NUR 210 Exam 2 V1 | NUR 210 Pharmacology | Actual Q&A with
Rationale (NUR 210 Exam 2) | Galen
1. A patient is prescribed Lisinopril for hypertension. Which side effect should the nurse
monitor for that is specific to ACE inhibitors?
A. Dry, nonproductive cough
B. Peripheral edema
C. Hypokalemia
D. Tachycardia
Answer: A
Rationale: ACE inhibitors prevent the breakdown of bradykinin, which often leads to the
development of a persistent, dry cough. This side effect is a common reason for patients to
switch to an Angiotensin II Receptor Blocker (ARB). The nurse must educate the patient
that this is a drug-specific reaction rather than a respiratory infection.
2. A nurse is preparing to administer Propranolol to a patient. Which medical history finding
would cause the nurse to hold the medication and contact the provider?
A. Hypertension
B. Bronchial asthma
C. Glaucoma
D. Angina pectoris
Answer: B
Rationale: Propranolol is a non-selective beta-blocker that affects both Beta-1 and Beta-2
receptors. Blocking Beta-2 receptors can cause bronchoconstriction, which is dangerous for
patients with a history of asthma or COPD. Selective beta-blockers like Metoprolol are
generally preferred for patients with respiratory issues.
3. A patient is receiving Digoxin for heart failure. Which laboratory value should the nurse
prioritize to prevent Digoxin toxicity?
A. Serum sodium level
B. Serum potassium level
C. Serum calcium level
D. Blood urea nitrogen (BUN)
Answer: B
,Rationale: Hypokalemia increases the sensitivity of the cardiac muscle to Digoxin,
significantly raising the risk of toxicity. The nurse must ensure that potassium levels
remain within the normal range (3.5 to 5.0 mEq/L) during therapy. If the patient is also on
a loop diuretic like Furosemide, the risk of low potassium and subsequent Digoxin toxicity
is even higher.
4. Which instruction is most important for a patient newly prescribed Nitroglycerin sublingual
tablets for angina?
A. Swallow the tablet with a full glass of water.
B. Store the tablets in a clear plastic container for easy access.
C. Take one tablet every 10 minutes until the pain stops.
D. Sit or lie down before taking the medication.
Answer: D
Rationale: Nitroglycerin is a potent vasodilator that can cause a significant drop in blood
pressure and resulting syncope. Sitting or lying down prevents falls and decreases the
workload of the heart during an anginal attack. Patients should also be taught to call 911 if
the pain is not relieved after the first dose.
5. A nurse is monitoring a patient on Heparin therapy. Which laboratory test is used to adjust
the infusion rate?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count
Answer: B
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated Heparin and to guide dosage adjustments. PT and INR are used to monitor
Warfarin therapy rather than Heparin. Maintaining the aPTT within the therapeutic range
(typically 1.5 to 2.5 times the control) is critical to prevent both clotting and bleeding.
6. What is the primary mechanism of action of Furosemide (Lasix)?
A. Blocking aldosterone receptors in the distal tubule.
B. Inhibition of sodium and chloride reabsorption in the ascending loop of Henle.
C. Inhibition of the sodium-potassium-chloride symporter in the proximal tubule.
D. Increasing osmotic pressure within the renal tubules.
Answer: B
, Rationale: Furosemide is a loop diuretic that works by inhibiting the reabsorption of
sodium and chloride in the thick ascending limb of the loop of Henle. This results in
significant diuresis as water follows the excreted salt. Because it is highly potent, the nurse
must monitor the patient closely for dehydration and electrolyte imbalances.
7. A patient is prescribed Atorvastatin (Lipitor). When should the nurse advise the patient to
take this medication for optimal effectiveness?
A. In the morning with breakfast.
B. Only when consuming a high-fat meal.
C. Immediately before exercise.
D. In the evening with or without food.
Answer: D
Rationale: Cholesterol synthesis in the liver occurs primarily at night; therefore, statins
are most effective when taken in the evening. While Atorvastatin has a longer half-life than
some other statins, evening dosing remains the clinical standard. The patient should also be
monitored for muscle pain, which could indicate rhabdomyolysis.
8. Which of the following is the antidote for a Warfarin overdose?
A. Vitamin K
B. Protamine sulfate
C. Flumazenil
D. Naloxone
Answer: A
Rationale: Vitamin K (phytonadione) is the specific antagonist used to reverse the
anticoagulant effects of Warfarin by promoting the synthesis of clotting factors. Protamine
sulfate is the antidote for Heparin, not Warfarin. The nurse must educate the patient on
maintaining a consistent intake of green leafy vegetables to prevent fluctuations in INR.
9. A patient with heart failure is taking Spironolactone. Which food choice indicates a need
for further teaching?
A. Apples
B. Bananas
C. White bread
D. Green beans
Answer: B
Rationale (NUR 210 Exam 2) | Galen
1. A patient is prescribed Lisinopril for hypertension. Which side effect should the nurse
monitor for that is specific to ACE inhibitors?
A. Dry, nonproductive cough
B. Peripheral edema
C. Hypokalemia
D. Tachycardia
Answer: A
Rationale: ACE inhibitors prevent the breakdown of bradykinin, which often leads to the
development of a persistent, dry cough. This side effect is a common reason for patients to
switch to an Angiotensin II Receptor Blocker (ARB). The nurse must educate the patient
that this is a drug-specific reaction rather than a respiratory infection.
2. A nurse is preparing to administer Propranolol to a patient. Which medical history finding
would cause the nurse to hold the medication and contact the provider?
A. Hypertension
B. Bronchial asthma
C. Glaucoma
D. Angina pectoris
Answer: B
Rationale: Propranolol is a non-selective beta-blocker that affects both Beta-1 and Beta-2
receptors. Blocking Beta-2 receptors can cause bronchoconstriction, which is dangerous for
patients with a history of asthma or COPD. Selective beta-blockers like Metoprolol are
generally preferred for patients with respiratory issues.
3. A patient is receiving Digoxin for heart failure. Which laboratory value should the nurse
prioritize to prevent Digoxin toxicity?
A. Serum sodium level
B. Serum potassium level
C. Serum calcium level
D. Blood urea nitrogen (BUN)
Answer: B
,Rationale: Hypokalemia increases the sensitivity of the cardiac muscle to Digoxin,
significantly raising the risk of toxicity. The nurse must ensure that potassium levels
remain within the normal range (3.5 to 5.0 mEq/L) during therapy. If the patient is also on
a loop diuretic like Furosemide, the risk of low potassium and subsequent Digoxin toxicity
is even higher.
4. Which instruction is most important for a patient newly prescribed Nitroglycerin sublingual
tablets for angina?
A. Swallow the tablet with a full glass of water.
B. Store the tablets in a clear plastic container for easy access.
C. Take one tablet every 10 minutes until the pain stops.
D. Sit or lie down before taking the medication.
Answer: D
Rationale: Nitroglycerin is a potent vasodilator that can cause a significant drop in blood
pressure and resulting syncope. Sitting or lying down prevents falls and decreases the
workload of the heart during an anginal attack. Patients should also be taught to call 911 if
the pain is not relieved after the first dose.
5. A nurse is monitoring a patient on Heparin therapy. Which laboratory test is used to adjust
the infusion rate?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count
Answer: B
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated Heparin and to guide dosage adjustments. PT and INR are used to monitor
Warfarin therapy rather than Heparin. Maintaining the aPTT within the therapeutic range
(typically 1.5 to 2.5 times the control) is critical to prevent both clotting and bleeding.
6. What is the primary mechanism of action of Furosemide (Lasix)?
A. Blocking aldosterone receptors in the distal tubule.
B. Inhibition of sodium and chloride reabsorption in the ascending loop of Henle.
C. Inhibition of the sodium-potassium-chloride symporter in the proximal tubule.
D. Increasing osmotic pressure within the renal tubules.
Answer: B
, Rationale: Furosemide is a loop diuretic that works by inhibiting the reabsorption of
sodium and chloride in the thick ascending limb of the loop of Henle. This results in
significant diuresis as water follows the excreted salt. Because it is highly potent, the nurse
must monitor the patient closely for dehydration and electrolyte imbalances.
7. A patient is prescribed Atorvastatin (Lipitor). When should the nurse advise the patient to
take this medication for optimal effectiveness?
A. In the morning with breakfast.
B. Only when consuming a high-fat meal.
C. Immediately before exercise.
D. In the evening with or without food.
Answer: D
Rationale: Cholesterol synthesis in the liver occurs primarily at night; therefore, statins
are most effective when taken in the evening. While Atorvastatin has a longer half-life than
some other statins, evening dosing remains the clinical standard. The patient should also be
monitored for muscle pain, which could indicate rhabdomyolysis.
8. Which of the following is the antidote for a Warfarin overdose?
A. Vitamin K
B. Protamine sulfate
C. Flumazenil
D. Naloxone
Answer: A
Rationale: Vitamin K (phytonadione) is the specific antagonist used to reverse the
anticoagulant effects of Warfarin by promoting the synthesis of clotting factors. Protamine
sulfate is the antidote for Heparin, not Warfarin. The nurse must educate the patient on
maintaining a consistent intake of green leafy vegetables to prevent fluctuations in INR.
9. A patient with heart failure is taking Spironolactone. Which food choice indicates a need
for further teaching?
A. Apples
B. Bananas
C. White bread
D. Green beans
Answer: B
