1 :

Hint : 💊 Don’t crush extended-release meds

Correct Answers:

  • "Swallow the medication whole and do not cut, crush, or chew the medication."


Rationale :

🍍 Nifedipine [Adalat XL] is an extended-release calcium channel blocker used to treat hypertension and angina.

🍍 It must be swallowed whole to maintain the extended-release mechanism, which allows for gradual drug absorption over time.

🍍 Crushing, chewing, or cutting the tablet can cause dose dumping, leading to rapid absorption, which may result in severe hypotension or cardiovascular effects.

🍍 While monitoring blood pressure and avoiding OTC medications is important, the priority teaching point is to preserve the integrity of the extended-release formulation.


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2 :

Hint : ⚡ Used in resistant V-fib

Correct Answers:

  • Amiodarone [Cordarone]


Rationale :

🍇 Amiodarone is a Class III antiarrhythmic agent that is highly effective in treating life-threatening ventricular arrhythmias, including ventricular fibrillation (VF) and ventricular tachycardia (VT).

🍇 It works by prolonging the action potential and refractory period of cardiac cells, helping to stabilize the cardiac rhythm when other medications or defibrillation have failed.

🍇 It can be administered intravenously in emergency situations, especially in cases of recurrent or resistant VF.

🍇 The nurse should monitor for pulmonary toxicity, bradycardia, and thyroid dysfunction as serious adverse effects with prolonged use.


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3 :

Hint : 🥤 Straw + dilution = stain prevention

Correct Answers:

  • "Dilute liquid preparations with juice or water and administer through a straw."


Rationale :

🍓 Ferrous sulfate is an oral iron supplement used to treat or prevent iron deficiency anemia.

🍓 Liquid formulations can stain the teeth, so clients should be instructed to dilute the solution with juice or water and drink it through a straw, then rinse the mouth afterward.

🍓 Citrus juices, like orange juice, can actually enhance iron absorption due to their vitamin C content and are encouraged—not avoided.

🍓 It is normal for iron to cause green or dark brown stools, and this does not need to be reported unless there are signs of GI bleeding.


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4 :

Hint : 🥤 Straw + dilution = stain prevention

Correct Answers:

  • "Dilute liquid preparations with juice or water and administer through a straw."


Rationale :

🍓 Ferrous sulfate is an oral iron supplement used to treat or prevent iron deficiency anemia.

🍓 Liquid formulations can stain the teeth, so clients should be instructed to dilute the solution with juice or water and drink it through a straw, then rinse the mouth afterward.

🍓 Citrus juices, like orange juice, can actually enhance iron absorption due to their vitamin C content and are encouraged—not avoided.

🍓 It is normal for iron to cause green or dark brown stools, and this does not need to be reported unless there are signs of GI bleeding.


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5 :

Hint : 👁️ Halo vision = digoxin red flag

Correct Answers:

  • Digoxin (Lanoxin) toxicity


Rationale :

🍍 Digoxin toxicity is characterized by classic visual disturbances, including blurred vision, yellow/green halos, and in some cases photophobia.

🍍 These symptoms often occur alongside other signs like nausea, vomiting, dizziness, bradycardia, and cardiac arrhythmias.

🍍 Digoxin has a narrow therapeutic index, so toxicity can easily occur, especially in older adults or those with renal impairment or hypokalemia.

🍍 The nurse should immediately notify the provider and anticipate holding the medication, checking serum digoxin levels, and monitoring cardiac rhythm closely.


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6 :

Hint : ⏳ Initial effects may take weeks

Correct Answers:

  • "This drug could take 1-3 weeks to begin working."


Rationale :

🍊 Fluoxetine (Prozac) is a selective serotonin reuptake inhibitor (SSRI) used for treating depression, anxiety, and other mood disorders.

🍊 It typically begins to show therapeutic effects within 1 to 3 weeks, although full symptom relief may take 4 to 6 weeks.

🍊 The nurse should provide reassurance and explain that the client’s feelings are common during early treatment, helping promote medication adherence.

🍊 Premature changes to medication are not necessary unless the client experiences severe side effects or worsening symptoms.


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7 :

Hint : 🧠 Mood stabilizer for mania

Correct Answers:

  • Lithium [Lithobid]


Rationale :

🍇 Lithium is a mood stabilizer and is the first-line treatment for managing acute manic episodes associated with bipolar disorder.

🍇 It helps control symptoms like elevated mood, hyperactivity, reduced need for sleep, and impulsive behavior.

🍇 Lithium requires serum level monitoring due to its narrow therapeutic range (typically 0.6–1.2 mEq/L) and potential for toxicity.

🍇 The nurse should educate the client about maintaining adequate fluid and sodium intake, as dehydration or sodium loss can raise lithium levels.


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8 :

Hint : 🤰 Pregnancy + ACE/ARB = danger

Correct Answers:

  • ARBs and ACE inhibitors are contraindicated during pregnancy.


Rationale :

🍋 ACE inhibitors (like lisinopril) and ARBs (like losartan) are both teratogenic and can cause fetal injury or death, especially in the second and third trimesters.

🍋 These drugs are absolutely contraindicated during pregnancy, and women of childbearing age should be advised to use effective contraception while on therapy.

🍋 Both drug classes are used to manage hypertension and heart failure, and they can increase potassium and cause neutropenia, so labs should be monitored.

🍋 Nurses should reinforce avoiding these drugs during pregnancy and monitoring for hyperkalemia and low WBCs.


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9 :

Hint : 💊 Drug scheduling = CSA law

Correct Answers:

  • Controlled Substances Act (CSA)


Rationale :

🍉 The Controlled Substances Act (CSA) is the federal law that regulates the manufacture, distribution, and classification of drugs considered to have potential for abuse.

🍉 It categorizes medications into Schedules I through V, with Schedule I being the most restrictive (e.g., heroin, no accepted medical use) and Schedule V the least restrictive.

🍉 The CSA is enforced by the Drug Enforcement Administration (DEA) and helps ensure the safe and legal use of narcotics and controlled medications.

🍉 This statute plays a critical role in guiding prescription practices, monitoring controlled substance use, and preventing drug diversion and abuse.


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10 :

Hint : 😮‍💨 Dry cough = think ACE inhibitor

Correct Answers:

  • Captopril (Capoten)


Rationale :

🍇 Captopril is an Angiotensin-Converting Enzyme (ACE) inhibitor, a class of drugs commonly used to treat hypertension and heart failure.

🍇 A well-known side effect of ACE inhibitors like captopril is a persistent, dry, nonproductive cough, which occurs in up to 20% of patients.

🍇 This cough is thought to be caused by the accumulation of bradykinin, a peptide that is normally broken down by ACE.

🍇 If the cough becomes intolerable, providers may switch the client to an Angiotensin II Receptor Blocker (ARB) like losartan, which does not cause this effect.


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Total Questions: 10

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