NUR 6011/NUR6011 Exam 4 V1 | Advance
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient with Parkinson’s disease is prescribed levodopa/carbidopa (Sinemet). What is the
primary rationale for the use of carbidopa?
A. Carbidopa acts as a dopamine agonist in the brain.
B. Carbidopa crosses the blood-brain barrier to increase dopamine levels.
C. Carbidopa inhibits the peripheral decarboxylation of levodopa.
D. Carbidopa reduces the gastrointestinal side effects of levodopa.
Correct Answer: C
Expert Explanation: Carbidopa is a decarboxylase inhibitor that does not cross the blood-
brain barrier. It is given with levodopa to prevent the peripheral conversion of levodopa
into dopamine. This allows more levodopa to reach the CNS and reduces peripheral side
effects such as tachycardia and nausea.
2. Which teaching point is most important for a patient starting phenytoin (Dilantin) for
seizure management?
A. Decrease fluid intake to prevent fluid retention.
B. Stop the medication immediately if a mild rash appears.
C. Maintain strict oral hygiene to prevent gingival hyperplasia.
,D. Take the medication only when a seizure is anticipated.
Correct Answer: C
Expert Explanation: Phenytoin is known to cause gingival hyperplasia in about 20% of
patients. Regular dental checkups and frequent flossing/brushing are essential to minimize
this effect. Patients should also be advised that this drug has a narrow therapeutic range
and requires consistent blood level monitoring.
3. A patient is being treated for a lithium-induced toxicity. Which serum lithium level is most
consistent with severe toxicity?
A. 2.5 mEq/L
B. 1.2 mEq/L
C. 1.5 mEq/L
D. 0.8 mEq/L
Correct Answer: A
Expert Explanation: The therapeutic range for lithium is narrow, typically between 0.6
and 1.2 mEq/L. Levels above 1.5 mEq/L are considered toxic, and levels exceeding 2.5
mEq/L are associated with severe toxicity and potential death. Severe toxicity requires
immediate medical intervention, which may include hemodialysis.
4. A nurse is reviewing the lab results for a patient taking valproic acid. Which lab value is the
most concerning?
A. Serum sodium 138 mEq/L
, B. AST 120 units/L
C. Platelet count 250,000/mm³
D. Glucose 110 mg/dL
Correct Answer: B
Expert Explanation: Valproic acid is associated with a risk of hepatotoxicity, especially in
young children and those with pre-existing liver disease. An AST of 120 units/L is
significantly elevated, indicating potential liver damage. Patients on this medication must
have regular liver function tests and be monitored for signs of jaundice.
5. Which of the following antidepressants carries the highest risk of hypertensive crisis when
consumed with tyramine-rich foods?
A. Fluoxetine (Prozac)
B. Phenelzine (Nardil)
C. Sertraline (Zoloft)
D. Amitriptyline (Elavil)
Correct Answer: B
Expert Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI). MAOIs block
the breakdown of tyramine in the body, which can lead to a massive release of
norepinephrine if tyramine-rich foods are consumed. This results in a hypertensive crisis
characterized by severe headache, tachycardia, and hypertension.
Pharmacology Q&A with Rationale |
William Paterson University
1. A patient with Parkinson’s disease is prescribed levodopa/carbidopa (Sinemet). What is the
primary rationale for the use of carbidopa?
A. Carbidopa acts as a dopamine agonist in the brain.
B. Carbidopa crosses the blood-brain barrier to increase dopamine levels.
C. Carbidopa inhibits the peripheral decarboxylation of levodopa.
D. Carbidopa reduces the gastrointestinal side effects of levodopa.
Correct Answer: C
Expert Explanation: Carbidopa is a decarboxylase inhibitor that does not cross the blood-
brain barrier. It is given with levodopa to prevent the peripheral conversion of levodopa
into dopamine. This allows more levodopa to reach the CNS and reduces peripheral side
effects such as tachycardia and nausea.
2. Which teaching point is most important for a patient starting phenytoin (Dilantin) for
seizure management?
A. Decrease fluid intake to prevent fluid retention.
B. Stop the medication immediately if a mild rash appears.
C. Maintain strict oral hygiene to prevent gingival hyperplasia.
,D. Take the medication only when a seizure is anticipated.
Correct Answer: C
Expert Explanation: Phenytoin is known to cause gingival hyperplasia in about 20% of
patients. Regular dental checkups and frequent flossing/brushing are essential to minimize
this effect. Patients should also be advised that this drug has a narrow therapeutic range
and requires consistent blood level monitoring.
3. A patient is being treated for a lithium-induced toxicity. Which serum lithium level is most
consistent with severe toxicity?
A. 2.5 mEq/L
B. 1.2 mEq/L
C. 1.5 mEq/L
D. 0.8 mEq/L
Correct Answer: A
Expert Explanation: The therapeutic range for lithium is narrow, typically between 0.6
and 1.2 mEq/L. Levels above 1.5 mEq/L are considered toxic, and levels exceeding 2.5
mEq/L are associated with severe toxicity and potential death. Severe toxicity requires
immediate medical intervention, which may include hemodialysis.
4. A nurse is reviewing the lab results for a patient taking valproic acid. Which lab value is the
most concerning?
A. Serum sodium 138 mEq/L
, B. AST 120 units/L
C. Platelet count 250,000/mm³
D. Glucose 110 mg/dL
Correct Answer: B
Expert Explanation: Valproic acid is associated with a risk of hepatotoxicity, especially in
young children and those with pre-existing liver disease. An AST of 120 units/L is
significantly elevated, indicating potential liver damage. Patients on this medication must
have regular liver function tests and be monitored for signs of jaundice.
5. Which of the following antidepressants carries the highest risk of hypertensive crisis when
consumed with tyramine-rich foods?
A. Fluoxetine (Prozac)
B. Phenelzine (Nardil)
C. Sertraline (Zoloft)
D. Amitriptyline (Elavil)
Correct Answer: B
Expert Explanation: Phenelzine is a Monoamine Oxidase Inhibitor (MAOI). MAOIs block
the breakdown of tyramine in the body, which can lead to a massive release of
norepinephrine if tyramine-rich foods are consumed. This results in a hypertensive crisis
characterized by severe headache, tachycardia, and hypertension.
