Saudi Prometric Nursing Pharmacology 4 — Questions and Answers
Question 1: A patient receiving aminoglycoside therapy should be monitored most closely for which adverse effects?
- Hepatotoxicity and rash
- Nephrotoxicity and ototoxicity (Correct answer)
- Thrombocytopenia and fever
- Peripheral neuropathy and hypotension
Correct answer: Nephrotoxicity and ototoxicity
Aminoglycosides accumulate in renal tubular cells and cochlear hair cells, causing nephrotoxicity and ototoxicity as primary adverse effects.
Question 2: Which antidote is administered for acetaminophen (paracetamol) overdose?
- Naloxone
- Flumazenil
- N-acetylcysteine (Correct answer)
- Atropine
Correct answer: N-acetylcysteine
N-acetylcysteine replenishes glutathione stores, preventing toxic accumulation of NAPQI that causes hepatic necrosis.
Question 3: A nurse is teaching a patient about metformin. Which condition is an absolute contraindication?
- Mild hypertension
- Euthyroid goiter
- Renal impairment (eGFR < 30 mL/min) (Correct answer)
- Obesity
Correct answer: Renal impairment (eGFR < 30 mL/min)
Severe renal impairment causes metformin accumulation, dramatically increasing risk of life-threatening lactic acidosis.
Question 4: Which beta-blocker property makes carvedilol different from metoprolol?
- Carvedilol is cardioselective
- Carvedilol also blocks alpha-1 receptors (Correct answer)
- Carvedilol crosses the blood-brain barrier
- Carvedilol has intrinsic sympathomimetic activity
Correct answer: Carvedilol also blocks alpha-1 receptors
Carvedilol is a non-selective beta-blocker with additional alpha-1 blocking activity, providing vasodilation along with beta blockade.
Question 5: A patient is started on isoniazid (INH) for tuberculosis. Which vitamin supplement should be co-administered to prevent peripheral neuropathy?
- Vitamin C
- Vitamin B12
- Pyridoxine (Vitamin B6) (Correct answer)
- Folic acid
Correct answer: Pyridoxine (Vitamin B6)
INH interferes with pyridoxine metabolism; B6 supplementation prevents the peripheral neuropathy caused by this drug-induced deficiency.
Question 6: Which of the following medications requires a peak and trough level to be drawn to monitor therapeutic efficacy and toxicity?
- Amoxicillin
- Gentamicin (Correct answer)
- Azithromycin
- Doxycycline
Correct answer: Gentamicin
Gentamicin (an aminoglycoside) has a narrow therapeutic index; peak levels assess efficacy and trough levels prevent nephrotoxicity and ototoxicity.
Question 7: A patient on digoxin reports seeing yellow-green halos around lights. The nurse's priority action is to:
- Administer the next scheduled dose as planned
- Check serum potassium and digoxin levels immediately (Correct answer)
- Reassure the patient this is a normal side effect
- Increase oral fluid intake
Correct answer: Check serum potassium and digoxin levels immediately
Visual disturbances (yellow-green halos) are a classic sign of digoxin toxicity; serum digoxin and electrolyte levels must be checked immediately.
Saudi Prometric Nursing Pharmacology 4
A patient receiving aminoglycoside therapy should be monitored most closely for which adverse effects?