ATI RN
Central Nervous System Stimulants and Related Drugs NCLEX Style Questions Questions
Question 1 of 9
Pharmacologic actions of acetylsalicylic acid include all of the following EXCEPT:
Correct Answer: C
Rationale: Acetylsalicylic acid (aspirin) inhibits COX enzymes, reducing prostaglandin synthesis (choice D), yielding analgesic (choice A) and antipyretic (choice B) effects by decreasing pain mediators and hypothalamic heat regulation, respectively. However, it inhibits, not promotes, platelet aggregation (choice C) by blocking thromboxane A2 production, a pro-aggregatory prostaglandin, making it antiplatelet, used in cardiovascular prophylaxis. Promotion of aggregation would contradict its mechanism. This exception tests understanding of aspirin's unique antiplatelet action among NSAIDs, critical for its clinical applications.
Question 2 of 9
Which of the following drugs would be most appropriate for this patient to substitute for valproic acid therapy?
Correct Answer: A
Rationale: Carbamazepine is a common alternative to valproic acid for seizure management, especially in women of childbearing age who want to start a family.
Question 3 of 9
Instead of depressing, morphine stimulates
Correct Answer: B
Rationale: Morphine stimulates the Edinger-Westphal nucleus, causing pupillary constriction (miosis).
Question 4 of 9
A 14-year-old girl is brought to the emergency room as her mother observed that her daughter experienced frequent impairments of consciousness lasting for about 30 seconds. Neurological evaluation indicates 'Absence seizures'. With which of the following drugs should we start treatment?
Correct Answer: C
Rationale: Ethosuximide (choice C) treats absence seizures by reducing T-type calcium currents, ideal for brief consciousness lapses. Alprazolam (choice A), Diazepam (choice B), and Midazolam (choice D), benzodiazepines, aren't first-line for absence. Ethosuximide's specificity is key.
Question 5 of 9
Which of the following opiate receptors is paired correctly with a physiological or psychological action?
Correct Answer: C
Rationale: Mu receptors (choice C) mediate respiratory depression, a key morphine effect. Mu doesn't cause dysphoria (choice A), kappa causes dysphoria, not euphoria (choice B), and delta (choice D) isn't primarily dysphoric. This correct pairing reflects opioid pharmacology.
Question 6 of 9
A 72-year-old man is brought to his physician by his son. The son complains that this patient has been becoming forgetful, confused, moody, and aggressive over the past few months. One drug that may be used to treat this patient's symptoms is donepezil. Which of the following describes an effect of donepezil?
Correct Answer: D
Rationale: Donepezil, a cholinesterase inhibitor, increases synaptic acetylcholine levels by preventing its breakdown, improving cognitive function in Alzheimer's disease.
Question 7 of 9
Digoxin affords the following benefit(s) in CHF
Correct Answer: D
Rationale: Digoxin improves symptoms but does not prolong survival in CHF.
Question 8 of 9
Which of the following drugs has been associated with Reye's syndrome in children?
Correct Answer: A
Rationale: Aspirin (choice A) is linked to Reye's syndrome, a rare liver/brain disorder in children post-viral infection. Acetaminophen (choice B), Ibuprofen (choice C), and Naproxen (choice D) aren't associated. This contraindication limits aspirin's pediatric use.
Question 9 of 9
A first-year surgery intern has rotated on numerous surgical services. He has gotten quite used to ordering morphine for pain control. However, which of the following is an absolute contraindication to opioid use?
Correct Answer: A
Rationale: Closed head injury (choice A) contraindicates morphine due to respiratory depression and ICP elevation, masking neurological signs. MI (choice B), pulmonary edema (choice C), and diarrhea (choice D) benefit from morphine. This exception ensures safety.