NURS 406 Pharmacology Assessment 1 & 2 |
Nursing Pharmacology Study Guide & Exam Prep
2026/2027 | Medication Administration,
Pharmacokinetics, Pharmacodynamics, Drug
Interactions, Adverse Effects, Patient Education,
Safe Medication Practice, Cardiovascular,
Respiratory, Endocrine, GI, Neurological & Anti-
Infective Drugs, Dosage Calculations, Clinical
Judgment, Practice Questions, Answers & Detailed
Rationalesav
Question 1: A patient with a history of ventricular tachycardia is prescribed
amiodarone. Which of the following baseline assessments is most critical to
obtain prior to initiating therapy?
A. Serum potassium and magnesium levels
B. Pulmonary function tests with diffusing capacity
C. Ophthalmic slit-lamp examination
D. Baseline thyroid-stimulating hormone (TSH)
CORRECT ANSWER: A. Serum potassium and magnesium levels
Rationale: Amiodarone prolongs the QT interval, and the risk of torsades de pointes is
significantly increased in the presence of hypokalemia or hypomagnesemia. While
pulmonary, ophthalmic, and thyroid assessments are important baseline tests for long-
term amiodarone therapy, correcting electrolyte imbalances is the most critical
immediate step to prevent life-threatening arrhythmias.
Question 2: A nurse is administering intravenous furosemide to a patient with
acute pulmonary edema. Which of the following assessment findings indicates
a therapeutic response to the medication?
A. Increased central venous pressure
B. Decreased dyspnea and clear breath sounds
C. Increased urine specific gravity
D. Decreased serum potassium level
CORRECT ANSWER: B. Decreased dyspnea and clear breath sounds
Rationale: Furosemide is a loop diuretic that reduces preload by promoting diuresis. The
therapeutic goal in pulmonary edema is to reduce fluid volume in the lungs, which
manifests clinically as decreased dyspnea, reduced crackles, and clearer breath sounds.
Increased CVP would indicate worsening fluid overload.
,Question 3: A patient receiving a continuous heparin infusion for a pulmonary
embolism has an aPTT of 110 seconds. The baseline aPTT was 30 seconds.
What is the most appropriate nursing action?
A. Increase the infusion rate by 2 mL/hr
B. Continue the infusion and monitor closely
C. Stop the infusion and notify the healthcare provider
D. Administer protamine sulfate immediately
CORRECT ANSWER: C. Stop the infusion and notify the healthcare provider
Rationale: The therapeutic aPTT goal for heparin therapy is typically 1.5 to 2.5 times the
baseline (45–75 seconds). An aPTT of 110 seconds indicates a supratherapeutic level
with a high risk of bleeding. The infusion should be stopped, and the provider notified.
Protamine sulfate is the antidote for severe bleeding, but it is not administered without
an order.
Question 4: Which medication is most commonly used as a first-line treatment
for anaphylaxis to reverse bronchospasm and hypotension?
A. Diphenhydramine
B. Methylprednisolone
C. Epinephrine
D. Albuterol
CORRECT ANSWER: C. Epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis. It has potent alpha-1
vasoconstrictor effects to reverse hypotension and beta-2 agonist effects to relieve
bronchospasm. Antihistamines and corticosteroids are adjunctive therapies that work
more slowly.
Question 5: A patient on long-term glucocorticoid therapy is scheduled for
surgery. The nurse anticipates that the provider will order which of the
following to prevent a complication?
A. Increased dose of glucocorticoids during the perioperative period
B. Discontinuation of glucocorticoids 24 hours before surgery
C. Administration of an H2-receptor antagonist
D. A tapering dose of glucocorticoids post-operatively
CORRECT ANSWER: A. Increased dose of glucocorticoids during the
perioperative period
Rationale: Chronic glucocorticoid therapy suppresses the hypothalamic-pituitary-
adrenal (HPA) axis. Surgery is a major stressor that requires an increased cortisol
,response. Without a stress-dose of glucocorticoids, the patient is at risk for an adrenal
crisis.
Question 6: A nurse is providing education to a patient prescribed warfarin.
Which statement by the patient indicates a need for further teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I will take ibuprofen for my occasional headaches."
C. "I will use an electric razor for shaving."
D. "I will have my blood tested regularly as scheduled."
CORRECT ANSWER: B. "I will take ibuprofen for my occasional headaches."
Rationale: Ibuprofen and other NSAIDs increase the risk of gastrointestinal bleeding and
can interfere with platelet function. When combined with warfarin, this significantly
increases the risk of bleeding. Patients should be advised to use alternative analgesics
like acetaminophen.
Question 7: The nurse is caring for a patient who has overdosed on a
benzodiazepine. Which medication should the nurse anticipate administering?
A. Naloxone
B. Acetylcysteine
C. Flumazenil
D. Atropine
CORRECT ANSWER: C. Flumazenil
Rationale: Flumazenil is a competitive benzodiazepine receptor antagonist used to
reverse the sedative effects of benzodiazepine overdose. Naloxone is for opioid
overdose, acetylcysteine is for acetaminophen toxicity, and atropine is for cholinergic
toxicity.
Question 8: A patient with Parkinson's disease is prescribed carbidopa-
levodopa. The nurse explains that the primary purpose of carbidopa is to:
A. Enhance the therapeutic effects of levodopa in the brain
B. Prevent the peripheral breakdown of levodopa
C. Reduce the 'on-off' phenomena
D. Provide dopamine receptor stimulation
CORRECT ANSWER: B. Prevent the peripheral breakdown of levodopa
Rationale: Carbidopa is a peripheral decarboxylase inhibitor. It prevents the breakdown
of levodopa in the periphery, allowing more levodopa to cross the blood-brain barrier.
, This reduces peripheral side effects (like nausea) and allows for a lower dose of
levodopa.
Question 9: A nurse is preparing to administer digoxin. Which of the following
pulse rates would indicate a need to hold the medication and notify the
provider?
A. 68 beats per minute
B. 55 beats per minute
C. 72 beats per minute
D. 90 beats per minute
CORRECT ANSWER: B. 55 beats per minute
Rationale: Digoxin decreases heart rate by increasing vagal tone and slowing AV
conduction. A pulse rate below 60 bpm (bradycardia) is a common sign of digoxin
toxicity. The nurse should hold the medication and assess for other signs of toxicity like
nausea, vomiting, or visual disturbances.
Question 10: A patient is started on isoniazid (INH) for tuberculosis. The nurse
teaches the patient to report which of the following symptoms immediately?
A. Red-orange discoloration of urine
B. Numbness and tingling in the hands and feet
C. Dry mouth and constipation
D. Photosensitivity
CORRECT ANSWER: B. Numbness and tingling in the hands and feet
Rationale: INH can cause peripheral neuropathy due to pyridoxine (vitamin B6)
deficiency. Numbness, tingling, or burning in the extremities are early signs. Red-orange
urine is a side effect of rifampin, not INH.
Question 11: A patient with type 1 diabetes mellitus is experiencing nausea
and vomiting and is unable to eat. What is the most important instruction for
the nurse to provide regarding insulin administration?
A. "Withhold your insulin until you can eat."
B. "Continue taking your usual dose of insulin."
C. "Reduce your insulin dose by 50%."
D. "Take your long-acting insulin but hold the short-acting."
CORRECT ANSWER: B. "Continue taking your usual dose of insulin."
Rationale: Even when unable to eat, patients with type 1 diabetes still require basal
insulin to prevent diabetic ketoacidosis (DKA). They should never withhold insulin. The
Nursing Pharmacology Study Guide & Exam Prep
2026/2027 | Medication Administration,
Pharmacokinetics, Pharmacodynamics, Drug
Interactions, Adverse Effects, Patient Education,
Safe Medication Practice, Cardiovascular,
Respiratory, Endocrine, GI, Neurological & Anti-
Infective Drugs, Dosage Calculations, Clinical
Judgment, Practice Questions, Answers & Detailed
Rationalesav
Question 1: A patient with a history of ventricular tachycardia is prescribed
amiodarone. Which of the following baseline assessments is most critical to
obtain prior to initiating therapy?
A. Serum potassium and magnesium levels
B. Pulmonary function tests with diffusing capacity
C. Ophthalmic slit-lamp examination
D. Baseline thyroid-stimulating hormone (TSH)
CORRECT ANSWER: A. Serum potassium and magnesium levels
Rationale: Amiodarone prolongs the QT interval, and the risk of torsades de pointes is
significantly increased in the presence of hypokalemia or hypomagnesemia. While
pulmonary, ophthalmic, and thyroid assessments are important baseline tests for long-
term amiodarone therapy, correcting electrolyte imbalances is the most critical
immediate step to prevent life-threatening arrhythmias.
Question 2: A nurse is administering intravenous furosemide to a patient with
acute pulmonary edema. Which of the following assessment findings indicates
a therapeutic response to the medication?
A. Increased central venous pressure
B. Decreased dyspnea and clear breath sounds
C. Increased urine specific gravity
D. Decreased serum potassium level
CORRECT ANSWER: B. Decreased dyspnea and clear breath sounds
Rationale: Furosemide is a loop diuretic that reduces preload by promoting diuresis. The
therapeutic goal in pulmonary edema is to reduce fluid volume in the lungs, which
manifests clinically as decreased dyspnea, reduced crackles, and clearer breath sounds.
Increased CVP would indicate worsening fluid overload.
,Question 3: A patient receiving a continuous heparin infusion for a pulmonary
embolism has an aPTT of 110 seconds. The baseline aPTT was 30 seconds.
What is the most appropriate nursing action?
A. Increase the infusion rate by 2 mL/hr
B. Continue the infusion and monitor closely
C. Stop the infusion and notify the healthcare provider
D. Administer protamine sulfate immediately
CORRECT ANSWER: C. Stop the infusion and notify the healthcare provider
Rationale: The therapeutic aPTT goal for heparin therapy is typically 1.5 to 2.5 times the
baseline (45–75 seconds). An aPTT of 110 seconds indicates a supratherapeutic level
with a high risk of bleeding. The infusion should be stopped, and the provider notified.
Protamine sulfate is the antidote for severe bleeding, but it is not administered without
an order.
Question 4: Which medication is most commonly used as a first-line treatment
for anaphylaxis to reverse bronchospasm and hypotension?
A. Diphenhydramine
B. Methylprednisolone
C. Epinephrine
D. Albuterol
CORRECT ANSWER: C. Epinephrine
Rationale: Epinephrine is the first-line treatment for anaphylaxis. It has potent alpha-1
vasoconstrictor effects to reverse hypotension and beta-2 agonist effects to relieve
bronchospasm. Antihistamines and corticosteroids are adjunctive therapies that work
more slowly.
Question 5: A patient on long-term glucocorticoid therapy is scheduled for
surgery. The nurse anticipates that the provider will order which of the
following to prevent a complication?
A. Increased dose of glucocorticoids during the perioperative period
B. Discontinuation of glucocorticoids 24 hours before surgery
C. Administration of an H2-receptor antagonist
D. A tapering dose of glucocorticoids post-operatively
CORRECT ANSWER: A. Increased dose of glucocorticoids during the
perioperative period
Rationale: Chronic glucocorticoid therapy suppresses the hypothalamic-pituitary-
adrenal (HPA) axis. Surgery is a major stressor that requires an increased cortisol
,response. Without a stress-dose of glucocorticoids, the patient is at risk for an adrenal
crisis.
Question 6: A nurse is providing education to a patient prescribed warfarin.
Which statement by the patient indicates a need for further teaching?
A. "I will avoid eating large amounts of leafy green vegetables."
B. "I will take ibuprofen for my occasional headaches."
C. "I will use an electric razor for shaving."
D. "I will have my blood tested regularly as scheduled."
CORRECT ANSWER: B. "I will take ibuprofen for my occasional headaches."
Rationale: Ibuprofen and other NSAIDs increase the risk of gastrointestinal bleeding and
can interfere with platelet function. When combined with warfarin, this significantly
increases the risk of bleeding. Patients should be advised to use alternative analgesics
like acetaminophen.
Question 7: The nurse is caring for a patient who has overdosed on a
benzodiazepine. Which medication should the nurse anticipate administering?
A. Naloxone
B. Acetylcysteine
C. Flumazenil
D. Atropine
CORRECT ANSWER: C. Flumazenil
Rationale: Flumazenil is a competitive benzodiazepine receptor antagonist used to
reverse the sedative effects of benzodiazepine overdose. Naloxone is for opioid
overdose, acetylcysteine is for acetaminophen toxicity, and atropine is for cholinergic
toxicity.
Question 8: A patient with Parkinson's disease is prescribed carbidopa-
levodopa. The nurse explains that the primary purpose of carbidopa is to:
A. Enhance the therapeutic effects of levodopa in the brain
B. Prevent the peripheral breakdown of levodopa
C. Reduce the 'on-off' phenomena
D. Provide dopamine receptor stimulation
CORRECT ANSWER: B. Prevent the peripheral breakdown of levodopa
Rationale: Carbidopa is a peripheral decarboxylase inhibitor. It prevents the breakdown
of levodopa in the periphery, allowing more levodopa to cross the blood-brain barrier.
, This reduces peripheral side effects (like nausea) and allows for a lower dose of
levodopa.
Question 9: A nurse is preparing to administer digoxin. Which of the following
pulse rates would indicate a need to hold the medication and notify the
provider?
A. 68 beats per minute
B. 55 beats per minute
C. 72 beats per minute
D. 90 beats per minute
CORRECT ANSWER: B. 55 beats per minute
Rationale: Digoxin decreases heart rate by increasing vagal tone and slowing AV
conduction. A pulse rate below 60 bpm (bradycardia) is a common sign of digoxin
toxicity. The nurse should hold the medication and assess for other signs of toxicity like
nausea, vomiting, or visual disturbances.
Question 10: A patient is started on isoniazid (INH) for tuberculosis. The nurse
teaches the patient to report which of the following symptoms immediately?
A. Red-orange discoloration of urine
B. Numbness and tingling in the hands and feet
C. Dry mouth and constipation
D. Photosensitivity
CORRECT ANSWER: B. Numbness and tingling in the hands and feet
Rationale: INH can cause peripheral neuropathy due to pyridoxine (vitamin B6)
deficiency. Numbness, tingling, or burning in the extremities are early signs. Red-orange
urine is a side effect of rifampin, not INH.
Question 11: A patient with type 1 diabetes mellitus is experiencing nausea
and vomiting and is unable to eat. What is the most important instruction for
the nurse to provide regarding insulin administration?
A. "Withhold your insulin until you can eat."
B. "Continue taking your usual dose of insulin."
C. "Reduce your insulin dose by 50%."
D. "Take your long-acting insulin but hold the short-acting."
CORRECT ANSWER: B. "Continue taking your usual dose of insulin."
Rationale: Even when unable to eat, patients with type 1 diabetes still require basal
insulin to prevent diabetic ketoacidosis (DKA). They should never withhold insulin. The
