SAMPLE EXAM QUESTIONS FOR NURSING 248, as occasionally instructed by Jim Middleton
(for purposes of review only)
if lost, return to the homepage for The Animating Apothecary

Some of these questions may appear redundant or repetitive.  This is the basic nature of education.  In fact, the written word reinforces the aural experience.  How's that for philosophy?
Questions, comments, or good recipes for zucchini bread, email:
_____ 1. Your patient is taking valproic acid (Depakote).  Which of the following is a false statement?
a.  Valproic acid requires hepatic monitoring
b.  Valproic acid has the lowest seizure relapse rate when discontinued
c.  Valproic acid is also used in migraine therapy
d.  Valproic acid is also used in bipolar disorder therapy

_____ 2. Your patient has been switched from valproic acid (Depakote) to gabepentin (Neurontin).  Which of the following is a false statement?
a. Gabapentin (Neurontin) is also used for bipolar disorder therapy
b. Gabapentin (Neurontin) requires more frequent hepatic monitoring
c. Gabapentin (Neurontin) is also used for migraine therapy
d. Gabapentin (Neurontin) should not be given concurrently with antacids containing magnesium

_____ 3. Your patient has been stabilized taking only primidone (Mysoline).  Which drug besides primidone may be assayed during his stay in the hospital to monitor his therapy?
a. pentobarbital
b. phenobarbital
c. valproic acid
d. phenytoin

_____ 4. Gingival hyperplasia is an oral condition possible in up to 50% of children using
a. phenobarbital
b. phenytoin (Dilantin)
c. pentobarbital
d. valproic acid (Depakote)

_____ 5. Fosphenytoin (Cerebyx)
a. is a controversial agent for depression
b. is used to control tremors due to Parkinsonism
c. can be administered intravenously
d. is ineffective after 5 days of therapy
_____ 6. James Parkinson first described Parkinsonism in 1817.  Since that time, it has been theorized that the disease stems from a deficiency of
a. money in the bank
b. serotonin in the GI system
c. acetylcholine in the basal ganglia
d. dopamine in the striatum

_____ 7. Regarding the combination product Sinemet (carbidopa/levodopa)
a. levodopa is converted to carbidopa in the blood
b. carbidopa crosses the blood-brain barrier to prevent tremors
c. levodopa can be converted to dopamine in the blood
d. carbidopa is converted to levodopa in the blood

_____ 8. Cyanosis and potential cyanide poisoning are possible with
a. nitroglycerin
b. nitroprusside (Nipride)
c. nitrofurantoin (Macrodantin)
d. nitrous oxide

_____ 9. Identify the beta blocker(s)
a. guanabenz (Wytensin)
b. prazocin (Minipres)
c. acetbutolol (Sectral)  -- hint -- look for the "olol" suffix!
d. enalapril (Vasotec)

_____ 10. Identify the ACE inhibitor(s)
a. atenolol (Tenormin)
b. captopril (Capoten) -- hint-- look for the "pril" suffix!
c. propranolol (Inderal)
d. ranitidine (Zantac)

_____ 11. Digoxin (Lanoxin) causes
a. negative inotropic, positive chronotropic action
b. negative inotropic, negative chronotropic action
c. positive inotropic, positive chronotropic action
d. positive inotropic, negative chronotropic action

_____ 12. Your patient is lethargic, nauseated,  and has a pulse of 52.  You see that he is taking digoxin (Lanoxin) 0.25mg daily, and also has hydrochlorothiazide (HydroDiuril) 50mg twice daily.  He is also playing with the color knobs on the television.  You would check for a
a. drop in sodium levels
b. drop in potassium levels
c. drop in digoxin (Lanoxin) levels
d. drop in calcium levels

_____ 13. Asthmatic patients could experience bronchoconstriction problems with which of the following agents?
a. isoproterinol (Isuprel)
b. digoxin (Lanoxin)
c. pindolol (Visken)  -- a beta blocker can cause B-2 blocking which can result in bronchospasm
d. dextromethorphan

_____ 14. Hypertensive therapy available as a 7-day patch
a. atenolol (Tenormin)
b. methyldopa (Aldomet)
c. minoxidil (Loniten)
d. clonidine (Catapres)

_____ 15. Regarding nitroglycerin
a. tingling on the tongue is a sign of toxicity with the sublingual tablets
b. special tubing is always used for IV infusion
c. oral “nitrates” such as Isordil and Sorbitrate are just as effective as topical patches
d. care should be taken to avoid absorption of the paste or injection solution onto the skin of the caregiver

_____ 16. Nonpharmacologic therapy of hypertension includes
a. dynamic exercise at least 3 times a week
b. magnesium and calcium supplementation
c. moderation in alcohol consumption
d. weight loss
e. all of the above
f. a, c, d only

_____ 17. Angiotensin II
a. is increased in the presence of enalapril (Vasotec)
b. causes drops in aldosterone levels
c. can result in water retention
d. increases sodium excretion

_____ 18. The antihypertensive agent also used for hair regrowth is
a. nitroglycerin
b. nitroprusside (Nipride)
c. minoxidil  (Loniten)  -- the topical hair regrowth product is also known as Rogaine
d. verapamil (Calan)

_____ 19. An example of a lidocaine bolus is
a. 10mg
b. 1gm
c. 100mg
d. 100mcg

______20. A “4:1" lidocaine drip contains
a. 4mg/liter
b. 4mg/100ml
c. 4g/ml
d. 4mg/ml

_____ 21. Dantrolene sodium (Dantrium) is used to treat
a. hypertension
b. malignant hypertension
c. malignant hyperthermia
d. cancer

_____ 22. High fiber diets can have what effect on the blood levels of digoxin (Lanoxin)?
a. lower
b. raise
c. no change

_____ 23. Your patient has a heart rate of 79.  After being stabilized on propranolol (Inderal), what is a likely heart rate?
a. 84
b. 65
c. propranolol (Inderal) has no effect on heart rate

_____ 24. Kava kava
a. must be chewed carefully before swallowing
b. can cause drowsiness
c. is a native of Australia

_____ 25. An anticholinergic drug used in Parkinsonism is
a. unnecessary
b. benztropine (Cogentin)
c. levodopa (Larodopa)

_____ 26. Your patient suffers from BPH (benign prostatic hypertrophy).  A contraindicated Parkinsonism therapy would be
a. bromocriptine (Parlodel)
b. levodopa/carbidopa (Sinemet)
c. benztropine (Cogentin)  -- anticholinergic effect can worsen BPH
d. amantadine (Symmetrel)

_____ 27. St. John’s wort
a. is useful for major depression
b. is useful for seasonal affective disorder (SAD)
c. is without side effects
d. is a condition requiring topical salicylic acid

_____ 28. For atrial fibrillation and atrial flutter, you turn to
a. lidocaine (Xylocaine)
b. quinidine (Qunidex)
c. amantadine (Symmetrel)
d. pilocarpine (Isopto Carpine)

_____ 29. The equation MAP = CO x TPR
a. is used to determine the flow rate of TPNs
b. describes the relationship of cardiac output and total peripheral resistance to the average blood (or “mean arterial”) pressure
c. shows that a decrease in CO can cause an increase in TPR
d. shows that an increase in MAP always means an increase in CO

_____ 1. Antidote for warfarin overdose
  a. protamine zinc insulin
  b. protamine sulfate
  c. vitamin K
  d. warfarin

_____ 2. Antidote for heparin overdose
  a. protamine sulfate
  b. vitamin K
  c. vitamin E
  d. cyanocobolamine

_____ 3. Antiplatelet agents include all of the following except
  a. acetylsalicylic acid
  b. acetaminophen
  c. ticlopidine (Ticlid)
  d. dipyridamole (Persantine)

_____ 4. Regarding cholesterol therapy, the goal is to
  a. reduce LDL and raise triglycerides
  b. reduce LDL and raise HDL
  c. raise LDL and raise HDL
  d. raise LDL and reduce triglycerides

_____ 5. Leukocytes are
  a. red blood cells
  b. white blood cells
  c. involved in coagulation
  d. used to transport oxygen

_____ 6. Which B-vitamin may be useful in lowering cholesterol?
  a. b-1 (thiamine)
  b. b-6 (pyridoxine)
  c. b-3 (niacin)
  d. b-12 (cyanocobolamine)

_____ 7. Which statement is false?
  a. Factor VIII is for classic hemophilia
  b. using niacinamide can reduce some of the “flushing” effect seen with niacin
  c. aminocaproic acid (Amicar) is ineffective orally
  d. azole antifungals such as Nizoral can interact with “statin” drugs used to treat elevated cholesterol

_____ 8. Which organ requires extra monitoring when the patient is undergoing lipid-lowering therapy?
  a. kidney
  b. brain
  c. liver
  d. pancreas

_____ 9. A classic drug interaction, greatly involving an increased bleeding time, involves warfarin and
  a. vitamin B-6
  b. acetaminophen
  c. acetylsalicylic acid
  d. all of the above

_____ 10. Chemotherapy
 a. is most effective against smaller tumors with slowly proliferating cells
 b. is most effective against larger tumors with rapidly proliferating cells
 c. is most effective against smaller tumors with rapidly proliferating cells
 d. is least effective against smaller tumors with rapidly proliferating cells

_____ 12. The most commonly used benzodiazepine drug for induction of retrograde amnesia during chemotherapy is
 a. chloral hydrate (Noctec)
 b. chlordiazepoxide (Librium)
 c.  lorazepam (Ativan)
 d. triazolam (Halcion)

_____ 13. Cancer is an obligate
 a. aerobic protein feeder
 b. anaerobic glucose feeder
 c. anaerobic protein feeder
 d. aerobic glucose feeder

_____ 14.  Antioxidant therapy helpful in minimizing adverse effects from radiation therapy include
 a. vitamins B6, B12, and niacin
 b. vitamins D, C, and the mineral vanadium
 c. vitamins A, C, E, and the mineral selenium
 d. vitamins A, D, E, and K

_____ 15. The chemotherapeutic agent with the most pronounced emetic potential is
 a. low dose methotrexate (Mexate)
 b. cisplatin (Platinol)
 c. cyclophosphamide (Cytoxan)
 d. 5-fluorouracil (5-FU)

_____ 16. The chemotherapeutic agent also used orally for severe forms of arthritis is
 a. 5-fluorouracil (5-FU)
 b. methotrexate (Mexate)
 c. cyclophosphamide (Cytoxan)
 d. cisplatin (Platinol)

____ 17. The drug derived from cannabis (delta 9 THC) and considered a controlled substance and is used to treat chemotherapy induced nausea is:

 a. dolasetron (Anzemet)
 b. lorazepam (Ativan)
 c. dronabinol (Marinol)
 d. metoclopramide (Reglan)

_____ 18. The anabolic steroid used to treat inoperable breast cancer or hypogonadism is
 a. tamoxifen (Nolvadex)
 b. megestrol (Megace)
 c. fluoxymesterone (Halotestin)
 d. vincristine (Oncovin)

_____ 19. The drug derived from the periwinkle plant and available in 1mg/ml injection form is
 a. 5-fluorouracil
 b. methotrexate
 c. cyclophosphamide (Cytoxan)
 d. vincristine (Oncovin)

_____ 20. The smallest detectible tumor is about
 a.  the size of a lemon
 b. 1000 cells in size
 c.  the size of a grape
 d. 100,000 cells in size

_____ 21. Toxicity from methotrexate can be treated with 
a. cyclophosphamide (Cytoxan)
 b. leucovorin
 c. dialysis
 d. vincristine (Oncovin)
_____ 22. Ondansetron (Zofran) and granisetron (Kytril) are
 a. used to treat extravasation
 b. antiulcer therapies
 c. used to treat chemotherapy-induced nausea
 d. used to treat metoclopramide (Reglan) toxicity

_____ 23. The agent with immune boosting activity yet recently implicated with causing severe depression and suicidal ideation is
 a. echinacea
 b. interferon
 c. dronabinol (Marinol)
 d. megestrol (Megace)

_____ 24. Handling precautions for chemotherapeutic agents should include
 a. thorough hand washing
 b. wearing of disposable gloves and gowns
 c. eye protection
 d. biohazard containers
 e. all of the above

_____   25. Your patient is receiving a protocol that includes both Adriamycin and Cytoxan.  You notice a redness in the urine.   You conclude that
 a. there must be a UTI and the patient needs a sulfa drug
 b. the redness is definitely blood since Adriamycin is known to cause hemorrhagic cystitis
 c. the redness is possibly, but not necessarily, indicative of the presence of blood in this case
 d. extravasation has occurred and protective measures are necessary

Of course there must be other questions that could be asked.  There are always other questions.