NSG124 Pharmacology Exam 2 2026/2027 -
100% Correct Questions & Graded A Verified
Answers for Herzing University
Module 1: Pharmacokinetics & Safety Principles
1. A 72-year-old patient with moderate renal impairment (estimated CrCl 40
mL/min) is prescribed gentamicin for a severe infection. Which nursing action is
most critical for safe administration?
A) Administer the medication with food to reduce GI upset.
B) Monitor peak and trough serum levels as ordered.
C) Ensure the patient is well-hydrated before the first dose.
D) Assess for hearing loss (ototoxicity) at the end of the therapy.
Correct Answer: B
Correct Answer Text: Monitor peak and trough serum levels as ordered.
Rationale: Gentamicin is a nephrotoxic and ototoxic aminoglycoside excreted renally. In
renal impairment, drug accumulation is a major risk. Monitoring peak (efficacy) and
trough (toxicity) levels is essential to adjust the dose and interval, preventing permanent
kidney damage and hearing loss. While hydration (C) and assessing for ototoxicity (D)
are important, therapeutic drug monitoring is the most critical safety intervention.
Administering with food (A) is not standard for IV gentamicin.
2. A nurse is preparing to administer warfarin 5 mg PO to a patient. The patient’s
current INR is 4.2. What is the nurse’s priority action?
A) Administer the dose as scheduled and recheck the INR tomorrow.
B) Withhold the dose and notify the prescribing provider immediately.
C) Administer vitamin K concurrently as a reversal agent.
D) Confirm the patient has not consumed any green leafy vegetables.
, Correct Answer: B
Correct Answer Text: Withhold the dose and notify the prescribing provider immediately.
Rationale: An INR of 4.2 is significantly above the typical therapeutic range (often
2.0-3.0), indicating a high risk of bleeding. The nurse must withhold the dose (a
dependent intervention) and notify the provider for further orders (e.g., dose hold,
reduction, or possible reversal). Administering the dose (A) would be dangerous.
Administering vitamin K (C) requires a specific order. While diet education (D) is
important, it does not address the immediate safety threat.
3. A patient with Type 1 Diabetes is prescribed regular insulin via sliding scale. The
nurse should monitor for signs of hypoglycemia most closely at which time after
administration?
A) 15-30 minutes
B) 1-2 hours
C) 4-6 hours
D) 8-12 hours
Correct Answer: B
Correct Answer Text: 1-2 hours
Rationale: Regular insulin has an onset of 30-60 minutes and a peak effect of 2-4 hours.
The patient is at greatest risk for hypoglycemia during the peak time, so vigilant
monitoring 1-2 hours after administration is crucial. Rapid-acting insulins peak earlier
(A), while intermediate (C) and long-acting (D) insulins have later peaks.
4. A nurse is reviewing new orders for a patient with heart failure who is currently
receiving digoxin 0.25 mg PO daily. The patient’s current serum potassium is 3.2
mEq/L. What is the nurse’s priority action?
A) Administer the digoxin and recheck potassium in the morning.
B) Hold the digoxin and notify the provider of the hypokalemia.
100% Correct Questions & Graded A Verified
Answers for Herzing University
Module 1: Pharmacokinetics & Safety Principles
1. A 72-year-old patient with moderate renal impairment (estimated CrCl 40
mL/min) is prescribed gentamicin for a severe infection. Which nursing action is
most critical for safe administration?
A) Administer the medication with food to reduce GI upset.
B) Monitor peak and trough serum levels as ordered.
C) Ensure the patient is well-hydrated before the first dose.
D) Assess for hearing loss (ototoxicity) at the end of the therapy.
Correct Answer: B
Correct Answer Text: Monitor peak and trough serum levels as ordered.
Rationale: Gentamicin is a nephrotoxic and ototoxic aminoglycoside excreted renally. In
renal impairment, drug accumulation is a major risk. Monitoring peak (efficacy) and
trough (toxicity) levels is essential to adjust the dose and interval, preventing permanent
kidney damage and hearing loss. While hydration (C) and assessing for ototoxicity (D)
are important, therapeutic drug monitoring is the most critical safety intervention.
Administering with food (A) is not standard for IV gentamicin.
2. A nurse is preparing to administer warfarin 5 mg PO to a patient. The patient’s
current INR is 4.2. What is the nurse’s priority action?
A) Administer the dose as scheduled and recheck the INR tomorrow.
B) Withhold the dose and notify the prescribing provider immediately.
C) Administer vitamin K concurrently as a reversal agent.
D) Confirm the patient has not consumed any green leafy vegetables.
, Correct Answer: B
Correct Answer Text: Withhold the dose and notify the prescribing provider immediately.
Rationale: An INR of 4.2 is significantly above the typical therapeutic range (often
2.0-3.0), indicating a high risk of bleeding. The nurse must withhold the dose (a
dependent intervention) and notify the provider for further orders (e.g., dose hold,
reduction, or possible reversal). Administering the dose (A) would be dangerous.
Administering vitamin K (C) requires a specific order. While diet education (D) is
important, it does not address the immediate safety threat.
3. A patient with Type 1 Diabetes is prescribed regular insulin via sliding scale. The
nurse should monitor for signs of hypoglycemia most closely at which time after
administration?
A) 15-30 minutes
B) 1-2 hours
C) 4-6 hours
D) 8-12 hours
Correct Answer: B
Correct Answer Text: 1-2 hours
Rationale: Regular insulin has an onset of 30-60 minutes and a peak effect of 2-4 hours.
The patient is at greatest risk for hypoglycemia during the peak time, so vigilant
monitoring 1-2 hours after administration is crucial. Rapid-acting insulins peak earlier
(A), while intermediate (C) and long-acting (D) insulins have later peaks.
4. A nurse is reviewing new orders for a patient with heart failure who is currently
receiving digoxin 0.25 mg PO daily. The patient’s current serum potassium is 3.2
mEq/L. What is the nurse’s priority action?
A) Administer the digoxin and recheck potassium in the morning.
B) Hold the digoxin and notify the provider of the hypokalemia.
