PHARMACOLOGY NURS 251 MODULE 3 EXAM 2026/2027
| Portage Learning ABCnursing Geneva College | Verified
Edition Questions & Answers | Pass Guaranteed - A+
Graded
Section 1: Central Nervous System Drugs (Questions 1-25)
Q1: A nursing student is reviewing the mechanism of action of benzodiazepines for a
pharmacology presentation. Which of the following accurately describes how drugs like
diazepam and lorazepam exert their therapeutic effect?
A. Blockade of dopamine D2 receptors in the mesolimbic pathway
B. Increase the frequency of chloride channel opening mediated by GABA-A receptors
C. Increase the frequency of chloride channel opening mediated by GABA-A receptors
[CORRECT]
D. Inhibit the reuptake of serotonin and norepinephrine in the synaptic cleft
Correct Answer: C
Rationale: Benzodiazepines bind to a specific site on the GABA-A receptor, increasing
the frequency of chloride channel opening, which hyperpolarizes the neuron and
produces CNS depression. A describes antipsychotics, B is an incomplete distractor,
and D describes SNRIs. Module 3 Exam Insight: Portage Learning heavily tests the
exact GABA-A/chloride channel mechanism, often confusing frequency of opening
(benzodiazepines) with duration of opening (barbiturates).
Q2: A patient arriving in the emergency department is unresponsive with severe
respiratory depression following a suspected benzodiazepine overdose. What is the
nurse's priority action?
A. Administer activated charcoal to prevent further systemic absorption
B. Prepare for immediate endotracheal intubation and mechanical ventilation
C. Administer flumazenil intravenously while securing the airway
D. Obtain a STAT electroencephalogram (EEG) to rule out status epilepticus
Correct Answer: C
Rationale: Flumazenil is a competitive benzodiazepine receptor antagonist and the
specific reversal agent for benzodiazepin toxicity, though airway protection remains
paramount. A is incorrect because the drug is already absorbed causing respiratory
depression, B is a secondary action if reversal fails, and D does not address the acute
toxicity. Module 3 Exam Insight: ABCnursing exams consistently pair
unresponsive/respiratory depression scenarios with the specific pharmacologic
antagonist, testing priority over general supportive care.
,Q3: A patient taking zolpidem reports experiencing unusual behaviors such as
sleep-eating and sleep-driving. What is the best nursing response regarding this
adverse effect?
A. Reassure the patient that these are normal placebo effects that will resolve
spontaneously
B. Instruct the patient to take the medication with a high-fat meal to slow absorption
C. Educate the patient that these are complex sleep behaviors requiring immediate
discontinuation and provider notification
D. Advise the patient to increase the dose to ensure a full night's uninterrupted sleep
Correct Answer: C
Rationale: Zolpidem, a non-benzodiazepine hypnotic, carries an FDA warning for
complex sleep behaviors (sleep-driving, sleep-eating) that require immediate drug
cessation. A minimizes a dangerous adverse effect, B is contraindicated as it alters
pharmacokinetics, and D increases the risk of the adverse effect. Module 3 Exam
Insight: Geneva College testing patterns emphasize FDA black box warnings and
"must-do" nursing actions like immediate discontinuation of causative agents.
Q4: A patient with generalized anxiety disorder is prescribed buspirone. Which
instruction is most important for the nurse to include in the discharge teaching?
A. Take the medication on an as-needed basis only when experiencing acute panic
B. Understand that therapeutic effects may take 2 to 4 weeks to become noticeable
C. Understand that therapeutic effects may take 2 to 4 weeks to become noticeable
[CORRECT]
D. Expect immediate sedation and avoid driving for the first few doses
Correct Answer: C
Rationale: Buspirone is a non-sedating anxiolytic with a delayed onset of action,
typically requiring 2 to 4 weeks for full therapeutic effect, unlike benzodiazepines. A is
wrong because buspirone is not effective PRN, and D describes benzodiazepines, not
buspirone. Module 3 Exam Insight: Portage exams frequently contrast buspirone's
delayed onset and lack of sedation with the rapid onset and sedation of
benzodiazepines.
Q5: A nurse is caring for a patient starting fluoxetine for anxiety. The patient asks why
they were not prescribed a benzodiazepine instead. What is the nurse's best response
based on current guidelines?
A. SSRIs are first-line because they avoid the dependence, sedation, and withdrawal
risks associated with benzodiazepines
B. SSRIs are first-line because they avoid the dependence, sedation, and withdrawal
risks associated with benzodiazepines [CORRECT]
C. Benzodiazepines are strictly contraindicated in patients under the age of 65
D. Fluoxetine provides immediate relief of panic symptoms within 24 hours
,Correct Answer: B
Rationale: Current clinical guidelines designate SSRIs as first-line therapy for
generalized anxiety due to their safer adverse effect profile and lack of addiction
potential compared to benzodiazepines. C is incorrect because benzodiazepines can be
used in the elderly with extreme caution, not strictly contraindicated, and D is false as
SSRIs take weeks to work. Module 3 Exam Insight: ABCnursing heavily tests first-line
pharmacologic therapies and the rationale for avoiding controlled substances when
safer alternatives exist.
Q6: A patient presents with severe muscle rigidity, hyperthermia, and altered mental
status after a recent increase in their SSRI dose by a second provider. Which condition
is the nurse's priority to suspect?
A. Neuroleptic malignant syndrome (NMS)
B. Extrapyramidal symptoms (EPS)
C. Serotonin syndrome
D. Tardive dyskinesia
Correct Answer: C
Rationale: Serotonin syndrome is a life-threatening condition caused by excessive
serotonergic activity, characterized by the triad of neuromuscular excitability (rigidity),
autonomic instability (hyperthermia), and altered mental status. A is caused by
antipsychotics, B presents with acute dystonia/akathisia, and D presents with
involuntary facial movements. Module 3 Exam Insight: Geneva College Module 3 exams
almost always feature a scenario contrasting serotonin syndrome (SSRIs) with NMS
(antipsychotics), testing recognition of the specific drug class culprit.
Q7: A patient taking amitriptyline reports severe dry mouth, constipation, and blurred
vision. The nurse recognizes these symptoms as side effects related to which
mechanism of action?
A. Dopamine D2 receptor antagonism
B. Potent blockade of muscarinic (anticholinergic) receptors
C. Potent blockade of muscarinic (anticholinergic) receptors [CORRECT]
D. Inhibition of monoamine oxidase enzymes
Correct Answer: B
Rationale: Tricyclic antidepressants (TCAs) like amitriptyline possess strong
anticholinergic properties, leading to classic side effects: dry mouth, constipation,
blurred vision, and urinary retention. A describes antipsychotics, and D describes
MAOIs. Module 3 Exam Insight: Portage Learning requires students to map adverse
effect clusters directly to secondary receptor affinities (e.g., TCA anticholinergic vs.
alpha-1 blockade).
, Q8: A patient prescribed phenelzine, an MAOI, is planning to attend a wine and cheese
party. What is the priority nursing teaching?
A. Consume alcohol in moderation to prevent sedation
B. Avoid aged cheeses and red wines to prevent a hypertensive crisis
C. Avoid aged cheeses and red wines to prevent a hypertensive crisis [CORRECT]
D. Eat a high-protein meal prior to the party to slow tyramine absorption
Correct Answer: B
Rationale: MAOIs inhibit the breakdown of tyramine, allowing it to displace
norepinephrine from nerve terminals, which can cause a fatal hypertensive crisis if
tyramine-rich foods (aged cheese, red wine) are consumed. A is unsafe, and D is
ineffective as the interaction is enzymatic, not absorption-based. Module 3 Exam
Insight: ABCnursing consistently tests the MAOI-tyramine interaction, emphasizing the
phrase "hypertensive crisis" and specific food examples.
Q9: A patient with a history of seizure disorder and depression is being evaluated for
medication therapy. Which antidepressant should the nurse anticipate the provider will
avoid?
A. Sertraline
B. Bupropion
C. Bupropion [CORRECT]
D. Mirtazapine
Correct Answer: B
Rationale: Bupropion lowers the seizure threshold in a dose-dependent manner and is
contraindicated in patients with a history of seizures or eating disorders. A and D do not
lower the seizure threshold and are considered safer alternatives in this population.
Module 3 Exam Insight: Geneva College exams frequently test bupropion's seizure risk
as a standalone contraindication, often pairing it with eating disorder history as well.
Q10: A patient receiving haloperidol develops sudden involuntary upward eye
movements and facial grimacing. What is the nurse's priority action?
A. Administer diphenhydramine or benztropine as ordered for acute dystonia
B. Administer diphenhydramine or benztropine as ordered for acute dystonia
[CORRECT]
C. Hold the next dose and monitor for signs of neuroleptic malignant syndrome
D. Reassure the patient that this is a temporary, harmless side effect of therapy
Correct Answer: A
Rationale: The patient is experiencing acute dystonia, an extrapyramidal symptom
(EPS) of typical antipsychotics like haloperidol, which requires immediate treatment with
anticholinergic medications. C is incorrect because NMS presents with hyperthermia
and rigidity, not focal dystonia, and D neglects a distressing acute reaction. Module 3
Exam Insight: Portage tests EPS management heavily, requiring the student to
| Portage Learning ABCnursing Geneva College | Verified
Edition Questions & Answers | Pass Guaranteed - A+
Graded
Section 1: Central Nervous System Drugs (Questions 1-25)
Q1: A nursing student is reviewing the mechanism of action of benzodiazepines for a
pharmacology presentation. Which of the following accurately describes how drugs like
diazepam and lorazepam exert their therapeutic effect?
A. Blockade of dopamine D2 receptors in the mesolimbic pathway
B. Increase the frequency of chloride channel opening mediated by GABA-A receptors
C. Increase the frequency of chloride channel opening mediated by GABA-A receptors
[CORRECT]
D. Inhibit the reuptake of serotonin and norepinephrine in the synaptic cleft
Correct Answer: C
Rationale: Benzodiazepines bind to a specific site on the GABA-A receptor, increasing
the frequency of chloride channel opening, which hyperpolarizes the neuron and
produces CNS depression. A describes antipsychotics, B is an incomplete distractor,
and D describes SNRIs. Module 3 Exam Insight: Portage Learning heavily tests the
exact GABA-A/chloride channel mechanism, often confusing frequency of opening
(benzodiazepines) with duration of opening (barbiturates).
Q2: A patient arriving in the emergency department is unresponsive with severe
respiratory depression following a suspected benzodiazepine overdose. What is the
nurse's priority action?
A. Administer activated charcoal to prevent further systemic absorption
B. Prepare for immediate endotracheal intubation and mechanical ventilation
C. Administer flumazenil intravenously while securing the airway
D. Obtain a STAT electroencephalogram (EEG) to rule out status epilepticus
Correct Answer: C
Rationale: Flumazenil is a competitive benzodiazepine receptor antagonist and the
specific reversal agent for benzodiazepin toxicity, though airway protection remains
paramount. A is incorrect because the drug is already absorbed causing respiratory
depression, B is a secondary action if reversal fails, and D does not address the acute
toxicity. Module 3 Exam Insight: ABCnursing exams consistently pair
unresponsive/respiratory depression scenarios with the specific pharmacologic
antagonist, testing priority over general supportive care.
,Q3: A patient taking zolpidem reports experiencing unusual behaviors such as
sleep-eating and sleep-driving. What is the best nursing response regarding this
adverse effect?
A. Reassure the patient that these are normal placebo effects that will resolve
spontaneously
B. Instruct the patient to take the medication with a high-fat meal to slow absorption
C. Educate the patient that these are complex sleep behaviors requiring immediate
discontinuation and provider notification
D. Advise the patient to increase the dose to ensure a full night's uninterrupted sleep
Correct Answer: C
Rationale: Zolpidem, a non-benzodiazepine hypnotic, carries an FDA warning for
complex sleep behaviors (sleep-driving, sleep-eating) that require immediate drug
cessation. A minimizes a dangerous adverse effect, B is contraindicated as it alters
pharmacokinetics, and D increases the risk of the adverse effect. Module 3 Exam
Insight: Geneva College testing patterns emphasize FDA black box warnings and
"must-do" nursing actions like immediate discontinuation of causative agents.
Q4: A patient with generalized anxiety disorder is prescribed buspirone. Which
instruction is most important for the nurse to include in the discharge teaching?
A. Take the medication on an as-needed basis only when experiencing acute panic
B. Understand that therapeutic effects may take 2 to 4 weeks to become noticeable
C. Understand that therapeutic effects may take 2 to 4 weeks to become noticeable
[CORRECT]
D. Expect immediate sedation and avoid driving for the first few doses
Correct Answer: C
Rationale: Buspirone is a non-sedating anxiolytic with a delayed onset of action,
typically requiring 2 to 4 weeks for full therapeutic effect, unlike benzodiazepines. A is
wrong because buspirone is not effective PRN, and D describes benzodiazepines, not
buspirone. Module 3 Exam Insight: Portage exams frequently contrast buspirone's
delayed onset and lack of sedation with the rapid onset and sedation of
benzodiazepines.
Q5: A nurse is caring for a patient starting fluoxetine for anxiety. The patient asks why
they were not prescribed a benzodiazepine instead. What is the nurse's best response
based on current guidelines?
A. SSRIs are first-line because they avoid the dependence, sedation, and withdrawal
risks associated with benzodiazepines
B. SSRIs are first-line because they avoid the dependence, sedation, and withdrawal
risks associated with benzodiazepines [CORRECT]
C. Benzodiazepines are strictly contraindicated in patients under the age of 65
D. Fluoxetine provides immediate relief of panic symptoms within 24 hours
,Correct Answer: B
Rationale: Current clinical guidelines designate SSRIs as first-line therapy for
generalized anxiety due to their safer adverse effect profile and lack of addiction
potential compared to benzodiazepines. C is incorrect because benzodiazepines can be
used in the elderly with extreme caution, not strictly contraindicated, and D is false as
SSRIs take weeks to work. Module 3 Exam Insight: ABCnursing heavily tests first-line
pharmacologic therapies and the rationale for avoiding controlled substances when
safer alternatives exist.
Q6: A patient presents with severe muscle rigidity, hyperthermia, and altered mental
status after a recent increase in their SSRI dose by a second provider. Which condition
is the nurse's priority to suspect?
A. Neuroleptic malignant syndrome (NMS)
B. Extrapyramidal symptoms (EPS)
C. Serotonin syndrome
D. Tardive dyskinesia
Correct Answer: C
Rationale: Serotonin syndrome is a life-threatening condition caused by excessive
serotonergic activity, characterized by the triad of neuromuscular excitability (rigidity),
autonomic instability (hyperthermia), and altered mental status. A is caused by
antipsychotics, B presents with acute dystonia/akathisia, and D presents with
involuntary facial movements. Module 3 Exam Insight: Geneva College Module 3 exams
almost always feature a scenario contrasting serotonin syndrome (SSRIs) with NMS
(antipsychotics), testing recognition of the specific drug class culprit.
Q7: A patient taking amitriptyline reports severe dry mouth, constipation, and blurred
vision. The nurse recognizes these symptoms as side effects related to which
mechanism of action?
A. Dopamine D2 receptor antagonism
B. Potent blockade of muscarinic (anticholinergic) receptors
C. Potent blockade of muscarinic (anticholinergic) receptors [CORRECT]
D. Inhibition of monoamine oxidase enzymes
Correct Answer: B
Rationale: Tricyclic antidepressants (TCAs) like amitriptyline possess strong
anticholinergic properties, leading to classic side effects: dry mouth, constipation,
blurred vision, and urinary retention. A describes antipsychotics, and D describes
MAOIs. Module 3 Exam Insight: Portage Learning requires students to map adverse
effect clusters directly to secondary receptor affinities (e.g., TCA anticholinergic vs.
alpha-1 blockade).
, Q8: A patient prescribed phenelzine, an MAOI, is planning to attend a wine and cheese
party. What is the priority nursing teaching?
A. Consume alcohol in moderation to prevent sedation
B. Avoid aged cheeses and red wines to prevent a hypertensive crisis
C. Avoid aged cheeses and red wines to prevent a hypertensive crisis [CORRECT]
D. Eat a high-protein meal prior to the party to slow tyramine absorption
Correct Answer: B
Rationale: MAOIs inhibit the breakdown of tyramine, allowing it to displace
norepinephrine from nerve terminals, which can cause a fatal hypertensive crisis if
tyramine-rich foods (aged cheese, red wine) are consumed. A is unsafe, and D is
ineffective as the interaction is enzymatic, not absorption-based. Module 3 Exam
Insight: ABCnursing consistently tests the MAOI-tyramine interaction, emphasizing the
phrase "hypertensive crisis" and specific food examples.
Q9: A patient with a history of seizure disorder and depression is being evaluated for
medication therapy. Which antidepressant should the nurse anticipate the provider will
avoid?
A. Sertraline
B. Bupropion
C. Bupropion [CORRECT]
D. Mirtazapine
Correct Answer: B
Rationale: Bupropion lowers the seizure threshold in a dose-dependent manner and is
contraindicated in patients with a history of seizures or eating disorders. A and D do not
lower the seizure threshold and are considered safer alternatives in this population.
Module 3 Exam Insight: Geneva College exams frequently test bupropion's seizure risk
as a standalone contraindication, often pairing it with eating disorder history as well.
Q10: A patient receiving haloperidol develops sudden involuntary upward eye
movements and facial grimacing. What is the nurse's priority action?
A. Administer diphenhydramine or benztropine as ordered for acute dystonia
B. Administer diphenhydramine or benztropine as ordered for acute dystonia
[CORRECT]
C. Hold the next dose and monitor for signs of neuroleptic malignant syndrome
D. Reassure the patient that this is a temporary, harmless side effect of therapy
Correct Answer: A
Rationale: The patient is experiencing acute dystonia, an extrapyramidal symptom
(EPS) of typical antipsychotics like haloperidol, which requires immediate treatment with
anticholinergic medications. C is incorrect because NMS presents with hyperthermia
and rigidity, not focal dystonia, and D neglects a distressing acute reaction. Module 3
Exam Insight: Portage tests EPS management heavily, requiring the student to
