NUR 354 Exam 3: Pharmacology II V2 - Arizona College
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient is prescribed furosemide for the management of pulmonary edema. Which laboratory value
should the nurse monitor most closely for potential adverse effects?
A. Serum Sodium
B. Serum Creatinine
C. Serum Potassium
D. Blood Urea Nitrogen
Ans: C
Explanation: Furosemide is a potent loop diuretic that causes significant excretion of potassium in the
urine. Hypokalemia is a common and dangerous adverse effect that can lead to life-threatening cardiac
dysrhythmias. The nurse must prioritize monitoring serum potassium levels to ensure patient safety
during therapy. If levels fall below the normal range, a potassium supplement may be required. While
other electrolytes and renal function tests are important, potassium depletion is the most critical acute
concern.
2. A nurse is caring for a patient receiving lisinopril. Which of the following findings would necessitate
notifying the healthcare provider immediately?
A. A persistent dry cough
B. Mild dizziness upon standing
C. A slight increase in serum potassium
D. Swelling of the tongue and lips
,Ans: D
Explanation: Swelling of the tongue and lips is a hallmark sign of angioedema, a rare but life-threatening
side effect of ACE inhibitors like lisinopril. This condition can lead to airway obstruction and requires
emergency medical intervention. A dry cough is common but usually not an emergency. While
hyperkalemia and orthostatic hypotension are side effects, they are generally less acute than angioedema.
Prompt identification and treatment of angioedema are essential to prevent respiratory failure.
3. Which assessment finding should the nurse prioritize before administering the daily dose of digoxin?
A. Blood pressure reading
B. Respiratory rate
C. Apical pulse for one full minute
D. Oxygen saturation
Ans: C
Explanation: Digoxin is a cardiac glycoside that slows the heart rate while increasing the force of
contraction. The nurse must assess the apical pulse for a full minute to detect bradycardia or irregular
rhythms. If the heart rate 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 index and
toxicity often manifests as bradycardia. Other vital signs are less specific to the immediate effects of
digoxin administration.
4. A patient is starting warfarin therapy for atrial fibrillation. Which lab test will be used to adjust the daily
dosage?
A. International Normalized Ratio (INR)
B. Platelet count
, C. Activated Partial Thromboplastin Time (aPTT)
D. Bleeding time
Ans: A
Explanation: Warfarin is an oral anticoagulant that requires careful monitoring using the PT and INR
values. The INR provides a standardized way to evaluate the effectiveness of warfarin across different
laboratories. For most indications, the target INR range is between 2.0 and 3.0. Dose adjustments are
based on these results to prevent either clot formation or excessive bleeding. The aPTT is used for
heparin monitoring, not for warfarin management.
5. What is the primary mechanism of action for spironolactone?
A. Inhibition of the sodium-potassium-chloride symporter
B. Direct inhibition of renin release
C. Antagonism of aldosterone receptors in the distal tubule
D. Blocking calcium channels in the smooth muscle
Ans: C
Explanation: Spironolactone is a potassium-sparing diuretic that works by blocking aldosterone
receptors in the kidney. By inhibiting aldosterone, the drug promotes sodium and water excretion while
retaining potassium. This mechanism makes it useful for treating hypertension and heart failure without
causing hypokalemia. Patients must be monitored for hyperkalemia, especially if they are also taking ACE
inhibitors. It is fundamentally different from loop diuretics which act on the ascending limb of Henle.
6. A nurse is teaching a patient about nitroglycerin sublingual tablets. Which instruction is most important
for the nurse to include?
A. Swallow the tablet with a full glass of water
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient is prescribed furosemide for the management of pulmonary edema. Which laboratory value
should the nurse monitor most closely for potential adverse effects?
A. Serum Sodium
B. Serum Creatinine
C. Serum Potassium
D. Blood Urea Nitrogen
Ans: C
Explanation: Furosemide is a potent loop diuretic that causes significant excretion of potassium in the
urine. Hypokalemia is a common and dangerous adverse effect that can lead to life-threatening cardiac
dysrhythmias. The nurse must prioritize monitoring serum potassium levels to ensure patient safety
during therapy. If levels fall below the normal range, a potassium supplement may be required. While
other electrolytes and renal function tests are important, potassium depletion is the most critical acute
concern.
2. A nurse is caring for a patient receiving lisinopril. Which of the following findings would necessitate
notifying the healthcare provider immediately?
A. A persistent dry cough
B. Mild dizziness upon standing
C. A slight increase in serum potassium
D. Swelling of the tongue and lips
,Ans: D
Explanation: Swelling of the tongue and lips is a hallmark sign of angioedema, a rare but life-threatening
side effect of ACE inhibitors like lisinopril. This condition can lead to airway obstruction and requires
emergency medical intervention. A dry cough is common but usually not an emergency. While
hyperkalemia and orthostatic hypotension are side effects, they are generally less acute than angioedema.
Prompt identification and treatment of angioedema are essential to prevent respiratory failure.
3. Which assessment finding should the nurse prioritize before administering the daily dose of digoxin?
A. Blood pressure reading
B. Respiratory rate
C. Apical pulse for one full minute
D. Oxygen saturation
Ans: C
Explanation: Digoxin is a cardiac glycoside that slows the heart rate while increasing the force of
contraction. The nurse must assess the apical pulse for a full minute to detect bradycardia or irregular
rhythms. If the heart rate 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 index and
toxicity often manifests as bradycardia. Other vital signs are less specific to the immediate effects of
digoxin administration.
4. A patient is starting warfarin therapy for atrial fibrillation. Which lab test will be used to adjust the daily
dosage?
A. International Normalized Ratio (INR)
B. Platelet count
, C. Activated Partial Thromboplastin Time (aPTT)
D. Bleeding time
Ans: A
Explanation: Warfarin is an oral anticoagulant that requires careful monitoring using the PT and INR
values. The INR provides a standardized way to evaluate the effectiveness of warfarin across different
laboratories. For most indications, the target INR range is between 2.0 and 3.0. Dose adjustments are
based on these results to prevent either clot formation or excessive bleeding. The aPTT is used for
heparin monitoring, not for warfarin management.
5. What is the primary mechanism of action for spironolactone?
A. Inhibition of the sodium-potassium-chloride symporter
B. Direct inhibition of renin release
C. Antagonism of aldosterone receptors in the distal tubule
D. Blocking calcium channels in the smooth muscle
Ans: C
Explanation: Spironolactone is a potassium-sparing diuretic that works by blocking aldosterone
receptors in the kidney. By inhibiting aldosterone, the drug promotes sodium and water excretion while
retaining potassium. This mechanism makes it useful for treating hypertension and heart failure without
causing hypokalemia. Patients must be monitored for hyperkalemia, especially if they are also taking ACE
inhibitors. It is fundamentally different from loop diuretics which act on the ascending limb of Henle.
6. A nurse is teaching a patient about nitroglycerin sublingual tablets. Which instruction is most important
for the nurse to include?
A. Swallow the tablet with a full glass of water
