NURS 251 Module 4 Exam V1 | NURS 251
Module 4 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 4 Exam)
1. A patient is prescribed Albuterol for the management of exercise-induced asthma. What is
the primary mechanism of action for this medication?
A. Inhibition of muscarinic receptors in the airway
B. Antagonism of leukotriene receptors
C. Blockage of Alpha-1 receptors to reduce inflammation
D. Stimulation of Beta-2 adrenergic receptors
Answer: D
Rationale: Albuterol is a selective Beta-2 adrenergic agonist that works by stimulating
receptors in the bronchial smooth muscle. This activation leads to bronchodilation, which
helps relieve bronchospasms. The nurse should educate the patient that this is a rescue
medication used for acute symptoms rather than maintenance.
2. Which of the following assessments is most critical before administering a dose of
Metoprolol?
A. Respiratory rate
B. Oxygen saturation
,C. Apical pulse and blood pressure
D. Serum glucose levels
Answer: C
Rationale: Metoprolol is a cardioselective Beta-1 blocker that decreases heart rate and
myocardial contractility. Because it can cause bradycardia and hypotension, the nurse must
assess the heart rate and blood pressure prior to administration. If the pulse is below 60
beats per minute or the systolic blood pressure is below 90-100 mmHg, the dose should
typically be withheld and the provider notified.
3. A patient taking Lisinopril for hypertension develops a dry, persistent cough. What is the
physiological reason for this side effect?
A. Accumulation of bradykinin in the lungs
B. Increased production of angiotensin II
C. Direct irritation of the bronchial mucosa by the drug
D. Fluid overload causing pulmonary edema
Answer: A
Rationale: ACE inhibitors like Lisinopril prevent the breakdown of bradykinin, a peptide
that can cause irritation in the lungs. This accumulation leads to the characteristic dry
cough associated with this class of medication. If the cough becomes intolerable, the patient
is often switched to an Angiotensin II Receptor Blocker (ARB) such as Losartan.
, 4. When administering Nitroglycerin sublingually for chest pain, the nurse should instruct the
patient to:
A. Swallow the tablet with a full glass of water
B. Chew the tablet thoroughly to speed absorption
C. Wait at least 30 minutes between consecutive doses
D. Place the tablet under the tongue and allow it to dissolve
Answer: D
Rationale: Sublingual Nitroglycerin is absorbed directly through the oral mucosa into the
systemic circulation, bypassing first-pass metabolism. Patients should be taught to sit or lie
down when taking it to prevent falls from orthostatic hypotension. If pain persists after one
dose, the patient can take up to three doses total, spaced five minutes apart.
5. A patient is receiving Heparin therapy for a deep vein thrombosis. Which laboratory value
is used to monitor the effectiveness of this treatment?
A. Activated Partial Thromboplastin Time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin Time (PT)
D. Platelet count only
Answer: A
Module 4 Exam – Pharmacology | Portage |
Q&A with Rationale (Portage NURS 251
Module 4 Exam)
1. A patient is prescribed Albuterol for the management of exercise-induced asthma. What is
the primary mechanism of action for this medication?
A. Inhibition of muscarinic receptors in the airway
B. Antagonism of leukotriene receptors
C. Blockage of Alpha-1 receptors to reduce inflammation
D. Stimulation of Beta-2 adrenergic receptors
Answer: D
Rationale: Albuterol is a selective Beta-2 adrenergic agonist that works by stimulating
receptors in the bronchial smooth muscle. This activation leads to bronchodilation, which
helps relieve bronchospasms. The nurse should educate the patient that this is a rescue
medication used for acute symptoms rather than maintenance.
2. Which of the following assessments is most critical before administering a dose of
Metoprolol?
A. Respiratory rate
B. Oxygen saturation
,C. Apical pulse and blood pressure
D. Serum glucose levels
Answer: C
Rationale: Metoprolol is a cardioselective Beta-1 blocker that decreases heart rate and
myocardial contractility. Because it can cause bradycardia and hypotension, the nurse must
assess the heart rate and blood pressure prior to administration. If the pulse is below 60
beats per minute or the systolic blood pressure is below 90-100 mmHg, the dose should
typically be withheld and the provider notified.
3. A patient taking Lisinopril for hypertension develops a dry, persistent cough. What is the
physiological reason for this side effect?
A. Accumulation of bradykinin in the lungs
B. Increased production of angiotensin II
C. Direct irritation of the bronchial mucosa by the drug
D. Fluid overload causing pulmonary edema
Answer: A
Rationale: ACE inhibitors like Lisinopril prevent the breakdown of bradykinin, a peptide
that can cause irritation in the lungs. This accumulation leads to the characteristic dry
cough associated with this class of medication. If the cough becomes intolerable, the patient
is often switched to an Angiotensin II Receptor Blocker (ARB) such as Losartan.
, 4. When administering Nitroglycerin sublingually for chest pain, the nurse should instruct the
patient to:
A. Swallow the tablet with a full glass of water
B. Chew the tablet thoroughly to speed absorption
C. Wait at least 30 minutes between consecutive doses
D. Place the tablet under the tongue and allow it to dissolve
Answer: D
Rationale: Sublingual Nitroglycerin is absorbed directly through the oral mucosa into the
systemic circulation, bypassing first-pass metabolism. Patients should be taught to sit or lie
down when taking it to prevent falls from orthostatic hypotension. If pain persists after one
dose, the patient can take up to three doses total, spaced five minutes apart.
5. A patient is receiving Heparin therapy for a deep vein thrombosis. Which laboratory value
is used to monitor the effectiveness of this treatment?
A. Activated Partial Thromboplastin Time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin Time (PT)
D. Platelet count only
Answer: A
