NSG 3280 Pharmacology Exam Test Bank with Solutions 2026/2027 | Complete Nursing
Pharmacology Study Guide & Practice Questions | Verified Answers with Rationales | Drug
Classifications, Medication Safety, NCLEX & Clinical Judgment Review | Graded A+ Prep
Course
NSG 3280
1. A client with heart failure has been taking digoxin for several months.
During the morning assessment, the client reports nausea, decreased
appetite, and seeing yellow-green halos around lights. The apical pulse is
52/min. What should the nurse do?
A. Administer the scheduled dose with breakfast
B. Hold the dose and notify the healthcare provider
C. Give the medication and recheck the pulse in 1 hour
D. Administer potassium immediately
Answer: B. Hold the dose and notify the healthcare provider
Rationale: The combination of nausea, visual disturbances, and bradycardia
is highly concerning for digoxin toxicity. Digoxin has a narrow therapeutic
index, so another dose could worsen toxicity. The nurse should withhold the
medication and anticipate assessment of the serum digoxin concentration,
electrolytes, renal function, and cardiac rhythm.
2. A client taking warfarin for atrial fibrillation tells the nurse, “I started
drinking a large green smoothie every morning because I heard vegetables
are healthy.” The client's INR has fallen below the therapeutic range. Which
response is most appropriate?
A. “You should eliminate all green vegetables.”
B. “Increase the warfarin dose whenever you drink the smoothie.”
C. “Try to keep your vitamin K intake consistent from day to day.”
D. “Vitamin K does not affect warfarin therapy.”
Answer: C. “Try to keep your vitamin K intake consistent from day to
day.”
Rationale: Vitamin K can reduce warfarin's anticoagulant effect. Clients do
not generally need to eliminate vitamin-K-containing foods, but substantial
changes in intake can alter INR. Consistency is the key teaching point, with
medication adjustments made based on INR monitoring.
,3. A client receiving an IV heparin infusion has a platelet count that
decreases from 242,000/mm³ to 108,000/mm³. The client also reports new
pain and swelling in the left calf. Which action is most appropriate?
A. Increase the heparin infusion
B. Suspect heparin-induced thrombocytopenia and notify the provider
C. Administer aspirin and continue the infusion
D. Reassure the client that thrombocytopenia is expected
Answer: B. Suspect heparin-induced thrombocytopenia and notify
the provider
Rationale: A substantial platelet decrease after heparin exposure combined
with a new thrombotic manifestation strongly suggests HIT. Unlike ordinary
thrombocytopenia, HIT is associated with paradoxical thrombosis. The
heparin exposure requires urgent reassessment and appropriate alternative
anticoagulation.
4. A client prescribed lisinopril develops swelling of the lips and tongue and
begins speaking with difficulty. Blood pressure is currently 124/76 mmHg.
What is the nurse's priority?
A. Reassess the blood pressure in 30 minutes
B. Administer the next dose with food
C. Assess the airway and initiate emergency management
D. Encourage oral fluids
Answer: C. Assess the airway and initiate emergency management
Rationale: ACE inhibitors can cause angioedema involving the tongue and
upper airway. Airway compromise can progress rapidly even when blood
pressure remains normal. This is an emergency rather than a routine adverse
effect.
5. A client receiving morphine after surgery becomes difficult to arouse.
Respirations are 7/min and oxygen saturation is 85%. Which intervention
should the nurse prioritize?
A. Administer the next analgesic dose later than scheduled
B. Support ventilation and prepare to administer naloxone as prescribed
C. Offer oral fluids
D. Place the client in a quiet room
Answer: B. Support ventilation and prepare to administer naloxone
as prescribed
,Rationale: Severe opioid-induced respiratory depression threatens airway
and breathing. The nurse should immediately support oxygenation and
ventilation while preparing an opioid antagonist such as naloxone according
to the clinical situation.
6. A client taking furosemide reports weakness and palpitations. The ECG
shows occasional ventricular ectopy. Which laboratory result would most
likely explain the findings?
A. Potassium 2.7 mEq/L
B. Sodium 139 mEq/L
C. Calcium 9.4 mg/dL
D. Magnesium 2.0 mg/dL
Answer: A. Potassium 2.7 mEq/L
Rationale: Furosemide increases urinary potassium loss. Significant
hypokalemia can produce muscle weakness and ventricular dysrhythmias.
The combination of symptoms and ECG changes makes this finding clinically
urgent.
7. A client taking lithium develops vomiting, coarse tremors, ataxia, and
confusion after several days of severe diarrhea. What is the nurse's priority?
A. Administer the next lithium dose with food
B. Hold lithium and obtain urgent evaluation
C. Encourage a low-sodium diet
D. Encourage vigorous exercise
Answer: B. Hold lithium and obtain urgent evaluation
Rationale: Lithium is primarily eliminated by the kidneys, and dehydration
can increase lithium reabsorption and serum concentration. Coarse tremors,
gastrointestinal symptoms, ataxia, and confusion are concerning for toxicity.
Sodium and fluid balance are particularly important during lithium therapy.
8. A client taking metoprolol has a heart rate of 48/min and reports dizziness
when standing. Which action should the nurse take?
A. Administer the medication because the dose is scheduled
B. Assess the client and follow prescribed parameters for holding the
medication
C. Give an additional dose to prevent rebound hypertension
D. Encourage the client to exercise before taking the medication
, Answer: B. Assess the client and follow prescribed parameters for
holding the medication
Rationale: Metoprolol can decrease heart rate and blood pressure.
Significant bradycardia accompanied by symptoms warrants assessment
before administration. The nurse should follow the specific medication order
and facility protocol.
9. A client prescribed levothyroxine says, “Some days I take it with breakfast,
other days at bedtime.” Which teaching is most appropriate?
A. Take it whenever symptoms of hypothyroidism appear
B. Take it consistently according to the prescribed administration instructions
C. Double the next dose whenever the medication is forgotten
D. Alternate morning and evening administration
Answer: B. Take it consistently according to the prescribed
administration instructions
Rationale: Consistent administration helps produce predictable absorption
and therapeutic effects. Levothyroxine therapy is intended to maintain
relatively stable thyroid hormone replacement rather than provide
intermittent symptom relief.
10. A client receiving an aminoglycoside develops rising serum creatinine
and new difficulty hearing. Which concern should the nurse prioritize?
A. Therapeutic drug response
B. Nephrotoxicity and ototoxicity
C. Improved medication clearance
D. Expected age-related changes
Answer: B. Nephrotoxicity and ototoxicity
Rationale: Aminoglycosides can cause both renal and auditory toxicity.
Rising creatinine indicates impaired renal function, while new hearing
changes may indicate ototoxicity. Continued therapy requires prompt
evaluation.
11. A client with asthma uses albuterol and reports mild tremors and a brief
increase in heart rate after each treatment. How should the nurse interpret
these findings?
A. They can occur because of beta-adrenergic stimulation
B. They indicate immediate heart failure
Pharmacology Study Guide & Practice Questions | Verified Answers with Rationales | Drug
Classifications, Medication Safety, NCLEX & Clinical Judgment Review | Graded A+ Prep
Course
NSG 3280
1. A client with heart failure has been taking digoxin for several months.
During the morning assessment, the client reports nausea, decreased
appetite, and seeing yellow-green halos around lights. The apical pulse is
52/min. What should the nurse do?
A. Administer the scheduled dose with breakfast
B. Hold the dose and notify the healthcare provider
C. Give the medication and recheck the pulse in 1 hour
D. Administer potassium immediately
Answer: B. Hold the dose and notify the healthcare provider
Rationale: The combination of nausea, visual disturbances, and bradycardia
is highly concerning for digoxin toxicity. Digoxin has a narrow therapeutic
index, so another dose could worsen toxicity. The nurse should withhold the
medication and anticipate assessment of the serum digoxin concentration,
electrolytes, renal function, and cardiac rhythm.
2. A client taking warfarin for atrial fibrillation tells the nurse, “I started
drinking a large green smoothie every morning because I heard vegetables
are healthy.” The client's INR has fallen below the therapeutic range. Which
response is most appropriate?
A. “You should eliminate all green vegetables.”
B. “Increase the warfarin dose whenever you drink the smoothie.”
C. “Try to keep your vitamin K intake consistent from day to day.”
D. “Vitamin K does not affect warfarin therapy.”
Answer: C. “Try to keep your vitamin K intake consistent from day to
day.”
Rationale: Vitamin K can reduce warfarin's anticoagulant effect. Clients do
not generally need to eliminate vitamin-K-containing foods, but substantial
changes in intake can alter INR. Consistency is the key teaching point, with
medication adjustments made based on INR monitoring.
,3. A client receiving an IV heparin infusion has a platelet count that
decreases from 242,000/mm³ to 108,000/mm³. The client also reports new
pain and swelling in the left calf. Which action is most appropriate?
A. Increase the heparin infusion
B. Suspect heparin-induced thrombocytopenia and notify the provider
C. Administer aspirin and continue the infusion
D. Reassure the client that thrombocytopenia is expected
Answer: B. Suspect heparin-induced thrombocytopenia and notify
the provider
Rationale: A substantial platelet decrease after heparin exposure combined
with a new thrombotic manifestation strongly suggests HIT. Unlike ordinary
thrombocytopenia, HIT is associated with paradoxical thrombosis. The
heparin exposure requires urgent reassessment and appropriate alternative
anticoagulation.
4. A client prescribed lisinopril develops swelling of the lips and tongue and
begins speaking with difficulty. Blood pressure is currently 124/76 mmHg.
What is the nurse's priority?
A. Reassess the blood pressure in 30 minutes
B. Administer the next dose with food
C. Assess the airway and initiate emergency management
D. Encourage oral fluids
Answer: C. Assess the airway and initiate emergency management
Rationale: ACE inhibitors can cause angioedema involving the tongue and
upper airway. Airway compromise can progress rapidly even when blood
pressure remains normal. This is an emergency rather than a routine adverse
effect.
5. A client receiving morphine after surgery becomes difficult to arouse.
Respirations are 7/min and oxygen saturation is 85%. Which intervention
should the nurse prioritize?
A. Administer the next analgesic dose later than scheduled
B. Support ventilation and prepare to administer naloxone as prescribed
C. Offer oral fluids
D. Place the client in a quiet room
Answer: B. Support ventilation and prepare to administer naloxone
as prescribed
,Rationale: Severe opioid-induced respiratory depression threatens airway
and breathing. The nurse should immediately support oxygenation and
ventilation while preparing an opioid antagonist such as naloxone according
to the clinical situation.
6. A client taking furosemide reports weakness and palpitations. The ECG
shows occasional ventricular ectopy. Which laboratory result would most
likely explain the findings?
A. Potassium 2.7 mEq/L
B. Sodium 139 mEq/L
C. Calcium 9.4 mg/dL
D. Magnesium 2.0 mg/dL
Answer: A. Potassium 2.7 mEq/L
Rationale: Furosemide increases urinary potassium loss. Significant
hypokalemia can produce muscle weakness and ventricular dysrhythmias.
The combination of symptoms and ECG changes makes this finding clinically
urgent.
7. A client taking lithium develops vomiting, coarse tremors, ataxia, and
confusion after several days of severe diarrhea. What is the nurse's priority?
A. Administer the next lithium dose with food
B. Hold lithium and obtain urgent evaluation
C. Encourage a low-sodium diet
D. Encourage vigorous exercise
Answer: B. Hold lithium and obtain urgent evaluation
Rationale: Lithium is primarily eliminated by the kidneys, and dehydration
can increase lithium reabsorption and serum concentration. Coarse tremors,
gastrointestinal symptoms, ataxia, and confusion are concerning for toxicity.
Sodium and fluid balance are particularly important during lithium therapy.
8. A client taking metoprolol has a heart rate of 48/min and reports dizziness
when standing. Which action should the nurse take?
A. Administer the medication because the dose is scheduled
B. Assess the client and follow prescribed parameters for holding the
medication
C. Give an additional dose to prevent rebound hypertension
D. Encourage the client to exercise before taking the medication
, Answer: B. Assess the client and follow prescribed parameters for
holding the medication
Rationale: Metoprolol can decrease heart rate and blood pressure.
Significant bradycardia accompanied by symptoms warrants assessment
before administration. The nurse should follow the specific medication order
and facility protocol.
9. A client prescribed levothyroxine says, “Some days I take it with breakfast,
other days at bedtime.” Which teaching is most appropriate?
A. Take it whenever symptoms of hypothyroidism appear
B. Take it consistently according to the prescribed administration instructions
C. Double the next dose whenever the medication is forgotten
D. Alternate morning and evening administration
Answer: B. Take it consistently according to the prescribed
administration instructions
Rationale: Consistent administration helps produce predictable absorption
and therapeutic effects. Levothyroxine therapy is intended to maintain
relatively stable thyroid hormone replacement rather than provide
intermittent symptom relief.
10. A client receiving an aminoglycoside develops rising serum creatinine
and new difficulty hearing. Which concern should the nurse prioritize?
A. Therapeutic drug response
B. Nephrotoxicity and ototoxicity
C. Improved medication clearance
D. Expected age-related changes
Answer: B. Nephrotoxicity and ototoxicity
Rationale: Aminoglycosides can cause both renal and auditory toxicity.
Rising creatinine indicates impaired renal function, while new hearing
changes may indicate ototoxicity. Continued therapy requires prompt
evaluation.
11. A client with asthma uses albuterol and reports mild tremors and a brief
increase in heart rate after each treatment. How should the nurse interpret
these findings?
A. They can occur because of beta-adrenergic stimulation
B. They indicate immediate heart failure
