NUR2474 PHARMACOLOGY EXAM 2
CERTIFICATION SCRIPT 2026 TESTED
QUESTIONS AND FULL SOLUTION
◉ A patient with heart failure who takes a thiazide diuretic and
digoxin (Lanoxin) is admitted for shortness of breath. The patient's
heart rate is 66 beats per minute, and the blood pressure is 130/88
mm Hg. The serum potassium level is 3.8 mEq/L, and the digoxin
level is 0.8 ng/mL. The nurse admitting this patient understands
that the patient:
a.has digoxin toxicity.
b.is showing signs of renal failure.
c.is experiencing worsening of the disease.
d.needs a potassium-sparing diuretic.. Answer: c.is experiencing
worsening of the disease.
This patient has a normal serum potassium level, and the digoxin
level is normal. The patient is showing signs of pulmonary edema,
which indicates progression of heart failure. The digoxin level is
within normal limits, and the heart rate is above 60 beats per
minute, so digoxin toxicity is not likely. There is no sign of renal
failure. A potassium-sparing diuretic is not indicated.
,◉ A patient has been taking digoxin (Lanoxin) 0.25 mg, and
furosemide (Lasix) 40 mg, daily. Upon routine assessment by the
nurse, the patient states, "I see yellow halos around the lights." The
nurse should perform which action based on this assessment?
a.Check the patient for other symptoms of digitalis toxicity.
b.Withhold the next dose of furosemide.
c.Continue to monitor the patient for heart failure.
d.Document the findings and reassess in 1 hour.. Answer: a.Check
the patient for other symptoms of digitalis toxicity.
Yellow halos around lights indicate digoxin toxicity. The use of
furosemide increases the risk of hypokalemia, which in turn
potentiates digoxin toxicity. The patient should also be assessed for
headache, nausea, and vomiting, and blood should be drawn for
measurement of the serum digoxin level. The nurse should not
withhold the dose of furosemide until further assessment is done,
including measurement of a serum digoxin level. No evidence
indicates that the patient is in worsening heart failure.
Documentation of findings is secondary to further assessment and
prevention of digoxin toxicity.
◉ Which medications are included in first-line therapy for heart
failure? (Select all that apply.)
,a.Agents that inhibit the renin-angiotensin-aldosterone system
(RAAS)
b.Aldosterone antagonists
c.Beta blockers
d.Cardiac glycosides
e.Diuretics. Answer: a.Agents that inhibit the renin-angiotensin-
aldosterone system (RAAS)
c.Beta blockers
e.Diuretics
For routine therapy, heart failure is treated with agents that inhibit
the RAAS, beta blockers, and diuretics. Aldosterone antagonists and
cardiac glycosides are not first-line drugs for HF.
◉ A nurse is providing teaching to a patient who is admitted to the
hospital for initiation of treatment with amiodarone (Cordarone) for
atrial fibrillation that has been refractory to other medications.
Which statement by the patient indicates a need for further
teaching?
a."I may have itching, malaise, and jaundice, but these symptoms will
subside."
b."I need to use sun block to help keep my skin from turning bluish
gray."
, c."I should not drink grapefruit juice while taking this medication."
d."I should report shortness of breath and cough and stop taking the
drug immediately.". Answer: a."I may have itching, malaise, and
jaundice, but these symptoms will subside."
Amiodarone has many toxic effects. Liver toxicity is rare but serious
and should be reported and the drug discontinued. Dermatologic
toxicity can occur, and sun block helps protect the skin, which, with
prolonged exposure to the sun, can turn bluish gray. Drinking
grapefruit juice can increase amiodarone levels. Pulmonary toxicity
is the greatest concern, and patients with pulmonary symptoms
should report these to the provider.
◉ A prescriber orders verapamil (Covera HS) for a patient who is
taking digoxin (Lanoxin) and warfarin. The nurse will expect the
prescriber to _____ the dose of _____.
a.lower. Answer: digoxin
b.increase; digoxin
c.lower; warfarin
d.increase; warfarin
;
a.lower; digoxin
CERTIFICATION SCRIPT 2026 TESTED
QUESTIONS AND FULL SOLUTION
◉ A patient with heart failure who takes a thiazide diuretic and
digoxin (Lanoxin) is admitted for shortness of breath. The patient's
heart rate is 66 beats per minute, and the blood pressure is 130/88
mm Hg. The serum potassium level is 3.8 mEq/L, and the digoxin
level is 0.8 ng/mL. The nurse admitting this patient understands
that the patient:
a.has digoxin toxicity.
b.is showing signs of renal failure.
c.is experiencing worsening of the disease.
d.needs a potassium-sparing diuretic.. Answer: c.is experiencing
worsening of the disease.
This patient has a normal serum potassium level, and the digoxin
level is normal. The patient is showing signs of pulmonary edema,
which indicates progression of heart failure. The digoxin level is
within normal limits, and the heart rate is above 60 beats per
minute, so digoxin toxicity is not likely. There is no sign of renal
failure. A potassium-sparing diuretic is not indicated.
,◉ A patient has been taking digoxin (Lanoxin) 0.25 mg, and
furosemide (Lasix) 40 mg, daily. Upon routine assessment by the
nurse, the patient states, "I see yellow halos around the lights." The
nurse should perform which action based on this assessment?
a.Check the patient for other symptoms of digitalis toxicity.
b.Withhold the next dose of furosemide.
c.Continue to monitor the patient for heart failure.
d.Document the findings and reassess in 1 hour.. Answer: a.Check
the patient for other symptoms of digitalis toxicity.
Yellow halos around lights indicate digoxin toxicity. The use of
furosemide increases the risk of hypokalemia, which in turn
potentiates digoxin toxicity. The patient should also be assessed for
headache, nausea, and vomiting, and blood should be drawn for
measurement of the serum digoxin level. The nurse should not
withhold the dose of furosemide until further assessment is done,
including measurement of a serum digoxin level. No evidence
indicates that the patient is in worsening heart failure.
Documentation of findings is secondary to further assessment and
prevention of digoxin toxicity.
◉ Which medications are included in first-line therapy for heart
failure? (Select all that apply.)
,a.Agents that inhibit the renin-angiotensin-aldosterone system
(RAAS)
b.Aldosterone antagonists
c.Beta blockers
d.Cardiac glycosides
e.Diuretics. Answer: a.Agents that inhibit the renin-angiotensin-
aldosterone system (RAAS)
c.Beta blockers
e.Diuretics
For routine therapy, heart failure is treated with agents that inhibit
the RAAS, beta blockers, and diuretics. Aldosterone antagonists and
cardiac glycosides are not first-line drugs for HF.
◉ A nurse is providing teaching to a patient who is admitted to the
hospital for initiation of treatment with amiodarone (Cordarone) for
atrial fibrillation that has been refractory to other medications.
Which statement by the patient indicates a need for further
teaching?
a."I may have itching, malaise, and jaundice, but these symptoms will
subside."
b."I need to use sun block to help keep my skin from turning bluish
gray."
, c."I should not drink grapefruit juice while taking this medication."
d."I should report shortness of breath and cough and stop taking the
drug immediately.". Answer: a."I may have itching, malaise, and
jaundice, but these symptoms will subside."
Amiodarone has many toxic effects. Liver toxicity is rare but serious
and should be reported and the drug discontinued. Dermatologic
toxicity can occur, and sun block helps protect the skin, which, with
prolonged exposure to the sun, can turn bluish gray. Drinking
grapefruit juice can increase amiodarone levels. Pulmonary toxicity
is the greatest concern, and patients with pulmonary symptoms
should report these to the provider.
◉ A prescriber orders verapamil (Covera HS) for a patient who is
taking digoxin (Lanoxin) and warfarin. The nurse will expect the
prescriber to _____ the dose of _____.
a.lower. Answer: digoxin
b.increase; digoxin
c.lower; warfarin
d.increase; warfarin
;
a.lower; digoxin
