BSN Advanced Pharmacology | Exam 3 Practice Questions With
Answers and detailed Rationales
Question 1.
A patient is prescribed metformin for type 2 diabetes. Which medical procedure requires
the nurse to withhold this medication?
A. Abdominal ultrasound
B. Chest X-ray
C. Computed Tomography (CT) with IV contrast
D. Electrocardiogram (ECG)
Correct Answer: C. Computed Tomography (CT) with IV contrast
Explanation: Metformin must be withheld 48 hours before and after procedures involving
iodine-based contrast media to prevent lactic acidosis and acute renal failure.
Question 2.
The nurse is teaching a patient about the administration of insulin glargine. Which
statement by the patient indicates a correct understanding?
A. I will mix this insulin with my rapid-acting insulin in one syringe.
B. I will take this insulin once daily at the same time every day.
C. I should expect this insulin to peak in about 4 hours.
D. I need to take this insulin 15 minutes before my breakfast.
Correct Answer: B. I will take this insulin once daily at the same time every day.
Explanation: Insulin glargine is a long-acting insulin with no peak and is administered
once daily at the same time. It should never be mixed with other insulins.
Question 3.
Which assessment finding in a patient taking levothyroxine for hypothyroidism indicates
the dose may be too high?
A. Bradycardia
B. Weight gain
C. Cold intolerance
D. Tremors and palpitations
Correct Answer: D. Tremors and palpitations
Explanation: Excessive levothyroxine causes symptoms of hyperthyroidism, such as
tachycardia, tremors, palpitations, and heat intolerance.
,Question 4.
A patient with Addison’s disease is taking prednisone. What instruction is most important
for the nurse to include in the teaching?
A. Stop the medication immediately if you develop a fever.
B. Take the medication on an empty stomach.
C. Never stop this medication abruptly.
D. Avoid taking the medication if you are stressed.
Correct Answer: C. Never stop this medication abruptly.
Explanation: Abrupt withdrawal of corticosteroids can lead to acute adrenal insufficiency
(Addisonian crisis), which is a life-threatening emergency.
Question 5.
The nurse is monitoring a patient on phenytoin for seizures. What is the therapeutic serum
drug level range for this medication?
A. 5 to 10 mcg/mL
B. 10 to 20 mcg/mL
C. 20 to 30 mcg/mL
D. 30 to 50 mcg/mL
Correct Answer: B. 10 to 20 mcg/mL
Explanation: The therapeutic range for phenytoin is 10 to 20 mcg/mL. Levels below this
increase seizure risk, while levels above can cause toxicity like nystagmus and ataxia.
Question 6.
A patient is prescribed levodopa-carbidopa for Parkinson’s disease. The patient asks why
carbidopa is added. What is the nurse’s best response?
A. It helps the levodopa cross the blood-brain barrier.
B. It treats the tremors while levodopa treats the stiffness.
C. It prevents levodopa from being broken down in the periphery.
D. It reduces the risk of allergic reactions to levodopa.
Correct Answer: C. It prevents levodopa from being broken down in the
periphery.
Explanation: Carbidopa inhibits the enzyme dopa decarboxylase in the periphery,
allowing more levodopa to reach the brain and reducing systemic side effects like nausea.
, Question 7.
A patient started on Lithium for bipolar disorder is experiencing polyuria and mild thirst.
What is the nurse’s priority action?
A. Notify the provider of immediate toxicity.
B. Assess the serum lithium level and sodium intake.
C. Instruct the patient to limit fluid intake.
D. Hold the next dose of lithium.
Correct Answer: B. Assess the serum lithium level and sodium intake.
Explanation: Lithium has a narrow therapeutic index. Sodium depletion can lead to
lithium retention and toxicity. Polyuria and thirst are common but require monitoring of
levels.
Question 8.
Which medication is the treatment of choice for a patient experiencing status epilepticus?
A. Oral phenytoin
B. Oral carbamazepine
C. Intramuscular valproic acid
D. Intravenous lorazepam
Correct Answer: D. Intravenous lorazepam
Explanation: IV benzodiazepines like lorazepam or diazepam are first-line treatments to
stop active, prolonged seizure activity (status epilepticus).
Question 9.
A patient is prescribed a Selective Serotonin Reuptake Inhibitor (SSRI). Which herbal
supplement should the nurse advise the patient to avoid?
A. St. John’s Wort
B. Echinacea
C. Ginkgo biloba
D. Ginseng
Correct Answer: A. St. John’s Wort
Explanation: Combining St. John’s Wort with SSRIs significantly increases the risk of
serotonin syndrome, a potentially fatal condition.
Answers and detailed Rationales
Question 1.
A patient is prescribed metformin for type 2 diabetes. Which medical procedure requires
the nurse to withhold this medication?
A. Abdominal ultrasound
B. Chest X-ray
C. Computed Tomography (CT) with IV contrast
D. Electrocardiogram (ECG)
Correct Answer: C. Computed Tomography (CT) with IV contrast
Explanation: Metformin must be withheld 48 hours before and after procedures involving
iodine-based contrast media to prevent lactic acidosis and acute renal failure.
Question 2.
The nurse is teaching a patient about the administration of insulin glargine. Which
statement by the patient indicates a correct understanding?
A. I will mix this insulin with my rapid-acting insulin in one syringe.
B. I will take this insulin once daily at the same time every day.
C. I should expect this insulin to peak in about 4 hours.
D. I need to take this insulin 15 minutes before my breakfast.
Correct Answer: B. I will take this insulin once daily at the same time every day.
Explanation: Insulin glargine is a long-acting insulin with no peak and is administered
once daily at the same time. It should never be mixed with other insulins.
Question 3.
Which assessment finding in a patient taking levothyroxine for hypothyroidism indicates
the dose may be too high?
A. Bradycardia
B. Weight gain
C. Cold intolerance
D. Tremors and palpitations
Correct Answer: D. Tremors and palpitations
Explanation: Excessive levothyroxine causes symptoms of hyperthyroidism, such as
tachycardia, tremors, palpitations, and heat intolerance.
,Question 4.
A patient with Addison’s disease is taking prednisone. What instruction is most important
for the nurse to include in the teaching?
A. Stop the medication immediately if you develop a fever.
B. Take the medication on an empty stomach.
C. Never stop this medication abruptly.
D. Avoid taking the medication if you are stressed.
Correct Answer: C. Never stop this medication abruptly.
Explanation: Abrupt withdrawal of corticosteroids can lead to acute adrenal insufficiency
(Addisonian crisis), which is a life-threatening emergency.
Question 5.
The nurse is monitoring a patient on phenytoin for seizures. What is the therapeutic serum
drug level range for this medication?
A. 5 to 10 mcg/mL
B. 10 to 20 mcg/mL
C. 20 to 30 mcg/mL
D. 30 to 50 mcg/mL
Correct Answer: B. 10 to 20 mcg/mL
Explanation: The therapeutic range for phenytoin is 10 to 20 mcg/mL. Levels below this
increase seizure risk, while levels above can cause toxicity like nystagmus and ataxia.
Question 6.
A patient is prescribed levodopa-carbidopa for Parkinson’s disease. The patient asks why
carbidopa is added. What is the nurse’s best response?
A. It helps the levodopa cross the blood-brain barrier.
B. It treats the tremors while levodopa treats the stiffness.
C. It prevents levodopa from being broken down in the periphery.
D. It reduces the risk of allergic reactions to levodopa.
Correct Answer: C. It prevents levodopa from being broken down in the
periphery.
Explanation: Carbidopa inhibits the enzyme dopa decarboxylase in the periphery,
allowing more levodopa to reach the brain and reducing systemic side effects like nausea.
, Question 7.
A patient started on Lithium for bipolar disorder is experiencing polyuria and mild thirst.
What is the nurse’s priority action?
A. Notify the provider of immediate toxicity.
B. Assess the serum lithium level and sodium intake.
C. Instruct the patient to limit fluid intake.
D. Hold the next dose of lithium.
Correct Answer: B. Assess the serum lithium level and sodium intake.
Explanation: Lithium has a narrow therapeutic index. Sodium depletion can lead to
lithium retention and toxicity. Polyuria and thirst are common but require monitoring of
levels.
Question 8.
Which medication is the treatment of choice for a patient experiencing status epilepticus?
A. Oral phenytoin
B. Oral carbamazepine
C. Intramuscular valproic acid
D. Intravenous lorazepam
Correct Answer: D. Intravenous lorazepam
Explanation: IV benzodiazepines like lorazepam or diazepam are first-line treatments to
stop active, prolonged seizure activity (status epilepticus).
Question 9.
A patient is prescribed a Selective Serotonin Reuptake Inhibitor (SSRI). Which herbal
supplement should the nurse advise the patient to avoid?
A. St. John’s Wort
B. Echinacea
C. Ginkgo biloba
D. Ginseng
Correct Answer: A. St. John’s Wort
Explanation: Combining St. John’s Wort with SSRIs significantly increases the risk of
serotonin syndrome, a potentially fatal condition.
