NUR 354 Exam 2: Pharmacology II V2 - Arizona College
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient is prescribed Lisinopril for hypertension. Which side effect should the nurse instruct the patient
to report immediately?
A. Yellowing of the skin
B. Increased appetite
C. Persistent dry cough
D. Occasional headache
Ans: C
Explanation: Lisinopril is an ACE inhibitor that commonly causes a dry, non-productive cough due to
bradykinin accumulation. This side effect is specific to ACE inhibitors and often requires a medication
change to an ARB. Other options like increased appetite are not associated with this drug class. Yellowing
of the skin indicates liver issues which are less common than respiratory symptoms. The nurse must
ensure the patient understands that this cough will not resolve with over-the-counter suppressants.
2. Which laboratory value is most important to monitor for a patient receiving a Heparin infusion?
A. Prothrombin Time (PT)
B. Platelet Count only
C. International Normalized Ratio (INR)
D. Activated Partial Thromboplastin Time (aPTT)
Ans: D
,Explanation: Heparin’s therapeutic effect is measured primarily through the aPTT to ensure the blood is
sufficiently anticoagulated. PT and INR are utilized for monitoring oral anticoagulants like Warfarin
rather than intravenous Heparin. While platelet counts are monitored for Heparin-Induced
Thrombocytopenia, the aPTT is the standard for dosage adjustment. Incorrectly monitoring the INR
would lead to improper dosing and increased bleeding risk. Nurses must titrate the infusion based on
specific facility protocols and aPTT results.
3. A patient is diagnosed with Digoxin toxicity. Which clinical manifestation is a classic sign of this condition?
A. Extreme thirst and dry mouth
B. High-pitched ringing in the ears
C. Visual disturbances such as yellow halos
D. Sudden increase in urinary output
Ans: C
Explanation: Digoxin toxicity often presents with gastrointestinal distress and visual changes like seeing
yellow-green halos around lights. Thirst and dry mouth are more indicative of dehydration or diabetes
than cardiac glycoside toxicity. Tinnitus is typically associated with aspirin toxicity rather than Digoxin.
Increased urinary output is a therapeutic goal of diuretics but not a sign of Digoxin overdose. The nurse
should check the apical pulse for one full minute before administration to prevent toxicity.
4. Which medication is considered the drug of choice for a patient experiencing an acute asthma attack?
A. Salmeterol
B. Fluticasone
C. Montelukast
D. Albuterol
, Ans: D
Explanation: Albuterol is a short-acting beta2-agonist (SABA) that provides rapid bronchodilation
during acute respiratory distress. Salmeterol is a long-acting agonist meant for maintenance and should
never be used for rescue. Montelukast and Fluticasone are used for long-term control and do not provide
immediate relief of bronchospasm. Choosing a maintenance drug during an attack can lead to worsening
hypoxia and respiratory failure. Patients must always carry their rescue inhaler to manage sudden
exacerbations effectively.
5. When administering Spironolactone, the nurse should monitor the patient for which electrolyte
imbalance?
A. Hypokalemia
B. Hyponatremia
C. Hypocalcemia
D. Hyperkalemia
Ans: D
Explanation: Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to the
retention of potassium. Unlike loop diuretics, this medication carries a high risk for hyperkalemia which
can cause cardiac arrhythmias. Hyponatremia is a potential side effect but is not the primary concern
compared to potassium levels. Hypocalcemia is not a standard risk associated with potassium-sparing
diuretic therapy. Nurses must advise patients to avoid salt substitutes that contain high amounts of
potassium.
6. A patient is prescribed Warfarin. What is the standard antidote for a Warfarin overdose?
A. Protamine Sulfate
Updated and Latest Questions and Correct Answers with
Rationale
1. A patient is prescribed Lisinopril for hypertension. Which side effect should the nurse instruct the patient
to report immediately?
A. Yellowing of the skin
B. Increased appetite
C. Persistent dry cough
D. Occasional headache
Ans: C
Explanation: Lisinopril is an ACE inhibitor that commonly causes a dry, non-productive cough due to
bradykinin accumulation. This side effect is specific to ACE inhibitors and often requires a medication
change to an ARB. Other options like increased appetite are not associated with this drug class. Yellowing
of the skin indicates liver issues which are less common than respiratory symptoms. The nurse must
ensure the patient understands that this cough will not resolve with over-the-counter suppressants.
2. Which laboratory value is most important to monitor for a patient receiving a Heparin infusion?
A. Prothrombin Time (PT)
B. Platelet Count only
C. International Normalized Ratio (INR)
D. Activated Partial Thromboplastin Time (aPTT)
Ans: D
,Explanation: Heparin’s therapeutic effect is measured primarily through the aPTT to ensure the blood is
sufficiently anticoagulated. PT and INR are utilized for monitoring oral anticoagulants like Warfarin
rather than intravenous Heparin. While platelet counts are monitored for Heparin-Induced
Thrombocytopenia, the aPTT is the standard for dosage adjustment. Incorrectly monitoring the INR
would lead to improper dosing and increased bleeding risk. Nurses must titrate the infusion based on
specific facility protocols and aPTT results.
3. A patient is diagnosed with Digoxin toxicity. Which clinical manifestation is a classic sign of this condition?
A. Extreme thirst and dry mouth
B. High-pitched ringing in the ears
C. Visual disturbances such as yellow halos
D. Sudden increase in urinary output
Ans: C
Explanation: Digoxin toxicity often presents with gastrointestinal distress and visual changes like seeing
yellow-green halos around lights. Thirst and dry mouth are more indicative of dehydration or diabetes
than cardiac glycoside toxicity. Tinnitus is typically associated with aspirin toxicity rather than Digoxin.
Increased urinary output is a therapeutic goal of diuretics but not a sign of Digoxin overdose. The nurse
should check the apical pulse for one full minute before administration to prevent toxicity.
4. Which medication is considered the drug of choice for a patient experiencing an acute asthma attack?
A. Salmeterol
B. Fluticasone
C. Montelukast
D. Albuterol
, Ans: D
Explanation: Albuterol is a short-acting beta2-agonist (SABA) that provides rapid bronchodilation
during acute respiratory distress. Salmeterol is a long-acting agonist meant for maintenance and should
never be used for rescue. Montelukast and Fluticasone are used for long-term control and do not provide
immediate relief of bronchospasm. Choosing a maintenance drug during an attack can lead to worsening
hypoxia and respiratory failure. Patients must always carry their rescue inhaler to manage sudden
exacerbations effectively.
5. When administering Spironolactone, the nurse should monitor the patient for which electrolyte
imbalance?
A. Hypokalemia
B. Hyponatremia
C. Hypocalcemia
D. Hyperkalemia
Ans: D
Explanation: Spironolactone is a potassium-sparing diuretic that inhibits aldosterone, leading to the
retention of potassium. Unlike loop diuretics, this medication carries a high risk for hyperkalemia which
can cause cardiac arrhythmias. Hyponatremia is a potential side effect but is not the primary concern
compared to potassium levels. Hypocalcemia is not a standard risk associated with potassium-sparing
diuretic therapy. Nurses must advise patients to avoid salt substitutes that contain high amounts of
potassium.
6. A patient is prescribed Warfarin. What is the standard antidote for a Warfarin overdose?
A. Protamine Sulfate
