Free NMC-CBT Medicines Management and Pharmacology Questions and Answers 1 — Questions and Answers
Question 1: Which of the following is a legal requirement for the administration of a Schedule 2 Controlled Drug on a hospital ward?
- The patient must give verbal consent each time.
- It must be prescribed by a consultant.
- It must be checked and administered by two registered nurses. (Correct answer)
- The patient's family must be informed before administration.
Correct answer: It must be checked and administered by two registered nurses.
Schedule 2 Controlled Drugs, such as morphine, have strict legal requirements for administration. They must be checked by two registered nurses to verify the patient, drug, dose, route, and time, and the administration must be recorded in a controlled drug register. This process minimises the risk of drug errors and misuse.
Question 2: A patient is being treated for anaphylaxis. What is the first-line medication that should be administered immediately?
- Intravenous hydrocortisone
- Nebulised salbutamol
- Oral chlorphenamine
- Intramuscular adrenaline (Correct answer)
Correct answer: Intramuscular adrenaline
Intramuscular adrenaline (epinephrine) is the first-line treatment for anaphylaxis as it acts rapidly to reverse bronchoconstriction and vasodilation, which are life-threatening features of the condition. Other drugs like antihistamines and corticosteroids are second-line treatments and do not act quickly enough to be used first.
Question 3: A patient taking warfarin should be advised to report which of the following symptoms to their doctor immediately?
- Mild headache
- Unexplained bruising or bleeding (Correct answer)
- Occasional nausea
- Increased appetite
Correct answer: Unexplained bruising or bleeding
Warfarin is an anticoagulant that increases the risk of bleeding. Unexplained bruising, prolonged bleeding from cuts, nosebleeds, or blood in the urine or stool are signs of an excessively high INR and potential haemorrhage. Patients must be educated to report these signs immediately for prompt medical review.
Question 4: What is the most critical side effect to monitor for in a patient receiving intravenous morphine?
- Hypertension
- Tachycardia
- Respiratory depression (Correct answer)
- Urinary retention
Correct answer: Respiratory depression
Opioids like morphine are potent central nervous system depressants. The most life-threatening adverse effect is respiratory depression, characterised by a slow, shallow breathing rate. Nurses must closely monitor the patient's respiratory rate, depth, and oxygen saturation.
Question 5: A patient taking a statin, such as atorvastatin, should be advised to avoid which of the following?
- Dairy products
- Grapefruit juice (Correct answer)
- Leafy green vegetables
- High-protein meals
Correct answer: Grapefruit juice
Grapefruit and its juice contain compounds that inhibit the CYP3A4 enzyme in the liver, which is responsible for metabolising many statins. Consuming grapefruit can lead to increased drug levels in the blood, raising the risk of serious side effects like myopathy and rhabdomyolysis. Therefore, patients on certain statins should avoid it completely.
Question 6: According to the 'Rights of Medication Administration', which of the following is a crucial check for a nurse to perform?
- Right manufacturer
- Right time of day (morning vs evening)
- Right expiry date (Correct answer)
- Right pharmacist who dispensed it
Correct answer: Right expiry date
The 'Rights' of medication administration are a fundamental safety checklist to prevent errors. Key rights include the Right Patient, Right Drug, Right Dose, Right Route, and Right Time. Checking the expiry date of the medication (Right Drug/Formulation) is essential to ensure its efficacy and safety.
Free NMC-CBT Medicines Management and Pharmacology Questions and Answers 1
Which of the following is a legal requirement for the administration of a Schedule 2 Controlled Drug on a hospital ward?