Pharmacology and Safe
Medication Administration
(Part 3)
### Question 1
The nurse is administering digoxin to a patient with heart failure. Which finding indicates the patient is
at risk for digoxin toxicity?
A. Serum potassium of 3.2 mEq/L
B. Serum creatinine of 1.0 mg/dL
C. Heart rate of 72 beats per minute
D. Blood pressure of 130/80 mmHg
,💫RATIONALE✔️✔️: Hypokalemia (serum potassium < 3.5 mEq/L) increases the risk of digoxin toxicity
by enhancing the effects of digoxin on the heart. The nurse should monitor potassium levels and report
hypokalemia to the healthcare provider. Other risk factors for digoxin toxicity include renal impairment
and advanced age.
💫ANSWER✔️✔️: A. Serum potassium of 3.2 mEq/L
---
### Question 2
A patient is prescribed enoxaparin for prophylaxis of deep vein thrombosis. The nurse should administer
this medication via which route?
A. Subcutaneous injection
B. Intramuscular injection
C. Intravenous infusion
D. Oral administration
💫RATIONALE✔️✔️: Enoxaparin is a low-molecular-weight heparin that should be administered by
subcutaneous injection, typically in the abdomen. The injection should be given in the fatty tissue,
alternating sides. The site should not be massaged after injection. A 25-27 gauge needle is typically used.
💫ANSWER✔️✔️: A. Subcutaneous injection
---
### Question 3
,The nurse is preparing to administer intravenous vancomycin to a patient with a methicillin-resistant
Staphylococcus aureus (MRSA) infection. Which action is essential for safe administration?
A. Infuse the medication over at least 60 minutes
B. Administer the medication as a rapid IV push
C. Monitor the patient's blood glucose levels
D. Pre-medicate with diphenhydramine
💫RATIONALE✔️✔️: Vancomycin should be infused over at least 60 minutes to prevent red man
syndrome, a hypersensitivity reaction characterized by flushing, rash, and hypotension. The nurse
should also monitor renal function and vancomycin trough levels. The infusion rate should be adjusted
based on the patient's weight and renal function.
💫ANSWER✔️✔️: A. Infuse the medication over at least 60 minutes
---
### Question 4
A patient is prescribed metoprolol for hypertension and angina. The nurse should monitor the patient
for which adverse effect?
A. Bradycardia and hypotension
B. Tachycardia and hypertension
C. Hyperglycemia and weight loss
D. Bronchospasm and wheezing
, 💫RATIONALE✔️✔️: Metoprolol is a beta-blocker that can cause bradycardia and hypotension. The
nurse should monitor the patient's heart rate and blood pressure before and after administration.
Bronchospasm is more common with non-selective beta-blockers; metoprolol is cardioselective but can
still cause bronchospasm at higher doses.
💫ANSWER✔️✔️: A. Bradycardia and hypotension
---
### Question 5
The nurse is providing education to a patient who has been prescribed warfarin. Which statement by the
patient indicates understanding?
A. "I will avoid eating green leafy vegetables."
B. "I will take my medication at the same time every day."
C. "I will stop taking my medication if I experience bleeding."
D. "I will take ibuprofen for headaches."
💫RATIONALE✔️✔️: Taking warfarin at the same time every day is essential for maintaining
consistent anticoagulation levels. The patient should maintain a consistent intake of vitamin K-rich foods
rather than avoiding them completely. Ibuprofen should be avoided due to increased bleeding risk.
💫ANSWER✔️✔️: B. "I will take my medication at the same time every day."
---
Medication Administration
(Part 3)
### Question 1
The nurse is administering digoxin to a patient with heart failure. Which finding indicates the patient is
at risk for digoxin toxicity?
A. Serum potassium of 3.2 mEq/L
B. Serum creatinine of 1.0 mg/dL
C. Heart rate of 72 beats per minute
D. Blood pressure of 130/80 mmHg
,💫RATIONALE✔️✔️: Hypokalemia (serum potassium < 3.5 mEq/L) increases the risk of digoxin toxicity
by enhancing the effects of digoxin on the heart. The nurse should monitor potassium levels and report
hypokalemia to the healthcare provider. Other risk factors for digoxin toxicity include renal impairment
and advanced age.
💫ANSWER✔️✔️: A. Serum potassium of 3.2 mEq/L
---
### Question 2
A patient is prescribed enoxaparin for prophylaxis of deep vein thrombosis. The nurse should administer
this medication via which route?
A. Subcutaneous injection
B. Intramuscular injection
C. Intravenous infusion
D. Oral administration
💫RATIONALE✔️✔️: Enoxaparin is a low-molecular-weight heparin that should be administered by
subcutaneous injection, typically in the abdomen. The injection should be given in the fatty tissue,
alternating sides. The site should not be massaged after injection. A 25-27 gauge needle is typically used.
💫ANSWER✔️✔️: A. Subcutaneous injection
---
### Question 3
,The nurse is preparing to administer intravenous vancomycin to a patient with a methicillin-resistant
Staphylococcus aureus (MRSA) infection. Which action is essential for safe administration?
A. Infuse the medication over at least 60 minutes
B. Administer the medication as a rapid IV push
C. Monitor the patient's blood glucose levels
D. Pre-medicate with diphenhydramine
💫RATIONALE✔️✔️: Vancomycin should be infused over at least 60 minutes to prevent red man
syndrome, a hypersensitivity reaction characterized by flushing, rash, and hypotension. The nurse
should also monitor renal function and vancomycin trough levels. The infusion rate should be adjusted
based on the patient's weight and renal function.
💫ANSWER✔️✔️: A. Infuse the medication over at least 60 minutes
---
### Question 4
A patient is prescribed metoprolol for hypertension and angina. The nurse should monitor the patient
for which adverse effect?
A. Bradycardia and hypotension
B. Tachycardia and hypertension
C. Hyperglycemia and weight loss
D. Bronchospasm and wheezing
, 💫RATIONALE✔️✔️: Metoprolol is a beta-blocker that can cause bradycardia and hypotension. The
nurse should monitor the patient's heart rate and blood pressure before and after administration.
Bronchospasm is more common with non-selective beta-blockers; metoprolol is cardioselective but can
still cause bronchospasm at higher doses.
💫ANSWER✔️✔️: A. Bradycardia and hypotension
---
### Question 5
The nurse is providing education to a patient who has been prescribed warfarin. Which statement by the
patient indicates understanding?
A. "I will avoid eating green leafy vegetables."
B. "I will take my medication at the same time every day."
C. "I will stop taking my medication if I experience bleeding."
D. "I will take ibuprofen for headaches."
💫RATIONALE✔️✔️: Taking warfarin at the same time every day is essential for maintaining
consistent anticoagulation levels. The patient should maintain a consistent intake of vitamin K-rich foods
rather than avoiding them completely. Ibuprofen should be avoided due to increased bleeding risk.
💫ANSWER✔️✔️: B. "I will take my medication at the same time every day."
---
