BSN315 Exam 2 Actual Exam Style V1 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client is prescribed digoxin for heart failure. Which laboratory value should the nurse
monitor most closely to prevent digoxin toxicity?
A. Serum potassium level
B. Serum sodium level
C. Serum calcium level
D. Serum glucose level
Answer: A
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
The nurse must monitor the potassium level, especially if the client is also taking a loop
diuretic. Maintaining a normal potassium range of 3.5 to 5.0 mEq/L is vital for client safety.
2. A nurse is preparing to administer sublingual nitroglycerin to a client with chest pain. What
is the priority assessment before administration?
A. Respiratory rate
B. Heart rate
C. Blood pressure
,D. Oxygen saturation
Answer: C
Rationale: Nitroglycerin is a potent vasodilator that can cause significant hypotension. The
nurse must assess the blood pressure before administration to ensure it is high enough to
tolerate the medication. If the systolic blood pressure is below 90 mmHg, the medication
should generally be withheld and the provider notified.
3. A client with Type 2 Diabetes is scheduled for a CT scan with intravenous contrast. Which
medication should be held 48 hours before and after the procedure?
A. Metformin
B. Glipizide
C. Pioglitazone
D. Insulin glargine
Answer: A
Rationale: Metformin must be discontinued prior to and for 48 hours after procedures
involving iodinated contrast media. Contrast can cause acute renal failure, which leads to
an accumulation of metformin and increases the risk of lactic acidosis. Resumption of
metformin depends on the verification of normal renal function through lab testing.
4. The nurse is teaching a client who has just been prescribed spironolactone. Which food
should the nurse instruct the client to avoid?
A. Bananas
, B. White bread
C. Apples
D. Chicken breast
Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia.
Bananas are high in potassium and should be consumed in moderation or avoided to
prevent dangerous electrolyte imbalances. The nurse should also advise the client to avoid
salt substitutes that contain potassium chloride.
5. Which medication is considered the ‘rescue’ inhaler for a client experiencing an acute
asthma attack?
A. Salmeterol
B. Fluticasone
C. Tiotropium
D. Albuterol
Answer: D
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) used for the rapid relief of
bronchospasm symptoms. It works quickly to dilate the airways during an acute
exacerbation of asthma or COPD. Other medications like salmeterol or fluticasone are used
for long-term maintenance and are not effective in emergencies.
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client is prescribed digoxin for heart failure. Which laboratory value should the nurse
monitor most closely to prevent digoxin toxicity?
A. Serum potassium level
B. Serum sodium level
C. Serum calcium level
D. Serum glucose level
Answer: A
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
The nurse must monitor the potassium level, especially if the client is also taking a loop
diuretic. Maintaining a normal potassium range of 3.5 to 5.0 mEq/L is vital for client safety.
2. A nurse is preparing to administer sublingual nitroglycerin to a client with chest pain. What
is the priority assessment before administration?
A. Respiratory rate
B. Heart rate
C. Blood pressure
,D. Oxygen saturation
Answer: C
Rationale: Nitroglycerin is a potent vasodilator that can cause significant hypotension. The
nurse must assess the blood pressure before administration to ensure it is high enough to
tolerate the medication. If the systolic blood pressure is below 90 mmHg, the medication
should generally be withheld and the provider notified.
3. A client with Type 2 Diabetes is scheduled for a CT scan with intravenous contrast. Which
medication should be held 48 hours before and after the procedure?
A. Metformin
B. Glipizide
C. Pioglitazone
D. Insulin glargine
Answer: A
Rationale: Metformin must be discontinued prior to and for 48 hours after procedures
involving iodinated contrast media. Contrast can cause acute renal failure, which leads to
an accumulation of metformin and increases the risk of lactic acidosis. Resumption of
metformin depends on the verification of normal renal function through lab testing.
4. The nurse is teaching a client who has just been prescribed spironolactone. Which food
should the nurse instruct the client to avoid?
A. Bananas
, B. White bread
C. Apples
D. Chicken breast
Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia.
Bananas are high in potassium and should be consumed in moderation or avoided to
prevent dangerous electrolyte imbalances. The nurse should also advise the client to avoid
salt substitutes that contain potassium chloride.
5. Which medication is considered the ‘rescue’ inhaler for a client experiencing an acute
asthma attack?
A. Salmeterol
B. Fluticasone
C. Tiotropium
D. Albuterol
Answer: D
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) used for the rapid relief of
bronchospasm symptoms. It works quickly to dilate the airways during an acute
exacerbation of asthma or COPD. Other medications like salmeterol or fluticasone are used
for long-term maintenance and are not effective in emergencies.
