BSN315 Exam 4 Actual Exam Style V3 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client with heart failure is receiving digoxin. Which laboratory value should the nurse
monitor most closely to prevent digoxin toxicity?
A. Serum potassium levels
B. Serum sodium levels
C. Serum calcium levels
D. Serum glucose levels
Answer: A
Rationale: Hypokalemia increases the risk of digoxin toxicity because potassium and
digoxin compete for the same binding sites. The nurse must monitor potassium levels
closely, especially if the client is also taking a diuretic. Maintaining a potassium level within
the normal range of 3.5 to 5.0 mEq/L is essential for client safety.
2. A client is prescribed lisinopril for hypertension. Which side effect should the nurse instruct
the client to report immediately?
A. A persistent dry cough
B. Occasional dizziness when standing
C. Increased appetite
,D. Mild headache in the morning
Answer: A
Rationale: A persistent dry cough is a common side effect of ACE inhibitors like lisinopril
due to the accumulation of bradykinin. While not life-threatening, it is often bothersome
enough to require a change in medication class. The nurse should explain that this cough
will likely not resolve without discontinuing the drug.
3. A client is starting warfarin therapy. Which lab test will the nurse monitor to determine the
effectiveness of the dose?
A. Activated partial thromboplastin time (aPTT)
B. Bleeding time
C. Platelet count
D. International Normalized Ratio (INR)
Answer: D
Rationale: The INR is the standard lab test used to monitor the effectiveness of warfarin
therapy. A therapeutic range for most conditions is typically between 2.0 and 3.0.
Consistent monitoring is required to adjust dosage and prevent bleeding or clotting
complications.
4. The nurse is preparing to administer phenytoin to a client with a seizure disorder. Which
teaching point is most important for long-term therapy?
A. Perform frequent oral hygiene and visit the dentist regularly.
, B. Take the medication only when a seizure is felt coming on.
C. Expect the urine to turn a bright orange color.
D. Stop the medication if a mild skin rash develops.
Answer: A
Rationale: Phenytoin can cause gingival hyperplasia, which is an overgrowth of the gum
tissue. Regular dental checkups and meticulous oral hygiene are necessary to minimize this
effect. Clients should never stop this medication abruptly, as it may trigger status
epilepticus.
5. A client is receiving intravenous heparin for a pulmonary embolism. Which medication
should the nurse have readily available as an antidote?
A. Vitamin K
B. Calcium gluconate
C. Glucagon
D. Protamine sulfate
Answer: D
Rationale: Protamine sulfate is the specific antagonist used to reverse the effects of
heparin in cases of overdose or severe bleeding. It works by binding to heparin to form a
stable salt, neutralizing its anticoagulant activity. Vitamin K is the antidote for warfarin, not
heparin.
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A client with heart failure is receiving digoxin. Which laboratory value should the nurse
monitor most closely to prevent digoxin toxicity?
A. Serum potassium levels
B. Serum sodium levels
C. Serum calcium levels
D. Serum glucose levels
Answer: A
Rationale: Hypokalemia increases the risk of digoxin toxicity because potassium and
digoxin compete for the same binding sites. The nurse must monitor potassium levels
closely, especially if the client is also taking a diuretic. Maintaining a potassium level within
the normal range of 3.5 to 5.0 mEq/L is essential for client safety.
2. A client is prescribed lisinopril for hypertension. Which side effect should the nurse instruct
the client to report immediately?
A. A persistent dry cough
B. Occasional dizziness when standing
C. Increased appetite
,D. Mild headache in the morning
Answer: A
Rationale: A persistent dry cough is a common side effect of ACE inhibitors like lisinopril
due to the accumulation of bradykinin. While not life-threatening, it is often bothersome
enough to require a change in medication class. The nurse should explain that this cough
will likely not resolve without discontinuing the drug.
3. A client is starting warfarin therapy. Which lab test will the nurse monitor to determine the
effectiveness of the dose?
A. Activated partial thromboplastin time (aPTT)
B. Bleeding time
C. Platelet count
D. International Normalized Ratio (INR)
Answer: D
Rationale: The INR is the standard lab test used to monitor the effectiveness of warfarin
therapy. A therapeutic range for most conditions is typically between 2.0 and 3.0.
Consistent monitoring is required to adjust dosage and prevent bleeding or clotting
complications.
4. The nurse is preparing to administer phenytoin to a client with a seizure disorder. Which
teaching point is most important for long-term therapy?
A. Perform frequent oral hygiene and visit the dentist regularly.
, B. Take the medication only when a seizure is felt coming on.
C. Expect the urine to turn a bright orange color.
D. Stop the medication if a mild skin rash develops.
Answer: A
Rationale: Phenytoin can cause gingival hyperplasia, which is an overgrowth of the gum
tissue. Regular dental checkups and meticulous oral hygiene are necessary to minimize this
effect. Clients should never stop this medication abruptly, as it may trigger status
epilepticus.
5. A client is receiving intravenous heparin for a pulmonary embolism. Which medication
should the nurse have readily available as an antidote?
A. Vitamin K
B. Calcium gluconate
C. Glucagon
D. Protamine sulfate
Answer: D
Rationale: Protamine sulfate is the specific antagonist used to reverse the effects of
heparin in cases of overdose or severe bleeding. It works by binding to heparin to form a
stable salt, neutralizing its anticoagulant activity. Vitamin K is the antidote for warfarin, not
heparin.
