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NUR 2474 Pharmacology for Professional Nursing Exam 2
EXAM QUESTIONS AND CORRECT VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR – JUST RELEASED
NUR 2474 Pharmacology for Professional Nursing Exam 2
EXAM COVERAGE OVERVIEW (10 Key Points)
1. Exam Focus Areas: This exam covers cardiovascular medications (antihypertensives,
diuretics, antidysrhythmics), respiratory medications (bronchodilators, corticosteroids),
gastrointestinal medications, antimicrobials, anticoagulants, and medication safety.
2. Format: Multiple-choice questions with NCLEX-style clinical scenarios testing critical
thinking, prioritization, and nursing interventions .
3. Diuretics and Electrolytes: Loop diuretics (furosemide) for acute pulmonary edema;
thiazides for hypertension; potassium-sparing diuretics risk hyperkalemia; monitor
potassium with digoxin due to toxicity risk .
4. Heart Failure Management: First-line therapy includes ACE inhibitors/ARBs, beta-
blockers, and diuretics; digoxin for symptom control; monitor therapeutic levels (0.5-2.0
ng/mL); toxicity signs: nausea, visual disturbances, bradycardia .
5. Respiratory Medications: Bronchodilators (albuterol = rescue; tiotropium =
maintenance); inhaled corticosteroids require mouth rinsing to prevent thrush; spacers
improve medication delivery .
6. Anticoagulant Management: Warfarin monitored via INR (therapeutic 2-3); vitamin K is
antidote for bleeding; heparin monitored via aPTT; protamine sulfate is heparin
antidote .
7. Antiplatelet Therapy: Aspirin prevents platelet aggregation; clopidogrel for CAD/stent
patients; dual therapy increases bleeding risk; monitor for GI bleeding (black/tarry
stools) .
8. Antimicrobial Considerations: Complete full course to prevent resistance; monitor for C.
difficile diarrhea; vancomycin requires peak/trough monitoring; avoid alcohol with
metronidazole .
9. Nitroglycerin: Promotes vasodilation reducing preload and oxygen demand; sublingual
for acute angina; store in dark bottle; headache is expected side effect .
10. Patient Education Priorities: Morning dosing for diuretics (avoid nocturia); don't stop
beta-blockers abruptly (rebound); ACE inhibitors can cause dry cough; ARBs are
alternative if cough occurs .
, Page 2 of 130
SECTION 1: DIURETICS (Questions 1-25)
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. Which drug
should the nurse expect to administer?
A) Hydrochlorothiazide (HydroDIURIL)
B) Furosemide (Lasix)
C) Mannitol (Osmitrol)
D) Spironolactone (Aldactone)
Answer: B) Furosemide (Lasix)
Rationale: Furosemide is a potent loop diuretic used when rapid mobilization of fluids is
needed. The patient's symptoms indicate pulmonary edema from congestive heart failure
requiring immediate diuresis. Hydrochlorothiazide has slower onset and is not appropriate for
acute pulmonary edema. Mannitol is used for increased intracranial pressure and can worsen
pulmonary congestion. Spironolactone has weak, slow diuretic effects .
2. A patient who is taking digoxin is admitted for congestive heart failure. The prescriber
orders furosemide. The nurse notes an irregular heart rate of 86 bpm, respiratory rate of 22,
BP 130/82, and 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%
, Page 3 of 130
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: Hypokalemia (3.5 mEq/L) increases the risk of digoxin toxicity and fatal dysrhythmias.
Furosemide causes potassium loss through the distal nephron. Blood glucose of 120 mg/dL is
slightly elevated but not immediately life-threatening. While oxygen saturation of 90% is
concerning, it may improve with diuresis .
3. A patient with hypertension is prescribed hydrochlorothiazide. Which assessment finding
indicates the medication is having the desired therapeutic effect?
A) Decreased peripheral edema
B) Increased urine output
C) Blood pressure of 128/78 mm Hg
D) Weight loss of 2 pounds
Answer: C) Blood pressure of 128/78 mm Hg
Rationale: The desired therapeutic effect of hydrochlorothiazide for hypertension is blood
pressure reduction. While increased urine output, decreased edema, and weight loss are
expected effects, the specific therapeutic goal for hypertension is blood pressure control .
4. A patient's serum potassium level is 3.2 mEq/L while taking furosemide. Which
intervention should the nurse anticipate?
, Page 4 of 130
A) Discontinue furosemide immediately
B) Administer potassium supplement
C) Increase furosemide dose
D) Administer spironolactone
Answer: B) Administer potassium supplement
Rationale: Furosemide causes hypokalemia. A level of 3.2 mEq/L is low and requires potassium
supplementation to prevent dysrhythmias. Discontinuing furosemide immediately may cause
fluid overload. Increasing the furosemide dose would worsen hypokalemia. Spironolactone may
be added but potassium supplement is the immediate intervention .
5. The nurse understands that thiazide diuretics act primarily at which nephron site?
A) Distal convoluted tubule
B) Ascending loop of Henle
C) Proximal tubule
D) Collecting duct
Answer: A) Distal convoluted tubule
Rationale: Thiazides block sodium-chloride reabsorption in the distal convoluted tubule (DCT).
The ascending loop of Henle is the site of loop diuretics. The proximal tubule relates to
osmotic/carbonic anhydrase agents. The collecting duct is where potassium-sparing agents
work .
6. A patient takes digoxin plus furosemide daily. The priority assessment is:
NUR 2474 Pharmacology for Professional Nursing Exam 2
EXAM QUESTIONS AND CORRECT VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR – JUST RELEASED
NUR 2474 Pharmacology for Professional Nursing Exam 2
EXAM COVERAGE OVERVIEW (10 Key Points)
1. Exam Focus Areas: This exam covers cardiovascular medications (antihypertensives,
diuretics, antidysrhythmics), respiratory medications (bronchodilators, corticosteroids),
gastrointestinal medications, antimicrobials, anticoagulants, and medication safety.
2. Format: Multiple-choice questions with NCLEX-style clinical scenarios testing critical
thinking, prioritization, and nursing interventions .
3. Diuretics and Electrolytes: Loop diuretics (furosemide) for acute pulmonary edema;
thiazides for hypertension; potassium-sparing diuretics risk hyperkalemia; monitor
potassium with digoxin due to toxicity risk .
4. Heart Failure Management: First-line therapy includes ACE inhibitors/ARBs, beta-
blockers, and diuretics; digoxin for symptom control; monitor therapeutic levels (0.5-2.0
ng/mL); toxicity signs: nausea, visual disturbances, bradycardia .
5. Respiratory Medications: Bronchodilators (albuterol = rescue; tiotropium =
maintenance); inhaled corticosteroids require mouth rinsing to prevent thrush; spacers
improve medication delivery .
6. Anticoagulant Management: Warfarin monitored via INR (therapeutic 2-3); vitamin K is
antidote for bleeding; heparin monitored via aPTT; protamine sulfate is heparin
antidote .
7. Antiplatelet Therapy: Aspirin prevents platelet aggregation; clopidogrel for CAD/stent
patients; dual therapy increases bleeding risk; monitor for GI bleeding (black/tarry
stools) .
8. Antimicrobial Considerations: Complete full course to prevent resistance; monitor for C.
difficile diarrhea; vancomycin requires peak/trough monitoring; avoid alcohol with
metronidazole .
9. Nitroglycerin: Promotes vasodilation reducing preload and oxygen demand; sublingual
for acute angina; store in dark bottle; headache is expected side effect .
10. Patient Education Priorities: Morning dosing for diuretics (avoid nocturia); don't stop
beta-blockers abruptly (rebound); ACE inhibitors can cause dry cough; ARBs are
alternative if cough occurs .
, Page 2 of 130
SECTION 1: DIURETICS (Questions 1-25)
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. Which drug
should the nurse expect to administer?
A) Hydrochlorothiazide (HydroDIURIL)
B) Furosemide (Lasix)
C) Mannitol (Osmitrol)
D) Spironolactone (Aldactone)
Answer: B) Furosemide (Lasix)
Rationale: Furosemide is a potent loop diuretic used when rapid mobilization of fluids is
needed. The patient's symptoms indicate pulmonary edema from congestive heart failure
requiring immediate diuresis. Hydrochlorothiazide has slower onset and is not appropriate for
acute pulmonary edema. Mannitol is used for increased intracranial pressure and can worsen
pulmonary congestion. Spironolactone has weak, slow diuretic effects .
2. A patient who is taking digoxin is admitted for congestive heart failure. The prescriber
orders furosemide. The nurse notes an irregular heart rate of 86 bpm, respiratory rate of 22,
BP 130/82, and 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%
, Page 3 of 130
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: Hypokalemia (3.5 mEq/L) increases the risk of digoxin toxicity and fatal dysrhythmias.
Furosemide causes potassium loss through the distal nephron. Blood glucose of 120 mg/dL is
slightly elevated but not immediately life-threatening. While oxygen saturation of 90% is
concerning, it may improve with diuresis .
3. A patient with hypertension is prescribed hydrochlorothiazide. Which assessment finding
indicates the medication is having the desired therapeutic effect?
A) Decreased peripheral edema
B) Increased urine output
C) Blood pressure of 128/78 mm Hg
D) Weight loss of 2 pounds
Answer: C) Blood pressure of 128/78 mm Hg
Rationale: The desired therapeutic effect of hydrochlorothiazide for hypertension is blood
pressure reduction. While increased urine output, decreased edema, and weight loss are
expected effects, the specific therapeutic goal for hypertension is blood pressure control .
4. A patient's serum potassium level is 3.2 mEq/L while taking furosemide. Which
intervention should the nurse anticipate?
, Page 4 of 130
A) Discontinue furosemide immediately
B) Administer potassium supplement
C) Increase furosemide dose
D) Administer spironolactone
Answer: B) Administer potassium supplement
Rationale: Furosemide causes hypokalemia. A level of 3.2 mEq/L is low and requires potassium
supplementation to prevent dysrhythmias. Discontinuing furosemide immediately may cause
fluid overload. Increasing the furosemide dose would worsen hypokalemia. Spironolactone may
be added but potassium supplement is the immediate intervention .
5. The nurse understands that thiazide diuretics act primarily at which nephron site?
A) Distal convoluted tubule
B) Ascending loop of Henle
C) Proximal tubule
D) Collecting duct
Answer: A) Distal convoluted tubule
Rationale: Thiazides block sodium-chloride reabsorption in the distal convoluted tubule (DCT).
The ascending loop of Henle is the site of loop diuretics. The proximal tubule relates to
osmotic/carbonic anhydrase agents. The collecting duct is where potassium-sparing agents
work .
6. A patient takes digoxin plus furosemide daily. The priority assessment is:
