NSG124/NSG 124 Exam 3 V2 |
Pharmacology Q&A with Rationale |
Herzing University
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding requires the nurse to withhold the medication and contact the provider?
A. Blood pressure of 110/70 mmHg
B. Apical pulse of 52 beats per minute
C. Respiratory rate of 18 breaths per minute
D. Potassium level of 4.2 mEq/L
Correct Answer: B
Rationale: Digoxin is a cardiac glycoside that has negative chronotropic effects, meaning it
slows the heart rate. The nurse must assess the apical pulse for one full minute prior to
administration. If the pulse is less than 60 beats per minute in an adult, the dose should be
held to prevent bradycardia and potential toxicity.
2. A patient is prescribed lisinopril for hypertension. The nurse should instruct the patient to
report which common but annoying side effect?
A. Yellowing of the sclera
B. Increased appetite
C. Persistent dry cough
,D. Lower extremity edema
Correct Answer: C
Rationale: ACE inhibitors like lisinopril prevent the breakdown of bradykinin in the lungs,
which can lead to a dry, non-productive cough. While this side effect is not life-threatening,
it is often bothersome enough for patients to discontinue the medication. The nurse should
explain that this symptom should be reported so the provider can consider switching the
patient to an ARB.
3. Which of the following instructions should the nurse include for a patient carrying
sublingual nitroglycerin tablets for angina?
A. Keep the tablets in the original dark glass bottle.
B. Discard the tablets every 12 months.
C. Take one tablet every 15 minutes up to 3 doses.
D. Swallow the tablet with a full glass of water.
Correct Answer: A
Rationale: Nitroglycerin is highly sensitive to light and heat and must be kept in its
original dark glass container to maintain potency. Patients should be taught to take one
tablet sublingually every 5 minutes for a maximum of 3 doses if chest pain persists. If pain
is not relieved after the first dose, the patient should call emergency services immediately.
, 4. A patient is receiving a continuous heparin infusion. Which laboratory value should the
nurse monitor to adjust the dosage?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count only
Correct Answer: A
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated heparin therapy. The therapeutic range is typically 1.5 to 2.5 times the
baseline value. PT and INR are used specifically for monitoring warfarin therapy rather
than heparin.
5. A patient with a history of asthma is prescribed propranolol for hypertension. Why should
the nurse clarify this order with the provider?
A. Propranolol is a non-selective beta-blocker that can cause bronchoconstriction.
B. Propranolol causes significant urinary retention.
C. The medication can cause excessive cough.
D. Propranolol interacts with rescue inhalers to cause hypotension.
Correct Answer: A
Pharmacology Q&A with Rationale |
Herzing University
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding requires the nurse to withhold the medication and contact the provider?
A. Blood pressure of 110/70 mmHg
B. Apical pulse of 52 beats per minute
C. Respiratory rate of 18 breaths per minute
D. Potassium level of 4.2 mEq/L
Correct Answer: B
Rationale: Digoxin is a cardiac glycoside that has negative chronotropic effects, meaning it
slows the heart rate. The nurse must assess the apical pulse for one full minute prior to
administration. If the pulse is less than 60 beats per minute in an adult, the dose should be
held to prevent bradycardia and potential toxicity.
2. A patient is prescribed lisinopril for hypertension. The nurse should instruct the patient to
report which common but annoying side effect?
A. Yellowing of the sclera
B. Increased appetite
C. Persistent dry cough
,D. Lower extremity edema
Correct Answer: C
Rationale: ACE inhibitors like lisinopril prevent the breakdown of bradykinin in the lungs,
which can lead to a dry, non-productive cough. While this side effect is not life-threatening,
it is often bothersome enough for patients to discontinue the medication. The nurse should
explain that this symptom should be reported so the provider can consider switching the
patient to an ARB.
3. Which of the following instructions should the nurse include for a patient carrying
sublingual nitroglycerin tablets for angina?
A. Keep the tablets in the original dark glass bottle.
B. Discard the tablets every 12 months.
C. Take one tablet every 15 minutes up to 3 doses.
D. Swallow the tablet with a full glass of water.
Correct Answer: A
Rationale: Nitroglycerin is highly sensitive to light and heat and must be kept in its
original dark glass container to maintain potency. Patients should be taught to take one
tablet sublingually every 5 minutes for a maximum of 3 doses if chest pain persists. If pain
is not relieved after the first dose, the patient should call emergency services immediately.
, 4. A patient is receiving a continuous heparin infusion. Which laboratory value should the
nurse monitor to adjust the dosage?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count only
Correct Answer: A
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated heparin therapy. The therapeutic range is typically 1.5 to 2.5 times the
baseline value. PT and INR are used specifically for monitoring warfarin therapy rather
than heparin.
5. A patient with a history of asthma is prescribed propranolol for hypertension. Why should
the nurse clarify this order with the provider?
A. Propranolol is a non-selective beta-blocker that can cause bronchoconstriction.
B. Propranolol causes significant urinary retention.
C. The medication can cause excessive cough.
D. Propranolol interacts with rescue inhalers to cause hypotension.
Correct Answer: A
