WGU D398 INTRODUCTION TO PHARMACOLOGY OBJECTIVE ASSESSMENT TEST – QUESTIONS AND ANSWERS |
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE
2026/2027
1. A patient with a history of peptic ulcer disease requires pain management post-surgery. Which medication
should the nurse question if prescribed?
A. Acetaminophen
B. Ibuprofen
C. Morphine sulfate
D. Hydromorphone
Correct Answer: B. Ibuprofen
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX) enzymes,
reducing prostaglandin synthesis. Prostaglandins protect the gastric mucosa; their inhibition can lead to gastric
irritation and ulceration. In a patient with a history of peptic ulcer disease, this could precipitate a gastrointestinal
bleed. Acetaminophen is a safer analgesic for this patient as it does not affect the GI mucosa. Morphine and
hydromorphone are opioid analgesics and do not cause the direct gastric mucosal damage associated with NSAIDs.
,2. A healthcare provider prescribes metoprolol for a patient with hypertension. The nurse understands that this
medication’s primary mechanism of action involves:
A. Blocking beta-1 adrenergic receptors in the heart
B. Blocking alpha-1 adrenergic receptors in blood vessels
C. Inhibiting the angiotensin-converting enzyme
D. Blocking calcium channels in the vascular smooth muscle
Correct Answer: A. Blocking beta-1 adrenergic receptors in the heart
Rationale: Metoprolol is a selective beta-1 adrenergic antagonist, primarily affecting the heart. By blocking beta-1
receptors, it decreases heart rate, contractility, and cardiac output, leading to a reduction in blood pressure. This makes
it a cardioselective beta-blocker. Option B describes alpha-1 blockers like prazosin; Option C describes ACE inhibitors
like lisinopril; and Option D describes calcium channel blockers like amlodipine. Understanding these mechanisms is
fundamental to safe medication administration.
3. A nurse is preparing to administer a scheduled dose of digoxin. The patient’s apical pulse is 52 beats per
minute. What is the nurse’s priority action?
,A. Administer the medication as ordered.
B. Hold the medication and notify the healthcare provider.
C. Administer the medication and monitor the pulse in 30 minutes.
D. Reassess the pulse in one hour.
Correct Answer: B. Hold the medication and notify the healthcare provider.
Rationale: Digoxin has a narrow therapeutic index and significantly decreases heart rate. The therapeutic range for
digoxin is typically 0.8-2.0 ng/mL, and toxicity can manifest as bradycardia. A general rule is to hold digoxin if the
apical pulse is less than 60 bpm in an adult and notify the prescriber. Administering it with a pulse of 52 would increase
the risk of severe bradycardia and other dysrhythmias. Reassessment or administration would be unsafe without a
provider's order for this parameter.
4. During a patient education session on warfarin, which statement by the patient indicates a need for further
teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I need to have my blood drawn regularly to check my levels."
C. "I can take ibuprofen for my headaches as needed."
D. "I should report any unusual bleeding or bruising to my doctor."
, Correct Answer: C. "I can take ibuprofen for my headaches as needed."
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. Ibuprofen is an NSAID that also inhibits
platelet aggregation and can increase the risk of gastrointestinal bleeding. Concurrent use significantly heightens the
bleeding risk. Patients on warfarin should avoid NSAIDs and consult their provider for pain management. The other
statements reflect appropriate understanding of warfarin therapy: the need for INR monitoring, the interaction of
vitamin K (found in leafy greens), and the importance of reporting bleeding signs.
5. A patient newly diagnosed with type 2 diabetes is prescribed metformin. What is the most important adverse
effect the nurse should educate the patient about?
A. Hypoglycemia
B. Lactic acidosis
C. Weight gain
D. Nephrotoxicity
Correct Answer: B. Lactic acidosis
Rationale: Metformin is a biguanide that decreases hepatic glucose production and increases insulin sensitivity. Its
most serious, though rare, adverse effect is lactic acidosis, which can be fatal. The risk is higher in patients with renal
VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE
2026/2027
1. A patient with a history of peptic ulcer disease requires pain management post-surgery. Which medication
should the nurse question if prescribed?
A. Acetaminophen
B. Ibuprofen
C. Morphine sulfate
D. Hydromorphone
Correct Answer: B. Ibuprofen
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that inhibits cyclooxygenase (COX) enzymes,
reducing prostaglandin synthesis. Prostaglandins protect the gastric mucosa; their inhibition can lead to gastric
irritation and ulceration. In a patient with a history of peptic ulcer disease, this could precipitate a gastrointestinal
bleed. Acetaminophen is a safer analgesic for this patient as it does not affect the GI mucosa. Morphine and
hydromorphone are opioid analgesics and do not cause the direct gastric mucosal damage associated with NSAIDs.
,2. A healthcare provider prescribes metoprolol for a patient with hypertension. The nurse understands that this
medication’s primary mechanism of action involves:
A. Blocking beta-1 adrenergic receptors in the heart
B. Blocking alpha-1 adrenergic receptors in blood vessels
C. Inhibiting the angiotensin-converting enzyme
D. Blocking calcium channels in the vascular smooth muscle
Correct Answer: A. Blocking beta-1 adrenergic receptors in the heart
Rationale: Metoprolol is a selective beta-1 adrenergic antagonist, primarily affecting the heart. By blocking beta-1
receptors, it decreases heart rate, contractility, and cardiac output, leading to a reduction in blood pressure. This makes
it a cardioselective beta-blocker. Option B describes alpha-1 blockers like prazosin; Option C describes ACE inhibitors
like lisinopril; and Option D describes calcium channel blockers like amlodipine. Understanding these mechanisms is
fundamental to safe medication administration.
3. A nurse is preparing to administer a scheduled dose of digoxin. The patient’s apical pulse is 52 beats per
minute. What is the nurse’s priority action?
,A. Administer the medication as ordered.
B. Hold the medication and notify the healthcare provider.
C. Administer the medication and monitor the pulse in 30 minutes.
D. Reassess the pulse in one hour.
Correct Answer: B. Hold the medication and notify the healthcare provider.
Rationale: Digoxin has a narrow therapeutic index and significantly decreases heart rate. The therapeutic range for
digoxin is typically 0.8-2.0 ng/mL, and toxicity can manifest as bradycardia. A general rule is to hold digoxin if the
apical pulse is less than 60 bpm in an adult and notify the prescriber. Administering it with a pulse of 52 would increase
the risk of severe bradycardia and other dysrhythmias. Reassessment or administration would be unsafe without a
provider's order for this parameter.
4. During a patient education session on warfarin, which statement by the patient indicates a need for further
teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I need to have my blood drawn regularly to check my levels."
C. "I can take ibuprofen for my headaches as needed."
D. "I should report any unusual bleeding or bruising to my doctor."
, Correct Answer: C. "I can take ibuprofen for my headaches as needed."
Rationale: Warfarin is an anticoagulant that increases the risk of bleeding. Ibuprofen is an NSAID that also inhibits
platelet aggregation and can increase the risk of gastrointestinal bleeding. Concurrent use significantly heightens the
bleeding risk. Patients on warfarin should avoid NSAIDs and consult their provider for pain management. The other
statements reflect appropriate understanding of warfarin therapy: the need for INR monitoring, the interaction of
vitamin K (found in leafy greens), and the importance of reporting bleeding signs.
5. A patient newly diagnosed with type 2 diabetes is prescribed metformin. What is the most important adverse
effect the nurse should educate the patient about?
A. Hypoglycemia
B. Lactic acidosis
C. Weight gain
D. Nephrotoxicity
Correct Answer: B. Lactic acidosis
Rationale: Metformin is a biguanide that decreases hepatic glucose production and increases insulin sensitivity. Its
most serious, though rare, adverse effect is lactic acidosis, which can be fatal. The risk is higher in patients with renal
