Nr341 TEST BANK for Pharmacology cje benchmark All
topics fully covered
drug classes, mechanisms,
side-effect management, safe medication administration,
dosage calculations, patient education
Therapeutic Uses
, Adverse Effects & Toxicity
, Interactions – drug-drug, drug-food, drug-disease interactions,
Special Populations – pediatrics, geriatrics, pregnancy, renal/hepatic impairment
Drug Classes
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which vital sign is
most important to check prior to administration?
A. Respiratory rate
B. Pulse rate
C. Blood pressure
D. Temperature
Answer: Pulse rate
Rationale: Digoxin increases cardiac contractility and slows AV nodal conduction, which can
lead to bradycardia or heart block. Checking the apical pulse for 1 full minute ensures the heart
rate is safe (usually >60 bpm) before giving the dose. If the pulse is too low, digoxin is typically
withheld to prevent severe bradyarrhythmias. Patient education should include recognizing
dizziness, fatigue, or palpitations as warning signs of digoxin toxicity.
2. True or False: Loop diuretics like furosemide can cause hypokalemia, which increases the risk
of digoxin toxicity.
Answer: True
Rationale: Loop diuretics inhibit sodium and chloride reabsorption in the ascending loop of
Henle, increasing potassium excretion. Hypokalemia enhances the effects of digoxin on the
myocardium, increasing the risk of arrhythmias. Nurses should monitor electrolytes, educate
, patients to consume potassium-rich foods or supplements as appropriate, and assess for
symptoms such as muscle cramps or palpitations.
3. A patient prescribed warfarin asks about dietary restrictions. Which food should the nurse
advise limiting?
A. Bananas
B. Cheese
C. Spinach
D. Milk
Answer: Spinach
Rationale: Spinach is high in vitamin K, which is essential for synthesizing clotting factors II,
VII, IX, and X. Sudden increases in vitamin K intake can reduce warfarin effectiveness, lowering
INR and increasing the risk of clot formation. Nurses should educate patients to maintain a
consistent vitamin K intake and report any signs of bleeding or bruising.
4. True or False: Beta blockers like metoprolol should be discontinued immediately if a patient
reports fatigue.
Answer: False
Rationale: Abrupt discontinuation of beta blockers can cause rebound hypertension, tachycardia,
or angina due to sudden increased sympathetic activity. Fatigue is a common, dose-related side
effect and should be assessed before changing therapy. Patient education includes gradual
tapering if discontinuation is needed and reporting persistent symptoms.
5. Which of the following is a common adverse effect of ACE inhibitors such as lisinopril?
A. Hypoglycemia
B. Dry cough
C. Constipation
D. Tinnitus
Answer: Dry cough
Rationale: ACE inhibitors increase bradykinin levels by inhibiting its breakdown. Elevated
bradykinin can stimulate sensory nerves in the respiratory tract, causing a persistent,
nonproductive cough. While generally benign, the cough may affect adherence, so patients
should report severe or persistent symptoms.
topics fully covered
drug classes, mechanisms,
side-effect management, safe medication administration,
dosage calculations, patient education
Therapeutic Uses
, Adverse Effects & Toxicity
, Interactions – drug-drug, drug-food, drug-disease interactions,
Special Populations – pediatrics, geriatrics, pregnancy, renal/hepatic impairment
Drug Classes
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which vital sign is
most important to check prior to administration?
A. Respiratory rate
B. Pulse rate
C. Blood pressure
D. Temperature
Answer: Pulse rate
Rationale: Digoxin increases cardiac contractility and slows AV nodal conduction, which can
lead to bradycardia or heart block. Checking the apical pulse for 1 full minute ensures the heart
rate is safe (usually >60 bpm) before giving the dose. If the pulse is too low, digoxin is typically
withheld to prevent severe bradyarrhythmias. Patient education should include recognizing
dizziness, fatigue, or palpitations as warning signs of digoxin toxicity.
2. True or False: Loop diuretics like furosemide can cause hypokalemia, which increases the risk
of digoxin toxicity.
Answer: True
Rationale: Loop diuretics inhibit sodium and chloride reabsorption in the ascending loop of
Henle, increasing potassium excretion. Hypokalemia enhances the effects of digoxin on the
myocardium, increasing the risk of arrhythmias. Nurses should monitor electrolytes, educate
, patients to consume potassium-rich foods or supplements as appropriate, and assess for
symptoms such as muscle cramps or palpitations.
3. A patient prescribed warfarin asks about dietary restrictions. Which food should the nurse
advise limiting?
A. Bananas
B. Cheese
C. Spinach
D. Milk
Answer: Spinach
Rationale: Spinach is high in vitamin K, which is essential for synthesizing clotting factors II,
VII, IX, and X. Sudden increases in vitamin K intake can reduce warfarin effectiveness, lowering
INR and increasing the risk of clot formation. Nurses should educate patients to maintain a
consistent vitamin K intake and report any signs of bleeding or bruising.
4. True or False: Beta blockers like metoprolol should be discontinued immediately if a patient
reports fatigue.
Answer: False
Rationale: Abrupt discontinuation of beta blockers can cause rebound hypertension, tachycardia,
or angina due to sudden increased sympathetic activity. Fatigue is a common, dose-related side
effect and should be assessed before changing therapy. Patient education includes gradual
tapering if discontinuation is needed and reporting persistent symptoms.
5. Which of the following is a common adverse effect of ACE inhibitors such as lisinopril?
A. Hypoglycemia
B. Dry cough
C. Constipation
D. Tinnitus
Answer: Dry cough
Rationale: ACE inhibitors increase bradykinin levels by inhibiting its breakdown. Elevated
bradykinin can stimulate sensory nerves in the respiratory tract, causing a persistent,
nonproductive cough. While generally benign, the cough may affect adherence, so patients
should report severe or persistent symptoms.
