NURS 615 PHARM EXAM 3 QUESTIONS
AND WELL DETAILED ANSWERS PLUS
RATIONALES || GRADED A+|| LATEST
UPDATE 2026/27
1. (Priority / ACE Inhibitors)
A patient taking lisinopril presents with swelling of the lips and difficulty breathing. What is the
priority action?
A. Administer antihistamine
B. Discontinue drug and give epinephrine
C. Monitor closely
D. Give corticosteroids
Answer: B
Rationale: This is angioedema, a life-threatening reaction. Airway compromise is priority →
stop ACE inhibitor and give epinephrine immediately. Antihistamines/steroids are supportive
but not first-line.
2. (Electrolytes / Diuretics)
A patient on furosemide has K⁺ = 2.9 mEq/L. Which finding requires immediate intervention?
A. Fatigue
B. Muscle cramps
C. Irregular heart rhythm
D. Increased urination
Answer: C
Rationale: Hypokalemia can cause fatal dysrhythmias. Cardiac effects take priority over
neuromuscular symptoms.
3. (Insulin / Clinical Judgment)
A patient receives rapid-acting insulin but refuses to eat. What is the best action?
A. Hold insulin
,B. Give insulin anyway
C. Notify provider and give carbohydrate
D. Administer glucagon
Answer: C
Rationale: Rapid insulin → risk of severe hypoglycemia if no food. Patient needs
carbohydrates immediately; provider may adjust dose.
4. (Warfarin Safety)
Which patient statement indicates correct understanding of warfarin therapy?
A. “I will increase leafy greens.”
B. “I will take aspirin for headaches.”
C. “I will have my INR checked regularly.”
D. “I can stop the medication if I feel fine.”
Answer: C
Rationale: INR monitoring is essential. Vitamin K intake must be consistent, not increased.
Aspirin ↑ bleeding risk.
5. (Beta Blockers / Contraindication)
Which patient should NOT receive propranolol?
A. Hypertension
B. History of MI
C. Asthma
D. Stable angina
Answer: C
Rationale: Nonselective beta-blockers block β2 receptors → bronchoconstriction, dangerous
in asthma.
6. (Antibiotics / Teaching)
A patient taking doxycycline reports severe sunburn. What is the cause?
A. Allergy
B. Drug toxicity
C. Photosensitivity
D. Overdose
,Answer: C
Rationale: Tetracyclines cause photosensitivity → patient education: sunscreen, avoid sun.
7. (Opioids / Safety)
A postoperative patient receiving morphine has RR = 8/min. What is the priority action?
A. Reassess in 30 minutes
B. Administer naloxone
C. Encourage deep breathing
D. Reduce dose
Answer: B
Rationale: RR < 10 = respiratory depression → emergency. Naloxone reverses opioid effects
immediately.
8. (SSRIs / Adverse Effects)
Which finding suggests serotonin syndrome?
A. Bradycardia and hypothermia
B. Tremor, agitation, hyperreflexia
C. Sedation and hypotension
D. Constipation and dry mouth
Answer: B
Rationale: Classic triad: mental status changes + autonomic instability + neuromuscular
hyperactivity.
9. (Digoxin Toxicity)
Which patient finding is most concerning?
A. HR 58 bpm
B. Yellow halos around lights
C. Nausea
D. Fatigue
Answer: B
Rationale: Visual disturbances are hallmark of digoxin toxicity. Bradycardia also matters, but
vision changes are highly specific.
, 10. (Heparin Monitoring)
A patient’s aPTT is 120 seconds. What is the priority?
A. Continue infusion
B. Increase dose
C. Stop infusion
D. Switch to warfarin
Answer: C
Rationale: aPTT is too high → bleeding risk → stop infusion immediately.
11. (Steroids / Long-term Use)
Which instruction is most important for a patient on prednisone?
A. Stop abruptly when better
B. Take with NSAIDs
C. Taper dose gradually
D. Avoid fluids
Answer: C
Rationale: Sudden stop → adrenal crisis. Must taper.
12. (Metformin Safety)
Which condition requires holding metformin?
A. Mild HTN
B. CT scan with contrast
C. Headache
D. Hyperlipidemia
Answer: B
Rationale: Contrast + metformin → lactic acidosis risk.
13. (Calcium Channel Blockers)
AND WELL DETAILED ANSWERS PLUS
RATIONALES || GRADED A+|| LATEST
UPDATE 2026/27
1. (Priority / ACE Inhibitors)
A patient taking lisinopril presents with swelling of the lips and difficulty breathing. What is the
priority action?
A. Administer antihistamine
B. Discontinue drug and give epinephrine
C. Monitor closely
D. Give corticosteroids
Answer: B
Rationale: This is angioedema, a life-threatening reaction. Airway compromise is priority →
stop ACE inhibitor and give epinephrine immediately. Antihistamines/steroids are supportive
but not first-line.
2. (Electrolytes / Diuretics)
A patient on furosemide has K⁺ = 2.9 mEq/L. Which finding requires immediate intervention?
A. Fatigue
B. Muscle cramps
C. Irregular heart rhythm
D. Increased urination
Answer: C
Rationale: Hypokalemia can cause fatal dysrhythmias. Cardiac effects take priority over
neuromuscular symptoms.
3. (Insulin / Clinical Judgment)
A patient receives rapid-acting insulin but refuses to eat. What is the best action?
A. Hold insulin
,B. Give insulin anyway
C. Notify provider and give carbohydrate
D. Administer glucagon
Answer: C
Rationale: Rapid insulin → risk of severe hypoglycemia if no food. Patient needs
carbohydrates immediately; provider may adjust dose.
4. (Warfarin Safety)
Which patient statement indicates correct understanding of warfarin therapy?
A. “I will increase leafy greens.”
B. “I will take aspirin for headaches.”
C. “I will have my INR checked regularly.”
D. “I can stop the medication if I feel fine.”
Answer: C
Rationale: INR monitoring is essential. Vitamin K intake must be consistent, not increased.
Aspirin ↑ bleeding risk.
5. (Beta Blockers / Contraindication)
Which patient should NOT receive propranolol?
A. Hypertension
B. History of MI
C. Asthma
D. Stable angina
Answer: C
Rationale: Nonselective beta-blockers block β2 receptors → bronchoconstriction, dangerous
in asthma.
6. (Antibiotics / Teaching)
A patient taking doxycycline reports severe sunburn. What is the cause?
A. Allergy
B. Drug toxicity
C. Photosensitivity
D. Overdose
,Answer: C
Rationale: Tetracyclines cause photosensitivity → patient education: sunscreen, avoid sun.
7. (Opioids / Safety)
A postoperative patient receiving morphine has RR = 8/min. What is the priority action?
A. Reassess in 30 minutes
B. Administer naloxone
C. Encourage deep breathing
D. Reduce dose
Answer: B
Rationale: RR < 10 = respiratory depression → emergency. Naloxone reverses opioid effects
immediately.
8. (SSRIs / Adverse Effects)
Which finding suggests serotonin syndrome?
A. Bradycardia and hypothermia
B. Tremor, agitation, hyperreflexia
C. Sedation and hypotension
D. Constipation and dry mouth
Answer: B
Rationale: Classic triad: mental status changes + autonomic instability + neuromuscular
hyperactivity.
9. (Digoxin Toxicity)
Which patient finding is most concerning?
A. HR 58 bpm
B. Yellow halos around lights
C. Nausea
D. Fatigue
Answer: B
Rationale: Visual disturbances are hallmark of digoxin toxicity. Bradycardia also matters, but
vision changes are highly specific.
, 10. (Heparin Monitoring)
A patient’s aPTT is 120 seconds. What is the priority?
A. Continue infusion
B. Increase dose
C. Stop infusion
D. Switch to warfarin
Answer: C
Rationale: aPTT is too high → bleeding risk → stop infusion immediately.
11. (Steroids / Long-term Use)
Which instruction is most important for a patient on prednisone?
A. Stop abruptly when better
B. Take with NSAIDs
C. Taper dose gradually
D. Avoid fluids
Answer: C
Rationale: Sudden stop → adrenal crisis. Must taper.
12. (Metformin Safety)
Which condition requires holding metformin?
A. Mild HTN
B. CT scan with contrast
C. Headache
D. Hyperlipidemia
Answer: B
Rationale: Contrast + metformin → lactic acidosis risk.
13. (Calcium Channel Blockers)
