COLLEGE OF NURSING

FINAL EXAMINATION
PHARMACOLOGY
st
1 Semester, AY 2019-2020
December 7, 2019

GENERAL DIRECTION:
1. Use the official answer sheet only
2. Shade only one box for each question on your answer sheet
3. Questions or clarification must be directed to your instructor only
4. Erasures or superimposition will invalidate your answer
5. Cheating in any form will automatically fail in the exam

Test I Multiple Choice: Choose the correct letter that corresponds to your answer.

1. The nurse in the clinical research setting is knowledgeable about ethical principles
and protection of human subjects. Which of the following principles is demonstrated
by ensuring the patient’s right to self determination?
A. Beneficence C. Justice
B. Respect for persons D. Informed consent

2. The research nurse is meeting with a patient and determines based on the
assessment, that the patient meets inclusion criteria for clinical research. The patient
agrees to participate in the clinical trial. The nurse advises the patient that which
member of the health care team has the responsibility to explain the study and
respond to questions?
A. Registered nurse C. Research associate
B. Pharmacist D. Health care provider

3. The clinical research nurse knows that only a small proportion of drugs survive the
research and development process. An appreciation of the process and associated
costs grows when the nurse is aware that approximately one in how many potential
drugs is approved by the US Food and Drug Administration?
A. 100 C. 10, 000
B. 1000 D. 100, 000

4. The nurse in interviewing a patient in a Phase I clinical trial. Which patient statement
indicates an understanding of this trial phase?
A. I am doing this to be sure this drug is safe.
B. I am doing this to be sure this drug is effective.
C. I hope this drug is better than the current treatment.
D. I can be part of a demonstrating a cure.

5. The foundation of clinical trials, Good Clinical Practice, is a helpful resource for
nurses. The nurse is correct in choosing Good Clinical Practice as a reference for
standards in which areas? (Select all that apply)
A. Design C. Analyses E. Outcomes evaluation
B. Monitoring and auditing D. Reporting
6. The nurse researcher reviews the proposed informed consent form for a future
clinical trial. The nurse expects to find which, in the document? (Select all that apply)
A. Description of benefits and risks
B. Identification of related drugs, treatments, and techniques
C. Description of outcomes
D. Statement of compensation for participants, if any
E. Description of serious risks

7. The nurse knows that the patient should be informed about the risks and benefits
related to clinical research. What ethical principle does this describe?
A. Respect for persons C. Beneficence
B. Justice D. Informed consent

8. The nurse is reviewing a patient’s list of medications and notes that several have the
highest abuse potential. According to US standards, the highest potential for abuse
of drugs with accepted medical uses is found in drugs included in which schedule?
A. II C. IV
B. III D. V

9. The nurse is reviewing the drug-approval process in the US and learns that the Food
and Drug Administration Modernization Act of 1997 contains which provisions?
(Select all that apply)
A. Review of new drugs is accelerated.
B. Drug companies must provide information on off-label use of drugs.
C. Privacy of individually identifiable health information must be protected.
D. Drug companies must offer advanced notice of plans to discontinue drugs.
E. Drug labels must describe side effects and adverse effects.

10. The patient has questions about counterfeit drugs. Which factors alert the patient or
nurse that a drug is counterfeit or adulterated? (Select all that apply)
A. Variations in packaging D. Different chemical components
B. Unexpected side effects E. Different odor
C. Different taste

11. The nurse knows the importance of administering the right medication to the patient
and that drugs have many names. It is therefore most important that drugs be
ordered by which name?
A. Generic C. Trade
B. Brand D. Chemical

12. What provisions from the Controlled Substances Act of 1970 were designed to
remedy drug abuse?
A. The act established treatment and rehabilitation facilities.
B. The act tightened controls on experimental drugs.
C. The act required clinical trial data on drugs.
D. The act required drug companies to give information on off-label use of drugs..
13. Mrs D, brought her 5 year old child to seek consultation due to cough with on and off
fever. She asked nurse J about the prescription given to her by the doctor. Which of
the following statements of nurse J about the drug name is correct?
A. The generic name is a trade mark name.
B. A drug may have multiple proprietary tag names
C. The official name must be used on all descriptions.
D. Drugs are listed by their chemical names in the US Pharmacopeias.

14. The doctor also prescribed Tempra Syrup 125mg/5 ml 1tsp every 4hrs PRN for
fever for Mrs.D”s child. Tempra is an example of
A. generic name. C. brand name
B. official name. D. chemical name

15. When the client asks “What is a generic name?” Which of the following is the best
response to this question?
A. Name given to the drug by FDA.
B. Trade name of the drug given by its developer.
C. Proprietary name of the drug by a manufacturer.
D. Drugs are listed by their chemical names in the US Pharmacopeias

16. Which components of pharmacokinetics does the nurse need to understand before
administering a drug? (Select all that apply.)
A. Drugs with a smaller volume of drug distribution have a longer half-life.
B. Oral drugs are dissolved through the process of pinocytosis.
C. Patients with kidney disease may have fewer protein-binding sites and are at
risk for drug toxicity.
D. Rapid absorption decreases the bioavailability of the drug.
E. When the drug metabolism rate is decreased, excess drug accumulation can
occur, which can cause toxicity.

17. The nurse will question the health care provider is a drug with a half-life of more than
24 hours is ordered to be given more than how often?
A. Once daily C. Twice weekly
B. Every other day D. Once weekly

18. The nurse is explaining drug action to a nursing student. Which statement made by
the nurse is correct?
A. Water-soluble and ionized drugs are quickly absorbed.
B. A drug not bound to protein is an active drug.
C. Most receptors are found under the cell membrane.
D. Toxic effects can result if the trough level is low.

19. A native American patient is newly diagnosed with type 2 diabetes mellitus and is
prescribed the antidiabetic drug metformin 500 mg per os with morning and evening
meals. Which statement best indicates to the nurse that the patient will adhere to the
therapeutic regimen?
A. “I will no longer put sugar on my cereal because that will help me be
healthier.”
B. “If I take this medicine, I will feel better soon and won’t have to take it
anymore.”
C. “To reduce possibility of the damage to my body, I must take the medicine as
scheduled.”
D. “I have diabetes because of my ancestry,so there’s not much I can do about
it.”
20. The nurse is aware that the rate of absorption can be changed by which actions?
(Select all that apply.)
A. Modifying gastric emptying time D. Forming drug complexes
B. Changing gastric pH E. Eating too slowly
C. Decreasing inflammation

21. Which of the following does not belong to a neurotransmitter?

a. Calcitonin which involved in the calcium production
b. Acetylcholine which is involved in with memory and learning
c. Norepinephrine Which is involved with mania depression and emotions
d. Serotonin which is involved with biological rhythms, sleep, emotion and pain.

22. Which drug hinders movement of the impulses from the thalamus to the brain cortex,
thus creating depression in the CNS?
A. Procaine C. Amphetamines
B. Ibuprofen D. Thiopental Sodium

23. When the drug prevents dissemination of electrical discharges in the motor cortex
area of the brain, it is known as
A. Sedatives C. Anticonvulsants
B. Narcotics D. Muscle relaxant

24. A patient received morphine sulfate for severe pain. The nurse assesses the
patient 20 minutes later. What is the best indication that the medication has been
effective?
A. Patient is resting.
B. Patient verbalizes pain relief.
C. Patient has an increase in heart rate.
D. Patient has an increase in blood pressure.

25. The nurse identifies which of the following as a common side effect/adverse
effect of morphine therapy?
A. Diarrhea C. Urinary retention
B. Hypertension D. Tachypnea

26. All but one is a Non-Steroidal Anti-Inflammatory Drug.

A. Piroxicam C. Prednisone
B. Naproxen D. Indomethacin

27. Non-Steroidal Anti- Inflammatory Drugs should not be given together with
antacids because
A. It may cause GI distress
B. It increases blood pressure
C. it decreases the potency of the drug
D. it increase higher incidence of bleeding

28. The nurse is caring a 70 year old client with sleep disturbance problem. When
treating an elderly person with a sedative, the dose may be
a. Increased C. Unchanged
b. Decreased D. Combined with another drug
29. Which information should be included in the teaching plan for patient taking
hypnotic medication for insomnia?
A. At bedtime, put medication on bedside table with a glass of water in case a
pill is needed
B. Avoid eating high protein foods between supper and bedtime
C. Keep a night-light on for patient safety in case they need to get out bed.
D. Go to bed 30 minutes earlier than usual to allow the hypnotic to work.

30. A client taking a barbiturate should be instructed to

A. Decrease the drug gradually rather than stop it abruptly
B. Decrease dose when drowsiness occurs
C. Drink alcohol only with medication
D. Operate of machinery or drive a car

31. When administering Phenobarbital, a nurse should initially implement which of

the following actions?
A. Emergency resuscitation equipment readily available
B. An indwelling urinary catheter or straight catheter on hand
C. A signed consent form for the drug.
D. Stay at the client’s bedside.

32. Dexamethasone IV is prescribed for a client with cerebral edema. The nurse
prepares the medication for administration and plan to
A. Mix the medication in 1000 ml of 5% dextrose
B. Prepare an undiluted direct injection of the medication
C. Mix the medication in 100 ml of lactated Ringer’s solution
D. Dilute the medication in diluted lactated Ringer’s solution and administer as a
direct injection
33. A patient who is known to be a narcotic abuser is involved in an automobile
accident and has extensive surgery. In planning for analgesia post-surgery, the
nurse should be aware that this patient is likely to
a. tolerate pain than a patient who is not a drug abuser.
b. refuse medication to prove addiction is not a problem
c. tolerate oral medication better than intravenous doses
d. require greater doses of medication before pain is relieved

34. What is the difference between epidural analgesia and IV analgesia?

a. Epidural analgesia has fewer side effects
b. Epidural analgesia has more sedative effect
c. Epidural analgesia has longer effect in the body.
d. Epidural analgesia is more effective in relieving pain

35. Which statement is appropriate for a nurse to make to a client who will undergo
surgery under an inhalation anesthetics?
a. “It’s normal for you to shiver after surgery.”
b. “I’ll monitor the area for a rash after surgery.”
c. “You may not have feeling in the surgical area when you wake up.”
d. “Your sense of touch will decrease and then you’ll lose motor function.”

36. An intubated, mechanically ventilated patient in the intensive care unit is

becoming increasingly restless and anxious. The nurse prepares which of the
following intravenous anesthetic drug?
A. Halothane C. Profopol (Diprivan)
B. Nitrous Oxide D. Isoflurane (Forane)
 37. A client with generalized anxiety disorder is prescribed an anxiolytic, such as
Alprazolam (Xanax), the nurse should instruct the patient to
a. take it before meals.
b. avoid alcoholic beverages.
c. increase potassium intake.
d. discontinue use of drugs like Tylenol.

38. The nurse would question the use of benzodiazepines to which of the following
clients?
a. CVA C. Anxious
b. Pregnant D. Chronic glaucoma

39. Which among these drugs stimulate the inhibitory neurotransmitter GABA?
a. Barbiturates C. Tricyclic Antidepressants
b. Benzodiazepines D. Selective Serotonin Reuptake Inhibitors

40. Nurse M is aware that the narcotic antagonist for respiratory depression is
a. Diphenhydramine HCl. C. Diazepam (Valium).
b. Naloxone HCl (Narcan). D. Ephedrine Sulfate.

41. An adult patient is taking cardiovascular drug that increases the force of myocardial
contraction. Which of the following drugs has a positive inotropic effect?
A. Nitrates C. Anti arrhythmic
B. Diuretics D. Cardiac glycosides

42. Which of the following drugs is an example of cardiac glycoside?

A. Lidocaine C. Digoxin
B. Atropine D. Propranolol

43. A nurse is about to administer cardiac glycoside. Which nursing action is most
appropriate prior to administration of cardiac glycoside?
A. Assess apical pulse C. Evaluate eye movements
B. Check mental status D. Monitor urine specific gravity

44. The doctor prescribed digoxin (lanoxin) once a day to a patient with CHF. The nurse
takes the apical pulse and the result is 51 bpm and the patient complains of nausea.
Which nursing action is important at this point?
a. Withhold the digoxin and notify the physician.
b. Administer the digoxin and notify the physician.
c. Administer the digoxin and medicate for nausea.
d. Withhold digoxin and obtain a serum digoxin level.

45. During digoxin therapy, the nurse should closely monitor the patient’s:
A. Urine glucose and ketones
B. Serum potassium and magnesium levels
C. Serum potassium and creatine kinase levels
D. Urine potassium and creatine kinase levels

46. Which of the following nursing actions would be most important when caring for a
patient who is receiving nifedipine (calcibloc )?
A. Palpating pedal pulses C. Auscultating heart sound
B. Assessing capillary refill D. Monitoring blood pressure
47. Nifedipine is ordered for the client with a ruptured cerebral aneurysm. The nurse
recognizes that the desired effect of this drug is to
A. Prevent the inflammatory process
B. Dissolve the clot that has formed
C. Prevent the influx of calcium into cells
D. Restore the client’s blood pressure to a normal reading

Situation; Mr.Z a 25 year old working student was driving a car when suddenly
ahit by a ten wheeler truck which resulted to head injury. He was rushed to the
hospital and a subdural hematoma was determined after CT scan, the doctor
prescribed Mannitol 75cc every 6hours. Questions 77-79,refer to this situation.
48. The physician ordered Mannitol for which of the following indications?
a. Cataract C. Normal Renal function
b. Heart failure D. Increased intracranial pressure

49. Which of the following results would indicate the therapeutic effect of Mannitol ?
A. Urine output increases
B. Pupils are 8 mm and nonreactive
C. Systolic blood pressure remains at 150 mm Hg.
D. Blood urea nitrogen (BUN) and creatinine levels return to normal.

50. Which of the following nursing interventions should be prioritized prior to

administration of mannitol?
A. Check for presence of hematuria
B. Asses the pupil reaction of the client.
C. Cautiously check the blood pressure of the client.
D. Check the renal and the liver function test of the client.

51. A patient is taking furosemide 40 mg daily for heart failure and hypertension. It is
most important for the nurse to assess the patient for the development of
A. low serum potassium, sodium, and magnesium, and elevated calcium.
B. low serum potassium and sodium, and elevated magnesium and calcium.
C. low serum potassium, sodium, magnesium, and calcium.
D. low serum potassium and sodium, with magnesium and calcium remaining
normal.

52. Which statement will the nurse include when teaching a patient about loop diuretics?
A. Take the medication at bedtime.
B. Take the medication on an empty stomach.
C. Rise slowly from a lying or sitting to standing position to prevent dizziness.
D. Avoid fruit and vegetables in the diet.

53. A patient is receiving furosemide. It is most important for the nurse to monitor the
patient for the development of
A. hyperkalemia. C. hyponatremia.
B. hypokalemia. D. hypernatremia.

54. A health care provider has been exposed to HIV while caring for a patient. Following
the postexposure prophylaxis regimen (PEP), the health care provider will most
likely receive treatment for how long?
A. 1 week C. 3 weeks
B. 2 weeks D. 4 weeks
55. A patient is receiving cyclosporine after transplantation surgery. Which of the
following items should be avoided?
A. Apple juice C. Orange juice
B. Grape juice D. Grapefruit juice

56. Which of the following are principles of immunosuppression?

A. Monotherapy reduces risk of organ rejection.
B. Multiple drug therapy reduces risk of drug toxicity.
C. Drugs which increase T-cell response reduce rejection.
D. Drugs that activate lymphocytes reduce risk of rejection.

57. A patient receiving an organ transplant was given basiliximab 2 h before surgical
transplantation. When will the second dose be given?
A. Immediately after transplantation surgery
B. Two hours after transplantation surgery
C. Four days after transplantation surgery
D. Six weeks after transplantation surgery

58. Newborns receive immunities via the transfer of maternal antibodies across the
placenta. This is known as
A. natural, passive immunity. C. natural, active immunity.
B. acquired, passive immunity. D. acquired, active immunity.

59. Before administering the varicella vaccine, it is most important for the nurse to
assess the patient for a history of allergy to
A. penicillin. C. neomycin.
B. eggs. D. milk.

60. Which statement about herpes zoster vaccine does the nurse identify as being true?
Herpes zoster vaccine
A. is a live attenuated vaccine.
B. should be administered every other year.
C. prevented zoster in 90% of the people who received the vaccine.
D. is indicated for the treatment of patients at age 40 years.

61. Ondansetron has been ordered for the patient undergoing cancer chemotherapy to
control the severe nausea and vomiting. What side effects should the nurse observe
for?
A. Anorexia and hair loss
B. Abdominal cramping and irritability
C. Headache, dizziness, and fatigue
D. Psychosis and middle ear disturbances

62. Bisacodyl has been ordered for a patient who is constipated. The nurse realizes that
bisacodyl
A. should be avoided during pregnancy as it is teratogenic.
B. increases peristalsis to produce a bowel movement.
C. is incompatible with alcohol consumption.
D. may lead to paralytic ileus.
63. A patient is ordered a phenothiazine antiemetic for treatment of nausea and vomiting
associated with chemotherapy. The drug will be most effective if administered
A. the day of treatment.
B. as requested by the patient.
C. 1 hour after chemotherapy administration.
D. the night before treatment, the day of treatment, and for 24 hours after treatment.

64. A toddler ingests a small amount of household cleaning fluid. What is the safest
advice for the nurse to provide the caregiver?
A. Give the child fluids and proceed to the emergency department.
B. Call the poison control center and follow directions.
C. Administer syrup of ipecac and monitor for vomiting.
D. Have the toddler eat bread to absorb the substance

65. A patient is ordered bisacodyl. Before administering the drug, it is most important for
the nurse to assess the patient for what?
A. Hypertension C. Allergy to penicillin
B. Anemia D. Appendicitis

66. Lactulose is ordered for a patient with liver disease. What would indicate the
medication is exerting a positive therapeutic effect on the patient?
A. Decreased ascites C. Decreased jaundice
B. Decreased ammonia level D. Decreased blood pressure

67. Which medications are most likely to be included in a dual drug therapy program for
peptic ulcer disease from H. pylori?
A. Omeprazole and clarithromycin C. Ciprofloxacin and sucralfate
B. Tetracycline and metronidazole D. Ranitidine and amoxicillin

68. A patient with peptic ulcer disease is noted to have a positive breath test for H.
pylori. The nurse would anticipate treating the patient with
A. antacids and narcotics. C. proton pump inhibitors and antibiotics.
B. pepsin inhibitors and antiemetics. D. emetic agents and tranquilizers

69. An older adult patient reports taking aluminum hydroxide on a daily basis to relieve
symptoms of gastroesophageal reflux disease. The nurse needs to evaluate for
which condition?
A. Constipation C. Flatulence
B. Diarrhea D. Abdominal pain

70. When administering the histamine2 blocker ranitidine, the nurse will
A. monitor laboratory results because ranitidine decreases the effect of oral
anticoagulants.
B. separate ranitidine and antacid dosage by at least 1 hour if possible.
C. teach the patient to avoid foods rich in vitamin B12.
D. expect a reduction in the patient’s pain to occur after 5 days of therapy.

71. A patient with a gastric ulcer is ordered sucralfate. This medication works to
A. calm the patient to reduce acid production.
B. neutralize the gastric acids.
C. block the H2 receptors.
D. coat the gastric lining.
72. The patient is ordered cimetidine. It is most important for the nurse to teach the
patient about what dietary needs?
A. Avoid use of salt substitutes. C. Eat a high-protein diet.
B. Eat foods rich in vitamin B12. D. Avoid citrus foods.

73. The nurse is teaching a patient with glaucoma. Which herbal product should the
nurse include as not recommended for patients with glaucoma?
A. Garlic C. Goldenseal
B. St. John’s wort D. Valerian

74. The nurse is showing the parent of a 2-year-old child how to administer eardrops.
Which are correct statements? (Select all that apply.)
A. Pull down on auricle.
B. Pull up on the auricle.
C. Position child’s head with affected ear up.
D. Position child’s head with affected ear down.
E. Warm the eardrop in the microwave prior to administration.

75. Pilocarpine has which action on the eye?

A. Miosis C. Ciliary muscle paralysis
B. Mydriasis D. Pupillary dilation

76. A child is treated four times during the summer for external ear infections or
“swimmer’s ear.” The nurse teaches the family to prevent these infections by.
A. taking high-dose vitamin C.
B. using custom-fitted ear plugs.
C. refraining from any submersion in water.
D. continuing antibiotic therapy through the summer season.

77. Finasteride is used to treat male pattern baldness. The nurse knows that in higher
doses, the drug is used to treat which condition?
A. Benign prostatic hypertrophy C. Migraine headache
B. Gastroesophageal reflux D. Impotence

78. A patient is ordered to receive isotretinoin for acne vulgaris. What is considered
priority information in teaching this patient?
A. Good skin hygiene
B. Optimal nutritional practices
C. Methods to avoid infection
D. Contraception or abstinence from sexual intercourse

79. A patient has adrenocortical insufficiency and was taking hydrocortisone 240 mg
every 12 h IV. Before discharge the drug was switched to prednisone. Which is
appropriate teaching for discharging a patient with oral prednisone?
A. Hyperkalemia is common.
B. Stop the drug when feeling better.
C. Prednisone is always given by injection.
D. The dose needs to be tapered off over 1 to 2 weeks.
80. Morphine Sulfate
A.NSAID C. Narcotic analgesic
B. Inotropic D. Anti ulcer

81. Levothyroxine
A. Thyroid Hormone C. Vitamin D analogue
B. Antithyroid D. Antidiuretic Hormone (ADH)

82. Vasopressin
A. Thyroid Replacement C. Vitamin D analogue
B. Antithyroid D. Antidiuretic Hormone (ADH)

83. Calcitriol
A. Thyroid Replacement C. Vitamin D analogue
B. Antithyroid D. Antidiuretic Hormone (ADH)

84. -Propylthiouracil (PTU)

A. Thyroid Hormone C. Vitamin D analogue
B. Antithyroid D. Antidiuretic Hormone (ADH)

85. Metformin
A. 1st generation Sulfonylureas C. Biguanides
B. 2nd generation Sulfonylurea. D,.Alpha Glucosidase Inhibitors

86. Nitrofurantoin
A. Urinary Antiseptic C. Urinary Stimulant
B. Urinary Analgesic D. Urinary Antispasmodic

87.Terbutaline Sulfate
A. Tocolytic C. Corticosteroid
B. Iron product D. Anti depressant

88.Methylergonovine Maleate
A. Tocolytic C. Ergot Alkaloid
B. Oxytoxic D. Cervical Ripening

89; Tsaang gubat is indicated for

A. diarrhea. C. renal stone.
B. hypertension.. D. diabetes mellitus.

90. Garlic
A. diarrhea. C. renal stone.
B. hypertension.. D. diabetes mellitus
90 – 100 Identify the onset, peak, duration and the color of the different types of
Insulin

Types of Insulin Onset Peak Duration / Color

1. Short Acting
Regular
Humulin R (Novolin)
2. Intermediate Acting
NPH
Humulin N
3. Rapid Acting
Insulin Lispro
(Humulog)

4. Long Acting
Insulin Glargine(Lantus)

Prepared by: Reviewed and Validated by:

Ma. Analita L. Bergado, RN,MN Dr. Bella P. Magnaye, RN

Department Coordinator
Pedrosa A. Bautista, RN,MAN
Faculty

Approved by:

Dr. Cecilia C. Pring, RN

Dean