NSG 3253 Pharmacotherapeutics for Nursing
Practice II Final Exam Success Guide | Complete
Questions & Detailed Answers 2026/2027
Question 1
A client with chronic heart failure is prescribed lisinopril. Which finding
indicates to the nurse that the client is experiencing a common and
expected side effect of this medication?
• A. Persistent dry cough
• B. Hypokalemia
• C. Tachycardia
• D. Weight loss
Correct Answer: A. Persistent dry cough
Detailed Rationale: ACE inhibitors like lisinopril frequently cause a
persistent, dry, hacking cough due to the accumulation of bradykinin in
the lungs. Hypokalemia is associated with loop or thiazide diuretics, not
ACE inhibitors. Tachycardia is not a common side effect, as these drugs
usually do not cause reflex tachycardia. Weight loss is not a standard
side effect; rather, monitoring for weight gain is crucial to assess for
fluid retention.
Question 2
,A nurse is caring for a client receiving intravenous heparin infusion for a
pulmonary embolism. Which laboratory test should the nurse monitor
to evaluate the therapeutic effectiveness of heparin?
• A. Prothrombin time (PT)
• B. International Normalized Ratio (INR)
• C. Activated partial thromboplastin time (aPTT)
• D. Platelet count
Correct Answer: C. Activated partial thromboplastin time (aPTT)
Detailed Rationale: The therapeutic effectiveness of unfractionated
heparin is monitored using the activated partial thromboplastin time
(aPTT). Prothrombin time (PT) and INR are used to monitor oral
anticoagulant therapy with warfarin. Platelet counts are monitored to
watch for heparin-induced thrombocytopenia (HIT), but they do not
measure the therapeutic anticoagulation level of heparin itself.
Question 3
A client with type 1 diabetes mellitus is prescribed regular insulin. The
nurse understands that regular insulin is classified as which type of
insulin regarding its onset and peak?
• A. Rapid-acting
• B. Short-acting
• C. Intermediate-acting
• D. Long-acting
Correct Answer: B. Short-acting
,Detailed Rationale: Regular insulin is a short-acting insulin with an onset
of approximately 30 to 60 minutes. Rapid-acting insulins include lispro,
aspart, and glulisine. Intermediate-acting insulin includes NPH. Long-
acting insulins include glargine and detemir.
Question 4
A client is prescribed gentamicin intravenously for a severe gram-
negative infection. Which critical adverse effects must the nurse
monitor for during therapy?
• A. Hepatotoxicity and visual disturbances
• B. Ototoxicity and nephrotoxicity
• C. Cardiotoxicity and pulmonary fibrosis
• D. Hyperglycemia and peripheral neuropathy
Correct Answer: B. Ototoxicity and nephrotoxicity
Detailed Rationale: Gentamicin is an aminoglycoside antibiotic well-
known for its potential to cause serious ototoxicity (damage to the
eighth cranial nerve affecting hearing and balance) and nephrotoxicity
(renal damage). Serum peak and trough levels are monitored closely to
prevent these toxicities. Hepatotoxicity and cardiotoxicity are not the
primary signature toxicities associated with aminoglycosides.
Question 5
A client experiencing an acute asthma attack is administered albuterol
via metered-dose inhaler. The nurse monitors the client for which
expected adverse effect?
• A. Bradycardia
, • B. Drowsiness
• C. Tachycardia
• D. Constipation
Correct Answer: C. Tachycardia
Detailed Rationale: Albuterol is a short-acting beta-2 adrenergic agonist.
While it dilates bronchial smooth muscle, stimulation of beta receptors
can also cause cardiovascular side effects such as tachycardia,
palpitations, and nervousness. It typically causes central nervous system
stimulation and tremors rather than drowsiness or constipation.
Question 6
A client starting sertraline for major depressive disorder asks when
therapeutic effects can be expected. What is the best response by the
nurse?
• A. "You will feel completely better within 24 to 48 hours."
• B. "Significant therapeutic improvements usually take 1 to 4
weeks, sometimes up to 6 weeks."
• C. "Antidepressants work immediately after the very first dose."
• D. "If you do not notice a mood change by day three, the
medication should be stopped."
Correct Answer: B. Significant therapeutic improvements usually take 1
to 4 weeks, sometimes up to 6 weeks.
Detailed Rationale: Selective serotonin reuptake inhibitors (SSRIs) like
sertraline require consistent daily administration over several weeks
(typically 1 to 4 weeks for initial effects and up to 6 to 8 weeks for
Practice II Final Exam Success Guide | Complete
Questions & Detailed Answers 2026/2027
Question 1
A client with chronic heart failure is prescribed lisinopril. Which finding
indicates to the nurse that the client is experiencing a common and
expected side effect of this medication?
• A. Persistent dry cough
• B. Hypokalemia
• C. Tachycardia
• D. Weight loss
Correct Answer: A. Persistent dry cough
Detailed Rationale: ACE inhibitors like lisinopril frequently cause a
persistent, dry, hacking cough due to the accumulation of bradykinin in
the lungs. Hypokalemia is associated with loop or thiazide diuretics, not
ACE inhibitors. Tachycardia is not a common side effect, as these drugs
usually do not cause reflex tachycardia. Weight loss is not a standard
side effect; rather, monitoring for weight gain is crucial to assess for
fluid retention.
Question 2
,A nurse is caring for a client receiving intravenous heparin infusion for a
pulmonary embolism. Which laboratory test should the nurse monitor
to evaluate the therapeutic effectiveness of heparin?
• A. Prothrombin time (PT)
• B. International Normalized Ratio (INR)
• C. Activated partial thromboplastin time (aPTT)
• D. Platelet count
Correct Answer: C. Activated partial thromboplastin time (aPTT)
Detailed Rationale: The therapeutic effectiveness of unfractionated
heparin is monitored using the activated partial thromboplastin time
(aPTT). Prothrombin time (PT) and INR are used to monitor oral
anticoagulant therapy with warfarin. Platelet counts are monitored to
watch for heparin-induced thrombocytopenia (HIT), but they do not
measure the therapeutic anticoagulation level of heparin itself.
Question 3
A client with type 1 diabetes mellitus is prescribed regular insulin. The
nurse understands that regular insulin is classified as which type of
insulin regarding its onset and peak?
• A. Rapid-acting
• B. Short-acting
• C. Intermediate-acting
• D. Long-acting
Correct Answer: B. Short-acting
,Detailed Rationale: Regular insulin is a short-acting insulin with an onset
of approximately 30 to 60 minutes. Rapid-acting insulins include lispro,
aspart, and glulisine. Intermediate-acting insulin includes NPH. Long-
acting insulins include glargine and detemir.
Question 4
A client is prescribed gentamicin intravenously for a severe gram-
negative infection. Which critical adverse effects must the nurse
monitor for during therapy?
• A. Hepatotoxicity and visual disturbances
• B. Ototoxicity and nephrotoxicity
• C. Cardiotoxicity and pulmonary fibrosis
• D. Hyperglycemia and peripheral neuropathy
Correct Answer: B. Ototoxicity and nephrotoxicity
Detailed Rationale: Gentamicin is an aminoglycoside antibiotic well-
known for its potential to cause serious ototoxicity (damage to the
eighth cranial nerve affecting hearing and balance) and nephrotoxicity
(renal damage). Serum peak and trough levels are monitored closely to
prevent these toxicities. Hepatotoxicity and cardiotoxicity are not the
primary signature toxicities associated with aminoglycosides.
Question 5
A client experiencing an acute asthma attack is administered albuterol
via metered-dose inhaler. The nurse monitors the client for which
expected adverse effect?
• A. Bradycardia
, • B. Drowsiness
• C. Tachycardia
• D. Constipation
Correct Answer: C. Tachycardia
Detailed Rationale: Albuterol is a short-acting beta-2 adrenergic agonist.
While it dilates bronchial smooth muscle, stimulation of beta receptors
can also cause cardiovascular side effects such as tachycardia,
palpitations, and nervousness. It typically causes central nervous system
stimulation and tremors rather than drowsiness or constipation.
Question 6
A client starting sertraline for major depressive disorder asks when
therapeutic effects can be expected. What is the best response by the
nurse?
• A. "You will feel completely better within 24 to 48 hours."
• B. "Significant therapeutic improvements usually take 1 to 4
weeks, sometimes up to 6 weeks."
• C. "Antidepressants work immediately after the very first dose."
• D. "If you do not notice a mood change by day three, the
medication should be stopped."
Correct Answer: B. Significant therapeutic improvements usually take 1
to 4 weeks, sometimes up to 6 weeks.
Detailed Rationale: Selective serotonin reuptake inhibitors (SSRIs) like
sertraline require consistent daily administration over several weeks
(typically 1 to 4 weeks for initial effects and up to 6 to 8 weeks for
