NURS 305 Exam 2 V3 | NURS 305 Pharmacology | Actual Q&A with
Rationale (NURS305 Exam 2) | Liberty University
1. A patient is prescribed Lisinopril for hypertension. The nurse should monitor for which
adverse effect specific to ACE inhibitors?
A. Hypokalemia
B. Tachycardia
C. Dry, persistent cough
D. Constipation
Answer: C
Explanation: ACE inhibitors prevent the breakdown of bradykinin and substance P, which
can lead to a persistent, non-productive cough. This side effect is a common reason for
patients to switch to an Angiotensin II Receptor Blocker (ARB). The nurse should educate
the patient that this is a drug-related effect and not a respiratory infection.
2. A patient with heart failure is receiving Digoxin. Which laboratory value should the nurse
monitor most closely to prevent toxicity?
A. Serum Potassium
B. Serum Sodium
C. Hemoglobin
D. Creatinine Phosphokinase
Answer: A
Explanation: Hypokalemia increases the risk of digoxin toxicity because potassium and
digoxin compete for the same binding sites on the Na+/K+ ATPase pump. The nurse must
ensure potassium levels are within the normal range of 3.5 to 5.0 mEq/L. Low potassium
levels allow more digoxin to bind, leading to toxic effects even if digoxin levels are
technically within the therapeutic range.
3. Which instruction is most important for a patient starting Warfarin therapy?
A. Increase intake of dark green leafy vegetables
B. Maintain a consistent intake of Vitamin K
C. Take aspirin for minor headaches
D. Stop the medication if bruising occurs
Answer: B
,Explanation: Vitamin K is the antagonist for Warfarin, and sudden changes in dietary
intake can drastically alter the International Normalized Ratio (INR). Patients do not need
to avoid Vitamin K entirely but must keep their consumption consistent to allow for
accurate dosing. The nurse should also instruct the patient to report signs of bleeding and
avoid other NSAIDs like aspirin.
4. A patient is receiving a Heparin infusion. Which laboratory test is used to monitor the
effectiveness of this medication?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Activated Partial Thromboplastin Time (aPTT)
Answer: D
Explanation: The aPTT is the standard laboratory test used to monitor the anticoagulant
effects of unfractionated heparin. The therapeutic goal is typically 1.5 to 2.5 times the
normal baseline value. While platelet counts are monitored for Heparin-Induced
Thrombocytopenia (HIT), they do not measure the anticoagulation level itself.
5. A patient is prescribed Atorvastatin. The nurse should advise the patient to report which
symptom immediately?
A. Headache
B. Dry mouth
C. Increased appetite
D. Unexplained muscle pain or tenderness
Answer: D
Explanation: Statins can cause myopathy, which may progress to life-threatening
rhabdomyolysis. The nurse must monitor Creatinine Kinase (CK) levels if muscle pain
occurs. Patients should also be monitored for liver enzyme elevations as statins are
processed in the liver.
6. Before administering a non-selective beta-blocker like Propranolol, the nurse should assess
for which condition in the patient’s history?
A. Hypertension
B. Glaucoma
C. Asthma
D. Tachycardia
, Answer: C
Explanation: Non-selective beta-blockers inhibit both Beta-1 (heart) and Beta-2 (lung)
receptors. Blocking Beta-2 receptors can cause bronchoconstriction, which is dangerous for
patients with asthma or COPD. The nurse should prioritize checking for respiratory
conditions before administration.
7. A patient is prescribed Diltiazem, a Calcium Channel Blocker. What should the nurse
include in the teaching?
A. Avoid grapefruit juice
B. Take the medication with high-fiber meals
C. Expect a decrease in urine output
D. Double the dose if one is missed
Answer: A
Explanation: Grapefruit juice inhibits the metabolism of many calcium channel blockers,
leading to toxic drug levels. This interaction can result in severe hypotension and
bradycardia. Patients should be taught to check food labels for grapefruit content.
8. Which medication is the drug of choice for a patient experiencing an acute asthma attack?
A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Answer: B
Explanation: Albuterol is a Short-Acting Beta-2 Agonist (SABA) that provides rapid
bronchodilation. It is considered a ‘rescue’ inhaler for acute symptoms. Long-acting
agonists and corticosteroids are used for maintenance and do not work fast enough for
acute distress.
9. A patient is prescribed Spironolactone. Which food choice indicates the patient needs
further teaching?
A. Apples
B. Bananas
C. White bread
D. Green beans
Answer: B
Rationale (NURS305 Exam 2) | Liberty University
1. A patient is prescribed Lisinopril for hypertension. The nurse should monitor for which
adverse effect specific to ACE inhibitors?
A. Hypokalemia
B. Tachycardia
C. Dry, persistent cough
D. Constipation
Answer: C
Explanation: ACE inhibitors prevent the breakdown of bradykinin and substance P, which
can lead to a persistent, non-productive cough. This side effect is a common reason for
patients to switch to an Angiotensin II Receptor Blocker (ARB). The nurse should educate
the patient that this is a drug-related effect and not a respiratory infection.
2. A patient with heart failure is receiving Digoxin. Which laboratory value should the nurse
monitor most closely to prevent toxicity?
A. Serum Potassium
B. Serum Sodium
C. Hemoglobin
D. Creatinine Phosphokinase
Answer: A
Explanation: Hypokalemia increases the risk of digoxin toxicity because potassium and
digoxin compete for the same binding sites on the Na+/K+ ATPase pump. The nurse must
ensure potassium levels are within the normal range of 3.5 to 5.0 mEq/L. Low potassium
levels allow more digoxin to bind, leading to toxic effects even if digoxin levels are
technically within the therapeutic range.
3. Which instruction is most important for a patient starting Warfarin therapy?
A. Increase intake of dark green leafy vegetables
B. Maintain a consistent intake of Vitamin K
C. Take aspirin for minor headaches
D. Stop the medication if bruising occurs
Answer: B
,Explanation: Vitamin K is the antagonist for Warfarin, and sudden changes in dietary
intake can drastically alter the International Normalized Ratio (INR). Patients do not need
to avoid Vitamin K entirely but must keep their consumption consistent to allow for
accurate dosing. The nurse should also instruct the patient to report signs of bleeding and
avoid other NSAIDs like aspirin.
4. A patient is receiving a Heparin infusion. Which laboratory test is used to monitor the
effectiveness of this medication?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Activated Partial Thromboplastin Time (aPTT)
Answer: D
Explanation: The aPTT is the standard laboratory test used to monitor the anticoagulant
effects of unfractionated heparin. The therapeutic goal is typically 1.5 to 2.5 times the
normal baseline value. While platelet counts are monitored for Heparin-Induced
Thrombocytopenia (HIT), they do not measure the anticoagulation level itself.
5. A patient is prescribed Atorvastatin. The nurse should advise the patient to report which
symptom immediately?
A. Headache
B. Dry mouth
C. Increased appetite
D. Unexplained muscle pain or tenderness
Answer: D
Explanation: Statins can cause myopathy, which may progress to life-threatening
rhabdomyolysis. The nurse must monitor Creatinine Kinase (CK) levels if muscle pain
occurs. Patients should also be monitored for liver enzyme elevations as statins are
processed in the liver.
6. Before administering a non-selective beta-blocker like Propranolol, the nurse should assess
for which condition in the patient’s history?
A. Hypertension
B. Glaucoma
C. Asthma
D. Tachycardia
, Answer: C
Explanation: Non-selective beta-blockers inhibit both Beta-1 (heart) and Beta-2 (lung)
receptors. Blocking Beta-2 receptors can cause bronchoconstriction, which is dangerous for
patients with asthma or COPD. The nurse should prioritize checking for respiratory
conditions before administration.
7. A patient is prescribed Diltiazem, a Calcium Channel Blocker. What should the nurse
include in the teaching?
A. Avoid grapefruit juice
B. Take the medication with high-fiber meals
C. Expect a decrease in urine output
D. Double the dose if one is missed
Answer: A
Explanation: Grapefruit juice inhibits the metabolism of many calcium channel blockers,
leading to toxic drug levels. This interaction can result in severe hypotension and
bradycardia. Patients should be taught to check food labels for grapefruit content.
8. Which medication is the drug of choice for a patient experiencing an acute asthma attack?
A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Answer: B
Explanation: Albuterol is a Short-Acting Beta-2 Agonist (SABA) that provides rapid
bronchodilation. It is considered a ‘rescue’ inhaler for acute symptoms. Long-acting
agonists and corticosteroids are used for maintenance and do not work fast enough for
acute distress.
9. A patient is prescribed Spironolactone. Which food choice indicates the patient needs
further teaching?
A. Apples
B. Bananas
C. White bread
D. Green beans
Answer: B
