BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A patient is prescribed Digoxin for heart failure. Which clinical manifestation should the
nurse recognize as a sign of early Digoxin toxicity?
A. Tachycardia
B. Hypertension
C. Increased urinary output
D. Yellow-green visual halos
Answer: D
Rationale: Digoxin toxicity commonly presents with gastrointestinal distress and visual
changes like yellow-green halos around lights. The nurse must assess the patient’s apical
pulse for a full minute before administration and hold the drug if the pulse is under 60
bpm. Early recognition of these symptoms prevents life-threatening arrhythmias
associated with toxic levels.
2. A nurse is preparing to administer Furosemide to a patient with pulmonary edema. Which
laboratory value should the nurse prioritize for monitoring?
A. Serum sodium
B. Hemoglobin levels
,C. Serum potassium
D. Blood urea nitrogen
Answer: C
Rationale: Furosemide is a loop diuretic that causes significant loss of potassium through
the kidneys. Hypokalemia can lead to dangerous cardiac dysrhythmias and muscle
weakness in patients. Monitoring serum potassium levels ensures the patient remains
within the safe range of 3.5 to 5.0 mEq/L.
3. A patient receiving Heparin therapy via continuous IV infusion has an aPTT of 120 seconds.
What is the priority nursing action?
A. Increase the infusion rate
B. Stop the infusion and notify the provider
C. Administer Vitamin K intramuscularly
D. Recheck the aPTT in four hours
Answer: B
Rationale: An aPTT of 120 seconds is significantly above the therapeutic range, which is
usually 1.5 to 2.5 times the normal value. The nurse must stop the infusion immediately to
prevent major bleeding episodes. Preparation of the antidote, protamine sulfate, may be
necessary if bleeding occurs.
, 4. Which instruction should a nurse provide to a patient starting Warfarin for atrial
fibrillation?
A. Expect the urine to turn a bright orange color
B. Avoid all sources of Vitamin K in the diet
C. Take Aspirin for minor headaches
D. Maintain a consistent intake of green leafy vegetables
Answer: D
Rationale: Consistency in Vitamin K intake is crucial because sudden changes can fluctuate
the INR and decrease Warfarin’s effectiveness. Patients should avoid taking Aspirin or
NSAIDs as they increase the risk of hemorrhage. Routine blood monitoring of PT and INR is
required to maintain therapeutic levels.
5. A nurse is caring for a patient prescribed Spironolactone. Which food choice should the
patient be advised to limit?
A. Bananas
B. Apples
C. White bread
D. Chicken breast
Answer: A