Download NSG6020 / NSG 6020 Midterm 1 Exam 2025 Questions and Answers Updated (2025 / 2026) (Veri and more Exams Nursing in PDF only on Docsity!
NSG6020 / NSG 6020 Midterm 1 Exam 2025
Questions and Answers Updated (2025 / 2026)
(Verified Answers)
- Which class of antihypertensive drugs is contraindicated in pregnancy due to teratogenicity? ACE inhibitors ACE inhibitors can cause fetal renal damage, oligohydramnios, and skull hypoplasia, making them contraindicated in pregnancy.
- What is the mechanism of action of calcium channel blockers? They inhibit calcium influx into vascular smooth muscle and myocardial cells. This inhibition results in vasodilation, decreased myocardial contractility, and reduced cardiac workload.
- Which antibiotic is safe to use during pregnancy? Amoxicillin Amoxicillin is a beta-lactam antibiotic considered safe in all trimesters of pregnancy.
- What adverse effect is commonly associated with statins? Myopathy
Statins can cause muscle damage leading to symptoms of muscle pain, tenderness, or weakness.
- Which drug is a selective beta-1 blocker? Metoprolol Metoprolol selectively blocks beta-1 receptors in the heart, reducing heart rate and contractility without significant bronchoconstriction.
- Which lab value should be monitored with warfarin therapy? INR The INR is used to assess the anticoagulant effect of warfarin and guide dosage adjustments.
- What is the black box warning for fluoroquinolones? Tendon rupture Fluoroquinolones can increase the risk of tendinitis and tendon rupture, especially in older adults and those on corticosteroids.
- Which diuretic is potassium-sparing? Spironolactone Spironolactone conserves potassium by antagonizing aldosterone in the distal nephron.
- Which medication is first-line for type 2 diabetes mellitus? Metformin Metformin decreases hepatic glucose production and increases insulin sensitivity, making it the preferred initial therapy. 10.Which antiplatelet drug irreversibly inhibits COX-1 and COX-2? Aspirin
Lispro is a rapid-acting insulin that starts working within 15 minutes of administration. 17.What is a contraindication for estrogen-containing contraceptives? History of thromboembolic events Estrogen increases clotting factors and can raise the risk of thrombosis. 18.What drug is a dopamine precursor used in Parkinson’s disease? Levodopa Levodopa is converted to dopamine in the brain, alleviating Parkinsonian symptoms. 19.Which vitamin deficiency can result from long-term metformin use? Vitamin B Metformin can reduce B12 absorption, potentially leading to neuropathy and anemia. 20.Which antidepressant is most associated with sexual dysfunction? Fluoxetine SSRIs like fluoxetine commonly cause decreased libido, anorgasmia, and delayed ejaculation. 21.What is the black box warning for SSRIs in children and adolescents? Increased risk of suicidal ideation Children and teens may experience increased suicidal thoughts, especially in early treatment. 22.Which class of medications is associated with the risk of lactic acidosis? Biguanides
Metformin, a biguanide, can rarely cause lactic acidosis, especially in renal impairment. 23.What is the preferred anticoagulant in pregnancy? Heparin Heparin does not cross the placenta and is safer for use during pregnancy compared to warfarin. 24.What class of drug is omeprazole? Proton pump inhibitor PPIs reduce gastric acid secretion by irreversibly blocking the H+/K+ ATPase in gastric parietal cells. 25.Which medication requires a washout period when switching from an MAOI? Fluoxetine Due to its long half-life, fluoxetine must be discontinued for at least 5 weeks before starting an MAOI to avoid serotonin syndrome. 26.What is a common side effect of niacin? Flushing Niacin causes vasodilation that leads to redness and warmth, especially in the face. 27.What drug is used for opioid dependence treatment and prevents euphoria? Naltrexone Naltrexone blocks opioid receptors, reducing cravings and preventing the euphoric effect of opioids.
33.What drug class is first-line for heart failure with reduced ejection fraction (HFrEF)? ACE inhibitors They reduce afterload, improve cardiac remodeling, and reduce mortality in HFrEF. 34.Which medication increases the risk of serotonin syndrome when combined with SSRIs? Tramadol Tramadol has serotonergic activity and can lead to serotonin syndrome when used with SSRIs. 35.What class of drug is used to treat BPH and can cause orthostatic hypotension? Alpha-1 blockers These drugs relax smooth muscle in the prostate and bladder but also lower blood pressure. 36.Which medication is used in alcohol dependence to prevent relapse? Disulfiram Disulfiram causes an unpleasant reaction with alcohol to discourage drinking. 37.Which drug is preferred in treating absence seizures? Ethosuximide Ethosuximide selectively inhibits T-type calcium channels involved in absence seizure activity.
38.What class of antibiotics inhibits bacterial protein synthesis by binding to the 50S ribosomal subunit? Macrolides Macrolides like erythromycin bind to the 50S subunit to inhibit bacterial protein synthesis. 39.What drug can cause ototoxicity and nephrotoxicity, especially when combined with other nephrotoxic agents? Vancomycin Vancomycin can damage the kidneys and inner ear, especially at high trough levels. 40.Which drug is an HMG-CoA reductase inhibitor? Atorvastatin Atorvastatin lowers cholesterol by inhibiting the rate-limiting step in hepatic cholesterol synthesis. 41.What is the main concern when using clozapine? Agranulocytosis Clozapine can suppress bone marrow and cause dangerous neutropenia. 42.What is the first-line treatment for status epilepticus? Lorazepam Lorazepam rapidly enhances GABA activity to stop seizure activity in emergency situations. 43.Which insulin has the longest duration of action? Insulin glargine
Metronidazole inhibits aldehyde dehydrogenase, leading to nausea, vomiting, and flushing with alcohol intake. 50.What type of insulin is used for basal coverage? Insulin detemir Detemir is a long-acting insulin that provides steady basal insulin levels over time. 51.Which medication should be avoided in a patient with sulfa allergy? Hydrochlorothiazide Thiazide diuretics have a sulfonamide group and may cause allergic reactions in sulfa-sensitive individuals. 52.What is the mechanism of action of glipizide? Stimulates insulin release from pancreatic beta cells Glipizide is a sulfonylurea that increases insulin secretion to lower blood glucose levels. 53.Which medication is most associated with gingival bleeding? Warfarin Warfarin inhibits vitamin K – dependent clotting factors, increasing bleeding risk. 54.Which antipsychotic has the highest risk of metabolic syndrome? Olanzapine Olanzapine is associated with significant weight gain, dyslipidemia, and insulin resistance.
55.What class of drug is used in both depression and neuropathic pain? SNRIs SNRIs like duloxetine target both serotonin and norepinephrine pathways, which help modulate pain. 56.Which medication should be discontinued before contrast imaging? Metformin Metformin should be stopped due to the risk of lactic acidosis if contrast- induced nephropathy occurs. 57.Which drug is a serotonin antagonist used for nausea? Ondansetron Ondansetron blocks 5-HT3 receptors in the chemoreceptor trigger zone to prevent nausea. 58.What drug is used to reverse benzodiazepine overdose? Flumazenil Flumazenil is a GABA receptor antagonist that reverses the sedative effects of benzodiazepines. 59.Which antibiotic inhibits bacterial DNA gyrase? Ciprofloxacin Fluoroquinolones inhibit DNA gyrase, preventing bacterial DNA replication. 60.Which medication is contraindicated with nitrates due to risk of severe hypotension? Sildenafil
66.What lab should be monitored with long-term amiodarone use? Thyroid function Amiodarone contains iodine and can cause hypo- or hyperthyroidism. 67.Which anticoagulant works by inhibiting factor Xa? Rivaroxaban Rivaroxaban directly inhibits factor Xa, preventing thrombin formation and clot development. 68.Which medication requires thyroid, liver, lung, and eye monitoring due to toxicities? Amiodarone Due to its tissue accumulation, amiodarone can cause toxic effects in multiple organs. 69.What is the mechanism of action of digoxin? Inhibits the sodium-potassium ATPase pump This increases intracellular calcium, improving cardiac contractility. 70.Which class of drugs is used as rescue therapy in asthma? Short-acting beta-agonists (SABA) SABAs quickly relax bronchial smooth muscle and are used for acute asthma symptoms. 71.Which antibiotic class can cause photosensitivity? Tetracyclines Tetracyclines increase skin sensitivity to UV light, leading to sunburn-like reactions.
72.Which oral hypoglycemic agent delays glucose absorption in the gut? Acarbose Acarbose inhibits alpha-glucosidase enzymes, delaying carbohydrate breakdown. 73.What is the therapeutic INR range for most patients on warfarin? 2.0–3. This range balances the risk of clotting and bleeding for most indications. 74.What medication is used for hypothyroidism? Levothyroxine Levothyroxine is synthetic T4, replacing deficient thyroid hormone. 75.Which diabetes drug is contraindicated in heart failure? Pioglitazone Pioglitazone can cause fluid retention, worsening heart failure. 76.What class is diltiazem? Non-dihydropyridine calcium channel blocker Diltiazem slows heart rate and reduces contractility, useful in arrhythmias and angina. 77.What is a side effect of clozapine that requires monitoring? Agranulocytosis Clozapine can suppress white blood cell production, necessitating regular CBCs. 78.What is a long-term risk of proton pump inhibitors? Osteoporosis and fractures PPIs may impair calcium absorption, increasing fracture risk.
85.Which antidepressant is safe in cardiac patients? Sertraline Sertraline has a favorable cardiac profile and is commonly used post-MI. 86.What is the black box warning for antipsychotics in dementia? Increased risk of death Elderly patients with dementia-related psychosis have a higher mortality risk with antipsychotics. 87.What is the mechanism of action of varenicline (Chantix)? Partial nicotine agonist Varenicline stimulates nicotine receptors and blocks nicotine binding to reduce cravings. 88.What is the side effect of abrupt beta-blocker withdrawal? Rebound hypertension Stopping beta-blockers suddenly can lead to increased sympathetic activity and elevated BP. 89.What medication used for hyperlipidemia can cause flushing? Niacin Niacin causes vasodilation leading to facial and upper-body flushing. 90.Which class of drugs should be avoided in asthma patients? Non-selective beta-blockers These can cause bronchoconstriction, worsening asthma symptoms. 91.What drug is used to treat opioid-induced constipation? Methylnaltrexone
Methylnaltrexone is a peripherally acting opioid antagonist that does not affect analgesia. 92.What insulin is clear and can be mixed with other insulins? Regular insulin Regular insulin is short-acting and can be mixed with intermediate insulins. 93.What drug is used for rapid heart rate in atrial fibrillation? Diltiazem Diltiazem slows AV node conduction and controls ventricular rate in AF. 94.What is the mechanism of action of albuterol? Beta-2 agonist Albuterol activates beta-2 receptors, relaxing bronchial smooth muscle. 95.Which drug class causes gynecomastia as a side effect? Spironolactone Spironolactone has antiandrogen effects, which can cause breast enlargement in males. 96.What antibiotic should not be given to children due to teeth staining? Tetracycline Tetracycline binds calcium in developing teeth, causing discoloration. 97.Which drug requires LFT monitoring due to hepatotoxicity? Statins Statins can elevate liver enzymes and rarely cause serious liver injury.
- Which pain medication has a ceiling effect? NSAIDs NSAIDs have a maximum analgesic dose beyond which no further pain relief occurs.
- Which class of drugs can cause tendon rupture? Fluoroquinolones These antibiotics interfere with collagen synthesis, increasing tendon rupture risk.
- Which drug may cause red-orange discoloration of bodily fluids? Rifampin Rifampin causes harmless red-orange staining of urine, tears, and saliva.
- Which medication used for tuberculosis can cause peripheral neuropathy? Isoniazid INH can deplete vitamin B6, leading to neuropathy if not supplemented.
- Which diabetes medication carries a risk of pancreatitis? GLP-1 receptor agonists These drugs are associated with rare but serious cases of pancreatitis.
- What is the antidote for acetaminophen overdose? N-acetylcysteine This restores glutathione, neutralizing toxic acetaminophen metabolites.
- Which medication should be tapered to avoid withdrawal seizures? Benzodiazepines Abrupt withdrawal can trigger seizures and rebound anxiety.
- What is a major side effect of carbamazepine? Aplastic anemia Carbamazepine can cause serious bone marrow suppression.
- Which drug class can cause rhabdomyolysis when combined with statins? Fibrates Combining statins and fibrates increases the risk of muscle breakdown.
- Which antiepileptic drug is known to cause hyponatremia? Carbamazepine It can cause SIADH, leading to low sodium levels.
- Which anticoagulant does not require routine monitoring? Apixaban Apixaban has predictable pharmacokinetics, eliminating the need for regular labs.
- What drug is used to prevent chemotherapy-induced nausea and vomiting? Ondansetron A serotonin antagonist effective against acute chemo-related nausea.
- What is the main adverse effect of lithium? Nephrotoxicity Chronic lithium use can impair renal function.
- What is the therapeutic range for lithium? 0.6–1.2 mEq/L Levels above 1.5 mEq/L can cause toxicity.
