WGU PHARMACOLOGY D441 OA COMPREHENSIVE
EXAMINATION STUDY GUIDE Questions with
Detailed Rationales Latest 2025-2026 Update |
Verified Answers | Grade A+ Preparation
1. A client receives a prescription for ciprofloxacin 400 mg intravenously
(IV) every 12 hours to be infused over an hour. The IV bag contains
ciprofloxacin 400 mg in dextrose 5% in water (D5W) 200 mL. The nurse
should program the infusion pump to deliver how many mL/hr?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 250 mL/hr
Answer: C
Rationale: 200 mL to be infused over 1 hour = 200 mL/hr. The pump should be
programmed to deliver the entire 200 mL bag over 60 minutes.
2. The nurse administers naloxone to a client with opioid-induced
respiratory depression. One hour later, the client has a respiratory rate
of 4 breaths/min, SpO2 of 75%, and is unarousable. Which action should
the nurse implement?
A. Administer a second dose of naloxone
B. Determine Glasgow Coma Scale score
C. Initiate cardiopulmonary resuscitation (CPR)
D. Prepare to assist with chest tube insertion
Answer: A
Rationale: Naloxone has a shorter half-life than most opioids. Recurrent
respiratory depression requires repeat dosing. Immediate airway and breathing
support should be provided while administering additional naloxone.
,3. The healthcare provider prescribes propylthiouracil (PTU) and
Lugol's solution for a client with hyperthyroidism. How should the nurse
schedule the administration of these medications?
A. Offer both drugs together with a meal
B. Schedule both medications at bedtime
C. Give parental dose once every 24 hours
D. Administer iodine one hour before PTU
Answer: D
Rationale: Iodine should be administered one hour before PTU to optimize
therapeutic effects in managing hyperthyroidism.
4. A client with atrial fibrillation is prescribed warfarin. The nurse
should monitor which laboratory value to evaluate therapeutic
effectiveness?
A. aPTT
B. PT/INR
C. Platelet count
D. Hemoglobin
Answer: B
Rationale: Prothrombin time (PT) and International Normalized Ratio (INR)
monitor warfarin's anticoagulant effect. Target INR is typically 2.0-3.0 for atrial
fibrillation.
5. The nurse is caring for a client prescribed digoxin and furosemide.
Which laboratory value is most important to monitor?
A. Serum sodium
B. Serum potassium
C. Serum magnesium
D. Serum calcium
Answer: B
Rationale: Furosemide causes potassium wasting. Hypokalemia increases the
risk of digoxin toxicity. Serum potassium must be monitored closely.
,6. A client is prescribed metformin for Type 2 diabetes. Which adverse
effect should the nurse monitor for?
A. Hypoglycemia
B. Lactic acidosis
C. Weight gain
D. Hypertension
Answer: B
Rationale: Lactic acidosis is a rare but serious adverse effect of metformin,
particularly in patients with renal impairment. Patients should report muscle
pain, weakness, and difficulty breathing.
7. The nurse is administering IV vancomycin to a client. Which action
should the nurse take to prevent red man syndrome?
A. Administer the medication as a rapid IV push
B. Infuse the medication over at least 60 minutes
C. Administer the medication with an antacid
D. Mix the medication with dextrose only
Answer: B
Rationale: Red man syndrome is caused by rapid infusion of vancomycin.
Infusing the medication over at least 60 minutes minimizes histamine release.
8. A client taking warfarin has an INR of 4.5 with no signs of bleeding.
What should the nurse anticipate?
A. Administer vitamin K immediately
B. Hold the next dose of warfarin
C. Increase the warfarin dose
D. Administer protamine sulfate
Answer: B
Rationale: Target INR is 2.0-3.0 for most indications. An INR of 4.5 is elevated;
without bleeding, hold the next 1-2 doses and monitor. Vitamin K is given for
INR >5.0 with no bleeding or any elevation with bleeding.
, 9. A client is prescribed lisinopril for hypertension. Which side effect
should the nurse monitor for?
A. Peripheral edema
B. Dry cough
C. Hyperkalemia
D. Both B and C
Answer: D
Rationale: ACE inhibitors like lisinopril commonly cause a dry cough (due to
bradykinin accumulation) and hyperkalemia. Switching to an ARB like losartan
typically resolves the cough.
10. The nurse is reinforcing teaching with a client prescribed sublingual
nitroglycerin. Which statement indicates understanding?
A. "I will take one tablet every 5 minutes until my pain is gone"
B. "I will take one tablet at the onset of chest pain"
C. "I will swallow the tablet with water"
D. "I will take a tablet 30 minutes before exercise"
Answer: B
Rationale: Sublingual nitroglycerin should be taken at the onset of chest pain. If
pain persists after one tablet, take a second in 5 minutes and a third in another 5
minutes, then seek emergency care.
11. A client is prescribed ciprofloxacin. Which instruction should the
nurse include?
A. "Take this medication with milk"
B. "Report tendon pain immediately"
C. "Take this medication with an antacid"
D. "This medication may cause drowsiness"
Answer: B
Rationale: Ciprofloxacin is associated with tendonitis and tendon rupture.
Tendon pain should be reported immediately and the medication discontinued.
EXAMINATION STUDY GUIDE Questions with
Detailed Rationales Latest 2025-2026 Update |
Verified Answers | Grade A+ Preparation
1. A client receives a prescription for ciprofloxacin 400 mg intravenously
(IV) every 12 hours to be infused over an hour. The IV bag contains
ciprofloxacin 400 mg in dextrose 5% in water (D5W) 200 mL. The nurse
should program the infusion pump to deliver how many mL/hr?
A. 100 mL/hr
B. 150 mL/hr
C. 200 mL/hr
D. 250 mL/hr
Answer: C
Rationale: 200 mL to be infused over 1 hour = 200 mL/hr. The pump should be
programmed to deliver the entire 200 mL bag over 60 minutes.
2. The nurse administers naloxone to a client with opioid-induced
respiratory depression. One hour later, the client has a respiratory rate
of 4 breaths/min, SpO2 of 75%, and is unarousable. Which action should
the nurse implement?
A. Administer a second dose of naloxone
B. Determine Glasgow Coma Scale score
C. Initiate cardiopulmonary resuscitation (CPR)
D. Prepare to assist with chest tube insertion
Answer: A
Rationale: Naloxone has a shorter half-life than most opioids. Recurrent
respiratory depression requires repeat dosing. Immediate airway and breathing
support should be provided while administering additional naloxone.
,3. The healthcare provider prescribes propylthiouracil (PTU) and
Lugol's solution for a client with hyperthyroidism. How should the nurse
schedule the administration of these medications?
A. Offer both drugs together with a meal
B. Schedule both medications at bedtime
C. Give parental dose once every 24 hours
D. Administer iodine one hour before PTU
Answer: D
Rationale: Iodine should be administered one hour before PTU to optimize
therapeutic effects in managing hyperthyroidism.
4. A client with atrial fibrillation is prescribed warfarin. The nurse
should monitor which laboratory value to evaluate therapeutic
effectiveness?
A. aPTT
B. PT/INR
C. Platelet count
D. Hemoglobin
Answer: B
Rationale: Prothrombin time (PT) and International Normalized Ratio (INR)
monitor warfarin's anticoagulant effect. Target INR is typically 2.0-3.0 for atrial
fibrillation.
5. The nurse is caring for a client prescribed digoxin and furosemide.
Which laboratory value is most important to monitor?
A. Serum sodium
B. Serum potassium
C. Serum magnesium
D. Serum calcium
Answer: B
Rationale: Furosemide causes potassium wasting. Hypokalemia increases the
risk of digoxin toxicity. Serum potassium must be monitored closely.
,6. A client is prescribed metformin for Type 2 diabetes. Which adverse
effect should the nurse monitor for?
A. Hypoglycemia
B. Lactic acidosis
C. Weight gain
D. Hypertension
Answer: B
Rationale: Lactic acidosis is a rare but serious adverse effect of metformin,
particularly in patients with renal impairment. Patients should report muscle
pain, weakness, and difficulty breathing.
7. The nurse is administering IV vancomycin to a client. Which action
should the nurse take to prevent red man syndrome?
A. Administer the medication as a rapid IV push
B. Infuse the medication over at least 60 minutes
C. Administer the medication with an antacid
D. Mix the medication with dextrose only
Answer: B
Rationale: Red man syndrome is caused by rapid infusion of vancomycin.
Infusing the medication over at least 60 minutes minimizes histamine release.
8. A client taking warfarin has an INR of 4.5 with no signs of bleeding.
What should the nurse anticipate?
A. Administer vitamin K immediately
B. Hold the next dose of warfarin
C. Increase the warfarin dose
D. Administer protamine sulfate
Answer: B
Rationale: Target INR is 2.0-3.0 for most indications. An INR of 4.5 is elevated;
without bleeding, hold the next 1-2 doses and monitor. Vitamin K is given for
INR >5.0 with no bleeding or any elevation with bleeding.
, 9. A client is prescribed lisinopril for hypertension. Which side effect
should the nurse monitor for?
A. Peripheral edema
B. Dry cough
C. Hyperkalemia
D. Both B and C
Answer: D
Rationale: ACE inhibitors like lisinopril commonly cause a dry cough (due to
bradykinin accumulation) and hyperkalemia. Switching to an ARB like losartan
typically resolves the cough.
10. The nurse is reinforcing teaching with a client prescribed sublingual
nitroglycerin. Which statement indicates understanding?
A. "I will take one tablet every 5 minutes until my pain is gone"
B. "I will take one tablet at the onset of chest pain"
C. "I will swallow the tablet with water"
D. "I will take a tablet 30 minutes before exercise"
Answer: B
Rationale: Sublingual nitroglycerin should be taken at the onset of chest pain. If
pain persists after one tablet, take a second in 5 minutes and a third in another 5
minutes, then seek emergency care.
11. A client is prescribed ciprofloxacin. Which instruction should the
nurse include?
A. "Take this medication with milk"
B. "Report tendon pain immediately"
C. "Take this medication with an antacid"
D. "This medication may cause drowsiness"
Answer: B
Rationale: Ciprofloxacin is associated with tendonitis and tendon rupture.
Tendon pain should be reported immediately and the medication discontinued.
