NSG 124 Exam 2 Actual Exam V2 | NSG 124 Pharmacology (NSG124
Exam 2) | Herzing University PDF
1. A nurse is caring for a patient newly prescribed lisinopril for hypertension. The patient
reports a persistent, dry, nonproductive cough. Which action should the nurse take?
A. Instruct the patient to use a humidifier and continue the medication.
B. Notify the healthcare provider as this is a common adverse effect of ACE inhibitors.
C. Suggest the patient take an over-the-counter cough suppressant.
D. Assess the patient for signs of a secondary bacterial lung infection.
Answer: B
Rationale: The dry cough associated with ACE inhibitors like lisinopril is caused by the
accumulation of bradykinin. This side effect is a common reason for patients to discontinue
the medication. The nurse should notify the provider because the patient may need to
switch to an Angiotensin II Receptor Blocker (ARB).
2. A patient with heart failure is receiving digoxin. Which laboratory value should the nurse
monitor most closely to prevent digoxin toxicity?
A. Serum sodium level
B. Serum calcium level
C. Serum potassium level
D. Serum glucose level
Answer: C
Rationale: Hypokalemia, or low potassium, significantly increases the risk of digoxin
toxicity because digoxin and potassium compete for the same binding sites. The nurse must
ensure the patient’s potassium remains within the normal range of 3.5 to 5.0 mEq/L.
Monitoring this value is critical for patient safety during heart failure management.
3. A nurse is preparing to administer furosemide 40 mg IV push to a patient with pulmonary
edema. How should the nurse proceed with the administration?
A. Administer the dose rapidly over 30 seconds to ensure immediate effect.
B. Dilute the medication in 100 mL of Normal Saline and infuse over 1 hour.
C. Wait until the patient has a urinary catheter placed before giving the dose.
D. Administer the dose slowly over 1 to 2 minutes to prevent ototoxicity.
Answer: D
,Rationale: Furosemide is a potent loop diuretic that can cause permanent hearing loss or
tinnitus if administered too quickly via the IV route. Standard practice requires slow
administration, typically at a rate of 20 mg per minute. This precaution ensures the patient
experiences diuresis without suffering neurosensory damage.
4. A patient is being discharged on warfarin following a deep vein thrombosis (DVT). Which
statement by the patient indicates a need for further teaching?
A. I will use an electric razor instead of a manual one for shaving.
B. I need to have my blood checked regularly for my INR level.
C. I should increase my intake of spinach and kale to stay healthy.
D. I will report any unusual bruising or dark stools to my doctor.
Answer: C
Rationale: Spinach and kale are high in Vitamin K, which acts as the antidote to warfarin
and can decrease its effectiveness. Patients should maintain a consistent intake of Vitamin
K rather than increasing or decreasing it abruptly. The other statements correctly reflect
safety precautions needed for anticoagulant therapy.
5. A patient is prescribed atorvastatin for the management of hyperlipidemia. Which
symptom should the nurse instruct the patient to report immediately?
A. Mild headache after taking the dose
B. Occasional flatulence and bloating
C. Increased appetite and weight gain
D. Unexplained muscle pain or weakness
Answer: D
Rationale: Muscle pain, tenderness, or weakness can be a sign of rhabdomyolysis, a rare
but serious breakdown of muscle tissue caused by statins. This condition can lead to acute
renal failure and requires immediate medical intervention. The nurse should emphasize
reporting these symptoms to prevent life-threatening complications.
6. A nurse is reviewing the medication list for a patient with a history of asthma who was
recently diagnosed with hypertension. Which medication should the nurse question?
A. Amlodipine
B. Hydrochlorothiazide
C. Metoprolol
D. Propranolol
Answer: D
, Rationale: Propranolol is a non-selective beta-blocker that blocks both beta-1 and beta-2
receptors, potentially causing bronchoconstriction in patients with asthma. Cardioselective
beta-blockers like metoprolol are generally safer but still used with caution. The nurse
must advocate for the patient to avoid medications that could trigger respiratory distress.
7. A patient is receiving a continuous intravenous heparin infusion for a pulmonary embolism.
The nurse notes the patient’s aPTT is 110 seconds (Control: 30 seconds). What is the priority
action?
A. Stop the infusion and notify the healthcare provider.
B. Increase the infusion rate to reach a therapeutic level.
C. Continue the infusion and recheck the aPTT in 6 hours.
D. Administer Vitamin K as the specific reversal agent.
Answer: A
Rationale: An aPTT of 110 seconds is significantly above the therapeutic range (usually 1.5
to 2.5 times the control, or 45-75 seconds). This places the patient at a high risk for
spontaneous bleeding. The nurse must stop the medication immediately and communicate
with the provider regarding the next steps.
8. Which of the following instructions should the nurse include for a patient starting
spironolactone?
A. Avoid foods high in potassium, such as bananas and oranges.
B. Take the medication at bedtime to maximize its effectiveness.
C. Use a salt substitute to reduce your overall sodium intake.
D. Drink at least 4 liters of water daily to maintain hydration.
Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic that blocks aldosterone, leading
to the retention of potassium. Consuming high-potassium foods or using salt substitutes
(which often contain potassium chloride) increases the risk of hyperkalemia. The nurse
should teach the patient to monitor their intake of these substances carefully.
9. A patient with chronic heart failure is prescribed carvedilol. What is a primary nursing
responsibility before administering the first dose?
A. Ensure the patient has not eaten for at least 4 hours.
B. Evaluate the patient’s serum BUN and creatinine levels.
C. Measure the patient’s abdominal girth.
D. Check the apical pulse and blood pressure.
Exam 2) | Herzing University PDF
1. A nurse is caring for a patient newly prescribed lisinopril for hypertension. The patient
reports a persistent, dry, nonproductive cough. Which action should the nurse take?
A. Instruct the patient to use a humidifier and continue the medication.
B. Notify the healthcare provider as this is a common adverse effect of ACE inhibitors.
C. Suggest the patient take an over-the-counter cough suppressant.
D. Assess the patient for signs of a secondary bacterial lung infection.
Answer: B
Rationale: The dry cough associated with ACE inhibitors like lisinopril is caused by the
accumulation of bradykinin. This side effect is a common reason for patients to discontinue
the medication. The nurse should notify the provider because the patient may need to
switch to an Angiotensin II Receptor Blocker (ARB).
2. A patient with heart failure is receiving digoxin. Which laboratory value should the nurse
monitor most closely to prevent digoxin toxicity?
A. Serum sodium level
B. Serum calcium level
C. Serum potassium level
D. Serum glucose level
Answer: C
Rationale: Hypokalemia, or low potassium, significantly increases the risk of digoxin
toxicity because digoxin and potassium compete for the same binding sites. The nurse must
ensure the patient’s potassium remains within the normal range of 3.5 to 5.0 mEq/L.
Monitoring this value is critical for patient safety during heart failure management.
3. A nurse is preparing to administer furosemide 40 mg IV push to a patient with pulmonary
edema. How should the nurse proceed with the administration?
A. Administer the dose rapidly over 30 seconds to ensure immediate effect.
B. Dilute the medication in 100 mL of Normal Saline and infuse over 1 hour.
C. Wait until the patient has a urinary catheter placed before giving the dose.
D. Administer the dose slowly over 1 to 2 minutes to prevent ototoxicity.
Answer: D
,Rationale: Furosemide is a potent loop diuretic that can cause permanent hearing loss or
tinnitus if administered too quickly via the IV route. Standard practice requires slow
administration, typically at a rate of 20 mg per minute. This precaution ensures the patient
experiences diuresis without suffering neurosensory damage.
4. A patient is being discharged on warfarin following a deep vein thrombosis (DVT). Which
statement by the patient indicates a need for further teaching?
A. I will use an electric razor instead of a manual one for shaving.
B. I need to have my blood checked regularly for my INR level.
C. I should increase my intake of spinach and kale to stay healthy.
D. I will report any unusual bruising or dark stools to my doctor.
Answer: C
Rationale: Spinach and kale are high in Vitamin K, which acts as the antidote to warfarin
and can decrease its effectiveness. Patients should maintain a consistent intake of Vitamin
K rather than increasing or decreasing it abruptly. The other statements correctly reflect
safety precautions needed for anticoagulant therapy.
5. A patient is prescribed atorvastatin for the management of hyperlipidemia. Which
symptom should the nurse instruct the patient to report immediately?
A. Mild headache after taking the dose
B. Occasional flatulence and bloating
C. Increased appetite and weight gain
D. Unexplained muscle pain or weakness
Answer: D
Rationale: Muscle pain, tenderness, or weakness can be a sign of rhabdomyolysis, a rare
but serious breakdown of muscle tissue caused by statins. This condition can lead to acute
renal failure and requires immediate medical intervention. The nurse should emphasize
reporting these symptoms to prevent life-threatening complications.
6. A nurse is reviewing the medication list for a patient with a history of asthma who was
recently diagnosed with hypertension. Which medication should the nurse question?
A. Amlodipine
B. Hydrochlorothiazide
C. Metoprolol
D. Propranolol
Answer: D
, Rationale: Propranolol is a non-selective beta-blocker that blocks both beta-1 and beta-2
receptors, potentially causing bronchoconstriction in patients with asthma. Cardioselective
beta-blockers like metoprolol are generally safer but still used with caution. The nurse
must advocate for the patient to avoid medications that could trigger respiratory distress.
7. A patient is receiving a continuous intravenous heparin infusion for a pulmonary embolism.
The nurse notes the patient’s aPTT is 110 seconds (Control: 30 seconds). What is the priority
action?
A. Stop the infusion and notify the healthcare provider.
B. Increase the infusion rate to reach a therapeutic level.
C. Continue the infusion and recheck the aPTT in 6 hours.
D. Administer Vitamin K as the specific reversal agent.
Answer: A
Rationale: An aPTT of 110 seconds is significantly above the therapeutic range (usually 1.5
to 2.5 times the control, or 45-75 seconds). This places the patient at a high risk for
spontaneous bleeding. The nurse must stop the medication immediately and communicate
with the provider regarding the next steps.
8. Which of the following instructions should the nurse include for a patient starting
spironolactone?
A. Avoid foods high in potassium, such as bananas and oranges.
B. Take the medication at bedtime to maximize its effectiveness.
C. Use a salt substitute to reduce your overall sodium intake.
D. Drink at least 4 liters of water daily to maintain hydration.
Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic that blocks aldosterone, leading
to the retention of potassium. Consuming high-potassium foods or using salt substitutes
(which often contain potassium chloride) increases the risk of hyperkalemia. The nurse
should teach the patient to monitor their intake of these substances carefully.
9. A patient with chronic heart failure is prescribed carvedilol. What is a primary nursing
responsibility before administering the first dose?
A. Ensure the patient has not eaten for at least 4 hours.
B. Evaluate the patient’s serum BUN and creatinine levels.
C. Measure the patient’s abdominal girth.
D. Check the apical pulse and blood pressure.
