Saudi Prometric Nursing Pharmacology 5 — Questions and Answers
Question 1: Which mechanism explains why proton pump inhibitors (PPIs) are more effective than H2 blockers in treating GERD?
- PPIs neutralize gastric acid directly
- PPIs irreversibly block the final step of acid secretion (Correct answer)
- PPIs increase gastric motility
- PPIs stimulate mucus production
Correct answer: PPIs irreversibly block the final step of acid secretion
PPIs irreversibly inhibit the H+/K+-ATPase pump (the final common pathway), suppressing acid from all stimuli more completely than H2 blockers.
Question 2: A nurse is preparing to give IV potassium chloride. Which action is most important?
- Administer as an IV bolus for rapid effect
- Dilute and infuse at no more than 10–20 mEq/hour (Correct answer)
- Mix the KCl in a lipid emulsion
- Give undiluted via peripheral IV push
Correct answer: Dilute and infuse at no more than 10–20 mEq/hour
Rapid IV potassium administration causes fatal cardiac arrhythmias; it must always be diluted and infused slowly (≤10–20 mEq/hr peripherally).
Question 3: Which drug used in the treatment of opioid use disorder acts as a partial agonist at mu-opioid receptors?
- Naltrexone
- Methadone
- Buprenorphine (Correct answer)
- Naloxone
Correct answer: Buprenorphine
Buprenorphine is a partial mu-opioid agonist with a ceiling effect, reducing cravings and withdrawal while limiting overdose risk.
Question 4: A patient on lithium therapy has a serum lithium level of 2.5 mEq/L. The nurse anticipates which clinical finding?
- Mild polyuria and fine hand tremor
- Coarse tremor, confusion, and seizures (Correct answer)
- Slight nausea and mild thirst
- Increased urinary output only
Correct answer: Coarse tremor, confusion, and seizures
A lithium level >2.0 mEq/L indicates severe toxicity, presenting with coarse tremors, confusion, seizures, and cardiovascular collapse.
Question 5: Which antibiotic class is associated with photosensitivity and should be accompanied by sun-avoidance counseling?
- Penicillins
- Cephalosporins
- Tetracyclines (Correct answer)
- Macrolides
Correct answer: Tetracyclines
Tetracyclines (e.g., doxycycline) cause photosensitivity reactions; patients must avoid prolonged sun exposure and use sunscreen.
Question 6: A nurse is about to administer a new medication and notes it has a 'first-pass effect.' This means the drug:
- Is rapidly excreted by the kidneys unchanged
- Is significantly metabolized by the liver before reaching systemic circulation (Correct answer)
- Requires parenteral administration only
- Is poorly absorbed from the GI tract regardless of dose
Correct answer: Is significantly metabolized by the liver before reaching systemic circulation
First-pass (hepatic) metabolism occurs when orally absorbed drugs are substantially broken down in the liver before entering systemic circulation, reducing bioavailability.
Question 7: Which medication used to treat hypertension is classified as a calcium channel blocker and primarily affects cardiac conduction?
- Amlodipine
- Nifedipine
- Verapamil (Correct answer)
- Hydralazine
Correct answer: Verapamil
Verapamil is a non-dihydropyridine calcium channel blocker that slows SA node automaticity and AV conduction, making it useful for rate control.
Saudi Prometric Nursing Pharmacology 5
Which mechanism explains why proton pump inhibitors (PPIs) are more effective than H2 blockers in treating GERD?