PNR 105/PNR105 Exam 4 V2 |
Pharmacology Q&A with Rationale | Fortis
College
1. A patient is prescribed Lithium carbonate for bipolar disorder. Which serum lithium level
would the nurse identify as within the therapeutic range?
A. 0.2 to 0.5 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.5 to 3.0 mEq/L
Correct Answer: B
Expert Explanation: The therapeutic range for lithium is narrow and typically falls
between 0.6 and 1.2 mEq/L for maintenance. Levels above 1.5 mEq/L are considered toxic
and require immediate intervention. Regular blood monitoring is essential to ensure safety
and prevent adverse reactions like tremors or renal failure.
2. A patient taking Phenelzine (Nardil), an MAOI, is being educated about dietary restrictions.
Which food choice indicates a need for further teaching?
A. Fresh grilled chicken
B. Steamed green beans
C. Aged cheddar cheese
,D. Apples
Correct Answer: C
Expert Explanation: Aged cheeses contain high amounts of tyramine, which can cause a
hypertensive crisis in patients taking MAOIs. The nurse must instruct the patient to avoid
fermented, cured, or aged products. Fresh foods like chicken and vegetables are generally
safe for consumption.
3. A patient is started on Fluoxetine (Prozac) for depression. Which assessment finding should
the nurse prioritize as a sign of Serotonin Syndrome?
A. Hallucinations, diaphoresis, and hyperreflexia
B. Dry mouth and constipation
C. Hypotension and bradycardia
D. Weight gain and sedation
Correct Answer: A
Expert Explanation: Serotonin syndrome is a potentially life-threatening condition caused
by excessive serotonin accumulation. Symptoms include mental status changes, autonomic
instability like sweating, and neuromuscular hyperactivity such as tremors or
hyperreflexia. Immediate cessation of the medication and supportive care are required if
these symptoms occur.
, 4. Which lab value is most important for a nurse to monitor in a patient receiving Clozapine
(Clozaril)?
A. Serum potassium
B. Blood urea nitrogen (BUN)
C. White blood cell (WBC) count
D. Hemoglobin A1C
Correct Answer: C
Expert Explanation: Clozapine carries a high risk for agranulocytosis, which is a
dangerous decrease in the white blood cell count. Patients must undergo weekly blood
monitoring during the first six months of treatment. If the WBC count falls below a certain
threshold, the medication must be discontinued immediately to prevent fatal infections.
5. A nurse is preparing to administer Haloperidol (Haldol). The nurse should monitor the
patient for which extrapyramidal symptom (EPS)?
A. Peripheral edema
B. Polyuria
C. Hyperglycemia
D. Dystonia
Correct Answer: D
Pharmacology Q&A with Rationale | Fortis
College
1. A patient is prescribed Lithium carbonate for bipolar disorder. Which serum lithium level
would the nurse identify as within the therapeutic range?
A. 0.2 to 0.5 mEq/L
B. 0.6 to 1.2 mEq/L
C. 1.5 to 2.0 mEq/L
D. 2.5 to 3.0 mEq/L
Correct Answer: B
Expert Explanation: The therapeutic range for lithium is narrow and typically falls
between 0.6 and 1.2 mEq/L for maintenance. Levels above 1.5 mEq/L are considered toxic
and require immediate intervention. Regular blood monitoring is essential to ensure safety
and prevent adverse reactions like tremors or renal failure.
2. A patient taking Phenelzine (Nardil), an MAOI, is being educated about dietary restrictions.
Which food choice indicates a need for further teaching?
A. Fresh grilled chicken
B. Steamed green beans
C. Aged cheddar cheese
,D. Apples
Correct Answer: C
Expert Explanation: Aged cheeses contain high amounts of tyramine, which can cause a
hypertensive crisis in patients taking MAOIs. The nurse must instruct the patient to avoid
fermented, cured, or aged products. Fresh foods like chicken and vegetables are generally
safe for consumption.
3. A patient is started on Fluoxetine (Prozac) for depression. Which assessment finding should
the nurse prioritize as a sign of Serotonin Syndrome?
A. Hallucinations, diaphoresis, and hyperreflexia
B. Dry mouth and constipation
C. Hypotension and bradycardia
D. Weight gain and sedation
Correct Answer: A
Expert Explanation: Serotonin syndrome is a potentially life-threatening condition caused
by excessive serotonin accumulation. Symptoms include mental status changes, autonomic
instability like sweating, and neuromuscular hyperactivity such as tremors or
hyperreflexia. Immediate cessation of the medication and supportive care are required if
these symptoms occur.
, 4. Which lab value is most important for a nurse to monitor in a patient receiving Clozapine
(Clozaril)?
A. Serum potassium
B. Blood urea nitrogen (BUN)
C. White blood cell (WBC) count
D. Hemoglobin A1C
Correct Answer: C
Expert Explanation: Clozapine carries a high risk for agranulocytosis, which is a
dangerous decrease in the white blood cell count. Patients must undergo weekly blood
monitoring during the first six months of treatment. If the WBC count falls below a certain
threshold, the medication must be discontinued immediately to prevent fatal infections.
5. A nurse is preparing to administer Haloperidol (Haldol). The nurse should monitor the
patient for which extrapyramidal symptom (EPS)?
A. Peripheral edema
B. Polyuria
C. Hyperglycemia
D. Dystonia
Correct Answer: D
