BSN315 Exam 3 Actual Exam Style V3 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client is prescribed digoxin for heart failure. Which clinical finding should the nurse
identify as a sign of digoxin toxicity?
A. Hyperkalemia
B. Increased urinary output
C. Visual disturbances such as yellow halos
D. Tachycardia
Answer: C
Rationale: Visual disturbances, specifically yellow-green halos or blurred vision, are
classic signs of digoxin toxicity. Other common signs include nausea, vomiting, and
bradycardia rather than tachycardia. The nurse must monitor the patient’s digoxin levels
and electrolyte balance closely to prevent these adverse effects.
2. A patient is receiving furosemide for pulmonary edema. Which laboratory value should the
nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
,D. Serum magnesium
Answer: B
Rationale: Furosemide is a loop diuretic that causes significant excretion of potassium,
leading to a high risk of hypokalemia. Low potassium levels can cause dangerous cardiac
arrhythmias and muscle weakness. The nurse should encourage the intake of potassium-
rich foods or administer supplements as ordered by the provider.
3. When administering albuterol to a client with asthma, the nurse should monitor for which
common side effect?
A. Bradycardia
B. Tachycardia
C. Drowsiness
D. Hypoglycemia
Answer: B
Rationale: Albuterol is a sympathomimetic beta-2 agonist that can stimulate beta-1
receptors in the heart, leading to tachycardia and tremors. These effects are common
because the medication triggers the ‘fight or flight’ response. Patients should be educated
that these sensations are expected but should be reported if they become severe.
4. A client is starting warfarin therapy for atrial fibrillation. Which education point should the
nurse include regarding diet?
A. Avoid all green leafy vegetables.
, B. Increase intake of citrus fruits.
C. Maintain a consistent intake of vitamin K.
D. Drink 3 liters of water daily.
E. Reduce protein intake.
Answer: C
Rationale: Warfarin works by antagonizing vitamin K, so sudden changes in vitamin K
intake can alter the medication’s effectiveness. Patients do not need to avoid vitamin K
entirely but must maintain a stable, consistent daily amount. Fluctuations in vitamin K can
lead to unstable International Normalized Ratio (INR) levels and increased risk of clotting
or bleeding.
5. A nurse is preparing to administer heparin subcutaneously. Which action is most
appropriate?
A. Aspirate for blood return before injecting.
B. Apply firm pressure to the site for 1 to 2 minutes.
C. Massage the site after injection to speed absorption.
D. Inject the medication into the deltoid muscle.
Answer: B
Rationale: Applying firm pressure after a heparin injection helps prevent bruising and
hematoma formation at the site. Aspiration and massaging are contraindicated because
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client is prescribed digoxin for heart failure. Which clinical finding should the nurse
identify as a sign of digoxin toxicity?
A. Hyperkalemia
B. Increased urinary output
C. Visual disturbances such as yellow halos
D. Tachycardia
Answer: C
Rationale: Visual disturbances, specifically yellow-green halos or blurred vision, are
classic signs of digoxin toxicity. Other common signs include nausea, vomiting, and
bradycardia rather than tachycardia. The nurse must monitor the patient’s digoxin levels
and electrolyte balance closely to prevent these adverse effects.
2. A patient is receiving furosemide for pulmonary edema. Which laboratory value should the
nurse monitor most closely?
A. Serum sodium
B. Serum potassium
C. Serum calcium
,D. Serum magnesium
Answer: B
Rationale: Furosemide is a loop diuretic that causes significant excretion of potassium,
leading to a high risk of hypokalemia. Low potassium levels can cause dangerous cardiac
arrhythmias and muscle weakness. The nurse should encourage the intake of potassium-
rich foods or administer supplements as ordered by the provider.
3. When administering albuterol to a client with asthma, the nurse should monitor for which
common side effect?
A. Bradycardia
B. Tachycardia
C. Drowsiness
D. Hypoglycemia
Answer: B
Rationale: Albuterol is a sympathomimetic beta-2 agonist that can stimulate beta-1
receptors in the heart, leading to tachycardia and tremors. These effects are common
because the medication triggers the ‘fight or flight’ response. Patients should be educated
that these sensations are expected but should be reported if they become severe.
4. A client is starting warfarin therapy for atrial fibrillation. Which education point should the
nurse include regarding diet?
A. Avoid all green leafy vegetables.
, B. Increase intake of citrus fruits.
C. Maintain a consistent intake of vitamin K.
D. Drink 3 liters of water daily.
E. Reduce protein intake.
Answer: C
Rationale: Warfarin works by antagonizing vitamin K, so sudden changes in vitamin K
intake can alter the medication’s effectiveness. Patients do not need to avoid vitamin K
entirely but must maintain a stable, consistent daily amount. Fluctuations in vitamin K can
lead to unstable International Normalized Ratio (INR) levels and increased risk of clotting
or bleeding.
5. A nurse is preparing to administer heparin subcutaneously. Which action is most
appropriate?
A. Aspirate for blood return before injecting.
B. Apply firm pressure to the site for 1 to 2 minutes.
C. Massage the site after injection to speed absorption.
D. Inject the medication into the deltoid muscle.
Answer: B
Rationale: Applying firm pressure after a heparin injection helps prevent bruising and
hematoma formation at the site. Aspiration and massaging are contraindicated because
