Advanced Pharmacology Test Bank

Advanced Pharmacology Test Bank Related

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Which of the following 'overdoses' is most commonly associated with respiratory alkalosis, but when more severe a metabolic acidosis?

  • A. Methanol
  • B. Lead
  • C. Paracetamol
  • D. Salicylate
Correct Answer: D

Rationale: Overdose toxicities differ in acid-base effects. Methanol causes metabolic acidosis via formic acid, not respiratory alkalosis. Lead poisoning leads to anemia or neurologic issues, rarely acid-base shifts. Paracetamol overdose induces lactic acidosis from liver failure, not respiratory changes initially. Salicylate (e.g., aspirin) overdose stimulates the respiratory center early, causing hyperventilation and respiratory alkalosis (low pCO2), but severe cases add metabolic acidosis (high anion gap) from uncoupled oxidative phosphorylation and lactic acid buildup. Codeine, an opioid, depresses respiration, causing acidosis, not alkalosis. Salicylate's dual pattern is distinctive, requiring urgent recognition—initial alkalosis shifts to acidosis as toxicity worsens, guiding bicarbonate or dialysis treatment.

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The nurse manages care for several clients receiving hormone replacement therapy (HRT). What will the priority assessment by the nurse include as related to side effects?

  • A. Pain in the calf
  • B. Decreased libido
  • C. Low-back pain
  • D. Chronic fatigue
Correct Answer: A

Rationale: HRT increases clotting risk, making calf pain a priority due to potential DVT, a life-threatening side effect. Libido , back pain , and fatigue are less urgent. A ensures safety, aligning with HRT risks, making it the priority.

A 59-year-old man with a history of depression cuts his wrists in a suicide attempt. He is brought to the local emergency department for care. He has bilateral medial 3-cm lacerations through the skin and subcutaneous tissues that will require sutures. A review of his prior medical history indicates an allergy to 2% lidocaine. The most likely explanation for this is which of the following?

  • A. Allergic
  • B. Mast cell mediated
  • C. Neurogenic
  • D. Psychogenic
Correct Answer: A

Rationale: Lidocaine allergy causing an issue with suturing suggests an allergic reaction , likely IgE-mediated (overlapping with B, but A is broader). Neurogenic , psychogenic , and vascular (E) don't fit. True local anesthetic allergies are rare but explain this history.

If you inject a drug with a pH of 6.5 and pka of 8.1 into a tissue with a pH of 7.4, to what extent would you expect this drug to be ionized in the tissue?

  • A. over 50%
  • B. 50%
  • C. under 50%
  • D. 100%
Correct Answer: A

Rationale: The percentage of ionization of a weak acid or base can be estimated using the Henderson-Hasselbalch equation:

Which of the following is NOT an opioid or NSAID?

  • A. Morphine
  • B. Ibuprofen
  • C. Hydromorpho
  • D. Acetaminoph en
Correct Answer: D

Rationale: Acetaminophen is not an opioid or NSAID. It is a pain reliever and fever reducer, but it works in a different way compared to opioids and NSAIDs. Unlike opioids, acetaminophen does not have the same risk of physical dependence or addiction. And unlike NSAIDs, acetaminophen does not have anti-inflammatory properties. It is often used for mild to moderate pain relief and as a fever reducer. Be cautious when taking acetaminophen, as high doses can be harmful to the liver.

A patient with extremely high blood pressure (BP) is in the emergency department. The physician will order therapy with nitroglycerin to manage the patient™s BP. Which form of nitroglycerin is most appropriate?

  • A. Sublingual spray
  • B. Transdermal patch
  • C. Oral capsule
  • D. IV infusion
Correct Answer: D

Rationale: In the emergency management of a patient with extremely high blood pressure, intravenous (IV) administration of nitroglycerin is the most appropriate form of delivery. IV infusion provides rapid and precise control of blood pressure by allowing the medication to take effect quickly and be titrated to the desired blood pressure level. This route of administration is crucial in acute settings like the emergency department, where immediate blood pressure management is needed. Other forms of nitroglycerin, such as sublingual spray, transdermal patch, or oral capsule, may not provide the rapid onset of action required in this critical situation.

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