CCRN Critical Care Pharmacology 3

Question 1

Which medication used for stress ulcer prophylaxis in ICU patients is associated with the highest risk of Clostridioides difficile infection?

Accepted Answer

Proton pump inhibitors (PPIs)

Answer

Sucralfate

Answer

H2-receptor antagonists

Answer

Antacids

Question 2

A patient receiving phenytoin IV for seizure management develops bradycardia and hypotension during infusion. What is the most appropriate intervention?

Accepted Answer

Slow the infusion rate to no faster than 50 mg/min

Answer

Stop phenytoin and administer atropine

Answer

Switch to oral phenytoin immediately

Answer

Administer calcium gluconate

Question 3

Which drug is used as a continuous infusion for refractory status epilepticus and requires monitoring for propylene glycol toxicity with prolonged use?

Accepted Answer

Midazolam

Answer

Levetiracetam

Answer

Lorazepam

Answer

Valproic acid

Question 4

A critically ill patient requires vasopressin. What is the primary mechanism of action of vasopressin in septic shock?

Accepted Answer

V1 receptor-mediated vasoconstriction of vascular smooth muscle

Answer

Beta-1 adrenergic stimulation increasing cardiac output

Answer

Alpha-1 stimulation causing pulmonary vasoconstriction

Answer

Dopaminergic stimulation improving renal perfusion

Question 5

Which corticosteroid is recommended by current Surviving Sepsis guidelines for refractory septic shock (vasopressor-dependent)?

Accepted Answer

Hydrocortisone 200 mg/day (continuous or divided doses)

Answer

Dexamethasone 10 mg IV q6h

Answer

Methylprednisolone 1 g IV daily

Answer

Prednisone 60 mg PO daily

Question 6

A patient is receiving a nicardipine infusion for hypertensive emergency. Which parameter should the nurse monitor most closely?

Accepted Answer

Blood pressure every 5–15 minutes during titration

Answer

Serum potassium

Answer

12-lead ECG for QT prolongation

Answer

Serum lactate