College Exams & Notes

Master your nursing exams with comprehensive practice questions and detailed explanations

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QUESTION #1
Pharmacology Exam 4 Pharmacology
A 45-year-old client receiving long-term warfarin therapy for atrial fibrillation is prescribed testosterone replacement therapy. The nurse should prioritize teaching the client to monitor for which critical adverse effect related to this drug combination?
A Signs of bleeding or bruising
B Increased risk of hepatic necrosis
C Decreased effects of warfarin
D Increased heart rate

Explanations

A
Testosterone can potentiate the anticoagulant effects of warfarin, increasing the risk of bleeding.
B
Hepatic necrosis is not the primary concern when testosterone is combined with warfarin.
C
Testosterone does not reduce warfarin’s effects and instead may enhance anticoagulation.
D
Increased heart rate is not a known interaction-related risk between testosterone and warfarin.
For this question, think about drug interactions that alter INR, and always prioritize bleeding risk over unrelated organ effects.
QUESTION #2
Pharmacology Exam 4 Pharmacology
A nurse is preparing to administer conjugated estrogen to a 62-year-old post-menopausal client. Which finding in the client’s electronic health record would necessitate the nurse holding the medication and notifying the healthcare provider?
A The client reports mild nausea and fluid retention
B The client has recently recovered from a Pulmonary Embolism
C The client reports using calcium and Vitamin D supplements
D The client stopped smoking 3 years ago

Explanations

A
Mild nausea and fluid retention are expected side effects of estrogen therapy and do not require holding the medication.
B
A history of pulmonary embolism significantly increases the risk of thromboembolic events with estrogen use.
C
Calcium and vitamin D supplementation is commonly recommended alongside estrogen therapy for bone health.
D
Smoking cessation lowers cardiovascular risk and does not contraindicate estrogen therapy.
With estrogen therapy questions, always pause and screen for past or current clotting disorders, because estrogen increases coagulation risk and overrides otherwise routine findings.
QUESTION #3
Pharmacology Exam 4 Pharmacology
A client with an acute urinary tract infection has been taking phenazopyridine in addition to a prescribed antibiotic. At a follow-up visit, the nurse evaluates the client’s response to the medication. Which assessment finding provides the best evidence that phenazopyridine is achieving its intended therapeutic effect?
A The client reports increased clarity of urine with no sediment present.
B The client states that urinary urgency and frequency have significantly decreased.
C The client reports marked reduction in dysuria during voiding.
D The nurse notes the urine has developed a deep orange to reddish tint.

Explanations

A
Urine clarity reflects infection status rather than the analgesic action of phenazopyridine.
B
Decreased urgency and frequency indicate improvement from antibiotic therapy, not phenazopyridine.
C
Relief of burning and pain with urination reflects the urinary analgesic effect of phenazopyridine.
D
Orange-red urine is an expected side effect and does not indicate therapeutic effectiveness.
Focus on symptom relief related to discomfort, not changes in infection markers or urine appearance, because this medication treats pain; not the underlying infection.
QUESTION #4
Pharmacology Exam 4 Pharmacology
A client currently prescribed nitrofurantoin for a urinary tract infection contacts the clinic describing several new symptoms that have developed during therapy. Which reported adverse manifestation should prompt the nurse to recognize the necessity for immediate discontinuation of nitrofurantoin and further clinical evaluation?
A Nausea
B Diarrhea
C Brown urine
D Cough and chest pain

Explanations

A
Nausea is a common gastrointestinal side effect of nitrofurantoin and does not require stopping the medication.
B
Diarrhea can occur with many antibiotics and is not an immediate indication for discontinuation unless severe or persistent.
C
Brown-colored urine is a harmless and expected effect of nitrofurantoin.
D
Cough and chest pain suggest a potentially serious pulmonary reaction associated with nitrofurantoin and require immediate evaluation.
When reviewing nitrofurantoin side effects, don't just focus on GI or urine color changes; also check on new respiratory symptoms, which signal a rare but dangerous lung toxicity that requires stopping the drug immediately.
QUESTION #5
Pharmacology Exam 4 Pharmacology
A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?
A Ondansetron
B Acyclovir
C Famotidine
D Azithromycin

Explanations

A
Ondansetron is primarily associated with headache and constipation rather than kidney toxicity.
B
Acyclovir can crystallize in the renal tubules and impair kidney function, especially in clients with existing renal disease.
C
Famotidine is renally excreted but is not known to cause direct nephrotoxicity.
D
Azithromycin is mainly metabolized by the liver and has minimal renal toxicity.
Review drugs that can precipitate in the kidneys or require high renal clearance, especially antivirals like acyclovir that depend heavily on adequate hydration and renal function.
QUESTION #6
Pharmacology Exam 4 Pharmacology
Take NSAIDs if headaches occur.
A Take NSAIDs if headaches occur.
B Decrease intake of vitamin D.
C Expect muscle cramps for several weeks.
D Report diarrhea to the provider.

Explanations

A
NSAIDs can worsen gastric irritation and increase the risk of GI bleeding, especially in clients with GERD.
B
Pantoprazole does not require reducing vitamin D intake, although long-term use may affect absorption.
C
Muscle cramps are not an expected routine effect and are not emphasized as a key teaching point.
D
Diarrhea may indicate a serious complication such as Clostridioides difficile infection and should be reported promptly.
With proton pump inhibitors, watch for unexpected or severe GI changes, especially diarrhea, which signals a complication rather than a routine side effect.
QUESTION #7
Pharmacology Exam 4 Pharmacology
A nurse is collecting data on a client who has a new prescription for ampicillin. The nurse should recognize which of the following findings is a priority?
A Nausea
B Candidiasis
C Wheezing
D Stomatitis

Explanations

A
Nausea is a common gastrointestinal side effect of antibiotics and is not immediately life-threatening.
B
Candidiasis indicates a superinfection but does not require urgent intervention compared with airway symptoms.
C
Wheezing suggests a possible allergic reaction that can progress rapidly to airway compromise and anaphylaxis.
D
Stomatitis may occur with antibiotic use but is not an acute priority finding.
When a question asks for the priority finding, scan for airway, breathing, or circulation clues, and let respiratory symptoms immediately outrank expected or delayed medication side effects.
QUESTION #8
Pharmacology Exam 4 Pharmacology
A nurse is teaching a client who is taking metronidazole. Which of the following neurological alterations should the nurse include as an adverse effect of metronidazole?
A Vision changes
B Numbness and tingling
C Hearing loss
D Insomnia

Explanations

A
Vision changes are not a common neurological adverse effect associated with metronidazole therapy.
B
Metronidazole can cause peripheral neuropathy, which presents as numbness and tingling in the extremities.
C
Hearing loss is more characteristic of ototoxic medications such as aminoglycosides.
D
Insomnia is not a typical or expected neurological adverse effect of metronidazole.
When reviewing antibiotics, connect metronidazole with peripheral nerve effects, and let symptoms that start in the hands or feet steer you toward neuropathy rather than sensory or sleep-related changes.
QUESTION #9
Pharmacology Exam 4 Pharmacology
A nurse is providing teaching to a client who has renal failure and GERD. The provider instructed the client to take aluminum hydroxide as needed for symptom management. For which of the following adverse effects should the nurse inform the client?
A Constipation
B Metallic taste
C Headache
D Diarrhea

Explanations

A
Aluminum-containing antacids slow gastrointestinal motility and commonly lead to constipation, especially in clients with renal impairment.
B
A metallic taste is more commonly associated with antibiotics such as metronidazole rather than antacids.
C
Headache is not a typical or expected adverse effect of aluminum hydroxide.
D
Diarrhea is more often associated with magnesium-based antacids, not aluminum-based products.
Aluminum causes constipation, magnesium causes diarrhea, and combining the two is often done clinically to balance bowel effects.
QUESTION #10
Pharmacology Exam 4 Pharmacology
A nurse is teaching a client who has a urinary tract infection (UTI) and is taking ciprofloxacin. Which of the following instructions should the nurse give to the client?
A “If the medicine causes an upset stomach, take an antacid at the same time.”
B “Limit your daily fluid intake while taking this medication.”
C “This medication can cause photophobia, so be sure to wear sunscreen.”
D “You should report any tendon discomfort you experience while taking this medication.”

Explanations

A
Antacids bind ciprofloxacin and significantly reduce its absorption, making this instruction unsafe.
B
Adequate fluid intake is encouraged with ciprofloxacin to help prevent crystalluria and kidney irritation.
C
Ciprofloxacin causes photosensitivity rather than photophobia, making sunscreen advice incomplete and less critical.
D
Fluoroquinolones are associated with tendonitis and tendon rupture, which requires immediate reporting.
When fluoroquinolones appear in a question, consider musculoskeletal red flags, because tendon pain is an uncommon but high-risk adverse effect that always outweighs routine side-effect teaching.