PRN 1381/PRN1381 Exam 3 V1 | Principles
of Pharmacology Q&A with Rationale |
Rasmussen University
1. A patient taking lithium carbonate for bipolar disorder reports feeling lethargic and having
a coarse hand tremor. Which lithium level should the nurse anticipate?
A. 0.4 mEq/L
B. 1.8 mEq/L
C. 1.2 mEq/L
D. 0.8 mEq/L
Correct Answer: B
Expert Explanation: A lithium level of 1.8 mEq/L indicates moderate toxicity, which often
presents with coarse tremors and lethargy. The therapeutic range for lithium is generally
between 0.6 and 1.2 mEq/L. Nurses must monitor these levels closely to prevent severe
complications like seizures or coma.
2. Which instruction should the nurse provide to a patient starting a new prescription for
phenelzine?
A. Avoid aged cheeses and cured meats.
B. Take the medication with orange juice.
C. Stop the medication immediately if a headache occurs.
,D. Increase intake of leafy green vegetables.
Correct Answer: A
Expert Explanation: Phenelzine is an MAOI that requires a tyramine-restricted diet to
prevent a hypertensive crisis. Foods like aged cheese, red wine, and cured meats contain
high levels of tyramine. Patients should also be taught to report a sudden, severe headache
which could indicate dangerously high blood pressure.
3. A nurse is caring for a patient who has a morphine overdose. Which medication should the
nurse prepare to administer?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
Correct Answer: A
Expert Explanation: Naloxone is an opioid antagonist used to reverse the effects of opioid-
induced respiratory depression. It works by competing for opioid receptor sites in the
central nervous system. Because its half-life is shorter than most opioids, repeated doses
may be necessary to maintain safety.
4. What is the therapeutic serum level for a patient taking phenytoin for seizure control?
A. 5 to 10 mcg/mL
, B. 10 to 20 mcg/mL
C. 20 to 30 mcg/mL
D. 40 to 50 mcg/mL
Correct Answer: B
Expert Explanation: The therapeutic range for phenytoin is 10 to 20 mcg/mL to ensure
efficacy while minimizing toxicity. Levels below this range increase the risk of
breakthrough seizures, while levels above it can lead to nystagmus and ataxia. Patients
require regular blood monitoring to maintain these steady-state levels.
5. A patient is prescribed fluoxetine for depression. Which symptom should the nurse instruct
the patient to report immediately as a sign of serotonin syndrome?
A. Dry mouth
B. Constipation
C. Weight gain
D. Hallucinations and tremors
Correct Answer: D
Expert Explanation: Serotonin syndrome is a potentially life-threatening condition
characterized by agitation, hallucinations, and muscle rigidity. It occurs when there is an
overabundance of serotonin in the synaptic cleft. Patients must be educated to seek
immediate medical attention if these neurologic changes occur.
of Pharmacology Q&A with Rationale |
Rasmussen University
1. A patient taking lithium carbonate for bipolar disorder reports feeling lethargic and having
a coarse hand tremor. Which lithium level should the nurse anticipate?
A. 0.4 mEq/L
B. 1.8 mEq/L
C. 1.2 mEq/L
D. 0.8 mEq/L
Correct Answer: B
Expert Explanation: A lithium level of 1.8 mEq/L indicates moderate toxicity, which often
presents with coarse tremors and lethargy. The therapeutic range for lithium is generally
between 0.6 and 1.2 mEq/L. Nurses must monitor these levels closely to prevent severe
complications like seizures or coma.
2. Which instruction should the nurse provide to a patient starting a new prescription for
phenelzine?
A. Avoid aged cheeses and cured meats.
B. Take the medication with orange juice.
C. Stop the medication immediately if a headache occurs.
,D. Increase intake of leafy green vegetables.
Correct Answer: A
Expert Explanation: Phenelzine is an MAOI that requires a tyramine-restricted diet to
prevent a hypertensive crisis. Foods like aged cheese, red wine, and cured meats contain
high levels of tyramine. Patients should also be taught to report a sudden, severe headache
which could indicate dangerously high blood pressure.
3. A nurse is caring for a patient who has a morphine overdose. Which medication should the
nurse prepare to administer?
A. Naloxone
B. Flumazenil
C. Acetylcysteine
D. Protamine sulfate
Correct Answer: A
Expert Explanation: Naloxone is an opioid antagonist used to reverse the effects of opioid-
induced respiratory depression. It works by competing for opioid receptor sites in the
central nervous system. Because its half-life is shorter than most opioids, repeated doses
may be necessary to maintain safety.
4. What is the therapeutic serum level for a patient taking phenytoin for seizure control?
A. 5 to 10 mcg/mL
, B. 10 to 20 mcg/mL
C. 20 to 30 mcg/mL
D. 40 to 50 mcg/mL
Correct Answer: B
Expert Explanation: The therapeutic range for phenytoin is 10 to 20 mcg/mL to ensure
efficacy while minimizing toxicity. Levels below this range increase the risk of
breakthrough seizures, while levels above it can lead to nystagmus and ataxia. Patients
require regular blood monitoring to maintain these steady-state levels.
5. A patient is prescribed fluoxetine for depression. Which symptom should the nurse instruct
the patient to report immediately as a sign of serotonin syndrome?
A. Dry mouth
B. Constipation
C. Weight gain
D. Hallucinations and tremors
Correct Answer: D
Expert Explanation: Serotonin syndrome is a potentially life-threatening condition
characterized by agitation, hallucinations, and muscle rigidity. It occurs when there is an
overabundance of serotonin in the synaptic cleft. Patients must be educated to seek
immediate medical attention if these neurologic changes occur.
