Pharmacology for Nurses 7th Edition Key Concepts
& Exam Questions 2026/2027 – Verified Q&As
with Detailed Rationales (Test Bank Bundle - 77
Questions)
---
**QUESTION 1:**
A client with heart failure is prescribed digoxin. The nurse should monitor for which early sign of
toxicity?
A) Visual disturbances
B) Anorexia and nausea
C) Cardiac dysrhythmias
D) Hyperkalemia
> 🎯 **CORRECT ANSWER:** B) Anorexia and nausea
> 💡 **DETAILED RATIONALE:** Early signs of digoxin toxicity include gastrointestinal symptoms such as
anorexia, nausea, and vomiting, which occur before cardiac dysrhythmias; these symptoms are due to
stimulation of the chemoreceptor trigger zone. Visual disturbances (A) (yellow-green halos) and
dysrhythmias (C) are later signs; hypokalemia, not hyperkalemia, potentiates toxicity.
---
**QUESTION 2:**
A client is prescribed an ACE inhibitor. The nurse should instruct the client to report which adverse
effect that is a hallmark of this drug class?
A) Dry, nonproductive cough
B) Hyperglycemia
C) Tachycardia
D) Diarrhea
> 🎯 **CORRECT ANSWER:** A) Dry, nonproductive cough
,> 💡 **DETAILED RATIONALE:** ACE inhibitors commonly cause a dry, persistent cough due to
bradykinin accumulation; this can occur in up to 20% of patients and is a reason for discontinuation.
Hyperglycemia (B) is not typical; tachycardia (C) is not a hallmark; diarrhea (D) is less common.
---
**QUESTION 3:**
A client is receiving IV heparin. The nurse notes that the aPTT is 110 seconds (therapeutic range 60-80
seconds). Which action should the nurse take?
A) Increase the heparin infusion rate
B) Decrease the heparin infusion rate
C) Continue the infusion at the current rate
D) Administer protamine sulfate
> 🎯 **CORRECT ANSWER:** B) Decrease the heparin infusion rate
> 💡 **DETAILED RATIONALE:** An aPTT above the therapeutic range indicates the client is at risk for
bleeding; the infusion rate should be decreased per protocol. Increasing the rate (A) would worsen the
risk; continuing (C) is unsafe; protamine sulfate (D) is reserved for severe bleeding.
---
**QUESTION 4:**
A client with diabetes mellitus type 2 is prescribed metformin. What is the most serious adverse effect
to monitor for?
A) Hypoglycemia
B) Lactic acidosis
C) Weight gain
D) Peripheral edema
> 🎯 **CORRECT ANSWER:** B) Lactic acidosis
> 💡 **DETAILED RATIONALE:** Metformin carries a risk of lactic acidosis, a rare but life-threatening
condition, especially in patients with renal impairment, dehydration, or acute illness; it is dose-limiting
and requires monitoring of renal function. Hypoglycemia (A) is uncommon; weight gain (C) is not typical;
peripheral edema (D) is associated with thiazolidinediones.
---
,**QUESTION 5:**
A client is prescribed warfarin. Which laboratory value should be monitored to assess therapeutic
effectiveness?
A) aPTT
B) Platelet count
C) INR
D) Hemoglobin
> 🎯 **CORRECT ANSWER:** C) INR
> 💡 **DETAILED RATIONALE:** Warfarin is monitored by the International Normalized Ratio (INR), with
a therapeutic goal of 2.0-3.0 for most indications; aPTT (A) is for heparin; platelet count (B) is for HIT;
hemoglobin (D) checks for bleeding but does not guide dosing.
---
**QUESTION 6:**
A client with asthma is prescribed albuterol. Which statement best describes the mechanism of action of
albuterol?
A) It blocks muscarinic receptors, causing bronchodilation.
B) It stimulates beta-2 adrenergic receptors, causing bronchodilation.
C) It inhibits mast cell degranulation.
D) It suppresses the inflammatory response in the airways.
> 🎯 **CORRECT ANSWER:** B) It stimulates beta-2 adrenergic receptors, causing bronchodilation.
> 💡 **DETAILED RATIONALE:** Albuterol is a selective beta-2 agonist that relaxes bronchial smooth
muscle by activating adenylyl cyclase and increasing cyclic AMP. Muscarinic blockade (A) is the
mechanism of ipratropium; mast cell stabilization (C) is cromolyn; anti-inflammatory action (D) is
corticosteroids.
---
**QUESTION 7:**
A client is receiving morphine for severe pain. Which side effect is the most common and requires
prophylactic management?
A) Urinary retention
, B) Nausea and vomiting
C) Respiratory depression
D) Constipation
> 🎯 **CORRECT ANSWER:** D) Constipation
> 💡 **DETAILED RATIONALE:** Constipation is the most common and persistent side effect of opioids
(including morphine), occurring in up to 90% of patients; prophylactic bowel regimen (stool
softener/stimulant) is essential. Urinary retention (A) and nausea (B) are common but less frequent;
respiratory depression (C) is the most serious but is not the most common.
---
**QUESTION 8:**
A client is prescribed a beta-blocker for hypertension. Which assessment finding would indicate a
therapeutic effect?
A) Heart rate of 55 beats/min
B) Blood pressure of 130/80 mmHg
C) Respiratory rate of 20 breaths/min
D) Decreased chest pain
> 🎯 **CORRECT ANSWER:** B) Blood pressure of 130/80 mmHg
> 💡 **DETAILED RATIONALE:** The therapeutic effect of a beta-blocker in hypertension is lowering
blood pressure; a reading of 130/80 reflects good control. A heart rate of 55 is within normal limits but
is not the primary therapeutic goal; decreased chest pain (D) is a therapeutic effect for angina, not
hypertension.
---
**QUESTION 9:**
A client is prescribed phenytoin for a seizure disorder. The nurse should monitor for which adverse
effect that is specific to this medication?
A) Gingival hyperplasia
B) Alopecia
C) Hyperglycemia
D) Hypothyroidism
& Exam Questions 2026/2027 – Verified Q&As
with Detailed Rationales (Test Bank Bundle - 77
Questions)
---
**QUESTION 1:**
A client with heart failure is prescribed digoxin. The nurse should monitor for which early sign of
toxicity?
A) Visual disturbances
B) Anorexia and nausea
C) Cardiac dysrhythmias
D) Hyperkalemia
> 🎯 **CORRECT ANSWER:** B) Anorexia and nausea
> 💡 **DETAILED RATIONALE:** Early signs of digoxin toxicity include gastrointestinal symptoms such as
anorexia, nausea, and vomiting, which occur before cardiac dysrhythmias; these symptoms are due to
stimulation of the chemoreceptor trigger zone. Visual disturbances (A) (yellow-green halos) and
dysrhythmias (C) are later signs; hypokalemia, not hyperkalemia, potentiates toxicity.
---
**QUESTION 2:**
A client is prescribed an ACE inhibitor. The nurse should instruct the client to report which adverse
effect that is a hallmark of this drug class?
A) Dry, nonproductive cough
B) Hyperglycemia
C) Tachycardia
D) Diarrhea
> 🎯 **CORRECT ANSWER:** A) Dry, nonproductive cough
,> 💡 **DETAILED RATIONALE:** ACE inhibitors commonly cause a dry, persistent cough due to
bradykinin accumulation; this can occur in up to 20% of patients and is a reason for discontinuation.
Hyperglycemia (B) is not typical; tachycardia (C) is not a hallmark; diarrhea (D) is less common.
---
**QUESTION 3:**
A client is receiving IV heparin. The nurse notes that the aPTT is 110 seconds (therapeutic range 60-80
seconds). Which action should the nurse take?
A) Increase the heparin infusion rate
B) Decrease the heparin infusion rate
C) Continue the infusion at the current rate
D) Administer protamine sulfate
> 🎯 **CORRECT ANSWER:** B) Decrease the heparin infusion rate
> 💡 **DETAILED RATIONALE:** An aPTT above the therapeutic range indicates the client is at risk for
bleeding; the infusion rate should be decreased per protocol. Increasing the rate (A) would worsen the
risk; continuing (C) is unsafe; protamine sulfate (D) is reserved for severe bleeding.
---
**QUESTION 4:**
A client with diabetes mellitus type 2 is prescribed metformin. What is the most serious adverse effect
to monitor for?
A) Hypoglycemia
B) Lactic acidosis
C) Weight gain
D) Peripheral edema
> 🎯 **CORRECT ANSWER:** B) Lactic acidosis
> 💡 **DETAILED RATIONALE:** Metformin carries a risk of lactic acidosis, a rare but life-threatening
condition, especially in patients with renal impairment, dehydration, or acute illness; it is dose-limiting
and requires monitoring of renal function. Hypoglycemia (A) is uncommon; weight gain (C) is not typical;
peripheral edema (D) is associated with thiazolidinediones.
---
,**QUESTION 5:**
A client is prescribed warfarin. Which laboratory value should be monitored to assess therapeutic
effectiveness?
A) aPTT
B) Platelet count
C) INR
D) Hemoglobin
> 🎯 **CORRECT ANSWER:** C) INR
> 💡 **DETAILED RATIONALE:** Warfarin is monitored by the International Normalized Ratio (INR), with
a therapeutic goal of 2.0-3.0 for most indications; aPTT (A) is for heparin; platelet count (B) is for HIT;
hemoglobin (D) checks for bleeding but does not guide dosing.
---
**QUESTION 6:**
A client with asthma is prescribed albuterol. Which statement best describes the mechanism of action of
albuterol?
A) It blocks muscarinic receptors, causing bronchodilation.
B) It stimulates beta-2 adrenergic receptors, causing bronchodilation.
C) It inhibits mast cell degranulation.
D) It suppresses the inflammatory response in the airways.
> 🎯 **CORRECT ANSWER:** B) It stimulates beta-2 adrenergic receptors, causing bronchodilation.
> 💡 **DETAILED RATIONALE:** Albuterol is a selective beta-2 agonist that relaxes bronchial smooth
muscle by activating adenylyl cyclase and increasing cyclic AMP. Muscarinic blockade (A) is the
mechanism of ipratropium; mast cell stabilization (C) is cromolyn; anti-inflammatory action (D) is
corticosteroids.
---
**QUESTION 7:**
A client is receiving morphine for severe pain. Which side effect is the most common and requires
prophylactic management?
A) Urinary retention
, B) Nausea and vomiting
C) Respiratory depression
D) Constipation
> 🎯 **CORRECT ANSWER:** D) Constipation
> 💡 **DETAILED RATIONALE:** Constipation is the most common and persistent side effect of opioids
(including morphine), occurring in up to 90% of patients; prophylactic bowel regimen (stool
softener/stimulant) is essential. Urinary retention (A) and nausea (B) are common but less frequent;
respiratory depression (C) is the most serious but is not the most common.
---
**QUESTION 8:**
A client is prescribed a beta-blocker for hypertension. Which assessment finding would indicate a
therapeutic effect?
A) Heart rate of 55 beats/min
B) Blood pressure of 130/80 mmHg
C) Respiratory rate of 20 breaths/min
D) Decreased chest pain
> 🎯 **CORRECT ANSWER:** B) Blood pressure of 130/80 mmHg
> 💡 **DETAILED RATIONALE:** The therapeutic effect of a beta-blocker in hypertension is lowering
blood pressure; a reading of 130/80 reflects good control. A heart rate of 55 is within normal limits but
is not the primary therapeutic goal; decreased chest pain (D) is a therapeutic effect for angina, not
hypertension.
---
**QUESTION 9:**
A client is prescribed phenytoin for a seizure disorder. The nurse should monitor for which adverse
effect that is specific to this medication?
A) Gingival hyperplasia
B) Alopecia
C) Hyperglycemia
D) Hypothyroidism
