BSN HESI 315 – Pharmacology Practice
Exam V2 (Nightingale College, 2025/2026) –
Verified Questions & Answers (Grade A,
100% Correct)
1. A client with anemia secondary to chronic kidney disease (CKD) started a prescription
for epoetin alfa two months ago. The client's hemoglobin and hematocrit levels are within
the normal range, but the blood pressure is now 158/90 mm Hg. What action should the
nurse take? Answer: Notify the healthcare provider.Rationale: Epoetin alfa stimulates
erythropoiesis but can cause hypertension due to increased red blood cell mass and
viscosity. Blood pressure should be monitored closely, and elevations above 140/90 mm
Hg require immediate provider notification for potential dose adjustment or
antihypertensive therapy.
2. The nurse is caring for a client who has taken atenolol for 2 years. The healthcare
provider recently changed the medication to enalapril to manage the client's blood
pressure. Which instruction should the nurse provide the client regarding the new
medication? Answer: Avoid using salt substitutes containing potassium.Rationale:
Enalapril, an ACE inhibitor, can cause hyperkalemia by reducing aldosterone secretion.
Salt substitutes often contain potassium chloride, which could exacerbate this risk.
Clients should be educated to monitor potassium intake and report symptoms like muscle
weakness.
3. A client is beginning therapy with montelukast PO 10 mg once a day in the evening. The
client asks the nurse, "When should I begin to feel better?" How should the nurse
respond? Answer: "It may take several weeks before you notice improvement in
your symptoms."Rationale: Montelukast is a leukotriene receptor antagonist used for
asthma prophylaxis. It does not provide immediate relief like bronchodilators; therapeutic
effects may take 1-2 weeks for prophylaxis and up to a month for full benefit.
4. The nurse is providing medication teaching for a client who has recently received a
prescription for clozapine. Which instruction should be included in this client's teaching
plan? Answer: "You will need to have your white blood cell count monitored
weekly."Rationale: Clozapine carries a risk of agranulocytosis (severe neutropenia),
, requiring weekly WBC monitoring for the first 6 months, then biweekly. This is a black-
box warning; clients must report signs of infection immediately.
5. A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis.
The nurse prepares for intravenous administration of edrophonium chloride (Tensilon).
What is the expected outcome for this client following administration of this
pharmacologic agent? Answer: Temporary improvement in muscle
strength.Rationale: Edrophonium is a short-acting cholinesterase inhibitor used in the
Tensilon test for myasthenia gravis. It increases acetylcholine availability at the
neuromuscular junction, leading to transient muscle strength improvement if MG is
present, confirming diagnosis.
6. A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at
the clinic complaining of muscle pain and weakness in his legs. Which statement reflects
the correct drug-specific teaching the nurse should provide to this client? Answer: "Stop
taking the medication and come to the clinic immediately."Rationale: Muscle pain
and weakness suggest rhabdomyolysis, a rare but serious adverse effect of statins like
atorvastatin due to myopathy. Immediate discontinuation and CK level assessment are
critical to prevent renal damage.
7. The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor
blocker (ARB), for a client with hypertension and heart failure. The client's potassium
level is 5.8 mEq/L. What action should the nurse take? Answer: Hold the dose and
notify the healthcare provider.Rationale: ARBs like losartan can cause hyperkalemia
by inhibiting aldosterone. A potassium level >5.0 mEq/L warrants holding the dose and
provider notification for potential adjustment or further evaluation.
8. A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which
medication should the nurse anticipate administering? Answer: Calcitonin
(Miacalcin).Rationale: Calcitonin lowers serum calcium by inhibiting bone resorption
and increasing renal excretion. It's used for hypercalcemia in hyperparathyroidism when
levels exceed 12 mg/dL, providing rapid onset.
9. Before administering the initial dose of sumatriptan succinate to a client with a migraine
headache, which action should the nurse implement? Answer: Assess the client for
cardiovascular disease history.Rationale: Sumatriptan, a serotonin receptor agonist, is
Exam V2 (Nightingale College, 2025/2026) –
Verified Questions & Answers (Grade A,
100% Correct)
1. A client with anemia secondary to chronic kidney disease (CKD) started a prescription
for epoetin alfa two months ago. The client's hemoglobin and hematocrit levels are within
the normal range, but the blood pressure is now 158/90 mm Hg. What action should the
nurse take? Answer: Notify the healthcare provider.Rationale: Epoetin alfa stimulates
erythropoiesis but can cause hypertension due to increased red blood cell mass and
viscosity. Blood pressure should be monitored closely, and elevations above 140/90 mm
Hg require immediate provider notification for potential dose adjustment or
antihypertensive therapy.
2. The nurse is caring for a client who has taken atenolol for 2 years. The healthcare
provider recently changed the medication to enalapril to manage the client's blood
pressure. Which instruction should the nurse provide the client regarding the new
medication? Answer: Avoid using salt substitutes containing potassium.Rationale:
Enalapril, an ACE inhibitor, can cause hyperkalemia by reducing aldosterone secretion.
Salt substitutes often contain potassium chloride, which could exacerbate this risk.
Clients should be educated to monitor potassium intake and report symptoms like muscle
weakness.
3. A client is beginning therapy with montelukast PO 10 mg once a day in the evening. The
client asks the nurse, "When should I begin to feel better?" How should the nurse
respond? Answer: "It may take several weeks before you notice improvement in
your symptoms."Rationale: Montelukast is a leukotriene receptor antagonist used for
asthma prophylaxis. It does not provide immediate relief like bronchodilators; therapeutic
effects may take 1-2 weeks for prophylaxis and up to a month for full benefit.
4. The nurse is providing medication teaching for a client who has recently received a
prescription for clozapine. Which instruction should be included in this client's teaching
plan? Answer: "You will need to have your white blood cell count monitored
weekly."Rationale: Clozapine carries a risk of agranulocytosis (severe neutropenia),
, requiring weekly WBC monitoring for the first 6 months, then biweekly. This is a black-
box warning; clients must report signs of infection immediately.
5. A client is admitted to the hospital for diagnostic testing for possible myasthenia gravis.
The nurse prepares for intravenous administration of edrophonium chloride (Tensilon).
What is the expected outcome for this client following administration of this
pharmacologic agent? Answer: Temporary improvement in muscle
strength.Rationale: Edrophonium is a short-acting cholinesterase inhibitor used in the
Tensilon test for myasthenia gravis. It increases acetylcholine availability at the
neuromuscular junction, leading to transient muscle strength improvement if MG is
present, confirming diagnosis.
6. A client who was prescribed atorvastatin (Lipitor) one month ago calls the triage nurse at
the clinic complaining of muscle pain and weakness in his legs. Which statement reflects
the correct drug-specific teaching the nurse should provide to this client? Answer: "Stop
taking the medication and come to the clinic immediately."Rationale: Muscle pain
and weakness suggest rhabdomyolysis, a rare but serious adverse effect of statins like
atorvastatin due to myopathy. Immediate discontinuation and CK level assessment are
critical to prevent renal damage.
7. The nurse is preparing the 0900 dose of losartan (Cozaar), an angiotensin II receptor
blocker (ARB), for a client with hypertension and heart failure. The client's potassium
level is 5.8 mEq/L. What action should the nurse take? Answer: Hold the dose and
notify the healthcare provider.Rationale: ARBs like losartan can cause hyperkalemia
by inhibiting aldosterone. A potassium level >5.0 mEq/L warrants holding the dose and
provider notification for potential adjustment or further evaluation.
8. A client with hyperparathyroidism has a serum calcium level of 13 mg/dL. Which
medication should the nurse anticipate administering? Answer: Calcitonin
(Miacalcin).Rationale: Calcitonin lowers serum calcium by inhibiting bone resorption
and increasing renal excretion. It's used for hypercalcemia in hyperparathyroidism when
levels exceed 12 mg/dL, providing rapid onset.
9. Before administering the initial dose of sumatriptan succinate to a client with a migraine
headache, which action should the nurse implement? Answer: Assess the client for
cardiovascular disease history.Rationale: Sumatriptan, a serotonin receptor agonist, is
