WGU D398 INTRODUCTION TO PHARMACOLOGY |
OBJECTIVE ASSESSMENT OA V1, V2 & V3 ACTUAL
EXAM
A patient presents to an emergency room complaining of palpitations and irregular heartbeat. The
advanced practice registered nurse (APRN) places the patient on a cardiac monitor and observes atrial
fibrillation. The APRN orders dofetilide.
How should the APRN recommend this medication be taken? - CORRECT ANSWERYES With food or an
empty stomach
A 70-year-old male calls a clinic complaining of chest pain that started after having sexual activity. He
took sildenafil 50 mg about eight hours ago. He has nitroglycerin 0.3 mg on hand.
How should the advanced practice registered nurse respond? - CORRECT ANSWERDo not take the
nitroglycerin and call 911
Taking the medications together can cause a serious drop in blood pressure leading to cardiovascular
collapse.
A patient diagnosed with bipolar disorder who is in a mental health clinic is discussing the possibility of
beginning lithium with an advanced practice registered nurse (APRN). The patient expresses
understanding and wishes to proceed with treatment. The APRN explains to the patient that this
medication requires specific lab monitoring and wants to draw baseline labs. The patient asks why the
test is needed.
Which explanation should the APRN provide to this patient? - CORRECT ANSWERA baseline blood urea
nitrogen (BUN) and creatinine (CREA) level needs to be drawn to assess kidney function prior to
treatment.
This drug can cause decreased renal function, and a baseline should be drawn for future comparison.
,An advanced practice registered nurse (APRN) is reviewing the medications that will be commonly
experienced with a new nurse to determine whether the drugs are safe for the patients. The new nurse
is given a scenario where a patient is being prescribed sildenafil 25 mg po prn, a prototype drug for
erectile dysfunction.
Which patient may take this drug safely? - CORRECT ANSWERYES A 54-year-male with a medical history
of hypertension, mild eczema, and previous history of a urolithiasis where all is well controlled and there
are no current complications
A 30-year-old patient presents to a primary care clinic with a history of anxiety. The advanced practice
registered nurse reviews the mechanism of action by which many neuropharmacological agents act and
decides to prescribe citalopram.
What is the mechanism of action of this medication? - CORRECT ANSWERYES Influences receptor activity
on target cells
Correct! This medication influences the activity in the receptors, and it targets cells.
A patient is admitted with a diagnosis of Huntington disease. On admission, the patient exhibits
uncontrolled twitching, difficulty walking, trouble swallowing, confusion, and memory loss. The
advanced practice registered nurse (APRN) prescribes baclofen.
What is the mechanism of action of this medication? - CORRECT ANSWERNO Modulates the effects of
glutamate at NMDA receptors
YES Inhibits neurotransmitter GABA
NO Halts the breakdown of acetylcholine by acetylcholinesterase
Alters the synthesis and release of norepinephrine, serotonin, and dopamine
Incorrect. Cholinesterase inhibitors prevent the breakdown of acetylcholine by acetylcholinesterase.
They are used in patients with Alzheimer's.
Correct! Huntington's disease involves a deficiency of the neurotransmitters acetylcholine and y-
aminobutyric acid in the basal ganglia and extrapyramidal system.
A 21-year-old patient accompanied by a parent comes to a clinic for an emergency visit with an
advanced practice registered nurse (APRN) following a seizure. Upon interviewing the patient and the
parent, the APRN determines that the seizure is classified by marked impairment of consciousness and is
followed by a period of central nervous system (CNS) depression.
Which type of seizure is this patient experiencing? - CORRECT ANSWERAtonic
,NO Myoclonic
YES Tonic-clonic
Absence
Incorrect. Myoclonic seizures consist of a sudden muscle contraction that lasts for just one second.
Correct! A tonic-clonic seizure is a type of seizure that is also called a convulsion. This type of seizure can
include muscle stiffness, loss of consciousness, and body jerking.
A patient has been taking oral oxycodone every six hours for back pain during the past three years. The
patient suddenly decides to stop taking the pain medication and is trying an alternative therapy without
a clinician's approval.
Which risk is of clinical concern? - CORRECT ANSWERYES Physical dependence
Correct! The patient suddenly stopping the medication will cause physical symptoms that can range
from nausea to seizures.
An advanced practice registered nurse has diagnosed a 44-year-old male with depression. A plan is
developed to start treatment with medication. The patient has a history of sexual dysfunction and is
concerned about taking medication that may worsen this condition.
Which antidepressant has the benefit of enhancing libido? - CORRECT ANSWERYES Bupropion
Correct! Bupropion does not cause sexual dysfunction. This will help the patient with a history of sexual
dysfunction. This will enhance the patient's libido, which will help with both depression and sexual
dysfunction.
A patient is wheezing and short of breath. The nurse assesses a heart rate of 88 beats per minute, a
respiratory rate of 24 breaths per minute, and a blood pressure of 124/78 mm Hg. The prescriber orders
a nonspecific beta-agonist medication.
Besides evaluating the patient for a reduction in respiratory distress, the nurse should monitor for which
side effect? - CORRECT ANSWERYES Tachycardia
Correct! Beta-agonists are used for asthma because of their beta2 effects on bronchial smooth muscle,
causing dilation. Beta1 effects cause tachycardia and hypertension. Beta receptors do not exert effects
on the bladder.
, A patient is experiencing toxic side effects from atropine, including delirium and hallucinations. Which
medication should the provider administer? - CORRECT ANSWERYES Physostigmine
Correct! Physostigmine is the drug of choice for treating poisoning from atropine and other drugs that
cause muscarinic blockade. Donepezil is used to treat Alzheimer disease. Edrophonium is used to
distinguish between a myasthenic crisis and a cholinesterase inhibitor overdose. Neostigmine does not
cross the blood-brain barrier and would not effectively treat this patient's central nervous system (CNS)
symptoms.
A patient brought to the emergency department requires sutures. The prescriber orders a local
anesthetic with epinephrine.
The epinephrine is ordered to ___________. - CORRECT ANSWERallow a reduced dose of the anesthetic
Correct! Epinephrine prolongs absorption of the anesthetic because it is an alpha1 agonist. It is
frequently combined with a local anesthetic for this purpose so the amount of anesthetic required may
be reduced. Local anesthetics do not induce hypertension; therefore, epinephrine would not be needed
to prevent it. Epinephrine does not act as an antiemetic and would not reduce anesthetic-induced
nausea. Epinephrine is not used to reduce the pain of an injection.
A patient has been diagnosed with Parkinson disease (PD) and begins treatment with carbidopa. After
several months of therapy, the patient reports no change in symptoms.
As the provider, you should do which of the following? - CORRECT ANSWERIncrease the dose of
carbidopa
Discuss the "on-off" phenomenon
Reevaluate the diagnosis
NO Add a dopamine agonist
Incorrect. Adding a dopamine agonist is not indicated.
A patient who is taking oral contraceptives begins taking valproic acid for seizures. After a week of
therapy with valproic acid, the patient tells the nurse that she is experiencing nausea.
What should the nurse do? - CORRECT ANSWERYES Ask the patient if she is taking the valproic acid with
food because taking the drug on an empty stomach can cause gastrointestinal side effects
OBJECTIVE ASSESSMENT OA V1, V2 & V3 ACTUAL
EXAM
A patient presents to an emergency room complaining of palpitations and irregular heartbeat. The
advanced practice registered nurse (APRN) places the patient on a cardiac monitor and observes atrial
fibrillation. The APRN orders dofetilide.
How should the APRN recommend this medication be taken? - CORRECT ANSWERYES With food or an
empty stomach
A 70-year-old male calls a clinic complaining of chest pain that started after having sexual activity. He
took sildenafil 50 mg about eight hours ago. He has nitroglycerin 0.3 mg on hand.
How should the advanced practice registered nurse respond? - CORRECT ANSWERDo not take the
nitroglycerin and call 911
Taking the medications together can cause a serious drop in blood pressure leading to cardiovascular
collapse.
A patient diagnosed with bipolar disorder who is in a mental health clinic is discussing the possibility of
beginning lithium with an advanced practice registered nurse (APRN). The patient expresses
understanding and wishes to proceed with treatment. The APRN explains to the patient that this
medication requires specific lab monitoring and wants to draw baseline labs. The patient asks why the
test is needed.
Which explanation should the APRN provide to this patient? - CORRECT ANSWERA baseline blood urea
nitrogen (BUN) and creatinine (CREA) level needs to be drawn to assess kidney function prior to
treatment.
This drug can cause decreased renal function, and a baseline should be drawn for future comparison.
,An advanced practice registered nurse (APRN) is reviewing the medications that will be commonly
experienced with a new nurse to determine whether the drugs are safe for the patients. The new nurse
is given a scenario where a patient is being prescribed sildenafil 25 mg po prn, a prototype drug for
erectile dysfunction.
Which patient may take this drug safely? - CORRECT ANSWERYES A 54-year-male with a medical history
of hypertension, mild eczema, and previous history of a urolithiasis where all is well controlled and there
are no current complications
A 30-year-old patient presents to a primary care clinic with a history of anxiety. The advanced practice
registered nurse reviews the mechanism of action by which many neuropharmacological agents act and
decides to prescribe citalopram.
What is the mechanism of action of this medication? - CORRECT ANSWERYES Influences receptor activity
on target cells
Correct! This medication influences the activity in the receptors, and it targets cells.
A patient is admitted with a diagnosis of Huntington disease. On admission, the patient exhibits
uncontrolled twitching, difficulty walking, trouble swallowing, confusion, and memory loss. The
advanced practice registered nurse (APRN) prescribes baclofen.
What is the mechanism of action of this medication? - CORRECT ANSWERNO Modulates the effects of
glutamate at NMDA receptors
YES Inhibits neurotransmitter GABA
NO Halts the breakdown of acetylcholine by acetylcholinesterase
Alters the synthesis and release of norepinephrine, serotonin, and dopamine
Incorrect. Cholinesterase inhibitors prevent the breakdown of acetylcholine by acetylcholinesterase.
They are used in patients with Alzheimer's.
Correct! Huntington's disease involves a deficiency of the neurotransmitters acetylcholine and y-
aminobutyric acid in the basal ganglia and extrapyramidal system.
A 21-year-old patient accompanied by a parent comes to a clinic for an emergency visit with an
advanced practice registered nurse (APRN) following a seizure. Upon interviewing the patient and the
parent, the APRN determines that the seizure is classified by marked impairment of consciousness and is
followed by a period of central nervous system (CNS) depression.
Which type of seizure is this patient experiencing? - CORRECT ANSWERAtonic
,NO Myoclonic
YES Tonic-clonic
Absence
Incorrect. Myoclonic seizures consist of a sudden muscle contraction that lasts for just one second.
Correct! A tonic-clonic seizure is a type of seizure that is also called a convulsion. This type of seizure can
include muscle stiffness, loss of consciousness, and body jerking.
A patient has been taking oral oxycodone every six hours for back pain during the past three years. The
patient suddenly decides to stop taking the pain medication and is trying an alternative therapy without
a clinician's approval.
Which risk is of clinical concern? - CORRECT ANSWERYES Physical dependence
Correct! The patient suddenly stopping the medication will cause physical symptoms that can range
from nausea to seizures.
An advanced practice registered nurse has diagnosed a 44-year-old male with depression. A plan is
developed to start treatment with medication. The patient has a history of sexual dysfunction and is
concerned about taking medication that may worsen this condition.
Which antidepressant has the benefit of enhancing libido? - CORRECT ANSWERYES Bupropion
Correct! Bupropion does not cause sexual dysfunction. This will help the patient with a history of sexual
dysfunction. This will enhance the patient's libido, which will help with both depression and sexual
dysfunction.
A patient is wheezing and short of breath. The nurse assesses a heart rate of 88 beats per minute, a
respiratory rate of 24 breaths per minute, and a blood pressure of 124/78 mm Hg. The prescriber orders
a nonspecific beta-agonist medication.
Besides evaluating the patient for a reduction in respiratory distress, the nurse should monitor for which
side effect? - CORRECT ANSWERYES Tachycardia
Correct! Beta-agonists are used for asthma because of their beta2 effects on bronchial smooth muscle,
causing dilation. Beta1 effects cause tachycardia and hypertension. Beta receptors do not exert effects
on the bladder.
, A patient is experiencing toxic side effects from atropine, including delirium and hallucinations. Which
medication should the provider administer? - CORRECT ANSWERYES Physostigmine
Correct! Physostigmine is the drug of choice for treating poisoning from atropine and other drugs that
cause muscarinic blockade. Donepezil is used to treat Alzheimer disease. Edrophonium is used to
distinguish between a myasthenic crisis and a cholinesterase inhibitor overdose. Neostigmine does not
cross the blood-brain barrier and would not effectively treat this patient's central nervous system (CNS)
symptoms.
A patient brought to the emergency department requires sutures. The prescriber orders a local
anesthetic with epinephrine.
The epinephrine is ordered to ___________. - CORRECT ANSWERallow a reduced dose of the anesthetic
Correct! Epinephrine prolongs absorption of the anesthetic because it is an alpha1 agonist. It is
frequently combined with a local anesthetic for this purpose so the amount of anesthetic required may
be reduced. Local anesthetics do not induce hypertension; therefore, epinephrine would not be needed
to prevent it. Epinephrine does not act as an antiemetic and would not reduce anesthetic-induced
nausea. Epinephrine is not used to reduce the pain of an injection.
A patient has been diagnosed with Parkinson disease (PD) and begins treatment with carbidopa. After
several months of therapy, the patient reports no change in symptoms.
As the provider, you should do which of the following? - CORRECT ANSWERIncrease the dose of
carbidopa
Discuss the "on-off" phenomenon
Reevaluate the diagnosis
NO Add a dopamine agonist
Incorrect. Adding a dopamine agonist is not indicated.
A patient who is taking oral contraceptives begins taking valproic acid for seizures. After a week of
therapy with valproic acid, the patient tells the nurse that she is experiencing nausea.
What should the nurse do? - CORRECT ANSWERYES Ask the patient if she is taking the valproic acid with
food because taking the drug on an empty stomach can cause gastrointestinal side effects
