NR566 Advanced Pharmacology for Care of the Family
– Week 4 Comprehensive Newest Exam (100
Questions with Rationales) INSTANT PDF
DOWNLOAD
1: Advanced Mixed Systems Pharmacology
1. A 58-year-old patient with hypertension is prescribed lisinopril. Which assessment
finding requires immediate intervention?
A. Dry cough
B. Serum potassium 5.8 mEq/L
C. Blood pressure 138/86 mmHg
D. Mild dizziness when standing
Answer: B
Rationale:
Lisinopril (an ACE inhibitor) can cause hyperkalemia due to decreased aldosterone
secretion. A potassium level of 5.8 mEq/L is dangerously high and increases risk of fatal
dysrhythmias. Mild cough and orthostatic hypotension are expected side effects.
2. A patient taking metformin is scheduled for a CT scan with IV contrast. What is the
priority nursing action?
A. Administer metformin immediately before the scan
B. Hold metformin before and after the procedure
C. Increase fluid intake only
D. Give insulin instead of metformin permanently
Answer: B
,Rationale:
Metformin must be withheld around contrast imaging due to risk of lactic acidosis,
especially if contrast causes renal impairment.
3. Which instruction is most important for a patient taking warfarin?
A. Increase intake of leafy green vegetables
B. Avoid all protein-rich foods
C. Maintain consistent vitamin K intake
D. Take with grapefruit juice
Answer: C
Rationale:
Warfarin effectiveness depends on vitamin K balance. Patients must maintain consistent
intake, not eliminate or increase suddenly.
4. A patient taking digoxin reports nausea, blurred vision, and yellow-green halos.
What is the priority action?
A. Give next dose with food
B. Hold medication and notify provider
C. Reassure patient symptoms are normal
D. Increase potassium intake
Answer: B
Rationale:
These are classic signs of digoxin toxicity, requiring immediate discontinuation and
evaluation.
5. Which medication is contraindicated in pregnancy for hypertension?
A. Methyldopa
B. Labetalol
,C. Lisinopril
D. Nifedipine
Answer: C
Rationale:
ACE inhibitors like lisinopril cause fetal renal damage, oligohydramnios, and fetal death.
6. A patient with asthma is prescribed albuterol. Which finding indicates therapeutic
effect?
A. Increased heart rate
B. Decreased wheezing
C. Thickened sputum
D. Drowsiness
Answer: B
Rationale:
Albuterol is a bronchodilator. Improvement is shown by reduced wheezing and improved
airflow.
7. A nurse is teaching about insulin glargine. Which statement is correct?
A. “It can be mixed with regular insulin.”
B. “It has a peak effect in 2 hours.”
C. “It provides steady basal coverage.”
D. “It is given only when glucose is high.”
Answer: C
Rationale:
Glargine is a long-acting basal insulin with no peak and cannot be mixed in the same
syringe.
8. Which symptom indicates opioid overdose?
, A. Pinpoint pupils and respiratory depression
B. Hypertension and agitation
C. Dilated pupils and diarrhea
D. Fever and muscle rigidity
Answer: A
Rationale:
Opioid overdose causes respiratory depression + miosis (pinpoint pupils).
9. A patient is taking furosemide. Which lab value is most concerning?
A. Potassium 3.1 mEq/L
B. Sodium 140 mEq/L
C. Calcium 9.0 mg/dL
D. Glucose 98 mg/dL
Answer: A
Rationale:
Furosemide causes potassium loss → hypokalemia, increasing risk of dysrhythmias.
10. Which drug requires monitoring for ototoxicity?
A. Amoxicillin
B. Gentamicin
C. Metoprolol
D. Omeprazole
Answer: B
Rationale:
Aminoglycosides like gentamicin can cause hearing loss and vestibular damage.
11. A patient taking levothyroxine reports palpitations and weight loss. What does
this indicate?
– Week 4 Comprehensive Newest Exam (100
Questions with Rationales) INSTANT PDF
DOWNLOAD
1: Advanced Mixed Systems Pharmacology
1. A 58-year-old patient with hypertension is prescribed lisinopril. Which assessment
finding requires immediate intervention?
A. Dry cough
B. Serum potassium 5.8 mEq/L
C. Blood pressure 138/86 mmHg
D. Mild dizziness when standing
Answer: B
Rationale:
Lisinopril (an ACE inhibitor) can cause hyperkalemia due to decreased aldosterone
secretion. A potassium level of 5.8 mEq/L is dangerously high and increases risk of fatal
dysrhythmias. Mild cough and orthostatic hypotension are expected side effects.
2. A patient taking metformin is scheduled for a CT scan with IV contrast. What is the
priority nursing action?
A. Administer metformin immediately before the scan
B. Hold metformin before and after the procedure
C. Increase fluid intake only
D. Give insulin instead of metformin permanently
Answer: B
,Rationale:
Metformin must be withheld around contrast imaging due to risk of lactic acidosis,
especially if contrast causes renal impairment.
3. Which instruction is most important for a patient taking warfarin?
A. Increase intake of leafy green vegetables
B. Avoid all protein-rich foods
C. Maintain consistent vitamin K intake
D. Take with grapefruit juice
Answer: C
Rationale:
Warfarin effectiveness depends on vitamin K balance. Patients must maintain consistent
intake, not eliminate or increase suddenly.
4. A patient taking digoxin reports nausea, blurred vision, and yellow-green halos.
What is the priority action?
A. Give next dose with food
B. Hold medication and notify provider
C. Reassure patient symptoms are normal
D. Increase potassium intake
Answer: B
Rationale:
These are classic signs of digoxin toxicity, requiring immediate discontinuation and
evaluation.
5. Which medication is contraindicated in pregnancy for hypertension?
A. Methyldopa
B. Labetalol
,C. Lisinopril
D. Nifedipine
Answer: C
Rationale:
ACE inhibitors like lisinopril cause fetal renal damage, oligohydramnios, and fetal death.
6. A patient with asthma is prescribed albuterol. Which finding indicates therapeutic
effect?
A. Increased heart rate
B. Decreased wheezing
C. Thickened sputum
D. Drowsiness
Answer: B
Rationale:
Albuterol is a bronchodilator. Improvement is shown by reduced wheezing and improved
airflow.
7. A nurse is teaching about insulin glargine. Which statement is correct?
A. “It can be mixed with regular insulin.”
B. “It has a peak effect in 2 hours.”
C. “It provides steady basal coverage.”
D. “It is given only when glucose is high.”
Answer: C
Rationale:
Glargine is a long-acting basal insulin with no peak and cannot be mixed in the same
syringe.
8. Which symptom indicates opioid overdose?
, A. Pinpoint pupils and respiratory depression
B. Hypertension and agitation
C. Dilated pupils and diarrhea
D. Fever and muscle rigidity
Answer: A
Rationale:
Opioid overdose causes respiratory depression + miosis (pinpoint pupils).
9. A patient is taking furosemide. Which lab value is most concerning?
A. Potassium 3.1 mEq/L
B. Sodium 140 mEq/L
C. Calcium 9.0 mg/dL
D. Glucose 98 mg/dL
Answer: A
Rationale:
Furosemide causes potassium loss → hypokalemia, increasing risk of dysrhythmias.
10. Which drug requires monitoring for ototoxicity?
A. Amoxicillin
B. Gentamicin
C. Metoprolol
D. Omeprazole
Answer: B
Rationale:
Aminoglycosides like gentamicin can cause hearing loss and vestibular damage.
11. A patient taking levothyroxine reports palpitations and weight loss. What does
this indicate?
