NR293 Exam 4 Actual Exam Style V2 | NR
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient is prescribed Fluoxetine for depression. Which symptom should the nurse
instruct the patient to report immediately?
A. Dry mouth
B. Occasional headache
C. Mild nausea
D. Agitation and tremors
Answer: D
Rationale: Fluoxetine is an SSRI that can cause Serotonin Syndrome, a potentially life-
threatening condition. Symptoms like agitation, tremors, and fever indicate excessive
serotonin levels and require immediate intervention. The nurse should educate the patient
that it may take several weeks to see the full therapeutic effects of this medication.
2. A nurse is monitoring a patient on Lithium carbonate. Which serum lithium level indicates
that the dose is within the therapeutic range for maintenance?
A. 0.2 mEq/L
B. 0.9 mEq/L
C. 1.6 mEq/L
,D. 2.4 mEq/L
Answer: B
Rationale: The therapeutic serum range for lithium maintenance is generally 0.6 to 1.2
mEq/L. Levels below 0.6 are subtherapeutic, while levels above 1.5 are considered toxic.
Monitoring sodium levels is also critical because low sodium can lead to lithium retention
and toxicity.
3. A patient with Type 1 Diabetes is prescribed Lispro insulin. When should the nurse
administer this medication?
A. 30 to 45 minutes before a meal
B. Immediately after a meal
C. 15 minutes before a meal
D. At bedtime with a snack
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. It must be
given shortly before a meal to prevent hypoglycemia once the drug starts working. The
nurse should always ensure the patient’s meal tray is present before administration.
4. A nurse is preparing to administer Metformin to a patient scheduled for a CT scan with IV
contrast. What action is most appropriate?
A. Administer the dose as scheduled
, B. Give a double dose the day before the procedure
C. Hold the medication for 48 hours before and after the procedure
D. Switch the patient to insulin for the day
Answer: C
Rationale: Metformin must be held for 48 hours before and after procedures involving
iodine-based contrast dye. The combination of metformin and contrast can lead to acute
renal failure and lactic acidosis. The nurse must verify renal function before resuming the
medication.
5. Which medication is the treatment of choice for a patient experiencing hypothyroidism?
A. Propylthiouracil
B. Methimazole
C. Levothyroxine
D. Radioactive iodine
Answer: C
Rationale: Levothyroxine is a synthetic form of T4 used for hormone replacement in
hypothyroidism. It should be taken on an empty stomach in the morning to maximize
absorption. Patients will likely require lifelong therapy and regular TSH monitoring to
adjust the dosage.
293 Pharmacology for Nursing Practice |
Chamberlain
1. A patient is prescribed Fluoxetine for depression. Which symptom should the nurse
instruct the patient to report immediately?
A. Dry mouth
B. Occasional headache
C. Mild nausea
D. Agitation and tremors
Answer: D
Rationale: Fluoxetine is an SSRI that can cause Serotonin Syndrome, a potentially life-
threatening condition. Symptoms like agitation, tremors, and fever indicate excessive
serotonin levels and require immediate intervention. The nurse should educate the patient
that it may take several weeks to see the full therapeutic effects of this medication.
2. A nurse is monitoring a patient on Lithium carbonate. Which serum lithium level indicates
that the dose is within the therapeutic range for maintenance?
A. 0.2 mEq/L
B. 0.9 mEq/L
C. 1.6 mEq/L
,D. 2.4 mEq/L
Answer: B
Rationale: The therapeutic serum range for lithium maintenance is generally 0.6 to 1.2
mEq/L. Levels below 0.6 are subtherapeutic, while levels above 1.5 are considered toxic.
Monitoring sodium levels is also critical because low sodium can lead to lithium retention
and toxicity.
3. A patient with Type 1 Diabetes is prescribed Lispro insulin. When should the nurse
administer this medication?
A. 30 to 45 minutes before a meal
B. Immediately after a meal
C. 15 minutes before a meal
D. At bedtime with a snack
Answer: C
Rationale: Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. It must be
given shortly before a meal to prevent hypoglycemia once the drug starts working. The
nurse should always ensure the patient’s meal tray is present before administration.
4. A nurse is preparing to administer Metformin to a patient scheduled for a CT scan with IV
contrast. What action is most appropriate?
A. Administer the dose as scheduled
, B. Give a double dose the day before the procedure
C. Hold the medication for 48 hours before and after the procedure
D. Switch the patient to insulin for the day
Answer: C
Rationale: Metformin must be held for 48 hours before and after procedures involving
iodine-based contrast dye. The combination of metformin and contrast can lead to acute
renal failure and lactic acidosis. The nurse must verify renal function before resuming the
medication.
5. Which medication is the treatment of choice for a patient experiencing hypothyroidism?
A. Propylthiouracil
B. Methimazole
C. Levothyroxine
D. Radioactive iodine
Answer: C
Rationale: Levothyroxine is a synthetic form of T4 used for hormone replacement in
hypothyroidism. It should be taken on an empty stomach in the morning to maximize
absorption. Patients will likely require lifelong therapy and regular TSH monitoring to
adjust the dosage.
