NSG 124 Exam 2 Actual Exam V3 | NSG 124 Pharmacology (NSG124
Exam 2) | Herzing University PDF
1. A patient is prescribed Digoxin 0.125 mg daily. Before administration, the nurse notes the
patient’s apical pulse is 52 beats per minute. What is the priority nursing action?
A. Hold the medication and notify the healthcare provider.
B. Administer the medication and document the heart rate.
C. Re-check the pulse in 30 minutes using a radial site.
D. Administer the dose with a full glass of water.
Answer: A
Rationale: The nurse must assess the apical pulse for one full minute prior to
administering Digoxin. If the heart rate is less than 60 beats per minute in an adult, the
dose should be withheld to prevent further bradycardia. The provider must be notified to
determine if the dose should be adjusted or discontinued due to potential toxicity.
2. A client receiving Furosemide (Lasix) reports feeling ‘skipped heartbeats’ and muscle
weakness. Which laboratory result would the nurse expect to find?
A. Sodium 142 mEq/L
B. Calcium 9.5 mg/dL
C. Creatinine 0.9 mg/dL
D. Potassium 2.8 mEq/L
Answer: D
Rationale: Furosemide is a loop diuretic that causes significant excretion of potassium
through the kidneys. A potassium level of 2.8 mEq/L indicates hypokalemia, which
commonly manifests as cardiac arrhythmias and muscle weakness. The nurse should
monitor electrolyte levels closely and anticipate the need for potassium replacement
therapy.
3. Which of the following teaching points is most important for a patient newly prescribed
Lisinopril for hypertension?
A. Report a persistent dry cough to the healthcare provider.
B. Increase intake of potassium-rich foods like bananas.
C. Expect a yellowing of the skin as a common side effect.
D. Take the medication with an antacid to prevent upset stomach.
,Answer: A
Rationale: A persistent dry, non-productive cough is a common side effect of ACE
inhibitors like Lisinopril due to the accumulation of bradykinin. Patients should be taught
to report this symptom as it often leads to the discontinuation of the drug. Furthermore,
ACE inhibitors can cause hyperkalemia, so increasing potassium intake is generally
discouraged.
4. A patient is admitted with deep vein thrombosis and started on a continuous Heparin
infusion. Which laboratory value is used to monitor the therapeutic effect of this medication?
A. Activated Partial Thromboplastin Time (aPTT)
B. Prothrombin Time (PT)
C. International Normalized Ratio (INR)
D. Platelet count
Answer: A
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated heparin therapy. The therapeutic range is typically 1.5 to 2.5 times the
normal control value. Nurses must monitor this value frequently to adjust the dosage
according to hospital protocols and prevent bleeding or clotting.
5. The nurse is preparing to administer Warfarin (Coumadin) to a client. Which of the
following findings would cause the nurse to hold the medication?
A. INR of 2.5
B. PT of 18 seconds
C. Presence of dark, tarry stools
D. Blood pressure of 130/80 mmHg
Answer: C
Rationale: Dark, tarry stools (melena) are a sign of internal gastrointestinal bleeding,
which is a major complication of anticoagulant therapy. If bleeding is suspected, the nurse
must hold the dose and notify the provider for further assessment. While an INR of 2.5 is
therapeutic, evidence of active bleeding takes priority over lab values.
6. A client is prescribed Spironolactone (Aldactone). Which dietary choice indicates the client
needs further teaching?
A. Eating small, frequent meals throughout the day.
B. Reducing the intake of high-sodium processed foods.
C. Drinking 2 liters of water per day.
, D. Switching to a salt substitute containing potassium chloride.
Answer: D
Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia.
Salt substitutes often contain potassium chloride instead of sodium chloride, which
increases the risk of dangerously high potassium levels. The client should be educated to
avoid these substitutes and limit high-potassium foods while on this medication.
7. What is the antidote for a patient experiencing a life-threatening hemorrhage due to
Heparin toxicity?
A. Vitamin K
B. Flumazenil
C. Acetylcysteine
D. Protamine Sulfate
Answer: D
Rationale: Protamine sulfate is the specific reversal agent for unfractionated heparin and
low-molecular-weight heparin. It works by binding to heparin to form a stable salt,
neutralizing its anticoagulant effect. Vitamin K is the antidote for Warfarin, while the other
options are for different types of toxicity.
8. A patient with chronic stable angina is prescribed Nitroglycerin sublingual tablets. What
instructions should the nurse provide regarding administration?
A. Swallow the tablet whole with a full glass of water.
B. Take the medication only before bedtime.
C. Place the tablet under the tongue and let it dissolve.
D. Crush the tablet and mix it with applesauce.
Answer: C
Rationale: Sublingual nitroglycerin is designed to be absorbed through the oral mucosa to
bypass the first-pass effect of the liver. Patients should be taught to place the tablet under
the tongue and avoid swallowing until it is completely dissolved. If chest pain persists after
the first dose, the patient should follow the prescribed emergency protocol, usually
involving calling 911.
9. A patient taking Atorvastatin (Lipitor) reports unexplained muscle pain and dark-colored
urine. Which complication does the nurse suspect?
A. Liver failure
B. Rhabdomyolysis
Exam 2) | Herzing University PDF
1. A patient is prescribed Digoxin 0.125 mg daily. Before administration, the nurse notes the
patient’s apical pulse is 52 beats per minute. What is the priority nursing action?
A. Hold the medication and notify the healthcare provider.
B. Administer the medication and document the heart rate.
C. Re-check the pulse in 30 minutes using a radial site.
D. Administer the dose with a full glass of water.
Answer: A
Rationale: The nurse must assess the apical pulse for one full minute prior to
administering Digoxin. If the heart rate is less than 60 beats per minute in an adult, the
dose should be withheld to prevent further bradycardia. The provider must be notified to
determine if the dose should be adjusted or discontinued due to potential toxicity.
2. A client receiving Furosemide (Lasix) reports feeling ‘skipped heartbeats’ and muscle
weakness. Which laboratory result would the nurse expect to find?
A. Sodium 142 mEq/L
B. Calcium 9.5 mg/dL
C. Creatinine 0.9 mg/dL
D. Potassium 2.8 mEq/L
Answer: D
Rationale: Furosemide is a loop diuretic that causes significant excretion of potassium
through the kidneys. A potassium level of 2.8 mEq/L indicates hypokalemia, which
commonly manifests as cardiac arrhythmias and muscle weakness. The nurse should
monitor electrolyte levels closely and anticipate the need for potassium replacement
therapy.
3. Which of the following teaching points is most important for a patient newly prescribed
Lisinopril for hypertension?
A. Report a persistent dry cough to the healthcare provider.
B. Increase intake of potassium-rich foods like bananas.
C. Expect a yellowing of the skin as a common side effect.
D. Take the medication with an antacid to prevent upset stomach.
,Answer: A
Rationale: A persistent dry, non-productive cough is a common side effect of ACE
inhibitors like Lisinopril due to the accumulation of bradykinin. Patients should be taught
to report this symptom as it often leads to the discontinuation of the drug. Furthermore,
ACE inhibitors can cause hyperkalemia, so increasing potassium intake is generally
discouraged.
4. A patient is admitted with deep vein thrombosis and started on a continuous Heparin
infusion. Which laboratory value is used to monitor the therapeutic effect of this medication?
A. Activated Partial Thromboplastin Time (aPTT)
B. Prothrombin Time (PT)
C. International Normalized Ratio (INR)
D. Platelet count
Answer: A
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated heparin therapy. The therapeutic range is typically 1.5 to 2.5 times the
normal control value. Nurses must monitor this value frequently to adjust the dosage
according to hospital protocols and prevent bleeding or clotting.
5. The nurse is preparing to administer Warfarin (Coumadin) to a client. Which of the
following findings would cause the nurse to hold the medication?
A. INR of 2.5
B. PT of 18 seconds
C. Presence of dark, tarry stools
D. Blood pressure of 130/80 mmHg
Answer: C
Rationale: Dark, tarry stools (melena) are a sign of internal gastrointestinal bleeding,
which is a major complication of anticoagulant therapy. If bleeding is suspected, the nurse
must hold the dose and notify the provider for further assessment. While an INR of 2.5 is
therapeutic, evidence of active bleeding takes priority over lab values.
6. A client is prescribed Spironolactone (Aldactone). Which dietary choice indicates the client
needs further teaching?
A. Eating small, frequent meals throughout the day.
B. Reducing the intake of high-sodium processed foods.
C. Drinking 2 liters of water per day.
, D. Switching to a salt substitute containing potassium chloride.
Answer: D
Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia.
Salt substitutes often contain potassium chloride instead of sodium chloride, which
increases the risk of dangerously high potassium levels. The client should be educated to
avoid these substitutes and limit high-potassium foods while on this medication.
7. What is the antidote for a patient experiencing a life-threatening hemorrhage due to
Heparin toxicity?
A. Vitamin K
B. Flumazenil
C. Acetylcysteine
D. Protamine Sulfate
Answer: D
Rationale: Protamine sulfate is the specific reversal agent for unfractionated heparin and
low-molecular-weight heparin. It works by binding to heparin to form a stable salt,
neutralizing its anticoagulant effect. Vitamin K is the antidote for Warfarin, while the other
options are for different types of toxicity.
8. A patient with chronic stable angina is prescribed Nitroglycerin sublingual tablets. What
instructions should the nurse provide regarding administration?
A. Swallow the tablet whole with a full glass of water.
B. Take the medication only before bedtime.
C. Place the tablet under the tongue and let it dissolve.
D. Crush the tablet and mix it with applesauce.
Answer: C
Rationale: Sublingual nitroglycerin is designed to be absorbed through the oral mucosa to
bypass the first-pass effect of the liver. Patients should be taught to place the tablet under
the tongue and avoid swallowing until it is completely dissolved. If chest pain persists after
the first dose, the patient should follow the prescribed emergency protocol, usually
involving calling 911.
9. A patient taking Atorvastatin (Lipitor) reports unexplained muscle pain and dark-colored
urine. Which complication does the nurse suspect?
A. Liver failure
B. Rhabdomyolysis
