NUR635 Pharm GCU final Exam
(Latest Update 2026/27) UPDATE!!
comprehensive questions fully
solved & updated|| GRADED A+
Course
NUR635 Pharm GCU
1. A patient taking lisinopril develops facial swelling and difficulty breathing. What is the priority
action?
A. Give the next dose with food
B. Hold lisinopril and seek emergency treatment
C. Administer potassium
D. Reassure the patient that this is expected
Answer: B. Hold lisinopril and seek emergency treatment
Rationale: Angioedema is a potentially life-threatening adverse effect of ACE inhibitors. Airway
compromise requires immediate intervention. The medication should be discontinued and
emergency treatment initiated.
2. Which laboratory value is most important to monitor in a patient receiving warfarin?
A. INR
B. Sodium
C. Hemoglobin A1c
D. Amylase
Answer: A. INR
Rationale: INR is used to monitor the anticoagulant effect of warfarin. Excessive anticoagulation
increases bleeding risk, while inadequate anticoagulation may fail to prevent thrombosis.
3. A patient taking warfarin reports black, tarry stools. What should the nurse do first?
A. Tell the patient to increase dietary vitamin K
B. Assess for gastrointestinal bleeding and notify the provider promptly
,C. Administer aspirin
D. Tell the patient this is an expected effect
Answer: B. Assess for gastrointestinal bleeding and notify the provider promptly
Rationale: Melena may indicate gastrointestinal bleeding. Anticoagulated patients require
prompt assessment because significant hemorrhage can occur.
4. Which medication reverses the anticoagulant effect of unfractionated heparin?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: B. Protamine sulfate
Rationale: Protamine sulfate is the specific reversal agent for unfractionated heparin. Vitamin K
is associated with reversal of warfarin's anticoagulant effect.
5. A patient taking atorvastatin reports severe unexplained muscle pain and weakness. Which
laboratory test is particularly relevant?
A. Creatine kinase
B. INR
C. Troponin only
D. Serum amylase
Answer: A. Creatine kinase
Rationale: Significant muscle pain or weakness during statin therapy raises concern for
myopathy or rhabdomyolysis. Creatine kinase can help evaluate muscle injury.
6. Which instruction is most appropriate for a patient prescribed levothyroxine?
A. Take it consistently, preferably on an empty stomach
B. Take it only when symptoms occur
C. Take it simultaneously with calcium supplements
D. Stop it once energy improves
Answer: A. Take it consistently, preferably on an empty stomach
,Rationale: Levothyroxine absorption is affected by food and several medications/supplements.
Consistent administration improves therapeutic control.
7. Which assessment finding suggests excessive thyroid hormone replacement?
A. Bradycardia
B. Cold intolerance
C. Palpitations and tachycardia
D. Weight gain
Answer: C. Palpitations and tachycardia
Rationale: Excess thyroid hormone can produce symptoms resembling hyperthyroidism,
including tachycardia, palpitations, tremor, heat intolerance and nervousness.
8. A patient with type 1 diabetes has a blood glucose of 52 mg/dL and is awake and able to
swallow. What is the appropriate initial intervention?
A. Give a rapid source of oral glucose
B. Administer long-acting insulin
C. Restrict carbohydrates
D. Administer metformin
Answer: A. Give a rapid source of oral glucose
Rationale: A conscious patient who can safely swallow should receive rapidly absorbed
carbohydrate for symptomatic hypoglycemia, followed by reassessment.
9. Which medication is commonly used as an emergency treatment for severe hypoglycemia
when the patient cannot safely take oral glucose?
A. Glucagon
B. Levothyroxine
C. Metformin
D. Furosemide
Answer: A. Glucagon
Rationale: Glucagon raises blood glucose by stimulating hepatic glycogenolysis and is useful
when oral carbohydrate cannot safely be administered.
, 10. Which adverse effect is particularly associated with metformin?
A. Severe hypoglycemia when used alone
B. Gastrointestinal upset
C. Ototoxicity
D. Severe constipation
Answer: B. Gastrointestinal upset
Rationale: Nausea, diarrhea and abdominal discomfort are common with metformin, especially
early in treatment. Serious complications such as lactic acidosis are rare but important.
11. Which patient should generally avoid taking nitroglycerin concurrently with sildenafil?
A. A patient with seasonal allergies
B. A patient using sildenafil for erectile dysfunction
C. A patient taking levothyroxine
D. A patient taking a multivitamin
Answer: B. A patient using sildenafil for erectile dysfunction
Rationale: PDE-5 inhibitors such as sildenafil can markedly potentiate the blood-pressure-
lowering effect of nitrates, potentially causing severe hypotension.
12. A patient receiving furosemide should be monitored particularly closely for which
electrolyte abnormality?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia only
Answer: B. Hypokalemia
Rationale: Loop diuretics increase urinary potassium excretion. Monitoring potassium is
important because significant hypokalemia can cause weakness and cardiac dysrhythmias.
13. Which assessment finding is most concerning in a patient receiving digoxin?
(Latest Update 2026/27) UPDATE!!
comprehensive questions fully
solved & updated|| GRADED A+
Course
NUR635 Pharm GCU
1. A patient taking lisinopril develops facial swelling and difficulty breathing. What is the priority
action?
A. Give the next dose with food
B. Hold lisinopril and seek emergency treatment
C. Administer potassium
D. Reassure the patient that this is expected
Answer: B. Hold lisinopril and seek emergency treatment
Rationale: Angioedema is a potentially life-threatening adverse effect of ACE inhibitors. Airway
compromise requires immediate intervention. The medication should be discontinued and
emergency treatment initiated.
2. Which laboratory value is most important to monitor in a patient receiving warfarin?
A. INR
B. Sodium
C. Hemoglobin A1c
D. Amylase
Answer: A. INR
Rationale: INR is used to monitor the anticoagulant effect of warfarin. Excessive anticoagulation
increases bleeding risk, while inadequate anticoagulation may fail to prevent thrombosis.
3. A patient taking warfarin reports black, tarry stools. What should the nurse do first?
A. Tell the patient to increase dietary vitamin K
B. Assess for gastrointestinal bleeding and notify the provider promptly
,C. Administer aspirin
D. Tell the patient this is an expected effect
Answer: B. Assess for gastrointestinal bleeding and notify the provider promptly
Rationale: Melena may indicate gastrointestinal bleeding. Anticoagulated patients require
prompt assessment because significant hemorrhage can occur.
4. Which medication reverses the anticoagulant effect of unfractionated heparin?
A. Vitamin K
B. Protamine sulfate
C. Naloxone
D. Acetylcysteine
Answer: B. Protamine sulfate
Rationale: Protamine sulfate is the specific reversal agent for unfractionated heparin. Vitamin K
is associated with reversal of warfarin's anticoagulant effect.
5. A patient taking atorvastatin reports severe unexplained muscle pain and weakness. Which
laboratory test is particularly relevant?
A. Creatine kinase
B. INR
C. Troponin only
D. Serum amylase
Answer: A. Creatine kinase
Rationale: Significant muscle pain or weakness during statin therapy raises concern for
myopathy or rhabdomyolysis. Creatine kinase can help evaluate muscle injury.
6. Which instruction is most appropriate for a patient prescribed levothyroxine?
A. Take it consistently, preferably on an empty stomach
B. Take it only when symptoms occur
C. Take it simultaneously with calcium supplements
D. Stop it once energy improves
Answer: A. Take it consistently, preferably on an empty stomach
,Rationale: Levothyroxine absorption is affected by food and several medications/supplements.
Consistent administration improves therapeutic control.
7. Which assessment finding suggests excessive thyroid hormone replacement?
A. Bradycardia
B. Cold intolerance
C. Palpitations and tachycardia
D. Weight gain
Answer: C. Palpitations and tachycardia
Rationale: Excess thyroid hormone can produce symptoms resembling hyperthyroidism,
including tachycardia, palpitations, tremor, heat intolerance and nervousness.
8. A patient with type 1 diabetes has a blood glucose of 52 mg/dL and is awake and able to
swallow. What is the appropriate initial intervention?
A. Give a rapid source of oral glucose
B. Administer long-acting insulin
C. Restrict carbohydrates
D. Administer metformin
Answer: A. Give a rapid source of oral glucose
Rationale: A conscious patient who can safely swallow should receive rapidly absorbed
carbohydrate for symptomatic hypoglycemia, followed by reassessment.
9. Which medication is commonly used as an emergency treatment for severe hypoglycemia
when the patient cannot safely take oral glucose?
A. Glucagon
B. Levothyroxine
C. Metformin
D. Furosemide
Answer: A. Glucagon
Rationale: Glucagon raises blood glucose by stimulating hepatic glycogenolysis and is useful
when oral carbohydrate cannot safely be administered.
, 10. Which adverse effect is particularly associated with metformin?
A. Severe hypoglycemia when used alone
B. Gastrointestinal upset
C. Ototoxicity
D. Severe constipation
Answer: B. Gastrointestinal upset
Rationale: Nausea, diarrhea and abdominal discomfort are common with metformin, especially
early in treatment. Serious complications such as lactic acidosis are rare but important.
11. Which patient should generally avoid taking nitroglycerin concurrently with sildenafil?
A. A patient with seasonal allergies
B. A patient using sildenafil for erectile dysfunction
C. A patient taking levothyroxine
D. A patient taking a multivitamin
Answer: B. A patient using sildenafil for erectile dysfunction
Rationale: PDE-5 inhibitors such as sildenafil can markedly potentiate the blood-pressure-
lowering effect of nitrates, potentially causing severe hypotension.
12. A patient receiving furosemide should be monitored particularly closely for which
electrolyte abnormality?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia only
Answer: B. Hypokalemia
Rationale: Loop diuretics increase urinary potassium excretion. Monitoring potassium is
important because significant hypokalemia can cause weakness and cardiac dysrhythmias.
13. Which assessment finding is most concerning in a patient receiving digoxin?
