NURS 300 (Pharmacology) Unit Exam 3
Latest 2026/2027 | Newly Released
San Diego State University (SDSU).
50 Questions and Answers With Expert Rationales
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Content:
,Q1. A patient with hypertension and chronic kidney disease is prescribed lisinopril. Which
laboratory value should the nurse monitor most closely during the first 2 weeks of therapy?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum magnesium
Correct Answer: A
ACE inhibitors like lisinopril can reduce aldosterone secretion, leading to potassium retention
and hyperkalemia, especially in patients with impaired renal function. The nurse should monitor
serum potassium levels closely during initial therapy and with dose adjustments. Early detection
prevents dangerous cardiac arrhythmias associated with elevated potassium.
Q2. A nurse is caring for a patient receiving warfarin therapy with an INR of 4.2. The patient has
no signs of bleeding. What is the nurse's priority action?
A. Administer vitamin K immediately
B. Hold the next dose and notify the provider
C. Continue the current dose and recheck in 1 week
D. Administer fresh frozen plasma
Correct Answer: B
An INR of 4.2 is above the typical therapeutic range of 2.0–3.0 for most indications, indicating
supratherapeutic anticoagulation. The nurse should hold the next warfarin dose and notify the
provider to discuss dose adjustment. Vitamin K is reserved for INR >10 or active bleeding, and
fresh frozen plasma is used for life-threatening hemorrhage.
Q3. A patient with asthma is prescribed a long-acting beta-2 agonist (LABA). Which medication
should the nurse ensure the patient is also prescribed?
A. A leukotriene receptor antagonist
B. An inhaled corticosteroid
C. An anticholinergic bronchodilator
D. An oral corticosteroid
Correct Answer: B
LABAs such as salmeterol must never be used as monotherapy in asthma due to increased risk of
, asthma-related death; they must be combined with an inhaled corticosteroid. Inhaled
corticosteroids reduce airway inflammation and are the cornerstone of long-term asthma control.
This combination provides bronchodilation while addressing underlying inflammation.
Q4. A patient with heart failure is prescribed digoxin 0.25 mg daily. The nurse notes the patient's
serum digoxin level is 2.5 ng/mL. What is the therapeutic range for digoxin, and what is the
nurse's priority concern?
A. 0.5–1.0 ng/mL; risk of hypokalemia
B. 0.5–0.8 ng/mL; risk of toxicity
C. 0.8–2.0 ng/mL; risk of toxicity
D. 1.0–2.5 ng/mL; risk of bradycardia
Correct Answer: C
The therapeutic range for digoxin is 0.8–2.0 ng/mL; a level of 2.5 ng/mL indicates toxicity.
Digoxin toxicity manifests with nausea, vomiting, visual disturbances, and cardiac arrhythmias
including bradycardia and ventricular ectopy. The nurse should hold the next dose, notify the
provider, and monitor the patient closely for signs of toxicity.
Q5. A patient receiving heparin therapy has an aPTT of 90 seconds. The therapeutic range is 1.5–
2.5 times the control (control = 30 seconds). What is the nurse's appropriate action?
A. Increase the heparin infusion rate
B. Decrease the heparin infusion rate
C. Continue the current infusion rate
D. Administer protamine sulfate
Correct Answer: B
The therapeutic range is 45–75 seconds (1.5–2.5 × 30); an aPTT of 90 seconds is above
therapeutic range, indicating increased bleeding risk. The nurse should decrease the heparin
infusion rate per protocol and recheck the aPTT in 4–6 hours. Protamine sulfate is reserved for
life-threatening hemorrhage, not for mild supratherapeutic levels.
Q6. A patient with GERD is prescribed omeprazole 20 mg daily. The nurse should include which
teaching point?
A. Take the medication 30 minutes before breakfast
B. Take the medication with food for best absorption
C. Take the medication at bedtime for optimal effect
D. Take the medication with an antacid for enhanced efficacy
Latest 2026/2027 | Newly Released
San Diego State University (SDSU).
50 Questions and Answers With Expert Rationales
Guaranteed Pass | Graded A +
Content:
,Q1. A patient with hypertension and chronic kidney disease is prescribed lisinopril. Which
laboratory value should the nurse monitor most closely during the first 2 weeks of therapy?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum magnesium
Correct Answer: A
ACE inhibitors like lisinopril can reduce aldosterone secretion, leading to potassium retention
and hyperkalemia, especially in patients with impaired renal function. The nurse should monitor
serum potassium levels closely during initial therapy and with dose adjustments. Early detection
prevents dangerous cardiac arrhythmias associated with elevated potassium.
Q2. A nurse is caring for a patient receiving warfarin therapy with an INR of 4.2. The patient has
no signs of bleeding. What is the nurse's priority action?
A. Administer vitamin K immediately
B. Hold the next dose and notify the provider
C. Continue the current dose and recheck in 1 week
D. Administer fresh frozen plasma
Correct Answer: B
An INR of 4.2 is above the typical therapeutic range of 2.0–3.0 for most indications, indicating
supratherapeutic anticoagulation. The nurse should hold the next warfarin dose and notify the
provider to discuss dose adjustment. Vitamin K is reserved for INR >10 or active bleeding, and
fresh frozen plasma is used for life-threatening hemorrhage.
Q3. A patient with asthma is prescribed a long-acting beta-2 agonist (LABA). Which medication
should the nurse ensure the patient is also prescribed?
A. A leukotriene receptor antagonist
B. An inhaled corticosteroid
C. An anticholinergic bronchodilator
D. An oral corticosteroid
Correct Answer: B
LABAs such as salmeterol must never be used as monotherapy in asthma due to increased risk of
, asthma-related death; they must be combined with an inhaled corticosteroid. Inhaled
corticosteroids reduce airway inflammation and are the cornerstone of long-term asthma control.
This combination provides bronchodilation while addressing underlying inflammation.
Q4. A patient with heart failure is prescribed digoxin 0.25 mg daily. The nurse notes the patient's
serum digoxin level is 2.5 ng/mL. What is the therapeutic range for digoxin, and what is the
nurse's priority concern?
A. 0.5–1.0 ng/mL; risk of hypokalemia
B. 0.5–0.8 ng/mL; risk of toxicity
C. 0.8–2.0 ng/mL; risk of toxicity
D. 1.0–2.5 ng/mL; risk of bradycardia
Correct Answer: C
The therapeutic range for digoxin is 0.8–2.0 ng/mL; a level of 2.5 ng/mL indicates toxicity.
Digoxin toxicity manifests with nausea, vomiting, visual disturbances, and cardiac arrhythmias
including bradycardia and ventricular ectopy. The nurse should hold the next dose, notify the
provider, and monitor the patient closely for signs of toxicity.
Q5. A patient receiving heparin therapy has an aPTT of 90 seconds. The therapeutic range is 1.5–
2.5 times the control (control = 30 seconds). What is the nurse's appropriate action?
A. Increase the heparin infusion rate
B. Decrease the heparin infusion rate
C. Continue the current infusion rate
D. Administer protamine sulfate
Correct Answer: B
The therapeutic range is 45–75 seconds (1.5–2.5 × 30); an aPTT of 90 seconds is above
therapeutic range, indicating increased bleeding risk. The nurse should decrease the heparin
infusion rate per protocol and recheck the aPTT in 4–6 hours. Protamine sulfate is reserved for
life-threatening hemorrhage, not for mild supratherapeutic levels.
Q6. A patient with GERD is prescribed omeprazole 20 mg daily. The nurse should include which
teaching point?
A. Take the medication 30 minutes before breakfast
B. Take the medication with food for best absorption
C. Take the medication at bedtime for optimal effect
D. Take the medication with an antacid for enhanced efficacy
