NUR 206: Pharmacology and Advanced Nursing
Practice Prep with Detailed Rationales
Course Code: NUR 206
Course Name: Advanced Pharmacology and Nursing Practice
Topic: Cardiovascular, Respiratory, Neurological, and Antimicrobial Therapeutics
Academic Year: 2026/2027
1. A patient arrives in the emergency department experiencing sudden-onset
supraventricular tachycardia (SVT). The monitor reveals a heart rate of
185 beats per minute. Which medication should the nurse anticipate
administering as a rapid intravenous push to temporarily slow down the
heart rate and allow for better rhythm visualization?
A. Adenosine
B. Amiodarone
C. Atropine Sulfate
D. Diltiazem
CORRECT ANSWER: A
RATIONALE: Adenosine is an ultra-short-acting antiarrhythmic that slows
conduction through the AV node, temporarily interrupting re-entry pathways and
causing transient asystole. This slows down the heart rate temporarily to allow for
better visualization of the underlying rhythm in patients with supraventricular
tachycardia (SVT). It must be given as a rapid IV push (typically 6 mg followed
by a 20 mL normal saline bolus) due to its extremely short half-life. Amiodarone is
used for ventricular and atrial arrhythmias but is not an ultra-rapid push agent for
SVT. Atropine increases heart rate and is contraindicated in tachycardia. Diltiazem
is a calcium channel blocker that slows the rate but does not act as rapidly or
abruptly as adenosine.
2. The nurse is caring for a patient diagnosed with recurring ventricular
tachycardia (VT). The healthcare provider prescribes oral amiodarone.
Which baseline and periodic diagnostic tests must the nurse ensure are
scheduled due to the drug's long-term toxicity profile?
A. Complete blood count, serum calcium, and uric acid levels
B. Pulmonary function test, thyroid function, and liver function tests
, C. Blood urea nitrogen, creatinine, and arterial blood gases
D. Coagulation profiles, serum amylase, and urinalysis
CORRECT ANSWER: B
RATIONALE: Amiodarone is an antiarrhythmic that slows the cardiac action
potential. Because it contains iodine and accumulates significantly in tissue, it
carries high risks of severe adverse effects, requiring regular monitoring of
pulmonary function tests (PFTs) (due to risk of fatal pulmonary fibrosis),
thyroid function tests (due to risk of amiodarone-induced hypo- or
hyperthyroidism), and liver function tests (LFTs) (due to hepatotoxicity). The
other diagnostic combinations do not monitor the targeted multi-organ toxicity
associated with amiodarone.
3. A patient is exhibiting symptomatic bradycardia with a heart rate of 42
beats per minute, complaining of dizziness and hypotension. The nurse
prepares to administer atropine sulfate. In which patient scenario must the
nurse use extreme caution or identify a clear contraindication for this drug?
A. A patient with asthma
B. A patient with acute myocardial infarction (MI) or glaucoma
C. A patient with hypothyroidism
D. A patient with chronic obstructive pulmonary disease (COPD)
CORRECT ANSWER: B
RATIONALE: Atropine sulfate is an anticholinergic drug that increases SA
node stimulus and increases conduction through the AV node to treat
bradycardia. It must be used cautiously in patients experiencing an acute
myocardial infarction (MI) because the resulting increase in heart rate elevates
myocardial oxygen demand, potentially worsening ischemia. It is also
contraindicated or used with extreme caution in patients with glaucoma because
anticholinergics increase intraocular pressure (IOP) and cause dry eyes. It does not
carry these severe specific risks for asthma, hypothyroidism, or COPD.
4. A patient with atrial fibrillation (AF) is being discharged on warfarin
therapy. What critical dietary and safety teaching should the nurse provide to
ensure therapeutic stabilization?
A. "Increase your intake of spinach and kale to enhance the drug's
effectiveness."
B. "Monitor your aPTT levels weekly at the outpatient clinic."
, C. "Monitor your INR and PT, limit leafy green vegetables, and use a
soft toothbrush."
D. "Switch your electric razor to a straight razor to prevent micro-
abrasions."
CORRECT ANSWER: C
RATIONALE: Warfarin is an oral anticoagulant that inhibits clot formation in
disorders like atrial fibrillation (AF). Patients must monitor their Prothrombin
Time (PT) and International Normalized Ratio (INR) to ensure safe dosing.
They must maintain a consistent intake or limit leafy green vegetables because
vitamin K is the direct antidote to warfarin and can counteract its therapeutic
effect. A soft toothbrush and electric razors are recommended to mitigate
bleeding risks. aPTT is utilized for monitoring heparin, not warfarin.
5. A patient presents with acute heparin-induced thrombocytopenia (HIT).
The nurse knows that if severe bleeding occurs due to an overdose of
unfractionated heparin (UFH), which specific antidote must be readily
available?
A. Vitamin K
B. Protamine sulfate
C. N-acetylcysteine
D. Flumazenil
CORRECT ANSWER: B
RATIONALE: Protamine sulfate is the specific chemical antidote used to
neutralize the anticoagulant effects of unfractionated heparin (UFH) when
severe hemorrhage or toxicity develops. Vitamin K is the antidote for warfarin. N-
acetylcysteine is used for acetaminophen toxicity, and flumazenil reverses
benzodiazepine overdoses.
6. The nurse is reviewing the medication profiles of patients prescribed new
oral anticoagulants such as dabigatran, rivaroxaban, and apixaban.
Which laboratory assessment is paramount to perform routinely for these
specific agents?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. Renal function tests
D. Liver enzyme panel
Practice Prep with Detailed Rationales
Course Code: NUR 206
Course Name: Advanced Pharmacology and Nursing Practice
Topic: Cardiovascular, Respiratory, Neurological, and Antimicrobial Therapeutics
Academic Year: 2026/2027
1. A patient arrives in the emergency department experiencing sudden-onset
supraventricular tachycardia (SVT). The monitor reveals a heart rate of
185 beats per minute. Which medication should the nurse anticipate
administering as a rapid intravenous push to temporarily slow down the
heart rate and allow for better rhythm visualization?
A. Adenosine
B. Amiodarone
C. Atropine Sulfate
D. Diltiazem
CORRECT ANSWER: A
RATIONALE: Adenosine is an ultra-short-acting antiarrhythmic that slows
conduction through the AV node, temporarily interrupting re-entry pathways and
causing transient asystole. This slows down the heart rate temporarily to allow for
better visualization of the underlying rhythm in patients with supraventricular
tachycardia (SVT). It must be given as a rapid IV push (typically 6 mg followed
by a 20 mL normal saline bolus) due to its extremely short half-life. Amiodarone is
used for ventricular and atrial arrhythmias but is not an ultra-rapid push agent for
SVT. Atropine increases heart rate and is contraindicated in tachycardia. Diltiazem
is a calcium channel blocker that slows the rate but does not act as rapidly or
abruptly as adenosine.
2. The nurse is caring for a patient diagnosed with recurring ventricular
tachycardia (VT). The healthcare provider prescribes oral amiodarone.
Which baseline and periodic diagnostic tests must the nurse ensure are
scheduled due to the drug's long-term toxicity profile?
A. Complete blood count, serum calcium, and uric acid levels
B. Pulmonary function test, thyroid function, and liver function tests
, C. Blood urea nitrogen, creatinine, and arterial blood gases
D. Coagulation profiles, serum amylase, and urinalysis
CORRECT ANSWER: B
RATIONALE: Amiodarone is an antiarrhythmic that slows the cardiac action
potential. Because it contains iodine and accumulates significantly in tissue, it
carries high risks of severe adverse effects, requiring regular monitoring of
pulmonary function tests (PFTs) (due to risk of fatal pulmonary fibrosis),
thyroid function tests (due to risk of amiodarone-induced hypo- or
hyperthyroidism), and liver function tests (LFTs) (due to hepatotoxicity). The
other diagnostic combinations do not monitor the targeted multi-organ toxicity
associated with amiodarone.
3. A patient is exhibiting symptomatic bradycardia with a heart rate of 42
beats per minute, complaining of dizziness and hypotension. The nurse
prepares to administer atropine sulfate. In which patient scenario must the
nurse use extreme caution or identify a clear contraindication for this drug?
A. A patient with asthma
B. A patient with acute myocardial infarction (MI) or glaucoma
C. A patient with hypothyroidism
D. A patient with chronic obstructive pulmonary disease (COPD)
CORRECT ANSWER: B
RATIONALE: Atropine sulfate is an anticholinergic drug that increases SA
node stimulus and increases conduction through the AV node to treat
bradycardia. It must be used cautiously in patients experiencing an acute
myocardial infarction (MI) because the resulting increase in heart rate elevates
myocardial oxygen demand, potentially worsening ischemia. It is also
contraindicated or used with extreme caution in patients with glaucoma because
anticholinergics increase intraocular pressure (IOP) and cause dry eyes. It does not
carry these severe specific risks for asthma, hypothyroidism, or COPD.
4. A patient with atrial fibrillation (AF) is being discharged on warfarin
therapy. What critical dietary and safety teaching should the nurse provide to
ensure therapeutic stabilization?
A. "Increase your intake of spinach and kale to enhance the drug's
effectiveness."
B. "Monitor your aPTT levels weekly at the outpatient clinic."
, C. "Monitor your INR and PT, limit leafy green vegetables, and use a
soft toothbrush."
D. "Switch your electric razor to a straight razor to prevent micro-
abrasions."
CORRECT ANSWER: C
RATIONALE: Warfarin is an oral anticoagulant that inhibits clot formation in
disorders like atrial fibrillation (AF). Patients must monitor their Prothrombin
Time (PT) and International Normalized Ratio (INR) to ensure safe dosing.
They must maintain a consistent intake or limit leafy green vegetables because
vitamin K is the direct antidote to warfarin and can counteract its therapeutic
effect. A soft toothbrush and electric razors are recommended to mitigate
bleeding risks. aPTT is utilized for monitoring heparin, not warfarin.
5. A patient presents with acute heparin-induced thrombocytopenia (HIT).
The nurse knows that if severe bleeding occurs due to an overdose of
unfractionated heparin (UFH), which specific antidote must be readily
available?
A. Vitamin K
B. Protamine sulfate
C. N-acetylcysteine
D. Flumazenil
CORRECT ANSWER: B
RATIONALE: Protamine sulfate is the specific chemical antidote used to
neutralize the anticoagulant effects of unfractionated heparin (UFH) when
severe hemorrhage or toxicity develops. Vitamin K is the antidote for warfarin. N-
acetylcysteine is used for acetaminophen toxicity, and flumazenil reverses
benzodiazepine overdoses.
6. The nurse is reviewing the medication profiles of patients prescribed new
oral anticoagulants such as dabigatran, rivaroxaban, and apixaban.
Which laboratory assessment is paramount to perform routinely for these
specific agents?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. Renal function tests
D. Liver enzyme panel
