/mL. What should the drip rate of the infusion be? Round the answer to the nearest whole number.
6 gtt/min
8 gtt/min
10 gtt/min
12 gtt/min
A client in the medical-surgical unit is to receive 250 mg of amiodarone now. The label on the drug bottle received from the pharmacy states 0.25 g in 2 mL. How many mLs should the nurse administer per dose? Round the answer to the nearest whole number.
1 mL
2 mL
3 mL
4 mL
The nurse is preparing to administer liquid famotidine 40 mg PO every 4 hr for a client who has GERD. The available concentration is famotidine 20 mg/5 mL. How many mLs should the nurse administer? Round the answer to the nearest tenth.
8.0 mL
10.0 mL
12.0 mL
15.0 mL
The health care provider prescribes ibuprofen 600 mg PO every 8 hours for a client with moderate pain. The drug is available in 200 mg tablets. How many tablets should the nurse administer per dose? Round the answer to the nearest whole number.
2 tablets
3 tablets
4 tablets
5 tablets
The nurse is caring for a client admitted with deep vein thrombosis who weighs 175 lbs. The health care provider prescribed heparin by continuous IV infusion at 12 units/kg/hr. Available is heparin 25,000 units in 250 mL D5W. What should the nurse set the IV pump to infuse at? Round the answer to the nearest tenth.
7.5 mL/hr
8.5 mL/hr
9.5 mL/hr
10.5 mL/hr
