NUR 2474 PHARMACOLOGY FINAL LATEST VERSIONS
(VERSION A & B) AND A STUDY GUIDE 2026-2027 ACTUAL
EXAM 150 QUESTIONS & CORRECT DETAILED ANSWERS
1. A patient asks a nurse how nitroglycerin works to relieve anginal pain. The
nurse correctly states, "Nitroglycerin:
a. dilates coronary arteries to increase blood flow to the heart."
b. increases the oxygen supply to the cardiac muscle."
c. increases ventricular filling to improve cardiac output."
d. promotes vasodilation, which reduces preload and oxygen demand."
d. promotes vasodilation, which reduces preload and oxygen demand."
*This vasodilation leads to a decrease in the heart's workload and oxygen demand,
ultimately relieving anginal pain.
2. A hospitalized patient complains of acute chest pain. The nurse administers a
0.3 mg sublingual nitroglycerin tablet, but the patient continues to complain of
pain. Vital signs remain stable. What is the nurse's next step?
a. Apply a nitroglycerin transdermal patch.
b. Continue dosing at 10-minute intervals.
c. Give a second dose of nitroglycerin in 5 minutes.
d. Request an order for intravenous nitroglycerin.
c. Give a second dose of nitroglycerin in 5 minutes.
*After one dose and a 5 minute wait period, you call 9-1-1 (if applicable) and give the
second dose. This can be repeated for a third time with stable vitals.
3. A patient who has begun using transdermal nitroglycerin for angina reports
occasional periods of tachycardia. The nurse will expect the prescriber to order:
a. digoxin (Lanoxin) to slow the heart rate.
b. immediate discontinuation of the nitroglycerin.
c. periods of rest when the heart rate increases.
d. verapamil as an adjunct to nitroglycerin therapy.
d. verapamil as an adjunct to nitroglycerin therapy.
*Nitroglycerin lowers blood pressure by reducing venous return and dilating the
arterioles. The lowered blood pressure
activates the baroreceptor reflex, causing reflex tachycardia, which can increase cardiac
,demand and negate the therapeutic
effects of nitroglycerin. Treatment with a beta blocker or verapamil suppresses the heart
to slow the rate.
4. A patient with histoplasmosis is being treated with itraconazole (Sporanox).
The nurse will teach this patient to report which symptoms?
a. Gynecomastia and decreased libido
b. Headache and rash
c. Nausea, vomiting, and anorexia
d. Visual disturbances
c. Nausea, vomiting, and anorexia
*well tolerated medication, but lowers potassium levels leads to dysrhythmias
5. A patient who is pregnant has a history of recurrent genital herpesvirus (HSV).
The patient asks the nurse what will be done to suppress an outbreak when she
is near term. The nurse will tell the patient that:
a. antiviral medications are not safe during pregnancy.
b. intravenous antiviral agents will be used if an outbreak occurs.
c. oral acyclovir (Zovirax) may be used during pregnancy.
d.topical acyclovir (Zovirax) must be used to control outbreaks
c. oral acyclovir (Zovirax) may be used during pregnancy.
*is considered safe for use during pregnancy to suppress or treat outbreaks of genital
herpes.
6. The nurse is caring for a patient receiving intravenous acyclovir (Zovirax). To
prevent nephrotoxicity associated with intravenous acyclovir, the nurse will:
a. hydrate the patient during the infusion and for 2 hours after the infusion.
b. increase the patient's intake of foods rich in vitamin C.
c. monitor urinary output every 30 minutes.
d. provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion.
a. hydrate the patient during the infusion and for 2 hours after the infusion.
*Intravenous acyclovir has the potential to cause nephrotoxicity, and one of the
preventive measures is to ensure adequate hydration.
,7. Which statement is correct about the contrast between a carbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects.
a. Miglitol has not been associated with hepatic dysfunction.
*key difference is that acarbose has been associated with rare cases of hepatic
dysfunction
8. A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for
which adverse reactions? (Select all that apply.)
a. Hypoglycemia
b. Flatulence
c. Elevated iron levels in the blood
d. Fluid retention
e. Diarrhea
b. Flatulence
e. Diarrhea
*due to build up of gasses (flatulence) from to undigested carbohydrates reaching the
colon and causing an osmotic effect (diarrhea)
9. The nurse is caring for a pregnant patient recently diagnosed with
hypothyroidism. The patient tells the nurse she does not want to take
medications while she is pregnant. What will the nurse explain to this patient?
a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
b. Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c. No danger to the fetus exists until the third trimester.
d. Treatment is required only if the patient is experiencing symptoms.
b. Neuropsychologic deficits in the fetus can occur if the condition is not treated.
*Thyroid hormones are crucial for the normal development of the fetal brain and
nervous system and must be treated in pregnancy.
10. A nurse is teaching a patient who has been diagnosed with hypothyroidism
about levothyroxine (Synthroid). Which statement by the patient indicates a need
for further teaching?
, a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider." c. "If I
take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
*this statement is incorrect since calcium interferes with the absorption of Synthroid, it
may need to be increased not decreased.
11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid).
The nurse assesses the patient at the beginning of the shift and notes a heart rate
of 62 beats per minute and a temperature of 97.2° F. The patient is lethargic and
difficult to arouse. The nurse will contact the provider to request an order for
which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole)
c. Intravenous levothyroxine
*IV allows for a more rapid correction of thyroid hormone levels especially
hypothyroidism with symptoms of myxedema coma or severe hypothyroidism. This is
considered a medical emergency.
12. A patient is admitted to the hospital and will begin taking levothyroxine
(Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The
nurse will notify the provider to discuss _____ the _____ dose.
a. reducing levothyroxine
b. reducing warfarin
c. increasing levothyroxine
d. increasing warfarin
b. reducing warfarin
*Levothyroxine (Synthroid) can potentially increase the effects of warfarin, leading to an
increased risk of bleeding.
13. An older adult patient is diagnosed with hypothyroidism. The initial free T4
level is 0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders
levothyroxine (Levothroid) 100 mcg/day PO. What will the nurse do?
(VERSION A & B) AND A STUDY GUIDE 2026-2027 ACTUAL
EXAM 150 QUESTIONS & CORRECT DETAILED ANSWERS
1. A patient asks a nurse how nitroglycerin works to relieve anginal pain. The
nurse correctly states, "Nitroglycerin:
a. dilates coronary arteries to increase blood flow to the heart."
b. increases the oxygen supply to the cardiac muscle."
c. increases ventricular filling to improve cardiac output."
d. promotes vasodilation, which reduces preload and oxygen demand."
d. promotes vasodilation, which reduces preload and oxygen demand."
*This vasodilation leads to a decrease in the heart's workload and oxygen demand,
ultimately relieving anginal pain.
2. A hospitalized patient complains of acute chest pain. The nurse administers a
0.3 mg sublingual nitroglycerin tablet, but the patient continues to complain of
pain. Vital signs remain stable. What is the nurse's next step?
a. Apply a nitroglycerin transdermal patch.
b. Continue dosing at 10-minute intervals.
c. Give a second dose of nitroglycerin in 5 minutes.
d. Request an order for intravenous nitroglycerin.
c. Give a second dose of nitroglycerin in 5 minutes.
*After one dose and a 5 minute wait period, you call 9-1-1 (if applicable) and give the
second dose. This can be repeated for a third time with stable vitals.
3. A patient who has begun using transdermal nitroglycerin for angina reports
occasional periods of tachycardia. The nurse will expect the prescriber to order:
a. digoxin (Lanoxin) to slow the heart rate.
b. immediate discontinuation of the nitroglycerin.
c. periods of rest when the heart rate increases.
d. verapamil as an adjunct to nitroglycerin therapy.
d. verapamil as an adjunct to nitroglycerin therapy.
*Nitroglycerin lowers blood pressure by reducing venous return and dilating the
arterioles. The lowered blood pressure
activates the baroreceptor reflex, causing reflex tachycardia, which can increase cardiac
,demand and negate the therapeutic
effects of nitroglycerin. Treatment with a beta blocker or verapamil suppresses the heart
to slow the rate.
4. A patient with histoplasmosis is being treated with itraconazole (Sporanox).
The nurse will teach this patient to report which symptoms?
a. Gynecomastia and decreased libido
b. Headache and rash
c. Nausea, vomiting, and anorexia
d. Visual disturbances
c. Nausea, vomiting, and anorexia
*well tolerated medication, but lowers potassium levels leads to dysrhythmias
5. A patient who is pregnant has a history of recurrent genital herpesvirus (HSV).
The patient asks the nurse what will be done to suppress an outbreak when she
is near term. The nurse will tell the patient that:
a. antiviral medications are not safe during pregnancy.
b. intravenous antiviral agents will be used if an outbreak occurs.
c. oral acyclovir (Zovirax) may be used during pregnancy.
d.topical acyclovir (Zovirax) must be used to control outbreaks
c. oral acyclovir (Zovirax) may be used during pregnancy.
*is considered safe for use during pregnancy to suppress or treat outbreaks of genital
herpes.
6. The nurse is caring for a patient receiving intravenous acyclovir (Zovirax). To
prevent nephrotoxicity associated with intravenous acyclovir, the nurse will:
a. hydrate the patient during the infusion and for 2 hours after the infusion.
b. increase the patient's intake of foods rich in vitamin C.
c. monitor urinary output every 30 minutes.
d. provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion.
a. hydrate the patient during the infusion and for 2 hours after the infusion.
*Intravenous acyclovir has the potential to cause nephrotoxicity, and one of the
preventive measures is to ensure adequate hydration.
,7. Which statement is correct about the contrast between a carbose and miglitol?
a. Miglitol has not been associated with hepatic dysfunction.
b. With miglitol, sucrose can be used to treat hypoglycemia.
c. Miglitol is less effective in African Americans.
d. Miglitol has no gastrointestinal side effects.
a. Miglitol has not been associated with hepatic dysfunction.
*key difference is that acarbose has been associated with rare cases of hepatic
dysfunction
8. A nurse counsels a patient with diabetes who is starting therapy with an alpha-
glucosidase inhibitor. The patient should be educated about the potential for
which adverse reactions? (Select all that apply.)
a. Hypoglycemia
b. Flatulence
c. Elevated iron levels in the blood
d. Fluid retention
e. Diarrhea
b. Flatulence
e. Diarrhea
*due to build up of gasses (flatulence) from to undigested carbohydrates reaching the
colon and causing an osmotic effect (diarrhea)
9. The nurse is caring for a pregnant patient recently diagnosed with
hypothyroidism. The patient tells the nurse she does not want to take
medications while she is pregnant. What will the nurse explain to this patient?
a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence.
b. Neuropsychologic deficits in the fetus can occur if the condition is not treated.
c. No danger to the fetus exists until the third trimester.
d. Treatment is required only if the patient is experiencing symptoms.
b. Neuropsychologic deficits in the fetus can occur if the condition is not treated.
*Thyroid hormones are crucial for the normal development of the fetal brain and
nervous system and must be treated in pregnancy.
10. A nurse is teaching a patient who has been diagnosed with hypothyroidism
about levothyroxine (Synthroid). Which statement by the patient indicates a need
for further teaching?
, a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider." c. "If I
take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
*this statement is incorrect since calcium interferes with the absorption of Synthroid, it
may need to be increased not decreased.
11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid).
The nurse assesses the patient at the beginning of the shift and notes a heart rate
of 62 beats per minute and a temperature of 97.2° F. The patient is lethargic and
difficult to arouse. The nurse will contact the provider to request an order for
which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole)
c. Intravenous levothyroxine
*IV allows for a more rapid correction of thyroid hormone levels especially
hypothyroidism with symptoms of myxedema coma or severe hypothyroidism. This is
considered a medical emergency.
12. A patient is admitted to the hospital and will begin taking levothyroxine
(Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The
nurse will notify the provider to discuss _____ the _____ dose.
a. reducing levothyroxine
b. reducing warfarin
c. increasing levothyroxine
d. increasing warfarin
b. reducing warfarin
*Levothyroxine (Synthroid) can potentially increase the effects of warfarin, leading to an
increased risk of bleeding.
13. An older adult patient is diagnosed with hypothyroidism. The initial free T4
level is 0.5 mg/dL, and the TSH level is 8 microunits/mL. The prescriber orders
levothyroxine (Levothroid) 100 mcg/day PO. What will the nurse do?
