100 multiple-choice questions (MCQs) based on Chapter 9: Fever from DiPiro’s Pharmacotherapy, 12th Edition Nehad J. Ahmed Written using Copilot
100 multiple-choice questions (MCQs) based on Chapter 9:
Fever from DiPiro’s Pharmacotherapy, 12th Edition
Nehad J. Ahmed
Written using Copilot
Key Concepts & Definitions
- What
is the primary thermoregulatory center in the brain?
- A.
Posterior hypothalamus
- B.
Anterior hypothalamus ✅
- C.
Medulla oblongata
- D.
Cerebellum
- Fever
is defined as:
- A.
Uncontrolled rise in body temperature
- B.
Body temperature below 36°C
- C.
Controlled elevation above normal range ✅
- D.
Temperature fluctuation due to circadian rhythm
- Which
of the following is NOT a common cause of fever?
- A.
Infection
- B.
Autoimmune disorder
- C.
Malignancy
- D.
Hypoglycemia ✅
- What
chemical mediators reset the hypothalamic set point during fever?
- A.
Cytokines
- B.
Prostaglandins ✅
- C.
Histamines
- D.
Bradykinin
- Which
temperature reading is typically highest?
- A.
Axillary
- B.
Oral
- C.
Rectal ✅
- D.
Tympanic
- Fever
of unknown origin is increasingly associated with:
- A.
Malignancies
- B.
Inflammatory diseases ✅
- C.
Viral infections
- D.
Bacterial infections
- Which
of the following is a red flag symptom in fever?
- A.
Mild headache
- B.
Rash with high temperature ✅
- C.
Slight fatigue
- D.
Runny nose
- Hyperpyrexia
is defined as a temperature above:
- A.
40°C
- B.
41.5°C ✅
- C.
38°C
- D.
39°C
- Hyperthermia
differs from fever because:
- A.
It responds to antipyretics
- B.
It is caused by infection
- C.
The hypothalamic set point is unchanged ✅
- D.
It is always fatal
- Which
of the following is NOT a medication commonly associated with drug-induced
fever?
- A.
Penicillin
- B.
Allopurinol
- C.
Ibuprofen
- D.
Metformin ✅
🔹 Patient Care Process
- What
is the first step in managing a patient with fever?
- A.
Assess
- B.
Plan
- C.
Collect ✅
- D.
Implement
- Which
of the following should be collected during patient evaluation?
- A.
Favorite foods
- B.
Medication history ✅
- C.
Shoe size
- D.
Blood type
- Which
factor is most important when assessing fever in a traveler?
- A.
Passport number
- B.
Travel destination ✅
- C.
Airline
- D.
Seat number
- Which
of the following is a nonpharmacologic method to reduce fever?
- A.
Ice bath
- B.
Alcohol rub
- C.
Tepid sponge bath ✅
- D.
Hot shower
- Which
medication is preferred for fever in most patients?
- A.
Aspirin
- B.
Acetaminophen ✅
- C.
Ibuprofen
- D.
Naproxen
- What
is the maximum daily dose of acetaminophen for adults?
- A.
2,000 mg
- B.
3,000 mg ✅
- C.
4,000 mg
- D.
5,000 mg
- Which
age group should seek medical care if fever persists beyond 24 hours?
- A.
Adults
- B.
Children over 2
- C.
Children under 2 ✅
- D.
Teenagers
- Which
of the following is contraindicated in pregnancy?
- A.
Acetaminophen
- B.
Ibuprofen ✅
- C.
Paracetamol
- D.
Vitamin C
- What
is the recommended dose of acetaminophen for children?
- A.
5 mg/kg
- B.
10–15 mg/kg ✅
- C.
20 mg/kg
- D.
25 mg/kg
- Which
of the following is a red flag symptom in adults with fever?
- A.
Mild cough
- B.
Chest pain ✅
- C.
Sneezing
- D.
Runny nose
🔹 Pharmacologic Therapy
- What
is the mechanism of action of acetaminophen in reducing fever?
- A.
Inhibits peripheral prostaglandins
- B.
Inhibits CNS prostaglandins ✅
- C.
Blocks histamine receptors
- D.
Stimulates hypothalamus
- Which
of the following is a contraindication for acetaminophen?
- A.
Pregnancy
- B.
Lactation
- C.
Severe hepatic impairment ✅
- D.
Mild renal impairment
- What
is the maximum dose of acetaminophen for children?
- A.
50 mg/kg/day
- B.
75 mg/kg/day ✅
- C.
100 mg/kg/day
- D.
150 mg/kg/day
- Ibuprofen
should be avoided in patients with:
- A.
Diabetes
- B.
Heart failure ✅
- C.
Asthma
- D.
Anemia
- Which
NSAID is contraindicated in coronary artery bypass graft surgery?
- A.
Naproxen
- B.
Ibuprofen ✅
- C.
Aspirin
- D.
Celecoxib
- Aspirin
should not be used in children due to risk of:
- A.
Asthma
- B.
Reye’s syndrome ✅
- C.
Diabetes
- D.
Seizures
- Which
antipyretic is safest during pregnancy?
- A.
Ibuprofen
- B.
Aspirin
- C.
Acetaminophen ✅
- D.
Naproxen
- Which
of the following is a common adverse effect of NSAIDs?
- A.
Constipation
- B.
Gastric ulceration ✅
- C.
Rash
- D.
Dry mouth
- What
is the recommended ibuprofen dose for children 6 months to 12 years?
- A.
2–5 mg/kg
- B.
5–10 mg/kg ✅
- C.
10–15 mg/kg
- D.
15–20 mg/kg
- Which
of the following medications is NOT an antipyretic?
- A.
Acetaminophen
- B.
Ibuprofen
- C.
Aspirin
- D.
Amoxicillin ✅
🔹 Special Populations
- Which
population is most vulnerable to fever-related complications?
- A.
Teenagers
- B.
Adults
- C.
Children under 2 ✅
- D.
Athletes
- Hyperthermia
is characterized by:
- A.
A reset hypothalamic set point
- B.
Response to antipyretics
- C.
Uncontrolled rise in body temperature ✅
- D.
Low-grade fever
- Which
of the following is a red flag in infants with fever?
- A.
Mild cough
- B.
Temperature >38°C ✅
- C.
Sneezing
- D.
Runny nose
- Hyperpyrexia
responds to:
- A.
Cooling blankets only
- B.
Antipyretics ✅
- C.
Hydration alone
- D.
No treatment
- Which
of the following symptoms in a febrile child warrants immediate medical
attention?
- A.
Mild fatigue
- B.
Refusal to eat
- C.
Drooling and inability to swallow ✅
- D.
Sneezing
- Which
condition is contraindicated for aspirin use in children?
- A.
Flu-like symptoms ✅
- B.
Fever
- C.
Headache
- D.
Sore throat
- Which
of the following is a sign of serious illness in a febrile adult?
- A.
Mild dizziness
- B.
Chest pain ✅
- C.
Runny nose
- D.
Sneezing
- Which
of the following is a red flag for fever in immunocompromised patients?
- A.
Mild rash
- B.
Temperature <37°C
- C.
Changes in mental status ✅
- D.
Sneezing
- Which
of the following is a red flag symptom in patients undergoing
chemotherapy?
- A.
Fever >38°C ✅
- B.
Mild fatigue
- C.
Sneezing
- D.
Runny nose
- Which
of the following is NOT a red flag symptom in children with fever?
- A.
Glassy eyes
- B.
Refusing fluids
- C.
Mild cough ✅
- D.
Rash
🔹 Differential Diagnosis
- Fever
is differentiated from hyperthermia by:
- A.
Response to antipyretics ✅
- B.
Temperature level
- C.
Cause of elevation
- D.
Duration
- Hyperthermia
is often caused by:
- A.
Infection
- B.
Drug reaction
- C.
Environmental exposure ✅
- D.
Autoimmune disease
- Which
of the following does NOT respond to antipyretics?
- A.
Fever
- B.
Hyperpyrexia
- C.
Hyperthermia ✅
- D.
Drug-induced fever
- Which
of the following is a common cause of hyperpyrexia?
- A.
Heat stroke
- B.
Viral infection ✅
- C.
Dehydration
- D.
Exercise
- Which
of the following conditions mimics fever symptoms?
- A.
Hypoglycemia
- B.
Hyperthyroidism ✅
- C.
Hypertension
- D.
Anemia
- Which
of the following is a key differentiator of hyperthermia?
- A.
Sudden onset
- B.
No change in hypothalamic set point ✅
- C.
Response to NSAIDs
- D.
Mild symptoms
- Which
of the following is NOT a cause of fever?
- A.
Infection
- B.
Malignancy
- C.
Dehydration ✅
- D.
Autoimmune disorder
- Which
of the following medications is most commonly associated with drug-induced
fever?
- A.
Metformin
- B.
Allopurinol ✅
- C.
Atorvastatin
- D.
Lisinopril
- Which
of the following is a common infectious cause of fever?
- A.
Osteomyelitis ✅
- B.
Hypertension
- C.
Diabetes
- D.
Asthma
- Which
of the following is a non-infectious cause of fever?
- A.
Appendicitis
- B.
Meningitis
- C.
Leukemia ✅
- D.
Sinusitis
🔹 Follow-Up Care
- When
should adults seek medical care for unresolved fever?
- A.
After 1 day
- B.
After 2 days
- C.
After 3 days ✅
- D.
After 5 days
- What
is the recommended follow-up interval for children over 2 with fever?
- A.
12 hours
- B.
24 hours
- C.
48 hours ✅
- D.
72 hours
- What
should patients use to track fever progress?
- A.
Blood pressure monitor
- B.
Fever diary ✅
- C.
Heart rate monitor
- D.
Pulse oximeter
- Which
of the following symptoms during fever treatment requires urgent
evaluation?
- A.
Mild headache
- B.
Neck stiffness ✅
- C.
Runny nose
- D.
Sneezing
- What
is the purpose of a fever diary?
- A.
Track hydration
- B.
Record temperature and symptoms ✅
- C.
Monitor appetite
- D.
Track sleep
- Which
of the following is a sign of bacterial infection during fever?
- A.
Sneezing
- B.
Diarrhea with abdominal pain ✅
- C.
Mild fatigue
- D.
Runny nose
- What
is the best way to monitor fever at home?
- A.
Use different thermometers
- B.
Use the same thermometer and site ✅
- C.
Estimate by touch
- D.
Use forehead strips
- Which
of the following is NOT a recommended follow-up strategy?
- A.
Fever diary
- B.
Temperature monitoring
- C.
Ignoring symptoms ✅
- D.
Seeking care if symptoms worsen
- Which
of the following is a key goal of fever therapy?
- A.
Increase body temperature
- B.
Reduce discomfort ✅
- C.
Promote sweating
- D.
Suppress appetite
- Which
of the following is a sign that fever therapy is effective?
- A.
Temperature increases
- B.
Symptoms worsen
- C.
Temperature decreases ✅
- D.
Appetite declines
🔹 Clinical Scenarios
- A
patient presents with fever and stiff neck. What is the most likely
concern?
- A.
Sinusitis
- B.
Meningitis ✅
- C.
Otitis media
- D.
Bronchitis
- A
child with fever refuses fluids and appears drowsy. What should be done?
- A.
Give acetaminophen
- B.
Monitor at home
- C.
Seek immediate medical care ✅
- D.
Offer juice
- A
traveler returns from Southeast Asia with fever. What is the next step?
- A.
Recommend rest
- B.
Suggest hydration
- C.
Evaluate for tropical infections ✅
- D.
Prescribe antibiotics
- A
patient with fever and recent chemotherapy reports chest pain. What is the
priority?
- A.
Monitor at home
- B.
Refer to urgent care ✅
- C.
Recommend NSAIDs
- D.
Suggest hydration
- A
patient with fever and a rash should be evaluated for:
- A.
Allergies
- B.
Viral exanthem ✅
- C.
Asthma
- D.
Hypertension
- A
patient with fever and delirium may be experiencing:
- A.
Mild flu
- B.
Severe infection ✅
- C.
Dehydration
- D.
Allergic reaction
- A
patient with fever and sore throat may have:
- A.
Otitis media
- B.
Pharyngitis ✅
- C.
Bronchitis
- D.
Sinusitis
- A
patient with fever and ear pain may have:
- A.
Otitis media ✅
- B.
Sinusitis
- C.
Pharyngitis
- D.
Tonsillitis
- A
patient with fever and vomiting should be evaluated for:
- A.
Gastroenteritis ✅
- B.
Asthma
- C.
Diabetes
- D.
Hypertension
- A
patient with fever and recent travel to sub-Saharan Africa should be
evaluated for:
- A.
Malaria ✅
- B.
Influenza
- C.
COVID-19
- D.
Tuberculosis
🔹 Medication Safety
- Which
of the following medications should be avoided in liver disease?
- A.
Acetaminophen ✅
- B.
Ibuprofen
- C.
Aspirin
- D.
Naproxen
- Which
medication increases risk of GI bleeding?
- A.
Acetaminophen
- B.
Ibuprofen ✅
- C.
Paracetamol
- D.
Loratadine
- Which
medication is contraindicated in renal failure?
- A.
Aspirin ✅
- B.
Acetaminophen
- C.
Diphenhydramine
- D.
Loratadine
- Which
medication should be avoided in pregnancy?
- A.
Acetaminophen
- B.
Ibuprofen ✅
- C.
Paracetamol
- D.
Dextromethorphan
- Which
medication is safest in lactation?
- A.
Acetaminophen ✅
- B.
Ibuprofen
- C.
Aspirin
- D.
Naproxen
- Which
medication is associated with Reye’s syndrome?
- A.
Acetaminophen
- B.
Aspirin ✅
- C.
Ibuprofen
- D.
Naproxen
- Which
medication should be used cautiously in alcohol abuse?
- A.
Acetaminophen ✅
- B.
Ibuprofen
- C.
Aspirin
- D.
Naproxen
- Which
medication is contraindicated in coronary artery bypass surgery?
- A.
Ibuprofen ✅
- B.
Acetaminophen
- C.
Aspirin
- D.
Naproxen
- Which
medication is safest for patients with cardiovascular disease?
- A.
Aspirin ✅
- B.
Ibuprofen
- C.
Naproxen
- D.
Celecoxib
- Which
medication should be avoided in stage 4 kidney disease?
- A.
Acetaminophen
- B.
Ibuprofen ✅
- C.
Aspirin
- D.
Loratadine
🔹 Patient Education
- Patients
should use the same thermometer and site because:
- A.
It’s cheaper
- B.
It ensures consistent readings ✅
- C.
It’s more comfortable
- D.
It’s faster
- Fever
diaries should be updated:
- A.
Once a day
- B.
Every 8 hours ✅
- C.
Weekly
- D.
Only when symptoms worsen
- Patients
should avoid which nonpharmacologic method?
- A.
Tepid sponge bath
- B.
Ice bath ✅
- C.
Light clothing
- D.
Hydration
- Which
of the following is a goal of fever therapy?
- A.
Increase temperature
- B.
Reduce discomfort ✅
- C.
Suppress immune system
- D.
Promote sweating
- Which
of the following should be avoided during fever?
- A.
Alcohol baths ✅
- B.
Light clothing
- C.
Hydration
- D.
Rest
- Which
of the following is a safe OTC antipyretic for children?
- A.
Aspirin
- B.
Acetaminophen ✅
- C.
Naproxen
- D.
Celecoxib
- Which
of the following is a common OTC dose of acetaminophen for adults?
- A.
325 mg every 2 hours
- B.
650 mg every 4–6 hours ✅
- C.
1,500 mg every 8 hours
- D.
100 mg every 2 hours
- Which
of the following should be considered when selecting fever therapy?
- A.
Patient’s favorite color
- B.
Cultural beliefs ✅
- C.
Shoe size
- D.
Height
- Which
of the following is a common OTC dose of ibuprofen for adults?
- A.
100 mg every 2 hours
- B.
200–400 mg every 4–6 hours ✅
- C.
600 mg every 8 hours
- D.
50 mg every 2 hours
- Which
of the following is a key factor in medication adherence?
- A.
Cost ✅
- B.
Taste
- C.
Color
·
D. Brand name
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