NSG 124 Exam 2 Actual Exam V1 | NSG 124 Pharmacology (NSG124
Exam 2) | Herzing University PDF
1. A patient newly prescribed lisinopril for hypertension reports a persistent, dry cough to the
nurse. Which action should the nurse take next?
A. Instruct the patient to take the medication with food.
B. Advise the patient that this is a common side effect and will resolve.
C. Notify the healthcare provider as the medication may need to be changed.
D. Administer an over-the-counter cough suppressant.
Answer: C
Rationale: A dry, non-productive cough is a classic side effect of ACE inhibitors due to the
accumulation of bradykinin in the respiratory tract. Because this symptom often persists
and affects compliance, the provider should be notified to consider switching the patient to
an Angiotensin II Receptor Blocker (ARB). Simply advising the patient to wait or using a
cough suppressant is generally ineffective for this specific drug-induced cough.
2. A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding would require the nurse to hold the medication?
A. Blood pressure of 140/90 mmHg
B. Apical pulse of 52 beats per minute
C. Respiratory rate of 20 breaths per minute
D. Serum potassium level of 4.5 mEq/L
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate while increasing the
force of contraction. Before administration, the nurse must assess the apical pulse for one
full minute and hold the dose if the heart rate is less than 60 beats per minute. Failing to do
so can lead to dangerous bradycardia or indicate worsening digoxin toxicity.
3. Which medication is the designated antidote for a patient experiencing life-threatening
bleeding while on warfarin therapy?
A. Protamine sulfate
B. Glucagon
C. Acetylcysteine
D. Vitamin K
,Answer: D
Rationale: Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting
factors. Therefore, Vitamin K (phytonadione) is the specific antidote used to reverse its
anticoagulant effects. The nurse must also monitor the International Normalized Ratio
(INR) to evaluate the effectiveness of the reversal.
4. A patient is receiving furosemide for the treatment of peripheral edema. Which electrolyte
imbalance should the nurse monitor for most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypercalcemia
Answer: A
Rationale: Furosemide is a loop diuretic that promotes the excretion of water, sodium, and
potassium in the kidneys. Loss of potassium is a significant risk, potentially leading to
cardiac dysrhythmias and muscle weakness. The nurse should encourage the intake of
potassium-rich foods or monitor the need for oral potassium supplements.
5. A nurse is reviewing the lab results of a patient taking spironolactone. Which finding would
be most concerning?
A. Sodium 138 mEq/L
B. Potassium 5.8 mEq/L
C. Glucose 110 mg/dL
D. Magnesium 2.0 mEq/L
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that inhibits aldosterone,
leading to the retention of potassium. A level of 5.8 mEq/L indicates hyperkalemia, which
can cause life-threatening cardiac arrhythmias. The nurse must educate the patient to
avoid salt substitutes containing potassium and to limit high-potassium foods.
6. A patient with a history of asthma is prescribed propranolol for hypertension. Why should
the nurse question this order?
A. Non-selective beta-blockers can cause bronchoconstriction.
B. Propranolol causes excessive sedation.
C. Beta-blockers increase the risk of hyperglycemia.
D. Propranolol is only used for heart failure, not hypertension.
, Answer: A
Rationale: Propranolol is a non-selective beta-adrenergic blocker that affects both Beta-1
(heart) and Beta-2 (lungs) receptors. Blocking Beta-2 receptors can trigger bronchospasm
in patients with reactive airway diseases like asthma. A cardioselective beta-blocker, such
as metoprolol, would be a safer alternative for this patient.
7. The nurse is teaching a patient about sublingual nitroglycerin for stable angina. Which
instruction is correct?
A. Swallow the tablet with a full glass of water.
B. Store the tablets in a clear plastic container for easy access.
C. Take up to five tablets every 10 minutes if pain persists.
D. Call 911 if the pain is not relieved after the first dose.
Answer: D
Rationale: Nitroglycerin should be placed under the tongue and allowed to dissolve
completely for rapid absorption. Current protocols suggest that if chest pain is not relieved
or worsens 5 minutes after the first dose, the patient should call emergency services.
Tablets must be kept in their original dark glass bottle to prevent degradation by light and
moisture.
8. A patient is receiving a continuous intravenous heparin infusion for a deep vein thrombosis
(DVT). Which laboratory value will the nurse monitor to adjust the dosage?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Answer: C
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated heparin therapy. The nurse adjusts the infusion rate based on the hospital’s
protocol to maintain the aPTT within a therapeutic range, usually 1.5 to 2.5 times the
control value. While PT and INR are used for warfarin, aPTT is specific to heparin
monitoring.
9. A patient taking atorvastatin reports new-onset muscle aches and weakness. What is the
nurse’s priority action?
A. Advise the patient to increase their fluid intake.
B. Instruct the patient to stop the medication and come in for a blood test.
C. Tell the patient to take the medication in the morning.
Exam 2) | Herzing University PDF
1. A patient newly prescribed lisinopril for hypertension reports a persistent, dry cough to the
nurse. Which action should the nurse take next?
A. Instruct the patient to take the medication with food.
B. Advise the patient that this is a common side effect and will resolve.
C. Notify the healthcare provider as the medication may need to be changed.
D. Administer an over-the-counter cough suppressant.
Answer: C
Rationale: A dry, non-productive cough is a classic side effect of ACE inhibitors due to the
accumulation of bradykinin in the respiratory tract. Because this symptom often persists
and affects compliance, the provider should be notified to consider switching the patient to
an Angiotensin II Receptor Blocker (ARB). Simply advising the patient to wait or using a
cough suppressant is generally ineffective for this specific drug-induced cough.
2. A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding would require the nurse to hold the medication?
A. Blood pressure of 140/90 mmHg
B. Apical pulse of 52 beats per minute
C. Respiratory rate of 20 breaths per minute
D. Serum potassium level of 4.5 mEq/L
Answer: B
Rationale: Digoxin is a cardiac glycoside that slows the heart rate while increasing the
force of contraction. Before administration, the nurse must assess the apical pulse for one
full minute and hold the dose if the heart rate is less than 60 beats per minute. Failing to do
so can lead to dangerous bradycardia or indicate worsening digoxin toxicity.
3. Which medication is the designated antidote for a patient experiencing life-threatening
bleeding while on warfarin therapy?
A. Protamine sulfate
B. Glucagon
C. Acetylcysteine
D. Vitamin K
,Answer: D
Rationale: Warfarin works by inhibiting the synthesis of vitamin K-dependent clotting
factors. Therefore, Vitamin K (phytonadione) is the specific antidote used to reverse its
anticoagulant effects. The nurse must also monitor the International Normalized Ratio
(INR) to evaluate the effectiveness of the reversal.
4. A patient is receiving furosemide for the treatment of peripheral edema. Which electrolyte
imbalance should the nurse monitor for most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hypernatremia
D. Hypercalcemia
Answer: A
Rationale: Furosemide is a loop diuretic that promotes the excretion of water, sodium, and
potassium in the kidneys. Loss of potassium is a significant risk, potentially leading to
cardiac dysrhythmias and muscle weakness. The nurse should encourage the intake of
potassium-rich foods or monitor the need for oral potassium supplements.
5. A nurse is reviewing the lab results of a patient taking spironolactone. Which finding would
be most concerning?
A. Sodium 138 mEq/L
B. Potassium 5.8 mEq/L
C. Glucose 110 mg/dL
D. Magnesium 2.0 mEq/L
Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that inhibits aldosterone,
leading to the retention of potassium. A level of 5.8 mEq/L indicates hyperkalemia, which
can cause life-threatening cardiac arrhythmias. The nurse must educate the patient to
avoid salt substitutes containing potassium and to limit high-potassium foods.
6. A patient with a history of asthma is prescribed propranolol for hypertension. Why should
the nurse question this order?
A. Non-selective beta-blockers can cause bronchoconstriction.
B. Propranolol causes excessive sedation.
C. Beta-blockers increase the risk of hyperglycemia.
D. Propranolol is only used for heart failure, not hypertension.
, Answer: A
Rationale: Propranolol is a non-selective beta-adrenergic blocker that affects both Beta-1
(heart) and Beta-2 (lungs) receptors. Blocking Beta-2 receptors can trigger bronchospasm
in patients with reactive airway diseases like asthma. A cardioselective beta-blocker, such
as metoprolol, would be a safer alternative for this patient.
7. The nurse is teaching a patient about sublingual nitroglycerin for stable angina. Which
instruction is correct?
A. Swallow the tablet with a full glass of water.
B. Store the tablets in a clear plastic container for easy access.
C. Take up to five tablets every 10 minutes if pain persists.
D. Call 911 if the pain is not relieved after the first dose.
Answer: D
Rationale: Nitroglycerin should be placed under the tongue and allowed to dissolve
completely for rapid absorption. Current protocols suggest that if chest pain is not relieved
or worsens 5 minutes after the first dose, the patient should call emergency services.
Tablets must be kept in their original dark glass bottle to prevent degradation by light and
moisture.
8. A patient is receiving a continuous intravenous heparin infusion for a deep vein thrombosis
(DVT). Which laboratory value will the nurse monitor to adjust the dosage?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Activated partial thromboplastin time (aPTT)
D. Platelet count
Answer: C
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
unfractionated heparin therapy. The nurse adjusts the infusion rate based on the hospital’s
protocol to maintain the aPTT within a therapeutic range, usually 1.5 to 2.5 times the
control value. While PT and INR are used for warfarin, aPTT is specific to heparin
monitoring.
9. A patient taking atorvastatin reports new-onset muscle aches and weakness. What is the
nurse’s priority action?
A. Advise the patient to increase their fluid intake.
B. Instruct the patient to stop the medication and come in for a blood test.
C. Tell the patient to take the medication in the morning.
