NU 150 EXAM 3 PHARMACOLOGY —
COMPLETE 150-QUESTION PRACTICE
EXAM Galen College of Nursing | 2026/2027 |
Questions with Answers & Rationales
SECTION 1: GASTROINTESTINAL AGENTS (Questions 1-25)
1. A nurse is caring for a patient taking omeprazole. Which of the following is
the best indication that the medication is effective?
A. Decreased bowel sounds
B. The patient reports no gastric reflux or heartburn
C. Increased appetite and weight gain
D. Decreased urination frequency
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor that reduces gastric acid.
Symptom relief—less heartburn and reflux—is the best indicator of
effectiveness.
2. A patient is being treated for a superinfection caused by prolonged
antibiotic use. Which of the following is the most likely explanation for the
development of the superinfection?
A. The antibiotic dose was too low
B. Overgrowth of resistant organisms
C. The infection was viral, not bacterial
D. The patient did not rest adequately
Correct Answer: B
Rationale: Prolonged or broad-spectrum antibiotic therapy disrupts normal
flora, allowing resistant organisms (e.g., C. difficile, Candida) to overgrow
and cause superinfection.
,3. A patient with a history of heart failure asks about using sodium
bicarbonate for indigestion. How should the nurse respond?
A. "It is completely safe to use every day."
B. "Sodium bicarbonate may worsen your heart failure symptoms."
C. "You should double the dose if your indigestion is severe."
D. "Take it with milk to protect your heart."
Correct Answer: B
Rationale: Sodium bicarbonate contains a high sodium load, which can cause
fluid retention and exacerbate heart failure. HF patients should avoid high-
sodium antacids.
4. A nurse is caring for a patient taking omeprazole. Which complication
should the nurse monitor for in a postmenopausal patient?
A. Deep vein thrombosis
B. Hip fractures
C. Hyperkalemia
D. Cataracts
Correct Answer: B
Rationale: Long-term PPI use is associated with decreased calcium
absorption and bone density, increasing the risk of fractures, especially in
older adults.
5. A nurse is caring for a patient taking omeprazole. Which of the following
conditions is most likely to develop with long-term use?
A. Increased risk of fractures
B. Hyperkalemia
C. Hypothyroidism
D. Increased clotting
Correct Answer: A
Rationale: Long-term PPI use is associated with decreased calcium
absorption and reduced bone density, increasing the risk of fractures,
particularly in postmenopausal women and older adults.
,6. A patient is prescribed sucralfate (Carafate) for a duodenal ulcer. The
nurse should instruct the patient to take this medication:
A. With meals to prevent gastric irritation
B. 1 hour before meals and at bedtime on an empty stomach
C. Immediately after meals to coat the stomach lining
D. At the same time as antacids for maximum effect
Correct Answer: B
Rationale: Sucralfate forms a protective barrier over ulcers by binding to
exposed proteins. It requires an acidic environment and an empty stomach
to work effectively. Antacids should be avoided 30 minutes before or after
because they alter gastric pH.
7. A patient is prescribed ondansetron (Zofran) for chemotherapy-induced
nausea. The nurse knows this medication works by:
A. Blocking dopamine receptors in the brain
B. Blocking serotonin (5-HT3) receptors in the GI tract and brain
C. Increasing gastric emptying
D. Coating the stomach lining
Correct Answer: B
*Rationale: Ondansetron is a selective 5-HT3 receptor antagonist. It blocks
serotonin receptors in the chemoreceptor trigger zone and the GI tract,
preventing nausea and vomiting signals.*
8. A patient taking metoclopramide (Reglan) for gastroparesis should be
monitored for which serious neurological side effect?
A. Seizures
B. Tardive dyskinesia
C. Peripheral neuropathy
D. Optic neuritis
Correct Answer: B
Rationale: Metoclopramide is a dopamine antagonist that can cause
extrapyramidal symptoms and irreversible tardive dyskinesia (involuntary
, movements of the face, tongue, and limbs). Risk increases with duration of
use, especially beyond 12 weeks.
9. A patient is prescribed docusate sodium (Colace). The nurse explains that
this medication works by:
A. Stimulating bowel muscle contraction
B. Softening stool by increasing water and fat penetration
C. Adding bulk to the stool
D. Lubricating the intestinal wall
Correct Answer: B
Rationale: Docusate is a stool softener (surfactant). It lowers the surface
tension of stool, allowing water and fats to penetrate and soften the fecal
mass. It does not stimulate peristalsis.
10. A patient is receiving lactulose for hepatic encephalopathy. The nurse
knows the medication is effective when the patient:
A. Has a serum ammonia level within normal limits
B. Reports decreased abdominal pain
C. Has at least 2-3 soft stools per day
D. Shows improvement in liver enzyme levels
Correct Answer: C
*Rationale: Lactulose acidifies the colon, trapping ammonia and promoting
its excretion in stool. Therapeutic effect is measured by achieving 2-3 soft,
acidic stools daily.*
11. A patient prescribed famotidine (Pepcid) asks how this medication differs
from omeprazole. The nurse's best response is:
A. "Famotidine works faster and lasts longer than omeprazole."
B. "Famotidine blocks histamine receptors, while omeprazole blocks the acid
pump itself."
C. "They are exactly the same type of medication."
D. "Famotidine requires a prescription; omeprazole does not."
COMPLETE 150-QUESTION PRACTICE
EXAM Galen College of Nursing | 2026/2027 |
Questions with Answers & Rationales
SECTION 1: GASTROINTESTINAL AGENTS (Questions 1-25)
1. A nurse is caring for a patient taking omeprazole. Which of the following is
the best indication that the medication is effective?
A. Decreased bowel sounds
B. The patient reports no gastric reflux or heartburn
C. Increased appetite and weight gain
D. Decreased urination frequency
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor that reduces gastric acid.
Symptom relief—less heartburn and reflux—is the best indicator of
effectiveness.
2. A patient is being treated for a superinfection caused by prolonged
antibiotic use. Which of the following is the most likely explanation for the
development of the superinfection?
A. The antibiotic dose was too low
B. Overgrowth of resistant organisms
C. The infection was viral, not bacterial
D. The patient did not rest adequately
Correct Answer: B
Rationale: Prolonged or broad-spectrum antibiotic therapy disrupts normal
flora, allowing resistant organisms (e.g., C. difficile, Candida) to overgrow
and cause superinfection.
,3. A patient with a history of heart failure asks about using sodium
bicarbonate for indigestion. How should the nurse respond?
A. "It is completely safe to use every day."
B. "Sodium bicarbonate may worsen your heart failure symptoms."
C. "You should double the dose if your indigestion is severe."
D. "Take it with milk to protect your heart."
Correct Answer: B
Rationale: Sodium bicarbonate contains a high sodium load, which can cause
fluid retention and exacerbate heart failure. HF patients should avoid high-
sodium antacids.
4. A nurse is caring for a patient taking omeprazole. Which complication
should the nurse monitor for in a postmenopausal patient?
A. Deep vein thrombosis
B. Hip fractures
C. Hyperkalemia
D. Cataracts
Correct Answer: B
Rationale: Long-term PPI use is associated with decreased calcium
absorption and bone density, increasing the risk of fractures, especially in
older adults.
5. A nurse is caring for a patient taking omeprazole. Which of the following
conditions is most likely to develop with long-term use?
A. Increased risk of fractures
B. Hyperkalemia
C. Hypothyroidism
D. Increased clotting
Correct Answer: A
Rationale: Long-term PPI use is associated with decreased calcium
absorption and reduced bone density, increasing the risk of fractures,
particularly in postmenopausal women and older adults.
,6. A patient is prescribed sucralfate (Carafate) for a duodenal ulcer. The
nurse should instruct the patient to take this medication:
A. With meals to prevent gastric irritation
B. 1 hour before meals and at bedtime on an empty stomach
C. Immediately after meals to coat the stomach lining
D. At the same time as antacids for maximum effect
Correct Answer: B
Rationale: Sucralfate forms a protective barrier over ulcers by binding to
exposed proteins. It requires an acidic environment and an empty stomach
to work effectively. Antacids should be avoided 30 minutes before or after
because they alter gastric pH.
7. A patient is prescribed ondansetron (Zofran) for chemotherapy-induced
nausea. The nurse knows this medication works by:
A. Blocking dopamine receptors in the brain
B. Blocking serotonin (5-HT3) receptors in the GI tract and brain
C. Increasing gastric emptying
D. Coating the stomach lining
Correct Answer: B
*Rationale: Ondansetron is a selective 5-HT3 receptor antagonist. It blocks
serotonin receptors in the chemoreceptor trigger zone and the GI tract,
preventing nausea and vomiting signals.*
8. A patient taking metoclopramide (Reglan) for gastroparesis should be
monitored for which serious neurological side effect?
A. Seizures
B. Tardive dyskinesia
C. Peripheral neuropathy
D. Optic neuritis
Correct Answer: B
Rationale: Metoclopramide is a dopamine antagonist that can cause
extrapyramidal symptoms and irreversible tardive dyskinesia (involuntary
, movements of the face, tongue, and limbs). Risk increases with duration of
use, especially beyond 12 weeks.
9. A patient is prescribed docusate sodium (Colace). The nurse explains that
this medication works by:
A. Stimulating bowel muscle contraction
B. Softening stool by increasing water and fat penetration
C. Adding bulk to the stool
D. Lubricating the intestinal wall
Correct Answer: B
Rationale: Docusate is a stool softener (surfactant). It lowers the surface
tension of stool, allowing water and fats to penetrate and soften the fecal
mass. It does not stimulate peristalsis.
10. A patient is receiving lactulose for hepatic encephalopathy. The nurse
knows the medication is effective when the patient:
A. Has a serum ammonia level within normal limits
B. Reports decreased abdominal pain
C. Has at least 2-3 soft stools per day
D. Shows improvement in liver enzyme levels
Correct Answer: C
*Rationale: Lactulose acidifies the colon, trapping ammonia and promoting
its excretion in stool. Therapeutic effect is measured by achieving 2-3 soft,
acidic stools daily.*
11. A patient prescribed famotidine (Pepcid) asks how this medication differs
from omeprazole. The nurse's best response is:
A. "Famotidine works faster and lasts longer than omeprazole."
B. "Famotidine blocks histamine receptors, while omeprazole blocks the acid
pump itself."
C. "They are exactly the same type of medication."
D. "Famotidine requires a prescription; omeprazole does not."
