BIO290 Pharmacology Exam Questions and
Correct Answers with Detailed Rationales |
Joyce University of Nursing and Health
Sciences | 2026 Update.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
148 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This exam assesses applied pharmacology for nursing practice, including pharmacokinetics and
pharmacodynamics, autonomic and cardiovascular agents, antimicrobials, endocrine and psychotropic drugs,
toxicology, and patient safety principles such as high-alert medications, interactions, and antidotes. Items
require clinical application, calculation, and interpretation of laboratory or prescription data consistent with
contemporary US nursing standards.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 75% (minimum 38/50 correct).
HIGHP - Page 1 of 48
,1. A patient with severe sepsis is prescribed gentamicin IV. Which laboratory value is the
most important to monitor to reduce the risk of nephrotoxicity?
[ ] A. Serum creatinine and trough drug level
[ ] B. Serum potassium and peak drug level
[ ] C. Hemoglobin and hematocrit
[ ] D. Platelet count and INR
CORRECT: A. Serum creatinine and trough drug level
Aminoglycosides like gentamicin are nephrotoxic and ototoxic; renal function (serum creatinine) and trough
levels (to ensure adequate clearance and avoid accumulation) are the key monitoring parameters. Peak
levels relate more to efficacy, while potassium, hemoglobin, and INR are not primary indicators of
aminoglycoside nephrotoxicity.
2. Which statement by a patient prescribed warfarin indicates a correct understanding of
dietary vitamin K interaction?
[ ] A. "I will increase my leafy green vegetables to boost the effect of warfarin."
[ ] B. "I will keep my intake of leafy green vegetables consistent each day."
[ ] C. "I will avoid all foods containing vitamin K while taking warfarin."
[ ] D. "I will take a vitamin K supplement to prevent bleeding."
CORRECT: B. "I will keep my intake of leafy green vegetables consistent each day."
Warfarin's anticoagulant effect is antagonized by vitamin K; maintaining a consistent daily intake of vitamin
K-rich foods (e.g., leafy greens) stabilizes the INR rather than fluctuating it. Increasing intake would decrease
warfarin's effect, complete avoidance is unnecessary and impractical, and vitamin K supplements would
directly antagonize warfarin.
3. A patient taking fluoxetine is now prescribed tramadol for pain. Which adverse effect
should the nurse prioritize monitoring for?
[ ] A. Serotonin syndrome
[ ] B. Hypertensive crisis
[ ] C. Severe hypoglycemia
[ ] D. Acute renal failure
CORRECT: A. Serotonin syndrome
Both fluoxetine (SSRI) and tramadol increase serotonin levels, creating a risk for serotonin syndrome
(agitation, hyperthermia, clonus, tachycardia). Hypertensive crisis is associated with MAOIs and tyramine,
hypoglycemia with insulin or sulfonylureas, and renal failure with nephrotoxic drugs, not this combination.
HIGHP - Page 2 of 48
,4. A patient with myasthenia gravis is prescribed pyridostigmine. Which assessment
finding indicates the dose may be excessive?
[ ] A. Increased muscle strength
[ ] B. Bradycardia and increased salivation
[ ] C. Improved ptosis and diplopia
[ ] D. Decreased respiratory secretions
CORRECT: B. Bradycardia and increased salivation
Pyridostigmine is a cholinesterase inhibitor; excessive dosing causes cholinergic crisis with bradycardia,
excessive salivation, lacrimation, and diarrhea. Increased muscle strength, improved ptosis, and decreased
secretions indicate therapeutic effect, not toxicity.
5. A patient with an acute asthma exacerbation is prescribed albuterol via nebulizer.
Which finding indicates the medication is effective?
[ ] A. Decreased peak expiratory flow
[ ] B. Increased wheezing
[ ] C. Improved oxygen saturation and decreased respiratory rate
[ ] D. Development of bradycardia
CORRECT: C. Improved oxygen saturation and decreased respiratory rate
Albuterol is a short-acting beta2 agonist that causes bronchodilation, improving oxygenation and reducing
respiratory effort. Decreased peak flow and increased wheezing indicate worsening bronchospasm, and
bradycardia is not an expected therapeutic effect (tachycardia is more common).
6. A patient is prescribed levothyroxine. Which instruction should the nurse include in
teaching?
[ ] A. Take the medication at bedtime with a snack.
[ ] B. Take the medication in the morning on an empty stomach.
[ ] C. Take the medication with calcium supplements.
[ ] D. Stop the medication once energy levels improve.
CORRECT: B. Take the medication in the morning on an empty stomach.
Levothyroxine absorption is enhanced when taken on an empty stomach in the morning, 30-60 minutes
before breakfast. Taking it with food or calcium reduces absorption, and therapy is lifelong for hypothyroidism,
so it should not be stopped when symptoms improve.
7. A patient receiving IV vancomycin develops flushing of the face, neck, and upper torso
with itching during infusion. Which action should the nurse take first?
[ ] A. Stop the infusion and notify the provider.
[ ] B. Slow the infusion rate and administer an antihistamine as ordered.
HIGHP - Page 3 of 48
, [ ] C. Increase the infusion rate to finish the dose quickly.
[ ] D. Document the finding as an expected effect and continue.
CORRECT: B. Slow the infusion rate and administer an antihistamine as ordered.
This is vancomycin infusion reaction (formerly 'red man syndrome'), related to rapid infusion; slowing the rate
and giving an antihistamine (if ordered) resolves symptoms. Stopping the infusion entirely may be
unnecessary unless severe, increasing the rate worsens the reaction, and it should not be ignored.
8. A patient is prescribed digoxin. Which assessment finding should the nurse report
immediately?
[ ] A. Heart rate 58 beats/min and nausea
[ ] B. Blood pressure 110/70 mm Hg
[ ] C. Serum potassium 4.0 mEq/L
[ ] D. Respiratory rate 18 breaths/min
CORRECT: A. Heart rate 58 beats/min and nausea
Digoxin toxicity often presents with bradycardia, nausea, vomiting, and visual disturbances; a heart rate
below 60 with nausea warrants immediate reporting. The other findings are within normal limits and do not
indicate toxicity.
9. A patient is prescribed furosemide. Which laboratory value should the nurse monitor
most closely?
[ ] A. Serum sodium
[ ] B. Serum potassium
[ ] C. Serum calcium
[ ] D. Serum magnesium
CORRECT: B. Serum potassium
Loop diuretics like furosemide cause significant potassium loss, leading to hypokalemia and increased risk of
dysrhythmias, especially in patients on digoxin. While sodium, calcium, and magnesium can also be affected,
potassium is the most critical and commonly monitored electrolyte.
10. A patient is prescribed a scheduled dose of insulin glargine at 0900. The patient's
breakfast tray has not arrived. Which action is most appropriate?
[ ] A. Administer the insulin as scheduled regardless of food intake.
[ ] B. Hold the insulin until the meal tray arrives and the patient is ready to eat.
[ ] C. Administer half the dose now and the rest after the meal.
[ ] D. Give the insulin with a glass of orange juice to prevent hypoglycemia.
HIGHP - Page 4 of 48
Correct Answers with Detailed Rationales |
Joyce University of Nursing and Health
Sciences | 2026 Update.
Practice Question Bank & Answer Rationale
THIS PACK CONTAINS
148 exam-style multiple-choice questions. Each question includes the correct answer and a complete
rationale for focused revision.
COVERAGE
This exam assesses applied pharmacology for nursing practice, including pharmacokinetics and
pharmacodynamics, autonomic and cardiovascular agents, antimicrobials, endocrine and psychotropic drugs,
toxicology, and patient safety principles such as high-alert medications, interactions, and antidotes. Items
require clinical application, calculation, and interpretation of laboratory or prescription data consistent with
contemporary US nursing standards.
STUDY GUIDE
Recommended duration: 2 hours. Passing target: 75% (minimum 38/50 correct).
HIGHP - Page 1 of 48
,1. A patient with severe sepsis is prescribed gentamicin IV. Which laboratory value is the
most important to monitor to reduce the risk of nephrotoxicity?
[ ] A. Serum creatinine and trough drug level
[ ] B. Serum potassium and peak drug level
[ ] C. Hemoglobin and hematocrit
[ ] D. Platelet count and INR
CORRECT: A. Serum creatinine and trough drug level
Aminoglycosides like gentamicin are nephrotoxic and ototoxic; renal function (serum creatinine) and trough
levels (to ensure adequate clearance and avoid accumulation) are the key monitoring parameters. Peak
levels relate more to efficacy, while potassium, hemoglobin, and INR are not primary indicators of
aminoglycoside nephrotoxicity.
2. Which statement by a patient prescribed warfarin indicates a correct understanding of
dietary vitamin K interaction?
[ ] A. "I will increase my leafy green vegetables to boost the effect of warfarin."
[ ] B. "I will keep my intake of leafy green vegetables consistent each day."
[ ] C. "I will avoid all foods containing vitamin K while taking warfarin."
[ ] D. "I will take a vitamin K supplement to prevent bleeding."
CORRECT: B. "I will keep my intake of leafy green vegetables consistent each day."
Warfarin's anticoagulant effect is antagonized by vitamin K; maintaining a consistent daily intake of vitamin
K-rich foods (e.g., leafy greens) stabilizes the INR rather than fluctuating it. Increasing intake would decrease
warfarin's effect, complete avoidance is unnecessary and impractical, and vitamin K supplements would
directly antagonize warfarin.
3. A patient taking fluoxetine is now prescribed tramadol for pain. Which adverse effect
should the nurse prioritize monitoring for?
[ ] A. Serotonin syndrome
[ ] B. Hypertensive crisis
[ ] C. Severe hypoglycemia
[ ] D. Acute renal failure
CORRECT: A. Serotonin syndrome
Both fluoxetine (SSRI) and tramadol increase serotonin levels, creating a risk for serotonin syndrome
(agitation, hyperthermia, clonus, tachycardia). Hypertensive crisis is associated with MAOIs and tyramine,
hypoglycemia with insulin or sulfonylureas, and renal failure with nephrotoxic drugs, not this combination.
HIGHP - Page 2 of 48
,4. A patient with myasthenia gravis is prescribed pyridostigmine. Which assessment
finding indicates the dose may be excessive?
[ ] A. Increased muscle strength
[ ] B. Bradycardia and increased salivation
[ ] C. Improved ptosis and diplopia
[ ] D. Decreased respiratory secretions
CORRECT: B. Bradycardia and increased salivation
Pyridostigmine is a cholinesterase inhibitor; excessive dosing causes cholinergic crisis with bradycardia,
excessive salivation, lacrimation, and diarrhea. Increased muscle strength, improved ptosis, and decreased
secretions indicate therapeutic effect, not toxicity.
5. A patient with an acute asthma exacerbation is prescribed albuterol via nebulizer.
Which finding indicates the medication is effective?
[ ] A. Decreased peak expiratory flow
[ ] B. Increased wheezing
[ ] C. Improved oxygen saturation and decreased respiratory rate
[ ] D. Development of bradycardia
CORRECT: C. Improved oxygen saturation and decreased respiratory rate
Albuterol is a short-acting beta2 agonist that causes bronchodilation, improving oxygenation and reducing
respiratory effort. Decreased peak flow and increased wheezing indicate worsening bronchospasm, and
bradycardia is not an expected therapeutic effect (tachycardia is more common).
6. A patient is prescribed levothyroxine. Which instruction should the nurse include in
teaching?
[ ] A. Take the medication at bedtime with a snack.
[ ] B. Take the medication in the morning on an empty stomach.
[ ] C. Take the medication with calcium supplements.
[ ] D. Stop the medication once energy levels improve.
CORRECT: B. Take the medication in the morning on an empty stomach.
Levothyroxine absorption is enhanced when taken on an empty stomach in the morning, 30-60 minutes
before breakfast. Taking it with food or calcium reduces absorption, and therapy is lifelong for hypothyroidism,
so it should not be stopped when symptoms improve.
7. A patient receiving IV vancomycin develops flushing of the face, neck, and upper torso
with itching during infusion. Which action should the nurse take first?
[ ] A. Stop the infusion and notify the provider.
[ ] B. Slow the infusion rate and administer an antihistamine as ordered.
HIGHP - Page 3 of 48
, [ ] C. Increase the infusion rate to finish the dose quickly.
[ ] D. Document the finding as an expected effect and continue.
CORRECT: B. Slow the infusion rate and administer an antihistamine as ordered.
This is vancomycin infusion reaction (formerly 'red man syndrome'), related to rapid infusion; slowing the rate
and giving an antihistamine (if ordered) resolves symptoms. Stopping the infusion entirely may be
unnecessary unless severe, increasing the rate worsens the reaction, and it should not be ignored.
8. A patient is prescribed digoxin. Which assessment finding should the nurse report
immediately?
[ ] A. Heart rate 58 beats/min and nausea
[ ] B. Blood pressure 110/70 mm Hg
[ ] C. Serum potassium 4.0 mEq/L
[ ] D. Respiratory rate 18 breaths/min
CORRECT: A. Heart rate 58 beats/min and nausea
Digoxin toxicity often presents with bradycardia, nausea, vomiting, and visual disturbances; a heart rate
below 60 with nausea warrants immediate reporting. The other findings are within normal limits and do not
indicate toxicity.
9. A patient is prescribed furosemide. Which laboratory value should the nurse monitor
most closely?
[ ] A. Serum sodium
[ ] B. Serum potassium
[ ] C. Serum calcium
[ ] D. Serum magnesium
CORRECT: B. Serum potassium
Loop diuretics like furosemide cause significant potassium loss, leading to hypokalemia and increased risk of
dysrhythmias, especially in patients on digoxin. While sodium, calcium, and magnesium can also be affected,
potassium is the most critical and commonly monitored electrolyte.
10. A patient is prescribed a scheduled dose of insulin glargine at 0900. The patient's
breakfast tray has not arrived. Which action is most appropriate?
[ ] A. Administer the insulin as scheduled regardless of food intake.
[ ] B. Hold the insulin until the meal tray arrives and the patient is ready to eat.
[ ] C. Administer half the dose now and the rest after the meal.
[ ] D. Give the insulin with a glass of orange juice to prevent hypoglycemia.
HIGHP - Page 4 of 48
