NUR 351 Final exam | Q&A | 2026/2027 | Pharmacology in Nursing |
ASU | Graded A+
1. A patient prescribed digoxin for heart failure reports nausea, vomiting, and
seeing yellow halos around lights. Which condition is most likely occurring?
A) An expected therapeutic response
B) A mild allergic reaction
C) Digoxin toxicity
D) A drug interaction with food
Correct Answer: Digoxin toxicity
Rationale: Nausea, vomiting, and visual disturbances (yellow or green halos)
are classic signs of digoxin toxicity. This is a serious adverse effect that
requires immediate assessment of serum digoxin levels and potential dose
adjustment.
2. The study of how medications alter function in the body is known as:
A) Pathophysiology
B) Pharmacodynamics
C) Pharmacokinetics
D) Pharmacognosy
Correct Answer: Pharmacodynamics
Rationale: Pharmacodynamics is the study of what the drug does to the body
—its mechanisms of action and effects. Pharmacokinetics is what the body
does to the drug. Pathophysiology studies disease processes, and
pharmacognosy is the study of natural drug sources.
,3. The nurse is teaching a patient about warfarin therapy. Which statement
by the patient indicates understanding?
A) "I will avoid eating green leafy vegetables."
B) "I will take ibuprofen for headaches."
C) "I will have my blood tested regularly."
D) "I can stop the medication if I feel better."
Correct Answer: "I will have my blood tested regularly."
Rationale: Warfarin requires regular monitoring of the International
Normalized Ratio (INR) to ensure therapeutic anticoagulation and prevent
bleeding complications. Patients should maintain consistent vitamin K intake
and avoid NSAIDs due to increased bleeding risk.
4. A patient prescribed a beta-blocker for hypertension asks how the
medication works. Which response is most accurate?
A) "It increases the force of heart contractions."
B) "It blocks the effects of epinephrine and norepinephrine on the heart."
C) "It causes vasodilation of peripheral blood vessels."
D) "It increases the heart rate."
Correct Answer: "It blocks the effects of epinephrine and norepinephrine on
the heart."
Rationale: Beta-blockers compete with catecholamines at beta-adrenergic
receptors, reducing heart rate, contractility, and cardiac output. This lowers
blood pressure and decreases myocardial oxygen demand.
5. A patient prescribed metformin for Type 2 diabetes should be educated
about the risk of which serious adverse effect?
,A) Hypoglycemia
B) Lactic acidosis
C) Weight gain
D) Pancreatitis
Correct Answer: Lactic acidosis
Rationale: Metformin can cause lactic acidosis, a rare but serious
complication, particularly in patients with renal impairment, hepatic disease,
or conditions predisposing to hypoxia. Patients should report symptoms such
as muscle pain, weakness, and difficulty breathing.
6. Rapid-acting insulin (e.g., insulin lispro) should be administered:
A) 30-60 minutes before meals
B) Immediately before or within 15 minutes of starting a meal
C) 1-2 hours after meals
D) At bedtime only
Correct Answer: Immediately before or within 15 minutes of starting a meal
Rationale: Rapid-acting insulin has an onset of action of approximately 15
minutes and should be given immediately before or within 15 minutes of
starting a meal to match the postprandial glucose rise.
7. Which medication is a selective COX-2 inhibitor that has a lower risk of
gastrointestinal bleeding?
A) Ibuprofen
B) Naproxen
C) Celecoxib
, D) Aspirin
Correct Answer: Celecoxib
Rationale: Celecoxib is a selective COX-2 inhibitor that spares COX-1,
reducing the risk of gastrointestinal bleeding. However, it may increase the
risk of cardiovascular events and should be used with caution in patients
with cardiovascular disease.
8. The antidote for heparin toxicity is:
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Correct Answer: Protamine sulfate
Rationale: Protamine sulfate is the antidote for heparin. It binds to heparin
and neutralizes its anticoagulant effect. Vitamin K is the antidote for
warfarin, naloxone for opioids, and flumazenil for benzodiazepines.
9. A patient prescribed an SSRI for depression should be educated that the
full therapeutic effect may take:
A) 1-2 days
B) 1-2 weeks
C) 4-6 weeks
D) Immediate
Correct Answer: 4-6 weeks
ASU | Graded A+
1. A patient prescribed digoxin for heart failure reports nausea, vomiting, and
seeing yellow halos around lights. Which condition is most likely occurring?
A) An expected therapeutic response
B) A mild allergic reaction
C) Digoxin toxicity
D) A drug interaction with food
Correct Answer: Digoxin toxicity
Rationale: Nausea, vomiting, and visual disturbances (yellow or green halos)
are classic signs of digoxin toxicity. This is a serious adverse effect that
requires immediate assessment of serum digoxin levels and potential dose
adjustment.
2. The study of how medications alter function in the body is known as:
A) Pathophysiology
B) Pharmacodynamics
C) Pharmacokinetics
D) Pharmacognosy
Correct Answer: Pharmacodynamics
Rationale: Pharmacodynamics is the study of what the drug does to the body
—its mechanisms of action and effects. Pharmacokinetics is what the body
does to the drug. Pathophysiology studies disease processes, and
pharmacognosy is the study of natural drug sources.
,3. The nurse is teaching a patient about warfarin therapy. Which statement
by the patient indicates understanding?
A) "I will avoid eating green leafy vegetables."
B) "I will take ibuprofen for headaches."
C) "I will have my blood tested regularly."
D) "I can stop the medication if I feel better."
Correct Answer: "I will have my blood tested regularly."
Rationale: Warfarin requires regular monitoring of the International
Normalized Ratio (INR) to ensure therapeutic anticoagulation and prevent
bleeding complications. Patients should maintain consistent vitamin K intake
and avoid NSAIDs due to increased bleeding risk.
4. A patient prescribed a beta-blocker for hypertension asks how the
medication works. Which response is most accurate?
A) "It increases the force of heart contractions."
B) "It blocks the effects of epinephrine and norepinephrine on the heart."
C) "It causes vasodilation of peripheral blood vessels."
D) "It increases the heart rate."
Correct Answer: "It blocks the effects of epinephrine and norepinephrine on
the heart."
Rationale: Beta-blockers compete with catecholamines at beta-adrenergic
receptors, reducing heart rate, contractility, and cardiac output. This lowers
blood pressure and decreases myocardial oxygen demand.
5. A patient prescribed metformin for Type 2 diabetes should be educated
about the risk of which serious adverse effect?
,A) Hypoglycemia
B) Lactic acidosis
C) Weight gain
D) Pancreatitis
Correct Answer: Lactic acidosis
Rationale: Metformin can cause lactic acidosis, a rare but serious
complication, particularly in patients with renal impairment, hepatic disease,
or conditions predisposing to hypoxia. Patients should report symptoms such
as muscle pain, weakness, and difficulty breathing.
6. Rapid-acting insulin (e.g., insulin lispro) should be administered:
A) 30-60 minutes before meals
B) Immediately before or within 15 minutes of starting a meal
C) 1-2 hours after meals
D) At bedtime only
Correct Answer: Immediately before or within 15 minutes of starting a meal
Rationale: Rapid-acting insulin has an onset of action of approximately 15
minutes and should be given immediately before or within 15 minutes of
starting a meal to match the postprandial glucose rise.
7. Which medication is a selective COX-2 inhibitor that has a lower risk of
gastrointestinal bleeding?
A) Ibuprofen
B) Naproxen
C) Celecoxib
, D) Aspirin
Correct Answer: Celecoxib
Rationale: Celecoxib is a selective COX-2 inhibitor that spares COX-1,
reducing the risk of gastrointestinal bleeding. However, it may increase the
risk of cardiovascular events and should be used with caution in patients
with cardiovascular disease.
8. The antidote for heparin toxicity is:
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Correct Answer: Protamine sulfate
Rationale: Protamine sulfate is the antidote for heparin. It binds to heparin
and neutralizes its anticoagulant effect. Vitamin K is the antidote for
warfarin, naloxone for opioids, and flumazenil for benzodiazepines.
9. A patient prescribed an SSRI for depression should be educated that the
full therapeutic effect may take:
A) 1-2 days
B) 1-2 weeks
C) 4-6 weeks
D) Immediate
Correct Answer: 4-6 weeks
