PHARMACOLOGY SAS 1 TO SAS 30 TEST BANK
QUESTIONS & ANSWERS WITH RATIONALE 2026 LATEST UPDATE)
SAS 1
1. A patient is prescribed Warfarin (Coumadin) for the treatment of a blood clot.
What is the Therapeutic INR range for this medication?
A. 2-3
B. 1-3
C. 4-8
D. 0.5-2.5
The answer is A. The therapeutic INR range is 2-3. It may be slightly higher if a
patient is at a high risk for clot formation….(ex: up to 4.5)
2. A patient is scheduled to take a dose of Warfarin (Coumadin) at 1800. The
patient's INR level is 6. As the nurse you will?
A. Administer the dose as scheduled
B. Hold the dose and notify the physician
C. Double the dose
D. Hold today's dose but administer tomorrow's dose as scheduled.
The answer is B. A therapeutic INR level should be 2-3 (it may be up to 4.5 if the
patient is at a HIGH risk for blood clot formation). A level of 6 is HIGH and places
the patient at risk for bleeding. The nurse should hold the dose and notify the
physician.
3. TRUE OR FALSE: If a patient's INR level falls too low, there is a risk of clot
formation and the Warfarin (Coumadin) dose needs to be decreased.
True
,False
The answer is False. If a patient's INR level falls too low, there is a risk of clot
formation and the Warfarin (Coumadin) dose needs to be INCREASED (not
decreased).
4. Myasthenia gravis is due to ____ receptors being blocked and destroyed by
antibodies.
A. Epinephrine
B. Nicotinic
C. Acetylcholine
D. Transient
ANSWER: ________
RATIO: Acetylcholine receptor antibody is a protein found in the blood of many
people with myasthenia gravis. The antibody affects a chemical that sends signals
from nerves to muscles and between nerves in the brain. This article discusses the
blood test for acetylcholine receptor antibody.
5. A client with myasthenia gravis has been receiving Neostigmine (Prostigmin).
This drug acts by:
A. Stimulating the cerebral cortex
B. Blocking the action of cholinesterase
C. Replacing deficient neurotransmitters
D. Accelerating transmission along neural swaths
ANSWER: ________
RATIO:Neostigmine inhibits the hydrolysis of acetylcholine by competing with
acetylcholine for attachment to acetylcholinesterase atsites of cholinergic
transmission. It enhances cholinergic action by facilitating the transmission of
impulses across neuromuscular junctions
,6. The most significant initial nursing observations that need to be made about a
client with myasthenia include:
A. Ability to chew and speak distinctly
B. Degree of anxiety about her diagnosis
C. Ability to smile an to close her eyelids
D. Respiratory exchange and ability to swallow
ANSWER: ________
RATIO:Muscle weakness can lead to respiratory failure that will require
emergency intervention and inability to swallow may lead to aspiration.
7. In making a diagnosis of myasthenia gravis Edrophonium HCI (Tensilon) is used.
The nurse knows that this drug will cause a temporary increase in:
A. Muscle strength
B. Symptoms
C. Blood pressure
D. Consciousness
ANSWER: ____A____
RATIO: Tensilon, an anticholinesterase drug, causes temporary relief of symptoms
of myasthenia gravis in client who have the disease and is therefore an effective
diagnostic aid.
8. The nurse is teaching the female client with myasthenia gravis about the
prevention of myasthenic and cholinergic crises. The
nurse tells the client that this is most effectively done by:
A. Eating large, well-balanced meals
B. Doing muscle-strengthening exercises
C. Doing all chores early in the day while less fatigued
D. Taking medications on time to maintain therapeutic blood levels
, ANSWER: ___D_____
RATIO:Clients with myasthenia gravis are taught to space out activities over the
day to conserve energy and restore muscle strength.Taking medications correctly
to maintain blood levels that are not too low or too high is important. Muscle-
strengthening exercises are not helpful and can fatigue the client. Overeating is a
cause of exacerbation of symptoms, as is exposure to heat, crowds, erratic sleep
habits, and emotional stress
9. Helen is diagnosed with myasthenia gravis and pyridostigmine bromide
(Mestinon) therapy is started. The Mestinon dosage is frequently changed during
the first week. While the dosage is being adjusted, the nurse’s priority
intervention is to:
A. Administer the medication exactly on time
B. Administer the medication with food or mild
C. Evaluate the client’s muscle strength hourly after medication
D. Evaluate the client’s emotional side effects between doses
ANSWER: ____C____
RATIO:Peak response occurs 1 hour after administration and lasts up to 8 hours;
the response will influence dosage levels.
10. A female client has experienced an episode of myasthenic crisis. The nurse
would assess whether the client has precipitating factors such as:
A. Getting too little exercise
B. Taking excess medication
C. Omitting doses of medication
D. Increasing intake of fatty foods
ANSWER: ________B
RATIO:Myasthenic crisis often is caused by undermedication and responds to the
administration of cholinergic medications, such as neostigmine (Prostigmin) and
pyridostigmine (Mestinon). Cholinergic crisis (the opposite problem) is caused by
QUESTIONS & ANSWERS WITH RATIONALE 2026 LATEST UPDATE)
SAS 1
1. A patient is prescribed Warfarin (Coumadin) for the treatment of a blood clot.
What is the Therapeutic INR range for this medication?
A. 2-3
B. 1-3
C. 4-8
D. 0.5-2.5
The answer is A. The therapeutic INR range is 2-3. It may be slightly higher if a
patient is at a high risk for clot formation….(ex: up to 4.5)
2. A patient is scheduled to take a dose of Warfarin (Coumadin) at 1800. The
patient's INR level is 6. As the nurse you will?
A. Administer the dose as scheduled
B. Hold the dose and notify the physician
C. Double the dose
D. Hold today's dose but administer tomorrow's dose as scheduled.
The answer is B. A therapeutic INR level should be 2-3 (it may be up to 4.5 if the
patient is at a HIGH risk for blood clot formation). A level of 6 is HIGH and places
the patient at risk for bleeding. The nurse should hold the dose and notify the
physician.
3. TRUE OR FALSE: If a patient's INR level falls too low, there is a risk of clot
formation and the Warfarin (Coumadin) dose needs to be decreased.
True
,False
The answer is False. If a patient's INR level falls too low, there is a risk of clot
formation and the Warfarin (Coumadin) dose needs to be INCREASED (not
decreased).
4. Myasthenia gravis is due to ____ receptors being blocked and destroyed by
antibodies.
A. Epinephrine
B. Nicotinic
C. Acetylcholine
D. Transient
ANSWER: ________
RATIO: Acetylcholine receptor antibody is a protein found in the blood of many
people with myasthenia gravis. The antibody affects a chemical that sends signals
from nerves to muscles and between nerves in the brain. This article discusses the
blood test for acetylcholine receptor antibody.
5. A client with myasthenia gravis has been receiving Neostigmine (Prostigmin).
This drug acts by:
A. Stimulating the cerebral cortex
B. Blocking the action of cholinesterase
C. Replacing deficient neurotransmitters
D. Accelerating transmission along neural swaths
ANSWER: ________
RATIO:Neostigmine inhibits the hydrolysis of acetylcholine by competing with
acetylcholine for attachment to acetylcholinesterase atsites of cholinergic
transmission. It enhances cholinergic action by facilitating the transmission of
impulses across neuromuscular junctions
,6. The most significant initial nursing observations that need to be made about a
client with myasthenia include:
A. Ability to chew and speak distinctly
B. Degree of anxiety about her diagnosis
C. Ability to smile an to close her eyelids
D. Respiratory exchange and ability to swallow
ANSWER: ________
RATIO:Muscle weakness can lead to respiratory failure that will require
emergency intervention and inability to swallow may lead to aspiration.
7. In making a diagnosis of myasthenia gravis Edrophonium HCI (Tensilon) is used.
The nurse knows that this drug will cause a temporary increase in:
A. Muscle strength
B. Symptoms
C. Blood pressure
D. Consciousness
ANSWER: ____A____
RATIO: Tensilon, an anticholinesterase drug, causes temporary relief of symptoms
of myasthenia gravis in client who have the disease and is therefore an effective
diagnostic aid.
8. The nurse is teaching the female client with myasthenia gravis about the
prevention of myasthenic and cholinergic crises. The
nurse tells the client that this is most effectively done by:
A. Eating large, well-balanced meals
B. Doing muscle-strengthening exercises
C. Doing all chores early in the day while less fatigued
D. Taking medications on time to maintain therapeutic blood levels
, ANSWER: ___D_____
RATIO:Clients with myasthenia gravis are taught to space out activities over the
day to conserve energy and restore muscle strength.Taking medications correctly
to maintain blood levels that are not too low or too high is important. Muscle-
strengthening exercises are not helpful and can fatigue the client. Overeating is a
cause of exacerbation of symptoms, as is exposure to heat, crowds, erratic sleep
habits, and emotional stress
9. Helen is diagnosed with myasthenia gravis and pyridostigmine bromide
(Mestinon) therapy is started. The Mestinon dosage is frequently changed during
the first week. While the dosage is being adjusted, the nurse’s priority
intervention is to:
A. Administer the medication exactly on time
B. Administer the medication with food or mild
C. Evaluate the client’s muscle strength hourly after medication
D. Evaluate the client’s emotional side effects between doses
ANSWER: ____C____
RATIO:Peak response occurs 1 hour after administration and lasts up to 8 hours;
the response will influence dosage levels.
10. A female client has experienced an episode of myasthenic crisis. The nurse
would assess whether the client has precipitating factors such as:
A. Getting too little exercise
B. Taking excess medication
C. Omitting doses of medication
D. Increasing intake of fatty foods
ANSWER: ________B
RATIO:Myasthenic crisis often is caused by undermedication and responds to the
administration of cholinergic medications, such as neostigmine (Prostigmin) and
pyridostigmine (Mestinon). Cholinergic crisis (the opposite problem) is caused by
