NR293 Exam 2 Actual Exam Style V3 | NR
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient is prescribed digoxin for heart failure. Which assessment finding would indicate
potential digoxin toxicity?
A. Blood pressure 140/90 mmHg
B. Heart rate of 82 beats per minute
C. Yellow-green visual halos
D. Increased appetite
Answer: C
Rationale: The correct answer is B because visual disturbances like yellow or green halos
are classic symptoms of digoxin toxicity. Digoxin is a cardiac glycoside that has a narrow
therapeutic range, usually between 0.5 to 2.0 ng/mL. The nurse must also monitor for
nausea, vomiting, and bradycardia before administering the next dose.
2. A nurse is preparing to administer furosemide to a patient with fluid overload. Which
electrolyte should the nurse monitor most closely?
A. Sodium
B. Calcium
C. Magnesium
,D. Potassium
Answer: D
Rationale: Furosemide is a loop diuretic that inhibits the reabsorption of sodium and
chloride in the loop of Henle, which leads to significant potassium loss. Monitoring
potassium is critical because hypokalemia can lead to life-threatening cardiac
dysrhythmias. The nurse should encourage high-potassium foods or anticipate a potassium
supplement prescription.
3. A patient with a history of asthma is diagnosed with hypertension. Which medication
should the nurse question if prescribed?
A. Lisinopril
B. Propranolol
C. Amlodipine
D. Hydrochlorothiazide
Answer: B
Rationale: Propranolol is a non-selective beta-blocker that blocks both beta-1 and beta-2
receptors. Blocking beta-2 receptors can cause bronchoconstriction, which is dangerous for
patients with asthma or COPD. Selective beta-1 blockers like metoprolol are preferred if a
beta-blocker must be used in these patients.
4. What is the primary mechanism of action for ACE inhibitors like lisinopril?
A. Stimulating alpha-2 receptors in the brain
, B. Blocking calcium channels in the heart
C. Antagonizing aldosterone receptors
D. Blocking the conversion of Angiotensin I to Angiotensin II
Answer: D
Rationale: ACE inhibitors work by preventing the conversion of Angiotensin I to
Angiotensin II, which is a potent vasoconstrictor. This reduction leads to vasodilation and
decreased aldosterone secretion, which helps lower blood pressure. It is important to
monitor for a dry, non-productive cough which is a common side effect of this drug class.
5. A patient is receiving heparin therapy for a deep vein thrombosis. Which laboratory value
is most important to monitor?
A. PT
B. aPTT
C. INR
D. Platelet count
Answer: B
Rationale: The activated partial thromboplastin time (aPTT) is used to monitor the
effectiveness and safety of heparin therapy. The therapeutic range is typically 1.5 to 2.5
times the control value. If the aPTT is too high, the patient is at risk for hemorrhage and
may require the antidote protamine sulfate.
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient is prescribed digoxin for heart failure. Which assessment finding would indicate
potential digoxin toxicity?
A. Blood pressure 140/90 mmHg
B. Heart rate of 82 beats per minute
C. Yellow-green visual halos
D. Increased appetite
Answer: C
Rationale: The correct answer is B because visual disturbances like yellow or green halos
are classic symptoms of digoxin toxicity. Digoxin is a cardiac glycoside that has a narrow
therapeutic range, usually between 0.5 to 2.0 ng/mL. The nurse must also monitor for
nausea, vomiting, and bradycardia before administering the next dose.
2. A nurse is preparing to administer furosemide to a patient with fluid overload. Which
electrolyte should the nurse monitor most closely?
A. Sodium
B. Calcium
C. Magnesium
,D. Potassium
Answer: D
Rationale: Furosemide is a loop diuretic that inhibits the reabsorption of sodium and
chloride in the loop of Henle, which leads to significant potassium loss. Monitoring
potassium is critical because hypokalemia can lead to life-threatening cardiac
dysrhythmias. The nurse should encourage high-potassium foods or anticipate a potassium
supplement prescription.
3. A patient with a history of asthma is diagnosed with hypertension. Which medication
should the nurse question if prescribed?
A. Lisinopril
B. Propranolol
C. Amlodipine
D. Hydrochlorothiazide
Answer: B
Rationale: Propranolol is a non-selective beta-blocker that blocks both beta-1 and beta-2
receptors. Blocking beta-2 receptors can cause bronchoconstriction, which is dangerous for
patients with asthma or COPD. Selective beta-1 blockers like metoprolol are preferred if a
beta-blocker must be used in these patients.
4. What is the primary mechanism of action for ACE inhibitors like lisinopril?
A. Stimulating alpha-2 receptors in the brain
, B. Blocking calcium channels in the heart
C. Antagonizing aldosterone receptors
D. Blocking the conversion of Angiotensin I to Angiotensin II
Answer: D
Rationale: ACE inhibitors work by preventing the conversion of Angiotensin I to
Angiotensin II, which is a potent vasoconstrictor. This reduction leads to vasodilation and
decreased aldosterone secretion, which helps lower blood pressure. It is important to
monitor for a dry, non-productive cough which is a common side effect of this drug class.
5. A patient is receiving heparin therapy for a deep vein thrombosis. Which laboratory value
is most important to monitor?
A. PT
B. aPTT
C. INR
D. Platelet count
Answer: B
Rationale: The activated partial thromboplastin time (aPTT) is used to monitor the
effectiveness and safety of heparin therapy. The therapeutic range is typically 1.5 to 2.5
times the control value. If the aPTT is too high, the patient is at risk for hemorrhage and
may require the antidote protamine sulfate.
