HOSMERIT
NR 565 ADVANCED PHARMACOLOGY
FUNDAMENTALS MIDTERM EXAM LATEST 2025
EXAM WITH 100% VERIFIED QUESTIONS
AND CORRECT SOLUTIONS
A hospitalized patient complains of acute chest pain. The nurse administers a 0.3-mg sublingual
nitroglycerin tablet, but the patient continues to complain of pain. Vital signs remain stable.
What is the nurse's next step?
a. Apply a nitroglycerin transdermal patch.
b. Continue dosing at 10-minute intervals.
c. Give a second dose of nitroglycerin in 5 minutes.
d. Request an order for intravenous nitroglycerin. - ANSWER: c.
A patient with stable exertional angina has been receiving a beta blocker. Before giving the drug,
the nurse notes a resting heart rate of 55 beats/minute. Which is an appropriate nursing action?
a. Administer the drug as ordered, because this is a desired effect.
b. Withhold the dose and notify the provider of the heart rate.
c. Request an order for a lower dose of the medication.
d. Request an order to change to another antianginal medication. - ANSWER: a.
A nursing student is helping to care for a patient who takes verapamil for stable angina. The
nurse asks the student to explain the purpose of verapamil in the treatment of this patient. Which
statement by the student indicates a need for further teaching?
a. "It relaxes coronary artery spasms."
b. "It reduces peripheral resistance to reduce oxygen demands."
c. "It reduces the heart rate, AV conduction, and contractility."
d. "It relaxes the peripheral arterioles to reduce afterload." - ANSWER: a.
A patient with angina who is taking ranolazine [Ranexa] has developed a respiratory infection
and a dysrhythmia. The provider has ordered azithromycin [Zithromax] for the infection and
amlodipine for the dysrhythmia. A nursing student caring for this patient tells the nurse that the
,patient's heart rate is 70 beats/minute, and the blood pressure is 128/80 mm Hg. The nurse asks
the student to discuss the plan for this patient's care. Which action is correct?
a. Observe the patient closely for signs of respiratory toxicity.
b. Question the order for azithromycin [Zithromax].
c. Report the patient's increase in blood pressure to the provider.
d. Request an order for a different calcium channel blocker. - ANSWER: b.
A patient with new-onset exertional angina has taken three nitroglycerin sublingual tablets at 5-
minute intervals, but the pain has intensified. The nurse notes that the patient has a heart rate of
76 beats/minute and a blood pressure of 120/82 mm Hg. The electrocardiogram is normal. The
patient's lips and nail beds are pink, and there is no respiratory distress. The nurse will anticipate
providing:
a. an angiotensin-converting enzyme (ACE) inhibitor.
b. intravenous nitroglycerin and a beta blocker.
c. ranolazine (Ranexa) and quinidine.
d. supplemental oxygen and intravenous morphine. - ANSWER: b.
A nurse is providing teaching for a patient with stable angina who will begin taking
nitroglycerin. Which statement by the patient indicates understanding of the teaching?
a. "I should not participate in aerobic exercise while taking this drug."
b. "I should take aspirin daily to reduce my need for nitroglycerin."
c. "If I take nitroglycerin before exertion, I can reduce the chance of an anginal attack."
d. "I take nitroglycerin to increase the amount of oxygen to my heart." - ANSWER: c.
A patient asks a nurse how nitroglycerin works to relieve anginal pain. The nurse correctly
states, "Nitroglycerin:
a. dilates coronary arteries to increase the blood flow to the heart."
b. increases the oxygen supply to the cardiac muscle."
c. increases ventricular filling to improve cardiac output."
d. promotes vasodilation, which reduces preload and oxygen demand." - ANSWER: d.
,A patient has been receiving heparin while in the hospital to treat deep vein thromboses and will
be discharged home with a prescription for enoxaparin [Lovenox]. The nurse provides teaching
for the nursing student who asks about the advantages of enoxaparin over heparin. Which
statement by the student indicates a need for further teaching?
a. "Enoxaparin does not require coagulation monitoring."
b. "Enoxaparin has greater bioavailability than heparin."
c. "Enoxaparin is more cost-effective than heparin."
d. "Enoxaparin may be given using a fixed dosage." - ANSWER: c.
A patient is receiving heparin postoperatively to prevent deep vein thrombosis. The nurse notes
that the patient has a blood pressure of 90/50 mm Hg and a heart rate of 98 beats/minute. The
patient's most recent aPTT is greater than 90 seconds. The patient reports lumbar pain. The nurse
will request an order for:
a. a repeat aPTT to be drawn immediately.
b. analgesic medication.
c. changing heparin to aspirin.
d. protamine sulfate. - ANSWER: d.
A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis
asks the nurse why the patient must take heparin rather than warfarin. Which response by the
nurse is correct?
a. "Heparin has a longer half-life."
b. "Heparin has fewer adverse effects."
c. "The onset of warfarin is delayed."
d. "Warfarin prevents platelet aggregation." - ANSWER: c.
A postoperative patient reports pain in the left lower extremity. The nurse notes swelling in the
lower leg, which feels warm to the touch. The nurse will anticipate giving which medication?
a. Aspirin
b. Clopidogrel [Plavix]
c. Enoxaparin [Lovenox]
, d. Warfarin [Coumadin] - ANSWER: c.
A patient who is taking warfarin [Coumadin] has just vomited blood. The nurse notifies the
provider, who orders laboratory work revealing a PT of 42 seconds and an INR of 3.5. The nurse
will expect to administer:
a. phytonadione (vitamin K1) 1 mg IV over 1 hour.
b. phytonadione (vitamin K1) 2.5 mg PO.
c. protamine sulfate 20 mg PO.
d. protamine sulfate 20 mg slow IV push. - ANSWER: a.
A patient is admitted to the emergency department with chest pain. An electrocardiogram shows
changes consistent with an evolving myocardial infarction. The patient's cardiac enzymes are
pending. The nurse caring for this patient will expect to:
a. administer aspirin when cardiac enzymes are completed.
b. give alteplase [Activase] within 2 hours.
c. give tenecteplase [TNKase] immediately.
d. obtain an order for an INR. - ANSWER: b.
A patient who takes warfarin for atrial fibrillation undergoes hip replacement surgery. On the
second postoperative day, the nurse assesses the patient and notes an oxygen saturation of 83%,
pleuritic chest pain, shortness of breath, and hemoptysis. The nurse will contact the provider to
report possible and request an order for .
a. congestive heart failure; furosemide [Lasix]
b. hemorrhage; vitamin K (phytonadione)
c. myocardial infarction; tissue plasminogen activator (tPA)
d. pulmonary embolism; heparin - ANSWER: d.
A patient with atrial fibrillation is receiving warfarin [Coumadin]. The nurse notes that the
patient's INR is 2.7. Before giving the next dose of warfarin, the nurse will notify the provider
and:
a. administer the dose as ordered.
NR 565 ADVANCED PHARMACOLOGY
FUNDAMENTALS MIDTERM EXAM LATEST 2025
EXAM WITH 100% VERIFIED QUESTIONS
AND CORRECT SOLUTIONS
A hospitalized patient complains of acute chest pain. The nurse administers a 0.3-mg sublingual
nitroglycerin tablet, but the patient continues to complain of pain. Vital signs remain stable.
What is the nurse's next step?
a. Apply a nitroglycerin transdermal patch.
b. Continue dosing at 10-minute intervals.
c. Give a second dose of nitroglycerin in 5 minutes.
d. Request an order for intravenous nitroglycerin. - ANSWER: c.
A patient with stable exertional angina has been receiving a beta blocker. Before giving the drug,
the nurse notes a resting heart rate of 55 beats/minute. Which is an appropriate nursing action?
a. Administer the drug as ordered, because this is a desired effect.
b. Withhold the dose and notify the provider of the heart rate.
c. Request an order for a lower dose of the medication.
d. Request an order to change to another antianginal medication. - ANSWER: a.
A nursing student is helping to care for a patient who takes verapamil for stable angina. The
nurse asks the student to explain the purpose of verapamil in the treatment of this patient. Which
statement by the student indicates a need for further teaching?
a. "It relaxes coronary artery spasms."
b. "It reduces peripheral resistance to reduce oxygen demands."
c. "It reduces the heart rate, AV conduction, and contractility."
d. "It relaxes the peripheral arterioles to reduce afterload." - ANSWER: a.
A patient with angina who is taking ranolazine [Ranexa] has developed a respiratory infection
and a dysrhythmia. The provider has ordered azithromycin [Zithromax] for the infection and
amlodipine for the dysrhythmia. A nursing student caring for this patient tells the nurse that the
,patient's heart rate is 70 beats/minute, and the blood pressure is 128/80 mm Hg. The nurse asks
the student to discuss the plan for this patient's care. Which action is correct?
a. Observe the patient closely for signs of respiratory toxicity.
b. Question the order for azithromycin [Zithromax].
c. Report the patient's increase in blood pressure to the provider.
d. Request an order for a different calcium channel blocker. - ANSWER: b.
A patient with new-onset exertional angina has taken three nitroglycerin sublingual tablets at 5-
minute intervals, but the pain has intensified. The nurse notes that the patient has a heart rate of
76 beats/minute and a blood pressure of 120/82 mm Hg. The electrocardiogram is normal. The
patient's lips and nail beds are pink, and there is no respiratory distress. The nurse will anticipate
providing:
a. an angiotensin-converting enzyme (ACE) inhibitor.
b. intravenous nitroglycerin and a beta blocker.
c. ranolazine (Ranexa) and quinidine.
d. supplemental oxygen and intravenous morphine. - ANSWER: b.
A nurse is providing teaching for a patient with stable angina who will begin taking
nitroglycerin. Which statement by the patient indicates understanding of the teaching?
a. "I should not participate in aerobic exercise while taking this drug."
b. "I should take aspirin daily to reduce my need for nitroglycerin."
c. "If I take nitroglycerin before exertion, I can reduce the chance of an anginal attack."
d. "I take nitroglycerin to increase the amount of oxygen to my heart." - ANSWER: c.
A patient asks a nurse how nitroglycerin works to relieve anginal pain. The nurse correctly
states, "Nitroglycerin:
a. dilates coronary arteries to increase the blood flow to the heart."
b. increases the oxygen supply to the cardiac muscle."
c. increases ventricular filling to improve cardiac output."
d. promotes vasodilation, which reduces preload and oxygen demand." - ANSWER: d.
,A patient has been receiving heparin while in the hospital to treat deep vein thromboses and will
be discharged home with a prescription for enoxaparin [Lovenox]. The nurse provides teaching
for the nursing student who asks about the advantages of enoxaparin over heparin. Which
statement by the student indicates a need for further teaching?
a. "Enoxaparin does not require coagulation monitoring."
b. "Enoxaparin has greater bioavailability than heparin."
c. "Enoxaparin is more cost-effective than heparin."
d. "Enoxaparin may be given using a fixed dosage." - ANSWER: c.
A patient is receiving heparin postoperatively to prevent deep vein thrombosis. The nurse notes
that the patient has a blood pressure of 90/50 mm Hg and a heart rate of 98 beats/minute. The
patient's most recent aPTT is greater than 90 seconds. The patient reports lumbar pain. The nurse
will request an order for:
a. a repeat aPTT to be drawn immediately.
b. analgesic medication.
c. changing heparin to aspirin.
d. protamine sulfate. - ANSWER: d.
A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis
asks the nurse why the patient must take heparin rather than warfarin. Which response by the
nurse is correct?
a. "Heparin has a longer half-life."
b. "Heparin has fewer adverse effects."
c. "The onset of warfarin is delayed."
d. "Warfarin prevents platelet aggregation." - ANSWER: c.
A postoperative patient reports pain in the left lower extremity. The nurse notes swelling in the
lower leg, which feels warm to the touch. The nurse will anticipate giving which medication?
a. Aspirin
b. Clopidogrel [Plavix]
c. Enoxaparin [Lovenox]
, d. Warfarin [Coumadin] - ANSWER: c.
A patient who is taking warfarin [Coumadin] has just vomited blood. The nurse notifies the
provider, who orders laboratory work revealing a PT of 42 seconds and an INR of 3.5. The nurse
will expect to administer:
a. phytonadione (vitamin K1) 1 mg IV over 1 hour.
b. phytonadione (vitamin K1) 2.5 mg PO.
c. protamine sulfate 20 mg PO.
d. protamine sulfate 20 mg slow IV push. - ANSWER: a.
A patient is admitted to the emergency department with chest pain. An electrocardiogram shows
changes consistent with an evolving myocardial infarction. The patient's cardiac enzymes are
pending. The nurse caring for this patient will expect to:
a. administer aspirin when cardiac enzymes are completed.
b. give alteplase [Activase] within 2 hours.
c. give tenecteplase [TNKase] immediately.
d. obtain an order for an INR. - ANSWER: b.
A patient who takes warfarin for atrial fibrillation undergoes hip replacement surgery. On the
second postoperative day, the nurse assesses the patient and notes an oxygen saturation of 83%,
pleuritic chest pain, shortness of breath, and hemoptysis. The nurse will contact the provider to
report possible and request an order for .
a. congestive heart failure; furosemide [Lasix]
b. hemorrhage; vitamin K (phytonadione)
c. myocardial infarction; tissue plasminogen activator (tPA)
d. pulmonary embolism; heparin - ANSWER: d.
A patient with atrial fibrillation is receiving warfarin [Coumadin]. The nurse notes that the
patient's INR is 2.7. Before giving the next dose of warfarin, the nurse will notify the provider
and:
a. administer the dose as ordered.
