Module 7 Exam — Pharmacology I (BSN/NCLEX-RN) 2026/2027
UPDATE
1. A client is prescribed digoxin for heart failure. Which laboratory value should
the nurse monitor most closely to prevent digoxin toxicity?
A. Serum potassium level
B. Serum sodium level
C. Serum calcium level
D. Serum glucose level
Answer: A
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity because
potassium and digoxin compete for the same binding sites on the ATPase pump.
2. A patient is receiving intravenous heparin for a pulmonary embolism. Which
laboratory test is used to monitor the effectiveness of this therapy?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
Answer: A
Rationale: The aPTT is used to monitor the therapeutic effect of heparin, whereas PT and
INR are used to monitor warfarin therapy.
,3. Which education should the nurse provide to a client starting a new
prescription for albuterol, a short-acting beta-agonist?
A. Take this medication at the same time every night.
B. Use this medication only for acute asthma attacks.
C. Rinse your mouth to prevent oral candidiasis.
D. Expect a decrease in heart rate after administration.
Answer: B
Rationale: Albuterol is a rescue medication used for rapid relief of bronchospasm. Rinsing
the mouth is specifically required for inhaled corticosteroids, not albuterol.
4. A nurse is preparing to administer spironolactone. Which finding would cause
the nurse to hold the medication and notify the provider?
A. Potassium level of 5.4 mEq/L
B. Blood pressure of 140/90 mmHg
C. Sodium level of 138 mEq/L
D. Urine output of 40 mL/hr
Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.4 mEq/L
indicates hyperkalemia, which is a contraindication.
5. A client is prescribed captopril, an ACE inhibitor. Which adverse effect is most
common and may require switching to an ARB?
A. Persistent dry cough
B. Peripheral edema
C. Hypokalemia
D. Tachycardia
Answer: A
, Rationale: ACE inhibitors prevent the breakdown of bradykinin in the lungs, often causing
a dry, non-productive cough. Angiotensin II Receptor Blockers (ARBs) do not have this
effect.
6. What is the primary mechanism of action of nitroglycerin when treating
stable angina?
A. Increasing heart rate to improve output
B. Vasodilation to decrease preload and oxygen demand
C. Constricting coronary arteries
D. Decreasing the blood’s viscosity
Answer: B
Rationale: Nitroglycerin acts as a vasodilator, primarily reducing venous return (preload),
which lowers the workload and oxygen demand of the heart.
7. A client is taking warfarin. Which over-the-counter medication should the
nurse instruct the client to avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Calcium carbonate
Answer: B
Rationale: NSAIDs like ibuprofen increase the risk of bleeding when taken with
anticoagulants like warfarin. Acetaminophen is generally preferred for mild pain.
UPDATE
1. A client is prescribed digoxin for heart failure. Which laboratory value should
the nurse monitor most closely to prevent digoxin toxicity?
A. Serum potassium level
B. Serum sodium level
C. Serum calcium level
D. Serum glucose level
Answer: A
Rationale: Hypokalemia (low potassium) increases the risk of digoxin toxicity because
potassium and digoxin compete for the same binding sites on the ATPase pump.
2. A patient is receiving intravenous heparin for a pulmonary embolism. Which
laboratory test is used to monitor the effectiveness of this therapy?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
Answer: A
Rationale: The aPTT is used to monitor the therapeutic effect of heparin, whereas PT and
INR are used to monitor warfarin therapy.
,3. Which education should the nurse provide to a client starting a new
prescription for albuterol, a short-acting beta-agonist?
A. Take this medication at the same time every night.
B. Use this medication only for acute asthma attacks.
C. Rinse your mouth to prevent oral candidiasis.
D. Expect a decrease in heart rate after administration.
Answer: B
Rationale: Albuterol is a rescue medication used for rapid relief of bronchospasm. Rinsing
the mouth is specifically required for inhaled corticosteroids, not albuterol.
4. A nurse is preparing to administer spironolactone. Which finding would cause
the nurse to hold the medication and notify the provider?
A. Potassium level of 5.4 mEq/L
B. Blood pressure of 140/90 mmHg
C. Sodium level of 138 mEq/L
D. Urine output of 40 mL/hr
Answer: A
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.4 mEq/L
indicates hyperkalemia, which is a contraindication.
5. A client is prescribed captopril, an ACE inhibitor. Which adverse effect is most
common and may require switching to an ARB?
A. Persistent dry cough
B. Peripheral edema
C. Hypokalemia
D. Tachycardia
Answer: A
, Rationale: ACE inhibitors prevent the breakdown of bradykinin in the lungs, often causing
a dry, non-productive cough. Angiotensin II Receptor Blockers (ARBs) do not have this
effect.
6. What is the primary mechanism of action of nitroglycerin when treating
stable angina?
A. Increasing heart rate to improve output
B. Vasodilation to decrease preload and oxygen demand
C. Constricting coronary arteries
D. Decreasing the blood’s viscosity
Answer: B
Rationale: Nitroglycerin acts as a vasodilator, primarily reducing venous return (preload),
which lowers the workload and oxygen demand of the heart.
7. A client is taking warfarin. Which over-the-counter medication should the
nurse instruct the client to avoid?
A. Acetaminophen
B. Ibuprofen
C. Diphenhydramine
D. Calcium carbonate
Answer: B
Rationale: NSAIDs like ibuprofen increase the risk of bleeding when taken with
anticoagulants like warfarin. Acetaminophen is generally preferred for mild pain.
