NUR 2474 Pharmacology for Professional Nursing
Exam 2 (Latest 2026)
Rasmussen University
1. A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30
breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient
will expect to administer which drug?
a. Furosemide (Lasix)
b. Hydrochlorothiazide (HydroDIURIL)
c. Mannitol (Osmitrol)
d. Spironolactone (Aldactone)
ANSWER✔✨-: a. Furosemide (Lasix)
Rationale: Furosemide is a potent loop diuretic used when rapid mobilization of fluids is needed. This
patient is presenting with classic signs of pulmonary edema secondary to congestive heart failure,
including frothy pink sputum, intercostal retractions, and tachypnea. Furosemide acts on the ascending
loop of Henle to inhibit sodium and chloride reabsorption, producing rapid diuresis. Hydrochlorothiazide
is a thiazide diuretic with a slower onset and less potent effect, making it inappropriate for acute
pulmonary edema. Mannitol is an osmotic diuretic used for increased intracranial pressure and can
worsen pulmonary congestion. Spironolactone is a potassium-sparing diuretic with weak diuretic effects
and slow onset, not suitable for acute fluid mobilization.
2. A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure.
The prescriber has ordered furosemide (Lasix). The nurse notes an irregular heart rate of 86 beats per
minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse
auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern?
,a. Blood glucose level of 120 mg/dL
b. Oxygen saturation of 90%
c. Potassium level of 3.5 mEq/L
d. Sodium level of 140 mEq/L
ANSWER✔✨-: c. Potassium level of 3.5 mEq/L
Rationale: The patient's potassium level of 3.5 mEq/L is at the lower limit of normal and is of significant
concern, particularly because the patient is taking digoxin. Hypokalemia potentiates digoxin toxicity and
can precipitate fatal dysrhythmias. Furosemide is a loop diuretic that causes potassium wasting,
increasing the risk for hypokalemia. The irregular heart rate may indicate a digoxin-induced dysrhythmia
exacerbated by low potassium. The blood glucose level of 120 mg/dL is slightly elevated but not
immediately concerning. The oxygen saturation of 90% is low and requires monitoring, but the
potassium level poses a more immediate life-threatening risk. The sodium level of 140 mEq/L is within
normal limits.
3. A patient with heart failure is prescribed furosemide (Lasix). Which assessment finding indicates that
the medication is having the desired therapeutic effect?
a. Decreased blood pressure
b. Increased urine output
c. Decreased heart rate
d. Increased respiratory rate
ANSWER✔✨-: b. Increased urine output
Rationale: Furosemide is a loop diuretic prescribed to reduce fluid overload in heart failure. The desired
therapeutic effect is increased urine output, which leads to decreased fluid volume, reduced preload,
and decreased pulmonary congestion. Decreased blood pressure is an expected effect but not the
primary therapeutic goal. Decreased heart rate may occur as a compensatory response to improved
cardiac function but is not the direct indicator of diuretic effectiveness. Increased respiratory rate would
indicate worsening respiratory status and is not a desired effect.
,4. Which laboratory value should be monitored closely in a patient receiving furosemide (Lasix) therapy?
a. Serum calcium
b. Serum potassium
c. Serum magnesium
d. Serum phosphorus
ANSWER✔✨-: b. Serum potassium
Rationale: Furosemide causes significant potassium wasting through its action on the ascending loop of
Henle, leading to hypokalemia. This is a critical electrolyte imbalance that can cause cardiac
dysrhythmias, especially in patients taking digoxin. Serum calcium may be affected but is not the
primary concern. Serum magnesium can also be depleted but is monitored less frequently. Serum
phosphorus is not significantly affected by loop diuretics.
5. A patient is prescribed hydrochlorothiazide (HydroDIURIL) for hypertension. Which adverse effect
should the nurse teach the patient to report?
a. Increased energy levels
b. Muscle weakness and fatigue
c. Weight gain
d. Increased appetite
ANSWER✔✨-: b. Muscle weakness and fatigue
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia, leading to muscle
weakness, fatigue, and leg cramps. Patients should be taught to report these symptoms promptly.
Increased energy levels are not associated with thiazide therapy. Weight gain may indicate fluid
retention and is not a typical adverse effect; weight loss is more common due to fluid loss. Increased
appetite is not a typical adverse effect of thiazide diuretics.
, 6. A patient with hypertension and gout is prescribed hydrochlorothiazide (HydroDIURIL). The nurse
should monitor for which potential complication?
a. Increased uric acid levels
b. Decreased blood glucose levels
c. Increased calcium excretion
d. Decreased potassium levels
ANSWER✔✨-: a. Increased uric acid levels
Rationale: Thiazide diuretics can increase serum uric acid levels by decreasing uric acid excretion. This
can precipitate gout attacks in patients with pre-existing gout. The patient's history of gout makes this a
significant concern. Blood glucose levels may increase, not decrease, with thiazide use. Calcium
excretion is decreased, not increased, with thiazide diuretics. Potassium levels decrease but are not the
primary concern in this scenario.
7. A patient is prescribed spironolactone (Aldactone) for heart failure. Which laboratory value requires
close monitoring?
a. Serum sodium
b. Serum potassium
c. Serum calcium
d. Serum magnesium
ANSWER✔✨-: b. Serum potassium
Rationale: Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia by blocking
aldosterone receptors. This can lead to life-threatening cardiac dysrhythmias. Serum potassium must be
monitored closely, especially in patients with renal impairment or those taking other medications that
increase potassium levels. Serum sodium may be affected but is less critical. Serum calcium and
magnesium are not significantly affected by spironolactone.
Exam 2 (Latest 2026)
Rasmussen University
1. A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30
breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient
will expect to administer which drug?
a. Furosemide (Lasix)
b. Hydrochlorothiazide (HydroDIURIL)
c. Mannitol (Osmitrol)
d. Spironolactone (Aldactone)
ANSWER✔✨-: a. Furosemide (Lasix)
Rationale: Furosemide is a potent loop diuretic used when rapid mobilization of fluids is needed. This
patient is presenting with classic signs of pulmonary edema secondary to congestive heart failure,
including frothy pink sputum, intercostal retractions, and tachypnea. Furosemide acts on the ascending
loop of Henle to inhibit sodium and chloride reabsorption, producing rapid diuresis. Hydrochlorothiazide
is a thiazide diuretic with a slower onset and less potent effect, making it inappropriate for acute
pulmonary edema. Mannitol is an osmotic diuretic used for increased intracranial pressure and can
worsen pulmonary congestion. Spironolactone is a potassium-sparing diuretic with weak diuretic effects
and slow onset, not suitable for acute fluid mobilization.
2. A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure.
The prescriber has ordered furosemide (Lasix). The nurse notes an irregular heart rate of 86 beats per
minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse
auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern?
,a. Blood glucose level of 120 mg/dL
b. Oxygen saturation of 90%
c. Potassium level of 3.5 mEq/L
d. Sodium level of 140 mEq/L
ANSWER✔✨-: c. Potassium level of 3.5 mEq/L
Rationale: The patient's potassium level of 3.5 mEq/L is at the lower limit of normal and is of significant
concern, particularly because the patient is taking digoxin. Hypokalemia potentiates digoxin toxicity and
can precipitate fatal dysrhythmias. Furosemide is a loop diuretic that causes potassium wasting,
increasing the risk for hypokalemia. The irregular heart rate may indicate a digoxin-induced dysrhythmia
exacerbated by low potassium. The blood glucose level of 120 mg/dL is slightly elevated but not
immediately concerning. The oxygen saturation of 90% is low and requires monitoring, but the
potassium level poses a more immediate life-threatening risk. The sodium level of 140 mEq/L is within
normal limits.
3. A patient with heart failure is prescribed furosemide (Lasix). Which assessment finding indicates that
the medication is having the desired therapeutic effect?
a. Decreased blood pressure
b. Increased urine output
c. Decreased heart rate
d. Increased respiratory rate
ANSWER✔✨-: b. Increased urine output
Rationale: Furosemide is a loop diuretic prescribed to reduce fluid overload in heart failure. The desired
therapeutic effect is increased urine output, which leads to decreased fluid volume, reduced preload,
and decreased pulmonary congestion. Decreased blood pressure is an expected effect but not the
primary therapeutic goal. Decreased heart rate may occur as a compensatory response to improved
cardiac function but is not the direct indicator of diuretic effectiveness. Increased respiratory rate would
indicate worsening respiratory status and is not a desired effect.
,4. Which laboratory value should be monitored closely in a patient receiving furosemide (Lasix) therapy?
a. Serum calcium
b. Serum potassium
c. Serum magnesium
d. Serum phosphorus
ANSWER✔✨-: b. Serum potassium
Rationale: Furosemide causes significant potassium wasting through its action on the ascending loop of
Henle, leading to hypokalemia. This is a critical electrolyte imbalance that can cause cardiac
dysrhythmias, especially in patients taking digoxin. Serum calcium may be affected but is not the
primary concern. Serum magnesium can also be depleted but is monitored less frequently. Serum
phosphorus is not significantly affected by loop diuretics.
5. A patient is prescribed hydrochlorothiazide (HydroDIURIL) for hypertension. Which adverse effect
should the nurse teach the patient to report?
a. Increased energy levels
b. Muscle weakness and fatigue
c. Weight gain
d. Increased appetite
ANSWER✔✨-: b. Muscle weakness and fatigue
Rationale: Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia, leading to muscle
weakness, fatigue, and leg cramps. Patients should be taught to report these symptoms promptly.
Increased energy levels are not associated with thiazide therapy. Weight gain may indicate fluid
retention and is not a typical adverse effect; weight loss is more common due to fluid loss. Increased
appetite is not a typical adverse effect of thiazide diuretics.
, 6. A patient with hypertension and gout is prescribed hydrochlorothiazide (HydroDIURIL). The nurse
should monitor for which potential complication?
a. Increased uric acid levels
b. Decreased blood glucose levels
c. Increased calcium excretion
d. Decreased potassium levels
ANSWER✔✨-: a. Increased uric acid levels
Rationale: Thiazide diuretics can increase serum uric acid levels by decreasing uric acid excretion. This
can precipitate gout attacks in patients with pre-existing gout. The patient's history of gout makes this a
significant concern. Blood glucose levels may increase, not decrease, with thiazide use. Calcium
excretion is decreased, not increased, with thiazide diuretics. Potassium levels decrease but are not the
primary concern in this scenario.
7. A patient is prescribed spironolactone (Aldactone) for heart failure. Which laboratory value requires
close monitoring?
a. Serum sodium
b. Serum potassium
c. Serum calcium
d. Serum magnesium
ANSWER✔✨-: b. Serum potassium
Rationale: Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia by blocking
aldosterone receptors. This can lead to life-threatening cardiac dysrhythmias. Serum potassium must be
monitored closely, especially in patients with renal impairment or those taking other medications that
increase potassium levels. Serum sodium may be affected but is less critical. Serum calcium and
magnesium are not significantly affected by spironolactone.
