NUR 2474 Pharmacology for Professional Nursing Rasmussen
College Academic Year 2026/2027 Examination 1
Comprehensive Examination 50 Verified Questions and
Correct Answer Rationales
About This Exam Bank
This comprehensive 133-question exam bank is designed to prepare candidates for NUR 2474 Pharmacology for
Professional Nursing Rasmussen College Academic Year 2026/2027 Examination 1 Comprehensive Examination 50
Verified Questions and Correct Answer Rationales. Every question is aligned with the latest official content outline
and includes a detailed, evidence-based rationale, an explanation of why each remaining option is incorrect, and a
supporting reference.
Keywords
NUR 2474 Pharmacology for Professional Nursing Rasmussen College Academic Year 2026/2027 Examination 1
Comprehensive Examination 50 Verified Questions and Correct Answer Rationales, exam bank, practice questions,
verified answers, detailed rationales, test prep, study guide, review questions, certification exam, latest update, NUR
2474 Pharmacology for Professional Nursing Rasmussen College Academic Year 2026/2027 Examination 1
Comprehensive Examination 50 Verified Questions and Correct Answer Rationales, exam bank, practice questions,
verified answers, detailed rationales
PART 1: APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO
PREDICT DRUG BEHAVIOR AND THERAPEUTIC OUTCOMES IN DIVERSE PATIENT
POPULATIONS
1. A patient with a history of heart failure is prescribed furosemide. Which laboratory value should the nurse monitor
most closely to detect a life-threatening adverse effect?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
' Correct Answer: A
Rationale: Furosemide, a loop diuretic, causes significant potassium loss, which can lead to life-threatening
hypokalemia and cardiac dysrhythmias. While sodium, calcium, and magnesium can also be affected, potassium is
the most critical to monitor for immediate risk of arrhythmias.
2. Which statement best describes the mechanism of action of metformin in managing type 2 diabetes mellitus?
A) Increases insulin secretion from pancreatic beta cells
B) Decreases hepatic glucose production and improves insulin sensitivity
C) Delays carbohydrate absorption in the gastrointestinal tract
D) Inhibits renal glucose reabsorption, increasing urinary glucose excretion
' Correct Answer: B
Rationale: Metformin primarily reduces hepatic gluconeogenesis and enhances peripheral insulin sensitivity,
without directly stimulating insulin release. Sulfonylureas increase insulin secretion, alpha-glucosidase inhibitors
delay carbohydrate absorption, and SGLT2 inhibitors inhibit renal glucose reabsorption.
Page 1
,3. A patient receiving warfarin therapy has an INR of 6.5 and is actively bleeding. Which intervention should the
nurse anticipate?
A) Administer vitamin K (phytonadione) subcutaneously
B) Administer fresh frozen plasma and vitamin K intravenously
C) Hold warfarin and administer protamine sulfate
D) Administer platelet transfusion and continue warfarin at a lower dose
' Correct Answer: B
Rationale: For major bleeding with a supratherapeutic INR, immediate reversal requires intravenous vitamin K and
fresh frozen plasma or prothrombin complex concentrate. Protamine sulfate reverses heparin, not warfarin; platelet
transfusion is not the primary reversal for warfarin; and subcutaneous vitamin K has a slower onset.
4. A patient is prescribed digoxin. Which assessment finding indicates a potential toxic effect requiring immediate
intervention?
A) Heart rate of 58 beats per minute
B) Serum digoxin level of 1.2 ng/mL
C) Visual disturbances with yellow halos
D) Blood pressure of 110/70 mm Hg
' Correct Answer: C
Rationale: Visual disturbances, such as yellow-green halos or blurred vision, are classic signs of digoxin toxicity.
A heart rate of 58 bpm may be acceptable if asymptomatic; a digoxin level of 1.2 ng/mL is within therapeutic range
(0.5-2.0 ng/mL); and a blood pressure of 110/70 mm Hg is not indicative of toxicity.
5. Which instruction is most important for the nurse to include when teaching a patient about sublingual
nitroglycerin?
A) Swallow the tablet with a full glass of water
B) Take one tablet every 5 minutes for up to 3 doses; if pain persists, call 911
C) Take the medication only when experiencing a headache
D) Store the tablets in a clear plastic container for easy access
' Correct Answer: B
Rationale: Sublingual nitroglycerin should be taken at 5-minute intervals for up to 3 doses; if chest pain persists,
emergency services should be activated. Swallowing the tablet reduces its effectiveness; headaches are a side effect,
not an indication; and nitroglycerin should be stored in its original dark glass container to prevent degradation.
6. A patient with a history of asthma is prescribed propranolol. Which assessment finding should alert the nurse to a
potential contraindication?
A) History of bronchospasm
B) Heart rate of 72 beats per minute
C) Blood pressure of 130/80 mm Hg
D) Occasional premature ventricular contractions
' Correct Answer: A
Rationale: Propranolol is a nonselective beta-blocker that can cause bronchoconstriction and is contraindicated in
patients with asthma or a history of bronchospasm. A heart rate of 72 bpm and blood pressure of 130/80 mm Hg are
within normal limits, and occasional PVCs are not an absolute contraindication.
7. A patient is receiving intravenous vancomycin. Which nursing action is essential to prevent vancomycin infusion
reaction (formerly known as red man syndrome)?
A) Administer the infusion over 30 minutes
B) Premedicate with diphenhydramine
Page 2
, C) Infuse over at least 60 minutes
D) Monitor serum creatinine levels daily
' Correct Answer: C
Rationale: Vancomycin infusion reaction is caused by rapid infusion and can be prevented by administering the
drug over at least 60 minutes. Premedication with diphenhydramine may mask symptoms but does not prevent the
reaction; monitoring creatinine is important for nephrotoxicity but not for preventing infusion reaction.
8. Which statement by a patient taking levothyroxine indicates a need for further teaching?
A) I will take this medication on an empty stomach in the morning.
B) I will avoid taking antacids within 4 hours of this medication.
C) I will report any chest pain or palpitations immediately.
D) I will stop taking this medication if I feel better.
' Correct Answer: D
Rationale: Levothyroxine is a lifelong therapy for hypothyroidism and should not be discontinued without provider
guidance, even if symptoms improve. Taking it on an empty stomach, avoiding antacids within 4 hours, and
reporting chest pain or palpitations are all correct instructions.
9. A patient is prescribed morphine sulfate for severe pain. Which assessment is the priority before administration?
A) Pain level and location
B) Respiratory rate and depth
C) Blood pressure and heart rate
D) Level of consciousness and orientation
' Correct Answer: B
Rationale: Morphine can cause respiratory depression, so assessing respiratory rate and depth is the priority before
administration. While pain level, vital signs, and level of consciousness are important, respiratory status is the most
critical to prevent life-threatening complications.
10. A patient with a history of peptic ulcer disease is prescribed ibuprofen. Which additional medication should the
nurse anticipate the provider will order to reduce gastrointestinal risk?
A) Acetaminophen
B) Misoprostol
C) Ondansetron
D) Metoclopramide
' Correct Answer: B
Rationale: Misoprostol is a prostaglandin analog that protects the gastric mucosa and is used to prevent
NSAID-induced ulcers. Acetaminophen is an analgesic but does not protect the stomach; ondansetron and
metoclopramide are antiemetics and do not reduce ulcer risk.
11. A patient with chronic kidney disease (CrCl 22 mL/min) is prescribed apixaban for nonvalvular atrial fibrillation.
Which parameter most directly determines the appropriate dose reduction according to current labeling?
A) Serum creatinine alone
B) Age, weight, and serum creatinine (CrCl)
C) INR and aPTT values
D) Hemoglobin and hematocrit
' Correct Answer: B
Rationale: Apixaban dose reduction in nonvalvular AF is based on two of three criteria: age "e80, weight "d60 kg, or
SCr 1.5 mg/dL; renal function alone does not dictate reduction. INR/aPTT do not guide apixaban dosing, and
hemoglobin/hematocrit are monitoring parameters, not dosing criteria.
Page 3
, 12. Which instruction is most critical when a patient is started on sublingual nitroglycerin for stable angina?
A) Swallow the tablet with a full glass of water
B) Take one tablet every 5 minutes up to three doses; call 911 if pain persists
C) Take with a PDE-5 inhibitor for faster relief
D) Use only when pain lasts longer than 30 minutes
' Correct Answer: B
Rationale: Sublingual nitroglycerin should be taken at 5-minute intervals for up to three doses; if chest pain
persists after three doses, emergency services should be activated. Swallowing the tablet inactivates it via first-pass
metabolism, PDE-5 inhibitors are contraindicated due to severe hypotension risk, and waiting 30 minutes risks
myocardial damage.
13. A patient on warfarin has an INR of 6.8 with no active bleeding. Which intervention is most appropriate?
A) Administer vitamin K 10 mg IV push
B) Hold warfarin and give oral vitamin K; consider prothrombin complex concentrate if bleeding occurs
C) Continue warfarin and recheck INR in 1 week
D) Transfuse fresh frozen plasma immediately
' Correct Answer: B
Rationale: For an elevated INR without bleeding, warfarin is held and low-dose oral vitamin K may be given; PCC
is reserved for serious bleeding. IV vitamin K 10 mg risks anaphylactoid reactions and overcorrection, continuing
warfarin worsens bleeding risk, and FFP is not first-line for asymptomatic elevation.
14. Which statement best explains why a beta-1 selective antagonist is preferred over a nonselective beta blocker in a
patient with asthma and hypertension?
A) Beta-1 selective agents have no effect on heart rate
B) Beta-1 selective agents minimize beta-2 blockade in the lungs, reducing bronchospasm risk
C) Nonselective beta blockers are more cardioselective
D) Beta-1 selective agents are more likely to cause bronchoconstriction
' Correct Answer: B
Rationale: Beta-1 selective antagonists preferentially block cardiac beta-1 receptors, sparing pulmonary beta-2
receptors and reducing bronchospasm risk in asthma. They still lower heart rate, nonselective agents are less
cardioselective, and beta-1 selective agents are less likely-not more likely-to cause bronchoconstriction.
15. A patient receiving vancomycin IV develops flushing, erythema, and hypotension during the infusion. Which
action is most appropriate?
A) Stop the infusion, administer diphenhydramine, and restart at a slower rate
B) Continue the infusion and monitor vital signs
C) Administer epinephrine IM immediately
D) Switch to oral vancomycin
' Correct Answer: A
Rationale: This presentation is vancomycin infusion reaction (formerly red man syndrome), managed by stopping
the infusion, giving an antihistamine, and restarting at a slower rate. Continuing the infusion risks worsening
hypotension, epinephrine is for anaphylaxis, and oral vancomycin is not used for systemic infections.
16. Which parameter is the most reliable indicator of long-term glycemic control in a patient with diabetes?
A) Fasting blood glucose
B) Postprandial glucose
C) Hemoglobin A1c
D) Random blood glucose
Page 4
College Academic Year 2026/2027 Examination 1
Comprehensive Examination 50 Verified Questions and
Correct Answer Rationales
About This Exam Bank
This comprehensive 133-question exam bank is designed to prepare candidates for NUR 2474 Pharmacology for
Professional Nursing Rasmussen College Academic Year 2026/2027 Examination 1 Comprehensive Examination 50
Verified Questions and Correct Answer Rationales. Every question is aligned with the latest official content outline
and includes a detailed, evidence-based rationale, an explanation of why each remaining option is incorrect, and a
supporting reference.
Keywords
NUR 2474 Pharmacology for Professional Nursing Rasmussen College Academic Year 2026/2027 Examination 1
Comprehensive Examination 50 Verified Questions and Correct Answer Rationales, exam bank, practice questions,
verified answers, detailed rationales, test prep, study guide, review questions, certification exam, latest update, NUR
2474 Pharmacology for Professional Nursing Rasmussen College Academic Year 2026/2027 Examination 1
Comprehensive Examination 50 Verified Questions and Correct Answer Rationales, exam bank, practice questions,
verified answers, detailed rationales
PART 1: APPLY PHARMACOKINETIC AND PHARMACODYNAMIC PRINCIPLES TO
PREDICT DRUG BEHAVIOR AND THERAPEUTIC OUTCOMES IN DIVERSE PATIENT
POPULATIONS
1. A patient with a history of heart failure is prescribed furosemide. Which laboratory value should the nurse monitor
most closely to detect a life-threatening adverse effect?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
' Correct Answer: A
Rationale: Furosemide, a loop diuretic, causes significant potassium loss, which can lead to life-threatening
hypokalemia and cardiac dysrhythmias. While sodium, calcium, and magnesium can also be affected, potassium is
the most critical to monitor for immediate risk of arrhythmias.
2. Which statement best describes the mechanism of action of metformin in managing type 2 diabetes mellitus?
A) Increases insulin secretion from pancreatic beta cells
B) Decreases hepatic glucose production and improves insulin sensitivity
C) Delays carbohydrate absorption in the gastrointestinal tract
D) Inhibits renal glucose reabsorption, increasing urinary glucose excretion
' Correct Answer: B
Rationale: Metformin primarily reduces hepatic gluconeogenesis and enhances peripheral insulin sensitivity,
without directly stimulating insulin release. Sulfonylureas increase insulin secretion, alpha-glucosidase inhibitors
delay carbohydrate absorption, and SGLT2 inhibitors inhibit renal glucose reabsorption.
Page 1
,3. A patient receiving warfarin therapy has an INR of 6.5 and is actively bleeding. Which intervention should the
nurse anticipate?
A) Administer vitamin K (phytonadione) subcutaneously
B) Administer fresh frozen plasma and vitamin K intravenously
C) Hold warfarin and administer protamine sulfate
D) Administer platelet transfusion and continue warfarin at a lower dose
' Correct Answer: B
Rationale: For major bleeding with a supratherapeutic INR, immediate reversal requires intravenous vitamin K and
fresh frozen plasma or prothrombin complex concentrate. Protamine sulfate reverses heparin, not warfarin; platelet
transfusion is not the primary reversal for warfarin; and subcutaneous vitamin K has a slower onset.
4. A patient is prescribed digoxin. Which assessment finding indicates a potential toxic effect requiring immediate
intervention?
A) Heart rate of 58 beats per minute
B) Serum digoxin level of 1.2 ng/mL
C) Visual disturbances with yellow halos
D) Blood pressure of 110/70 mm Hg
' Correct Answer: C
Rationale: Visual disturbances, such as yellow-green halos or blurred vision, are classic signs of digoxin toxicity.
A heart rate of 58 bpm may be acceptable if asymptomatic; a digoxin level of 1.2 ng/mL is within therapeutic range
(0.5-2.0 ng/mL); and a blood pressure of 110/70 mm Hg is not indicative of toxicity.
5. Which instruction is most important for the nurse to include when teaching a patient about sublingual
nitroglycerin?
A) Swallow the tablet with a full glass of water
B) Take one tablet every 5 minutes for up to 3 doses; if pain persists, call 911
C) Take the medication only when experiencing a headache
D) Store the tablets in a clear plastic container for easy access
' Correct Answer: B
Rationale: Sublingual nitroglycerin should be taken at 5-minute intervals for up to 3 doses; if chest pain persists,
emergency services should be activated. Swallowing the tablet reduces its effectiveness; headaches are a side effect,
not an indication; and nitroglycerin should be stored in its original dark glass container to prevent degradation.
6. A patient with a history of asthma is prescribed propranolol. Which assessment finding should alert the nurse to a
potential contraindication?
A) History of bronchospasm
B) Heart rate of 72 beats per minute
C) Blood pressure of 130/80 mm Hg
D) Occasional premature ventricular contractions
' Correct Answer: A
Rationale: Propranolol is a nonselective beta-blocker that can cause bronchoconstriction and is contraindicated in
patients with asthma or a history of bronchospasm. A heart rate of 72 bpm and blood pressure of 130/80 mm Hg are
within normal limits, and occasional PVCs are not an absolute contraindication.
7. A patient is receiving intravenous vancomycin. Which nursing action is essential to prevent vancomycin infusion
reaction (formerly known as red man syndrome)?
A) Administer the infusion over 30 minutes
B) Premedicate with diphenhydramine
Page 2
, C) Infuse over at least 60 minutes
D) Monitor serum creatinine levels daily
' Correct Answer: C
Rationale: Vancomycin infusion reaction is caused by rapid infusion and can be prevented by administering the
drug over at least 60 minutes. Premedication with diphenhydramine may mask symptoms but does not prevent the
reaction; monitoring creatinine is important for nephrotoxicity but not for preventing infusion reaction.
8. Which statement by a patient taking levothyroxine indicates a need for further teaching?
A) I will take this medication on an empty stomach in the morning.
B) I will avoid taking antacids within 4 hours of this medication.
C) I will report any chest pain or palpitations immediately.
D) I will stop taking this medication if I feel better.
' Correct Answer: D
Rationale: Levothyroxine is a lifelong therapy for hypothyroidism and should not be discontinued without provider
guidance, even if symptoms improve. Taking it on an empty stomach, avoiding antacids within 4 hours, and
reporting chest pain or palpitations are all correct instructions.
9. A patient is prescribed morphine sulfate for severe pain. Which assessment is the priority before administration?
A) Pain level and location
B) Respiratory rate and depth
C) Blood pressure and heart rate
D) Level of consciousness and orientation
' Correct Answer: B
Rationale: Morphine can cause respiratory depression, so assessing respiratory rate and depth is the priority before
administration. While pain level, vital signs, and level of consciousness are important, respiratory status is the most
critical to prevent life-threatening complications.
10. A patient with a history of peptic ulcer disease is prescribed ibuprofen. Which additional medication should the
nurse anticipate the provider will order to reduce gastrointestinal risk?
A) Acetaminophen
B) Misoprostol
C) Ondansetron
D) Metoclopramide
' Correct Answer: B
Rationale: Misoprostol is a prostaglandin analog that protects the gastric mucosa and is used to prevent
NSAID-induced ulcers. Acetaminophen is an analgesic but does not protect the stomach; ondansetron and
metoclopramide are antiemetics and do not reduce ulcer risk.
11. A patient with chronic kidney disease (CrCl 22 mL/min) is prescribed apixaban for nonvalvular atrial fibrillation.
Which parameter most directly determines the appropriate dose reduction according to current labeling?
A) Serum creatinine alone
B) Age, weight, and serum creatinine (CrCl)
C) INR and aPTT values
D) Hemoglobin and hematocrit
' Correct Answer: B
Rationale: Apixaban dose reduction in nonvalvular AF is based on two of three criteria: age "e80, weight "d60 kg, or
SCr 1.5 mg/dL; renal function alone does not dictate reduction. INR/aPTT do not guide apixaban dosing, and
hemoglobin/hematocrit are monitoring parameters, not dosing criteria.
Page 3
, 12. Which instruction is most critical when a patient is started on sublingual nitroglycerin for stable angina?
A) Swallow the tablet with a full glass of water
B) Take one tablet every 5 minutes up to three doses; call 911 if pain persists
C) Take with a PDE-5 inhibitor for faster relief
D) Use only when pain lasts longer than 30 minutes
' Correct Answer: B
Rationale: Sublingual nitroglycerin should be taken at 5-minute intervals for up to three doses; if chest pain
persists after three doses, emergency services should be activated. Swallowing the tablet inactivates it via first-pass
metabolism, PDE-5 inhibitors are contraindicated due to severe hypotension risk, and waiting 30 minutes risks
myocardial damage.
13. A patient on warfarin has an INR of 6.8 with no active bleeding. Which intervention is most appropriate?
A) Administer vitamin K 10 mg IV push
B) Hold warfarin and give oral vitamin K; consider prothrombin complex concentrate if bleeding occurs
C) Continue warfarin and recheck INR in 1 week
D) Transfuse fresh frozen plasma immediately
' Correct Answer: B
Rationale: For an elevated INR without bleeding, warfarin is held and low-dose oral vitamin K may be given; PCC
is reserved for serious bleeding. IV vitamin K 10 mg risks anaphylactoid reactions and overcorrection, continuing
warfarin worsens bleeding risk, and FFP is not first-line for asymptomatic elevation.
14. Which statement best explains why a beta-1 selective antagonist is preferred over a nonselective beta blocker in a
patient with asthma and hypertension?
A) Beta-1 selective agents have no effect on heart rate
B) Beta-1 selective agents minimize beta-2 blockade in the lungs, reducing bronchospasm risk
C) Nonselective beta blockers are more cardioselective
D) Beta-1 selective agents are more likely to cause bronchoconstriction
' Correct Answer: B
Rationale: Beta-1 selective antagonists preferentially block cardiac beta-1 receptors, sparing pulmonary beta-2
receptors and reducing bronchospasm risk in asthma. They still lower heart rate, nonselective agents are less
cardioselective, and beta-1 selective agents are less likely-not more likely-to cause bronchoconstriction.
15. A patient receiving vancomycin IV develops flushing, erythema, and hypotension during the infusion. Which
action is most appropriate?
A) Stop the infusion, administer diphenhydramine, and restart at a slower rate
B) Continue the infusion and monitor vital signs
C) Administer epinephrine IM immediately
D) Switch to oral vancomycin
' Correct Answer: A
Rationale: This presentation is vancomycin infusion reaction (formerly red man syndrome), managed by stopping
the infusion, giving an antihistamine, and restarting at a slower rate. Continuing the infusion risks worsening
hypotension, epinephrine is for anaphylaxis, and oral vancomycin is not used for systemic infections.
16. Which parameter is the most reliable indicator of long-term glycemic control in a patient with diabetes?
A) Fasting blood glucose
B) Postprandial glucose
C) Hemoglobin A1c
D) Random blood glucose
Page 4
