BSN HESI 315
Pharmacology Exam V1
Questions with Revised
Answers, Nightingale College
(Latest update ):
THIS EXAM CONSISTS OF
Questions and Answers
Multiple-choice Style
100% Guarantee Pass.
Each Question Includes The Correct Answer
Expert-Verified rationales
,A patient is prescribed lisinopril for hypertension. Which of the following
adverse effects should the nurse monitor for during the first few weeks of
therapy?
A) Bradycardia
B) Dry, persistent cough
C) Hypokalemia
D) Hyperglycemia
Answer: B) Dry, persistent cough
Rationale: Lisinopril is an ACE inhibitor. ACE inhibitors block the breakdown
of bradykinin, which can accumulate in the lungs and cause a persistent,
nonproductive cough. It can also cause hyperkalemia (not hypokalemia). It
does not typically cause bradycardia or hyperglycemia.
A client receiving IV furosemide reports ringing in their ears. What is the
nurse's priority action?
A) Increase the IV infusion rate to clear the medication faster.
B) Discontinue the infusion and notify the healthcare provider.
C) Administer an antiemetic as prescribed.
D) Document the finding as an expected side effect.
Answer: B) Discontinue the infusion and notify the healthcare provider.
Rationale: Furosemide is a loop diuretic that can be ototoxic. Tinnitus
(ringing in the ears) is an early sign of ototoxicity. The nurse should stop the
IV to prevent permanent hearing loss and notify the provider.
A patient is taking warfarin daily. Which food should the nurse instruct the
patient to consume in consistent, moderate amounts rather than drastically
increasing or decreasing intake?
A) Citrus fruits
B) Spinach
C) Eggs
D) Bananas
Answer: B) Spinach
Rationale: Spinach is high in Vitamin K, which directly antagonizes the effects
of warfarin. Patients do not need to avoid Vitamin K completely, but their
intake should remain consistent to maintain stable INR levels.
A nurse is preparing to administer digoxin to a patient with atrial fibrillation.
The patient's apical pulse is 52 bpm. What is the nurse's best action?
A) Administer the medication as prescribed.
B) Administer half the prescribed dose.
C) Withhold the medication and notify the provider.
D) Administer atropine to increase the heart rate.
Answer: C) Withhold the medication and notify the provider.
Rationale: Digoxin slows the heart rate. If the apical pulse is below 60 bpm,
the medication should be withheld to prevent severe bradycardia or heart
block, and the provider should be notified.
Which laboratory value must be closely monitored in a patient taking IV
,gentamicin?
A) Potassium and sodium
B) BUN and creatinine
C) AST and ALT
D) Platelets and WBC
Answer: B) BUN and creatinine
Rationale: Gentamicin is an aminoglycoside antibiotic that is nephrotoxic.
Monitoring BUN and creatinine is essential to detect early kidney
impairment.
A patient with type 2 diabetes is prescribed metformin. The nurse should
hold the dose and contact the provider for which scheduled procedure?
A) Magnetic resonance imaging (MRI) with contrast
B) Routine electrocardiogram (ECG)
C) Computed tomography (CT) scan without contrast
D) Colonoscopy
Answer: A) Magnetic resonance imaging (MRI) with contrast
Rationale: Metformin combined with iodine-based IV contrast dye increases
the risk for lactic acidosis and acute kidney injury. Metformin should be
withheld 24 hours before and 48 hours after contrast administration.
A patient is prescribed alendronate for osteoporosis. Which instruction is
most important for the nurse to provide?
A) "Take the medication with a full glass of water and remain upright for 30
minutes."
B) "Take the medication right before bedtime."
C) "Take the medication with a calcium supplement to enhance absorption."
D) "Lie down for 20 minutes after taking the medication."
Answer: A) "Take the medication with a full glass of water and remain
upright for 30 minutes."
Rationale: Alendronate, a bisphosphonate, is highly irritating to the
esophagus. The patient must take it with water and sit upright for 30
minutes to prevent esophageal ulceration. Calcium supplements can
interfere with absorption and should be taken at a different time.
A client is receiving a continuous heparin infusion. The client's aPTT is 120
seconds (normal 30-40 seconds). The healthcare provider orders protamine
sulfate. The nurse knows the mechanism of action of protamine sulfate is to:
A) Inactivate thrombin.
B) Bind to heparin and neutralize its effect.
C) Increase the degradation of fibrin.
D) Stimulate the production of Vitamin K.
Answer: B) Bind to heparin and neutralize its effect.
Rationale: Protamine sulfate is the specific antidote for heparin. It is a
strongly basic protein that binds to the strongly acidic heparin, neutralizing
its anticoagulant effect immediately.
A patient newly diagnosed with hypothyroidism is prescribed levothyroxine.
, Which symptom should the nurse instruct the patient to report immediately
as it may indicate toxicity?
A) Weight gain and fatigue
B) Chest pain and palpitations
C) Dry skin and brittle hair
D) Constipation
Answer: B) Chest pain and palpitations
Rationale: Levothyroxine replaces thyroid hormone. Signs of toxicity
(hyperthyroidism) include tachycardia, palpitations, angina, and weight loss.
The other options are symptoms of untreated hypothyroidism.
A patient taking lithium for bipolar disorder presents with severe vomiting,
diarrhea, and a coarse hand tremor. Which action should the nurse take?
A) Administer an antiemetic.
B) Encourage oral fluid intake.
C) Withhold the lithium and prepare to draw lithium levels.
D) Administer the next dose of lithium.
Answer: C) Withhold the lithium and prepare to draw lithium levels.
Rationale: Severe vomiting, diarrhea, and coarse tremors are classic signs of
lithium toxicity. The medication must be withheld, a lithium blood level
drawn, and the provider notified.
A client is ordered an IM injection of lorazepam for severe acute anxiety.
Which adverse effect requires immediate nursing intervention?
A) Mild sedation
B) Respiratory depression
C) Dry mouth
D) Hypertension
Answer: B) Respiratory depression
Rationale: Lorazepam, a benzodiazepine, acts as a CNS depressant.
Respiratory depression is the most life-threatening adverse effect and
requires immediate intervention.
A patient is prescribed isoniazid (INH) for latent tuberculosis. The nurse
understands that concurrent administration of which supplement is
necessary to prevent peripheral neuropathy?
A) Vitamin B12
B) Folic Acid
C) Vitamin C
D) Pyridoxine (Vitamin B6)
Answer: D) Pyridoxine (Vitamin B6)
Rationale: Isoniazid depletes Vitamin B6, leading to peripheral neuropathy.
Therefore, pyridoxine is routinely co-administered with INH to prevent this
adverse effect.
A patient receiving IV vancomycin develops sudden flushing, hypotension,
and a rash on the face and upper trunk. The nurse should recognize this as:
A) An anaphylactic reaction.
Pharmacology Exam V1
Questions with Revised
Answers, Nightingale College
(Latest update ):
THIS EXAM CONSISTS OF
Questions and Answers
Multiple-choice Style
100% Guarantee Pass.
Each Question Includes The Correct Answer
Expert-Verified rationales
,A patient is prescribed lisinopril for hypertension. Which of the following
adverse effects should the nurse monitor for during the first few weeks of
therapy?
A) Bradycardia
B) Dry, persistent cough
C) Hypokalemia
D) Hyperglycemia
Answer: B) Dry, persistent cough
Rationale: Lisinopril is an ACE inhibitor. ACE inhibitors block the breakdown
of bradykinin, which can accumulate in the lungs and cause a persistent,
nonproductive cough. It can also cause hyperkalemia (not hypokalemia). It
does not typically cause bradycardia or hyperglycemia.
A client receiving IV furosemide reports ringing in their ears. What is the
nurse's priority action?
A) Increase the IV infusion rate to clear the medication faster.
B) Discontinue the infusion and notify the healthcare provider.
C) Administer an antiemetic as prescribed.
D) Document the finding as an expected side effect.
Answer: B) Discontinue the infusion and notify the healthcare provider.
Rationale: Furosemide is a loop diuretic that can be ototoxic. Tinnitus
(ringing in the ears) is an early sign of ototoxicity. The nurse should stop the
IV to prevent permanent hearing loss and notify the provider.
A patient is taking warfarin daily. Which food should the nurse instruct the
patient to consume in consistent, moderate amounts rather than drastically
increasing or decreasing intake?
A) Citrus fruits
B) Spinach
C) Eggs
D) Bananas
Answer: B) Spinach
Rationale: Spinach is high in Vitamin K, which directly antagonizes the effects
of warfarin. Patients do not need to avoid Vitamin K completely, but their
intake should remain consistent to maintain stable INR levels.
A nurse is preparing to administer digoxin to a patient with atrial fibrillation.
The patient's apical pulse is 52 bpm. What is the nurse's best action?
A) Administer the medication as prescribed.
B) Administer half the prescribed dose.
C) Withhold the medication and notify the provider.
D) Administer atropine to increase the heart rate.
Answer: C) Withhold the medication and notify the provider.
Rationale: Digoxin slows the heart rate. If the apical pulse is below 60 bpm,
the medication should be withheld to prevent severe bradycardia or heart
block, and the provider should be notified.
Which laboratory value must be closely monitored in a patient taking IV
,gentamicin?
A) Potassium and sodium
B) BUN and creatinine
C) AST and ALT
D) Platelets and WBC
Answer: B) BUN and creatinine
Rationale: Gentamicin is an aminoglycoside antibiotic that is nephrotoxic.
Monitoring BUN and creatinine is essential to detect early kidney
impairment.
A patient with type 2 diabetes is prescribed metformin. The nurse should
hold the dose and contact the provider for which scheduled procedure?
A) Magnetic resonance imaging (MRI) with contrast
B) Routine electrocardiogram (ECG)
C) Computed tomography (CT) scan without contrast
D) Colonoscopy
Answer: A) Magnetic resonance imaging (MRI) with contrast
Rationale: Metformin combined with iodine-based IV contrast dye increases
the risk for lactic acidosis and acute kidney injury. Metformin should be
withheld 24 hours before and 48 hours after contrast administration.
A patient is prescribed alendronate for osteoporosis. Which instruction is
most important for the nurse to provide?
A) "Take the medication with a full glass of water and remain upright for 30
minutes."
B) "Take the medication right before bedtime."
C) "Take the medication with a calcium supplement to enhance absorption."
D) "Lie down for 20 minutes after taking the medication."
Answer: A) "Take the medication with a full glass of water and remain
upright for 30 minutes."
Rationale: Alendronate, a bisphosphonate, is highly irritating to the
esophagus. The patient must take it with water and sit upright for 30
minutes to prevent esophageal ulceration. Calcium supplements can
interfere with absorption and should be taken at a different time.
A client is receiving a continuous heparin infusion. The client's aPTT is 120
seconds (normal 30-40 seconds). The healthcare provider orders protamine
sulfate. The nurse knows the mechanism of action of protamine sulfate is to:
A) Inactivate thrombin.
B) Bind to heparin and neutralize its effect.
C) Increase the degradation of fibrin.
D) Stimulate the production of Vitamin K.
Answer: B) Bind to heparin and neutralize its effect.
Rationale: Protamine sulfate is the specific antidote for heparin. It is a
strongly basic protein that binds to the strongly acidic heparin, neutralizing
its anticoagulant effect immediately.
A patient newly diagnosed with hypothyroidism is prescribed levothyroxine.
, Which symptom should the nurse instruct the patient to report immediately
as it may indicate toxicity?
A) Weight gain and fatigue
B) Chest pain and palpitations
C) Dry skin and brittle hair
D) Constipation
Answer: B) Chest pain and palpitations
Rationale: Levothyroxine replaces thyroid hormone. Signs of toxicity
(hyperthyroidism) include tachycardia, palpitations, angina, and weight loss.
The other options are symptoms of untreated hypothyroidism.
A patient taking lithium for bipolar disorder presents with severe vomiting,
diarrhea, and a coarse hand tremor. Which action should the nurse take?
A) Administer an antiemetic.
B) Encourage oral fluid intake.
C) Withhold the lithium and prepare to draw lithium levels.
D) Administer the next dose of lithium.
Answer: C) Withhold the lithium and prepare to draw lithium levels.
Rationale: Severe vomiting, diarrhea, and coarse tremors are classic signs of
lithium toxicity. The medication must be withheld, a lithium blood level
drawn, and the provider notified.
A client is ordered an IM injection of lorazepam for severe acute anxiety.
Which adverse effect requires immediate nursing intervention?
A) Mild sedation
B) Respiratory depression
C) Dry mouth
D) Hypertension
Answer: B) Respiratory depression
Rationale: Lorazepam, a benzodiazepine, acts as a CNS depressant.
Respiratory depression is the most life-threatening adverse effect and
requires immediate intervention.
A patient is prescribed isoniazid (INH) for latent tuberculosis. The nurse
understands that concurrent administration of which supplement is
necessary to prevent peripheral neuropathy?
A) Vitamin B12
B) Folic Acid
C) Vitamin C
D) Pyridoxine (Vitamin B6)
Answer: D) Pyridoxine (Vitamin B6)
Rationale: Isoniazid depletes Vitamin B6, leading to peripheral neuropathy.
Therefore, pyridoxine is routinely co-administered with INH to prevent this
adverse effect.
A patient receiving IV vancomycin develops sudden flushing, hypotension,
and a rash on the face and upper trunk. The nurse should recognize this as:
A) An anaphylactic reaction.
