BSN Advanced Pharmacology Exam 3 Practice 2026
UPDATED ACTUAL Questions and CORRECT Answers
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)
Answer: C
Rationale: Metformin must be withheld 48 hours before and after procedures involving
iodine-based contrast media to prevent lactic acidosis and acute renal failure.
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.
Answer: B
Rationale: 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.
,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
Answer: D
Rationale: Excessive levothyroxine causes symptoms of hyperthyroidism, such as
tachycardia, tremors, palpitations, and heat intolerance.
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.
Answer: C
Rationale: Abrupt withdrawal of corticosteroids can lead to acute adrenal insufficiency
(Addisonian crisis), which is a life-threatening emergency.
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
Answer: B
Rationale: 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.
, 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.
Answer: C
Rationale: Carbidopa inhibits the enzyme dopa decarboxylase in the periphery, allowing
more levodopa to reach the brain and reducing systemic side effects like nausea.
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.
Answer: B
Rationale: 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.
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
Answer: D
Rationale: IV benzodiazepines like lorazepam or diazepam are first-line treatments to stop
active, prolonged seizure activity (status epilepticus).
UPDATED ACTUAL Questions and CORRECT Answers
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)
Answer: C
Rationale: Metformin must be withheld 48 hours before and after procedures involving
iodine-based contrast media to prevent lactic acidosis and acute renal failure.
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.
Answer: B
Rationale: 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.
,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
Answer: D
Rationale: Excessive levothyroxine causes symptoms of hyperthyroidism, such as
tachycardia, tremors, palpitations, and heat intolerance.
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.
Answer: C
Rationale: Abrupt withdrawal of corticosteroids can lead to acute adrenal insufficiency
(Addisonian crisis), which is a life-threatening emergency.
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
Answer: B
Rationale: 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.
, 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.
Answer: C
Rationale: Carbidopa inhibits the enzyme dopa decarboxylase in the periphery, allowing
more levodopa to reach the brain and reducing systemic side effects like nausea.
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.
Answer: B
Rationale: 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.
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
Answer: D
Rationale: IV benzodiazepines like lorazepam or diazepam are first-line treatments to stop
active, prolonged seizure activity (status epilepticus).
