NURS 305 Exam 3 V2 | NURS 305 Pharmacology | Actual Q&A with
Rationale (NURS305 Exam 3) | Liberty University
1. A patient is prescribed levothyroxine for hypothyroidism. Which finding indicates the
medication dosage is too high?
A. Tachycardia
B. Bradycardia
C. Drowsiness
D. Constipation
Answer: A
Explanation: Levothyroxine toxicity mimics signs of hyperthyroidism due to excessive
metabolic stimulation. Tachycardia, palpitations, and insomnia are key indicators that the
dose may need to be lowered. The nurse should monitor the heart rate and apical pulse
before administration if toxicity is suspected.
2. A nurse is teaching a patient about the onset of insulin lispro. How soon before a meal
should this be administered?
A. 60 minutes
B. 30 to 45 minutes
C. 15 minutes
D. 2 to 4 hours
Answer: C
Explanation: Insulin lispro is a rapid-acting insulin with an onset of approximately 15
minutes. It should be administered right before or even after a meal to prevent
hypoglycemia. Patients must ensure that food is present and ready to be consumed when
the injection is given.
3. Which electrolyte imbalance should a nurse monitor for in a patient taking large doses of
prednisone?
A. Hyperkalemia
B. Hypercalcemia
C. Hyponatremia
D. Hypokalemia
Answer: D
,Explanation: Glucocorticoids like prednisone have mineralocorticoid effects that lead to
sodium retention and potassium excretion. This results in the loss of potassium through
the kidneys, potentially causing hypokalemia. Nurses should monitor for muscle weakness
or cardiac arrhythmias associated with low potassium levels.
4. A patient with type 2 diabetes is prescribed metformin. What is a major contraindication
for this drug?
A. Hypertension
B. Renal impairment
C. Glaucoma
D. Hypothyroidism
Answer: B
Explanation: Metformin is excreted primarily by the kidneys and can accumulate in
patients with renal failure, leading to lactic acidosis. The creatinine level must be
monitored closely to ensure safe administration. This medication is often held before and
after procedures involving IV contrast dye to protect the kidneys.
5. When administering radioactive iodine (I-131) for hyperthyroidism, which safety
precaution is essential?
A. Limit fluid intake to 1 liter daily
B. Take with an antacid to prevent reflux
C. Exercise daily to improve absorption
D. Avoid close contact with pregnant women
Answer: D
Explanation: Radioactive iodine emits radiation that can be harmful to a developing fetus.
Patients are advised to maintain distance from children and pregnant women for several
days following treatment. Additionally, they should use separate bathroom facilities and
wash their clothes separately from others.
6. A patient is prescribed omeprazole for GERD. When should the nurse instruct the patient to
take this medication?
A. With a high-fat snack
B. Immediately after lunch
C. At bedtime
D. 30 minutes before breakfast
Answer: D
, Explanation: Proton pump inhibitors like omeprazole work best when the proton pumps
are most active, which occurs after fasting. Taking the dose before the first meal of the day
provides maximum suppression of acid production. It should be swallowed whole and not
crushed or chewed.
7. What is the primary mechanism of action for sucralfate in treating peptic ulcers?
A. Neutralizing gastric acid
B. Inhibiting the H2 receptor
C. Creating a protective barrier over the ulcer
D. Killing H. pylori bacteria
Answer: C
Explanation: Sucralfate reacts with gastric acid to form a thick, paste-like substance that
adheres to the ulcer site. This physical barrier protects the ulcerated tissue from further
damage by acid and pepsin. Because it requires an acidic environment to activate, it should
not be taken with antacids.
8. A patient is using an albuterol inhaler for asthma. Which side effect is most commonly
observed?
A. Sedation
B. Urinary retention
C. Bradycardia
D. Tremors and nervousness
Answer: D
Explanation: Albuterol is a beta-2 adrenergic agonist that can have systemic effects,
including stimulation of the central nervous system. This often manifests as fine muscle
tremors, nervousness, and a rapid heart rate. These effects are usually transient but can be
distressing to the patient.
9. Which assessment is most critical before administering a dose of theophylline?
A. Blood glucose level
B. Deep tendon reflexes
C. Serum drug level
D. Bowel sounds
Answer: C
Explanation: Theophylline has a narrow therapeutic range, typically between 10 and 20
mcg/mL. Toxicity can lead to severe complications like seizures or life-threatening
Rationale (NURS305 Exam 3) | Liberty University
1. A patient is prescribed levothyroxine for hypothyroidism. Which finding indicates the
medication dosage is too high?
A. Tachycardia
B. Bradycardia
C. Drowsiness
D. Constipation
Answer: A
Explanation: Levothyroxine toxicity mimics signs of hyperthyroidism due to excessive
metabolic stimulation. Tachycardia, palpitations, and insomnia are key indicators that the
dose may need to be lowered. The nurse should monitor the heart rate and apical pulse
before administration if toxicity is suspected.
2. A nurse is teaching a patient about the onset of insulin lispro. How soon before a meal
should this be administered?
A. 60 minutes
B. 30 to 45 minutes
C. 15 minutes
D. 2 to 4 hours
Answer: C
Explanation: Insulin lispro is a rapid-acting insulin with an onset of approximately 15
minutes. It should be administered right before or even after a meal to prevent
hypoglycemia. Patients must ensure that food is present and ready to be consumed when
the injection is given.
3. Which electrolyte imbalance should a nurse monitor for in a patient taking large doses of
prednisone?
A. Hyperkalemia
B. Hypercalcemia
C. Hyponatremia
D. Hypokalemia
Answer: D
,Explanation: Glucocorticoids like prednisone have mineralocorticoid effects that lead to
sodium retention and potassium excretion. This results in the loss of potassium through
the kidneys, potentially causing hypokalemia. Nurses should monitor for muscle weakness
or cardiac arrhythmias associated with low potassium levels.
4. A patient with type 2 diabetes is prescribed metformin. What is a major contraindication
for this drug?
A. Hypertension
B. Renal impairment
C. Glaucoma
D. Hypothyroidism
Answer: B
Explanation: Metformin is excreted primarily by the kidneys and can accumulate in
patients with renal failure, leading to lactic acidosis. The creatinine level must be
monitored closely to ensure safe administration. This medication is often held before and
after procedures involving IV contrast dye to protect the kidneys.
5. When administering radioactive iodine (I-131) for hyperthyroidism, which safety
precaution is essential?
A. Limit fluid intake to 1 liter daily
B. Take with an antacid to prevent reflux
C. Exercise daily to improve absorption
D. Avoid close contact with pregnant women
Answer: D
Explanation: Radioactive iodine emits radiation that can be harmful to a developing fetus.
Patients are advised to maintain distance from children and pregnant women for several
days following treatment. Additionally, they should use separate bathroom facilities and
wash their clothes separately from others.
6. A patient is prescribed omeprazole for GERD. When should the nurse instruct the patient to
take this medication?
A. With a high-fat snack
B. Immediately after lunch
C. At bedtime
D. 30 minutes before breakfast
Answer: D
, Explanation: Proton pump inhibitors like omeprazole work best when the proton pumps
are most active, which occurs after fasting. Taking the dose before the first meal of the day
provides maximum suppression of acid production. It should be swallowed whole and not
crushed or chewed.
7. What is the primary mechanism of action for sucralfate in treating peptic ulcers?
A. Neutralizing gastric acid
B. Inhibiting the H2 receptor
C. Creating a protective barrier over the ulcer
D. Killing H. pylori bacteria
Answer: C
Explanation: Sucralfate reacts with gastric acid to form a thick, paste-like substance that
adheres to the ulcer site. This physical barrier protects the ulcerated tissue from further
damage by acid and pepsin. Because it requires an acidic environment to activate, it should
not be taken with antacids.
8. A patient is using an albuterol inhaler for asthma. Which side effect is most commonly
observed?
A. Sedation
B. Urinary retention
C. Bradycardia
D. Tremors and nervousness
Answer: D
Explanation: Albuterol is a beta-2 adrenergic agonist that can have systemic effects,
including stimulation of the central nervous system. This often manifests as fine muscle
tremors, nervousness, and a rapid heart rate. These effects are usually transient but can be
distressing to the patient.
9. Which assessment is most critical before administering a dose of theophylline?
A. Blood glucose level
B. Deep tendon reflexes
C. Serum drug level
D. Bowel sounds
Answer: C
Explanation: Theophylline has a narrow therapeutic range, typically between 10 and 20
mcg/mL. Toxicity can lead to severe complications like seizures or life-threatening
