NUR 100/NUR100 Exam 4 V2 | Pharmacology Q&A
with Rationale | Fortis College
1. A nurse is preparing to administer metformin to a client with type 2 diabetes mellitus.
Which laboratory value should the nurse monitor most closely to prevent lactic acidosis?
A. Serum potassium
B. Prothrombin time
C. Creatinine clearance
D. Serum amylase
Correct Answer: C
Explanation: Metformin is primarily excreted by the kidneys, and impaired renal function
increases the risk of metformin-associated lactic acidosis. The nurse must monitor the
client’s creatinine clearance and serum creatinine levels before and during therapy. If renal
function is significantly impaired, the medication must be discontinued immediately to
prevent life-threatening complications.
2. A client is prescribed insulin lispro for postprandial glucose control. When should the nurse
instruct the client to administer this medication?
A. 30 to 60 minutes before a meal
B. Immediately after the meal
C. At bedtime with a snack
,D. 15 minutes before a meal
Correct Answer: D
Explanation: Insulin lispro is a rapid-acting insulin with an onset of approximately 15
minutes. It is essential that the client eats shortly after administration to prevent
hypoglycemia. This timing ensures that the insulin peak matches the glucose spike from
food consumption.
3. Which of the following medications is the specific antidote for a client experiencing a
heparin overdose?
A. Vitamin K
B. Acetylcysteine
C. Protamine sulfate
D. Calcium gluconate
Correct Answer: C
Explanation: Protamine sulfate is the pharmacological antagonist used to neutralize the
effects of heparin. It works by binding to heparin molecules to form a stable salt, thereby
inactivating the anticoagulant. The nurse should monitor the Partial Thromboplastin Time
(PTT) to evaluate the effectiveness of the reversal.
4. A nurse is caring for a client receiving digoxin for heart failure. The client reports seeing
yellow-green halos around lights. What is the nurse’s priority action?
A. Document the finding as a common side effect.
, B. Assess the client’s apical pulse and hold the next dose.
C. Request a serum potassium level immediately.
D. Administer the next scheduled dose as ordered.
Correct Answer: B
Explanation: Visual disturbances, such as yellow-green halos, are classic signs of digoxin
toxicity. The nurse must immediately assess the apical pulse, as bradycardia is another sign
of toxicity, and withhold the dose. Notifying the provider and obtaining a serum digoxin
level are subsequent necessary steps.
5. A client with a history of asthma is prescribed propranolol for hypertension. Why should
the nurse question this order?
A. Propranolol causes profound tachycardia in asthmatics.
B. The medication will increase the risk of respiratory infections.
C. Non-selective beta-blockers can cause bronchoconstriction.
D. Propranolol interacts with albuterol to cause hypertension.
Correct Answer: C
Explanation: Propranolol is a non-selective beta-adrenergic antagonist that blocks both
Beta-1 and Beta-2 receptors. Blocking Beta-2 receptors in the lungs can lead to
bronchospasm, which is dangerous for clients with asthma or COPD. The nurse should
advocate for a cardio-selective beta-blocker like metoprolol instead.
with Rationale | Fortis College
1. A nurse is preparing to administer metformin to a client with type 2 diabetes mellitus.
Which laboratory value should the nurse monitor most closely to prevent lactic acidosis?
A. Serum potassium
B. Prothrombin time
C. Creatinine clearance
D. Serum amylase
Correct Answer: C
Explanation: Metformin is primarily excreted by the kidneys, and impaired renal function
increases the risk of metformin-associated lactic acidosis. The nurse must monitor the
client’s creatinine clearance and serum creatinine levels before and during therapy. If renal
function is significantly impaired, the medication must be discontinued immediately to
prevent life-threatening complications.
2. A client is prescribed insulin lispro for postprandial glucose control. When should the nurse
instruct the client to administer this medication?
A. 30 to 60 minutes before a meal
B. Immediately after the meal
C. At bedtime with a snack
,D. 15 minutes before a meal
Correct Answer: D
Explanation: Insulin lispro is a rapid-acting insulin with an onset of approximately 15
minutes. It is essential that the client eats shortly after administration to prevent
hypoglycemia. This timing ensures that the insulin peak matches the glucose spike from
food consumption.
3. Which of the following medications is the specific antidote for a client experiencing a
heparin overdose?
A. Vitamin K
B. Acetylcysteine
C. Protamine sulfate
D. Calcium gluconate
Correct Answer: C
Explanation: Protamine sulfate is the pharmacological antagonist used to neutralize the
effects of heparin. It works by binding to heparin molecules to form a stable salt, thereby
inactivating the anticoagulant. The nurse should monitor the Partial Thromboplastin Time
(PTT) to evaluate the effectiveness of the reversal.
4. A nurse is caring for a client receiving digoxin for heart failure. The client reports seeing
yellow-green halos around lights. What is the nurse’s priority action?
A. Document the finding as a common side effect.
, B. Assess the client’s apical pulse and hold the next dose.
C. Request a serum potassium level immediately.
D. Administer the next scheduled dose as ordered.
Correct Answer: B
Explanation: Visual disturbances, such as yellow-green halos, are classic signs of digoxin
toxicity. The nurse must immediately assess the apical pulse, as bradycardia is another sign
of toxicity, and withhold the dose. Notifying the provider and obtaining a serum digoxin
level are subsequent necessary steps.
5. A client with a history of asthma is prescribed propranolol for hypertension. Why should
the nurse question this order?
A. Propranolol causes profound tachycardia in asthmatics.
B. The medication will increase the risk of respiratory infections.
C. Non-selective beta-blockers can cause bronchoconstriction.
D. Propranolol interacts with albuterol to cause hypertension.
Correct Answer: C
Explanation: Propranolol is a non-selective beta-adrenergic antagonist that blocks both
Beta-1 and Beta-2 receptors. Blocking Beta-2 receptors in the lungs can lead to
bronchospasm, which is dangerous for clients with asthma or COPD. The nurse should
advocate for a cardio-selective beta-blocker like metoprolol instead.
