Central Nervous System Drugs: Pharmacology for Nurses

Question 1

Which of the following adverse effects is most commonly reported with the use of selective serotonin reuptake inhibitors (SSRIs)?

Accepted Answer

Sexual dysfunction

Answer

Extrapyramidal symptoms

Answer

Hepatotoxicity

Answer

Cardiotoxicity

Question 2

For patients receiving phenytoin as an anticonvulsant, which laboratory parameter is most critical for monitoring potential toxicity?

Accepted Answer

Serum phenytoin concentration

Answer

Complete blood count

Answer

Liver enzyme levels

Answer

Renal function tests

Question 3

Which drug is contraindicated for use in patients with a history of seizures due to its potential to lower the seizure threshold?

Accepted Answer

Bupropion

Answer

Fluoxetine

Answer

Venlafaxine

Answer

Trazodone

Question 4

Which medication is a non-benzodiazepine anxiolytic that is commonly used for the treatment of generalized anxiety disorder?

Accepted Answer

Buspirone

Answer

Propranolol

Answer

Clonidine

Answer

Gabapentin

Question 5

Which neurotransmitter system is primarily targeted by antipsychotic medications?

Accepted Answer

Dopaminergic

Answer

Serotonergic

Answer

Noradrenergic

Answer

Glutamatergic

Question 6

What is the primary mechanism of action by which benzodiazepines exert their pharmacological effects?

Accepted Answer

Enhancing the inhibitory neurotransmission mediated by gamma-aminobutyric acid (GABA)

Answer

Blocking the excitatory neurotransmission mediated by N-methyl-D-aspartate (NMDA) receptors

Answer

Stimulating the release of dopamine in the reward pathways of the brain

Answer

Inhibiting the enzyme acetylcholinesterase, thereby increasing acetylcholine levels in the synapse

Question 7

Among the following options, which medication is typically considered as a first-line treatment for major depressive disorder?

Accepted Answer

Fluoxetine (Prozac)

Answer

Venlafaxine (Effexor)

Answer

Lamotrigine (Lamictal)

Answer

Valproate (Depakote)

Question 8

What is the approximate duration of action typically associated with short-acting benzodiazepines?

Accepted Answer

4-8 hours

Answer

12-24 hours

Answer

24-48 hours

Answer

Greater than 48 hours

Question 9

During therapy with anticonvulsant medications, which of the following parameters is most commonly monitored to ensure patient safety?

Accepted Answer

Serum electrolytes

Answer

Blood pressure

Answer

Liver function tests

Answer

Cardiac rhythm

Question 10

Which type of headache is the most prevalent?

Accepted Answer

Tension headache

Answer

Cluster headache

Answer

Migraine

Answer

Trigeminal neuralgia

Question 11

In the context of epilepsy, which neurotransmitter plays a significant role in the pathophysiology of seizures?

Accepted Answer

Glutamate

Answer

GABA

Answer

Dopamine

Answer

Serotonin

Question 12

Which is a common adverse effect of antipsychotics?

Accepted Answer

Tardive dyskinesia

Answer

Hypertension

Answer

Hyponatremia

Answer

Hepatotoxicity

Question 13

What is the foremost nursing action to assist a patient having a seizure?

Accepted Answer

Clear the airway

Answer

Administer anticonvulsant medications

Answer

Restrain the patient

Answer

Elevate the head of the bed

Question 14

What is a contraindication for using MAO inhibitors?

Accepted Answer

Pheochromocytoma

Answer

Hypertension

Answer

Pregnancy

Answer

Breastfeeding

Question 15

What is the most common drug interaction with CNS medications?

Accepted Answer

Additive CNS depression

Answer

CYP450 inhibition

Answer

Serotonin syndrome

Answer

Anticholinergic syndrome

Question 16

Which of the following is an uncommon adverse effect of benzodiazepines?

Accepted Answer

Increased alertness

Answer

Drowsiness

Answer

Impaired coordination

Answer

Memory problems

Question 17

How does the blood-brain barrier regulate drug distribution in the central nervous system?

Accepted Answer

It selectively allows the passage of essential nutrients, ions, and certain medications into the CNS.

Answer

It limits the entry of lipid-soluble drugs into the CNS.

Answer

It permits the unrestricted entry of water-soluble drugs into the CNS.

Question 18

In the legal classification and scheduling of CNS drugs, which factor is of primary importance?

Accepted Answer

Abuse and dependence potential

Answer

Therapeutic use only

Answer

Manufacturer's marketing efforts

Question 19

Which of the following is NOT a mechanism of action associated with benzodiazepines?

Accepted Answer

Blockade of serotonin reuptake

Answer

Potentiation of GABA-mediated neurotransmission

Answer

Inhibition of NMDA receptor activity

Answer

Reduction of dopaminergic activity

Question 20

What is the primary therapeutic use of tricyclic antidepressants (TCAs)?

Accepted Answer

Depression

Answer

Anxiety disorders

Answer

Bipolar disorder

Answer

Schizophrenia

Question 21

What is the major difference between first- and second-generation antipsychotics?

Accepted Answer

Second-generation antipsychotics are more effective in treating negative symptoms of schizophrenia

Answer

First-generation antipsychotics are less likely to cause extrapyramidal side effects

Answer

First-generation antipsychotics are not as effective as second-generation antipsychotics

Answer

Second-generation antipsychotics are primarily used for the treatment of bipolar disorder

Question 22

What is the primary mechanism of action of selective serotonin reuptake inhibitors (SSRIs)?

Accepted Answer

Inhibition of serotonin reuptake

Answer

Inhibition of norepinephrine reuptake

Answer

Enhancement of GABAergic neurotransmission

Answer

Blockade of dopamine receptors

Question 23

Which benzodiazepine is specifically indicated for the treatment of panic disorder, exhibiting high efficacy and tolerability?

Accepted Answer

Alprazolam, a potent and fast-acting anxiolytic

Answer

Diazepam, known for its long-acting sedative effects

Answer

Lorazepam, commonly used for short-term anxiety relief

Answer

Clonazepam, primarily indicated for seizure control

Question 24

Among the selective serotonin reuptake inhibitors (SSRIs), which one stands out with the longest half-life, allowing for once-a-day dosing?

Accepted Answer

Fluoxetine, exhibiting a half-life of approximately 2-4 days

Answer

Sertraline, with a moderate half-life of about 24-26 hours

Answer

Citalopram, having a half-life of around 36 hours

Answer

Escitalopram, known for its shorter half-life of approximately 27-32 hours

Question 25

Which anticonvulsant is primarily used for the effective management of absence seizures, characterized by brief lapses in consciousness?

Accepted Answer

Ethosuximide, specifically effective against absence seizures

Answer

Phenytoin, commonly employed for generalized tonic-clonic seizures

Answer

Valproic acid, known for its broad-spectrum anticonvulsant activity

Answer

Lamotrigine, primarily indicated for partial seizures

Question 26

Which of the following symptoms is a common adverse effect associated with the use of opioid analgesics, potentially leading to discomfort and constipation?

Accepted Answer

Constipation, resulting from decreased gastrointestinal motility

Answer

Insomnia, due to stimulation of the central nervous system

Answer

Tremor, caused by overactivity in certain brain regions

Answer

Hypersensitivity, manifested as exaggerated reactions to stimuli

Question 27

In nursing practice, which intervention takes priority when caring for a patient receiving a monoamine oxidase inhibitor (MAOI), ensuring their safety and well-being?

Accepted Answer

Vigilantly monitoring for the development of serotonin syndrome, a potentially life-threatening condition

Answer

Limiting fluid intake to prevent water retention

Answer

Avoiding strenuous exercise to minimize the risk of orthostatic hypotension

Answer

Encouraging smoking cessation, as nicotine can interact with MAOIs

Question 28

In the central nervous system, which neurotransmitter plays a crucial role in inhibitory neurotransmission, contributing to balance and preventing overexcitation?

Accepted Answer

GABA (gamma-aminobutyric acid), the major inhibitory neurotransmitter

Answer

Glutamate, the primary excitatory neurotransmitter

Answer

Dopamine, involved in reward and motivation

Answer

Acetylcholine, responsible for neuromuscular transmission

Question 29

Which of the following is a potential complication of chronic benzodiazepine use, highlighting the importance of judicious prescribing and monitoring?

Accepted Answer

Addiction, characterized by compulsive use and withdrawal symptoms

Answer

Hepatotoxicity, damage to the liver caused by excessive metabolism

Answer

Hypertension, abnormally high blood pressure

Answer

Hyponatremia, dangerously low levels of sodium in the blood

Question 30

Explain how cytochrome P450 (CYP450) enzyme inhibition and induction can influence the metabolism of CNS drugs. Provide specific examples of clinically significant drug interactions.

Accepted Answer

CYP450 inhibition slows down drug metabolism, potentially leading to increased drug concentrations and toxicity.

Accepted Answer

CYP450 induction accelerates drug metabolism, potentially decreasing drug concentrations and reducing efficacy.

Answer

CYP450 enzymes do not significantly affect the metabolism of CNS drugs.

Answer

CYP450 inhibition and induction always result in clinically insignificant drug interactions.

Question 31

Which of the following is a primary mechanism of action of opioids?

Accepted Answer

Inhibition of substance P release

Answer

Inhibition of norepinephrine reuptake

Answer

Agonism at GABA receptors

Answer

Stimulation of muscarinic receptors

Question 32

What is the most common adverse effect associated with benzodiazepines?

Accepted Answer

Sedation

Answer

Tachycardia

Answer

Hypertension

Answer

Bronchospasm

Question 33

Which nursing intervention is most critical for patients taking antidepressants?

Accepted Answer

Monitoring for suicidal ideation

Answer

Administering medications at bedtime

Answer

Encouraging increased fluid intake

Answer

Assessing for potential constipation

Question 34

Levodopa is primarily used in the treatment of which disease?

Accepted Answer

Parkinson's disease

Answer

Epilepsy

Answer

Schizophrenia

Answer

Depression

Question 35

Which type of medication is diazepam?

Accepted Answer

Benzodiazepine

Answer

Antidepressant

Answer

Anticonvulsant

Answer

Antipsychotic

Question 36

What is the safe maximum daily dosage of acetaminophen (Tylenol) for adults?

Accepted Answer

2,000 mg

Answer

1,000 mg

Answer

3,000 mg

Answer

4,000 mg

Question 37

Which medication interacts with warfarin, potentially increasing its anticoagulant effects?

Accepted Answer

Aspirin

Answer

Ibuprofen

Answer

Acetaminophen

Answer

Vitamin C

Question 38

What is the primary distinction between selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs)?

Accepted Answer

SSRIs selectively inhibit serotonin reuptake, while SNRIs inhibit both serotonin and norepinephrine reuptake.

Answer

SNRIs selectively inhibit serotonin reuptake, while SSRIs inhibit both serotonin and norepinephrine reuptake.

Answer

SSRIs and SNRIs have identical mechanisms of action.

Answer

SNRIs are generally more effective than SSRIs in treating depression.

Question 39

Which of the following accurately describes the primary mechanism of action for benzodiazepines?

Accepted Answer

Inhibition of GABA reuptake

Answer

Stimulation of NMDA receptors

Answer

Activation of serotonin receptors

Answer

Blockade of dopamine receptors

Question 40

Identify a potential adverse effect associated with the use of opioids:

Accepted Answer

Respiratory depression

Answer

Tachycardia

Answer

Hypertension

Answer

Insomnia

Question 41

Which drug is commonly used in the management of Parkinson's disease?

Accepted Answer

Levodopa

Answer

Propranolol

Answer

Lithium

Answer

Valproic acid

Question 42

Which of the following is not categorized as an antidepressant?

Accepted Answer

Benzodiazepines

Answer

Selective serotonin reuptake inhibitors (SSRIs)

Answer

Tricyclic antidepressants (TCAs)

Answer

Monoamine oxidase inhibitors (MAOIs)

Question 43

In the event of an opioid overdose, what is the appropriate antidote?

Accepted Answer

Naloxone

Answer

Flumazenil

Answer

Atropine

Answer

Epinephrine

Question 44

When assessing a patient receiving opioids, which vital sign requires the closest monitoring?

Accepted Answer

Respiratory rate

Answer

Level of consciousness

Answer

Blood pressure

Answer

Skin color

Question 45

Benzodiazepines exert their anxiolytic effects primarily by:

Accepted Answer

Enhancing the activity of inhibitory neurotransmitter GABA

Answer

Blocking the reuptake of excitatory neurotransmitter glutamate

Answer

Stimulating the release of mood-elevating neurotransmitter serotonin

Answer

Inhibiting the breakdown of the neurotransmitter norepinephrine

Question 46

Which of the following antidepressants belongs to the tricyclic antidepressant (TCA) class?

Accepted Answer

Imipramine

Answer

Fluoxetine

Answer

Citalopram

Answer

Bupropion

Question 47

A common adverse effect associated with opioid use is:

Accepted Answer

Constipation

Answer

Tachycardia

Answer

Euphoria

Answer

Increased libido

Question 48

Which drug is commonly used as an anticonvulsant to treat seizures?

Accepted Answer

Phenytoin

Answer

Acetaminophen

Answer

Ibuprofen

Answer

Codeine

Question 49

A major neurotransmitter in the central nervous system involved in reward and motivation is:

Accepted Answer

Dopamine

Answer

Acetylcholine

Answer

Epinephrine

Answer

Norepinephrine

Question 50

Which drug should be used with caution in patients with a history of heart problems?

Accepted Answer

Theophylline

Answer

Atenolol

Answer

Nitroglycerin

Answer

Morphine

Question 51

Which of the following is NOT classified as an opioid analgesic?

Accepted Answer

Ibuprofen

Answer

Morphine

Answer

Oxycodone

Answer

Fentanyl

Question 52

Benzodiazepines are a group of medications primarily used to treat:

Accepted Answer

Anxiety

Answer

Depression

Answer

Epilepsy

Answer

Pain

Question 53

In the event of an opioid overdose, which medication is specifically indicated as an antagonist to reverse its effects?

Accepted Answer

Naloxone

Answer

Flumazenil

Answer

Activated charcoal

Answer

Ipecac syrup

Question 54

Which of the following is NOT considered a major classification of antipsychotic medications?

Accepted Answer

Benzodiazepines

Answer

Typical antipsychotics

Answer

Atypical antipsychotics

Answer

Tricyclic antidepressants

Question 55

Which of the following adverse effects is commonly associated with tricyclic antidepressants?

Accepted Answer

Anticholinergic effects

Answer

Extrapyramidal symptoms

Answer

Tardive dyskinesia

Answer

Increased seizure risk

Question 56

Which CNS drug has a high potential for drug interactions?

Accepted Answer

Phenytoin

Answer

Warfarin

Answer

Acetaminophen

Answer

Ibuprofen

Question 57

The most common type of seizure disorder treated with anticonvulsants is:

Accepted Answer

Generalized tonic-clonic seizures

Answer

Absence seizures

Answer

Complex partial seizures

Answer

Myoclonic seizures

Question 58

Which of the following accurately describes the primary mechanism of action of benzodiazepines?

Accepted Answer

Enhancing GABAergic neurotransmission.

Answer

Blocking NMDA receptors.

Answer

Activating muscarinic cholinoreceptors.

Answer

Inhibiting serotonin reuptake.

Question 59

Which of the following is a common side effect associated with the use of opioids?

Accepted Answer

Constipation

Answer

Insomnia

Answer

Tachycardia

Answer

Hallucinations

Question 60

Which of the following categorizes antipsychotic medications?

Accepted Answer

Both typical and atypical

Answer

Typical

Answer

Atypical

Answer

Neither typical nor atypical

Question 61

Which of the following is a common indication for the use of opioids?

Accepted Answer

Moderate to severe pain

Answer

Anxiety

Answer

Depression

Answer

Epilepsy

Question 62

Which mechanism of action is primarily responsible for the analgesic effects of opioid analgesics?

Accepted Answer

Binding to mu-opioid receptors

Answer

Inhibition of norepinephrine reuptake

Answer

Blockade of sodium channels

Answer

Enhancement of GABA activity

Question 63

Which of the following is a common adverse effect associated with the use of benzodiazepines?

Accepted Answer

Respiratory depression

Answer

Euphoria

Answer

Hallucinations

Answer

Tardive dyskinesia

Question 64

What is the primary mechanism of action of nonsteroidal anti-inflammatory drugs (NSAIDs)?

Accepted Answer

Inhibition of cyclooxygenase enzymes

Answer

Blockade of serotonin receptors

Answer

Activation of adenosine receptors

Answer

Enhancement of endorphin release