NURS 6521N Final Exam V1 | NURS 6521N
Advanced Pharmacology | Actual Q&A
with Rationale (NURS6521N Final Exam) |
Walden University
1. An Advanced Practice Registered Nurse (APRN) is prescribing Lisinopril for a patient with
hypertension. Which adverse effect should the APRN emphasize as a common reason for
discontinuing this medication?
A. Peripheral edema
B. Dry, non-productive cough
C. Hypokalemia
D. Tachycardia
Answer: B
Rationale: Lisinopril is an ACE inhibitor that frequently causes a persistent dry cough due
to the accumulation of bradykinin in the lungs. This side effect is a common reason for
switching patients to an Angiotensin II Receptor Blocker (ARB). The APRN must monitor
for this effect to ensure patient adherence and comfort.
2. A patient taking Digoxin for heart failure reports seeing yellow-green halos around lights.
What is the priority action for the provider?
A. Increase the dosage of Digoxin
,B. Administer a dose of potassium
C. Assess the serum digoxin level
D. Schedule a routine eye exam
Answer: C
Rationale: Visual disturbances, specifically yellow-green halos, are a classic sign of digitalis
toxicity. The provider must obtain a serum level to confirm if the concentration is above the
therapeutic range of 0.5 to 2.0 ng/mL. Prompt identification of toxicity is essential to
prevent life-threatening cardiac arrhythmias.
3. When prescribing Metformin for a patient with Type 2 Diabetes, the APRN knows that the
drug is contraindicated in which of the following scenarios?
A. BMI greater than 30
B. Severe renal impairment
C. History of hypertension
D. Age over 50 years
Answer: B
Rationale: Metformin is primarily excreted by the kidneys and can accumulate in patients
with renal dysfunction, increasing the risk of lactic acidosis. It is generally contraindicated
when the estimated glomerular filtration rate (eGFR) falls below 30 mL/min/1.73m².
Monitoring renal function is a critical component of safe prescribing for this biguanide.
, 4. Which lab value is the gold standard for monitoring the therapeutic effect of Warfarin
therapy?
A. Partial Thromboplastin Time (PTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Rationale: The International Normalized Ratio (INR) provides a standardized
measurement of prothrombin time to ensure consistent dosing across different labs. For
most indications like atrial fibrillation, a target range of 2.0 to 3.0 is maintained.
Maintaining this range balances the prevention of thromboembolism with the risk of major
hemorrhage.
5. A patient is started on Furosemide for fluid overload. The APRN should educate the patient
about the increased risk of which electrolyte imbalance?
A. Hyperkalemia
B. Hypercalcemia
C. Hypernatremia
D. Hypokalemia
Answer: D
Advanced Pharmacology | Actual Q&A
with Rationale (NURS6521N Final Exam) |
Walden University
1. An Advanced Practice Registered Nurse (APRN) is prescribing Lisinopril for a patient with
hypertension. Which adverse effect should the APRN emphasize as a common reason for
discontinuing this medication?
A. Peripheral edema
B. Dry, non-productive cough
C. Hypokalemia
D. Tachycardia
Answer: B
Rationale: Lisinopril is an ACE inhibitor that frequently causes a persistent dry cough due
to the accumulation of bradykinin in the lungs. This side effect is a common reason for
switching patients to an Angiotensin II Receptor Blocker (ARB). The APRN must monitor
for this effect to ensure patient adherence and comfort.
2. A patient taking Digoxin for heart failure reports seeing yellow-green halos around lights.
What is the priority action for the provider?
A. Increase the dosage of Digoxin
,B. Administer a dose of potassium
C. Assess the serum digoxin level
D. Schedule a routine eye exam
Answer: C
Rationale: Visual disturbances, specifically yellow-green halos, are a classic sign of digitalis
toxicity. The provider must obtain a serum level to confirm if the concentration is above the
therapeutic range of 0.5 to 2.0 ng/mL. Prompt identification of toxicity is essential to
prevent life-threatening cardiac arrhythmias.
3. When prescribing Metformin for a patient with Type 2 Diabetes, the APRN knows that the
drug is contraindicated in which of the following scenarios?
A. BMI greater than 30
B. Severe renal impairment
C. History of hypertension
D. Age over 50 years
Answer: B
Rationale: Metformin is primarily excreted by the kidneys and can accumulate in patients
with renal dysfunction, increasing the risk of lactic acidosis. It is generally contraindicated
when the estimated glomerular filtration rate (eGFR) falls below 30 mL/min/1.73m².
Monitoring renal function is a critical component of safe prescribing for this biguanide.
, 4. Which lab value is the gold standard for monitoring the therapeutic effect of Warfarin
therapy?
A. Partial Thromboplastin Time (PTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Rationale: The International Normalized Ratio (INR) provides a standardized
measurement of prothrombin time to ensure consistent dosing across different labs. For
most indications like atrial fibrillation, a target range of 2.0 to 3.0 is maintained.
Maintaining this range balances the prevention of thromboembolism with the risk of major
hemorrhage.
5. A patient is started on Furosemide for fluid overload. The APRN should educate the patient
about the increased risk of which electrolyte imbalance?
A. Hyperkalemia
B. Hypercalcemia
C. Hypernatremia
D. Hypokalemia
Answer: D
