NSG124/NSG 124 Exam 2 V3 |
Pharmacology Q&A with Rationale |
Herzing University
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding would require the nurse to withhold the medication?
A. Blood pressure of 110/70 mmHg
B. Potassium level of 4.2 mEq/L
C. Apical pulse of 52 beats per minute
D. Respiratory rate of 18 breaths per minute
Correct Answer: C
Rationale: Prior to the administration of digoxin, the nurse must assess the apical pulse for
one full minute to ensure it is at least 60 beats per minute. A pulse rate of 52 indicates
bradycardia, which can be a clinical sign of digoxin toxicity. The nurse must withhold the
dose and notify the healthcare provider immediately to prevent further cardiac depression.
2. A patient is prescribed lisinopril for hypertension. The nurse should instruct the patient to
report which common adverse effect associated with ACE inhibitors?
A. Persistent dry cough
B. Increased urinary output
C. Yellowing of the sclera
,D. Constipation
Correct Answer: A
Rationale: A persistent dry, nonproductive cough is a common side effect of ACE inhibitors
due to the accumulation of bradykinin in the respiratory tract. While this side effect is not
usually life-threatening, it can be bothersome enough for patients to discontinue the
medication. The nurse should explain that if this occurs, the provider may switch the
patient to an Angiotensin II Receptor Blocker (ARB).
3. Which laboratory value is the most important for the nurse to monitor for a patient
receiving a continuous heparin infusion?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Glycosylated hemoglobin (HbA1c)
Correct Answer: B
Rationale: The aPTT is the primary laboratory test used to monitor the effectiveness and
safety of unfractionated heparin therapy. The nurse must adjust the infusion rate based on
the facility’s titration protocol to maintain the aPTT within the therapeutic range.
Monitoring this value is essential to prevent both subtherapeutic dosing and life-
threatening hemorrhage.
, 4. A nurse is teaching a patient about the proper use of a nitroglycerin sublingual tablet.
Which instruction is most appropriate?
A. Place the tablet under the tongue and let it dissolve.
B. Swallow the tablet with a full glass of water.
C. Take the medication only after exercising for 30 minutes.
D. Crush the tablet and mix it with applesauce if it tastes bitter.
Correct Answer: A
Rationale: Sublingual nitroglycerin must be placed under the tongue to allow for rapid
absorption through the oral mucosa, bypassing first-pass metabolism in the liver. Patients
should be taught to sit or lie down before taking the dose to prevent orthostatic
hypotension and potential falls. If chest pain is not relieved after one dose, the patient
should call emergency services immediately while waiting to take subsequent doses.
5. Which medication is considered a potassium-sparing diuretic?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Bumetanide
Correct Answer: B
Pharmacology Q&A with Rationale |
Herzing University
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding would require the nurse to withhold the medication?
A. Blood pressure of 110/70 mmHg
B. Potassium level of 4.2 mEq/L
C. Apical pulse of 52 beats per minute
D. Respiratory rate of 18 breaths per minute
Correct Answer: C
Rationale: Prior to the administration of digoxin, the nurse must assess the apical pulse for
one full minute to ensure it is at least 60 beats per minute. A pulse rate of 52 indicates
bradycardia, which can be a clinical sign of digoxin toxicity. The nurse must withhold the
dose and notify the healthcare provider immediately to prevent further cardiac depression.
2. A patient is prescribed lisinopril for hypertension. The nurse should instruct the patient to
report which common adverse effect associated with ACE inhibitors?
A. Persistent dry cough
B. Increased urinary output
C. Yellowing of the sclera
,D. Constipation
Correct Answer: A
Rationale: A persistent dry, nonproductive cough is a common side effect of ACE inhibitors
due to the accumulation of bradykinin in the respiratory tract. While this side effect is not
usually life-threatening, it can be bothersome enough for patients to discontinue the
medication. The nurse should explain that if this occurs, the provider may switch the
patient to an Angiotensin II Receptor Blocker (ARB).
3. Which laboratory value is the most important for the nurse to monitor for a patient
receiving a continuous heparin infusion?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Glycosylated hemoglobin (HbA1c)
Correct Answer: B
Rationale: The aPTT is the primary laboratory test used to monitor the effectiveness and
safety of unfractionated heparin therapy. The nurse must adjust the infusion rate based on
the facility’s titration protocol to maintain the aPTT within the therapeutic range.
Monitoring this value is essential to prevent both subtherapeutic dosing and life-
threatening hemorrhage.
, 4. A nurse is teaching a patient about the proper use of a nitroglycerin sublingual tablet.
Which instruction is most appropriate?
A. Place the tablet under the tongue and let it dissolve.
B. Swallow the tablet with a full glass of water.
C. Take the medication only after exercising for 30 minutes.
D. Crush the tablet and mix it with applesauce if it tastes bitter.
Correct Answer: A
Rationale: Sublingual nitroglycerin must be placed under the tongue to allow for rapid
absorption through the oral mucosa, bypassing first-pass metabolism in the liver. Patients
should be taught to sit or lie down before taking the dose to prevent orthostatic
hypotension and potential falls. If chest pain is not relieved after one dose, the patient
should call emergency services immediately while waiting to take subsequent doses.
5. Which medication is considered a potassium-sparing diuretic?
A. Furosemide
B. Spironolactone
C. Hydrochlorothiazide
D. Bumetanide
Correct Answer: B
