NUR 376 PHARMACOLOGY
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient with a history of heart failure is prescribed lisinopril. Which laboratory value
should the nurse monitor most closely during the initial phase of therapy?
A. Serum potassium level
B. Serum sodium level
C. Serum calcium level
D. Serum magnesium level
Answer: A
Conceptual Explanation: ACE inhibitors like lisinopril can cause hyperkalemia by
inhibiting aldosterone secretion, which normally promotes potassium excretion.
Monitoring potassium is critical, especially in heart failure patients.
2. A client is receiving a continuous intravenous infusion of heparin. The nurse notes the
client’s aPTT is 115 seconds. Which action should the nurse take first?
A. Increase the infusion rate per protocol
B. Stop the infusion and notify the provider
,C. Maintain the current infusion rate
D. Administer Vitamin K intramuscularly
Answer: B
Conceptual Explanation: The therapeutic range for aPTT is generally 1.5 to 2.5 times the
control value (approx. 60-80 seconds). 115 seconds is significantly high, posing a major
bleeding risk; the infusion must be stopped immediately.
3. Which teaching point is most important for a patient newly prescribed a monoamine
oxidase inhibitor (MAOI) for depression?
A. Stop the medication immediately if dry mouth occurs
B. Take the medication with orange juice to increase absorption
C. Avoid foods high in tyramine, such as aged cheeses and cured meats
D. Expect the full therapeutic effect within 24 hours
Answer: C
Conceptual Explanation: MAOIs interact with tyramine-rich foods to cause a hypertensive
crisis. This is a life-threatening interaction and is the priority teaching point.
4. A nurse is preparing to administer digoxin to a patient with atrial fibrillation. Which
assessment finding would require the nurse to hold the medication?
A. Blood pressure of 140/90 mmHg
B. Apical pulse of 52 beats per minute
, C. Respiratory rate of 22 breaths per minute
D. Potassium level of 4.8 mEq/L
Answer: B
Conceptual Explanation: Digoxin is a positive inotrope and negative chronotrope. It
should be held if the apical pulse is less than 60 bpm to prevent further bradycardia.
5. A patient is prescribed vancomycin for a severe MRSA infection. To prevent ‘Red Man
Syndrome,’ what action should the nurse take?
A. Infuse the medication over at least 60 to 90 minutes
B. Pre-treat the patient with an oral antifungal medication
C. Administer the medication via rapid IV bolus
D. Dilute the medication in 10 mL of normal saline
Answer: A
Conceptual Explanation: Red Man Syndrome is a rate-dependent infusion reaction.
Slowing the infusion rate to at least 60 minutes prevents the massive histamine release
responsible for the flushing and hypotension.
6. When administering spironolactone, a potassium-sparing diuretic, the nurse should
question the concurrent use of which medication?
A. Enalapril
B. Warfarin
COMPREHENSIVE EXAM QUESTIONS
AND ANSWERS
1. A patient with a history of heart failure is prescribed lisinopril. Which laboratory value
should the nurse monitor most closely during the initial phase of therapy?
A. Serum potassium level
B. Serum sodium level
C. Serum calcium level
D. Serum magnesium level
Answer: A
Conceptual Explanation: ACE inhibitors like lisinopril can cause hyperkalemia by
inhibiting aldosterone secretion, which normally promotes potassium excretion.
Monitoring potassium is critical, especially in heart failure patients.
2. A client is receiving a continuous intravenous infusion of heparin. The nurse notes the
client’s aPTT is 115 seconds. Which action should the nurse take first?
A. Increase the infusion rate per protocol
B. Stop the infusion and notify the provider
,C. Maintain the current infusion rate
D. Administer Vitamin K intramuscularly
Answer: B
Conceptual Explanation: The therapeutic range for aPTT is generally 1.5 to 2.5 times the
control value (approx. 60-80 seconds). 115 seconds is significantly high, posing a major
bleeding risk; the infusion must be stopped immediately.
3. Which teaching point is most important for a patient newly prescribed a monoamine
oxidase inhibitor (MAOI) for depression?
A. Stop the medication immediately if dry mouth occurs
B. Take the medication with orange juice to increase absorption
C. Avoid foods high in tyramine, such as aged cheeses and cured meats
D. Expect the full therapeutic effect within 24 hours
Answer: C
Conceptual Explanation: MAOIs interact with tyramine-rich foods to cause a hypertensive
crisis. This is a life-threatening interaction and is the priority teaching point.
4. A nurse is preparing to administer digoxin to a patient with atrial fibrillation. Which
assessment finding would require the nurse to hold the medication?
A. Blood pressure of 140/90 mmHg
B. Apical pulse of 52 beats per minute
, C. Respiratory rate of 22 breaths per minute
D. Potassium level of 4.8 mEq/L
Answer: B
Conceptual Explanation: Digoxin is a positive inotrope and negative chronotrope. It
should be held if the apical pulse is less than 60 bpm to prevent further bradycardia.
5. A patient is prescribed vancomycin for a severe MRSA infection. To prevent ‘Red Man
Syndrome,’ what action should the nurse take?
A. Infuse the medication over at least 60 to 90 minutes
B. Pre-treat the patient with an oral antifungal medication
C. Administer the medication via rapid IV bolus
D. Dilute the medication in 10 mL of normal saline
Answer: A
Conceptual Explanation: Red Man Syndrome is a rate-dependent infusion reaction.
Slowing the infusion rate to at least 60 minutes prevents the massive histamine release
responsible for the flushing and hypotension.
6. When administering spironolactone, a potassium-sparing diuretic, the nurse should
question the concurrent use of which medication?
A. Enalapril
B. Warfarin
