BSN315 Exam 2 Actual Exam Style V3 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client is prescribed lisinopril for the management of hypertension. Which side effect
should the nurse instruct the client to report immediately to the healthcare provider?
A. Occasional dizziness upon standing
B. Increased urine output during the day
C. Mild nausea after taking the medication
D. A persistent, dry, nonproductive cough
Correct Answer: D
Expert Explanation: Lisinopril is an ACE inhibitor that can lead to the accumulation of
bradykinin in the lungs. This accumulation often results in a persistent, dry cough that can
be distressing for the patient. The nurse should inform the client that this is a common side
effect but requires medical evaluation to potentially switch to an Angiotensin II Receptor
Blocker (ARB).
2. A patient with heart failure is receiving digoxin. Which of the following laboratory results
would most concern the nurse regarding potential digoxin toxicity?
A. Serum sodium level of 138 mEq/L
B. Serum digoxin level of 1.2 ng/mL
C. Serum potassium level of 3.0 mEq/L
,D. Serum calcium level of 9.5 mg/dL
Correct Answer: C
Expert Explanation: Hypokalemia, defined as a potassium level below 3.5 mEq/L,
significantly increases the risk of digoxin toxicity. Digoxin competes with potassium for
binding sites on the sodium-potassium ATPase pump. Therefore, low potassium levels
allow more digoxin to bind, leading to toxic effects even if the digoxin level is within the
therapeutic range.
3. The nurse is preparing to administer warfarin to a client with deep vein thrombosis. Which
laboratory value should the nurse check to determine the effectiveness and safety of the
dose?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Correct Answer: C
Expert Explanation: The International Normalized Ratio (INR) is the standard laboratory
test used to monitor the effectiveness of warfarin therapy. For most patients on warfarin,
the target therapeutic INR range is between 2.0 and 3.0. The nurse must verify this value
before administration to prevent subtherapeutic dosing or life-threatening hemorrhage.
, 4. A client is receiving a continuous heparin infusion for a pulmonary embolism. The nurse
notes the client has developed hematuria and epistaxis. Which medication should the nurse
anticipate the provider will order?
A. Vitamin K
B. Protamine sulfate
C. Enoxaparin
D. Aminocaproic acid
Correct Answer: B
Expert Explanation: Protamine sulfate is the specific pharmacological antagonist used to
reverse the anticoagulant effects of heparin. If a patient exhibits signs of active bleeding
while on heparin, the infusion should be stopped and the antidote administered. The nurse
should also continue to monitor the client’s aPTT levels closely during this time.
5. The nurse is teaching a patient about a new prescription for spironolactone. Which dietary
instruction is most important for the nurse to include?
A. Avoid salt substitutes containing potassium
B. Increase intake of bananas and orange juice
C. Limit intake of green leafy vegetables
D. Consume at least 3 liters of fluid daily
Correct Answer: A
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client is prescribed lisinopril for the management of hypertension. Which side effect
should the nurse instruct the client to report immediately to the healthcare provider?
A. Occasional dizziness upon standing
B. Increased urine output during the day
C. Mild nausea after taking the medication
D. A persistent, dry, nonproductive cough
Correct Answer: D
Expert Explanation: Lisinopril is an ACE inhibitor that can lead to the accumulation of
bradykinin in the lungs. This accumulation often results in a persistent, dry cough that can
be distressing for the patient. The nurse should inform the client that this is a common side
effect but requires medical evaluation to potentially switch to an Angiotensin II Receptor
Blocker (ARB).
2. A patient with heart failure is receiving digoxin. Which of the following laboratory results
would most concern the nurse regarding potential digoxin toxicity?
A. Serum sodium level of 138 mEq/L
B. Serum digoxin level of 1.2 ng/mL
C. Serum potassium level of 3.0 mEq/L
,D. Serum calcium level of 9.5 mg/dL
Correct Answer: C
Expert Explanation: Hypokalemia, defined as a potassium level below 3.5 mEq/L,
significantly increases the risk of digoxin toxicity. Digoxin competes with potassium for
binding sites on the sodium-potassium ATPase pump. Therefore, low potassium levels
allow more digoxin to bind, leading to toxic effects even if the digoxin level is within the
therapeutic range.
3. The nurse is preparing to administer warfarin to a client with deep vein thrombosis. Which
laboratory value should the nurse check to determine the effectiveness and safety of the
dose?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Correct Answer: C
Expert Explanation: The International Normalized Ratio (INR) is the standard laboratory
test used to monitor the effectiveness of warfarin therapy. For most patients on warfarin,
the target therapeutic INR range is between 2.0 and 3.0. The nurse must verify this value
before administration to prevent subtherapeutic dosing or life-threatening hemorrhage.
, 4. A client is receiving a continuous heparin infusion for a pulmonary embolism. The nurse
notes the client has developed hematuria and epistaxis. Which medication should the nurse
anticipate the provider will order?
A. Vitamin K
B. Protamine sulfate
C. Enoxaparin
D. Aminocaproic acid
Correct Answer: B
Expert Explanation: Protamine sulfate is the specific pharmacological antagonist used to
reverse the anticoagulant effects of heparin. If a patient exhibits signs of active bleeding
while on heparin, the infusion should be stopped and the antidote administered. The nurse
should also continue to monitor the client’s aPTT levels closely during this time.
5. The nurse is teaching a patient about a new prescription for spironolactone. Which dietary
instruction is most important for the nurse to include?
A. Avoid salt substitutes containing potassium
B. Increase intake of bananas and orange juice
C. Limit intake of green leafy vegetables
D. Consume at least 3 liters of fluid daily
Correct Answer: A
