, NUR 2474 Pharmacology for Professional
Nursing Final Exam Review Questions and
Answers with Rationale 2026/2027
Question 1
A nurse is assessing a client who has been taking a loop diuretic
(such as furosemide) for chronic heart failure. Which finding
should the nurse report immediately to the healthcare provider?
A. Blood pressure of 118/76 mm Hg
B. Serum potassium level of 2.8 mEq/L
C. Mild diuresis reported by the client
D. Weight loss of 1 pound over 48 hours
Correct Answer: B
Rationale: Loop diuretics inhibit the reabsorption of sodium
and chloride in the ascending loop of Henle, leading to
significant excretion of water, potassium, and other electrolytes.
A serum potassium level of 2.8 mEq/L indicates severe
hypokalemia (normal is 3.5 to 5.0 mEq/L), which places the
client at high risk for life-threatening cardiac dysrhythmias. The
other options reflect expected therapeutic outcomes or normal
hemodynamic parameters.
Question 2
,Which medication order should the nurse question immediately
for a client who is currently diagnosed with acute asthma
exacerbation?
A. Albuterol metered-dose inhaler
B. Intravenous methylprednisolone
C. Nonselective beta-blocker (propranolol)
D. Oxygen via nasal cannula at 2 L/min
Correct Answer: C
Rationale: Nonselective beta-blockers block both beta-1 and
beta-2 adrenergic receptors. Blocking beta-2 receptors in the
lungs causes bronchoconstriction, which can trigger a severe,
life-threatening asthma attack. Therefore, nonselective beta-
blockers are strictly contraindicated in clients with asthma or
chronic obstructive pulmonary disease (COPD).
Question 3
A client with a new prescription for warfarin asks the nurse why
dietary counseling is necessary. What is the most appropriate
nursing response?
A. "Vitamin K-rich foods enhance the breakdown of warfarin,
making it completely ineffective."
B. "Consistent intake of foods containing vitamin K is
essential because sudden changes can alter your INR
levels."
, C. "You must eliminate all green leafy vegetables from your
diet to prevent fatal bleeding."
D. "Dietary vitamin K has no interaction with oral
anticoagulants as long as you take your dose at night."
Correct Answer: B
Rationale: Vitamin K is the antidote for warfarin and promotes
the synthesis of clotting factors. Patients do not need to avoid
vitamin K entirely, but they must maintain a consistent, steady
daily intake. Sudden increases or decreases in dietary vitamin K
will drastically alter the International Normalized Ratio (INR),
leading to either subtherapeutic clotting or hemorrhage.
Question 4
A hospitalized client is prescribed regular insulin sliding scale
and insulin glargine (Lantus) once daily. When should the nurse
plan to administer the insulin glargine dose?
A. Immediately after meals and at bedtime
B. 30 minutes before breakfast and dinner
C. Once daily at the exact same time every day
D. Only when blood glucose levels exceed 200 mg/dL
Correct Answer: C
Rationale: Insulin glargine is a long-acting, peakless basal
insulin designed to maintain a steady blood glucose baseline
over 24 hours. To ensure consistent systemic coverage and
Nursing Final Exam Review Questions and
Answers with Rationale 2026/2027
Question 1
A nurse is assessing a client who has been taking a loop diuretic
(such as furosemide) for chronic heart failure. Which finding
should the nurse report immediately to the healthcare provider?
A. Blood pressure of 118/76 mm Hg
B. Serum potassium level of 2.8 mEq/L
C. Mild diuresis reported by the client
D. Weight loss of 1 pound over 48 hours
Correct Answer: B
Rationale: Loop diuretics inhibit the reabsorption of sodium
and chloride in the ascending loop of Henle, leading to
significant excretion of water, potassium, and other electrolytes.
A serum potassium level of 2.8 mEq/L indicates severe
hypokalemia (normal is 3.5 to 5.0 mEq/L), which places the
client at high risk for life-threatening cardiac dysrhythmias. The
other options reflect expected therapeutic outcomes or normal
hemodynamic parameters.
Question 2
,Which medication order should the nurse question immediately
for a client who is currently diagnosed with acute asthma
exacerbation?
A. Albuterol metered-dose inhaler
B. Intravenous methylprednisolone
C. Nonselective beta-blocker (propranolol)
D. Oxygen via nasal cannula at 2 L/min
Correct Answer: C
Rationale: Nonselective beta-blockers block both beta-1 and
beta-2 adrenergic receptors. Blocking beta-2 receptors in the
lungs causes bronchoconstriction, which can trigger a severe,
life-threatening asthma attack. Therefore, nonselective beta-
blockers are strictly contraindicated in clients with asthma or
chronic obstructive pulmonary disease (COPD).
Question 3
A client with a new prescription for warfarin asks the nurse why
dietary counseling is necessary. What is the most appropriate
nursing response?
A. "Vitamin K-rich foods enhance the breakdown of warfarin,
making it completely ineffective."
B. "Consistent intake of foods containing vitamin K is
essential because sudden changes can alter your INR
levels."
, C. "You must eliminate all green leafy vegetables from your
diet to prevent fatal bleeding."
D. "Dietary vitamin K has no interaction with oral
anticoagulants as long as you take your dose at night."
Correct Answer: B
Rationale: Vitamin K is the antidote for warfarin and promotes
the synthesis of clotting factors. Patients do not need to avoid
vitamin K entirely, but they must maintain a consistent, steady
daily intake. Sudden increases or decreases in dietary vitamin K
will drastically alter the International Normalized Ratio (INR),
leading to either subtherapeutic clotting or hemorrhage.
Question 4
A hospitalized client is prescribed regular insulin sliding scale
and insulin glargine (Lantus) once daily. When should the nurse
plan to administer the insulin glargine dose?
A. Immediately after meals and at bedtime
B. 30 minutes before breakfast and dinner
C. Once daily at the exact same time every day
D. Only when blood glucose levels exceed 200 mg/dL
Correct Answer: C
Rationale: Insulin glargine is a long-acting, peakless basal
insulin designed to maintain a steady blood glucose baseline
over 24 hours. To ensure consistent systemic coverage and
