NMC CBT NMC-CBT Medicines Management and Pharmacology 2 — Questions and Answers
Question 1: A patient is prescribed warfarin and starts taking ibuprofen for joint pain. What is the primary concern with this drug interaction?
- Reduced warfarin absorption
- Increased bleeding risk due to enhanced anticoagulant effect (Correct answer)
- Decreased anti-inflammatory effect of ibuprofen
- Warfarin toxicity causing hepatotoxicity
Correct answer: Increased bleeding risk due to enhanced anticoagulant effect
NSAIDs like ibuprofen inhibit platelet function and can displace warfarin from protein binding sites, significantly increasing bleeding risk.
Question 2: When calculating a drug dose for a child weighing 18 kg who requires 5 mg/kg of amoxicillin, what is the correct dose?
- 72 mg
- 90 mg (Correct answer)
- 108 mg
- 180 mg
Correct answer: 90 mg
5 mg/kg × 18 kg = 90 mg is the correct calculated dose.
Question 3: A nurse discovers a medication error where a patient received double the prescribed dose of metformin. What is the FIRST priority action?
- Complete the incident report
- Notify the pharmacy department
- Assess the patient's current condition (Correct answer)
- Inform the ward manager
Correct answer: Assess the patient's current condition
Patient safety is always the first priority; assessing for signs of lactic acidosis or hypoglycemia must occur before documentation or reporting.
Question 4: Which route of administration provides the fastest onset of drug action in an emergency?
- Sublingual
- Intramuscular
- Intravenous (Correct answer)
- Subcutaneous
Correct answer: Intravenous
Intravenous administration delivers the drug directly into the bloodstream, providing the fastest onset of action.
Question 5: A patient on morphine reports severe constipation. Which medication is most appropriate to manage opioid-induced constipation?
- Lactulose only
- Senna with docusate (Correct answer)
- Bulk-forming laxatives like ispaghula
- Glycerin suppositories only
Correct answer: Senna with docusate
A stimulant laxative (senna) combined with a softener (docusate) is the standard first-line treatment for opioid-induced constipation.
Question 6: Which of the following is an example of a Schedule 2 Controlled Drug under UK legislation?
- Codeine linctus
- Temazepam
- Morphine (Correct answer)
- Tramadol
Correct answer: Morphine
Morphine is a Schedule 2 Controlled Drug requiring a special register, full prescribing requirements, and witnessed destruction.
Question 7: A patient has a penicillin allergy documented. The prescriber orders co-amoxiclav. What should the nurse do?
- Administer the drug as prescribed by a doctor
- Withhold the drug and contact the prescriber immediately (Correct answer)
- Substitute with a cephalosporin instead
- Ask the patient if their allergy is mild or severe
Correct answer: Withhold the drug and contact the prescriber immediately
Co-amoxiclav contains amoxicillin (a penicillin), so administering it to a penicillin-allergic patient is unsafe; the nurse must withhold it and contact the prescriber.
NMC CBT NMC-CBT Medicines Management and Pharmacology 2
A patient is prescribed warfarin and starts taking ibuprofen for joint pain.
What is the primary concern with this drug interaction?