NSG124/NSG 124 Exam 2 V1 |
Pharmacology Q&A with Rationale |
Herzing University
1. A patient is prescribed Digoxin for heart failure. Which clinical manifestation should the
nurse recognize as an early sign of digitalis toxicity?
A. Yellow-green halos around lights
B. Increased urine output
C. Increased appetite
D. Occipital headache
Correct Answer: A
Rationale: Visual disturbances, specifically yellow or green halos around lights, are a
classic early indicator of digoxin toxicity. The nurse must also monitor for gastrointestinal
symptoms like anorexia and nausea, which often occur alongside visual changes. Assessing
the serum digoxin level and potassium levels is essential because hypokalemia potentiates
the risk of toxicity.
2. A patient taking Lisinopril for hypertension complains of a persistent, dry, nonproductive
cough. What is the nurse’s best action?
A. Notify the provider as the medication may need to be changed.
B. Instruct the patient to increase fluid intake.
,C. Advise the patient to take the medication with food.
D. Suggest an over-the-counter antitussive.
Correct Answer: A
Rationale: The dry cough associated with ACE inhibitors like Lisinopril is due to the
accumulation of bradykinin in the respiratory tract. This side effect is often intolerable and
usually does not resolve without discontinuing the drug. The provider will typically switch
the patient to an Angiotensin II Receptor Blocker (ARB) to avoid this complication.
3. Which laboratory value is used to monitor the therapeutic effect of Warfarin (Coumadin)?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Bleeding time
Correct Answer: B
Rationale: Warfarin therapy is monitored using the PT/INR to ensure the blood is
sufficiently thinned to prevent clots while avoiding hemorrhage. For most indications like
atrial fibrillation, a therapeutic INR range is between 2.0 and 3.0. Frequent monitoring is
necessary because many foods and medications interact with Warfarin’s metabolism.
4. What is the primary antidote for a patient experiencing heparin-induced bleeding?
A. Protamine sulfate
, B. Aminocaproic acid
C. Vitamin K
D. Calcium gluconate
Correct Answer: A
Rationale: Protamine sulfate is the specific antagonist used to neutralize the effects of
Heparin by forming a stable salt complex. It is typically administered via slow IV injection
in emergency situations where bleeding is life-threatening. The nurse must monitor for
adverse effects of protamine, such as bradycardia and hypotension, during administration.
5. A patient is receiving Furosemide (Lasix). Which electrolyte imbalance should the nurse
prioritize in the assessment?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium along
with water and sodium, leading to a high risk of hypokalemia. Low potassium levels can
lead to life-threatening cardiac dysrhythmias and muscle weakness. Patients are often
Pharmacology Q&A with Rationale |
Herzing University
1. A patient is prescribed Digoxin for heart failure. Which clinical manifestation should the
nurse recognize as an early sign of digitalis toxicity?
A. Yellow-green halos around lights
B. Increased urine output
C. Increased appetite
D. Occipital headache
Correct Answer: A
Rationale: Visual disturbances, specifically yellow or green halos around lights, are a
classic early indicator of digoxin toxicity. The nurse must also monitor for gastrointestinal
symptoms like anorexia and nausea, which often occur alongside visual changes. Assessing
the serum digoxin level and potassium levels is essential because hypokalemia potentiates
the risk of toxicity.
2. A patient taking Lisinopril for hypertension complains of a persistent, dry, nonproductive
cough. What is the nurse’s best action?
A. Notify the provider as the medication may need to be changed.
B. Instruct the patient to increase fluid intake.
,C. Advise the patient to take the medication with food.
D. Suggest an over-the-counter antitussive.
Correct Answer: A
Rationale: The dry cough associated with ACE inhibitors like Lisinopril is due to the
accumulation of bradykinin in the respiratory tract. This side effect is often intolerable and
usually does not resolve without discontinuing the drug. The provider will typically switch
the patient to an Angiotensin II Receptor Blocker (ARB) to avoid this complication.
3. Which laboratory value is used to monitor the therapeutic effect of Warfarin (Coumadin)?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Bleeding time
Correct Answer: B
Rationale: Warfarin therapy is monitored using the PT/INR to ensure the blood is
sufficiently thinned to prevent clots while avoiding hemorrhage. For most indications like
atrial fibrillation, a therapeutic INR range is between 2.0 and 3.0. Frequent monitoring is
necessary because many foods and medications interact with Warfarin’s metabolism.
4. What is the primary antidote for a patient experiencing heparin-induced bleeding?
A. Protamine sulfate
, B. Aminocaproic acid
C. Vitamin K
D. Calcium gluconate
Correct Answer: A
Rationale: Protamine sulfate is the specific antagonist used to neutralize the effects of
Heparin by forming a stable salt complex. It is typically administered via slow IV injection
in emergency situations where bleeding is life-threatening. The nurse must monitor for
adverse effects of protamine, such as bradycardia and hypotension, during administration.
5. A patient is receiving Furosemide (Lasix). Which electrolyte imbalance should the nurse
prioritize in the assessment?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypermagnesemia
Correct Answer: B
Rationale: Furosemide is a loop diuretic that promotes the excretion of potassium along
with water and sodium, leading to a high risk of hypokalemia. Low potassium levels can
lead to life-threatening cardiac dysrhythmias and muscle weakness. Patients are often
