PRN 1381/PRN1381 Exam 4 V1 | Principles
of Pharmacology Q&A with Rationale |
Rasmussen University
1. A patient is prescribed Digoxin for heart failure. Which clinical manifestation should the
nurse recognize as an early sign of Digoxin toxicity?
A. Increased appetite and weight gain
B. Hypertension and tachycardia
C. Sudden increase in urinary output
D. Anorexia, nausea, and vomiting
Answer: D
Rationale: Digoxin toxicity commonly presents with gastrointestinal symptoms such as
anorexia and nausea as early indicators. The nurse must monitor the patient for these
subtle changes to prevent more severe cardiac dysrhythmias. Visual disturbances like
yellow-green halos are also classic signs that occur as toxicity progresses.
2. Which laboratory value is most critical for the nurse to monitor in a patient receiving
Warfarin (Coumadin) therapy?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Serum potassium levels
,D. Platelet count
Answer: B
Rationale: The INR is the standard laboratory test used to monitor the effectiveness of
Warfarin therapy. A therapeutic INR for most patients is typically between 2.0 and 3.0.
Frequent monitoring is necessary to adjust dosing and prevent complications such as
hemorrhage or thrombosis.
3. A patient is receiving an intravenous Heparin infusion. Which medication should the nurse
have readily available as an antidote in case of overdose?
A. Protamine sulfate
B. Vitamin K
C. Glucagon
D. Calcium gluconate
Answer: A
Rationale: Protamine sulfate is the specific antagonist used to reverse the effects of
Heparin. It works by binding with Heparin to form a stable salt, neutralizing its
anticoagulant activity. The nurse must administer this slowly via the IV route to avoid rapid
hypotension.
4. The nurse is providing education to a patient regarding the storage of sublingual
Nitroglycerin tablets. Which statement by the patient indicates understanding?
A. I will keep the tablets in a clear plastic container for easy access.
, B. I should store the bottle in the glove compartment of my car.
C. I can mix these tablets with my other daily medications in a pill organizer.
D. I will keep the tablets in the original dark glass bottle.
Answer: D
Rationale: Nitroglycerin is highly sensitive to light, heat, and moisture, which can degrade
the medication’s potency. Keeping it in the original amber-colored glass bottle ensures that
the tablets remain effective when needed for chest pain. Patients should also replace the
bottle every 6 months even if tablets remain.
5. A patient taking Lisinopril for hypertension develops a persistent, dry cough. What is the
nurse’s best action?
A. Advise the patient to take an over-the-counter cough suppressant.
B. Inform the patient that this is a common, harmless side effect that will disappear.
C. Instruct the patient to stop the medication and notify the healthcare provider.
D. Suggest that the patient drink more water to soothe the throat.
Answer: C
Rationale: A dry, hacking cough is a well-known side effect of ACE inhibitors like Lisinopril
due to the accumulation of bradykinin. This side effect is often intolerable and usually
requires switching the patient to an Angiotensin II Receptor Blocker (ARB). The patient
of Pharmacology Q&A with Rationale |
Rasmussen University
1. A patient is prescribed Digoxin for heart failure. Which clinical manifestation should the
nurse recognize as an early sign of Digoxin toxicity?
A. Increased appetite and weight gain
B. Hypertension and tachycardia
C. Sudden increase in urinary output
D. Anorexia, nausea, and vomiting
Answer: D
Rationale: Digoxin toxicity commonly presents with gastrointestinal symptoms such as
anorexia and nausea as early indicators. The nurse must monitor the patient for these
subtle changes to prevent more severe cardiac dysrhythmias. Visual disturbances like
yellow-green halos are also classic signs that occur as toxicity progresses.
2. Which laboratory value is most critical for the nurse to monitor in a patient receiving
Warfarin (Coumadin) therapy?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Serum potassium levels
,D. Platelet count
Answer: B
Rationale: The INR is the standard laboratory test used to monitor the effectiveness of
Warfarin therapy. A therapeutic INR for most patients is typically between 2.0 and 3.0.
Frequent monitoring is necessary to adjust dosing and prevent complications such as
hemorrhage or thrombosis.
3. A patient is receiving an intravenous Heparin infusion. Which medication should the nurse
have readily available as an antidote in case of overdose?
A. Protamine sulfate
B. Vitamin K
C. Glucagon
D. Calcium gluconate
Answer: A
Rationale: Protamine sulfate is the specific antagonist used to reverse the effects of
Heparin. It works by binding with Heparin to form a stable salt, neutralizing its
anticoagulant activity. The nurse must administer this slowly via the IV route to avoid rapid
hypotension.
4. The nurse is providing education to a patient regarding the storage of sublingual
Nitroglycerin tablets. Which statement by the patient indicates understanding?
A. I will keep the tablets in a clear plastic container for easy access.
, B. I should store the bottle in the glove compartment of my car.
C. I can mix these tablets with my other daily medications in a pill organizer.
D. I will keep the tablets in the original dark glass bottle.
Answer: D
Rationale: Nitroglycerin is highly sensitive to light, heat, and moisture, which can degrade
the medication’s potency. Keeping it in the original amber-colored glass bottle ensures that
the tablets remain effective when needed for chest pain. Patients should also replace the
bottle every 6 months even if tablets remain.
5. A patient taking Lisinopril for hypertension develops a persistent, dry cough. What is the
nurse’s best action?
A. Advise the patient to take an over-the-counter cough suppressant.
B. Inform the patient that this is a common, harmless side effect that will disappear.
C. Instruct the patient to stop the medication and notify the healthcare provider.
D. Suggest that the patient drink more water to soothe the throat.
Answer: C
Rationale: A dry, hacking cough is a well-known side effect of ACE inhibitors like Lisinopril
due to the accumulation of bradykinin. This side effect is often intolerable and usually
requires switching the patient to an Angiotensin II Receptor Blocker (ARB). The patient
