NURS 305 Final Exam V1 | NURS 305 Pharmacology | Actual Q&A with
Rationale (NURS305 Final Exam) | Liberty University
1. A patient is taking digoxin for heart failure. Which assessment finding should the nurse
prioritize as a sign of potential toxicity?
A. Increased urine output
B. Heart rate of 82 beats per minute
C. Visual disturbances such as yellow-green halos
D. Blood pressure of 120/80 mmHg
Answer: C
Explanation: Visual changes like yellow-green halos are classic indicators of digoxin
toxicity and require immediate intervention. Normal findings such as a heart rate of 82 or
stable blood pressure do not indicate toxicity. The nurse must monitor serum digoxin
levels to ensure they stay within the therapeutic range of 0.5 to 2.0 ng/mL.
2. Which education should the nurse provide to a patient newly prescribed an ACE inhibitor
like lisinopril?
A. Increase intake of potassium-rich foods
B. Report a persistent, dry nonproductive cough
C. Take the medication with a calcium supplement
D. Expect a significant increase in heart rate
Answer: B
Explanation: A persistent dry cough is a common side effect of ACE inhibitors caused by
the accumulation of bradykinin in the lungs. Patients should be taught to report this
because it often necessitates a switch to an ARB. Monitoring for hyperkalemia is also
important, so increasing potassium intake would actually be contraindicated.
3. A patient receives a prescription for warfarin. Which laboratory result is most essential for
the nurse to monitor to evaluate the medication’s effectiveness?
A. International Normalized Ratio (INR)
B. Platelet count
C. White blood cell count
D. Activated partial thromboplastin time (aPTT)
Answer: A
,Explanation: The INR is the standard laboratory value used to monitor the therapeutic
effect of warfarin. The aPTT is used for monitoring heparin therapy, not warfarin.
Maintaining an INR within the target range (usually 2.0-3.0) is vital to prevent both clotting
and excessive bleeding.
4. What is the primary mechanism of action for the loop diuretic furosemide?
A. Inhibiting sodium reabsorption in the distal convoluted tubule
B. Blocking aldosterone receptors in the collecting duct
C. Inhibiting the sodium-potassium-chloride symporter in the ascending limb of the loop of
Henle
D. Increasing osmotic pressure within the renal tubules
Answer: C
Explanation: Furosemide acts primarily by blocking the reabsorption of sodium and
chloride in the thick ascending limb of the loop of Henle. This results in significant diuresis
due to the loss of electrolytes and water. Nurses must monitor for hypokalemia, as this
drug causes significant potassium excretion.
5. When administering intravenous vancomycin, the nurse notes the patient’s face and neck
have become flushed and red. What is the nurse’s priority action?
A. Slow the rate of the infusion
B. Stop the infusion and notify the provider of an allergic reaction
C. Apply a cold compress to the affected area
D. Administer intramuscular epinephrine immediately
Answer: A
Explanation: Red Man Syndrome is a rate-dependent reaction to vancomycin, not a true
IgE-mediated allergy. The appropriate nursing intervention is to slow the infusion rate to
alleviate the symptoms. Stopping the drug and calling the provider is necessary for
anaphylaxis, but flushing alone usually responds to rate adjustment.
6. A patient with type 1 diabetes is prescribed lispro (Humalog) insulin. When should the
nurse instruct the patient to take this medication?
A. 30 to 60 minutes before a meal
B. Two hours after a meal
C. Only at bedtime
D. Immediately before or within 15 minutes of eating
Answer: D
, Explanation: Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. It must be
administered in close proximity to a meal to prevent hypoglycemia. Regular insulin is
typically given 30 to 60 minutes before meals, whereas lispro is much faster.
7. Which medication is considered the drug of choice for treating an acute asthma attack?
A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Answer: B
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
bronchodilation during an acute exacerbation. Medications like salmeterol and fluticasone
are used for long-term maintenance and will not act quickly enough during an emergency.
Montelukast is a leukotriene receptor antagonist used for prophylaxis.
8. A patient is prescribed atorvastatin. Which adverse effect should the patient be instructed
to report to the healthcare provider immediately?
A. Constipation
B. Headache
C. Dry mouth
D. Unexplained muscle pain or tenderness
Answer: D
Explanation: Muscle pain or weakness can be a sign of rhabdomyolysis, a rare but serious
breakdown of muscle tissue caused by statins. If left untreated, this condition can lead to
acute renal failure. The nurse must educate the patient that this symptom requires urgent
medical evaluation and laboratory testing.
9. What is the primary indication for the administration of naloxone?
A. Reversal of benzodiazepine overdose
B. Management of alcohol withdrawal
C. Treatment of opioid-induced respiratory depression
D. Prevention of seizures during surgery
Answer: C
Explanation: Naloxone is an opioid antagonist that displaces opioids from receptor sites to
reverse respiratory depression. It has no effect on benzodiazepines, which require
Rationale (NURS305 Final Exam) | Liberty University
1. A patient is taking digoxin for heart failure. Which assessment finding should the nurse
prioritize as a sign of potential toxicity?
A. Increased urine output
B. Heart rate of 82 beats per minute
C. Visual disturbances such as yellow-green halos
D. Blood pressure of 120/80 mmHg
Answer: C
Explanation: Visual changes like yellow-green halos are classic indicators of digoxin
toxicity and require immediate intervention. Normal findings such as a heart rate of 82 or
stable blood pressure do not indicate toxicity. The nurse must monitor serum digoxin
levels to ensure they stay within the therapeutic range of 0.5 to 2.0 ng/mL.
2. Which education should the nurse provide to a patient newly prescribed an ACE inhibitor
like lisinopril?
A. Increase intake of potassium-rich foods
B. Report a persistent, dry nonproductive cough
C. Take the medication with a calcium supplement
D. Expect a significant increase in heart rate
Answer: B
Explanation: A persistent dry cough is a common side effect of ACE inhibitors caused by
the accumulation of bradykinin in the lungs. Patients should be taught to report this
because it often necessitates a switch to an ARB. Monitoring for hyperkalemia is also
important, so increasing potassium intake would actually be contraindicated.
3. A patient receives a prescription for warfarin. Which laboratory result is most essential for
the nurse to monitor to evaluate the medication’s effectiveness?
A. International Normalized Ratio (INR)
B. Platelet count
C. White blood cell count
D. Activated partial thromboplastin time (aPTT)
Answer: A
,Explanation: The INR is the standard laboratory value used to monitor the therapeutic
effect of warfarin. The aPTT is used for monitoring heparin therapy, not warfarin.
Maintaining an INR within the target range (usually 2.0-3.0) is vital to prevent both clotting
and excessive bleeding.
4. What is the primary mechanism of action for the loop diuretic furosemide?
A. Inhibiting sodium reabsorption in the distal convoluted tubule
B. Blocking aldosterone receptors in the collecting duct
C. Inhibiting the sodium-potassium-chloride symporter in the ascending limb of the loop of
Henle
D. Increasing osmotic pressure within the renal tubules
Answer: C
Explanation: Furosemide acts primarily by blocking the reabsorption of sodium and
chloride in the thick ascending limb of the loop of Henle. This results in significant diuresis
due to the loss of electrolytes and water. Nurses must monitor for hypokalemia, as this
drug causes significant potassium excretion.
5. When administering intravenous vancomycin, the nurse notes the patient’s face and neck
have become flushed and red. What is the nurse’s priority action?
A. Slow the rate of the infusion
B. Stop the infusion and notify the provider of an allergic reaction
C. Apply a cold compress to the affected area
D. Administer intramuscular epinephrine immediately
Answer: A
Explanation: Red Man Syndrome is a rate-dependent reaction to vancomycin, not a true
IgE-mediated allergy. The appropriate nursing intervention is to slow the infusion rate to
alleviate the symptoms. Stopping the drug and calling the provider is necessary for
anaphylaxis, but flushing alone usually responds to rate adjustment.
6. A patient with type 1 diabetes is prescribed lispro (Humalog) insulin. When should the
nurse instruct the patient to take this medication?
A. 30 to 60 minutes before a meal
B. Two hours after a meal
C. Only at bedtime
D. Immediately before or within 15 minutes of eating
Answer: D
, Explanation: Lispro is a rapid-acting insulin with an onset of 15 to 30 minutes. It must be
administered in close proximity to a meal to prevent hypoglycemia. Regular insulin is
typically given 30 to 60 minutes before meals, whereas lispro is much faster.
7. Which medication is considered the drug of choice for treating an acute asthma attack?
A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Answer: B
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
bronchodilation during an acute exacerbation. Medications like salmeterol and fluticasone
are used for long-term maintenance and will not act quickly enough during an emergency.
Montelukast is a leukotriene receptor antagonist used for prophylaxis.
8. A patient is prescribed atorvastatin. Which adverse effect should the patient be instructed
to report to the healthcare provider immediately?
A. Constipation
B. Headache
C. Dry mouth
D. Unexplained muscle pain or tenderness
Answer: D
Explanation: Muscle pain or weakness can be a sign of rhabdomyolysis, a rare but serious
breakdown of muscle tissue caused by statins. If left untreated, this condition can lead to
acute renal failure. The nurse must educate the patient that this symptom requires urgent
medical evaluation and laboratory testing.
9. What is the primary indication for the administration of naloxone?
A. Reversal of benzodiazepine overdose
B. Management of alcohol withdrawal
C. Treatment of opioid-induced respiratory depression
D. Prevention of seizures during surgery
Answer: C
Explanation: Naloxone is an opioid antagonist that displaces opioids from receptor sites to
reverse respiratory depression. It has no effect on benzodiazepines, which require
