Saudi Prometric Nursing Pharmacology 3 — Questions and Answers
Question 1: A patient is prescribed warfarin. Which food should the nurse instruct the patient to keep at a consistent intake level?
- Grapefruit juice
- Vitamin K-rich leafy greens (Correct answer)
- Dairy products
- High-fiber cereals
Correct answer: Vitamin K-rich leafy greens
Vitamin K directly antagonizes warfarin's anticoagulant effect, so consistent (not zero) intake prevents INR fluctuations.
Question 2: Which adverse effect is most associated with long-term use of corticosteroids?
- Hypoglycemia
- Osteoporosis (Correct answer)
- Bradycardia
- Hypotension
Correct answer: Osteoporosis
Long-term corticosteroid use inhibits bone formation and increases bone resorption, leading to osteoporosis.
Question 3: A nurse administers IV vancomycin too rapidly and the patient develops flushing, erythema, and hypotension. This reaction is called:
- Anaphylaxis
- Stevens-Johnson syndrome
- Red man syndrome (Correct answer)
- Serum sickness
Correct answer: Red man syndrome
Red man syndrome is caused by rapid vancomycin infusion triggering histamine release, producing flushing, erythema, and hypotension.
Question 4: Which opioid analgesic is considered safest in patients with renal failure?
- Morphine
- Codeine
- Meperidine
- Fentanyl (Correct answer)
Correct answer: Fentanyl
Fentanyl is preferred in renal failure because its metabolites are not renally excreted and do not accumulate.
Question 5: A patient taking a monoamine oxidase inhibitor (MAOI) reports eating aged cheese. The nurse should monitor for:
- Hypoglycemia
- Hypertensive crisis (Correct answer)
- Respiratory depression
- Prolonged QT interval
Correct answer: Hypertensive crisis
Tyramine in aged cheese cannot be metabolized when MAO is inhibited, causing a dangerous surge in catecholamines and hypertensive crisis.
Question 6: Which class of diuretics can cause hyperuricemia and is therefore used cautiously in patients with gout?
- Loop diuretics (Correct answer)
- Potassium-sparing diuretics
- Carbonic anhydrase inhibitors
- Osmotic diuretics
Correct answer: Loop diuretics
Loop diuretics (e.g., furosemide) compete with uric acid for renal tubular secretion, reducing uric acid excretion and raising serum uric acid.
Question 7: The nurse is preparing to administer heparin subcutaneously. Which technique is correct?
- Aspirate before injection to check for blood return
- Inject into the abdomen at least 5 cm from the umbilicus (Correct answer)
- Massage the site vigorously after injection
- Use the deltoid muscle as preferred site
Correct answer: Inject into the abdomen at least 5 cm from the umbilicus
Heparin SC is best injected in the abdomen ≥5 cm from the umbilicus; aspiration and massage increase bruising and bleeding risk.
Saudi Prometric Nursing Pharmacology 3
A patient is prescribed warfarin.
Which food should the nurse instruct the patient to keep at a consistent intake level?