Pharmacology and the Nursing
Process
10th Edition
• Author(s)Linda Lane Lilley;
Shelly Rainforth Collins; Julie
S. Snyder
,TEST BANK
Here is a professional, publication-quality pharmacology
examination review question bank. The questions are designed
to test clinical judgment, safety, and the application of the
nursing process, adhering strictly to the NCLEX-RN and Next-
Generation NCLEX (NGN) testing standards.
Question 1: Next-Generation NCLEX (NGN) Matrix/Grid Item
1. Item Type
Matrix/Grid (Clinical Judgment)
2. Clinical Scenario
A 67-year-old male patient with a history of chronic heart
failure (HF) and chronic kidney disease (CKD) Stage 3 is
admitted with worsening peripheral edema and dyspnea on
exertion. The provider prescribes an aggressive intravenous
loop diuretic regimen. The nurse is preparing to administer the
first dose of IV furosemide 40 mg.
,3. Question Stem
The nurse reviews the patient's morning laboratory results and
vital signs before administration. For each clinical finding, click
to indicate whether the finding requires the nurse to Hold the
Medication and Notify the Provider, Proceed with
Administration but Monitor Closely, or represents an Expected
Outcome of the therapy.
Hold Proceed
Expected
Clinical Finding and and
Outcome
Notify Monitor
Potassium: 3.1
mEq/L (3.1 mmol/L)
Serum Creatinine:
1.8 mg/dL (159
µmol/L) (Baseline:
1.7 mg/dL)
Blood Pressure:
142/88 mmHg
, Hold Proceed
Expected
Clinical Finding and and
Outcome
Notify Monitor
Urinary Output: 800
mL over the next 4
hours
4. Answer Options & Correct Choices
• Potassium: 3.1 mEq/L $\rightarrow$ Hold and Notify
• Serum Creatinine: 1.8 mg/dL $\rightarrow$ Proceed and
Monitor
• Blood Pressure: 142/88 mmHg $\rightarrow$ Proceed and
Monitor
• Urinary Output: 800 mL over 4 hours $\rightarrow$
Expected Outcome
5. Comprehensive Rationale
Furosemide is a potent loop diuretic that inhibits sodium and
chloride reabsorption in the thick ascending limb of the loop of
Henle. It causes significant excretion of potassium. A potassium
level of 3.1 mEq/L represents severe hypokalemia (normal: 3.5–
5.0 mEq/L). Administering a loop diuretic to a hypokalemic
patient increases the risk of fatal cardiac dysrhythmias.
Process
10th Edition
• Author(s)Linda Lane Lilley;
Shelly Rainforth Collins; Julie
S. Snyder
,TEST BANK
Here is a professional, publication-quality pharmacology
examination review question bank. The questions are designed
to test clinical judgment, safety, and the application of the
nursing process, adhering strictly to the NCLEX-RN and Next-
Generation NCLEX (NGN) testing standards.
Question 1: Next-Generation NCLEX (NGN) Matrix/Grid Item
1. Item Type
Matrix/Grid (Clinical Judgment)
2. Clinical Scenario
A 67-year-old male patient with a history of chronic heart
failure (HF) and chronic kidney disease (CKD) Stage 3 is
admitted with worsening peripheral edema and dyspnea on
exertion. The provider prescribes an aggressive intravenous
loop diuretic regimen. The nurse is preparing to administer the
first dose of IV furosemide 40 mg.
,3. Question Stem
The nurse reviews the patient's morning laboratory results and
vital signs before administration. For each clinical finding, click
to indicate whether the finding requires the nurse to Hold the
Medication and Notify the Provider, Proceed with
Administration but Monitor Closely, or represents an Expected
Outcome of the therapy.
Hold Proceed
Expected
Clinical Finding and and
Outcome
Notify Monitor
Potassium: 3.1
mEq/L (3.1 mmol/L)
Serum Creatinine:
1.8 mg/dL (159
µmol/L) (Baseline:
1.7 mg/dL)
Blood Pressure:
142/88 mmHg
, Hold Proceed
Expected
Clinical Finding and and
Outcome
Notify Monitor
Urinary Output: 800
mL over the next 4
hours
4. Answer Options & Correct Choices
• Potassium: 3.1 mEq/L $\rightarrow$ Hold and Notify
• Serum Creatinine: 1.8 mg/dL $\rightarrow$ Proceed and
Monitor
• Blood Pressure: 142/88 mmHg $\rightarrow$ Proceed and
Monitor
• Urinary Output: 800 mL over 4 hours $\rightarrow$
Expected Outcome
5. Comprehensive Rationale
Furosemide is a potent loop diuretic that inhibits sodium and
chloride reabsorption in the thick ascending limb of the loop of
Henle. It causes significant excretion of potassium. A potassium
level of 3.1 mEq/L represents severe hypokalemia (normal: 3.5–
5.0 mEq/L). Administering a loop diuretic to a hypokalemic
patient increases the risk of fatal cardiac dysrhythmias.
