NCLEX Practice Exam for Pharmacology: Respiratory and Gastrointestinal Medications

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1. Nurse Rita is giving instructions to her client who is taking antihistamine. Which of the following nurse teachings is appropriate for the client?

  1. Avoid ingesting alcohol.
  2. Be aware that you may need to take a decongestant.
  3. Be aware that you may have increased saliva.
  4. Expect a relief in 24 hours.

2. Daniel has vertigo, which antihistamine is best for his condition?

  1. Terfenadine
  2. Meclizine
  3. Hydrocodone
  4. Guaifenesin

3. Raul, a 20-year-old student, used to buy OTC drugs whenever he feels sick. Which of the following statements best describes the danger of self-medication with over-the-counter drugs?

  1. Clients are not aware of the action of over-the-counter drugs.
  2. Clients are not aware of the side effects of over-the-counter drugs.
  3. Clients minimize the effects of over-the-counter drugs because they are available without prescription.
  4. Clients do not realize the effects of over-the-counter drugs.

4. Shenaya will be having her exam in pharmacology tomorrow. She should be aware that antitussive is indicated to:

  1. encourage removal of secretions through coughing.
  2. relieve rhinitis.
  3. control a productive cough.
  4. relieve a dry cough.

5. The nurse should instruct a client who is taking an expectorant to:

  1. restrict fluids.
  2. increase fluids.
  3. avoid vaporizers.
  4. take antihistamines.

6. When administering the methylxanthine theophylline, the nurse can expect:

  1. Decreased pulmonary function
  2. Increased pulmonary function
  3. Increased residual volume
  4. Decreased tidal volume

7. A client with which of the following conditions may experience a dangerous or fatal side effect of theophylline?

  1. Cardiac disorder
  2. Diabetes
  3. Renal disease
  4. Hepatic disease

8. To evaluate the effectiveness of theophylline therapy, which of the following laboratory values must be drawn?

  1. Glucose
  2. Hematocrit
  3. Potassium
  4. Theophylline levels

9. The effects of theophylline may be increased by:

  1. Phenobarbital
  2. Phenytoin
  3. Rifampin
  4. Cimetidine

10. Which of the following statements describes the action of antacids?

  1. Antacids neutralize gastric acid.
  2. Antacids block the production of gastric acid.
  3. Antacids block dopamine.
  4. Antacids enhance action of acetylcholine.

11. Jam is under chemotherapy in which nausea is an expected side effect. Which of the following drugs is indicated to prevent such side effect?

  1. metoclopramide
  2. cimetidine
  3. Tagamet
  4. famotidine

12. Which of the following drugs will reduce the effectiveness of sucralfate?

  1. ranitidine
  2. Carafate
  3. metoclopramide
  4. meclizine

13. Extrapyramidal symptoms are a side effect of which of the following drugs?

  1. ranitidine
  2. omeprazole
  3. famotidine
  4. metoclopramide

14. Which histamine-2 antagonist is associated with the most drug interactions?

  1. ranitidine
  2. cimetidine
  3. Prilosec
  4. nizatidine

15. Hydrochloric acid secretion is blocked by which of the following category of drugs?

  1. antacids
  2. gastric stimulants
  3. histamine-2 antagonists
  4. antihistamines

16. Which category of drugs prevents/treats constipation by the osmotic drawing of water from extravascular space to intestinal lumen?

  1. Stimulants
  2. Bulk-forming agents
  3. Hyperosmotic agents
  4. Lubricants

17. Which of the following is a bulk-forming agent?

  1. glycerin
  2. lactulose
  3. FiberCon
  4. Milk of Magnesia

18. A client needs rapid cleansing of the bowel, which category is best used?

  1. Bacid
  2. Bulk-forming agent
  3. Saline laxatives with magnesium
  4. Intestinal flora modifiers

19. Which of the following categories is used for diarrhea and constipation?

  1. Bulk-forming agents
  2. Intestinal flora modifiers
  3. Cascara
  4. Milk of Magnesia

20. Which of the following may be used for a bowel preparation and is not recommended for treatment of constipation?

  1. Correctol
  2. Fiberall
  3. mineral oil
  4. castor oil
Answers and Rationales
  1. Answer: A. Avoid ingesting alcohol. Because alcohol and antihistamines have sedating properties, concurrent administration of these drugs should be avoided. Antihistamines and decongestants are often given together. Dry mouth is a common side effect, not increased salivation. Not all antihistamines last 24 hours.
  2. Answer: B. Meclizine. Meclizine (Antivert) is given for vertigo and motion sickness. Choices C and D are not antihistamines. Choice A is an antihistamine, but meclizine is the standard drug in the treatment of vertigo.
  3. Answer: C. Clients minimize the effects of over-the-counter drugs because they are available without prescription. This choice is correct because it includes the other three risks noted in choices A, B, and D.
  4. Answer: D. relieve a dry cough. An antitussive is a cough suppressant. Choices A and C describe the action of an expectorant. Choice D describes the action of a decongestant.
  5. Answer: B. increase fluids. Increasing fluids will help liquefy secretions and facilitate removal.
  6. Answer: B. Increased pulmonary function. Theophylline will improve ventilation so there will be an overall improvement of pulmonary measurements. Other choices are the opposite of what will actually occur with theophylline administration.
  7. Answer: A. Cardiac disorder. A client with a heart condition may experience dangerous stimulation from this drug. Theophylline should be administered cautiously with all the other choices, but consequences are most dangerous or possibly fatal for clients with a heart condition.
  8. Answer: D. Theophylline levels. Theophylline levels must be drawn to determine if the drug is present in therapeutic amounts in the client’s serum.
  9. Answer: D. Cimetidine. Cimetidine will increase the effects of theophylline.
  10. Answer: A. Antacids neutralize gastric acid. Antacids act to bring the pH above 3. Other choices are incorrect because they describe actions of antiacid drugs.
  11. Answer: A. metoclopramide. This is the only drug among the choices that is indicated to prevent nausea.
  12. Answer: A. ranitidine. Ranitidine decreases the effectiveness of sucralfate because it decreases the acid content of gastric secretion. Choice B is the trade name for sucralfate. Choice C is a gastric stimulant that does not alter pH. Choice D is an antihistamine and its GI effect is antiemetic.
  13. Answer: D. metoclopramide. A side effect of metoclopramide is EPS.
  14. Answer: B. cimetidine. Cimetidine was the first histamine-2 antagonist developed and is associated with the most toxic drug interactions of the group.
  15. Answer: C. histamine-2 antagonists. This is the only category of drugs that reduces the volume of secretions.
  16. Answer: C. Hyperosmotic agents. Hyperosmotic agents change the osmotic gradient between the intestine and extravascular space causing water to move into the intestinal lumen and balance the gradient.
  17. Answer: C. FiberCon. FiberCon is the bulk-forming agent. Choices A and B are incorrect because they are hyperosmotic agents. Choice D, meanwhile, is a saline laxative.
  18. Answer: C. Saline laxatives with magnesium. Saline laxatives are the best agents for rapid bowel cleansing. Bacid is an intestinal flora modifier. Bulk-forming agents will not produce rapid cleansing. Intestinal flora modifiers will not not produce rapid cleansing as well.
  19. Answer: A. Bulk-forming agents. Bulk-forming agents are used for diarrhea and constipation.
  20. Answer: D. castor oil. Castor oil is not recommended for treatment of constipation because it causes such severe abdominal pain.
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