NUR 210 Final Exam V3 | NUR 210 Pharmacology | Actual Q&A with
Rationale (NUR 210 Final Exam) | Galen
1. A patient is prescribed Digoxin for heart failure. Which clinical manifestation should the
nurse identify as an early sign of Digoxin toxicity?
A. Increased urinary output
B. Anorexia and nausea
C. Tachycardia
D. Hypertension
Answer: B
Rationale: Early signs of digoxin toxicity include gastrointestinal disturbances such as
anorexia, nausea, and vomiting. The nurse must also monitor for neurological symptoms
like blurred vision or yellow-green halos. It is critical to assess the apical pulse for one full
minute prior to administration to ensure safe dosing.
2. When teaching a patient about the side effects of ACE inhibitors, such as Lisinopril, which
symptom should the nurse emphasize as a common reason for discontinuing the medication?
A. Increased appetite
B. Weight gain
C. Hypoglycemia
D. Persistent dry cough
Answer: D
Rationale: A persistent dry cough is a well-known side effect of ACE inhibitors caused by
the accumulation of bradykinin in the respiratory tract. Patients often find this side effect
intolerable, leading to the need for a medication change to an Angiotensin II Receptor
Blocker (ARB). The nurse should educate the patient that this cough is not indicative of an
infection but a drug reaction.
3. A nurse is preparing to administer Heparin subcutaneously. Which action should the nurse
take to ensure patient safety?
A. Aspirate before injecting the medication
B. Massage the injection site after delivery
C. Administer the dose in the deltoid muscle
D. Use a 25- to 27-gauge needle for the injection
,Answer: D
Rationale: A fine-gauge needle, such as a 25- to 27-gauge, is appropriate for subcutaneous
heparin to minimize tissue trauma and hematoma formation. The nurse should avoid
aspirating or massaging the site because these actions increase the risk of local bleeding.
Documentation should include the specific abdominal site used to ensure systematic
rotation of injections.
4. Which laboratory value is the most critical for a nurse to monitor in a patient receiving
Warfarin therapy?
A. International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Serum potassium
D. White blood cell count
Answer: A
Rationale: The INR is the standardized measurement used to determine the effectiveness
of Warfarin and the patient’s risk for bleeding. A therapeutic range is typically between 2.0
and 3.0 for most indications like atrial fibrillation. The nurse must assess this value
frequently and teach the patient about consistent Vitamin K intake to maintain stability.
5. A patient with a history of asthma is prescribed Propranolol for hypertension. Why should
the nurse question this order?
A. Non-selective beta-blockers can cause bronchoconstriction
B. Propranolol causes tachycardia which masks asthma
C. The medication will increase respiratory secretions
D. Propranolol is only used for cardiac arrhythmias
Answer: A
Rationale: Propranolol is a non-selective beta-adrenergic blocker that blocks both Beta-1
and Beta-2 receptors. Blocking Beta-2 receptors in the lungs can lead to
bronchoconstriction, which is dangerous for patients with asthma or COPD. The nurse
should advocate for a cardio-selective beta-blocker like Metoprolol if a beta-blocker is
necessary.
6. A nurse is caring for a patient receiving Furosemide. Which electrolyte imbalance is this
patient at highest risk for developing?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
, D. Hypocalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of sodium, water, and
potassium. Hypokalemia is a significant risk that can lead to cardiac dysrhythmias and
potentiation of digoxin toxicity. The nurse should encourage the intake of potassium-rich
foods or administer supplements as prescribed.
7. A patient is prescribed Albuterol via a metered-dose inhaler (MDI). Which statement by the
patient indicates a need for further teaching?
A. I will wait 1 minute between puffs of the same medication.
B. I will take this medication every day to prevent an attack.
C. I will use this inhaler if I feel short of breath suddenly.
D. I will rinse my mouth after using the inhaler.
Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) intended for rescue use during
acute bronchospasm, not for long-term daily prevention. Regular daily use of a rescue
inhaler suggests poorly controlled asthma and the need for a controller medication. The
patient should be taught to recognize the difference between rescue and maintenance
therapies.
8. A nurse is administering Spironolactone to a patient. Which medication, if taken
concurrently, increases the risk of hyperkalemia?
A. Furosemide
B. Hydrochlorothiazide
C. Enalapril
D. Amlodipine
Answer: C
Rationale: Combining a potassium-sparing diuretic like Spironolactone with an ACE
inhibitor like Enalapril significantly increases the risk of hyperkalemia. Both drugs
promote potassium retention in the body. The nurse must monitor serum potassium levels
closely and monitor for EKG changes associated with high potassium.
9. Which assessment finding is the most concerning for a patient taking Clozapine?
A. Weight gain of 2 pounds in a month
B. Dry mouth and constipation
C. Temperature of 101.5°F and sore throat
Rationale (NUR 210 Final Exam) | Galen
1. A patient is prescribed Digoxin for heart failure. Which clinical manifestation should the
nurse identify as an early sign of Digoxin toxicity?
A. Increased urinary output
B. Anorexia and nausea
C. Tachycardia
D. Hypertension
Answer: B
Rationale: Early signs of digoxin toxicity include gastrointestinal disturbances such as
anorexia, nausea, and vomiting. The nurse must also monitor for neurological symptoms
like blurred vision or yellow-green halos. It is critical to assess the apical pulse for one full
minute prior to administration to ensure safe dosing.
2. When teaching a patient about the side effects of ACE inhibitors, such as Lisinopril, which
symptom should the nurse emphasize as a common reason for discontinuing the medication?
A. Increased appetite
B. Weight gain
C. Hypoglycemia
D. Persistent dry cough
Answer: D
Rationale: A persistent dry cough is a well-known side effect of ACE inhibitors caused by
the accumulation of bradykinin in the respiratory tract. Patients often find this side effect
intolerable, leading to the need for a medication change to an Angiotensin II Receptor
Blocker (ARB). The nurse should educate the patient that this cough is not indicative of an
infection but a drug reaction.
3. A nurse is preparing to administer Heparin subcutaneously. Which action should the nurse
take to ensure patient safety?
A. Aspirate before injecting the medication
B. Massage the injection site after delivery
C. Administer the dose in the deltoid muscle
D. Use a 25- to 27-gauge needle for the injection
,Answer: D
Rationale: A fine-gauge needle, such as a 25- to 27-gauge, is appropriate for subcutaneous
heparin to minimize tissue trauma and hematoma formation. The nurse should avoid
aspirating or massaging the site because these actions increase the risk of local bleeding.
Documentation should include the specific abdominal site used to ensure systematic
rotation of injections.
4. Which laboratory value is the most critical for a nurse to monitor in a patient receiving
Warfarin therapy?
A. International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Serum potassium
D. White blood cell count
Answer: A
Rationale: The INR is the standardized measurement used to determine the effectiveness
of Warfarin and the patient’s risk for bleeding. A therapeutic range is typically between 2.0
and 3.0 for most indications like atrial fibrillation. The nurse must assess this value
frequently and teach the patient about consistent Vitamin K intake to maintain stability.
5. A patient with a history of asthma is prescribed Propranolol for hypertension. Why should
the nurse question this order?
A. Non-selective beta-blockers can cause bronchoconstriction
B. Propranolol causes tachycardia which masks asthma
C. The medication will increase respiratory secretions
D. Propranolol is only used for cardiac arrhythmias
Answer: A
Rationale: Propranolol is a non-selective beta-adrenergic blocker that blocks both Beta-1
and Beta-2 receptors. Blocking Beta-2 receptors in the lungs can lead to
bronchoconstriction, which is dangerous for patients with asthma or COPD. The nurse
should advocate for a cardio-selective beta-blocker like Metoprolol if a beta-blocker is
necessary.
6. A nurse is caring for a patient receiving Furosemide. Which electrolyte imbalance is this
patient at highest risk for developing?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
, D. Hypocalcemia
Answer: B
Rationale: Furosemide is a loop diuretic that causes the excretion of sodium, water, and
potassium. Hypokalemia is a significant risk that can lead to cardiac dysrhythmias and
potentiation of digoxin toxicity. The nurse should encourage the intake of potassium-rich
foods or administer supplements as prescribed.
7. A patient is prescribed Albuterol via a metered-dose inhaler (MDI). Which statement by the
patient indicates a need for further teaching?
A. I will wait 1 minute between puffs of the same medication.
B. I will take this medication every day to prevent an attack.
C. I will use this inhaler if I feel short of breath suddenly.
D. I will rinse my mouth after using the inhaler.
Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) intended for rescue use during
acute bronchospasm, not for long-term daily prevention. Regular daily use of a rescue
inhaler suggests poorly controlled asthma and the need for a controller medication. The
patient should be taught to recognize the difference between rescue and maintenance
therapies.
8. A nurse is administering Spironolactone to a patient. Which medication, if taken
concurrently, increases the risk of hyperkalemia?
A. Furosemide
B. Hydrochlorothiazide
C. Enalapril
D. Amlodipine
Answer: C
Rationale: Combining a potassium-sparing diuretic like Spironolactone with an ACE
inhibitor like Enalapril significantly increases the risk of hyperkalemia. Both drugs
promote potassium retention in the body. The nurse must monitor serum potassium levels
closely and monitor for EKG changes associated with high potassium.
9. Which assessment finding is the most concerning for a patient taking Clozapine?
A. Weight gain of 2 pounds in a month
B. Dry mouth and constipation
C. Temperature of 101.5°F and sore throat
