BSN HESI 315
Pharmacology Exam V1
Questions and Answers with
rationales, 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 digoxin 0.25 mg PO daily. The nurse notes the
patient's apical heart rate is 58 beats per minute. Which action should the
nurse take first?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider.
C. Administer atropine 1 mg IV push.
D. Reassess the heart rate in 30 minutes.
Answer: B
Rationale: Digoxin slows the heart rate via vagal stimulation. The standard
nursing guideline is to withhold the dose if the apical heart rate is less than
60 bpm in an adult, as administering it could precipitate severe bradycardia
or heart block. The provider should be notified for further orders.
A patient receiving IV heparin for a deep vein thrombosis (DVT) has an aPTT
of 110 seconds (normal range 30-40 seconds). The provider orders
protamine sulfate. Which assessment finding indicates the antidote is
effective?
A. The patient's respiratory rate decreases to 16 breaths/min.
B. The patient's blood pressure stabilizes at 120/80 mmHg.
C. The patient's aPTT drops to 40 seconds.
D. The patient reports a decrease in calf pain.
Answer: C
Rationale: Protamine sulfate is the specific antidote for heparin. It
neutralizes heparin's anticoagulant effects. The most direct and objective
indicator of its effectiveness is a decrease in the activated partial
thromboplastin time (aPTT) back to the target therapeutic range (or
baseline).
A nurse is preparing to administer IV vancomycin to a patient with a
methicillin-resistant Staphylococcus aureus (MRSA) infection. To prevent
"Red Man Syndrome," the nurse should:
A. Administer an antihistamine 30 minutes prior to the infusion.
B. Infuse the medication over at least 60 minutes.
C. Ensure the patient is well-hydrated before administration.
D. Monitor the patient's peak levels closely.
Answer: B
Rationale: Red Man Syndrome is a rate-related infusion reaction to
vancomycin caused by histamine release. It is prevented primarily by
infusing the medication slowly (over at least 60 minutes, or 90 minutes for
larger doses). While antihistamines can help treat symptoms, slowing the
infusion rate is the primary preventative measure.
A patient with type 2 diabetes mellitus is prescribed metformin. Which
finding should prompt the nurse to hold the medication and contact the
provider?
A. The patient's blood glucose is 130 mg/dL.
B. The patient is scheduled for a CT scan with contrast dye today.
,C. The patient reports a mild headache.
D. The patient's hemoglobin A1c is 7.0%.
Answer: B
Rationale: Metformin carries a risk of lactic acidosis, which is significantly
increased if the patient receives IV iodinated contrast dye due to the risk of
acute kidney injury. Metformin must be withheld before and for 48 hours
after procedures involving contrast dye, pending a normal renal function
test.
A patient is prescribed lisinopril for hypertension. Which adverse effect
requires immediate discontinuation of the medication?
A. Dry, persistent cough
B. Angioedema of the lips and tongue
C. Serum potassium of 4.2 mEq/L
D. Orthostatic hypotension
Answer: B
Rationale: Angioedema is a life-threatening adverse effect of ACE inhibitors
like lisinopril, characterized by swelling of the face, lips, tongue, and throat,
which can compromise the airway. It requires immediate discontinuation of
the drug and emergency intervention. A dry cough is common and annoying
but not life-threatening.
A patient is receiving furosemide IV push. Which electrolyte imbalance is the
nurse most concerned about monitoring to prevent life-threatening cardiac
dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the kidneys to excrete
significant amounts of potassium. Hypokalemia (low potassium) increases
cardiac excitability and can lead to fatal dysrhythmias. The nurse must
closely monitor serum potassium levels and assess for signs of hypokalemia.
A patient taking warfarin sodium asks the nurse about dietary changes. The
nurse should instruct the patient to:
A. Avoid all green leafy vegetables completely.
B. Maintain a consistent intake of vitamin K-rich foods.
C. Increase intake of citrus fruits to enhance absorption.
D. Take the medication with a high-fat meal.
Answer: B
Rationale: Warfarin is a vitamin K antagonist. Sudden increases or decreases
in vitamin K intake (found in green leafy vegetables) can drastically alter the
patient's INR and bleeding risk. The key is consistency; the patient does not
need to avoid these foods entirely but should maintain a stable daily intake.
A patient is prescribed phenytoin for seizure control. The nurse observes the
, patient has gingival hyperplasia. What is the best nursing intervention?
A. Instruct the patient to stop taking the medication immediately.
B. Teach the patient to perform meticulous oral hygiene and gum massage.
C. Administer an antiemetic as prescribed.
D. Request a prescription for an antibiotic.
Answer: B
Rationale: Gingival hyperplasia (overgrowth of gum tissue) is a common and
expected side effect of phenytoin. It is not a reason to stop the medication.
The best intervention is to teach the patient meticulous oral hygiene,
including brushing, flossing, and gum massage, to minimize the overgrowth
and prevent infection.
The nurse is preparing to administer regular insulin and NPH insulin
subcutaneously. Which action ensures the medications are mixed safely?
A. Draw up the NPH insulin first, then the regular insulin.
B. Draw up the regular insulin first, then the NPH insulin.
C. Inject air into the regular insulin vial, then the NPH vial, then draw up
NPH.
D. Shake the NPH vial vigorously before drawing it up.
Answer: B
Rationale: When mixing a clear insulin (Regular) with a cloudy insulin (NPH),
the nurse must draw up the clear insulin first to prevent contaminating the
regular insulin vial with NPH. The correct sequence is: inject air into NPH,
inject air into Regular, draw up Regular, then draw up NPH.
A patient with asthma is prescribed albuterol via inhaler. The nurse
recognizes this medication is classified as a:
A. Corticosteroid
B. Beta-2 adrenergic agonist
C. Anticholinergic
D. Mast cell stabilizer
Answer: B
Rationale: Albuterol is a short-acting beta-2 adrenergic agonist (SABA). It
works by stimulating beta-2 receptors in the lungs, causing bronchodilation.
It is used as a rescue medication for acute bronchospasm.
A patient is prescribed morphine sulfate 4 mg IV for severe postoperative
pain. After administration, the patient's respiratory rate drops to 8 breaths
per minute. Which medication should the nurse prepare to administer?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Answer: B
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced
respiratory depression. Morphine is an opioid agonist; if the patient
experiences respiratory depression (RR < 12), naloxone should be
Pharmacology Exam V1
Questions and Answers with
rationales, 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 digoxin 0.25 mg PO daily. The nurse notes the
patient's apical heart rate is 58 beats per minute. Which action should the
nurse take first?
A. Administer the medication as prescribed.
B. Withhold the medication and notify the provider.
C. Administer atropine 1 mg IV push.
D. Reassess the heart rate in 30 minutes.
Answer: B
Rationale: Digoxin slows the heart rate via vagal stimulation. The standard
nursing guideline is to withhold the dose if the apical heart rate is less than
60 bpm in an adult, as administering it could precipitate severe bradycardia
or heart block. The provider should be notified for further orders.
A patient receiving IV heparin for a deep vein thrombosis (DVT) has an aPTT
of 110 seconds (normal range 30-40 seconds). The provider orders
protamine sulfate. Which assessment finding indicates the antidote is
effective?
A. The patient's respiratory rate decreases to 16 breaths/min.
B. The patient's blood pressure stabilizes at 120/80 mmHg.
C. The patient's aPTT drops to 40 seconds.
D. The patient reports a decrease in calf pain.
Answer: C
Rationale: Protamine sulfate is the specific antidote for heparin. It
neutralizes heparin's anticoagulant effects. The most direct and objective
indicator of its effectiveness is a decrease in the activated partial
thromboplastin time (aPTT) back to the target therapeutic range (or
baseline).
A nurse is preparing to administer IV vancomycin to a patient with a
methicillin-resistant Staphylococcus aureus (MRSA) infection. To prevent
"Red Man Syndrome," the nurse should:
A. Administer an antihistamine 30 minutes prior to the infusion.
B. Infuse the medication over at least 60 minutes.
C. Ensure the patient is well-hydrated before administration.
D. Monitor the patient's peak levels closely.
Answer: B
Rationale: Red Man Syndrome is a rate-related infusion reaction to
vancomycin caused by histamine release. It is prevented primarily by
infusing the medication slowly (over at least 60 minutes, or 90 minutes for
larger doses). While antihistamines can help treat symptoms, slowing the
infusion rate is the primary preventative measure.
A patient with type 2 diabetes mellitus is prescribed metformin. Which
finding should prompt the nurse to hold the medication and contact the
provider?
A. The patient's blood glucose is 130 mg/dL.
B. The patient is scheduled for a CT scan with contrast dye today.
,C. The patient reports a mild headache.
D. The patient's hemoglobin A1c is 7.0%.
Answer: B
Rationale: Metformin carries a risk of lactic acidosis, which is significantly
increased if the patient receives IV iodinated contrast dye due to the risk of
acute kidney injury. Metformin must be withheld before and for 48 hours
after procedures involving contrast dye, pending a normal renal function
test.
A patient is prescribed lisinopril for hypertension. Which adverse effect
requires immediate discontinuation of the medication?
A. Dry, persistent cough
B. Angioedema of the lips and tongue
C. Serum potassium of 4.2 mEq/L
D. Orthostatic hypotension
Answer: B
Rationale: Angioedema is a life-threatening adverse effect of ACE inhibitors
like lisinopril, characterized by swelling of the face, lips, tongue, and throat,
which can compromise the airway. It requires immediate discontinuation of
the drug and emergency intervention. A dry cough is common and annoying
but not life-threatening.
A patient is receiving furosemide IV push. Which electrolyte imbalance is the
nurse most concerned about monitoring to prevent life-threatening cardiac
dysrhythmias?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the kidneys to excrete
significant amounts of potassium. Hypokalemia (low potassium) increases
cardiac excitability and can lead to fatal dysrhythmias. The nurse must
closely monitor serum potassium levels and assess for signs of hypokalemia.
A patient taking warfarin sodium asks the nurse about dietary changes. The
nurse should instruct the patient to:
A. Avoid all green leafy vegetables completely.
B. Maintain a consistent intake of vitamin K-rich foods.
C. Increase intake of citrus fruits to enhance absorption.
D. Take the medication with a high-fat meal.
Answer: B
Rationale: Warfarin is a vitamin K antagonist. Sudden increases or decreases
in vitamin K intake (found in green leafy vegetables) can drastically alter the
patient's INR and bleeding risk. The key is consistency; the patient does not
need to avoid these foods entirely but should maintain a stable daily intake.
A patient is prescribed phenytoin for seizure control. The nurse observes the
, patient has gingival hyperplasia. What is the best nursing intervention?
A. Instruct the patient to stop taking the medication immediately.
B. Teach the patient to perform meticulous oral hygiene and gum massage.
C. Administer an antiemetic as prescribed.
D. Request a prescription for an antibiotic.
Answer: B
Rationale: Gingival hyperplasia (overgrowth of gum tissue) is a common and
expected side effect of phenytoin. It is not a reason to stop the medication.
The best intervention is to teach the patient meticulous oral hygiene,
including brushing, flossing, and gum massage, to minimize the overgrowth
and prevent infection.
The nurse is preparing to administer regular insulin and NPH insulin
subcutaneously. Which action ensures the medications are mixed safely?
A. Draw up the NPH insulin first, then the regular insulin.
B. Draw up the regular insulin first, then the NPH insulin.
C. Inject air into the regular insulin vial, then the NPH vial, then draw up
NPH.
D. Shake the NPH vial vigorously before drawing it up.
Answer: B
Rationale: When mixing a clear insulin (Regular) with a cloudy insulin (NPH),
the nurse must draw up the clear insulin first to prevent contaminating the
regular insulin vial with NPH. The correct sequence is: inject air into NPH,
inject air into Regular, draw up Regular, then draw up NPH.
A patient with asthma is prescribed albuterol via inhaler. The nurse
recognizes this medication is classified as a:
A. Corticosteroid
B. Beta-2 adrenergic agonist
C. Anticholinergic
D. Mast cell stabilizer
Answer: B
Rationale: Albuterol is a short-acting beta-2 adrenergic agonist (SABA). It
works by stimulating beta-2 receptors in the lungs, causing bronchodilation.
It is used as a rescue medication for acute bronchospasm.
A patient is prescribed morphine sulfate 4 mg IV for severe postoperative
pain. After administration, the patient's respiratory rate drops to 8 breaths
per minute. Which medication should the nurse prepare to administer?
A. Flumazenil
B. Naloxone
C. Atropine
D. Protamine sulfate
Answer: B
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced
respiratory depression. Morphine is an opioid agonist; if the patient
experiences respiratory depression (RR < 12), naloxone should be
