NURS 305 Exam 2 V2 | NURS 305 Pharmacology | Actual Q&A with
Rationale (NURS305 Exam 2) | Liberty University
1. A patient is prescribed Furosemide (Lasix) for the treatment of peripheral edema
associated with heart failure. Which laboratory value is the priority for the nurse to monitor?
A. Serum sodium levels
B. Serum calcium levels
C. Blood urea nitrogen (BUN)
D. Serum potassium levels
Answer: D
Explanation: Furosemide is a potent loop diuretic that causes significant excretion of
potassium in the urine. Hypokalemia is a dangerous side effect that can lead to cardiac
dysrhythmias and muscle weakness. Monitoring serum potassium is critical to ensure the
patient stays within a safe therapeutic range (3.5-5.0 mEq/L).
2. A patient taking Lisinopril (Prinivil) develops a dry, persistent cough. What is the nurse’s
best response regarding this side effect?
A. Explain that the cough is a known side effect of ACE inhibitors and should be reported to
the provider.
B. Advise the patient that the cough will subside after two weeks of therapy.
C. Suggest the patient use an over-the-counter cough suppressant.
D. Instruct the patient to increase fluid intake to loosen secretions.
Answer: A
Explanation: The dry cough associated with ACE inhibitors like Lisinopril is caused by the
accumulation of bradykinin in the lungs. This side effect is not harmful but is often
intolerable for the patient and does not typically resolve with time. The healthcare provider
usually switches the patient to an Angiotensin II Receptor Blocker (ARB) if the cough
persists.
3. Which assessment finding would lead the nurse to withhold a scheduled dose of Digoxin
(Lanoxin)?
A. Blood pressure of 100/60 mmHg
B. Respiratory rate of 22 breaths per minute
C. Apical pulse of 52 beats per minute
D. Serum digoxin level of 0.8 ng/mL
,Answer: C
Explanation: Digoxin is a cardiac glycoside that exerts a negative chronotropic effect,
meaning it slows the heart rate. It is standard nursing practice to withhold the medication
and notify the provider if the apical pulse is less than 60 beats per minute in an adult. This
prevents further bradycardia and potential digoxin toxicity.
4. A nurse is preparing to administer Heparin subcutaneously. Which action should the nurse
take to ensure safety and proper technique?
A. Aspirate for blood return before injecting the medication.
B. Massage the injection site after the needle is removed.
C. Administer the injection in the abdomen, at least 2 inches away from the umbilicus.
D. Use a 21-gauge needle to ensure deep tissue penetration.
Answer: C
Explanation: Heparin should be injected into the subcutaneous fat of the abdomen for
consistent absorption. The nurse must avoid the area within 2 inches of the umbilicus and
rotate sites to prevent hematomas. Aspiration and massaging are contraindicated as they
increase the risk of tissue trauma and bruising.
5. A patient is receiving Warfarin (Coumadin) therapy for deep vein thrombosis. Which
laboratory result indicates that the medication is within the therapeutic range?
A. aPTT of 60 seconds
B. INR of 2.5
C. Platelet count of 150,000/mm3
D. Prothrombin time (PT) of 10 seconds
Answer: B
Explanation: The International Normalized Ratio (INR) is the standard measurement used
to monitor the effectiveness of Warfarin. For most patients, a therapeutic INR range is
between 2.0 and 3.0. An INR lower than this range indicates a risk for clots, while an INR
higher than this range indicates a risk for bleeding.
6. A patient is prescribed Atorvastatin (Lipitor). The nurse should instruct the patient to
report which serious adverse effect immediately?
A. Mild headache
B. Muscle pain or tenderness
C. Constipation
D. Flushing of the face
, Answer: B
Explanation: Muscle pain, tenderness, or weakness in a patient taking a statin may
indicate rhabdomyolysis, a rare but life-threatening breakdown of muscle tissue. This
condition can lead to acute renal failure due to the release of myoglobin into the
bloodstream. Patients should be monitored for increased creatine kinase (CK) levels if
these symptoms occur.
7. A patient with a history of asthma is diagnosed with hypertension. Which medication
should the nurse question if prescribed for this patient?
A. Propranolol (Inderal)
B. Amlodipine (Norvasc)
C. Hydrochlorothiazide (HCTZ)
D. Losartan (Cozaar)
Answer: A
Explanation: Propranolol is a non-selective beta-blocker that blocks both Beta-1 and Beta-
2 receptors. Blocking Beta-2 receptors in the lungs can cause bronchoconstriction, which is
dangerous for patients with asthma or COPD. Selective beta-blockers like Metoprolol are
generally preferred for patients with respiratory conditions.
8. What is the primary mechanism of action of Nitroglycerin in relieving anginal pain?
A. Increasing the force of myocardial contraction
B. Decreasing the heart rate to increase diastolic filling time
C. Blocking calcium channels in the smooth muscles of the heart
D. Promoting vasodilation to reduce preload and myocardial oxygen demand
Answer: D
Explanation: Nitroglycerin acts directly on vascular smooth muscle to cause peripheral
vasodilation, primarily in the veins. This reduces the amount of blood returning to the
heart (preload), which lowers the workload and oxygen demand of the myocardium. It also
dilates coronary arteries, improving blood flow to ischemic areas.
9. A nurse is teaching a patient about Spironolactone (Aldactone). Which dietary instruction is
most important?
A. Increase intake of bananas and orange juice.
B. Drink at least 3 liters of water per day.
C. Maintain a high-protein diet to prevent muscle wasting.
D. Avoid using salt substitutes containing potassium.
Rationale (NURS305 Exam 2) | Liberty University
1. A patient is prescribed Furosemide (Lasix) for the treatment of peripheral edema
associated with heart failure. Which laboratory value is the priority for the nurse to monitor?
A. Serum sodium levels
B. Serum calcium levels
C. Blood urea nitrogen (BUN)
D. Serum potassium levels
Answer: D
Explanation: Furosemide is a potent loop diuretic that causes significant excretion of
potassium in the urine. Hypokalemia is a dangerous side effect that can lead to cardiac
dysrhythmias and muscle weakness. Monitoring serum potassium is critical to ensure the
patient stays within a safe therapeutic range (3.5-5.0 mEq/L).
2. A patient taking Lisinopril (Prinivil) develops a dry, persistent cough. What is the nurse’s
best response regarding this side effect?
A. Explain that the cough is a known side effect of ACE inhibitors and should be reported to
the provider.
B. Advise the patient that the cough will subside after two weeks of therapy.
C. Suggest the patient use an over-the-counter cough suppressant.
D. Instruct the patient to increase fluid intake to loosen secretions.
Answer: A
Explanation: The dry cough associated with ACE inhibitors like Lisinopril is caused by the
accumulation of bradykinin in the lungs. This side effect is not harmful but is often
intolerable for the patient and does not typically resolve with time. The healthcare provider
usually switches the patient to an Angiotensin II Receptor Blocker (ARB) if the cough
persists.
3. Which assessment finding would lead the nurse to withhold a scheduled dose of Digoxin
(Lanoxin)?
A. Blood pressure of 100/60 mmHg
B. Respiratory rate of 22 breaths per minute
C. Apical pulse of 52 beats per minute
D. Serum digoxin level of 0.8 ng/mL
,Answer: C
Explanation: Digoxin is a cardiac glycoside that exerts a negative chronotropic effect,
meaning it slows the heart rate. It is standard nursing practice to withhold the medication
and notify the provider if the apical pulse is less than 60 beats per minute in an adult. This
prevents further bradycardia and potential digoxin toxicity.
4. A nurse is preparing to administer Heparin subcutaneously. Which action should the nurse
take to ensure safety and proper technique?
A. Aspirate for blood return before injecting the medication.
B. Massage the injection site after the needle is removed.
C. Administer the injection in the abdomen, at least 2 inches away from the umbilicus.
D. Use a 21-gauge needle to ensure deep tissue penetration.
Answer: C
Explanation: Heparin should be injected into the subcutaneous fat of the abdomen for
consistent absorption. The nurse must avoid the area within 2 inches of the umbilicus and
rotate sites to prevent hematomas. Aspiration and massaging are contraindicated as they
increase the risk of tissue trauma and bruising.
5. A patient is receiving Warfarin (Coumadin) therapy for deep vein thrombosis. Which
laboratory result indicates that the medication is within the therapeutic range?
A. aPTT of 60 seconds
B. INR of 2.5
C. Platelet count of 150,000/mm3
D. Prothrombin time (PT) of 10 seconds
Answer: B
Explanation: The International Normalized Ratio (INR) is the standard measurement used
to monitor the effectiveness of Warfarin. For most patients, a therapeutic INR range is
between 2.0 and 3.0. An INR lower than this range indicates a risk for clots, while an INR
higher than this range indicates a risk for bleeding.
6. A patient is prescribed Atorvastatin (Lipitor). The nurse should instruct the patient to
report which serious adverse effect immediately?
A. Mild headache
B. Muscle pain or tenderness
C. Constipation
D. Flushing of the face
, Answer: B
Explanation: Muscle pain, tenderness, or weakness in a patient taking a statin may
indicate rhabdomyolysis, a rare but life-threatening breakdown of muscle tissue. This
condition can lead to acute renal failure due to the release of myoglobin into the
bloodstream. Patients should be monitored for increased creatine kinase (CK) levels if
these symptoms occur.
7. A patient with a history of asthma is diagnosed with hypertension. Which medication
should the nurse question if prescribed for this patient?
A. Propranolol (Inderal)
B. Amlodipine (Norvasc)
C. Hydrochlorothiazide (HCTZ)
D. Losartan (Cozaar)
Answer: A
Explanation: Propranolol is a non-selective beta-blocker that blocks both Beta-1 and Beta-
2 receptors. Blocking Beta-2 receptors in the lungs can cause bronchoconstriction, which is
dangerous for patients with asthma or COPD. Selective beta-blockers like Metoprolol are
generally preferred for patients with respiratory conditions.
8. What is the primary mechanism of action of Nitroglycerin in relieving anginal pain?
A. Increasing the force of myocardial contraction
B. Decreasing the heart rate to increase diastolic filling time
C. Blocking calcium channels in the smooth muscles of the heart
D. Promoting vasodilation to reduce preload and myocardial oxygen demand
Answer: D
Explanation: Nitroglycerin acts directly on vascular smooth muscle to cause peripheral
vasodilation, primarily in the veins. This reduces the amount of blood returning to the
heart (preload), which lowers the workload and oxygen demand of the myocardium. It also
dilates coronary arteries, improving blood flow to ischemic areas.
9. A nurse is teaching a patient about Spironolactone (Aldactone). Which dietary instruction is
most important?
A. Increase intake of bananas and orange juice.
B. Drink at least 3 liters of water per day.
C. Maintain a high-protein diet to prevent muscle wasting.
D. Avoid using salt substitutes containing potassium.
