NUR 354 Final Exam: Pharmacology II V2 - Arizona College
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with a known allergy to penicillin is prescribed Cefazolin. Which action should the nurse take
first?
A. Administer the medication and monitor for 30 minutes.
B. Assess the specific nature of the penicillin allergy.
C. Notify the pharmacist to substitute the medication.
D. Administer an antihistamine before the dose.
Ans: B
Explanation: Cephalosporins like Cefazolin share a similar structure with penicillins, leading to potential
cross-sensitivity. The nurse must determine if the previous reaction was a mild rash or life-threatening
anaphylaxis. This assessment is critical to ensure patient safety before any medication administration
occurs. If the reaction was severe, the provider must be notified to find an alternative therapy.
Documenting the allergy details correctly prevents future adverse events in the clinical setting.
2. When administering Digoxin, which electrolyte imbalance most increases the risk for toxicity?
A. Hypokalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypermagnesemia
Ans: A
,Explanation: Low serum potassium levels enhance the effects of Digoxin at the cellular level. This
increased sensitivity can lead to dangerous cardiac arrhythmias even at therapeutic drug levels. Nurses
must monitor potassium levels closely, especially if the patient is also taking loop diuretics.
Supplementing potassium may be necessary to maintain levels within the target range of 3.5 to 5.0
mEq/L. Educating the patient about consuming potassium-rich foods helps manage this risk effectively.
3. A client is taking Lithium for bipolar disorder. Which dietary instruction is most important?
A. Restrict salt intake to less than 2 grams per day.
B. Avoid foods high in tyramine like aged cheese.
C. Maintain a consistent intake of sodium and fluids.
D. Increase intake of green leafy vegetables.
Ans: C
Explanation: Lithium is a salt, and its excretion is inversely related to sodium levels in the body. If
sodium intake decreases or fluid loss increases, the kidneys retain lithium, leading to toxicity. The patient
should aim for a steady intake of salt and at least 2 to 3 liters of fluid daily. Dehydration or excessive
sweating can rapidly increase lithium concentrations to dangerous levels. Regular blood tests are
required to ensure the lithium level remains in the therapeutic range.
4. Which lab value is most important to monitor for a patient receiving a continuous Heparin infusion?
A. Activated Partial Thromboplastin Time (aPTT)
B. Prothrombin Time (PT)
C. International Normalized Ratio (INR)
D. Platelet count only
Ans: A
, Explanation: The aPTT measures the effectiveness of the intrinsic pathway which Heparin specifically
targets. Therapeutic levels are generally 1.5 to 2.5 times the normal baseline value. If the aPTT is too high,
the patient is at significant risk for spontaneous bleeding. The nurse adjusts the infusion rate based on
standardized titration protocols provided by the facility. Frequent monitoring ensures that
anticoagulation remains within the safe and effective window.
5. A patient is prescribed Warfarin. Which medication should the nurse instruct the patient to avoid for pain
relief?
A. Acetaminophen
B. Ibuprofen
C. Gabapentin
D. Oxycodone
Ans: B
Explanation: Nonsteroidal anti-inflammatory drugs like Ibuprofen can increase the risk of
gastrointestinal bleeding while on Warfarin. These drugs interfere with platelet aggregation and can
irritate the stomach lining. Acetaminophen is generally the preferred choice for mild pain in patients
taking anticoagulants. The nurse should explain that even over-the-counter NSAIDs can significantly
impact bleeding times. Patients must be taught to check labels for hidden aspirin or ibuprofen content.
6. Which insulin should the nurse clarify if the order states to administer it intravenously?
A. Insulin Glargine
B. Regular Insulin
C. Insulin Lispro
D. Insulin Aspart
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient with a known allergy to penicillin is prescribed Cefazolin. Which action should the nurse take
first?
A. Administer the medication and monitor for 30 minutes.
B. Assess the specific nature of the penicillin allergy.
C. Notify the pharmacist to substitute the medication.
D. Administer an antihistamine before the dose.
Ans: B
Explanation: Cephalosporins like Cefazolin share a similar structure with penicillins, leading to potential
cross-sensitivity. The nurse must determine if the previous reaction was a mild rash or life-threatening
anaphylaxis. This assessment is critical to ensure patient safety before any medication administration
occurs. If the reaction was severe, the provider must be notified to find an alternative therapy.
Documenting the allergy details correctly prevents future adverse events in the clinical setting.
2. When administering Digoxin, which electrolyte imbalance most increases the risk for toxicity?
A. Hypokalemia
B. Hyponatremia
C. Hypercalcemia
D. Hypermagnesemia
Ans: A
,Explanation: Low serum potassium levels enhance the effects of Digoxin at the cellular level. This
increased sensitivity can lead to dangerous cardiac arrhythmias even at therapeutic drug levels. Nurses
must monitor potassium levels closely, especially if the patient is also taking loop diuretics.
Supplementing potassium may be necessary to maintain levels within the target range of 3.5 to 5.0
mEq/L. Educating the patient about consuming potassium-rich foods helps manage this risk effectively.
3. A client is taking Lithium for bipolar disorder. Which dietary instruction is most important?
A. Restrict salt intake to less than 2 grams per day.
B. Avoid foods high in tyramine like aged cheese.
C. Maintain a consistent intake of sodium and fluids.
D. Increase intake of green leafy vegetables.
Ans: C
Explanation: Lithium is a salt, and its excretion is inversely related to sodium levels in the body. If
sodium intake decreases or fluid loss increases, the kidneys retain lithium, leading to toxicity. The patient
should aim for a steady intake of salt and at least 2 to 3 liters of fluid daily. Dehydration or excessive
sweating can rapidly increase lithium concentrations to dangerous levels. Regular blood tests are
required to ensure the lithium level remains in the therapeutic range.
4. Which lab value is most important to monitor for a patient receiving a continuous Heparin infusion?
A. Activated Partial Thromboplastin Time (aPTT)
B. Prothrombin Time (PT)
C. International Normalized Ratio (INR)
D. Platelet count only
Ans: A
, Explanation: The aPTT measures the effectiveness of the intrinsic pathway which Heparin specifically
targets. Therapeutic levels are generally 1.5 to 2.5 times the normal baseline value. If the aPTT is too high,
the patient is at significant risk for spontaneous bleeding. The nurse adjusts the infusion rate based on
standardized titration protocols provided by the facility. Frequent monitoring ensures that
anticoagulation remains within the safe and effective window.
5. A patient is prescribed Warfarin. Which medication should the nurse instruct the patient to avoid for pain
relief?
A. Acetaminophen
B. Ibuprofen
C. Gabapentin
D. Oxycodone
Ans: B
Explanation: Nonsteroidal anti-inflammatory drugs like Ibuprofen can increase the risk of
gastrointestinal bleeding while on Warfarin. These drugs interfere with platelet aggregation and can
irritate the stomach lining. Acetaminophen is generally the preferred choice for mild pain in patients
taking anticoagulants. The nurse should explain that even over-the-counter NSAIDs can significantly
impact bleeding times. Patients must be taught to check labels for hidden aspirin or ibuprofen content.
6. Which insulin should the nurse clarify if the order states to administer it intravenously?
A. Insulin Glargine
B. Regular Insulin
C. Insulin Lispro
D. Insulin Aspart
