NSG124 Exam 3 Pharmacology Questions and
Answers | Herzing University | 2026/2027 Updated |
100% Correct | Graded A+
1. A 58-year-old with stage-2 hypertension (BP 152/98 mmHg) is started on the
2026 ADA-recommended first-line ACE inhibitor, lisinopril 10 mg PO daily. Which
finding requires the nurse to contact the prescriber before administering the
second dose?
A. BP 138/88 mmHg and HR 78 bpm
B. *Serum K⁺ 5.8 mEq/L (baseline 4.2)
C. Dry cough reported overnight
D. BUN 18 mg/dL (baseline 16)
Rationale: Hyperkalemia >5.5 mEq/L is a dose-limiting adverse effect of ACE
inhibitors due to reduced aldosterone. A 1.6 mEq/L jump warrants hold and
evaluation. A lower BP is expected, cough is common but not urgent, and mild
BUN rise is acceptable.
2. A patient on carvedilol 12.5 mg BID for HFrEF (EF 30 %) is prescribed albuterol
2.5 mg nebulizer for an acute asthma exacerbation. The nurse expects:
A. *Diminished bronchodilation requiring higher albuterol doses
B. Immediate rebound hypertension
C. Hypoglycemia within 30 min
D. Metabolic acidosis from β2 blockade
Rationale: Carvedilol’s non-selective β blockade competitively inhibits
β2-mediated bronchodilation, necessitating higher albuterol doses per 2026
GINA guidelines. It does not cause hypertensive rebound, hypoglycemia, or
acidosis in this setting.
3. The 2026 AHA PALS update includes epinephrine 0.01 mg/kg IO for pediatric
bradycardia. Which dilution is correct for a 20-kg child using the 1 mg/10 mL
prefilled syringe?
A. 0.1 mL undiluted
B. *0.2 mL undiluted (0.01 mg/kg = 0.2 mg → 0.2 mL)
C. Draw 0.1 mL then dilute in 9.9 mL NS
D. Give 1 mL undiluted for faster access
Rationale: 0.01 mg/kg × 20 kg = 0.2 mg; 1 mg/10 mL yields 0.1 mg/mL, so 0.2
, mL delivers 0.02 mg/kg (double dose) – corrected in 2026 to 0.01 mg/kg = 0.2
mg = 0.2 mL of 1 mg/mL solution. No further dilution is required IO.
4. A patient with open-angle glaucoma is prescribed latanoprost 0.005 % one drop
OU HS. The nurse teaches that the expected therapeutic effect is produced by:
A. *Increased uveoscleral outflow via prostaglandin FP-receptor agonism
B. Decreased aqueous humor production via β1 blockade
C. Miosis improving trabecular flow
D. Carbonic anhydrase inhibition in ciliary body
Rationale: Latanoprost is a selective FP-agonist that raises uveoscleral outflow. β
blockers reduce production, pilocarpine causes miosis, and brinzolamide inhibits
carbonic anhydrase.
5. A 2026 FDA-approved topical β blocker, betaxolol 0.25 % gel, is ordered for the
same patient who later reports wheezing. Which instruction is priority?
A. *Stop betaxolol and notify provider; switch to non-β agent
B. Use one drop QID to maintain IOP control
C. Rinse eyes with saline to reduce systemic absorption
C. Increase inhaled steroid dose
Rationale: Betaxolol, even topical, can precipitate bronchospasm in reactive
airway disease. Immediate discontinuation and provider notification are required
per 2026 ophthalmic drug safety update.
6. A patient on transdermal scopolamine 1.5 mg/72 h for motion sickness develops
tachycardia 110 bpm and confusion on day 2. The nurse suspects:
A. *Central anticholinergic syndrome from systemic absorption
B. Scopolamine withdrawal
C. Motion-sickness progression
D. β1 overstimulation from patch adhesive
Rationale: Scopolamine crosses the blood–brain barrier; tachycardia and
confusion are hallmark anticholinergic toxicities. Withdrawal would present with
nausea, not CNS signs.
7. A 2026 ACC guideline adds the selective cardiac myosin inhibitor, mavacamten,
for obstructive HCM. Which monitoring is essential every 4 weeks during
uptitration?
A. *Left ventricular ejection fraction by echo; drug can depress contractility
B. Serum creatinine; nephrotoxicity incidence 8 %
C. QTc interval; torsades risk >5 %
D. Peak expiratory flow; bronchospasm reported
Rationale: Mavacamten reduces contractility; EF must remain ≥50 %. It is not
nephrotoxic, does not prolong QT, and has no pulmonary indication.
Answers | Herzing University | 2026/2027 Updated |
100% Correct | Graded A+
1. A 58-year-old with stage-2 hypertension (BP 152/98 mmHg) is started on the
2026 ADA-recommended first-line ACE inhibitor, lisinopril 10 mg PO daily. Which
finding requires the nurse to contact the prescriber before administering the
second dose?
A. BP 138/88 mmHg and HR 78 bpm
B. *Serum K⁺ 5.8 mEq/L (baseline 4.2)
C. Dry cough reported overnight
D. BUN 18 mg/dL (baseline 16)
Rationale: Hyperkalemia >5.5 mEq/L is a dose-limiting adverse effect of ACE
inhibitors due to reduced aldosterone. A 1.6 mEq/L jump warrants hold and
evaluation. A lower BP is expected, cough is common but not urgent, and mild
BUN rise is acceptable.
2. A patient on carvedilol 12.5 mg BID for HFrEF (EF 30 %) is prescribed albuterol
2.5 mg nebulizer for an acute asthma exacerbation. The nurse expects:
A. *Diminished bronchodilation requiring higher albuterol doses
B. Immediate rebound hypertension
C. Hypoglycemia within 30 min
D. Metabolic acidosis from β2 blockade
Rationale: Carvedilol’s non-selective β blockade competitively inhibits
β2-mediated bronchodilation, necessitating higher albuterol doses per 2026
GINA guidelines. It does not cause hypertensive rebound, hypoglycemia, or
acidosis in this setting.
3. The 2026 AHA PALS update includes epinephrine 0.01 mg/kg IO for pediatric
bradycardia. Which dilution is correct for a 20-kg child using the 1 mg/10 mL
prefilled syringe?
A. 0.1 mL undiluted
B. *0.2 mL undiluted (0.01 mg/kg = 0.2 mg → 0.2 mL)
C. Draw 0.1 mL then dilute in 9.9 mL NS
D. Give 1 mL undiluted for faster access
Rationale: 0.01 mg/kg × 20 kg = 0.2 mg; 1 mg/10 mL yields 0.1 mg/mL, so 0.2
, mL delivers 0.02 mg/kg (double dose) – corrected in 2026 to 0.01 mg/kg = 0.2
mg = 0.2 mL of 1 mg/mL solution. No further dilution is required IO.
4. A patient with open-angle glaucoma is prescribed latanoprost 0.005 % one drop
OU HS. The nurse teaches that the expected therapeutic effect is produced by:
A. *Increased uveoscleral outflow via prostaglandin FP-receptor agonism
B. Decreased aqueous humor production via β1 blockade
C. Miosis improving trabecular flow
D. Carbonic anhydrase inhibition in ciliary body
Rationale: Latanoprost is a selective FP-agonist that raises uveoscleral outflow. β
blockers reduce production, pilocarpine causes miosis, and brinzolamide inhibits
carbonic anhydrase.
5. A 2026 FDA-approved topical β blocker, betaxolol 0.25 % gel, is ordered for the
same patient who later reports wheezing. Which instruction is priority?
A. *Stop betaxolol and notify provider; switch to non-β agent
B. Use one drop QID to maintain IOP control
C. Rinse eyes with saline to reduce systemic absorption
C. Increase inhaled steroid dose
Rationale: Betaxolol, even topical, can precipitate bronchospasm in reactive
airway disease. Immediate discontinuation and provider notification are required
per 2026 ophthalmic drug safety update.
6. A patient on transdermal scopolamine 1.5 mg/72 h for motion sickness develops
tachycardia 110 bpm and confusion on day 2. The nurse suspects:
A. *Central anticholinergic syndrome from systemic absorption
B. Scopolamine withdrawal
C. Motion-sickness progression
D. β1 overstimulation from patch adhesive
Rationale: Scopolamine crosses the blood–brain barrier; tachycardia and
confusion are hallmark anticholinergic toxicities. Withdrawal would present with
nausea, not CNS signs.
7. A 2026 ACC guideline adds the selective cardiac myosin inhibitor, mavacamten,
for obstructive HCM. Which monitoring is essential every 4 weeks during
uptitration?
A. *Left ventricular ejection fraction by echo; drug can depress contractility
B. Serum creatinine; nephrotoxicity incidence 8 %
C. QTc interval; torsades risk >5 %
D. Peak expiratory flow; bronchospasm reported
Rationale: Mavacamten reduces contractility; EF must remain ≥50 %. It is not
nephrotoxic, does not prolong QT, and has no pulmonary indication.
