NSG 124 Final Exam Actual Exam V3 | NSG 124 Pharmacology
(NSG124 Final Exam) | Herzing University PDF
1. A nurse is caring for an elderly patient with heart failure who is prescribed Digoxin 0.125
mg daily. The patient’s potassium level is 3.2 mEq/L. Which action should the nurse take first?
A. Notify the healthcare provider of the potassium level.
B. Administer the medication as ordered.
C. Assess the patient’s apical pulse for 60 seconds.
D. Provide the patient with a potassium-rich snack.
Answer: A
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
The nurse must notify the provider regarding the low potassium level before administering
the medication to prevent potentially lethal arrhythmias. This is a critical safety step in
pharmacological management for patients on narrow therapeutic index drugs.
2. A patient is being discharged with a new prescription for Warfarin. Which statement by the
patient indicates a need for further teaching?
A. ‘I will use a soft-bristled toothbrush to prevent bleeding.’
B. ‘I will need to have my blood checked regularly for the INR.’
C. ‘I will report any unusual bruising or dark stools to my doctor.’
D. ‘I will increase my intake of spinach and kale to improve my health.’
Answer: D
Rationale: Warfarin works by inhibiting Vitamin K-dependent clotting factors, so a sudden
increase in Vitamin K-rich foods like spinach and kale can reduce the drug’s effectiveness.
Patients are instructed to maintain a consistent intake of Vitamin K rather than increasing
or decreasing it abruptly. Education focuses on preventing bleeding and ensuring
therapeutic monitoring of the International Normalized Ratio (INR).
3. A patient with Type 2 Diabetes is scheduled for a CT scan with intravenous contrast. Which
medication must be held for 48 hours after the procedure?
A. Lisinopril
B. Metformin
C. Atorvastatin
D. Glipizide
,Answer: B
Rationale: Metformin must be withheld prior to and for 48 hours after procedures
involving IV contrast dye to prevent the risk of lactic acidosis. Contrast media can cause
acute renal failure, which would lead to the accumulation of metformin in the body. The
nurse must verify renal function via creatinine levels before the patient resumes metformin
therapy.
4. The nurse is preparing to administer Albuterol via a metered-dose inhaler (MDI) to a
patient with acute asthma. What is the primary therapeutic effect expected?
A. Bronchodilation to improve airflow.
B. Thinning of thick pulmonary secretions.
C. Reduction in airway inflammation.
D. Prevention of future asthma attacks.
Answer: A
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that causes rapid relaxation of
bronchial smooth muscle, leading to bronchodilation. It is considered a ‘rescue’ medication
used to treat acute symptoms rather than a long-term controller. Patients should be taught
that this medication provides immediate relief during an asthma exacerbation.
5. A patient is prescribed Furosemide 40 mg IV push for pulmonary edema. Which laboratory
value should the nurse monitor most closely?
A. Serum Sodium
B. Hemoglobin
C. White Blood Cell Count
D. Serum Potassium
Answer: D
Rationale: Furosemide is a loop diuretic that promotes the excretion of water, sodium, and
potassium, which can lead to hypokalemia. Low potassium levels can cause cardiac
dysrhythmias and muscle weakness, especially in patients also taking cardiac glycosides.
Monitoring electrolytes is a standard of care when administering potent diuretics to ensure
patient safety.
6. A nurse is educating a patient on the administration of Levothyroxine. Which instruction is
most important for the nurse to include?
A. Take the medication in the morning on an empty stomach.
B. Take the medication at bedtime with a glass of milk.
C. Take the medication with a full meal to avoid GI upset.
, D. Take the medication only when feeling fatigued.
Answer: A
Rationale: Levothyroxine should be taken on an empty stomach, at least 30 to 60 minutes
before breakfast, to maximize absorption. Absorption is significantly impaired by food,
calcium, and certain other medications. Consistency in administration is vital for
maintaining steady-state thyroid hormone levels in the body.
7. A patient receiving intravenous Vancomycin begins to develop flushing of the neck and
face, along with a rapid heart rate. What is the nurse’s priority action?
A. Slow the rate of the infusion.
B. Administer diphenhydramine as ordered.
C. Stop the infusion immediately.
D. Notify the physician of a possible allergic reaction.
Answer: A
Rationale: The symptoms described are consistent with Red Man Syndrome, which is a
rate-dependent infusion reaction rather than a true allergic reaction. Slowing the infusion
rate typically resolves the flushing and hypotension associated with rapid vancomycin
administration. While it is important to monitor the patient, stopping the drug entirely is
usually unnecessary if the rate is adjusted.
8. Which medication is considered the ‘gold standard’ for treating an acute opioid overdose?
A. Flumazenil
B. Acetylcysteine
C. Atropine
D. Naloxone
Answer: D
Rationale: Naloxone is an opioid antagonist that displaces opioids from receptor sites,
reversing respiratory depression and sedation. It has a shorter half-life than many opioids,
so repeated doses may be necessary to prevent the patient from relapsing into respiratory
failure. Monitoring the patient’s respiratory status and level of consciousness is critical
after administration.
9. A patient is prescribed Spironolactone for hypertension. The nurse should instruct the
patient to avoid which of the following?
A. Whole grain breads
B. Dairy products
(NSG124 Final Exam) | Herzing University PDF
1. A nurse is caring for an elderly patient with heart failure who is prescribed Digoxin 0.125
mg daily. The patient’s potassium level is 3.2 mEq/L. Which action should the nurse take first?
A. Notify the healthcare provider of the potassium level.
B. Administer the medication as ordered.
C. Assess the patient’s apical pulse for 60 seconds.
D. Provide the patient with a potassium-rich snack.
Answer: A
Rationale: Hypokalemia significantly increases the risk of digoxin toxicity because
potassium and digoxin compete for binding sites on the sodium-potassium ATPase pump.
The nurse must notify the provider regarding the low potassium level before administering
the medication to prevent potentially lethal arrhythmias. This is a critical safety step in
pharmacological management for patients on narrow therapeutic index drugs.
2. A patient is being discharged with a new prescription for Warfarin. Which statement by the
patient indicates a need for further teaching?
A. ‘I will use a soft-bristled toothbrush to prevent bleeding.’
B. ‘I will need to have my blood checked regularly for the INR.’
C. ‘I will report any unusual bruising or dark stools to my doctor.’
D. ‘I will increase my intake of spinach and kale to improve my health.’
Answer: D
Rationale: Warfarin works by inhibiting Vitamin K-dependent clotting factors, so a sudden
increase in Vitamin K-rich foods like spinach and kale can reduce the drug’s effectiveness.
Patients are instructed to maintain a consistent intake of Vitamin K rather than increasing
or decreasing it abruptly. Education focuses on preventing bleeding and ensuring
therapeutic monitoring of the International Normalized Ratio (INR).
3. A patient with Type 2 Diabetes is scheduled for a CT scan with intravenous contrast. Which
medication must be held for 48 hours after the procedure?
A. Lisinopril
B. Metformin
C. Atorvastatin
D. Glipizide
,Answer: B
Rationale: Metformin must be withheld prior to and for 48 hours after procedures
involving IV contrast dye to prevent the risk of lactic acidosis. Contrast media can cause
acute renal failure, which would lead to the accumulation of metformin in the body. The
nurse must verify renal function via creatinine levels before the patient resumes metformin
therapy.
4. The nurse is preparing to administer Albuterol via a metered-dose inhaler (MDI) to a
patient with acute asthma. What is the primary therapeutic effect expected?
A. Bronchodilation to improve airflow.
B. Thinning of thick pulmonary secretions.
C. Reduction in airway inflammation.
D. Prevention of future asthma attacks.
Answer: A
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that causes rapid relaxation of
bronchial smooth muscle, leading to bronchodilation. It is considered a ‘rescue’ medication
used to treat acute symptoms rather than a long-term controller. Patients should be taught
that this medication provides immediate relief during an asthma exacerbation.
5. A patient is prescribed Furosemide 40 mg IV push for pulmonary edema. Which laboratory
value should the nurse monitor most closely?
A. Serum Sodium
B. Hemoglobin
C. White Blood Cell Count
D. Serum Potassium
Answer: D
Rationale: Furosemide is a loop diuretic that promotes the excretion of water, sodium, and
potassium, which can lead to hypokalemia. Low potassium levels can cause cardiac
dysrhythmias and muscle weakness, especially in patients also taking cardiac glycosides.
Monitoring electrolytes is a standard of care when administering potent diuretics to ensure
patient safety.
6. A nurse is educating a patient on the administration of Levothyroxine. Which instruction is
most important for the nurse to include?
A. Take the medication in the morning on an empty stomach.
B. Take the medication at bedtime with a glass of milk.
C. Take the medication with a full meal to avoid GI upset.
, D. Take the medication only when feeling fatigued.
Answer: A
Rationale: Levothyroxine should be taken on an empty stomach, at least 30 to 60 minutes
before breakfast, to maximize absorption. Absorption is significantly impaired by food,
calcium, and certain other medications. Consistency in administration is vital for
maintaining steady-state thyroid hormone levels in the body.
7. A patient receiving intravenous Vancomycin begins to develop flushing of the neck and
face, along with a rapid heart rate. What is the nurse’s priority action?
A. Slow the rate of the infusion.
B. Administer diphenhydramine as ordered.
C. Stop the infusion immediately.
D. Notify the physician of a possible allergic reaction.
Answer: A
Rationale: The symptoms described are consistent with Red Man Syndrome, which is a
rate-dependent infusion reaction rather than a true allergic reaction. Slowing the infusion
rate typically resolves the flushing and hypotension associated with rapid vancomycin
administration. While it is important to monitor the patient, stopping the drug entirely is
usually unnecessary if the rate is adjusted.
8. Which medication is considered the ‘gold standard’ for treating an acute opioid overdose?
A. Flumazenil
B. Acetylcysteine
C. Atropine
D. Naloxone
Answer: D
Rationale: Naloxone is an opioid antagonist that displaces opioids from receptor sites,
reversing respiratory depression and sedation. It has a shorter half-life than many opioids,
so repeated doses may be necessary to prevent the patient from relapsing into respiratory
failure. Monitoring the patient’s respiratory status and level of consciousness is critical
after administration.
9. A patient is prescribed Spironolactone for hypertension. The nurse should instruct the
patient to avoid which of the following?
A. Whole grain breads
B. Dairy products
