MSNCB Pharmacology & Medication Management 3 — Questions and Answers
Question 1: A post-op patient is prescribed ketorolac (Toradol). The nurse should assess which organ system most closely during therapy?
- Liver function
- Renal function (Correct answer)
- Pulmonary function
- Neurological function
Correct answer: Renal function
Ketorolac is an NSAID that can cause renal vasoconstriction and acute kidney injury, particularly in hypovolemic or older patients.
Question 2: Which medication used for type 2 diabetes is associated with the highest risk of hypoglycemia when used as monotherapy?
- Metformin
- Sitagliptin (Januvia)
- Glipizide (Glucotrol) (Correct answer)
- Empagliflozin (Jardiance)
Correct answer: Glipizide (Glucotrol)
Sulfonylureas like glipizide stimulate insulin release independent of blood glucose levels, making hypoglycemia the most common serious adverse effect.
Question 3: A patient prescribed furosemide should be monitored for which electrolyte disturbance?
- Hyperkalemia
- Hypernatremia
- Hypokalemia (Correct answer)
- Hypercalcemia
Correct answer: Hypokalemia
Furosemide is a loop diuretic that causes significant potassium loss in the urine, requiring routine monitoring for hypokalemia.
Question 4: A nurse administers insulin glargine at 0800. When should the nurse assess the patient for peak hypoglycemic effect?
- 0900–1000
- 1200–1400
- 1800–2000
- Glargine has no pronounced peak (Correct answer)
Correct answer: Glargine has no pronounced peak
Insulin glargine (Lantus) is a long-acting insulin with a flat pharmacokinetic profile and no pronounced peak, providing stable 24-hour basal coverage.
Question 5: Which medication requires the nurse to hold it if the patient's heart rate is below 60 bpm?
- Amlodipine
- Metoprolol (Correct answer)
- Lisinopril
- Hydralazine
Correct answer: Metoprolol
Metoprolol is a beta-blocker that decreases heart rate and should be withheld and the provider notified if the apical pulse is below 60 bpm.
Question 6: A patient is prescribed nitroglycerine for angina. Which patient teaching point is most important?
- Take one tablet every 15 minutes until pain resolves
- Sit or lie down before taking nitroglycerin (Correct answer)
- Store tablets in a clear plastic bag for easy access
- Take with food to prevent gastrointestinal upset
Correct answer: Sit or lie down before taking nitroglycerin
Nitroglycerin causes rapid vasodilation and orthostatic hypotension, so sitting or lying down prevents falls and syncope upon administration.
Question 7: A patient taking isoniazid (INH) for tuberculosis prophylaxis should receive which supplement to prevent peripheral neuropathy?
- Vitamin C
- Vitamin B12
- Pyridoxine (Vitamin B6) (Correct answer)
- Folic acid
Correct answer: Pyridoxine (Vitamin B6)
Isoniazid interferes with pyridoxine (vitamin B6) metabolism, causing peripheral neuropathy that is prevented by concurrent B6 supplementation.
MSNCB Pharmacology & Medication Management 3
A post-op patient is prescribed ketorolac (Toradol).
The nurse should assess which organ system most closely during therapy?