140 MUST KNOW NCLEX MEDS EXAM QUESTIONS
WITH COMPLETE SOLUTIONS UPDATED 2024/2025
Alteplase (t-PA)
class: thrombolytics
Indication: MI, acute ischemic stroke, occluded central lines
Action: converts plasminogen to plasmin which degrades the fibrin found
Nursing Considerations:
- contraindicated in active bleeding
-monitor for anaphylaxis
- use caution with uncontrolled hypertension
Atorvastatin (Lipitor)
class: lipid-lowering agent
Indication: management of high cholesterol (hypercholesterolemia), primary prevention
of cardiovascular disease
Action: lowers total cholesterol as well as LDL while slightly increasing HDL. Inhibits
HMG-CoA reductase which plays a role in the liver in cholesterol formation
Nursing Considerations
- contraindicated in active liver disease
- may cause rhabdomyolysis
- monitor serum cholesterol
- monitor liver function tests, renal function
Acetaminophen (Tylenol)
class: antipyretic, non-opioid analgesic
Indication: pain, fever
Action: inhibit the synthesis of prostaglandins which play a role in transmission of pain
signals and fever response
Nursing Considerations:
,- do not exceed 4g of acetaminophen per day
- overdose will lead to hepatotoxicity
- *Acetadote*is the antidote for overdose
- may increase risk for bleed with warfarin therapy
Acyclovir (Zovirax)
class: antiviral, purine analogues
Indication:genital herpes, herpes zoster, chicken pox
Action: interferes with viral DNA synthesis
Nursing Considerations:
- may cause seizures, renal failure, Stevens-Johnson syndrome, thrombotic
thrombocytopenic purpura syndrome, diarrhea, dizziness, nausea
- monitor renal function
- assess lesions
- instruct patient to use proper protection during sexual intercourse
Albuterol (Proventil)
class: bronchodilator ,adrenergic
Indication:bronchodilator used to prevent airway obstruction in asthma and COPD
Action: binds to Beta2 adrenergic receptors in the airway leading to relaxation of the
smooth muscles in the airways
Nursing Considerations:
- may decrease the effectiveness of Beta Blockers
-use caution with: heart disease, diabetes, glaucoma, seizure disorder
- overuse of inhalers can lead to bronchospasm
- monitor for chest pain and palpitations
- can decrease digoxin levels
Alendronate (Fosamax)
class: bone resorption inhibitor, biphosphnates
Indication: osteoporosis (aging, menopause, corticosteroid induced)
Action: inhibits osteoclast activity leading to inhibition of resorption of bone
Nursing Considerations:
- take first thing in the morning with full glass of water 30 min prior to eating
,- assess serum calcium and vitamin D
- may lead to muscle pain
Alprazolam (Xanax)
class: benzodiazepine, anti-anxiety agent
Indication:anxiety, panic disorder, manage symptoms of PMS, insomnia, mania,
psychosis
Action: works in CNS to produce anxiolytic effect causing CNS depression.
Nursing Considerations:
- may cause CNS depression, drowsiness, lethargy
- may lead to physical dependence
- assess anxiety and mental status
- Flumazenil is the antidote for overdose
- Grapefruit juice may increase blood levels
Amiodarone (Cordarone)
class: Antiarrhythmic class III, Potassium channel blocker
Indication: ventricular arrhythmias, SVT, ACLS protocol for v-fib and vTACH
Action: prolongs action potential, inhibits adrenergic stimulation, slows rate, decreases
peripheral vascular resistance causing vasodilation
Nursing Considerations:
- may lead to ARDS, pulmonary toxicity, CHF, bradycardia, hypotension
- increases risk for QT prolongation
- increases digoxin levels
- increases activity of warfarin
- monitor EKG
- assess for signs and symptoms of ARDS
- monitor liver function test
- check dosage with another RN
- avoid drinking grapefruit juice
Amitryptiline (Elavil)
class: tricyclic antidepressant
Indication: depression, anxiety, insomnia
, Action: increases effect of serotonin and norepinephrine in the CNS, exhibits
anticholinergic effects
Nursing Considerations:
- contraindicated in MI, heart failure, QT prolongation, glaucoma
- may increase risk for suicidal ideation
- may cause arrhythmias, hypotension, EKG changes
- may cause alterations in blood glucose levels
- may lead to general sedation and lethargy
- do not use within 2 weeks of MAOIs
- monitor for orthostatic hypotension
- may lead to photosensitivity, instruct patient to use sunscreen
- may turn urine blue/green color
Amlodipine (Norvasc)
class: Ca channel blocker, antihypertensive
Indication: hypertension, angina
Action: blocks transport of calcium into muscle cells inhibiting excitation and contraction
Nursing Considerations:
- may cause gingival hyperplasia
- grapefruit juice may increase drug level
- monitor blood pressure and pulse
- monitor intake and output
- assess for signs of CHF
- assess characteristics of angina
- instruct patient of interventions for hypertension and how to take BP
Amoxicillin (Moxatag)
class: anti-infectives, antiulcer agent, aminopenicillins
Indication: skin infections, respiratory infections, sinusitis, endocarditis prophylaxis,
lime disease
Action: Inhibits synthesis of bacterial cell wall leading to cell death.
Nursing Considerations:
- Contraindicated with penicillin allergy
WITH COMPLETE SOLUTIONS UPDATED 2024/2025
Alteplase (t-PA)
class: thrombolytics
Indication: MI, acute ischemic stroke, occluded central lines
Action: converts plasminogen to plasmin which degrades the fibrin found
Nursing Considerations:
- contraindicated in active bleeding
-monitor for anaphylaxis
- use caution with uncontrolled hypertension
Atorvastatin (Lipitor)
class: lipid-lowering agent
Indication: management of high cholesterol (hypercholesterolemia), primary prevention
of cardiovascular disease
Action: lowers total cholesterol as well as LDL while slightly increasing HDL. Inhibits
HMG-CoA reductase which plays a role in the liver in cholesterol formation
Nursing Considerations
- contraindicated in active liver disease
- may cause rhabdomyolysis
- monitor serum cholesterol
- monitor liver function tests, renal function
Acetaminophen (Tylenol)
class: antipyretic, non-opioid analgesic
Indication: pain, fever
Action: inhibit the synthesis of prostaglandins which play a role in transmission of pain
signals and fever response
Nursing Considerations:
,- do not exceed 4g of acetaminophen per day
- overdose will lead to hepatotoxicity
- *Acetadote*is the antidote for overdose
- may increase risk for bleed with warfarin therapy
Acyclovir (Zovirax)
class: antiviral, purine analogues
Indication:genital herpes, herpes zoster, chicken pox
Action: interferes with viral DNA synthesis
Nursing Considerations:
- may cause seizures, renal failure, Stevens-Johnson syndrome, thrombotic
thrombocytopenic purpura syndrome, diarrhea, dizziness, nausea
- monitor renal function
- assess lesions
- instruct patient to use proper protection during sexual intercourse
Albuterol (Proventil)
class: bronchodilator ,adrenergic
Indication:bronchodilator used to prevent airway obstruction in asthma and COPD
Action: binds to Beta2 adrenergic receptors in the airway leading to relaxation of the
smooth muscles in the airways
Nursing Considerations:
- may decrease the effectiveness of Beta Blockers
-use caution with: heart disease, diabetes, glaucoma, seizure disorder
- overuse of inhalers can lead to bronchospasm
- monitor for chest pain and palpitations
- can decrease digoxin levels
Alendronate (Fosamax)
class: bone resorption inhibitor, biphosphnates
Indication: osteoporosis (aging, menopause, corticosteroid induced)
Action: inhibits osteoclast activity leading to inhibition of resorption of bone
Nursing Considerations:
- take first thing in the morning with full glass of water 30 min prior to eating
,- assess serum calcium and vitamin D
- may lead to muscle pain
Alprazolam (Xanax)
class: benzodiazepine, anti-anxiety agent
Indication:anxiety, panic disorder, manage symptoms of PMS, insomnia, mania,
psychosis
Action: works in CNS to produce anxiolytic effect causing CNS depression.
Nursing Considerations:
- may cause CNS depression, drowsiness, lethargy
- may lead to physical dependence
- assess anxiety and mental status
- Flumazenil is the antidote for overdose
- Grapefruit juice may increase blood levels
Amiodarone (Cordarone)
class: Antiarrhythmic class III, Potassium channel blocker
Indication: ventricular arrhythmias, SVT, ACLS protocol for v-fib and vTACH
Action: prolongs action potential, inhibits adrenergic stimulation, slows rate, decreases
peripheral vascular resistance causing vasodilation
Nursing Considerations:
- may lead to ARDS, pulmonary toxicity, CHF, bradycardia, hypotension
- increases risk for QT prolongation
- increases digoxin levels
- increases activity of warfarin
- monitor EKG
- assess for signs and symptoms of ARDS
- monitor liver function test
- check dosage with another RN
- avoid drinking grapefruit juice
Amitryptiline (Elavil)
class: tricyclic antidepressant
Indication: depression, anxiety, insomnia
, Action: increases effect of serotonin and norepinephrine in the CNS, exhibits
anticholinergic effects
Nursing Considerations:
- contraindicated in MI, heart failure, QT prolongation, glaucoma
- may increase risk for suicidal ideation
- may cause arrhythmias, hypotension, EKG changes
- may cause alterations in blood glucose levels
- may lead to general sedation and lethargy
- do not use within 2 weeks of MAOIs
- monitor for orthostatic hypotension
- may lead to photosensitivity, instruct patient to use sunscreen
- may turn urine blue/green color
Amlodipine (Norvasc)
class: Ca channel blocker, antihypertensive
Indication: hypertension, angina
Action: blocks transport of calcium into muscle cells inhibiting excitation and contraction
Nursing Considerations:
- may cause gingival hyperplasia
- grapefruit juice may increase drug level
- monitor blood pressure and pulse
- monitor intake and output
- assess for signs of CHF
- assess characteristics of angina
- instruct patient of interventions for hypertension and how to take BP
Amoxicillin (Moxatag)
class: anti-infectives, antiulcer agent, aminopenicillins
Indication: skin infections, respiratory infections, sinusitis, endocarditis prophylaxis,
lime disease
Action: Inhibits synthesis of bacterial cell wall leading to cell death.
Nursing Considerations:
- Contraindicated with penicillin allergy
