NUR 354 Exam 1: Pharmacology II V3 - Arizona College
Updated and Latest Questions and Correct Answers with
Rationale
1. A client is prescribed Digoxin for heart failure. Which laboratory value should the nurse monitor most
closely to prevent toxicity?
A. Serum sodium level
B. Serum potassium level
C. Serum calcium level
D. Serum magnesium level
Ans: B
Explanation: Low serum potassium levels significantly increase the risk of digoxin toxicity. Digoxin
binds to the same site on the ATPase pump as potassium. Therefore, hypokalemia allows more digoxin to
bind, enhancing its effects and potential for toxicity. The nurse must monitor electrolyte panels
frequently during therapy. Educating the patient on potassium-rich foods is also a vital intervention.
2. Which assessment finding is a priority for a nurse to report in a patient taking an ACE inhibitor such as
Lisopril?
A. Swelling of the tongue and lips
B. A persistent dry cough
C. A slightly elevated potassium level
D. Occasional dizziness when standing
Ans: A
,Explanation: Swelling of the face, tongue, and lips indicates angioedema, a life-threatening adverse
effect. This condition can lead to airway obstruction and requires immediate medical intervention. While
a dry cough is common, it is not as critical as airway compromise. The nurse should instruct the patient to
stop the medication immediately if this occurs. Emergency equipment should be readily available for
patients experiencing this reaction.
3. A patient is receiving Warfarin therapy. What is the standard lab test used to monitor the therapeutic
effect of this drug?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Ans: C
Explanation: The INR is the standardized measurement used to determine the effectiveness of warfarin
therapy. Usually, a therapeutic range for most conditions is between 2.0 and 3.0. Frequent monitoring is
necessary to ensure the dosage is safe and effective. If the INR is too high, the risk for spontaneous
bleeding increases significantly. Vitamin K serves as the reversal agent if the INR reaches dangerous
levels.
4. Which instruction should the nurse include for a client newly prescribed Alendronate for osteoporosis?
A. Take the medication right before going to bed.
B. Sit upright for 30 minutes after taking the dose.
C. Take the medication with a full glass of milk.
D. Crush the tablet if it is too difficult to swallow.
, A.
Ans: B
Explanation: Alendronate can cause severe esophageal irritation and ulceration if it remains in the
esophagus. Staying upright for at least 30 minutes uses gravity to ensure the pill reaches the stomach. It
must be taken with a full glass of plain water only. Taking it on an empty stomach is required for optimal
absorption. Patients should also wait 30 minutes before eating or drinking anything else.
5. A client is prescribed Furosemide. Which of the following should the nurse encourage the client to
increase in their diet?
A. Leafy green vegetables
B. Bananas and orange juice
C. Whole grain breads
D. Red meats and poultry
Ans: B
Explanation: Furosemide is a loop diuretic that causes significant loss of potassium through the urine.
Bananas and orange juice are excellent sources of potassium to replace these losses. Preventing
hypokalemia is essential to avoid cardiac arrhythmias. The nurse should monitor the patient’s serum
potassium levels regularly. If levels fall too low, a potassium supplement may be ordered.
6. What is the primary mechanism of action for Metformin in treating Type 2 Diabetes?
A. Stimulating the pancreas to secrete more insulin
B. Decreasing glucose production by the liver
C. Increasing the absorption of glucose in the intestines
Updated and Latest Questions and Correct Answers with
Rationale
1. A client is prescribed Digoxin for heart failure. Which laboratory value should the nurse monitor most
closely to prevent toxicity?
A. Serum sodium level
B. Serum potassium level
C. Serum calcium level
D. Serum magnesium level
Ans: B
Explanation: Low serum potassium levels significantly increase the risk of digoxin toxicity. Digoxin
binds to the same site on the ATPase pump as potassium. Therefore, hypokalemia allows more digoxin to
bind, enhancing its effects and potential for toxicity. The nurse must monitor electrolyte panels
frequently during therapy. Educating the patient on potassium-rich foods is also a vital intervention.
2. Which assessment finding is a priority for a nurse to report in a patient taking an ACE inhibitor such as
Lisopril?
A. Swelling of the tongue and lips
B. A persistent dry cough
C. A slightly elevated potassium level
D. Occasional dizziness when standing
Ans: A
,Explanation: Swelling of the face, tongue, and lips indicates angioedema, a life-threatening adverse
effect. This condition can lead to airway obstruction and requires immediate medical intervention. While
a dry cough is common, it is not as critical as airway compromise. The nurse should instruct the patient to
stop the medication immediately if this occurs. Emergency equipment should be readily available for
patients experiencing this reaction.
3. A patient is receiving Warfarin therapy. What is the standard lab test used to monitor the therapeutic
effect of this drug?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Ans: C
Explanation: The INR is the standardized measurement used to determine the effectiveness of warfarin
therapy. Usually, a therapeutic range for most conditions is between 2.0 and 3.0. Frequent monitoring is
necessary to ensure the dosage is safe and effective. If the INR is too high, the risk for spontaneous
bleeding increases significantly. Vitamin K serves as the reversal agent if the INR reaches dangerous
levels.
4. Which instruction should the nurse include for a client newly prescribed Alendronate for osteoporosis?
A. Take the medication right before going to bed.
B. Sit upright for 30 minutes after taking the dose.
C. Take the medication with a full glass of milk.
D. Crush the tablet if it is too difficult to swallow.
, A.
Ans: B
Explanation: Alendronate can cause severe esophageal irritation and ulceration if it remains in the
esophagus. Staying upright for at least 30 minutes uses gravity to ensure the pill reaches the stomach. It
must be taken with a full glass of plain water only. Taking it on an empty stomach is required for optimal
absorption. Patients should also wait 30 minutes before eating or drinking anything else.
5. A client is prescribed Furosemide. Which of the following should the nurse encourage the client to
increase in their diet?
A. Leafy green vegetables
B. Bananas and orange juice
C. Whole grain breads
D. Red meats and poultry
Ans: B
Explanation: Furosemide is a loop diuretic that causes significant loss of potassium through the urine.
Bananas and orange juice are excellent sources of potassium to replace these losses. Preventing
hypokalemia is essential to avoid cardiac arrhythmias. The nurse should monitor the patient’s serum
potassium levels regularly. If levels fall too low, a potassium supplement may be ordered.
6. What is the primary mechanism of action for Metformin in treating Type 2 Diabetes?
A. Stimulating the pancreas to secrete more insulin
B. Decreasing glucose production by the liver
C. Increasing the absorption of glucose in the intestines
