NUR 354 Exam 2: Pharmacology II V3 - Arizona College
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient is prescribed Digoxin for heart failure. Which clinical finding should the nurse recognize as an
early sign of digoxin toxicity?
A. Anorexia, nausea, and vomiting
B. Tachycardia and hypertension
C. Increased urinary output
D. Fine tremors of the hands
Ans: A
Explanation: Digoxin toxicity often manifests early with gastrointestinal symptoms such as anorexia and
nausea. These signs occur because the drug affects the chemoreceptor trigger zone in the brain. If left
untreated, the patient may progress to visual disturbances like yellow-green halos. It is essential for the
nurse to monitor serum digoxin levels frequently to maintain a therapeutic range. Assessing the apical
pulse for a full minute before administration is a critical safety measure.
2. Which electrolyte imbalance increases the risk of Digoxin toxicity in a patient also taking Furosemide?
A. Hypokalemia
B. Hypermagnesemia
C. Hypernatremia
D. Hypocalcemia
Ans: A
,Explanation: Hypokalemia sensitizes the myocardium to digoxin, significantly increasing the risk of
toxicity. Furosemide is a loop diuretic that causes the excretion of potassium along with water and
sodium. Nurses must monitor potassium levels closely when these two medications are used
concurrently. Supplementation or potassium-rich diets are often required to maintain homeostasis.
Stable potassium levels ensure the cardiac glycoside works effectively without causing lethal
arrhythmias.
3. A patient taking Lisinopril develops a persistent, non-productive cough. What is the most likely cause of
this side effect?
A. Development of pulmonary edema
B. Accumulation of bradykinin in the lungs
C. A secondary bacterial respiratory infection
D. Bronchoconstriction caused by beta-blockade
Ans: B
Explanation: ACE inhibitors like Lisinopril prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This chemical buildup triggers a dry, hacking cough in about 10 to
20 percent of patients. The cough is not harmful but is often bothersome enough for patients to
discontinue the medication. Switching the patient to an Angiotensin II Receptor Blocker (ARB) usually
resolves the issue. Nurses should educate patients that this is a class-specific side effect of ACE inhibitors.
4. Which laboratory value is most important for a nurse to monitor in a patient receiving a continuous
Heparin infusion?
A. Activated Partial Thromboplastin Time (aPTT)
B. International Normalized Ratio (INR)
, C. Prothrombin Time (PT)
D. Bleeding Time
Ans: A
Explanation: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated heparin. A therapeutic aPTT is typically 1.5 to 2.5 times the normal baseline value. If the
aPTT is too high, the patient is at risk for spontaneous hemorrhage and may need the dose reduced. If the
aPTT is too low, the patient remains at risk for developing clots or pulmonary emboli. Precise monitoring
allows for weight-based titration to maintain safety and efficacy.
5. A nurse is preparing to administer Warfarin. Which medication should be available as the reversal agent
for Warfarin toxicity?
A. Protamine sulfate
B. Vitamin K
C. Glucagon
D. Acetylcysteine
Ans: B
Explanation: Warfarin works by inhibiting the synthesis of Vitamin K-dependent clotting factors in the
liver. In cases of overdose or excessive bleeding, Vitamin K is administered to restore clotting ability. It
can be given orally, subcutaneously, or intravenously depending on the clinical urgency. Full reversal may
take several hours as the liver must synthesize new clotting factors. Patients should be taught to maintain
a consistent intake of Vitamin K-rich foods like leafy greens.
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient is prescribed Digoxin for heart failure. Which clinical finding should the nurse recognize as an
early sign of digoxin toxicity?
A. Anorexia, nausea, and vomiting
B. Tachycardia and hypertension
C. Increased urinary output
D. Fine tremors of the hands
Ans: A
Explanation: Digoxin toxicity often manifests early with gastrointestinal symptoms such as anorexia and
nausea. These signs occur because the drug affects the chemoreceptor trigger zone in the brain. If left
untreated, the patient may progress to visual disturbances like yellow-green halos. It is essential for the
nurse to monitor serum digoxin levels frequently to maintain a therapeutic range. Assessing the apical
pulse for a full minute before administration is a critical safety measure.
2. Which electrolyte imbalance increases the risk of Digoxin toxicity in a patient also taking Furosemide?
A. Hypokalemia
B. Hypermagnesemia
C. Hypernatremia
D. Hypocalcemia
Ans: A
,Explanation: Hypokalemia sensitizes the myocardium to digoxin, significantly increasing the risk of
toxicity. Furosemide is a loop diuretic that causes the excretion of potassium along with water and
sodium. Nurses must monitor potassium levels closely when these two medications are used
concurrently. Supplementation or potassium-rich diets are often required to maintain homeostasis.
Stable potassium levels ensure the cardiac glycoside works effectively without causing lethal
arrhythmias.
3. A patient taking Lisinopril develops a persistent, non-productive cough. What is the most likely cause of
this side effect?
A. Development of pulmonary edema
B. Accumulation of bradykinin in the lungs
C. A secondary bacterial respiratory infection
D. Bronchoconstriction caused by beta-blockade
Ans: B
Explanation: ACE inhibitors like Lisinopril prevent the breakdown of bradykinin, leading to its
accumulation in the respiratory tract. This chemical buildup triggers a dry, hacking cough in about 10 to
20 percent of patients. The cough is not harmful but is often bothersome enough for patients to
discontinue the medication. Switching the patient to an Angiotensin II Receptor Blocker (ARB) usually
resolves the issue. Nurses should educate patients that this is a class-specific side effect of ACE inhibitors.
4. Which laboratory value is most important for a nurse to monitor in a patient receiving a continuous
Heparin infusion?
A. Activated Partial Thromboplastin Time (aPTT)
B. International Normalized Ratio (INR)
, C. Prothrombin Time (PT)
D. Bleeding Time
Ans: A
Explanation: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated heparin. A therapeutic aPTT is typically 1.5 to 2.5 times the normal baseline value. If the
aPTT is too high, the patient is at risk for spontaneous hemorrhage and may need the dose reduced. If the
aPTT is too low, the patient remains at risk for developing clots or pulmonary emboli. Precise monitoring
allows for weight-based titration to maintain safety and efficacy.
5. A nurse is preparing to administer Warfarin. Which medication should be available as the reversal agent
for Warfarin toxicity?
A. Protamine sulfate
B. Vitamin K
C. Glucagon
D. Acetylcysteine
Ans: B
Explanation: Warfarin works by inhibiting the synthesis of Vitamin K-dependent clotting factors in the
liver. In cases of overdose or excessive bleeding, Vitamin K is administered to restore clotting ability. It
can be given orally, subcutaneously, or intravenously depending on the clinical urgency. Full reversal may
take several hours as the liver must synthesize new clotting factors. Patients should be taught to maintain
a consistent intake of Vitamin K-rich foods like leafy greens.
