NR 293 Pharmacology (ATI-Based) Exam 8 Study Guide 2026
|Chamberlain College
1. A nurse is caring for a client who is taking phenytoin for seizures. Which of
the following instructions should the nurse provide to the client?
A. Maintain strict oral hygiene to prevent gingival hyperplasia.
B. Stop the medication immediately if a skin rash appears.
C. Drink 3 liters of water daily to prevent renal calculi.
D. Expect urine to turn a dark orange color.
Answer: A
Rationale: Phenytoin often causes gingival hyperplasia (overgrowth of gum tissue). Proper
oral hygiene, including flossing and gum massage, can help minimize this effect.
2. A client is prescribed lithium carbonate for bipolar disorder. Which of the
following dietary instructions is most important?
A. Limit caffeine intake to one cup per day.
B. Avoid foods high in tyramine, such as aged cheese.
C. Increase protein intake to 2 grams per kilogram.
D. Maintain a consistent intake of dietary sodium.
Answer: D
Rationale: Lithium is a salt; if sodium levels drop (due to low intake or sweating), the
kidneys retain lithium to compensate, leading to toxicity. Consistent sodium intake is vital.
,3. A nurse is assessing a client taking levodopa/carbidopa for Parkinson’s
disease. Which finding indicates the medication is effective?
A. Increased heart rate and blood pressure.
B. Improved ability to perform ADLs.
C. Decreased appetite and weight loss.
D. Increased urinary output.
Answer: B
Rationale: Levodopa/carbidopa works by increasing dopamine levels in the brain, which
improves motor function and the ability to perform activities of daily living (ADLs).
4. A client is starting phenelzine, an MAOI. Which food should the nurse instruct
the client to avoid?
A. Fresh green leafy vegetables.
B. Smoked sausage and pepperoni.
C. Pasteurized milk products.
D. Whole grain bread products.
Answer: B
Rationale: MAOIs interact with tyramine-rich foods (like smoked meats, aged cheeses, and
red wine), which can cause a hypertensive crisis.
5. A nurse is monitoring a client who recently started fluoxetine. Which
symptoms would suggest the development of Serotonin Syndrome?
A. Hypothermia, bradycardia, and constipation.
B. Confusion, agitation, and hyperreflexia.
C. Urinary retention, dry mouth, and blurred vision.
D. Weight gain, sedation, and increased appetite.
Answer: B
, Rationale: Serotonin Syndrome is characterized by mental status changes (confusion,
agitation), autonomic instability, and neuromuscular hyperactivity (hyperreflexia,
tremors).
6. What is the reversal agent for a benzodiazepine overdose?
A. Flumazenil
B. Acetylcysteine
C. Naloxone
D. Protamine sulfate
Answer: A
Rationale: Flumazenil is the specific competitive antagonist for benzodiazepines used to
reverse sedation and respiratory depression.
7. A client taking haloperidol develops a high fever, muscle rigidity, and
tachycardia. What complication does the nurse suspect?
A. Neuroleptic Malignant Syndrome (NMS)
B. Extrapyramidal symptoms (EPS)
C. Anticholinergic toxicity
D. Agranulocytosis
Answer: A
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by ‘lead-pipe’
rigidity, high fever, and autonomic instability.
8. A nurse is reviewing the lab results of a client taking clozapine. Which result
would require the nurse to withhold the medication?
A. Sodium of 138 mEq/L
B. Blood glucose of 110 mg/dL
C. Potassium of 3.8 mEq/L
D. WBC count of 2,500/mm³
Answer: D
|Chamberlain College
1. A nurse is caring for a client who is taking phenytoin for seizures. Which of
the following instructions should the nurse provide to the client?
A. Maintain strict oral hygiene to prevent gingival hyperplasia.
B. Stop the medication immediately if a skin rash appears.
C. Drink 3 liters of water daily to prevent renal calculi.
D. Expect urine to turn a dark orange color.
Answer: A
Rationale: Phenytoin often causes gingival hyperplasia (overgrowth of gum tissue). Proper
oral hygiene, including flossing and gum massage, can help minimize this effect.
2. A client is prescribed lithium carbonate for bipolar disorder. Which of the
following dietary instructions is most important?
A. Limit caffeine intake to one cup per day.
B. Avoid foods high in tyramine, such as aged cheese.
C. Increase protein intake to 2 grams per kilogram.
D. Maintain a consistent intake of dietary sodium.
Answer: D
Rationale: Lithium is a salt; if sodium levels drop (due to low intake or sweating), the
kidneys retain lithium to compensate, leading to toxicity. Consistent sodium intake is vital.
,3. A nurse is assessing a client taking levodopa/carbidopa for Parkinson’s
disease. Which finding indicates the medication is effective?
A. Increased heart rate and blood pressure.
B. Improved ability to perform ADLs.
C. Decreased appetite and weight loss.
D. Increased urinary output.
Answer: B
Rationale: Levodopa/carbidopa works by increasing dopamine levels in the brain, which
improves motor function and the ability to perform activities of daily living (ADLs).
4. A client is starting phenelzine, an MAOI. Which food should the nurse instruct
the client to avoid?
A. Fresh green leafy vegetables.
B. Smoked sausage and pepperoni.
C. Pasteurized milk products.
D. Whole grain bread products.
Answer: B
Rationale: MAOIs interact with tyramine-rich foods (like smoked meats, aged cheeses, and
red wine), which can cause a hypertensive crisis.
5. A nurse is monitoring a client who recently started fluoxetine. Which
symptoms would suggest the development of Serotonin Syndrome?
A. Hypothermia, bradycardia, and constipation.
B. Confusion, agitation, and hyperreflexia.
C. Urinary retention, dry mouth, and blurred vision.
D. Weight gain, sedation, and increased appetite.
Answer: B
, Rationale: Serotonin Syndrome is characterized by mental status changes (confusion,
agitation), autonomic instability, and neuromuscular hyperactivity (hyperreflexia,
tremors).
6. What is the reversal agent for a benzodiazepine overdose?
A. Flumazenil
B. Acetylcysteine
C. Naloxone
D. Protamine sulfate
Answer: A
Rationale: Flumazenil is the specific competitive antagonist for benzodiazepines used to
reverse sedation and respiratory depression.
7. A client taking haloperidol develops a high fever, muscle rigidity, and
tachycardia. What complication does the nurse suspect?
A. Neuroleptic Malignant Syndrome (NMS)
B. Extrapyramidal symptoms (EPS)
C. Anticholinergic toxicity
D. Agranulocytosis
Answer: A
Rationale: NMS is a life-threatening reaction to antipsychotics characterized by ‘lead-pipe’
rigidity, high fever, and autonomic instability.
8. A nurse is reviewing the lab results of a client taking clozapine. Which result
would require the nurse to withhold the medication?
A. Sodium of 138 mEq/L
B. Blood glucose of 110 mg/dL
C. Potassium of 3.8 mEq/L
D. WBC count of 2,500/mm³
Answer: D
