Pharmacology Comprehensive Final
(SU 2026) Questions and Answers with
Rationale
Question 1
A nurse is preparing to administer digoxin to a client with heart
failure. Which assessment should the nurse perform first?
A. Measure blood pressure.
B. Auscultate lung sounds.
C. Check the apical pulse for 1 full minute.
D. Assess bowel sounds.
Answer: C. Check the apical pulse for 1 full minute.
Rationale: Digoxin slows cardiac conduction. The nurse should
assess the apical pulse for a full minute before administration
and generally withhold the medication if the heart rate is below
the prescribed parameter (often <60 beats/min in adults) and
notify the provider.
Question 2
Which laboratory value places a client taking digoxin at greatest
risk for toxicity?
,A. Potassium 2.9 mEq/L
B. Sodium 140 mEq/L
C. Calcium 9.2 mg/dL
D. Glucose 102 mg/dL
Answer: A. Potassium 2.9 mEq/L
Rationale: Hypokalemia increases the binding of digoxin to the
myocardium, increasing the risk of digoxin toxicity, which may
present with nausea, vomiting, visual changes, and
dysrhythmias.
Question 3
A client taking lisinopril reports a persistent dry cough. What is
the nurse's best response?
A. Stop the medication immediately.
B. This is a common adverse effect of ACE inhibitors.
C. Increase fluid intake.
D. Take the medication with food.
Answer: B. This is a common adverse effect of ACE
inhibitors.
Rationale: ACE inhibitors commonly cause a persistent dry
cough due to increased bradykinin. The provider may switch the
client to an ARB if the cough is bothersome.
Question 4
,Which medication should not be administered with sildenafil
because of the risk of profound hypotension?
A. Aspirin
B. Nitroglycerin
C. Metoprolol
D. Atorvastatin
Answer: B. Nitroglycerin
Rationale: Nitrates and phosphodiesterase-5 inhibitors both
cause vasodilation. Combined use can lead to severe
hypotension and cardiovascular collapse.
Question 5
A client taking warfarin has an INR of 5.8. What is the nurse's
priority action?
A. Administer the scheduled dose.
B. Hold the medication and notify the provider.
C. Encourage foods high in vitamin K immediately.
D. Increase fluid intake.
Answer: B. Hold the medication and notify the provider.
Rationale: An INR of 5.8 indicates excessive anticoagulation
and an increased risk of bleeding. The provider may order
vitamin K depending on the clinical situation.
, Question 6
Which medication is the antidote for opioid overdose?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: B. Naloxone
Rationale: Naloxone rapidly reverses opioid-induced
respiratory depression. Clients require continued monitoring
because naloxone's duration is shorter than many opioids.
Question 7
A nurse administers furosemide. Which electrolyte should be
monitored most closely?
A. Potassium
B. Calcium
C. Sodium
D. Phosphate
Answer: A. Potassium
Rationale: Loop diuretics increase potassium excretion and can
cause hypokalemia, increasing the risk of dysrhythmias.
Question 8
(SU 2026) Questions and Answers with
Rationale
Question 1
A nurse is preparing to administer digoxin to a client with heart
failure. Which assessment should the nurse perform first?
A. Measure blood pressure.
B. Auscultate lung sounds.
C. Check the apical pulse for 1 full minute.
D. Assess bowel sounds.
Answer: C. Check the apical pulse for 1 full minute.
Rationale: Digoxin slows cardiac conduction. The nurse should
assess the apical pulse for a full minute before administration
and generally withhold the medication if the heart rate is below
the prescribed parameter (often <60 beats/min in adults) and
notify the provider.
Question 2
Which laboratory value places a client taking digoxin at greatest
risk for toxicity?
,A. Potassium 2.9 mEq/L
B. Sodium 140 mEq/L
C. Calcium 9.2 mg/dL
D. Glucose 102 mg/dL
Answer: A. Potassium 2.9 mEq/L
Rationale: Hypokalemia increases the binding of digoxin to the
myocardium, increasing the risk of digoxin toxicity, which may
present with nausea, vomiting, visual changes, and
dysrhythmias.
Question 3
A client taking lisinopril reports a persistent dry cough. What is
the nurse's best response?
A. Stop the medication immediately.
B. This is a common adverse effect of ACE inhibitors.
C. Increase fluid intake.
D. Take the medication with food.
Answer: B. This is a common adverse effect of ACE
inhibitors.
Rationale: ACE inhibitors commonly cause a persistent dry
cough due to increased bradykinin. The provider may switch the
client to an ARB if the cough is bothersome.
Question 4
,Which medication should not be administered with sildenafil
because of the risk of profound hypotension?
A. Aspirin
B. Nitroglycerin
C. Metoprolol
D. Atorvastatin
Answer: B. Nitroglycerin
Rationale: Nitrates and phosphodiesterase-5 inhibitors both
cause vasodilation. Combined use can lead to severe
hypotension and cardiovascular collapse.
Question 5
A client taking warfarin has an INR of 5.8. What is the nurse's
priority action?
A. Administer the scheduled dose.
B. Hold the medication and notify the provider.
C. Encourage foods high in vitamin K immediately.
D. Increase fluid intake.
Answer: B. Hold the medication and notify the provider.
Rationale: An INR of 5.8 indicates excessive anticoagulation
and an increased risk of bleeding. The provider may order
vitamin K depending on the clinical situation.
, Question 6
Which medication is the antidote for opioid overdose?
A. Flumazenil
B. Naloxone
C. Protamine sulfate
D. Vitamin K
Answer: B. Naloxone
Rationale: Naloxone rapidly reverses opioid-induced
respiratory depression. Clients require continued monitoring
because naloxone's duration is shorter than many opioids.
Question 7
A nurse administers furosemide. Which electrolyte should be
monitored most closely?
A. Potassium
B. Calcium
C. Sodium
D. Phosphate
Answer: A. Potassium
Rationale: Loop diuretics increase potassium excretion and can
cause hypokalemia, increasing the risk of dysrhythmias.
Question 8
