NUR 210 Exam 4: Principles of Pharmacology - Galen
College of Nursing Updated and Latest Questions and
Correct Answers with Rationale
1. A nurse is preparing to administer Lithium Carbonate to a patient with bipolar disorder. Which serum
lithium level should the nurse recognize as being within the therapeutic range?
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Correct Answer: C
Rationale: Lithium is a mood stabilizer used primarily for the long-term treatment of bipolar disorder.
The therapeutic window for lithium is very narrow, generally considered to be 0.6 to 1.2 mEq/L. Levels
above 1.5 mEq/L are considered toxic and require immediate clinical intervention. Patients must
maintain a consistent sodium intake to prevent lithium retention and subsequent toxicity. Regular blood
draws are essential to ensure the patient remains within the safe and effective dosage range.
2. A patient is prescribed Phenelzine, an MAO inhibitor. Which of the following foods must the nurse
instruct the patient to avoid?
A. Aged cheddar cheese
B. Fresh green beans
C. Grilled chicken breast
D. Whole grain bread
Correct Answer: A
,Rationale: Phenelzine is an MAO inhibitor that prevents the breakdown of tyramine in the body.
Consumption of high-tyramine foods like aged cheeses can lead to a hypertensive crisis. This dangerous
elevation in blood pressure occurs due to excessive norepinephrine release. Patients must be educated to
avoid fermented, cured, or aged food products entirely. Maintaining a strict diet is the most critical safety
intervention for patients on this medication class.
3. A nurse is caring for a patient starting Fluoxetine. The nurse should monitor for which life-threatening
condition associated with excessive serotonin?
A. Neuroleptic malignant syndrome
B. Stevens-Johnson syndrome
C. Serotonin syndrome
D. Tardive dyskinesia
Correct Answer: C
Rationale: Fluoxetine is an SSRI that increases serotonin levels in the synaptic cleft. Serotonin syndrome
is a potentially fatal condition characterized by agitation, fever, and muscle rigidity. It often occurs when
multiple serotonergic agents are combined or when dosages are rapidly increased. Nurses must monitor
for autonomic instability and hyperreflexia as early warning signs. Immediate discontinuation of the drug
and supportive care are necessary to manage this medical emergency.
4. A patient with asthma is prescribed Albuterol and Beclomethasone inhalers. What is the correct sequence
for administration?
A. Administer Albuterol first, then Beclomethasone
B. Administer Beclomethasone first, then Albuterol
C. Administer both simultaneously for better effect
, D. Wait 2 hours between the two medications
Correct Answer: A
Rationale: Albuterol is a short-acting beta-2 agonist that works as a bronchodilator to open airways
quickly. Beclomethasone is a corticosteroid that reduces inflammation but takes longer to act. Using the
bronchodilator first allows the steroid to penetrate deeper into the opened lung tissues. The nurse should
instruct the patient to wait about five minutes between the different inhalers. This sequence maximizes
the therapeutic benefit of the anti-inflammatory medication in the lower respiratory tract.
5. What is the primary mechanism of action for the medication Sucralfate?
A. Forming a protective barrier over ulcers
B. Inhibiting the H2 receptor
C. Neutralizing gastric acid
D. Blocking the proton pump
Correct Answer: A
Rationale: Sucralfate is a mucosal protectant used to treat and prevent duodenal ulcers. It reacts with
gastric acid to create a thick, paste-like substance that adheres to the ulcer site. This physical barrier
protects the injured tissue from further damage by acid and pepsin. It does not significantly change the
pH of the stomach or inhibit acid secretion. For optimal results, it should be administered on an empty
stomach at least one hour before meals.
6. A nurse is teaching a patient about Rifampin for tuberculosis. Which side effect should the nurse inform
the patient is expected?
A. Peripheral neuropathy
B. Orange discoloration of urine and tears
College of Nursing Updated and Latest Questions and
Correct Answers with Rationale
1. A nurse is preparing to administer Lithium Carbonate to a patient with bipolar disorder. Which serum
lithium level should the nurse recognize as being within the therapeutic range?
A. 0.2 - 0.5 mEq/L
B. 1.5 - 2.0 mEq/L
C. 0.6 - 1.2 mEq/L
D. 2.5 - 3.0 mEq/L
Correct Answer: C
Rationale: Lithium is a mood stabilizer used primarily for the long-term treatment of bipolar disorder.
The therapeutic window for lithium is very narrow, generally considered to be 0.6 to 1.2 mEq/L. Levels
above 1.5 mEq/L are considered toxic and require immediate clinical intervention. Patients must
maintain a consistent sodium intake to prevent lithium retention and subsequent toxicity. Regular blood
draws are essential to ensure the patient remains within the safe and effective dosage range.
2. A patient is prescribed Phenelzine, an MAO inhibitor. Which of the following foods must the nurse
instruct the patient to avoid?
A. Aged cheddar cheese
B. Fresh green beans
C. Grilled chicken breast
D. Whole grain bread
Correct Answer: A
,Rationale: Phenelzine is an MAO inhibitor that prevents the breakdown of tyramine in the body.
Consumption of high-tyramine foods like aged cheeses can lead to a hypertensive crisis. This dangerous
elevation in blood pressure occurs due to excessive norepinephrine release. Patients must be educated to
avoid fermented, cured, or aged food products entirely. Maintaining a strict diet is the most critical safety
intervention for patients on this medication class.
3. A nurse is caring for a patient starting Fluoxetine. The nurse should monitor for which life-threatening
condition associated with excessive serotonin?
A. Neuroleptic malignant syndrome
B. Stevens-Johnson syndrome
C. Serotonin syndrome
D. Tardive dyskinesia
Correct Answer: C
Rationale: Fluoxetine is an SSRI that increases serotonin levels in the synaptic cleft. Serotonin syndrome
is a potentially fatal condition characterized by agitation, fever, and muscle rigidity. It often occurs when
multiple serotonergic agents are combined or when dosages are rapidly increased. Nurses must monitor
for autonomic instability and hyperreflexia as early warning signs. Immediate discontinuation of the drug
and supportive care are necessary to manage this medical emergency.
4. A patient with asthma is prescribed Albuterol and Beclomethasone inhalers. What is the correct sequence
for administration?
A. Administer Albuterol first, then Beclomethasone
B. Administer Beclomethasone first, then Albuterol
C. Administer both simultaneously for better effect
, D. Wait 2 hours between the two medications
Correct Answer: A
Rationale: Albuterol is a short-acting beta-2 agonist that works as a bronchodilator to open airways
quickly. Beclomethasone is a corticosteroid that reduces inflammation but takes longer to act. Using the
bronchodilator first allows the steroid to penetrate deeper into the opened lung tissues. The nurse should
instruct the patient to wait about five minutes between the different inhalers. This sequence maximizes
the therapeutic benefit of the anti-inflammatory medication in the lower respiratory tract.
5. What is the primary mechanism of action for the medication Sucralfate?
A. Forming a protective barrier over ulcers
B. Inhibiting the H2 receptor
C. Neutralizing gastric acid
D. Blocking the proton pump
Correct Answer: A
Rationale: Sucralfate is a mucosal protectant used to treat and prevent duodenal ulcers. It reacts with
gastric acid to create a thick, paste-like substance that adheres to the ulcer site. This physical barrier
protects the injured tissue from further damage by acid and pepsin. It does not significantly change the
pH of the stomach or inhibit acid secretion. For optimal results, it should be administered on an empty
stomach at least one hour before meals.
6. A nurse is teaching a patient about Rifampin for tuberculosis. Which side effect should the nurse inform
the patient is expected?
A. Peripheral neuropathy
B. Orange discoloration of urine and tears
