NUR 210 Exam 2 V3 | NUR 210 Pharmacology | Actual Q&A with
Rationale (NUR 210 Exam 2) | Galen
1. A patient is prescribed tetracycline for a respiratory infection. Which instruction should the
nurse provide to ensure proper absorption?
A. Take the medication with a full glass of milk.
B. Crush the tablets and mix them with applesauce.
C. Take the medication immediately after a heavy meal.
D. Avoid taking the medication with antacids or iron supplements.
Answer: D
Rationale: Tetracyclines form nonabsorbable chelates with metal ions such as calcium,
magnesium, and iron. Taking them with antacids or dairy products significantly reduces
their absorption and effectiveness. The nurse must instruct the patient to space these
substances at least 2 hours apart from the antibiotic dose.
2. A client receiving gentamicin intravenous (IV) therapy reports sudden ringing in the ears.
What is the nurse’s priority action?
A. Slow the infusion rate and monitor for improvement.
B. Document the finding and reassess in four hours.
C. Stop the infusion immediately and notify the healthcare provider.
D. Administer an antihistamine as prescribed for a possible allergic reaction.
Answer: C
Rationale: Aminoglycosides like gentamicin are known for causing ototoxicity, which can
be irreversible if not addressed promptly. Tinnitus, or ringing in the ears, is often the first
sign of eighth cranial nerve damage. The nurse should stop the drug to prevent further
damage and consult the provider regarding serum peak and trough levels.
3. A patient newly prescribed lisinopril asks the nurse why they have developed a persistent,
dry cough. What is the most accurate explanation?
A. The cough is a result of fluid accumulation in the lungs due to heart failure.
B. The medication causes an accumulation of bradykinin in the respiratory tract.
C. This is a temporary side effect that will resolve within 48 hours.
D. The cough indicates a viral upper respiratory infection unrelated to the drug.
Answer: B
,Rationale: ACE inhibitors like lisinopril prevent the breakdown of bradykinin, which leads
to irritation in the lungs and a characteristic dry cough. This side effect occurs in about 10-
20% of patients and is the most common reason for discontinuing the drug. If the cough is
intolerable, the provider may switch the patient to an Angiotensin II Receptor Blocker
(ARB).
4. The nurse is preparing to administer vancomycin via IV piggyback. Which vital sign or
assessment finding is most critical to monitor to prevent ‘Red Man Syndrome’?
A. Blood pressure and heart rate.
B. Infusion rate and skin color.
C. Oxygen saturation levels.
D. Deep tendon reflexes.
Answer: B
Rationale: Red Man Syndrome is a rate-dependent infusion reaction characterized by
flushing, rash, and pruritus, primarily on the face and neck. It occurs when vancomycin is
infused too rapidly, causing a massive release of histamine. The nurse should ensure the
infusion lasts at least 60 minutes to minimize this risk.
5. Which laboratory value is most important for the nurse to monitor in a patient receiving a
loop diuretic such as furosemide?
A. Serum potassium level of 3.2 mEq/L.
B. Serum sodium level of 138 mEq/L.
C. Serum calcium level of 9.5 mg/dL.
D. Serum creatinine level of 0.8 mg/dL.
Answer: A
Rationale: Furosemide is a potent loop diuretic that causes significant loss of potassium
through the kidneys. A potassium level of 3.2 mEq/L indicates hypokalemia, which can lead
to life-threatening cardiac arrhythmias. The nurse must monitor electrolytes closely and
potentially advocate for potassium supplements.
6. A patient is being discharged with a prescription for sublingual nitroglycerin. Which
statement by the patient indicates a need for further teaching?
A. I will store the tablets in the original dark glass bottle.
B. I should take one tablet every 5 minutes for up to three doses if chest pain persists.
C. I should keep the bottle in my shirt pocket so it is always close to my heart.
D. I will call 911 if the pain is not relieved after the first dose.
, Answer: C
Rationale: Nitroglycerin is highly sensitive to light and heat; keeping it in a shirt pocket
against the body can degrade the medication’s potency. It should be kept in its original dark
glass container in a cool, dry place. The patient should indeed call emergency services if the
first dose does not alleviate symptoms.
7. A patient is prescribed warfarin for the prevention of deep vein thrombosis. Which dietary
instruction is essential?
A. Maintain a consistent intake of foods high in Vitamin K.
B. Eliminate all green leafy vegetables from your diet entirely.
C. Increase your intake of grapefruit juice to improve absorption.
D. Take a daily Vitamin E supplement to enhance the blood-thinning effect.
Answer: A
Rationale: Warfarin works by inhibiting Vitamin K-dependent clotting factors, so sudden
changes in Vitamin K intake can alter the drug’s effectiveness. Rather than eliminating
Vitamin K, patients should maintain a consistent daily intake to keep their Prothrombin
Time (PT) and International Normalized Ratio (INR) stable. Large fluctuations in diet can
lead to either subtherapeutic levels or increased bleeding risk.
8. A nurse is administering digoxin to a patient with heart failure. Which assessment finding
would require the nurse to withhold the medication?
A. An apical heart rate of 52 beats per minute.
B. A blood pressure of 110/70 mmHg.
C. A respiratory rate of 18 breaths per minute.
D. A serum digoxin level of 0.8 ng/mL.
Answer: A
Rationale: Digoxin is a positive inotrope and negative chronotrope, meaning it slows the
heart rate while increasing the force of contraction. The nurse must assess the apical pulse
for one full minute and withhold the dose if the heart rate is less than 60 bpm in an adult.
Bradycardia is a classic sign of digoxin toxicity.
9. A patient with a history of asthma is diagnosed with hypertension. Which antihypertensive
medication should the nurse question?
A. Amlodipine.
B. Metoprolol.
C. Hydrochlorothiazide.
Rationale (NUR 210 Exam 2) | Galen
1. A patient is prescribed tetracycline for a respiratory infection. Which instruction should the
nurse provide to ensure proper absorption?
A. Take the medication with a full glass of milk.
B. Crush the tablets and mix them with applesauce.
C. Take the medication immediately after a heavy meal.
D. Avoid taking the medication with antacids or iron supplements.
Answer: D
Rationale: Tetracyclines form nonabsorbable chelates with metal ions such as calcium,
magnesium, and iron. Taking them with antacids or dairy products significantly reduces
their absorption and effectiveness. The nurse must instruct the patient to space these
substances at least 2 hours apart from the antibiotic dose.
2. A client receiving gentamicin intravenous (IV) therapy reports sudden ringing in the ears.
What is the nurse’s priority action?
A. Slow the infusion rate and monitor for improvement.
B. Document the finding and reassess in four hours.
C. Stop the infusion immediately and notify the healthcare provider.
D. Administer an antihistamine as prescribed for a possible allergic reaction.
Answer: C
Rationale: Aminoglycosides like gentamicin are known for causing ototoxicity, which can
be irreversible if not addressed promptly. Tinnitus, or ringing in the ears, is often the first
sign of eighth cranial nerve damage. The nurse should stop the drug to prevent further
damage and consult the provider regarding serum peak and trough levels.
3. A patient newly prescribed lisinopril asks the nurse why they have developed a persistent,
dry cough. What is the most accurate explanation?
A. The cough is a result of fluid accumulation in the lungs due to heart failure.
B. The medication causes an accumulation of bradykinin in the respiratory tract.
C. This is a temporary side effect that will resolve within 48 hours.
D. The cough indicates a viral upper respiratory infection unrelated to the drug.
Answer: B
,Rationale: ACE inhibitors like lisinopril prevent the breakdown of bradykinin, which leads
to irritation in the lungs and a characteristic dry cough. This side effect occurs in about 10-
20% of patients and is the most common reason for discontinuing the drug. If the cough is
intolerable, the provider may switch the patient to an Angiotensin II Receptor Blocker
(ARB).
4. The nurse is preparing to administer vancomycin via IV piggyback. Which vital sign or
assessment finding is most critical to monitor to prevent ‘Red Man Syndrome’?
A. Blood pressure and heart rate.
B. Infusion rate and skin color.
C. Oxygen saturation levels.
D. Deep tendon reflexes.
Answer: B
Rationale: Red Man Syndrome is a rate-dependent infusion reaction characterized by
flushing, rash, and pruritus, primarily on the face and neck. It occurs when vancomycin is
infused too rapidly, causing a massive release of histamine. The nurse should ensure the
infusion lasts at least 60 minutes to minimize this risk.
5. Which laboratory value is most important for the nurse to monitor in a patient receiving a
loop diuretic such as furosemide?
A. Serum potassium level of 3.2 mEq/L.
B. Serum sodium level of 138 mEq/L.
C. Serum calcium level of 9.5 mg/dL.
D. Serum creatinine level of 0.8 mg/dL.
Answer: A
Rationale: Furosemide is a potent loop diuretic that causes significant loss of potassium
through the kidneys. A potassium level of 3.2 mEq/L indicates hypokalemia, which can lead
to life-threatening cardiac arrhythmias. The nurse must monitor electrolytes closely and
potentially advocate for potassium supplements.
6. A patient is being discharged with a prescription for sublingual nitroglycerin. Which
statement by the patient indicates a need for further teaching?
A. I will store the tablets in the original dark glass bottle.
B. I should take one tablet every 5 minutes for up to three doses if chest pain persists.
C. I should keep the bottle in my shirt pocket so it is always close to my heart.
D. I will call 911 if the pain is not relieved after the first dose.
, Answer: C
Rationale: Nitroglycerin is highly sensitive to light and heat; keeping it in a shirt pocket
against the body can degrade the medication’s potency. It should be kept in its original dark
glass container in a cool, dry place. The patient should indeed call emergency services if the
first dose does not alleviate symptoms.
7. A patient is prescribed warfarin for the prevention of deep vein thrombosis. Which dietary
instruction is essential?
A. Maintain a consistent intake of foods high in Vitamin K.
B. Eliminate all green leafy vegetables from your diet entirely.
C. Increase your intake of grapefruit juice to improve absorption.
D. Take a daily Vitamin E supplement to enhance the blood-thinning effect.
Answer: A
Rationale: Warfarin works by inhibiting Vitamin K-dependent clotting factors, so sudden
changes in Vitamin K intake can alter the drug’s effectiveness. Rather than eliminating
Vitamin K, patients should maintain a consistent daily intake to keep their Prothrombin
Time (PT) and International Normalized Ratio (INR) stable. Large fluctuations in diet can
lead to either subtherapeutic levels or increased bleeding risk.
8. A nurse is administering digoxin to a patient with heart failure. Which assessment finding
would require the nurse to withhold the medication?
A. An apical heart rate of 52 beats per minute.
B. A blood pressure of 110/70 mmHg.
C. A respiratory rate of 18 breaths per minute.
D. A serum digoxin level of 0.8 ng/mL.
Answer: A
Rationale: Digoxin is a positive inotrope and negative chronotrope, meaning it slows the
heart rate while increasing the force of contraction. The nurse must assess the apical pulse
for one full minute and withhold the dose if the heart rate is less than 60 bpm in an adult.
Bradycardia is a classic sign of digoxin toxicity.
9. A patient with a history of asthma is diagnosed with hypertension. Which antihypertensive
medication should the nurse question?
A. Amlodipine.
B. Metoprolol.
C. Hydrochlorothiazide.
