BSN315 Exam 3 Actual Exam Style V2 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A patient is receiving lithium carbonate for the treatment of bipolar disorder. Which
electrolyte imbalance should the nurse monitor most closely to prevent lithium toxicity?
A. Hyponatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: A
Rationale: Lithium is a salt and is processed by the kidneys in a similar manner to sodium.
When sodium levels are low, the kidneys reabsorb lithium in an attempt to maintain
electrolyte balance, which can lead to toxic serum levels. Therefore, maintaining a
consistent salt and fluid intake is critical for patients on this medication.
2. A patient is prescribed haloperidol for the treatment of schizophrenia. The nurse notes the
patient is experiencing high fever, muscle rigidity, and altered mental status. What is the
priority nursing action?
A. Apply a cooling blanket and notify the provider
B. Administer the next dose of haloperidol
,C. Administer an anticholinergic like benztropine
D. Encourage the patient to drink more fluids
Answer: A
Rationale: These symptoms are indicative of Neuroleptic Malignant Syndrome (NMS), a
life-threatening reaction to antipsychotic medications. The nurse must immediately stop
the medication, initiate cooling measures, and notify the healthcare provider. NMS is a
medical emergency that requires intensive supportive care and monitoring.
3. A client with a history of heart failure is prescribed digoxin. Which of the following
symptoms would most likely indicate digoxin toxicity?
A. Increased appetite and weight gain
B. Hypertension and tachycardia
C. Visual disturbances such as yellow-green halos
D. Profuse sweating and dry mouth
Answer: C
Rationale: Digoxin toxicity often manifests as gastrointestinal distress and neurological
symptoms, including visual changes like halos or blurred vision. Early signs include
anorexia, nausea, and vomiting, while cardiac dysrhythmias can also occur. Monitoring
serum digoxin levels and potassium levels is essential as hypokalemia increases the risk of
toxicity.
, 4. A patient is starting therapy with an ACE inhibitor for hypertension. What specific side
effect should the nurse instruct the patient to report immediately?
A. Swelling of the tongue or lips
B. A persistent dry cough
C. Occasional dizziness when standing
D. Orange-colored urine
Answer: A
Rationale: Swelling of the tongue, lips, or face indicates angioedema, a rare but life-
threatening adverse effect of ACE inhibitors that can compromise the airway. While a dry
cough is a common side effect due to bradykinin buildup, it is not an emergency.
Angioedema requires immediate medical intervention and permanent discontinuation of
the drug class.
5. When teaching a patient about taking spironolactone, which dietary instruction is most
important?
A. Increase intake of bananas and spinach
B. Drink at least 3 liters of water per day
C. Avoid salt substitutes containing potassium
D. Take the medication on an empty stomach
Answer: C
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A patient is receiving lithium carbonate for the treatment of bipolar disorder. Which
electrolyte imbalance should the nurse monitor most closely to prevent lithium toxicity?
A. Hyponatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: A
Rationale: Lithium is a salt and is processed by the kidneys in a similar manner to sodium.
When sodium levels are low, the kidneys reabsorb lithium in an attempt to maintain
electrolyte balance, which can lead to toxic serum levels. Therefore, maintaining a
consistent salt and fluid intake is critical for patients on this medication.
2. A patient is prescribed haloperidol for the treatment of schizophrenia. The nurse notes the
patient is experiencing high fever, muscle rigidity, and altered mental status. What is the
priority nursing action?
A. Apply a cooling blanket and notify the provider
B. Administer the next dose of haloperidol
,C. Administer an anticholinergic like benztropine
D. Encourage the patient to drink more fluids
Answer: A
Rationale: These symptoms are indicative of Neuroleptic Malignant Syndrome (NMS), a
life-threatening reaction to antipsychotic medications. The nurse must immediately stop
the medication, initiate cooling measures, and notify the healthcare provider. NMS is a
medical emergency that requires intensive supportive care and monitoring.
3. A client with a history of heart failure is prescribed digoxin. Which of the following
symptoms would most likely indicate digoxin toxicity?
A. Increased appetite and weight gain
B. Hypertension and tachycardia
C. Visual disturbances such as yellow-green halos
D. Profuse sweating and dry mouth
Answer: C
Rationale: Digoxin toxicity often manifests as gastrointestinal distress and neurological
symptoms, including visual changes like halos or blurred vision. Early signs include
anorexia, nausea, and vomiting, while cardiac dysrhythmias can also occur. Monitoring
serum digoxin levels and potassium levels is essential as hypokalemia increases the risk of
toxicity.
, 4. A patient is starting therapy with an ACE inhibitor for hypertension. What specific side
effect should the nurse instruct the patient to report immediately?
A. Swelling of the tongue or lips
B. A persistent dry cough
C. Occasional dizziness when standing
D. Orange-colored urine
Answer: A
Rationale: Swelling of the tongue, lips, or face indicates angioedema, a rare but life-
threatening adverse effect of ACE inhibitors that can compromise the airway. While a dry
cough is a common side effect due to bradykinin buildup, it is not an emergency.
Angioedema requires immediate medical intervention and permanent discontinuation of
the drug class.
5. When teaching a patient about taking spironolactone, which dietary instruction is most
important?
A. Increase intake of bananas and spinach
B. Drink at least 3 liters of water per day
C. Avoid salt substitutes containing potassium
D. Take the medication on an empty stomach
Answer: C
