NCLEX-STYLE PRACTICE QUESTIONS
WITH ANSWERS
This document contains NCLEX-style pharmacology questions and answers
specifically designed for NUR 2474 Exam 2. It covers major drug classifications,
mechanisms of action, adverse effects, contraindications, and nursing implications
aligned with NCLEX testing standards. Perfect for Rasmussen nursing students or
anyone preparing for pharmacology exams, this guide helps strengthen test-
taking skills and clinical reasoning.
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NUR 2474 – Pharmacology Exam 2 | NCLEX-Style Practice Questions with Answers
A patient is brought to the emergency department with shortness of breath, a respiratory rate of
30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this
patient will expect to administer which drug?
a.Furosemide (Lasix)
b.Hydrochlorothiazide (HydroDIURIL)
c.Mannitol (Osmitrol)
d.Spironolactone (Aldactone) - Correct a.Furosemide (Lasix)
Furosemide, a potent diuretic, is used when rapid or massive mobilization of fluids is needed.
This patient shows severe signs of congestive heart failure with respiratory distress and
pulmonary edema and needs immediate mobilization of fluid. Hydrochlorothiazide and
spironolactone are not indicated for pulmonary edema, because their diuretic effects are less
rapid. Mannitol is indicated for patients with increased intracranial pressure and must be
discontinued immediately if signs of pulmonary congestion or heart failure occur.
A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart
failure. The prescriber has ordered furosemide (Lasix). The nurse notes an irregular heart rate of
86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82
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mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse
the most concern?
a.Blood glucose level of 120 mg/dL
b.Oxygen saturation of 90%
c.Potassium level of 3.5 mEq/L
d.Sodium level of 140 mEq/L - Correct c.Potassium level of 3.5 mEq/L
This patient has an irregular, rapid heartbeat that might be caused by a dysrhythmia. This
patient's serum potassium level is low, which can trigger fatal dysrhythmias, especially in
patients taking digoxin. Furosemide contributes to loss of potassium through its effects on the
distal nephron. Potassium-sparing diuretics often are used in conjunction with furosemide to
prevent this complication. This patient's serum glucose and sodium levels are normal and of no
concern at this point, although they can be affected by furosemide. The oxygen saturation is
somewhat low and needs to be monitored, although it may improve with diuresis.
A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs
reveals crackles bilaterally, and the serum potassium level is 6 mEq/L. Which diuretic agent
ordered by the prescriber should the nurse question?
a.Bumetanide (Bumex)
b.Furosemide (Lasix)
c.Spironolactone (Aldactone)
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d.Hydrochlorothiazide (HydroDIURIL) - Correct c.Spironolactone (Aldactone)
Spironolactone is a non-potassium-wasting diuretic; therefore, if the patient has a serum
potassium level of 6 mEq/L, indicating hyperkalemia, an order for this drug should be
questioned. Bumetanide, furosemide, and hydrochlorothiazide are potassium-wasting diuretics
and would be appropriate to administer in a patient with hyperkalemia.
A nurse preparing to administer morning medications notes that a patient with a history of
hypertension has been prescribed the angiotensin-converting enzyme (ACE) inhibitor captopril
(Capoten) concurrently with spironolactone (Aldactone). Morning laboratory results reveal a
serum sodium level of 144 mg/dL, a serum potassium level of 5.1 mEq/L, and a blood glucose
level of 128 mg/dL. Which intervention is appropriate?
a.Administer the medications as ordered.
b.Ask the patient about the use of salt substitutes.
c.Contact the provider to report the laboratory values.
d.Request an order for furosemide (Lasix). - Correct c.Contact the provider to report the
laboratory values.
Spironolactone should not be administered with ACE inhibitors, which can also elevate
potassium levels. Because the potassium level is elevated, the nurse should not administer the
medication and should obtain clarification of the order. There is no need to repeat the potassium