NR293 Exam 2 Actual Exam Style V2 | NR
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient is prescribed digoxin for heart failure. Which laboratory value should the nurse
monitor most closely to prevent digoxin toxicity?
A. Serum sodium 140 mEq/L
B. Serum glucose 110 mg/dL
C. Serum calcium 9.0 mg/dL
D. Serum potassium 3.0 mEq/L
Answer: D
Rationale: Hypokalemia increases the risk of digoxin toxicity because potassium and
digoxin compete for the same binding sites on the sodium-potassium ATPase pump. When
potassium levels are low, more digoxin can bind, leading to excessive drug effects. The
nurse must monitor electrolyte levels frequently and notify the provider if potassium is
below the normal range.
2. A nurse is preparing to administer sublingual nitroglycerin to a patient with chest pain.
Which action should the nurse take first?
A. Assess the patient’s blood pressure and heart rate.
B. Administer a glass of water to help swallow the tablet.
,C. Call the healthcare provider to report the pain.
D. Place the tablet under the patient’s tongue and wait 15 minutes.
Answer: A
Rationale: Nitroglycerin is a potent vasodilator that can cause significant hypotension. The
nurse must assess the patient’s baseline vital signs before administration to ensure the
patient can tolerate the medication. If the systolic blood pressure is below 90 mmHg, the
dose should typically be withheld and the provider notified.
3. The nurse is teaching a patient about a new prescription for lisinopril. Which side effect
should the nurse instruct the patient to report immediately?
A. Increased appetite
B. Frequent urination
C. A metallic taste in the mouth
D. Swelling of the face or tongue
Answer: D
Rationale: Swelling of the face or tongue indicates angioedema, which is a life-threatening
adverse effect of ACE inhibitors. This reaction can lead to airway obstruction and requires
emergency medical intervention. Patients must be taught that this can occur at any time
during therapy, not just with the first dose.
, 4. A patient is receiving heparin therapy for a deep vein thrombosis. Which laboratory result
indicates the medication is in the therapeutic range?
A. PT of 12 seconds
B. aPTT of 65 seconds
C. INR of 2.5
D. Platelet count of 100,000
Answer: B
Rationale: The activated partial thromboplastin time (aPTT) is used to monitor the
effectiveness of heparin therapy. A therapeutic range is typically 1.5 to 2.5 times the
baseline or control value. The INR and PT are used for monitoring warfarin therapy, not
heparin.
5. Which medication is considered a potassium-sparing diuretic?
A. Furosemide
B. Hydrochlorothiazide
C. Mannitol
D. Spironolactone
Answer: D
Rationale: Spironolactone is a potassium-sparing diuretic that works by antagonizing
aldosterone receptors in the distal tubule. Unlike loop or thiazide diuretics, it does not
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient is prescribed digoxin for heart failure. Which laboratory value should the nurse
monitor most closely to prevent digoxin toxicity?
A. Serum sodium 140 mEq/L
B. Serum glucose 110 mg/dL
C. Serum calcium 9.0 mg/dL
D. Serum potassium 3.0 mEq/L
Answer: D
Rationale: Hypokalemia increases the risk of digoxin toxicity because potassium and
digoxin compete for the same binding sites on the sodium-potassium ATPase pump. When
potassium levels are low, more digoxin can bind, leading to excessive drug effects. The
nurse must monitor electrolyte levels frequently and notify the provider if potassium is
below the normal range.
2. A nurse is preparing to administer sublingual nitroglycerin to a patient with chest pain.
Which action should the nurse take first?
A. Assess the patient’s blood pressure and heart rate.
B. Administer a glass of water to help swallow the tablet.
,C. Call the healthcare provider to report the pain.
D. Place the tablet under the patient’s tongue and wait 15 minutes.
Answer: A
Rationale: Nitroglycerin is a potent vasodilator that can cause significant hypotension. The
nurse must assess the patient’s baseline vital signs before administration to ensure the
patient can tolerate the medication. If the systolic blood pressure is below 90 mmHg, the
dose should typically be withheld and the provider notified.
3. The nurse is teaching a patient about a new prescription for lisinopril. Which side effect
should the nurse instruct the patient to report immediately?
A. Increased appetite
B. Frequent urination
C. A metallic taste in the mouth
D. Swelling of the face or tongue
Answer: D
Rationale: Swelling of the face or tongue indicates angioedema, which is a life-threatening
adverse effect of ACE inhibitors. This reaction can lead to airway obstruction and requires
emergency medical intervention. Patients must be taught that this can occur at any time
during therapy, not just with the first dose.
, 4. A patient is receiving heparin therapy for a deep vein thrombosis. Which laboratory result
indicates the medication is in the therapeutic range?
A. PT of 12 seconds
B. aPTT of 65 seconds
C. INR of 2.5
D. Platelet count of 100,000
Answer: B
Rationale: The activated partial thromboplastin time (aPTT) is used to monitor the
effectiveness of heparin therapy. A therapeutic range is typically 1.5 to 2.5 times the
baseline or control value. The INR and PT are used for monitoring warfarin therapy, not
heparin.
5. Which medication is considered a potassium-sparing diuretic?
A. Furosemide
B. Hydrochlorothiazide
C. Mannitol
D. Spironolactone
Answer: D
Rationale: Spironolactone is a potassium-sparing diuretic that works by antagonizing
aldosterone receptors in the distal tubule. Unlike loop or thiazide diuretics, it does not
