PHARMACOLOGY QUIZ (NURS 180) 2026
QUESTIONS AND ANSWERS
1. A patient with chronic kidney disease is prescribed Enoxaparin. Which laboratory
parameter is the most specific for monitoring this drug’s effect in this population?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. International Normalized Ratio (INR)
D. Anti-Xa levels
Answer: D
Conceptual Explanation: While routine monitoring is not required for Low Molecular
Weight Heparins like Enoxaparin, Anti-Xa levels are the standard for patients with renal
impairment or obesity.
2. Which mechanism explains why Nitroglycerin causes a severe headache in many patients?
A. Stimulation of alpha-1 adrenergic receptors
B. Cerebral vasodilation and increased intracranial pressure
C. Direct irritation of the meningeal nerves
D. Reflex vasoconstriction of cranial arteries
,Answer: B
Conceptual Explanation: Nitroglycerin is a potent vasodilator. Dilation of cerebral vessels
increases pressure and stretches vessel walls, leading to headaches.
3. A patient is taking Lisinopril and Spironolactone. Which electrolyte imbalance is the nurse
most concerned about?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: Both ACE inhibitors (Lisinopril) and potassium-sparing diuretics
(Spironolactone) reduce potassium excretion, increasing the risk of life-threatening
hyperkalemia.
4. What is the primary rationale for administering Leucovorin after high-dose Methotrexate
therapy?
A. To enhance the cytotoxic effect on tumor cells
B. To provide a source of reduced folate to rescue normal cells
C. To prevent Methotrexate from entering the central nervous system
D. To alkalinize the urine and prevent crystal formation
, Answer: B
Conceptual Explanation: Leucovorin bypasses the metabolic block caused by
Methotrexate (dihydrofolate reductase inhibition), allowing normal cells to synthesize
DNA.
5. When administering Adenosine for supraventricular tachycardia, why must it be given as a
rapid IV push?
A. It has a very short half-life of less than 10 seconds
B. It is highly protein-bound and needs high pressure to release
C. Slow administration causes paradoxical ventricular fibrillation
D. It is rapidly metabolized by the liver on the first pass
Answer: A
Conceptual Explanation: Adenosine has an extremely short half-life (seconds). It must
reach the heart quickly before being metabolized by erythrocytes and endothelial cells.
6. Which medication should be held for 48 hours after a procedure involving iodinated
contrast media to prevent lactic acidosis?
A. Glyburide
B. Metformin
C. Pioglitazone
D. Sitagliptin
QUESTIONS AND ANSWERS
1. A patient with chronic kidney disease is prescribed Enoxaparin. Which laboratory
parameter is the most specific for monitoring this drug’s effect in this population?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. International Normalized Ratio (INR)
D. Anti-Xa levels
Answer: D
Conceptual Explanation: While routine monitoring is not required for Low Molecular
Weight Heparins like Enoxaparin, Anti-Xa levels are the standard for patients with renal
impairment or obesity.
2. Which mechanism explains why Nitroglycerin causes a severe headache in many patients?
A. Stimulation of alpha-1 adrenergic receptors
B. Cerebral vasodilation and increased intracranial pressure
C. Direct irritation of the meningeal nerves
D. Reflex vasoconstriction of cranial arteries
,Answer: B
Conceptual Explanation: Nitroglycerin is a potent vasodilator. Dilation of cerebral vessels
increases pressure and stretches vessel walls, leading to headaches.
3. A patient is taking Lisinopril and Spironolactone. Which electrolyte imbalance is the nurse
most concerned about?
A. Hypokalemia
B. Hypercalcemia
C. Hyponatremia
D. Hyperkalemia
Answer: D
Conceptual Explanation: Both ACE inhibitors (Lisinopril) and potassium-sparing diuretics
(Spironolactone) reduce potassium excretion, increasing the risk of life-threatening
hyperkalemia.
4. What is the primary rationale for administering Leucovorin after high-dose Methotrexate
therapy?
A. To enhance the cytotoxic effect on tumor cells
B. To provide a source of reduced folate to rescue normal cells
C. To prevent Methotrexate from entering the central nervous system
D. To alkalinize the urine and prevent crystal formation
, Answer: B
Conceptual Explanation: Leucovorin bypasses the metabolic block caused by
Methotrexate (dihydrofolate reductase inhibition), allowing normal cells to synthesize
DNA.
5. When administering Adenosine for supraventricular tachycardia, why must it be given as a
rapid IV push?
A. It has a very short half-life of less than 10 seconds
B. It is highly protein-bound and needs high pressure to release
C. Slow administration causes paradoxical ventricular fibrillation
D. It is rapidly metabolized by the liver on the first pass
Answer: A
Conceptual Explanation: Adenosine has an extremely short half-life (seconds). It must
reach the heart quickly before being metabolized by erythrocytes and endothelial cells.
6. Which medication should be held for 48 hours after a procedure involving iodinated
contrast media to prevent lactic acidosis?
A. Glyburide
B. Metformin
C. Pioglitazone
D. Sitagliptin
