The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A.

Gapuz

PART V

THE
CHECK PRINCIPLE
APPLIED IN PHARMACOLOGY

Remember to
take your
Tagamet with
meals!

Oftentimes PHARMACOLOGY is the most dreaded part of a

nursing exam. One reason could be that it requires you to memorize
facts, and more often than not, it is difficult to decide on WHAT TO
MEMORIZE. But not anymore, the CHECK PRINCIPLE provides you
with a framework.

It stands for…

C – heck why the medication is given and know the classification of

the drug . In other words, you should know the purpose why the
medication is given.

H –ow will you know if the medication is effective. What are your
assessment parameters in monitoring the effects of the drug?

E – xactly what time should the medication be given. Some drugs

are best taken with meals, some after meals and some, on an
empty stomach. Other drugs may also be taken without regard
to meals. You should know all of these!

C – lient teaching tips. What would you tell your patient to expect.
You should be able to give instructions related to the
therapeutic and side effects of the drug.

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K – eys to giving it safely. You should be able to identify

interventions to counteract the adverse/side effects of the drug.

So now, if you’re ready let’s CHECK the most commonly

asked drugs in the actual exam…

A
Aldomet (Methyldopa)

C – Antihypertensive
H – Decreased BP
E – Take the drug regularly exactly as prescribed
C – Impotence can be expected
K – Check the BP, the drug may cause hypotension

Sample question: In a hypertensive male patient who is taking

methyldopa (Aldomet) as a maintenance medication, the nurse would
most likely anticipate the patient to complain of:

a. photosensitivity c. urticaria
b. impotence d. tarry stool
Answer: (B)

Aminophylline (Theophylline)

C – Bronchodilator
H – Ease of breathing
E – Best taken in the morning on an empty stomach, because the
drug causes insomnia
C – Stop smoking as it interferes with the drugs’ effectiveness
K – Check the heart rate, the drug may cause tachycardia
Maintain adequate urine output
Avoid caffeine containing foods

Sample question: A nurse should assess a patient who is receiving

aminophylline for which of the following side effects of the
medication?
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a. bradycardia c. tinnitus
b. tachycardia d. ecchymosis
Answer: (B)

Amphogel (Aluminum Hydroxide gel)

C – Antacid; it neutralizes or reduces gastric acidity

H – Decreased phosphate level
E – Best taken between meals and at bedtime
C – The drug may cause constipation
K – Administer the drug with a glass of water
Report black tarry stool.
Monitor for signs and symptoms of hypophosphatemia.

Sample question: An adult has been taking aluminum hydroxide

(Amphogel) for hyperphosphatemia. It is most important for the nurse
to teach the patient:

a. to inform the physician if he has constipation

b. the tablets tend to be more effective than the liquid
c. to report signs of muscle weakness, anorexia, and malaise
d. to take large amount of water to ensure passage of the
medication to the stomach
Answer: (C)

Antabuse (Disulfiram)

C – Antialcoholic agent; causes an unpleasant reaction when

combined with alcohol
H – Patient avoids alcohol
E – Best taken after abstaining from alcohol for 12 hours
C – Instruct the patient to avoid alcohol based substances like:

M - OUTH WASH
O - VER THE COUNTER COLD REMEDIES
F - RUIT FLAVORED EXTRACTS
F - OOD SAUCES MADE UP OF WINE
A - FTER SHAVE LOTION
V - INEGAR
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S - KIN PRODUCTS

K – Inspect the patient’s belongings and confiscate alcohol based

substances
Monitor liver function tests

Sample question: Which of the following statements, if made by a

patient who is addicted to alcohol, would indicate an adequate
understanding of disulfiram (Antabuse) ?

a. “I will read the labels on mouthwash before using it.”

b. “I need to take this medication on an empty stomach.”
c. “This medication will decrease my desire for alcohol.”
d. “I need to take precautions in the sun.”
Answer: (A)

Apresoline ( Hydralazine)

C – Antihypertensive
H – Decreased blood pressure
E – Best taken with food
C – Rise slowly from a lying or sitting position
K – Monitor for signs and symptoms of orthostatic hypotension
Monitor the heart rate for tachycardia

Sample question: Prior to the administration of hydralazine

(Apresoline) the nurse would evaluate for which of the following?

a. A decrease in the pulse pressure

b. Pulse rate in excess of 110.
c. A significant decrease in blood pressure
d. Presence of confusion and disorientation.
Answer: (C)

Artane (Trihexyphenidyl HCL)

C – Anti-parkinsonian; given with antipsychotics to prevent

pseudoparkinsonism
Ex. Amantadine Symmetrel
- dopaminergic agent
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- increases dopamine levels

Trihexyphenidyl (Artane)
Bipeviden HCl (Akineton)
Benztropine Mesylate (Cogentin)
- Anticholinergics  decreases acetylcholine
H – Muscles become less stiff; decreased pill-rolling tremors
E – Best taken after meals
C – Avoid driving, the drug causes blurred vision
K – Check the BP, the drug may cause hypotension

Sample question: The nurse monitors the therapeutic effectiveness

of trihexyphenidyl hydrochloride (Artane) in the treatment of
parkinson’s disease by evaluating for a decrease in:

a. bradykinesia c. tremors
b. occulogyric crisis d. propulsive gait

Answer: (C)

ASA (Aspirin)

C – Anti-inflammatory; reduces inflammation

Ex. Acetylsalicylic acid (Aspirin)
Ibuprofen (Motrin, Advil)
Indomethacin (Indocin)
H – (-) Fever, Inflammation, Pain
E – Best taken on full stomach
C – Tinnitus indicates toxicity
Avoid other over-the-counter cold remedy
K – Assess the patient for bleeding tendencies
Induce vomiting if overdose occurs

Sample question: A patient is taking acetylsalicylic acid (Aspirin)

four times daily. To minimize possible complications of this therapy,
the nurse should give the patient which of these instructions?

a. “Avoid taking the aspirin with dairy products.”

b. “Drink a glass of water with the aspirin.”
c. “Aspirin should be taken one hour before meals.”
d. “Take the aspirin with food.”

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Answer: (D)

Atropine Sulfate

C – Anticholinergic; reduces salivation, reverse heartblocks

Ex. Atropine sulfate (Isopto atropine)
Propantheline bromide (Pro-Banthine)
H – It increases heart rate in a patient with heartblock
E – Best taken 30 minutes before meals
C - The drug may cause facial flushing
Avoid tasks that require acute vision
Avoid hot environment
K – Check the BP, the drug causes hypotension, constipation and
drymouth

Sample question: Preoperatively, a patient is given atropine sulfate.

Which of these findings would indicate that the desired effects of the
medication have been achieved?

a. increase in heart rate c. onset of drowsiness

b. dryness of the lips d. relief of nausea
Answer: (B)

Ca Edta (Edetate Calcium Disodium)

C – Antidote in lead poisoning

H – Increased urinary excretion of lead
E – No specific
C – Report pain at injection site
K – Monitor BUN levels, can damage the kidneys
Keep the patient supine

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Sample question: The side effect which is attributed to both the

lead toxicity and the primary chelating agent, Ca Edta, is:

a. hypocalcemia
b. bone-marrow depression
c. increased intracranial pressure
d. nephrotoxicity
Answer: (D)

Cephulac (Lactulose)

C – Laxative; ammonia reduction agent

H – Decreased serum ammonia
E – No specific
C – Report diarrhea
K – Monitor serum ammonia levels
Administer with juice to disguise the taste

Sample question: Lactulose (Cephulac) is ordered for a patient with

liver cirrhosis. What is the purpose of this drug?

a. to stimulate secretion of renin

b. to improve glucose utilization
c. to limit excretion of sodium
d. to decrease ammonia absorption
Answer: (D)

C – Oral anticoagulants; depresses the synthesis of vitamin K

dependent clotting factors
Ex. Warfarin sodium (Coumadin)
Dicumarol (Bishydroxycoumarin)
H – (-) Thrombus
E – No specific
C – Avoid green leafy vegetables as the Vitamin K content of these
vegetables interfere with the absorption of the drug.
Avoid contact sports
K – Assess for any sign of bleeding
Keep vitamin K at the bedside
Do not give patient any IM injection
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Many factors (diet, fever, environment) may change the body’s

response to the drug

Sample question: A nurse has given patient instructions about

taking warfarin sodium (Coumadin). Which of the following
statements, if made by the patient, indicates that the patient
understands the instructions?
a. “I can expect to gain weight while taking this medication.”
b. “I will take my pulse prior to each dose.”
c. “I can take Aspirin when I have a headache.”
d. “I will take the medication at the same time every day.”

Answer: (D)

D
Demerol (Meperidine HCL)

C – Narcotic Analgesic; used to relieve pain of nephrolithiasis

H – (-) Pain
E – No specific
C – Avoid activities that requires alertness
Avoid alcohol
It may cause facial flushing
K – Keep the antidote, naloxone HCL at the bedside

Sample question: For the first two days following thoracic

surgery, a patient received meperidine hydrochloride (Demerol) every
three hours. On the third day, three hours after receiving the
Demerol, the patient refuses to cough because of pain in the
operative area and feeling nervous. The patient’s respirations are
shallow. Based on the above data, which of these actions should the
nurse take?

a. delay giving the medication to prevent the patient from becoming

addicted to the narcotic
b. delay giving the medication to avoid further depressing the
patient’s respiration
c. administer the medication to facilitate the patient’s respiratory
exercises
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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

d. administer the medication to relieve the patient’s tension

Answer: (C)

C – Hypoglycemic agents; stimulate the pancreas to secrete insulin

Ex. Chlorpropamide (Diabinase)
Tolbutamide (Orinase)
Tolazamide (Tolinase)
H – Blood sugar level within normal range
E – Best given in the morning with food, so sleep will not be
disturbed by increased urination
C – Take weight daily
Protect the skin from exposure to the sun
K – Assess for signs and symptoms of hypoglycemia like
drowsiness, diaphoresis, and dizziness.

Sample question: Diabinase is most effective in which type of

diabetes?

a. insulin dependent diabetes mellitus

b. non-insulin dependent diabetes mellitus
c. gestational diabetes
d. diabetic ketoacidosis
Answer: (B)

C – Carbonic anhydrase inhibitors; promotes sodium excretion

Ex. Acetazolamide (Diamox)
H – Increased urine output, decreased vertigo in meniere’s disease
E – Best taken in the morning with meals
C – Avoid driving
Avoid exposure to sunlight
K – Assess for unusual bleeding

Sample question: A patient with meniere’s disease is prescribed

with Diamox. What observation shows that the drug is taking effect?

a. increased urinary output

b. patient is relieved of constipation
c. patient has clearer vision
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d. vertigo is significantly lessened

Answer: (D)

Digoxin (Lanoxin)

C – Cardiac Glycoside; increases myocardial contraction, decreases

heart rate; stones conduction through the AV node
Ex. Digoxin (Lanoxin)
Deslanoxide (Cedilanid)
H – Normal heart rate in patient with atrial fibrillation
E – No specific
C – Report greenish vision, sign of toxicity
Take pulse everyday
K – Assess the patients’ heartrate, it causes bradycardia
Assess for signs of toxicity (Nausea, Anorexia, Vomiting,
Diarrhea)
Monitor serum K level.

Sample question: A patient who is receiving a digitalis preparation

should be observed for symptoms of toxicity, which include:

a. hypertension c. tinnitus
b. oliguria d. vomiting

Answer: (D)

Dilantin (Phenytoin)

C – Anti-convulsants; decreases spread of the seizure process

Ex. Phenytoin (Dilantin)
H – (-) Seizure
E – Best taken with food to enhance absorption
C – Massage the gums, it causes gingival hypertrophy
May turn the urine pink, red or reddish brown
K – Monitor for signs and symptoms of bone marrow depression
Do not discontinue abruptly
Use saline flush before and after IV administration
Report skin rash

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

Sample question: Margaret Tempo is a 7-year-old who has been on

phenytoin (Dilantin) and phenobarbital for control of chronic recurrent
seizures. In the physical exam, the nurse notes that Margaret has
hyperplasia of the gums which is:

a. a common occurrence with chronic recurrent seizures

b. a common side effect of phenytoin (Dilantin)
c. not related to the drug or the disease
d. an unusual side effect of phenobarbital
Answer: (B)

Diuril (Chlorothiazide)

C – Diuretic
H – Increased urine output
E – Best taken with food early in the day, so sleep will not be
disrupted by increased urination
C – Protect the skin from exposure to the sun
Muscle weakness in the lower extremities indicate
hypokalemia
Increase K in the diet
K – Monitor weight

Sample question: Mr. Backster should be instructed about the side

effects of diuril which include:

a. insomnia b. dysuria c. diplopia d. weakness

Answer: (D)

Elavil (Amitriptyline)

C – Tricyclic anti-depressant; prevents the reuptake of

norepinephrine
H – Increased appetite; adequate sleep
E – Best given after meals

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C – Therapeutic effects may become evident only after 2-3

weeks of intake
K – Check the BP, it causes hypotension
Check the heartrate, it causes cardiac arrythmias

Sample question: A community mental health nurse is caring for an

elderly homebound patient who has a diagnosis of major depression.
Which of the following observations would be typical of a patient who
received amitriptyline hydrochloride (Elavil) for a week?

a. elevated mood c. improved hygiene

b. increased social activity d. improved sleep pattern

Answer: (D)

F
Ferrous SO4

C – Iron preparation; used in the prevention and treatment of iron

deficiency anemia
H – (-) Pallor
E – Best taken on an empty stomach
C – Avoid milk, egg, coffee and tea, these decrease absorption
Take the drug with orange juice to promote absorption
K – Keep the antidote, deferoxamine mesylate, at the bedside

Sample question: How should a patient take ferrous sulfate?

a. before taking the morning coffee

b. on an empty stomach
c. with citrus juice
d. after meals
Answer: (C)

G
Garamycin (Gentamicin)

C – inhibits protein synthesis; bacteriostatic and bactericidal

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Ex. Gentamicin (Garamycin)

Tobramycin (Nebcin)
Streptomycin
H – (-) Infection
E – No specific
C – Increase fluid intake
Tinnitus indicates ototoxicity
K – Monitor for signs and symptoms of ototoxicity, nephrotoxicity
and neurotoxicity.

Sample question: Nelson Hall is a 5-years-old in a pediatric

intensive care unit. He has a diagnosis of otitis media, dehydration,
and tonsillitis. Nelson is receiving gentamicin via intravenous
piggyback every 8 hours. Which of the following statements by
Nelson’s mother should alert the nurse to a potential problem?

a. “He seems to be hungry today, always asking for ice cream.”

b. “He still has some pain, but the shots seem to help”
c. “Sometimes he takes a nap and doesn’t want to play.”
d. “Nelson is ignoring me. He did not look up when I called him.”

Answer: (D)

H
Haldol (Haloperidol)

C – Antipsychotics; blocks dopamine receptor sites

Ex. Haloperidol (Haldol)
Chlorpromazine (Thorazine)
Fluphenazine (Prolixin)
H – Decreased delusions, hallucinations, looseness of
association
E – Best taken after meals
C – Avoid exposure to sunlight
K – Monitor BP, it causes hypotension
The long acting type (Haloperidol Decanoate) is given once a
month

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

Sample question: After administering an injection of Haloperidol

Decanoate (Haldol) to a patient, the nurse should instruct the patient
to:

a. stay recumbent for four hours

b. avoid foods containing tyramine
c. return for the next injection in four weeks
d. decrease salt intake
Answer: (C)

C – Parenteral anticoagulants; prevents conversion of prothrombin to

thrombin
Ex. Heparin Sodium
H – Prolonged PTT
E – No specific
C – Report signs and symptoms of bleeding
K – Monitor the patient partial thromboplastin time
Keep protamine SO4 (antidote) at the bedside
Do not give by IM injection

Sample question: A nurse should expect a patient who has a deep

vein thrombosis to be given Heparin sodium (Heparin) to

a. dissolve the thrombus c. prevent clot enlargement

b. decrease the pain d. reduce tissue edema
Answer: (C)

Inderal (Propanolol Hydrochloride)

C – Antianginal, Antiarrythmic, Antihypertensive; reduces portal
pressure and decreases the risk of bleeding from esophageal
varices
H – Decreased BP
E – Best taken with meals
C – Avoid driving; do not discontinue abruptly
K – Check the BP, it may cause hypotension

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

Sample question: A nurse should expect a patient who has been

diagnosed with hyperthyroidism to be prescribed propanolol (Inderal)
in order to:

a. inhibit the synthesis of thyroid hormone

b. increase the effect of calcium on cardiac tissue
c. enhance TSH secretion from the pituitary gland
d. slow the sympathetic nervous system response

Answer: (D)

INH (Isoniazid)

C – Antitubercular agents, inhibits mycolic acid thus causing a

tuberculostatic or tuberculocidal effect
Ex. Isoniazid (INH)
Rifampicin (Rifadin)
Streptomycin
H – (-) Infection
E – Best taken on an empty stomach
C – Report tingling sensation in the lower extremities, it indicates
peripheral neuropathy
Avoid alcohol
K – Liver function studies should be done before the start of therapy
Therapeutic effects generally occur in 2 – 3 weeks.
Administer with Vitamin B6 to prevent peripheral neuropathy.

Sample question: Mrs. Silvia is prescribed isoniazid (INH) for

treatment of tuberculosis. The nurse should instruct Mrs. Silvia on
which of the following?

a. decreased niacin c. increased niacin stores

b. increased folate stores d. decreased in vitamin A

Answer: (A)

C – Parenteral hypoglycemic agents; aids glucose across the cell

Ex. 1. Rapid acting:
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Regular
Semilente
2. Intermediate acting:
NPH
Lente
3. Long acting
Ultra Lente
H – Normal blood sugar level
E – Best given before breakfast
C – Report signs and symptoms of hypoglycemia (tremors,
nervousness)
K – Serve meals on time to prevent hypoglycemia
When mixing these types of insulin, inject air into the NPH
insulin first before the regular insulin, but aspirate the regular
insulin first before the NPH insulin

Sample question: A patient who is receiving total parenteral nutrition

has an elevated blood glucose level and is to be administered
intravenous insulin. Which of the following types of insulin should a
nurse have available?

a. Isophane insulin (NPH)

b. Regular insulin (Humulin R)
c. Insulin zinc suspension (Lente)
d. Semi-lente insulin (Semitard)
Answer: (B)

L
C – Loop diuretic; blocks the reabsorption of sodium in the loop of
Henle
Ex. Furosemide (Lasix)
Remember: Lasix – it’s a loop diuretic which acts on the
ascending loop
H – Increased urine output
E – Best given in the morning

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C – Eat bananas and citrus fruits because they are good sources of
potassium
K – Monitor serum potassium levels, it can cause hypokalemia

Sample question: A patient in renal failure is being treated with

furosemide (Lasix) via a continuous IV infusion. The nurse knows
that the dosage of furosemide (Lasix) to be delivered should not
exceed:

a. 10 mg/min c. 4 mg/kg
b. 4 mg/min d. 100mg/day

Answer: (B)

Lithium Carbonate

C – Antimanic
H – Decreased hyperactivity
E – Best taken after meals
C – Increase fluid intake (3 L /day) and sodium intake (3 gm./day)
Avoid activities that increase perspiration
K – It takes 10-14 days before therapeutic effect becomes evident.
Antipsychotic is administered during the first two weeks to
manage the acute symptoms of mania until lithium takes effect
Monitor serum level, normal is .5-1.5 meq/L.
Nausea, Anorexia, Vomiting, Diarrhea and Abdominal cramps
indicates lithium toxicity
Mannitol is administered if toxicity occurs

Sample question: A nurse is caring for a patient who is receiving

Lithium carbonate (Eskalith). Prior to administration of the next dose,
the nurse finds that the patient’s lithium blood level is 1.6 mEq/L.
Which of the following actions should the nurse take first?

a. call the patient’s physician

b. withhold the dose
c.take the patient’s vital signs
d. repeat the blood lithium level
Answer: (B)

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

Magnesium SO4

C – Anticonvulsant
H – (-) Convulsion
E – No specific
C – Diarrhea is a side effect
K – Keep the antidote, calcium gluconate at the bedside
Assess the patient’s respiratory rate, (should be at least
12/min.) deep tendon reflex and urine output, (should be at
least 30 ml./hr.)

Sample question: During labor a woman is receiving magnesium

sulfate intravenously. It is essential that a nurse have which of the
following drugs available to counteract potential adverse effects?

a. Oxytocin (Pitocin) c. Phenytoin sodium (Dilantin)

b. Sodium bicarbonate d. Calcium gluconate

Answer: (D)

C – Osmotics; decreases water reabsorption

Ex. Mannitol (Osmitrol)
H – Increased urine output
E – Best given in the morning
C – Avoid alcohol and prolonged exposure to sunlight
K – Monitor BP and serum potassium

Sample question: A patient with a closed head injury is started on IV

mannitol to decrease intracranial pressure. If the patient complains of
headache or becomes confused several hours after the drug is
administered, the nurse should assess the patient for which of the
following?

a. elevated atrial blood pressure

b. elevated serum electrolytes
c. elevated intracranial pressure
d. elevated central venous pressure

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Answer: (C)

Mestinon (Pyridostigmine)

C –Cholinesterase inhibitor; used as treatment for myasthenia

gravis
H – Increased muscle strength
E – Usually administered before meals
C – Report the development of rash, the drug may increase
peristalsis
K – Monitor for muscle weakness
Keep the antidote, atropine SO4 at the bedside

Sample question: A diagnosis of myasthenia gravis is confirmed,

and Ms. Gaddi is started on pyridostigmine (Mestinon) orally. The
nurse will be alert for which of the following adverse effect of
Mestinon?

a. constipation c. diarrhea
b. urinary retention d. dry mouth
Answer: (C)

Methergin (Methylergonovine Maleate)

C – Oxytocic; used as a treatment for postpartum atony and

hemorrhage
H – Firmly contracted uterus
E – No specific
C – Report difficulty of breathing
K – Monitor the BP, it causes hypertension

Sample question: A potential side effect of Methergin is:

a. hypotension c. hypokalemia
b. hypertension d. hyperphosphatemia

Answer: (B)

Monoamine Oxidase Inhibitor (MAOI)

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C – Antidepressant
H – Increased appetite; adequate sleep
E – Best taken after meals
C – Report headache; it indicates hypertensive crisis
Avoid tyramine containing foods like:

A-vocado
B-anana
C-heddar and aged cheese
S-oysauce and preserved foods
K – Monitor the BP

Sample question: Which of the following foods, if chosen by a

patient who is taking a monoamine oxidase inhibitor (MAOI),
indicates that the patient is following the prescribed diet?

a. Prunes c. Fresh vegetables

b. Aged cheese d. Sausage
Answer: (C)

Morphine SO4

C – Narcotic Agonist, Analgesic; given to decrease anxiety in a

patient with pulmonary edema; promotes venous pooling of blood
in the periphery, so it decreases venous return to the heart
H – Relief of pain
E – Best taken with food
C – Avoid driving,
Report severe nausea and vomiting
K – Keep Naloxone HCL (antidote) at the bedside
Instruct the patient to lie down during IV administration.
Morphine causes more pain in pancreatitis because it
increases the spasm of the sphincter of oddi, so avoid giving
it.

Sample question: A nurse should be aware that morphine sulfate is

administered to a patient who has pulmonary edema in order to:

a. diminish venous return to the heart

b. decrease pain
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c. decrease the respiratory rate

d. reduce the glomerular rate
Answer: (A)

Nitroglycerin

C – Antianginals; decreases oxygen demand, decreases preload by

dilating veins
Ex. Nitroglycerin (Nitrobid, Tridil, Transderm, Deponit)
H – Relief of chest pain
E – Best taken before any strenous activity
C – Place a tablet under the tongue at the first sign of chest pain
“Burning sensation” under the tongue is a sign of potency of
the drug. Facial flushing is a side effect.
Do not chew the tablet.
Keep the tablets in a dark container.
K – Monitor the BP and heart rate

Sample question: Which of these statements, if made by a patient

who has a prescription for sublingual nitroglycerin tablets, would
indicate a correct understanding of the medication instructions?

a. “I should take these pills with a full glass of water.”

b. “I should protect these pills from light.”
c. “I should wait 30 minutes before taking the second pill.”
d. “I should chew the pill for a faster effect.”

Answer: (B)

O
P

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Penicillin

C – interferes with division of bacteria

Ex. Penicillin
Methicillin
Amoxicilin
H – (-) Infection
E – Best taken on an empty stomach with a full glass of water
C – Report the development of rash
K – Keep the antidote, epinephrine at the bedside

Sample question: A child who is being treated for rheumatic fever is

given instructions about her penicillin therapy. The child’s parents ask
the nurse, “What is the purpose of our child being on penicillin for an
indefinite time?” the nurse should respond that the purpose of the
penicillin regimen is to:

a. stimulate the immune system

b. prevent a recurrence of the disease
c. alter the flora in the respiratory tract
d. prevent permanent pathologic changes in the joints

Answer: (B)

Phenergan ( Promethazine Hydrochloride)

C – Antihistamine
H – (-) Allergy
E – No specific
C – Avoid alcohol and prolonged exposure to sunlight
K – Do not administer SC, tissue necrosis may occur

Sample question: A patient is scheduled for surgery and is to

receive promethazine hydrochloride (Phenergan) 35 mg
intramuscularly. The drug is available in ampules containing 50 mg./
1 ml of solution. The patient should receive how many milliliters of
solution?

a. 0.3 b. 0.7 c. 1.0 d. 1.4

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Answer: (B)

Pitocin (Oxytocin)

C – Oxytocic; used to induce labor after artificial rupture of the

membranes
H – Firmly contracted uterus
E – No specific
C – Report the development of rash
K – Monitor the BP
Discontinue if hypertension develops

Sample question: Because a woman is receiving oxytocin (Pitocin)

for induction of labor, it is essential for the nurse to monitor:

a. fundal height c. cervical changes

b. patellar reflexes d. level of consciousness

Answer: (C)

Probenecid (Benemid)

C – Antigout
Ex. Colchicine (Novocolchine)
- control inflammation of the attack
Probenecid (Benemid)
- increases excretion of uric acid
Allopurinol (Zyloprim)
- decreases production of uric acid
H – Decreased uric acid levels
E – Best taken with meals
C – Change position slowly
K – Increase fluid intake

Sample question: Mr. Ray states that he is taking a medication for

gout but cannot remember the name. He states that it is especially
important that he drinks eight glasses of water daily to keep the
excreted uric acid dilute. This drug is contraindicated in patients with
renal failure or with a history of renal stones. Which drug is Mr. Ray
most probably taking?
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a. Probenecid c. Colchicine
b. Allopurinol d. Tylenol
Answer: (A)

Prostigmin (Neostigmine)

C – Anticholinesterase; increases muscle strength by inhibiting

acetylcholinesterase
Ex. Endrophonuim chloride (Tensilon)
Neostigmine methylsulfate (Prostigmin)
Pyridostigmine bromide (Regonol)
H – Increased muscle strength
E – No specific
C – Report diarrhea, abdominal pain and muscle weakness
Avoid hot and excessively humid environment
K – Keep the antidote, pralidoxime chloride (PAM) or atropine at
the bedside

Sample question: In a patient receiving prostigmin (Neostigmine) for

treatment of Myasthenia Gravis, the nurse should plan to have which
of the following drugs at the bedside ?

a. lidocaine c. atropine
b. epinephrine d. procainamide
Answer: (C)

PTU (Propylthiouracil)

C – Antithyroid; inhibits synthesis of thyroid hormone

H – Decreased heart rate; adequate sleep
E – Take the drug around the clock at 8 hour interval
C – Treatment is lifelong
Report the development of sorethroat, it indicates
agranulocytosis
K – Monitor the heart rate, it causes tachycardia contraindicated in
pregnant patients

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

Sample question: A patient with hyperthyroidism is started on

propylthiouracil (PTU). When should the nurse expect noticeable
improvement in the patients’ condition?
a. in 24 to 48 hrs c. in 2 to 4 weeks
b. in 6 to 7 days d. in 6 months
Answer: (C)

RhoGAM (Rho Immune Globulin)

C – Prevents sensitization to the Rho factor

H – (-) Erythroblastosis Fetalis
E – Administer within 72 hours after Rh incompatible delivery
C – Report pain and soreness at injection site
K – Given to Rh (-) mother with an Rh (+), Coombs (-) Baby

Sample question: An Rh – negative mother would need to receive

Rho (D) immune –globulin (RhoGAM) within 72 hours after delivery if
her newborn had which of the following blood test results?

a. Rh negative, Coombs positive

b. Rh negative, Coombs negative
c. Rh positive, Coombs negative
d. Rh positive, Coombs positive
Answer: (C)

C – Stimulants; increases attention span thus decreasing

hyperactivity
Ex. Methylphenidate (Ritalin)
Amphetamine (Benzedrine)
H – Decreased hyperactivity
E – Best given after meals because it suppresses the appetite if
given before meals;
Give it in the morning or at least 6 hours before bedtime since
it causes insomnia
C – May cause growth retardation
K – Monitor growth and development
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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

Sample question: Methylphenidate (Ritalin) calms impulsiveness,

hyperactivity and restlessness of attention deficit disorder (ADD) or
hyperactive children by a paradoxical calming effect. The nurse
knows that this means:

a. Ritalin is an anxiolytic and calms the child

b. Ritalin is a stimulant and calms the child
c. Ritalin is an analgesic and calms the child
d. Ritalin is a relaxant and calms the child
Answer: (B)

S
Streptomycin

C – Aminoglycoside; used to destroy the vestibular apparatus to

decrease vertigo in a patient with meniere’s disease
H – (-) Infection
E – Best taken after meals, to decrease GI upset
C – Report oliguria, it indicates nephrotoxicity
K – Increase fluids
Monitor BP and pulse
The drug causes ototoxicity, nephrotoxicity and neurotoxicity

Sample question: If a patient is receiving Streptomycin, which of

the following should the clinic nurse report immediately to the
physician?

a. drooping of the eyelids c. inflammation of the joint

b. stoma of the mouth d. loss of hearing

Answer: (D)

Symmetrel (Amantadine)

C – Antiparkinsonian, Dopaminergic, Antiviral

H – Muscles become less stiff
E – No specific
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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

C – Report swelling of fingers

K – Do not discontinue abruptly

Sample question: Amantadine hydrochloride (Symmetrel) is

prescribed for a patient with Parkinson’s disease. The patient asks
how the drug works. In formulating a response, the nurse recalls that
the drug:

a. Allows accumulation of dopamine

b. Corrects mineral deficiencies
c. Elevates the patient’s mood
d. Blocks dopamine receptors
Answer: (A)

C – Thyroid agents; replace missing thyroid hormones

Ex. Levothyroxine sodium (Synthroid)
Thyroglobulin (Proloid)
Liotrix (Euthroid)
H – Normal T4 levels; in female patients there will be resumption of
menstruation
E – Best taken in the morning, to prevent insomnia
C – Treatment is lifelong
K – Monitor BP and pulse

Sample question: A female patient is ordered to take Synthroid 0.4

mg daily. She has been taking this medication for 4 days. Which of
the following statements would indicate that the nurse should
recommend a change in the patient’s medication?

a. develops nervousness and difficulty sleeping

b. states she has “NO ENERGY” and is “just tired”
c. patient has coarse hair and skin
d. has a persistent weight gain
Answer: (A)

T
Tagamet (Cimetidine)

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

C – Histamine antagonist; inhibits gastric acid secretion

H – Relief of symptoms of heartburn, acid indigestion
E – Best given with food, when administering it with an antacid, give
the antacid one hour before cimetidine
C – Avoid smoking, it decreases drug efficacy
K – Administer IM dose undiluted deep into large muscle
Infusion should be diluted in at least 50 cc of D5W

Sample question: Mr. Ojastro is receiving cimetidine (Tagamet) 300

mg every 6 hours IVPB for a duodenal ulcer. The nurse should
administer the medication using which of the following methods?

a. undiluted, IV push over 1 minute

b. diluted in 20 cc of compatible solution and IV push over 1 minute
c. diluted in 50 cc of compatible solution and infused over 15 to 20
minutes
d. undiluted and infused over 15 to 20 minutes
Answer: (C)

Timolol Maleate (Timoptic)

C – Antihypertensives; lowers the blood pressure

Ex. Beta adrenergics blockers
- decreases cardiac output
Atenolol (Tenormin)
Timolol (Blocadren)
H – Decreased BP; IOP
E – No specific
C – Avoid driving
K – Administer ophthalmic eye drops in the lower conjunctival sac
The drug may cause hyperglycemia or hypoglycemia

Sample question: A patient is given a prescription for timolol

maleate (Timoptic) eyedrops. The nurse should instruct the patient to
instill the eyedrops at which of these areas of the eyes?

a. in the inner canthus c. in the conjunctival sac

b. on the cornea d. on the center of the pupil

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

Answer: (C)

C – Antianxiety agents; anxiolytics

- depresses the reticular activating system
Ex. Diazepam (Valium)
Chlordiazepoxide (Librium)
Oxazepam (Serax)
H – Decreased anxiety, adequate sleep
E – Best taken before meals, food in the stomach delays absorption
C – Avoid driving, intake of alcohol and caffeine containing foods,
since it alters the effect of the drug
K - Administer it separately, it is incompatible with any drug

Sample question: The nurse is caring for a patient with severe back
strain. The nurse administers diazepam (Valium) 10 mg qid. Which
observation is most indicative of the need to reassess this order?

a. drowsiness
b. hyperesthesia of the arms
c. loss of appetite
d. severe muscle spasms
Answer: (D)

Vitamin K (Phytonadione)

C – Antidote, promotes formation of prothrombin, given in neonates

to prevent bleeding
H – (-) Bleeding
E – No specific
C – Report the development of rash
K – Monitor prothrombin time, to determine dosage effectiveness

Sample question: A newborn receives vitamin K (Aquamephyton)

to:

a. protect the eyes from infection

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

b. prevent bleeding problems

c. boost the immune response
d. stimulate growth of gastrointestinal flora

Answer: (B)

X
Xylocaine (Lidocaine)

C – Antiarrhythmic, Anesthetic; used to treat premature ventricular

contractions
H – Normal heart rate
E – No specific
C – Tinnitus is a side effect
K – Monitor BP and serum electrolytes
Convulsion is the first sign of toxicity

Sample question: The nurse will plan to assess for the following
side effects related to intravenous lidocaine therapy:

a. disorientation c. dry mouth

b. photophobia d. abdominal cramps

Answer: (A)

Y
Yutopar (Ritodrine)

C – Tocolytic, used to treat pre-term labor by decreasing the intensity

and frequency of uterine contractions.
H – Relaxed uterus
E – No Specific
C – Report increase in pulse rate, it causes palpitation
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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

K – Contraindicated before 20th week of pregnancy, in patients with

hemorrhage, hypertension, infection, bleeding disorders and
spontaneous abortion.

Sample question: Richelle is admitted to the labor and delivery unit

at 22 weeks gestation. She is evaluated for abruptio placenta. The
nurse knows that ritodrine HCl (Yutopar) is indicated in this case to
prevent labor. Which of the following is not a contraindication for
ritodrine HCl?

a. pregnancy induced hypertension

b. chorioamnionitis
c. maternal cardiac disease
d. multiple fetuses
Answer: (D)

Zyloprim (Allopurinol)

C – Antigout; used to prevent or treat attacks of gout

H – Decreased uric acid levels
E – Best taken with food
C – Instruct the patient to report sore throat, it signals the
development of agranulocytosis
K – Increase fluid intake to facilitate excretion of uric acid crystals
Avoid over the counter medications, most of these contain
vitamin C which can increase the likelihood of renal stone
formation

Sample question: Inez is 9-years-old, and newly diagnosed with

leukemia. She is just starting her chemotherapy. The physician also
orders Allopurinol for her. This drug has been ordered for Inez to
decrease the possibility of:

a. infection c. nausea and vomiting

b. hyperuricemia d. bone narrow depression

Answer: (B)
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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

N.B.

To facilitate easier recall the brand names of the drugs were

written ahead of the generic names.

Let’s SYNTHESIZE!

After going through that list, I’m sure you would agree with me
if I tell you that we can still make things MORE SIMPLE. Let’s
start …

Drugs with ANTIDOTE

Acetaminophen…………………………………………….Acetylcysteine
Benzodiazepine……………………………….……………….Flumazenil
Coumadin………………………..……………………………….Vitamin K
Curare……………………………………..…...Endrophonium (Tensilon)
Cyanide poisoning………..…….……………..………....Methylene blue
Digitalis…………………………..……….……..…………………Digibind
Ethylene poisoning………………………..…….…..Fomepizol (Antizol)
Heparin……………………………...…..……….…….Protamine Sulfate
Iron………………………………..….Deferoxamine Mesylate (Desferal)
Lead……………………………….…...…...…Edetate Disodium (EDTA)
Dimercaprol (BAL)
Succimer (CHEMET)
Lovenox..………………………………………….………Protamine SO4
Magnesium sulfate………………….……………….Calcium Gluconate
Morphine sulfate………………..……………...Naloxone Hydrochloride
Methotrexate……………………………………………....….Leucovorine
Mestinon…………………………………………………..Atropine Sulfate
Neostigmine……………...…………………Pralidoxime Chloride (PAM)
Penicillin…………………………...…………………………..Epinephrine

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

Drugs which are BEST TAKEN WITH MEALS

Allopurinol Flagyl
Apresoline Inderal
ASA Morphine
Azulfidine Pancreatin
Benemid Serpasil
Dilantin Tagamet
Diuril Tylenol

Drugs which are BEST TAKEN BEFORE MEALS

Atropine Sulfate Dalmane Mestinon

Bactrim Insulin Valium

Drugs which are BEST TAKEN AFTER MEALS

Artane Haldol Ritalin

Cogentin Lithium Streptomycin
Clozaril MAOI Thorazine
Deltasone Nardil Tofranil
Elavil Pyridium

Drugs which are BEST TAKEN ON AN EMPTY STOMACH

Ampicin Ferrous Sulfate Penicillin

Chloromycetin INH Rifadin
Erythrocin Isordil

Drugs which need to be taken in the MORNING

Accutane Diabinase Sudafed

Adriamycin Diamox Synthroid
Aminophylline Epinephrine Tamofen
Cytoxan Mannitol Theodur

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The ABC’s of PASSING FOREIGN NURSING EXAMS…………...…As prepared by R.A. Gapuz

Drugs which can be taken WITHOUT regard to MEALS

Ancef Demerol Phenergan

AZT Dexasone Pitocin
Ca EDTA Gentamicin Povan
Cardiazem Heparin Prostigmine
Cefoxitin Na Methergin Robaxin
Cephulac Neomycin Sulfate Rocephin
Codeine Nipride Sulfamylon
Coumadin Oncovin Symmetrel

Drugs which can cause URINE DISCOLORATION

Adriamycin……..……………………………………….Reddish
Bactrim………………………………………………Red Orange
Dilantin…………………………………………..……Pink tinged
Flagyl…………………………………………………..Brownish
Azulfidine…………………………………………Orange Yellow
Rifabutin………………………………………………Red Orange
Rifampicin………………………………………….Red Orange
Robaxin………………………………Brown, Black or Greenish

Drugs which should be TAKEN FOR THE REST OF THE

PATIENTS’ LIFE

Anticholinesterase (MESTINON)…………………..Myasthenia Gravis

Antithyroid drugs (PTU)………………………………..Hyperthyroidism
Aspirin………………………………………………………….…..Arthritis
AZT ……………………………………………………………..…… AIDS
Dopaminergic agents (L-DOPA)………………….Parkinsons’ Disease
Glucocorticoids (DELTASONE)…………….. ……..Addisons’ Disease
Glucocorticoid synthesis inhibitors (Mitotane) …... Cushing’s disease
Insulin (NPH,REGULAR)…………….…………….… Diabetes Mellitus
Miotics(PILOCARPINE)………………………………….……Glaucoma
Penicillin……………………………………....Rheumatic Heart Disease
Thyroid Supplement ( SYNTHROID)………….……….Hypothyroidism
Vitamin B 12…………………………………………..Pernicious Anemia

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Common SIDE EFFECTS associated with certain DRUGS

Anaphylactic Shock……………………………………….Penicillin
Bone Marrow suppression………………Chloramphenicol, AZT
Hepatotoxicity………………………………………………..….INH
Renal Toxicity………………………………..…..Aminoglycosides
Ototoxicity………………………………………..Aminoglycosides
Photosensitivity……………………………………..Antipsychotics

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