ARIZONA COLLEGE OF NURSING
NUR 354 - Pharmacology II
EXAM 3 - FALL 2026
Student Name: Date:
Score________/ 100 Term: Fall 2026
1. Which additional neurologic assessment is emphasized for a client receiving lidocaine?
A. New yellow-green halos only
B. Blue-gray skin discoloration
C. Blurred vision and new numbness or tingling around the mouth or fingers
D. Loss of taste only
✓ Correct Answer: C. Blurred vision and new numbness or tingling around
the mouth or fingers
Rationale: The lidocaine section highlights orientation, blurred vision, and perioral/finger numbness or
tingling.
2. Which medication is the reversal agent for dabigatran?
A. Vitamin K
B. Protamine sulfate
C. Andexanet alfa
D. Idarucizumab
✓ Correct Answer: D. Idarucizumab
Rationale: The source identifies idarucizumab as the antidote/reversal agent for dabigatran.
3. A client taking clopidogrel is scheduled for surgery. What does the review recommend?
A. Crush the tablet and take it immediately before surgery
B. Continue it and add aspirin without an order
C. Discontinue clopidogrel at least 5 days before surgery as prescribed
D. Take an extra dose the morning of surgery
✓ Correct Answer: C. Discontinue clopidogrel at least 5 days before
surgery as prescribed
Rationale: The source recommends discontinuing clopidogrel at least 5 days before surgery because of
its antiplatelet effect and half-life.
4. A client receiving adenosine briefly appears to have a flat ECG tracing. How should the nurse
interpret this?
A. A brief pause can occur because adenosine transiently slows conduction
B. This always means permanent cardiac arrest
C. It is caused by hyperlipidemia
D. It proves the drug was not absorbed
✓ Correct Answer: A. A brief pause can occur because adenosine
transiently slows conduction
Rationale: The source notes that the ECG may briefly flatline because adenosine pauses electrical
conductivity; its onset and duration are very short.
Page 1
,5. Which electrolyte disturbance is a priority concern with furosemide?
A. Hypokalemia
B. Hypernatremia only
C. Hypermagnesemia only
D. Hypercalcemia only
✓ Correct Answer: A. Hypokalemia
Rationale: The review specifically directs monitoring potassium because furosemide can cause
hypokalemia.
6. Which finding is most suggestive of digoxin toxicity in the review?
A. Increased urine output with no symptoms
B. Increased appetite with clear vision
C. Fishy taste only
D. Yellow-green halos with nausea or dysrhythmias
✓ Correct Answer: D. Yellow-green halos with nausea or dysrhythmias
Rationale: The source lists visual disturbances such as yellow-green halos, nausea/vomiting, fatigue, and
dysrhythmias as toxicity/adverse-effect findings.
7. Which client statement about statin therapy indicates correct understanding?
A. I should stop the medicine as soon as my LDL improves
B. I will take the medication only when I eat a high-fat meal
C. I will avoid grapefruit juice while taking this medication
D. I will double my dose if I miss one
✓ Correct Answer: C. I will avoid grapefruit juice while taking this
medication Rationale: The notes repeatedly instruct clients to avoid grapefruit juice because it
can inhibit statin metabolism and increase toxicity risk.
8. How do ACE inhibitors help a client with HF according to the review?
A. They increase afterload and blood volume
B. They reduce afterload and peripheral resistance, improving cardiac output
C. They directly dissolve thrombi
D. They increase platelet aggregation
✓ Correct Answer: B. They reduce afterload and peripheral resistance,
improving cardiac output
Rationale: ACE inhibitors reduce peripheral resistance/afterload and blood volume, thereby reducing
workload and improving cardiac output.
9. Which condition is listed as a contraindication to cholestyramine?
A. Seasonal allergies
B. Mild headache
C. Total biliary obstruction
D. Atrial fibrillation
✓ Correct Answer: C. Total biliary obstruction
Rationale: The cholestyramine section lists total biliary obstruction as a contraindication.
10. Why should IV furosemide be administered slowly?
A. Slow administration prevents all diuresis
B. Rapid administration causes platelet clumping
C. Slow administration prevents hyperkalemia
D. Rapid administration can cause ototoxicity
✓ Correct Answer: D. Rapid administration can cause ototoxicity
Rationale: The notes emphasize slow IV furosemide administration to reduce the risk of ototoxicity.
Page 2
, 11. Where is the preferred site for subcutaneous heparin administration in the source material?
A. Deltoid muscle
B. Forearm vein
C. Abdomen
D. Dorsogluteal muscle
✓ Correct Answer: C. Abdomen
Rationale: The review identifies the abdomen as the preferred subcutaneous heparin site and instructs
rotating injection sites.
12. Which combination increases bleeding risk according to the source?
A. Clopidogrel with soluble fiber
B. Clopidogrel with an exercise plan
C. Clopidogrel used with anticoagulants, thrombolytics, or NSAIDs
D. Clopidogrel with a low-fat diet
✓ Correct Answer: C. Clopidogrel used with anticoagulants, thrombolytics,
or NSAIDs Rationale: The source warns that combining clopidogrel with anticoagulants, other
antiplatelets, thrombolytics, or NSAIDs increases bleeding risk.
13. A client with HF gains 2 lb (about 1 kg) in 24 hours. How should the nurse interpret this according to
the review?
A. It proves the client is dehydrated
B. It may indicate fluid retention and should be reported
C. It indicates rhabdomyolysis
D. It is expected and never needs follow-up
✓ Correct Answer: B. It may indicate fluid retention and should be reported
Rationale: The source advises daily weights and reporting a gain or loss of more than about 2 lb in 24
hours because it may reflect fluid imbalance.
14. Which assessment is a priority during alteplase therapy?
A. Daily visual-acuity testing only
B. Monthly lipid panel only
C. Frequent neurologic assessment for intracranial bleeding
D. Weekly hearing test only
✓ Correct Answer: C. Frequent neurologic assessment for intracranial
bleeding Rationale: The review identifies intracranial hemorrhage as a major complication and
directs frequent neurologic monitoring during alteplase therapy.
15. A client has a large waistline, high blood pressure, and high fasting glucose. How should the
nurse interpret these findings according to the review?
A. The findings are diagnostic of heart failure
B. The client meets three listed features of metabolic syndrome
C. The client has only one metabolic-syndrome feature
D. The findings rule out cardiovascular risk
✓ Correct Answer: B. The client meets three listed features of metabolic
syndrome Rationale: The notes state that metabolic syndrome is present when three listed features
are present, including large waistline, high BP, high fasting glucose, high triglycerides, and low
HDL.
Page 3
NUR 354 - Pharmacology II
EXAM 3 - FALL 2026
Student Name: Date:
Score________/ 100 Term: Fall 2026
1. Which additional neurologic assessment is emphasized for a client receiving lidocaine?
A. New yellow-green halos only
B. Blue-gray skin discoloration
C. Blurred vision and new numbness or tingling around the mouth or fingers
D. Loss of taste only
✓ Correct Answer: C. Blurred vision and new numbness or tingling around
the mouth or fingers
Rationale: The lidocaine section highlights orientation, blurred vision, and perioral/finger numbness or
tingling.
2. Which medication is the reversal agent for dabigatran?
A. Vitamin K
B. Protamine sulfate
C. Andexanet alfa
D. Idarucizumab
✓ Correct Answer: D. Idarucizumab
Rationale: The source identifies idarucizumab as the antidote/reversal agent for dabigatran.
3. A client taking clopidogrel is scheduled for surgery. What does the review recommend?
A. Crush the tablet and take it immediately before surgery
B. Continue it and add aspirin without an order
C. Discontinue clopidogrel at least 5 days before surgery as prescribed
D. Take an extra dose the morning of surgery
✓ Correct Answer: C. Discontinue clopidogrel at least 5 days before
surgery as prescribed
Rationale: The source recommends discontinuing clopidogrel at least 5 days before surgery because of
its antiplatelet effect and half-life.
4. A client receiving adenosine briefly appears to have a flat ECG tracing. How should the nurse
interpret this?
A. A brief pause can occur because adenosine transiently slows conduction
B. This always means permanent cardiac arrest
C. It is caused by hyperlipidemia
D. It proves the drug was not absorbed
✓ Correct Answer: A. A brief pause can occur because adenosine
transiently slows conduction
Rationale: The source notes that the ECG may briefly flatline because adenosine pauses electrical
conductivity; its onset and duration are very short.
Page 1
,5. Which electrolyte disturbance is a priority concern with furosemide?
A. Hypokalemia
B. Hypernatremia only
C. Hypermagnesemia only
D. Hypercalcemia only
✓ Correct Answer: A. Hypokalemia
Rationale: The review specifically directs monitoring potassium because furosemide can cause
hypokalemia.
6. Which finding is most suggestive of digoxin toxicity in the review?
A. Increased urine output with no symptoms
B. Increased appetite with clear vision
C. Fishy taste only
D. Yellow-green halos with nausea or dysrhythmias
✓ Correct Answer: D. Yellow-green halos with nausea or dysrhythmias
Rationale: The source lists visual disturbances such as yellow-green halos, nausea/vomiting, fatigue, and
dysrhythmias as toxicity/adverse-effect findings.
7. Which client statement about statin therapy indicates correct understanding?
A. I should stop the medicine as soon as my LDL improves
B. I will take the medication only when I eat a high-fat meal
C. I will avoid grapefruit juice while taking this medication
D. I will double my dose if I miss one
✓ Correct Answer: C. I will avoid grapefruit juice while taking this
medication Rationale: The notes repeatedly instruct clients to avoid grapefruit juice because it
can inhibit statin metabolism and increase toxicity risk.
8. How do ACE inhibitors help a client with HF according to the review?
A. They increase afterload and blood volume
B. They reduce afterload and peripheral resistance, improving cardiac output
C. They directly dissolve thrombi
D. They increase platelet aggregation
✓ Correct Answer: B. They reduce afterload and peripheral resistance,
improving cardiac output
Rationale: ACE inhibitors reduce peripheral resistance/afterload and blood volume, thereby reducing
workload and improving cardiac output.
9. Which condition is listed as a contraindication to cholestyramine?
A. Seasonal allergies
B. Mild headache
C. Total biliary obstruction
D. Atrial fibrillation
✓ Correct Answer: C. Total biliary obstruction
Rationale: The cholestyramine section lists total biliary obstruction as a contraindication.
10. Why should IV furosemide be administered slowly?
A. Slow administration prevents all diuresis
B. Rapid administration causes platelet clumping
C. Slow administration prevents hyperkalemia
D. Rapid administration can cause ototoxicity
✓ Correct Answer: D. Rapid administration can cause ototoxicity
Rationale: The notes emphasize slow IV furosemide administration to reduce the risk of ototoxicity.
Page 2
, 11. Where is the preferred site for subcutaneous heparin administration in the source material?
A. Deltoid muscle
B. Forearm vein
C. Abdomen
D. Dorsogluteal muscle
✓ Correct Answer: C. Abdomen
Rationale: The review identifies the abdomen as the preferred subcutaneous heparin site and instructs
rotating injection sites.
12. Which combination increases bleeding risk according to the source?
A. Clopidogrel with soluble fiber
B. Clopidogrel with an exercise plan
C. Clopidogrel used with anticoagulants, thrombolytics, or NSAIDs
D. Clopidogrel with a low-fat diet
✓ Correct Answer: C. Clopidogrel used with anticoagulants, thrombolytics,
or NSAIDs Rationale: The source warns that combining clopidogrel with anticoagulants, other
antiplatelets, thrombolytics, or NSAIDs increases bleeding risk.
13. A client with HF gains 2 lb (about 1 kg) in 24 hours. How should the nurse interpret this according to
the review?
A. It proves the client is dehydrated
B. It may indicate fluid retention and should be reported
C. It indicates rhabdomyolysis
D. It is expected and never needs follow-up
✓ Correct Answer: B. It may indicate fluid retention and should be reported
Rationale: The source advises daily weights and reporting a gain or loss of more than about 2 lb in 24
hours because it may reflect fluid imbalance.
14. Which assessment is a priority during alteplase therapy?
A. Daily visual-acuity testing only
B. Monthly lipid panel only
C. Frequent neurologic assessment for intracranial bleeding
D. Weekly hearing test only
✓ Correct Answer: C. Frequent neurologic assessment for intracranial
bleeding Rationale: The review identifies intracranial hemorrhage as a major complication and
directs frequent neurologic monitoring during alteplase therapy.
15. A client has a large waistline, high blood pressure, and high fasting glucose. How should the
nurse interpret these findings according to the review?
A. The findings are diagnostic of heart failure
B. The client meets three listed features of metabolic syndrome
C. The client has only one metabolic-syndrome feature
D. The findings rule out cardiovascular risk
✓ Correct Answer: B. The client meets three listed features of metabolic
syndrome Rationale: The notes state that metabolic syndrome is present when three listed features
are present, including large waistline, high BP, high fasting glucose, high triglycerides, and low
HDL.
Page 3
