NU 578 Unit 3 Exam (2026/2027 Update) University of
South Alabama - Advanced Pharmacology Complete
100 Q&A Study Guide with Detailed Rationales
,1. A patient is prescribed spironolactone for heart failure. The nurse
understands that this medication is classified as which type of diuretic?
• A) Loop diuretic
• B) Thiazide diuretic
• C) Potassium-sparing diuretic
• D) Osmotic diuretic
Rationale: Spironolactone is an aldosterone antagonist that promotes sodium and
water excretion while retaining potassium. It is classified as a potassium-sparing
diuretic and is used in heart failure to improve symptoms, reduce hospitalizations,
and prolong survival. Unlike loop or thiazide diuretics, it does not cause significant
potassium loss and carries a risk of hyperkalemia.
2. The nurse is administering furosemide (Lasix) to a patient with pulmonary
edema. Which assessment finding indicates the medication is effective?
• A) Increased urine output and decreased crackles in lung bases
• B) Increased blood pressure and heart rate
• C) Decreased urine output and increased peripheral edema
• D) Increased serum potassium levels
Rationale: Furosemide is a loop diuretic that produces rapid diuresis, reducing
preload and pulmonary congestion. Effectiveness is demonstrated by increased
urine output, decreased crackles (pulmonary edema), reduced dyspnea, and
improved oxygenation. It does not increase blood pressure (may decrease it), does
not decrease urine output, and typically causes hypokalemia (not hyperkalemia).
3. A patient with hypertension is started on hydrochlorothiazide. The nurse
should monitor for which potential adverse effect?
• A) Hyperkalemia
• B) Hypokalemia and hyperglycemia
• C) Metabolic acidosis
, • D) Hypernatremia
Rationale: Thiazide diuretics such as hydrochlorothiazide can cause hypokalemia
(due to increased potassium excretion) and hyperglycemia (due to impaired insulin
release and decreased insulin sensitivity). They may also cause hyperuricemia,
hyponatremia, and hypercalcemia. Unlike potassium-sparing diuretics, they do not
cause hyperkalemia.
4. The nurse is administering IV potassium chloride to a patient with
hypokalemia. Which safety precaution is most important?
• A) Administer as a rapid IV push for immediate effect
• B) Infuse slowly, no faster than 10 mEq/hour, and never give via IV
push
• C) Mix in minimal amount of fluid to avoid dilution
• D) Administer through a central line only
Rationale: IV potassium MUST be infused slowly (no faster than 10 mEq/hour)
and NEVER given via IV push, as rapid administration can cause cardiac arrest
(lethal injection). It must be diluted properly as it is extremely irritating to veins.
Cardiac monitoring is recommended during infusion.
5. A patient taking digoxin and furosemide reports nausea, vomiting, and
yellow vision. Which laboratory value should the nurse assess first?
• A) Serum sodium
• B) Serum potassium
• C) Serum calcium
• D) Serum magnesium
Rationale: Nausea, vomiting, and visual disturbances (yellow vision) are classic
signs of digoxin toxicity. Furosemide (a loop diuretic) can cause hypokalemia,
which increases digoxin binding and risk of toxicity. Potassium levels must be
maintained between 3.5-5 mEq/L in patients taking digoxin. Hypokalemia is the
most common cause of digoxin-induced dysrhythmias.
, 6. The nurse is educating a patient about spironolactone. Which statement by
the patient indicates understanding?
• A) "I should use salt substitutes to prevent low potassium."
• B) "I need to avoid potassium-rich foods and salt substitutes while
taking this medication."
• C) "This medication will increase my potassium excretion."
• D) "I can take this medication with my potassium supplement."
Rationale: Spironolactone is a potassium-sparing diuretic that causes potassium
retention. Patients should avoid potassium-rich foods (bananas, oranges,
avocados), salt substitutes (which contain potassium), and potassium supplements
to prevent life-threatening hyperkalemia. It does not increase potassium excretion.
7. The nurse is reviewing the RAAS system. Which statement accurately
describes the role of angiotensin II?
• A) It causes vasodilation and decreases blood pressure
• B) It promotes sodium excretion and water loss
• C) It causes vasoconstriction and stimulates aldosterone release
• D) It inhibits the release of antidiuretic hormone
Rationale: Angiotensin II is a potent vasoconstrictor that raises blood pressure by
increasing total peripheral resistance. It also stimulates aldosterone release from
the adrenal cortex, which promotes sodium and water retention, further increasing
blood pressure.
8. A patient with heart failure is prescribed furosemide. The nurse should
monitor for which electrolyte imbalance?
• A) Hyperkalemia
• B) Hypokalemia
• C) Hypernatremia
South Alabama - Advanced Pharmacology Complete
100 Q&A Study Guide with Detailed Rationales
,1. A patient is prescribed spironolactone for heart failure. The nurse
understands that this medication is classified as which type of diuretic?
• A) Loop diuretic
• B) Thiazide diuretic
• C) Potassium-sparing diuretic
• D) Osmotic diuretic
Rationale: Spironolactone is an aldosterone antagonist that promotes sodium and
water excretion while retaining potassium. It is classified as a potassium-sparing
diuretic and is used in heart failure to improve symptoms, reduce hospitalizations,
and prolong survival. Unlike loop or thiazide diuretics, it does not cause significant
potassium loss and carries a risk of hyperkalemia.
2. The nurse is administering furosemide (Lasix) to a patient with pulmonary
edema. Which assessment finding indicates the medication is effective?
• A) Increased urine output and decreased crackles in lung bases
• B) Increased blood pressure and heart rate
• C) Decreased urine output and increased peripheral edema
• D) Increased serum potassium levels
Rationale: Furosemide is a loop diuretic that produces rapid diuresis, reducing
preload and pulmonary congestion. Effectiveness is demonstrated by increased
urine output, decreased crackles (pulmonary edema), reduced dyspnea, and
improved oxygenation. It does not increase blood pressure (may decrease it), does
not decrease urine output, and typically causes hypokalemia (not hyperkalemia).
3. A patient with hypertension is started on hydrochlorothiazide. The nurse
should monitor for which potential adverse effect?
• A) Hyperkalemia
• B) Hypokalemia and hyperglycemia
• C) Metabolic acidosis
, • D) Hypernatremia
Rationale: Thiazide diuretics such as hydrochlorothiazide can cause hypokalemia
(due to increased potassium excretion) and hyperglycemia (due to impaired insulin
release and decreased insulin sensitivity). They may also cause hyperuricemia,
hyponatremia, and hypercalcemia. Unlike potassium-sparing diuretics, they do not
cause hyperkalemia.
4. The nurse is administering IV potassium chloride to a patient with
hypokalemia. Which safety precaution is most important?
• A) Administer as a rapid IV push for immediate effect
• B) Infuse slowly, no faster than 10 mEq/hour, and never give via IV
push
• C) Mix in minimal amount of fluid to avoid dilution
• D) Administer through a central line only
Rationale: IV potassium MUST be infused slowly (no faster than 10 mEq/hour)
and NEVER given via IV push, as rapid administration can cause cardiac arrest
(lethal injection). It must be diluted properly as it is extremely irritating to veins.
Cardiac monitoring is recommended during infusion.
5. A patient taking digoxin and furosemide reports nausea, vomiting, and
yellow vision. Which laboratory value should the nurse assess first?
• A) Serum sodium
• B) Serum potassium
• C) Serum calcium
• D) Serum magnesium
Rationale: Nausea, vomiting, and visual disturbances (yellow vision) are classic
signs of digoxin toxicity. Furosemide (a loop diuretic) can cause hypokalemia,
which increases digoxin binding and risk of toxicity. Potassium levels must be
maintained between 3.5-5 mEq/L in patients taking digoxin. Hypokalemia is the
most common cause of digoxin-induced dysrhythmias.
, 6. The nurse is educating a patient about spironolactone. Which statement by
the patient indicates understanding?
• A) "I should use salt substitutes to prevent low potassium."
• B) "I need to avoid potassium-rich foods and salt substitutes while
taking this medication."
• C) "This medication will increase my potassium excretion."
• D) "I can take this medication with my potassium supplement."
Rationale: Spironolactone is a potassium-sparing diuretic that causes potassium
retention. Patients should avoid potassium-rich foods (bananas, oranges,
avocados), salt substitutes (which contain potassium), and potassium supplements
to prevent life-threatening hyperkalemia. It does not increase potassium excretion.
7. The nurse is reviewing the RAAS system. Which statement accurately
describes the role of angiotensin II?
• A) It causes vasodilation and decreases blood pressure
• B) It promotes sodium excretion and water loss
• C) It causes vasoconstriction and stimulates aldosterone release
• D) It inhibits the release of antidiuretic hormone
Rationale: Angiotensin II is a potent vasoconstrictor that raises blood pressure by
increasing total peripheral resistance. It also stimulates aldosterone release from
the adrenal cortex, which promotes sodium and water retention, further increasing
blood pressure.
8. A patient with heart failure is prescribed furosemide. The nurse should
monitor for which electrolyte imbalance?
• A) Hyperkalemia
• B) Hypokalemia
• C) Hypernatremia
