Saudi Prometric Nursing Pharmacology and Drug Calculations 4

Question 1

A child weighing 20 kg is prescribed paracetamol (acetaminophen) 15 mg/kg PO q6h. The available suspension is 250 mg/5 mL. What volume should be given per dose?

Accepted Answer

6 mL

Answer

Dose = 15 mg/kg × 20 kg = 300 mg per dose. Volume = (300 mg / 250 mg) × 5 mL = 1.2 × 5 = 6 mL. Pediatric paracetamol dosing is weight-based; exceeding maximum doses causes hepatotoxicity.

Question 2

Which class of drugs is contraindicated in patients with bilateral renal artery stenosis?

Accepted Answer

ACE inhibitors and ARBs

Answer

ACE inhibitors and ARBs reduce glomerular filtration pressure by dilating the efferent arteriole. In bilateral renal artery stenosis, where perfusion pressure is maintained by angiotensin II, this effect causes acute renal failure. These drugs are contraindicated in this condition.

Question 3

The nurse is preparing to give IV morphine for severe pain. Which side effect must the nurse have equipment ready to manage?

Accepted Answer

Respiratory depression — have naloxone (Narcan) at bedside

Answer

The most dangerous side effect of opioids is respiratory depression, which can be fatal. Naloxone (Narcan) is the opioid antagonist used to reverse respiratory depression. Resuscitation equipment should also be available when administering IV opioids.

Question 4

A patient on long-term corticosteroid therapy is at risk for which electrolyte imbalance?

Accepted Answer

Hypokalemia and hypernatremia

Answer

Corticosteroids have mineralocorticoid effects causing sodium and water retention (hypernatremia) and potassium excretion (hypokalemia). They also impair calcium absorption and promote bone resorption. Long-term use requires monitoring of potassium, sodium, blood glucose, and bone density.

Question 5

The nurse is administering IV calcium gluconate. What medication must be available at the bedside as an antidote?

Accepted Answer

Sodium bicarbonate and cardiac monitoring equipment

Answer

Calcium gluconate is used to treat hypocalcemia and to protect the heart in hyperkalemia. However, rapid administration can cause bradycardia and cardiac arrest. ECG monitoring and resuscitation equipment (including sodium bicarbonate to manage arrhythmias) should be available.

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Pharmacology and Drug Calculations 4