NURS 305 Exam 2 V1 | NURS 305 Pharmacology | Actual Q&A with
Rationale (NURS305 Exam 2) | Liberty University
1. A nurse is providing teaching to a patient prescribed lisinopril for hypertension. Which side
effect should the nurse instruct the patient to report immediately to the provider?
A. Occasional dizziness upon standing
B. Swelling of the lips and tongue
C. A persistent dry, nonproductive cough
D. Occasional nausea after taking the medication
Answer: B
Explanation: Angioedema, characterized by swelling of the face, lips, or tongue, is a life-
threatening adverse effect of ACE inhibitors. While a dry cough is common, it is not an
emergency. Dizziness is an expected orthostatic effect that requires caution but not
immediate reporting unless severe.
2. A client with chronic heart failure is receiving digoxin 0.125 mg daily. Which of the
following laboratory values should concern the nurse most?
A. Serum digoxin level of 1.2 ng/mL
B. Serum potassium level of 3.1 mEq/L
C. Serum sodium level of 138 mEq/L
D. Serum calcium level of 9.5 mg/dL
Answer: B
Explanation: Hypokalemia significantly increases the risk of digoxin toxicity. Digoxin and
potassium compete for the same binding sites on the sodium-potassium ATPase pump.
Therefore, low potassium levels allow more digoxin to bind, leading to toxic effects even
with normal serum drug levels.
3. The nurse is preparing to administer sublingual nitroglycerin to a patient with stable
angina. What should the nurse assess before administration?
A. Blood pressure
B. Radial pulse rate
C. Axillary temperature
D. Deep tendon reflexes
Answer: A
,Explanation: Nitroglycerin is a potent vasodilator that can cause significant hypotension.
The nurse must check blood pressure before each dose to ensure the patient is not
hemodynamically unstable. If the systolic blood pressure is below 90 mmHg, the dose
should typically be held.
4. A patient is prescribed warfarin for atrial fibrillation. The nurse explains that the
effectiveness of the treatment will be monitored using which laboratory test?
A. Activated partial thromboplastin time (aPTT)
B. Complete blood count (CBC)
C. Platelet count
D. International Normalized Ratio (INR)
Answer: D
Explanation: The INR is the standardized measurement used to monitor the effectiveness
of warfarin therapy. The target INR for atrial fibrillation is generally between 2.0 and 3.0.
aPTT is used to monitor heparin therapy, not warfarin.
5. When administering intravenous heparin for a pulmonary embolism, the nurse should have
which medication readily available as an antidote?
A. Vitamin K
B. Protamine sulfate
C. Glucagon
D. Calcium gluconate
Answer: B
Explanation: Protamine sulfate is the specific reversal agent for heparin. It works by
binding with heparin to form a stable salt, neutralizing the anticoagulant effect. Vitamin K
is the antidote for warfarin, not heparin.
6. A patient is being started on atorvastatin. Which of the following should the nurse include
in the discharge teaching?
A. Report any unexplained muscle pain or tenderness
B. Take the medication in the morning with breakfast
C. Increase intake of grapefruit juice to improve absorption
D. Expect the urine to turn a bright orange color
Answer: A
Explanation: Statins can cause rhabdomyolysis, a serious condition involving the
breakdown of muscle tissue. Patients must report muscle pain or weakness immediately to
, prevent renal failure. Statins are usually taken in the evening when cholesterol synthesis is
highest, and grapefruit juice should be avoided.
7. A patient with a history of asthma is prescribed propranolol for hypertension. Which action
should the nurse take?
A. Administer the medication as prescribed
B. Question the order because propranolol is a non-selective beta-blocker
C. Request a higher dose to ensure effectiveness
D. Instruct the patient to use their albuterol inhaler 30 minutes before the dose
Answer: B
Explanation: Propranolol is a non-selective beta-adrenergic antagonist that blocks both
Beta-1 and Beta-2 receptors. Blocking Beta-2 receptors in the lungs can cause
bronchoconstriction, which is dangerous for patients with asthma. A cardioselective beta-
blocker like metoprolol would be a safer alternative.
8. The nurse is teaching a patient about the use of a fluticasone metered-dose inhaler. What
is the most important instruction to prevent a common side effect?
A. Wait 5 minutes between puffs
B. Use the inhaler only when feeling short of breath
C. Rinse the mouth with water after each use
D. Clean the plastic inhaler casing with bleach weekly
Answer: C
Explanation: Inhaled corticosteroids like fluticasone can cause oral candidiasis (thrush)
due to local immunosuppression. Rinsing the mouth and spitting after administration helps
remove residual medication from the oral mucosa. This medication is for maintenance and
should not be used as a rescue inhaler.
9. A patient is receiving furosemide 40 mg IV push for pulmonary edema. Which assessment
finding indicates the medication is effective?
A. Increased heart rate
B. Lungs clear to auscultation
C. Decreased urine output
D. Increased peripheral edema
Answer: B
Explanation: Furosemide is a loop diuretic used to remove excess fluid from the body. In
the context of pulmonary edema, clear lung sounds indicate that fluid has been successfully
Rationale (NURS305 Exam 2) | Liberty University
1. A nurse is providing teaching to a patient prescribed lisinopril for hypertension. Which side
effect should the nurse instruct the patient to report immediately to the provider?
A. Occasional dizziness upon standing
B. Swelling of the lips and tongue
C. A persistent dry, nonproductive cough
D. Occasional nausea after taking the medication
Answer: B
Explanation: Angioedema, characterized by swelling of the face, lips, or tongue, is a life-
threatening adverse effect of ACE inhibitors. While a dry cough is common, it is not an
emergency. Dizziness is an expected orthostatic effect that requires caution but not
immediate reporting unless severe.
2. A client with chronic heart failure is receiving digoxin 0.125 mg daily. Which of the
following laboratory values should concern the nurse most?
A. Serum digoxin level of 1.2 ng/mL
B. Serum potassium level of 3.1 mEq/L
C. Serum sodium level of 138 mEq/L
D. Serum calcium level of 9.5 mg/dL
Answer: B
Explanation: Hypokalemia significantly increases the risk of digoxin toxicity. Digoxin and
potassium compete for the same binding sites on the sodium-potassium ATPase pump.
Therefore, low potassium levels allow more digoxin to bind, leading to toxic effects even
with normal serum drug levels.
3. The nurse is preparing to administer sublingual nitroglycerin to a patient with stable
angina. What should the nurse assess before administration?
A. Blood pressure
B. Radial pulse rate
C. Axillary temperature
D. Deep tendon reflexes
Answer: A
,Explanation: Nitroglycerin is a potent vasodilator that can cause significant hypotension.
The nurse must check blood pressure before each dose to ensure the patient is not
hemodynamically unstable. If the systolic blood pressure is below 90 mmHg, the dose
should typically be held.
4. A patient is prescribed warfarin for atrial fibrillation. The nurse explains that the
effectiveness of the treatment will be monitored using which laboratory test?
A. Activated partial thromboplastin time (aPTT)
B. Complete blood count (CBC)
C. Platelet count
D. International Normalized Ratio (INR)
Answer: D
Explanation: The INR is the standardized measurement used to monitor the effectiveness
of warfarin therapy. The target INR for atrial fibrillation is generally between 2.0 and 3.0.
aPTT is used to monitor heparin therapy, not warfarin.
5. When administering intravenous heparin for a pulmonary embolism, the nurse should have
which medication readily available as an antidote?
A. Vitamin K
B. Protamine sulfate
C. Glucagon
D. Calcium gluconate
Answer: B
Explanation: Protamine sulfate is the specific reversal agent for heparin. It works by
binding with heparin to form a stable salt, neutralizing the anticoagulant effect. Vitamin K
is the antidote for warfarin, not heparin.
6. A patient is being started on atorvastatin. Which of the following should the nurse include
in the discharge teaching?
A. Report any unexplained muscle pain or tenderness
B. Take the medication in the morning with breakfast
C. Increase intake of grapefruit juice to improve absorption
D. Expect the urine to turn a bright orange color
Answer: A
Explanation: Statins can cause rhabdomyolysis, a serious condition involving the
breakdown of muscle tissue. Patients must report muscle pain or weakness immediately to
, prevent renal failure. Statins are usually taken in the evening when cholesterol synthesis is
highest, and grapefruit juice should be avoided.
7. A patient with a history of asthma is prescribed propranolol for hypertension. Which action
should the nurse take?
A. Administer the medication as prescribed
B. Question the order because propranolol is a non-selective beta-blocker
C. Request a higher dose to ensure effectiveness
D. Instruct the patient to use their albuterol inhaler 30 minutes before the dose
Answer: B
Explanation: Propranolol is a non-selective beta-adrenergic antagonist that blocks both
Beta-1 and Beta-2 receptors. Blocking Beta-2 receptors in the lungs can cause
bronchoconstriction, which is dangerous for patients with asthma. A cardioselective beta-
blocker like metoprolol would be a safer alternative.
8. The nurse is teaching a patient about the use of a fluticasone metered-dose inhaler. What
is the most important instruction to prevent a common side effect?
A. Wait 5 minutes between puffs
B. Use the inhaler only when feeling short of breath
C. Rinse the mouth with water after each use
D. Clean the plastic inhaler casing with bleach weekly
Answer: C
Explanation: Inhaled corticosteroids like fluticasone can cause oral candidiasis (thrush)
due to local immunosuppression. Rinsing the mouth and spitting after administration helps
remove residual medication from the oral mucosa. This medication is for maintenance and
should not be used as a rescue inhaler.
9. A patient is receiving furosemide 40 mg IV push for pulmonary edema. Which assessment
finding indicates the medication is effective?
A. Increased heart rate
B. Lungs clear to auscultation
C. Decreased urine output
D. Increased peripheral edema
Answer: B
Explanation: Furosemide is a loop diuretic used to remove excess fluid from the body. In
the context of pulmonary edema, clear lung sounds indicate that fluid has been successfully
