NURS 305 Exam 2 V3 | NURS 305
Pharmacology | Actual Q&A with Rationale
(NURS305 Exam 2) | Liberty University
1. A patient taking Lisinopril for hypertension develops a persistent, dry, nonproductive
cough. What is the nurse’s best action?
A. Notify the healthcare provider to discuss switching to an Angiotensin II Receptor Blocker
(ARB).
B. Advise the patient to increase fluid intake to soothe the throat.
C. Instruct the patient to take the medication with food to reduce irritation.
D. Explain that the cough is a normal part of the body adjusting to the drug.
Answer: A
Rationale: The dry cough associated with ACE inhibitors like Lisinopril is caused by the
accumulation of bradykinin in the respiratory tract. Since this is an adverse effect that does
not resolve over time, the medication usually needs to be discontinued. ARBs are a
common alternative because they do not affect bradykinin metabolism.
2. A patient is prescribed Furosemide (Lasix) for heart failure. Which laboratory value should
the nurse monitor most closely?
A. Serum Sodium levels
B. Serum Potassium levels
,C. Hemoglobin and Hematocrit
D. Prothrombin Time (PT)
Answer: B
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium along
with water and sodium. Hypokalemia is a significant risk that can lead to life-threatening
cardiac dysrhythmias. Monitoring potassium levels ensures patient safety and indicates the
need for potential supplementation.
3. Which instruction should the nurse include for a patient newly prescribed Sublingual
Nitroglycerin?
A. Swallow the tablet with a full glass of water.
B. Place one tablet under the tongue at the first sign of chest pain.
C. Store the medication in a clear plastic container for easy access.
D. Take a dose every 15 minutes until the pain is gone.
Answer: B
Rationale: Sublingual nitroglycerin must be placed under the tongue to bypass first-pass
metabolism for rapid absorption. Patients should take one dose immediately upon
experiencing chest pain. If pain is not relieved after one dose, they should call 911 while
taking subsequent doses as prescribed.
, 4. A patient on Warfarin (Coumadin) therapy has an International Normalized Ratio (INR) of
5.0. What is the priority nursing intervention?
A. Administer the next scheduled dose as ordered.
B. Assess the patient for signs of a pulmonary embolism.
C. Hold the dose and notify the healthcare provider.
D. Increase the patient’s intake of green leafy vegetables.
Answer: C
Rationale: A therapeutic INR for a patient on Warfarin is typically between 2.0 and 3.0. An
INR of 5.0 indicates a high risk for spontaneous bleeding. The nurse must withhold the
medication and seek orders for potential reversal agents like Vitamin K.
5. What is the antidote for a patient experiencing heparin-induced bleeding?
A. Vitamin K
B. Calcium Gluconate
C. Protamine Sulfate
D. Acetylcysteine
Answer: C
Rationale: Protamine Sulfate is the specific pharmacological antagonist used to neutralize
the anticoagulant effects of heparin. It works by forming a stable salt with the strongly
Pharmacology | Actual Q&A with Rationale
(NURS305 Exam 2) | Liberty University
1. A patient taking Lisinopril for hypertension develops a persistent, dry, nonproductive
cough. What is the nurse’s best action?
A. Notify the healthcare provider to discuss switching to an Angiotensin II Receptor Blocker
(ARB).
B. Advise the patient to increase fluid intake to soothe the throat.
C. Instruct the patient to take the medication with food to reduce irritation.
D. Explain that the cough is a normal part of the body adjusting to the drug.
Answer: A
Rationale: The dry cough associated with ACE inhibitors like Lisinopril is caused by the
accumulation of bradykinin in the respiratory tract. Since this is an adverse effect that does
not resolve over time, the medication usually needs to be discontinued. ARBs are a
common alternative because they do not affect bradykinin metabolism.
2. A patient is prescribed Furosemide (Lasix) for heart failure. Which laboratory value should
the nurse monitor most closely?
A. Serum Sodium levels
B. Serum Potassium levels
,C. Hemoglobin and Hematocrit
D. Prothrombin Time (PT)
Answer: B
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium along
with water and sodium. Hypokalemia is a significant risk that can lead to life-threatening
cardiac dysrhythmias. Monitoring potassium levels ensures patient safety and indicates the
need for potential supplementation.
3. Which instruction should the nurse include for a patient newly prescribed Sublingual
Nitroglycerin?
A. Swallow the tablet with a full glass of water.
B. Place one tablet under the tongue at the first sign of chest pain.
C. Store the medication in a clear plastic container for easy access.
D. Take a dose every 15 minutes until the pain is gone.
Answer: B
Rationale: Sublingual nitroglycerin must be placed under the tongue to bypass first-pass
metabolism for rapid absorption. Patients should take one dose immediately upon
experiencing chest pain. If pain is not relieved after one dose, they should call 911 while
taking subsequent doses as prescribed.
, 4. A patient on Warfarin (Coumadin) therapy has an International Normalized Ratio (INR) of
5.0. What is the priority nursing intervention?
A. Administer the next scheduled dose as ordered.
B. Assess the patient for signs of a pulmonary embolism.
C. Hold the dose and notify the healthcare provider.
D. Increase the patient’s intake of green leafy vegetables.
Answer: C
Rationale: A therapeutic INR for a patient on Warfarin is typically between 2.0 and 3.0. An
INR of 5.0 indicates a high risk for spontaneous bleeding. The nurse must withhold the
medication and seek orders for potential reversal agents like Vitamin K.
5. What is the antidote for a patient experiencing heparin-induced bleeding?
A. Vitamin K
B. Calcium Gluconate
C. Protamine Sulfate
D. Acetylcysteine
Answer: C
Rationale: Protamine Sulfate is the specific pharmacological antagonist used to neutralize
the anticoagulant effects of heparin. It works by forming a stable salt with the strongly
