TARLAC STATE UNIVERSITY NURSING NCM 104
CARDIOVASCULAR AND ENDOCRINE EXERCISES QUESTIONS
AND ANSWERS | STUDY GUIDE & PRACTICE TEST 2026/2027
Pharmacology Diagnostic Test
Direction: Multiple choice. Select the corresponding answer and give the rationale
behind of your
answer.
1. The nurse should teach the client of signs of digitalis toxicity include which of the following
A. skin rush over the chest and back
B. increased appetite
C. visual disturbances such as seeing yellow spots
D. elevated
BP ANSWER: C
RATIONALE: Colored vision and seeing yellow spots are symptoms of digoxin toxicity. Abdominal
pain, anorexia, and vomiting are other common symptoms of digoxin toxicity. Additional signs of
digoxin toxicity arrhythmias, such as atrial fibrillation or bradycardia.
Rash, increased appetite, and elevated blood pressure ARE NOT associated with digoxin toxicity.
2. The nurse should be especially alert for signs & symptoms of digitalis toxicity if serum
level indicates that the client has a
A. low Na level
B. high glucose level
C. high calcium level
D. low K
level ANSWER: D
RATIONALE: A low serum potassium level (hypokalemia) predisposes the client to digoxin toxicity.
Because potassium INHIBITS cardiac excitability, a low potassium level would mean that the client
would be prone to increased cardiac excitability. Sodium, glucose, and calcium levels do NOT
affect digoxin or contribute to digoxin toxicity.
3. A client who has undergone a mitral valve placement experiences persistent bleeding from
the surgical incision during the early postoperative period. Which of the following
pharmaceutical agents should the nurse be prepared to administer to this client?
A. vit. C
B. protamine sulfate
C. quinidine sulfate
D. warfarin Na
(coumadin) ANSWER: B
RATIONALE: protamine sulfate is used to help combat persistent bleeding in a client who has had
open heart surgery. Vitamin C and quinidine sulfate do not influence blood clotting. Warfarin
sodium is an anticoagulant, as is heparin, and these two agents would tend to cause the client to
bleed even more.
4. The nurse teaches the client who is receiving warfarin Na that
A. partial thromboplastin time values determine the dosage of warfarin Na.
B. protamine sulfate is under to reversed the effects of warfarin Na
C. the internal normalized ratio (NR) is used to assess effectiveness
D. warfarin Na will facilitate clotting of
the blood ANSWER: C
RATIONALE: The INR is the value used to assess effectiveness of the warfarin sodium therapy. INR
is the prothrombin time ratio that would be obtained if the thromboplastin reagent from the World
Health Organization was used for the plasma test. It is now the recommended method to monitor
effectiveness of warfarin sodium. Generally, the INR for clients administered warfarin sodium
should range from 2 to 3. In the past, prothrombin time was used to assess effectiveness of
warfarin sodium and was maintained at 1.5 to 2.5 times the control value. Partial thromboplastin
time is used to assess the effectiveness of heparin therapy. Fresh frozen plasma or vitamin K is
used to reverse warfarin sodium’s anticoagulant effect, whereas protamine sulfate reverses the
effects of heparin. Warfarin sodium will help to prevent blood clots.
5. A client experienced some initial signs of excitation having an IV infusion of lidocaine
hydrochloride started. The nurse would assess that the client is demonstrating a typical
A/R to lidocaine when client complaints of
A. palpitation
, B. tinnitus
C. urinary frequency
D. letharg
y ANSWER: B
RATIONALE: Common adverse effects of lidocaine hydrochloride include dizziness, tinnitus, blurred
vision, tremors, numbness and tingling of extremities, excessive perspiration, hypotension,
convulsions, and finally coma. Cardiac effects include slowed conduction and cardiac arrest.
Palpitations, urinary frequency, and lethargy are not considered typical adverse reactions to
lidocaine hydrochloride.
6. The nurse teached the client with angina about the common expected side effects of
nitroglecerin, include
A. headache
CARDIOVASCULAR AND ENDOCRINE EXERCISES QUESTIONS
AND ANSWERS | STUDY GUIDE & PRACTICE TEST 2026/2027
Pharmacology Diagnostic Test
Direction: Multiple choice. Select the corresponding answer and give the rationale
behind of your
answer.
1. The nurse should teach the client of signs of digitalis toxicity include which of the following
A. skin rush over the chest and back
B. increased appetite
C. visual disturbances such as seeing yellow spots
D. elevated
BP ANSWER: C
RATIONALE: Colored vision and seeing yellow spots are symptoms of digoxin toxicity. Abdominal
pain, anorexia, and vomiting are other common symptoms of digoxin toxicity. Additional signs of
digoxin toxicity arrhythmias, such as atrial fibrillation or bradycardia.
Rash, increased appetite, and elevated blood pressure ARE NOT associated with digoxin toxicity.
2. The nurse should be especially alert for signs & symptoms of digitalis toxicity if serum
level indicates that the client has a
A. low Na level
B. high glucose level
C. high calcium level
D. low K
level ANSWER: D
RATIONALE: A low serum potassium level (hypokalemia) predisposes the client to digoxin toxicity.
Because potassium INHIBITS cardiac excitability, a low potassium level would mean that the client
would be prone to increased cardiac excitability. Sodium, glucose, and calcium levels do NOT
affect digoxin or contribute to digoxin toxicity.
3. A client who has undergone a mitral valve placement experiences persistent bleeding from
the surgical incision during the early postoperative period. Which of the following
pharmaceutical agents should the nurse be prepared to administer to this client?
A. vit. C
B. protamine sulfate
C. quinidine sulfate
D. warfarin Na
(coumadin) ANSWER: B
RATIONALE: protamine sulfate is used to help combat persistent bleeding in a client who has had
open heart surgery. Vitamin C and quinidine sulfate do not influence blood clotting. Warfarin
sodium is an anticoagulant, as is heparin, and these two agents would tend to cause the client to
bleed even more.
4. The nurse teaches the client who is receiving warfarin Na that
A. partial thromboplastin time values determine the dosage of warfarin Na.
B. protamine sulfate is under to reversed the effects of warfarin Na
C. the internal normalized ratio (NR) is used to assess effectiveness
D. warfarin Na will facilitate clotting of
the blood ANSWER: C
RATIONALE: The INR is the value used to assess effectiveness of the warfarin sodium therapy. INR
is the prothrombin time ratio that would be obtained if the thromboplastin reagent from the World
Health Organization was used for the plasma test. It is now the recommended method to monitor
effectiveness of warfarin sodium. Generally, the INR for clients administered warfarin sodium
should range from 2 to 3. In the past, prothrombin time was used to assess effectiveness of
warfarin sodium and was maintained at 1.5 to 2.5 times the control value. Partial thromboplastin
time is used to assess the effectiveness of heparin therapy. Fresh frozen plasma or vitamin K is
used to reverse warfarin sodium’s anticoagulant effect, whereas protamine sulfate reverses the
effects of heparin. Warfarin sodium will help to prevent blood clots.
5. A client experienced some initial signs of excitation having an IV infusion of lidocaine
hydrochloride started. The nurse would assess that the client is demonstrating a typical
A/R to lidocaine when client complaints of
A. palpitation
, B. tinnitus
C. urinary frequency
D. letharg
y ANSWER: B
RATIONALE: Common adverse effects of lidocaine hydrochloride include dizziness, tinnitus, blurred
vision, tremors, numbness and tingling of extremities, excessive perspiration, hypotension,
convulsions, and finally coma. Cardiac effects include slowed conduction and cardiac arrest.
Palpitations, urinary frequency, and lethargy are not considered typical adverse reactions to
lidocaine hydrochloride.
6. The nurse teached the client with angina about the common expected side effects of
nitroglecerin, include
A. headache
