1
PHARMACOLOGY EXAM II – IV MEDICATIONS,
CALCULATIONS & ADVERSE EFFECTS 2026-28
ACTUAL EXAM VERSION
1.
A nurse is preparing to administer IV vancomycin. Which action
is MOST important?
• A. Infuse over 30 minutes
• B. Infuse over at least 60 minutes
• C. Give as IV push
• D. Mix with 5% dextrose only
Answer: B
Rationale: Vancomycin must be infused over ≥60 minutes to
prevent “Red Man Syndrome,” a histamine-mediated reaction.
2.
A patient receives IV furosemide 40 mg. The nurse notes K⁺ 3.0
mEq/L. Which is the priority action?
• A. Administer furosemide
• B. Hold furosemide and notify provider
,2
• C. Give normal saline
• D. Administer potassium-wasting diuretic
Answer: B
Rationale: Furosemide is potassium-wasting; hypokalemia
increases risk of arrhythmias.
3.
Which IV medication requires central line administration due to
tissue necrosis risk?
• A. Dopamine
• B. Morphine
• C. Acetaminophen
• D. Heparin
Answer: A
Rationale: Dopamine is a vasopressor; extravasation can cause
tissue necrosis; central line preferred.
4.
A patient is receiving IV gentamicin. Which lab should be
monitored closely?
• A. Creatinine and BUN
,3
• B. Sodium and potassium
• C. Liver function tests
• D. Hemoglobin
Answer: A
Rationale: Gentamicin is nephrotoxic; renal function must be
monitored to prevent toxicity.
5.
A patient develops flushing, hypotension, and rash during IV
vancomycin. What is the correct intervention?
• A. Slow the infusion and monitor
• B. Stop the infusion and notify provider
• C. Administer IV push diphenhydramine
• D. Increase infusion rate
Answer: B
Rationale: Symptoms indicate severe infusion reaction;
immediate discontinuation is required.
6.
Which IV electrolyte is given slowly to prevent cardiac arrest?
, 4
• A. Sodium chloride 0.9%
• B. Potassium chloride
• C. Calcium gluconate
• D. Magnesium sulfate
Answer: B
Rationale: Rapid IV K⁺ can cause fatal arrhythmias; it must be
diluted and infused slowly.
7.
A patient requires IV insulin. Which assessment is PRIORITY?
• A. Blood glucose
• B. Blood pressure
• C. Heart rate
• D. Temperature
Answer: A
Rationale: Insulin can cause hypoglycemia; glucose must be
monitored before and during infusion.
8.
Which IV medication can cause extravasation injury?
PHARMACOLOGY EXAM II – IV MEDICATIONS,
CALCULATIONS & ADVERSE EFFECTS 2026-28
ACTUAL EXAM VERSION
1.
A nurse is preparing to administer IV vancomycin. Which action
is MOST important?
• A. Infuse over 30 minutes
• B. Infuse over at least 60 minutes
• C. Give as IV push
• D. Mix with 5% dextrose only
Answer: B
Rationale: Vancomycin must be infused over ≥60 minutes to
prevent “Red Man Syndrome,” a histamine-mediated reaction.
2.
A patient receives IV furosemide 40 mg. The nurse notes K⁺ 3.0
mEq/L. Which is the priority action?
• A. Administer furosemide
• B. Hold furosemide and notify provider
,2
• C. Give normal saline
• D. Administer potassium-wasting diuretic
Answer: B
Rationale: Furosemide is potassium-wasting; hypokalemia
increases risk of arrhythmias.
3.
Which IV medication requires central line administration due to
tissue necrosis risk?
• A. Dopamine
• B. Morphine
• C. Acetaminophen
• D. Heparin
Answer: A
Rationale: Dopamine is a vasopressor; extravasation can cause
tissue necrosis; central line preferred.
4.
A patient is receiving IV gentamicin. Which lab should be
monitored closely?
• A. Creatinine and BUN
,3
• B. Sodium and potassium
• C. Liver function tests
• D. Hemoglobin
Answer: A
Rationale: Gentamicin is nephrotoxic; renal function must be
monitored to prevent toxicity.
5.
A patient develops flushing, hypotension, and rash during IV
vancomycin. What is the correct intervention?
• A. Slow the infusion and monitor
• B. Stop the infusion and notify provider
• C. Administer IV push diphenhydramine
• D. Increase infusion rate
Answer: B
Rationale: Symptoms indicate severe infusion reaction;
immediate discontinuation is required.
6.
Which IV electrolyte is given slowly to prevent cardiac arrest?
, 4
• A. Sodium chloride 0.9%
• B. Potassium chloride
• C. Calcium gluconate
• D. Magnesium sulfate
Answer: B
Rationale: Rapid IV K⁺ can cause fatal arrhythmias; it must be
diluted and infused slowly.
7.
A patient requires IV insulin. Which assessment is PRIORITY?
• A. Blood glucose
• B. Blood pressure
• C. Heart rate
• D. Temperature
Answer: A
Rationale: Insulin can cause hypoglycemia; glucose must be
monitored before and during infusion.
8.
Which IV medication can cause extravasation injury?
