NUR2140C
Nursing
Pharmacotherapeutics
EXAM Q & A
2024
1. A 65-year-old man with a history of hypertension, diabetes mellitus,
and chronic kidney disease is prescribed lisinopril, a medication that
belongs to the class of angiotensin-converting enzyme (ACE)
inhibitors. What is the main mechanism of action of ACE inhibitors
in lowering blood pressure?
a) They block the production of angiotensin II, a potent vasoconstrictor.
b) They inhibit the breakdown of bradykinin, a vasodilator.
c) They reduce the secretion of aldosterone, a hormone that causes
sodium and water retention.
d) All of the above.*
Rationale: ACE inhibitors lower blood pressure by blocking the
production of angiotensin II, inhibiting the breakdown of bradykinin,
and reducing the secretion of aldosterone. These effects result in
vasodilation, decreased blood volume, and decreased peripheral
resistance.
2. A 45-year-old woman with a history of asthma is prescribed
albuterol, a medication that belongs to the class of beta-2 adrenergic
agonists. What is the main adverse effect of beta-2 adrenergic
agonists in patients with asthma?
a) Bronchoconstriction
b) Tachycardia*
,c) Hypotension
d) Sedation
Rationale: Beta-2 adrenergic agonists are bronchodilators that relax the
smooth muscles of the airways. However, they also stimulate the
beta-2 receptors in the heart, causing increased heart rate and
palpitations. This can be dangerous for patients with cardiac
disorders or arrhythmias.
3. A 25-year-old man with a history of depression is prescribed
fluoxetine, a medication that belongs to the class of selective
serotonin reuptake inhibitors (SSRIs). What is the main indication of
SSRIs in treating depression?
a) They increase the availability of serotonin, a neurotransmitter that
regulates mood and emotion.
b) They decrease the activity of monoamine oxidase, an enzyme that
breaks down serotonin.
c) They enhance the binding of serotonin to its receptors, increasing its
signaling effect.
d) All of the above.*
Rationale: SSRIs treat depression by increasing the availability of
serotonin in the synaptic cleft, decreasing the activity of monoamine
oxidase, and enhancing the binding of serotonin to its receptors.
These effects result in increased serotonin levels and improved mood
and affect.
4. A 55-year-old woman with a history of osteoporosis is prescribed
alendronate, a medication that belongs to the class of
bisphosphonates. What is the main action of bisphosphonates in
preventing bone loss?
a) They stimulate osteoblasts, the cells that build bone tissue.
b) They inhibit osteoclasts, the cells that resorb bone tissue.*
c) They increase calcium absorption from the gastrointestinal tract.
d) They decrease calcium excretion from the kidneys.
Rationale: Bisphosphonates prevent bone loss by inhibiting osteoclasts,
the cells that resorb bone tissue. This reduces bone turnover and
preserves bone density and strength.
, 5. A 35-year-old man with a history of gout is prescribed allopurinol, a
medication that belongs to the class of xanthine oxidase inhibitors.
What is the main goal of xanthine oxidase inhibitors in managing
gout?
a) They reduce the production of uric acid, a waste product that forms
crystals in the joints.*
b) They increase the solubility of uric acid, facilitating its excretion in
urine.
c) They decrease the inflammation caused by uric acid crystals in the
joints.
d) They relieve the pain associated with gout attacks.
Rationale: Xanthine oxidase inhibitors reduce the production of uric
acid by blocking xanthine oxidase, an enzyme that converts purines
into uric acid. This lowers serum uric acid levels and prevents crystal
formation and deposition in the joints.
B:
Drugs affecting the Cardiovascular and Renal System
1. Know the treatment principles of general prescribing of a diuretic.
Given for edema, HTN, ascites, CHF, kidney failure, and liver failure; used in
stage c of HF; prior to initiating therapy, check BUN, crt, lytes, uric acid, and
glucose level
2. What classification of diuretic is considered to be first line diuretic
therapy? Thiazide diuretics are first-line diuretic therapy (HCTZ,
chlorthalidone, indapamine, metolazone); monitor for hypokalemia; watch in
pts w/ HLD; high dose therapy (>50) has increased risk for hypokalemia.
Increase uric acid levels, and serious CV outcomes, use in combination versus
pushing high doses. Watch with pts w/ HLD.
3. Identify s/s of digoxin toxicity.
Anorexia, n/v, diarrhea (most common); fatigue, disorientation, visual
disturbances: yellow vision, and green halos around lights, depression,
hallucinations; atrial arrhythmias/tachycardia in children; bradycardia, PVCs,
junctional and AV block arrhythmias, PVCs, and bigeminy; avoid using in pts
with normal LV systolic fx; commonly occurs when serum levels greater than
2 ng/mL; monitor K levels
4. Identify common side effects or adverse effects of the following
medications and/or class of drugs.
Nursing
Pharmacotherapeutics
EXAM Q & A
2024
1. A 65-year-old man with a history of hypertension, diabetes mellitus,
and chronic kidney disease is prescribed lisinopril, a medication that
belongs to the class of angiotensin-converting enzyme (ACE)
inhibitors. What is the main mechanism of action of ACE inhibitors
in lowering blood pressure?
a) They block the production of angiotensin II, a potent vasoconstrictor.
b) They inhibit the breakdown of bradykinin, a vasodilator.
c) They reduce the secretion of aldosterone, a hormone that causes
sodium and water retention.
d) All of the above.*
Rationale: ACE inhibitors lower blood pressure by blocking the
production of angiotensin II, inhibiting the breakdown of bradykinin,
and reducing the secretion of aldosterone. These effects result in
vasodilation, decreased blood volume, and decreased peripheral
resistance.
2. A 45-year-old woman with a history of asthma is prescribed
albuterol, a medication that belongs to the class of beta-2 adrenergic
agonists. What is the main adverse effect of beta-2 adrenergic
agonists in patients with asthma?
a) Bronchoconstriction
b) Tachycardia*
,c) Hypotension
d) Sedation
Rationale: Beta-2 adrenergic agonists are bronchodilators that relax the
smooth muscles of the airways. However, they also stimulate the
beta-2 receptors in the heart, causing increased heart rate and
palpitations. This can be dangerous for patients with cardiac
disorders or arrhythmias.
3. A 25-year-old man with a history of depression is prescribed
fluoxetine, a medication that belongs to the class of selective
serotonin reuptake inhibitors (SSRIs). What is the main indication of
SSRIs in treating depression?
a) They increase the availability of serotonin, a neurotransmitter that
regulates mood and emotion.
b) They decrease the activity of monoamine oxidase, an enzyme that
breaks down serotonin.
c) They enhance the binding of serotonin to its receptors, increasing its
signaling effect.
d) All of the above.*
Rationale: SSRIs treat depression by increasing the availability of
serotonin in the synaptic cleft, decreasing the activity of monoamine
oxidase, and enhancing the binding of serotonin to its receptors.
These effects result in increased serotonin levels and improved mood
and affect.
4. A 55-year-old woman with a history of osteoporosis is prescribed
alendronate, a medication that belongs to the class of
bisphosphonates. What is the main action of bisphosphonates in
preventing bone loss?
a) They stimulate osteoblasts, the cells that build bone tissue.
b) They inhibit osteoclasts, the cells that resorb bone tissue.*
c) They increase calcium absorption from the gastrointestinal tract.
d) They decrease calcium excretion from the kidneys.
Rationale: Bisphosphonates prevent bone loss by inhibiting osteoclasts,
the cells that resorb bone tissue. This reduces bone turnover and
preserves bone density and strength.
, 5. A 35-year-old man with a history of gout is prescribed allopurinol, a
medication that belongs to the class of xanthine oxidase inhibitors.
What is the main goal of xanthine oxidase inhibitors in managing
gout?
a) They reduce the production of uric acid, a waste product that forms
crystals in the joints.*
b) They increase the solubility of uric acid, facilitating its excretion in
urine.
c) They decrease the inflammation caused by uric acid crystals in the
joints.
d) They relieve the pain associated with gout attacks.
Rationale: Xanthine oxidase inhibitors reduce the production of uric
acid by blocking xanthine oxidase, an enzyme that converts purines
into uric acid. This lowers serum uric acid levels and prevents crystal
formation and deposition in the joints.
B:
Drugs affecting the Cardiovascular and Renal System
1. Know the treatment principles of general prescribing of a diuretic.
Given for edema, HTN, ascites, CHF, kidney failure, and liver failure; used in
stage c of HF; prior to initiating therapy, check BUN, crt, lytes, uric acid, and
glucose level
2. What classification of diuretic is considered to be first line diuretic
therapy? Thiazide diuretics are first-line diuretic therapy (HCTZ,
chlorthalidone, indapamine, metolazone); monitor for hypokalemia; watch in
pts w/ HLD; high dose therapy (>50) has increased risk for hypokalemia.
Increase uric acid levels, and serious CV outcomes, use in combination versus
pushing high doses. Watch with pts w/ HLD.
3. Identify s/s of digoxin toxicity.
Anorexia, n/v, diarrhea (most common); fatigue, disorientation, visual
disturbances: yellow vision, and green halos around lights, depression,
hallucinations; atrial arrhythmias/tachycardia in children; bradycardia, PVCs,
junctional and AV block arrhythmias, PVCs, and bigeminy; avoid using in pts
with normal LV systolic fx; commonly occurs when serum levels greater than
2 ng/mL; monitor K levels
4. Identify common side effects or adverse effects of the following
medications and/or class of drugs.
