NR293 Final Exam Actual Exam Style V3 |
NR 293 Pharmacology for Nursing Practice
| Chamberlain
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which of the
following actions should the nurse take first?
A. Assess the patient’s blood pressure.
B. Check the patient’s respiratory rate.
C. Review the patient’s recent serum calcium level.
D. Measure the apical pulse for one full minute.
Answer: D
Rationale: Before administering digoxin, the nurse must always measure the apical pulse
for a full 60 seconds. If the pulse is below 60 beats per minute in an adult, the medication
should be withheld and the provider notified. This assessment is critical because digoxin
has a narrow therapeutic range and can cause significant bradycardia.
2. A patient is receiving heparin therapy for a deep vein thrombosis. Which laboratory value
should the nurse monitor to evaluate the effectiveness of this medication?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. International Normalized Ratio (INR)
,D. Bleeding time
Answer: A
Rationale: The activated partial thromboplastin time (aPTT) is the standard laboratory
test used to monitor the effectiveness of heparin therapy. Prothrombin time and INR are
primarily used to monitor warfarin therapy rather than heparin. Consistent monitoring
ensures the patient remains within the therapeutic range to prevent further clotting
without causing excessive bleeding.
3. A nurse is teaching a patient who has a new prescription for levothyroxine to treat
hypothyroidism. Which of the following instructions should the nurse include?
A. Take the medication with a full meal.
B. Take the medication with an antacid if stomach upset occurs.
C. Take the medication immediately before bedtime.
D. Take the medication on an empty stomach in the morning.
Answer: D
Rationale: Levothyroxine should be taken on an empty stomach, typically 30 to 60 minutes
before breakfast, to ensure optimal absorption. Absorption can be significantly decreased
by food, calcium, and certain other medications or supplements. Taking it consistently at
the same time every morning helps maintain steady thyroid hormone levels in the blood.
, 4. A patient who is taking an ACE inhibitor for hypertension develops a dry, persistent cough.
What is the nurse’s best response?
A. Instruct the patient to use an over-the-counter cough suppressant.
B. Notify the provider as the medication may need to be changed.
C. Explain that the cough is a sign of a secondary respiratory infection.
D. Tell the patient to increase fluid intake to soothe the throat.
Answer: B
Rationale: A dry, nonproductive cough is a common side effect of ACE inhibitors caused by
the accumulation of bradykinin in the lungs. This side effect often leads to noncompliance
and usually necessitates a switch to an Angiotensin II Receptor Blocker (ARB). The nurse
should report this to the provider so an alternative antihypertensive can be prescribed.
5. Which of the following medications is considered the antidote for an overdose of warfarin?
A. Protamine sulfate
B. Glucagon
C. Vitamin K
D. Calcium gluconate
Answer: C
Rationale: Vitamin K is the specific antagonist used to reverse the effects of warfarin by
promoting the synthesis of clotting factors. Protamine sulfate is the antidote for heparin,
NR 293 Pharmacology for Nursing Practice
| Chamberlain
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which of the
following actions should the nurse take first?
A. Assess the patient’s blood pressure.
B. Check the patient’s respiratory rate.
C. Review the patient’s recent serum calcium level.
D. Measure the apical pulse for one full minute.
Answer: D
Rationale: Before administering digoxin, the nurse must always measure the apical pulse
for a full 60 seconds. If the pulse is below 60 beats per minute in an adult, the medication
should be withheld and the provider notified. This assessment is critical because digoxin
has a narrow therapeutic range and can cause significant bradycardia.
2. A patient is receiving heparin therapy for a deep vein thrombosis. Which laboratory value
should the nurse monitor to evaluate the effectiveness of this medication?
A. Activated partial thromboplastin time (aPTT)
B. Prothrombin time (PT)
C. International Normalized Ratio (INR)
,D. Bleeding time
Answer: A
Rationale: The activated partial thromboplastin time (aPTT) is the standard laboratory
test used to monitor the effectiveness of heparin therapy. Prothrombin time and INR are
primarily used to monitor warfarin therapy rather than heparin. Consistent monitoring
ensures the patient remains within the therapeutic range to prevent further clotting
without causing excessive bleeding.
3. A nurse is teaching a patient who has a new prescription for levothyroxine to treat
hypothyroidism. Which of the following instructions should the nurse include?
A. Take the medication with a full meal.
B. Take the medication with an antacid if stomach upset occurs.
C. Take the medication immediately before bedtime.
D. Take the medication on an empty stomach in the morning.
Answer: D
Rationale: Levothyroxine should be taken on an empty stomach, typically 30 to 60 minutes
before breakfast, to ensure optimal absorption. Absorption can be significantly decreased
by food, calcium, and certain other medications or supplements. Taking it consistently at
the same time every morning helps maintain steady thyroid hormone levels in the blood.
, 4. A patient who is taking an ACE inhibitor for hypertension develops a dry, persistent cough.
What is the nurse’s best response?
A. Instruct the patient to use an over-the-counter cough suppressant.
B. Notify the provider as the medication may need to be changed.
C. Explain that the cough is a sign of a secondary respiratory infection.
D. Tell the patient to increase fluid intake to soothe the throat.
Answer: B
Rationale: A dry, nonproductive cough is a common side effect of ACE inhibitors caused by
the accumulation of bradykinin in the lungs. This side effect often leads to noncompliance
and usually necessitates a switch to an Angiotensin II Receptor Blocker (ARB). The nurse
should report this to the provider so an alternative antihypertensive can be prescribed.
5. Which of the following medications is considered the antidote for an overdose of warfarin?
A. Protamine sulfate
B. Glucagon
C. Vitamin K
D. Calcium gluconate
Answer: C
Rationale: Vitamin K is the specific antagonist used to reverse the effects of warfarin by
promoting the synthesis of clotting factors. Protamine sulfate is the antidote for heparin,
