NURS 305 Final Exam V2 | NURS 305 Pharmacology | Actual Q&A with
Rationale (NURS305 Final Exam) | Liberty University
1. A patient is prescribed digoxin for heart failure. Which assessment finding should the nurse
prioritize as a primary indicator of digoxin toxicity?
A. Increased urine output
B. Blood pressure of 140/90 mmHg
C. Respiratory rate of 18 breaths/min
D. Visual disturbances such as yellow-green halos
Answer: D
Explanation: Digoxin toxicity often manifests as gastrointestinal distress and neurological
changes, specifically visual disturbances like seeing yellow-green halos around lights. The
therapeutic range for digoxin is narrow, typically between 0.5 to 2.0 ng/mL, requiring
frequent monitoring. The nurse must assess for these symptoms and check pulse rate
before administration to ensure patient safety.
2. When administering an aminoglycoside antibiotic like gentamicin, the nurse should
monitor for which significant adverse effect?
A. Hypertension
B. Constipation
C. Hyperglycemia
D. Ototoxicity and nephrotoxicity
Answer: D
Explanation: Aminoglycosides are known for their high potential to cause damage to the
kidneys and the eighth cranial nerve. Monitoring peak and trough levels is essential to
prevent these permanent toxicities from occurring during therapy. Patients should be
assessed for hearing loss, tinnitus, and changes in serum creatinine or BUN levels.
3. A patient with type 1 diabetes mellitus is prescribed lispro (Humalog) insulin. When should
the nurse instruct the patient to eat after administration?
A. 60 minutes after the injection
B. 30 to 45 minutes after the injection
C. Within 15 minutes of the injection
D. Immediately before the injection
,Answer: C
Explanation: Lispro is a rapid-acting insulin with an onset of action between 15 to 30
minutes. Failure to consume carbohydrates shortly after administration significantly
increases the risk of acute hypoglycemia. The nurse should confirm that a meal is ready or
already at the bedside before injecting this type of insulin.
4. A patient is receiving heparin therapy for a deep vein thrombosis. Which laboratory value
should the nurse monitor to evaluate the effectiveness of the treatment?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count only
Answer: A
Explanation: The aPTT is the standard laboratory test used to monitor the therapeutic
effect of unfractionated heparin. A therapeutic range is generally 1.5 to 2.5 times the
normal control value provided by the lab. Nurses must closely watch this value to adjust
dosages and prevent either clotting or excessive bleeding.
5. What is the primary mechanism of action for ACE inhibitors like lisinopril in treating
hypertension?
A. Blocking beta-1 receptors in the heart
B. Preventing the conversion of angiotensin I to angiotensin II
C. Promoting the excretion of potassium in the distal tubule
D. Directly vasodilating the peripheral veins
Answer: B
Explanation: ACE inhibitors work by inhibiting the enzyme that converts angiotensin I to
angiotensin II, which is a potent vasoconstrictor. This reduction in angiotensin II leads to
vasodilation and decreased aldosterone secretion, which lowers blood pressure. A common
side effect to monitor for is a dry, persistent cough caused by the accumulation of
bradykinin.
6. A patient is prescribed spironolactone for heart failure. The nurse should instruct the
patient to avoid which of the following?
A. Leafy green vegetables
B. Salt substitutes containing potassium
C. Dairy products
, D. Foods high in Vitamin C
Answer: B
Explanation: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia
if potassium intake is excessive. Most salt substitutes use potassium chloride instead of
sodium chloride, posing a significant risk to the patient. Educating the patient on dietary
restrictions is critical to prevent cardiac arrhythmias associated with high potassium
levels.
7. A nurse is preparing to administer phenytoin (Dilantin) to a patient with a seizure disorder.
Which teaching point is most important for long-term therapy?
A. Restrict fluid intake to 1 liter a day
B. Maintain meticulous oral hygiene to prevent gingival hyperplasia
C. Stop the medication if a rash appears without calling the doctor
D. Take the medication only when a seizure is felt coming on
Answer: B
Explanation: Gingival hyperplasia, or overgrowth of the gums, is a well-documented side
effect of long-term phenytoin use. Regular dental checkups and proper brushing/flossing
techniques can help mitigate this specific adverse reaction. The patient should also be
advised not to discontinue the drug abruptly to avoid status epilepticus.
8. Which medication is considered the ‘gold standard’ for the treatment of an acute asthma
attack?
A. Albuterol
B. Fluticasone
C. Salmeterol
D. Montelukast
Answer: A
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
bronchodilation during acute respiratory distress. Unlike long-acting agonists or inhaled
corticosteroids, it works within minutes to open the airways. Patients must be taught to
keep their rescue inhaler available at all times for emergencies.
9. A patient is started on warfarin (Coumadin) therapy. Which vitamin should the nurse
instruct the patient to keep consistent in their diet?
A. Vitamin C
B. Vitamin D
Rationale (NURS305 Final Exam) | Liberty University
1. A patient is prescribed digoxin for heart failure. Which assessment finding should the nurse
prioritize as a primary indicator of digoxin toxicity?
A. Increased urine output
B. Blood pressure of 140/90 mmHg
C. Respiratory rate of 18 breaths/min
D. Visual disturbances such as yellow-green halos
Answer: D
Explanation: Digoxin toxicity often manifests as gastrointestinal distress and neurological
changes, specifically visual disturbances like seeing yellow-green halos around lights. The
therapeutic range for digoxin is narrow, typically between 0.5 to 2.0 ng/mL, requiring
frequent monitoring. The nurse must assess for these symptoms and check pulse rate
before administration to ensure patient safety.
2. When administering an aminoglycoside antibiotic like gentamicin, the nurse should
monitor for which significant adverse effect?
A. Hypertension
B. Constipation
C. Hyperglycemia
D. Ototoxicity and nephrotoxicity
Answer: D
Explanation: Aminoglycosides are known for their high potential to cause damage to the
kidneys and the eighth cranial nerve. Monitoring peak and trough levels is essential to
prevent these permanent toxicities from occurring during therapy. Patients should be
assessed for hearing loss, tinnitus, and changes in serum creatinine or BUN levels.
3. A patient with type 1 diabetes mellitus is prescribed lispro (Humalog) insulin. When should
the nurse instruct the patient to eat after administration?
A. 60 minutes after the injection
B. 30 to 45 minutes after the injection
C. Within 15 minutes of the injection
D. Immediately before the injection
,Answer: C
Explanation: Lispro is a rapid-acting insulin with an onset of action between 15 to 30
minutes. Failure to consume carbohydrates shortly after administration significantly
increases the risk of acute hypoglycemia. The nurse should confirm that a meal is ready or
already at the bedside before injecting this type of insulin.
4. A patient is receiving heparin therapy for a deep vein thrombosis. Which laboratory value
should the nurse monitor to evaluate the effectiveness of the treatment?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count only
Answer: A
Explanation: The aPTT is the standard laboratory test used to monitor the therapeutic
effect of unfractionated heparin. A therapeutic range is generally 1.5 to 2.5 times the
normal control value provided by the lab. Nurses must closely watch this value to adjust
dosages and prevent either clotting or excessive bleeding.
5. What is the primary mechanism of action for ACE inhibitors like lisinopril in treating
hypertension?
A. Blocking beta-1 receptors in the heart
B. Preventing the conversion of angiotensin I to angiotensin II
C. Promoting the excretion of potassium in the distal tubule
D. Directly vasodilating the peripheral veins
Answer: B
Explanation: ACE inhibitors work by inhibiting the enzyme that converts angiotensin I to
angiotensin II, which is a potent vasoconstrictor. This reduction in angiotensin II leads to
vasodilation and decreased aldosterone secretion, which lowers blood pressure. A common
side effect to monitor for is a dry, persistent cough caused by the accumulation of
bradykinin.
6. A patient is prescribed spironolactone for heart failure. The nurse should instruct the
patient to avoid which of the following?
A. Leafy green vegetables
B. Salt substitutes containing potassium
C. Dairy products
, D. Foods high in Vitamin C
Answer: B
Explanation: Spironolactone is a potassium-sparing diuretic that can lead to hyperkalemia
if potassium intake is excessive. Most salt substitutes use potassium chloride instead of
sodium chloride, posing a significant risk to the patient. Educating the patient on dietary
restrictions is critical to prevent cardiac arrhythmias associated with high potassium
levels.
7. A nurse is preparing to administer phenytoin (Dilantin) to a patient with a seizure disorder.
Which teaching point is most important for long-term therapy?
A. Restrict fluid intake to 1 liter a day
B. Maintain meticulous oral hygiene to prevent gingival hyperplasia
C. Stop the medication if a rash appears without calling the doctor
D. Take the medication only when a seizure is felt coming on
Answer: B
Explanation: Gingival hyperplasia, or overgrowth of the gums, is a well-documented side
effect of long-term phenytoin use. Regular dental checkups and proper brushing/flossing
techniques can help mitigate this specific adverse reaction. The patient should also be
advised not to discontinue the drug abruptly to avoid status epilepticus.
8. Which medication is considered the ‘gold standard’ for the treatment of an acute asthma
attack?
A. Albuterol
B. Fluticasone
C. Salmeterol
D. Montelukast
Answer: A
Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
bronchodilation during acute respiratory distress. Unlike long-acting agonists or inhaled
corticosteroids, it works within minutes to open the airways. Patients must be taught to
keep their rescue inhaler available at all times for emergencies.
9. A patient is started on warfarin (Coumadin) therapy. Which vitamin should the nurse
instruct the patient to keep consistent in their diet?
A. Vitamin C
B. Vitamin D
