NURS 300 (Pharmacology) Unit Exam 3
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 asthma is prescribed montelukast. The nurse should instruct the patient to take
this medication:
A. Only during acute asthma attacks
B. 30 minutes before exercise as needed
C. Daily in the evening, regardless of symptoms
D. With food to enhance absorption
Correct Answer: C
Rationale: Montelukast is a leukotriene receptor antagonist used for chronic asthma
management and allergic rhinitis. It is taken daily, typically in the evening, as a controller
medication. It is not effective for acute bronchospasm rescue and should not be used as-needed.
Food does not significantly affect its absorption.
,Q2. A patient using a fluticasone/salmeterol combination inhaler reports oral candidiasis. Which
instruction should the nurse reinforce?
A. Discontinue the salmeterol component only
B. Rinse the mouth with water after each use and use a spacer device
C. Switch to oral corticosteroids to avoid inhalation-related infections
D. Take an antifungal medication before each inhaler use
Correct Answer: B
Rationale: Oral candidiasis is a common side effect of inhaled corticosteroids like fluticasone.
Rinsing the mouth with water and spitting after each use, along with using a spacer device,
significantly reduces local corticosteroid deposition in the oropharynx. Discontinuing the
medication or switching to oral steroids is inappropriate for this manageable side effect.
Q3. A patient is prescribed spironolactone for heart failure. The nurse should monitor for which
electrolyte imbalance?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that acts as an aldosterone antagonist,
promoting potassium retention. In heart failure patients, especially those also taking ACE
inhibitors or ARBs, hyperkalemia is a significant risk. Serum potassium and renal function must
be monitored regularly, and potassium supplements should generally be avoided.
Q4. A patient taking clopidogrel is scheduled for elective surgery. The nurse knows that
clopidogrel should be discontinued approximately how many days before surgery to allow
platelet recovery?
A. 7 to 10 days
B. 1 to 2 days
C. 3 to 5 days
D. 14 to 21 days
Correct Answer: A
Rationale: Clopidogrel irreversibly inhibits platelet aggregation, and new platelets must be
generated to restore normal function. It takes approximately 7 to 10 days for sufficient platelet
, turnover after discontinuation. Premature surgery increases bleeding risk, while excessive delay
may increase thrombotic risk in patients with recent stent placement.
Q5. A patient with severe asthma exacerbation is receiving systemic corticosteroids. The nurse
should monitor for which adverse effect during short-term high-dose therapy?
A. Hypoglycemia
B. Hypotension
C. Hyperglycemia
D. Bradycardia
Correct Answer: C
Rationale: Systemic corticosteroids increase gluconeogenesis and induce insulin resistance,
leading to hyperglycemia, especially in patients with pre-existing diabetes or those receiving
high-dose short-term therapy. Blood glucose should be monitored regularly. Hypoglycemia,
hypotension, and bradycardia are not typical effects of corticosteroid administration.
Q6. A patient with atrial fibrillation is prescribed warfarin. The nurse knows the therapeutic INR
range for most conditions is:
A. 2.0 to 3.0
B. 1.5 to 2.0
C. 3.0 to 4.0
D. 4.0 to 5.0
Correct Answer: A
Rationale: The standard therapeutic INR range for warfarin therapy in conditions like atrial
fibrillation, DVT, and pulmonary embolism is 2.0 to 3.0. Higher ranges (2.5-3.5) may be used for
mechanical heart valves. INR values below 2.0 increase thrombosis risk, while values above 3.0
increase bleeding risk.
Q7. A patient with chronic constipation is prescribed polyethylene glycol (PEG 3350). The nurse
should instruct the patient that this laxative works by:
A. Stimulating peristalsis through direct action on intestinal nerves
B. Coating the stool surface to allow easier passage
C. Adding bulk to the stool to stimulate defecation
D. Drawing water into the intestinal lumen by osmotic action
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 asthma is prescribed montelukast. The nurse should instruct the patient to take
this medication:
A. Only during acute asthma attacks
B. 30 minutes before exercise as needed
C. Daily in the evening, regardless of symptoms
D. With food to enhance absorption
Correct Answer: C
Rationale: Montelukast is a leukotriene receptor antagonist used for chronic asthma
management and allergic rhinitis. It is taken daily, typically in the evening, as a controller
medication. It is not effective for acute bronchospasm rescue and should not be used as-needed.
Food does not significantly affect its absorption.
,Q2. A patient using a fluticasone/salmeterol combination inhaler reports oral candidiasis. Which
instruction should the nurse reinforce?
A. Discontinue the salmeterol component only
B. Rinse the mouth with water after each use and use a spacer device
C. Switch to oral corticosteroids to avoid inhalation-related infections
D. Take an antifungal medication before each inhaler use
Correct Answer: B
Rationale: Oral candidiasis is a common side effect of inhaled corticosteroids like fluticasone.
Rinsing the mouth with water and spitting after each use, along with using a spacer device,
significantly reduces local corticosteroid deposition in the oropharynx. Discontinuing the
medication or switching to oral steroids is inappropriate for this manageable side effect.
Q3. A patient is prescribed spironolactone for heart failure. The nurse should monitor for which
electrolyte imbalance?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Correct Answer: B
Rationale: Spironolactone is a potassium-sparing diuretic that acts as an aldosterone antagonist,
promoting potassium retention. In heart failure patients, especially those also taking ACE
inhibitors or ARBs, hyperkalemia is a significant risk. Serum potassium and renal function must
be monitored regularly, and potassium supplements should generally be avoided.
Q4. A patient taking clopidogrel is scheduled for elective surgery. The nurse knows that
clopidogrel should be discontinued approximately how many days before surgery to allow
platelet recovery?
A. 7 to 10 days
B. 1 to 2 days
C. 3 to 5 days
D. 14 to 21 days
Correct Answer: A
Rationale: Clopidogrel irreversibly inhibits platelet aggregation, and new platelets must be
generated to restore normal function. It takes approximately 7 to 10 days for sufficient platelet
, turnover after discontinuation. Premature surgery increases bleeding risk, while excessive delay
may increase thrombotic risk in patients with recent stent placement.
Q5. A patient with severe asthma exacerbation is receiving systemic corticosteroids. The nurse
should monitor for which adverse effect during short-term high-dose therapy?
A. Hypoglycemia
B. Hypotension
C. Hyperglycemia
D. Bradycardia
Correct Answer: C
Rationale: Systemic corticosteroids increase gluconeogenesis and induce insulin resistance,
leading to hyperglycemia, especially in patients with pre-existing diabetes or those receiving
high-dose short-term therapy. Blood glucose should be monitored regularly. Hypoglycemia,
hypotension, and bradycardia are not typical effects of corticosteroid administration.
Q6. A patient with atrial fibrillation is prescribed warfarin. The nurse knows the therapeutic INR
range for most conditions is:
A. 2.0 to 3.0
B. 1.5 to 2.0
C. 3.0 to 4.0
D. 4.0 to 5.0
Correct Answer: A
Rationale: The standard therapeutic INR range for warfarin therapy in conditions like atrial
fibrillation, DVT, and pulmonary embolism is 2.0 to 3.0. Higher ranges (2.5-3.5) may be used for
mechanical heart valves. INR values below 2.0 increase thrombosis risk, while values above 3.0
increase bleeding risk.
Q7. A patient with chronic constipation is prescribed polyethylene glycol (PEG 3350). The nurse
should instruct the patient that this laxative works by:
A. Stimulating peristalsis through direct action on intestinal nerves
B. Coating the stool surface to allow easier passage
C. Adding bulk to the stool to stimulate defecation
D. Drawing water into the intestinal lumen by osmotic action
