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NSG 3253 — PHARMACOTHERAPEUTICS FOR
NURSING PRACTICE II PRACTICE EXAM —
(MIDTERM REVIEW) QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2025|2026 Q&A | INSTANT
DOWNLOAD PDF
1. A patient starts on a new ACE inhibitor for hypertension. The nurse should
teach the patient to report which common early adverse effect?
A. Constipation
B. Dry cough
C. Bradycardia
D. Peripheral edema
Answer: B. Dry cough
ACE inhibitors commonly cause a persistent dry cough due to increased
bradykinin; report to provider if bothersome.
2. A patient on warfarin (Coumadin) has an INR of 5.2 and no bleeding. The
nurse anticipates which action?
A. Continue current dose
B. Give vitamin K orally and hold warfarin
C. Immediately administer fresh frozen plasma
D. Give protamine sulfate
Answer: B. Give vitamin K orally and hold warfarin
An INR >5 with no bleeding often requires holding warfarin and giving low-
dose oral vitamin K; FFP or PCC reserved for major bleeding. Protamine
reverses heparin, not warfarin.
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3. A provider orders nitroglycerin sublingual for chest pain. Key teaching point
for the patient:
A. Take while lying down only
B. Place tablet under tongue and let it dissolve; expect tingling/HA
C. Chew and swallow tablet for faster effect
D. Store tablet in medication blister packs in bathroom cabinet
Answer: B. Place tablet under tongue and let it dissolve; expect
tingling/HA
Sublingual nitroglycerin is absorbed rapidly under the tongue; common side
effects include headache and flushing. Keep in original container, away
from heat/moisture.
4. A patient with bacterial pneumonia is prescribed a broad-spectrum
cephalosporin. Which allergy history is most concerning?
A. Seasonal pollen allergy
B. Penicillin allergy with anaphylaxis 2 years ago
C. Sulfa drug rash in childhood
D. Mild acetaminophen intolerance
Answer: B. Penicillin allergy with anaphylaxis 2 years ago
Cross-reactivity exists between penicillins and some cephalosporins; a
history of anaphylaxis raises concern—consult provider for alternatives or
allergy testing.
5. A patient receiving morphine reports respiratory rate 8 breaths/min and
somnolence. The nurse should first:
A. Increase morphine dose for pain control
B. Administer naloxone per protocol
C. Encourage deep breathing exercises
D. Document and reassess in 30 minutes
Answer: B. Administer naloxone per protocol
Respiratory depression is a life-threatening opioid effect; naloxone is the
opioid antagonist and should be given per protocol immediately.
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6. A person with Type 1 diabetes is prescribed insulin glargine (Lantus). Which
statement indicates correct understanding?
A. It is rapid-acting and used at mealtime.
B. It provides a steady basal insulin level for 24 hours.
C. It should be mixed with regular insulin in the same syringe.
D. It peaks at 1–2 hours.
Answer: B. It provides a steady basal insulin level for 24 hours.
Insulin glargine is long-acting basal insulin with minimal peak; do not mix
with other insulins in same syringe.
7. A patient on heparin infusion has a platelet count drop of >50% from
baseline. The nurse suspects:
A. Heparin-induced thrombocytopenia (HIT)
B. Simple lab error—ignore
C. Normal side effect without consequence
D. Allergic reaction to heparin
Answer: A. Heparin-induced thrombocytopenia (HIT)
A significant platelet drop while on heparin suggests HIT, a prothrombotic
condition requiring immediate cessation of heparin and alternative
anticoagulation.
8. Which antibiotic requires monitoring of peak and trough levels to prevent
toxicity?
A. Azithromycin
B. Gentamicin
C. Ciprofloxacin
D. Doxycycline
Answer: B. Gentamicin
Aminoglycosides (e.g., gentamicin) are nephrotoxic and ototoxic;
therapeutic drug monitoring with peaks/troughs is necessary.
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9. A patient on digoxin reports nausea, visual halos, and confusion. The nurse
recognizes these as signs of:
A. Digoxin toxicity
B. Hypoglycemia
C. Early heart failure symptoms
D. Benign side effects—no action needed
Answer: A. Digoxin toxicity
GI and visual disturbances plus CNS changes are classic for digoxin
toxicity—check level, potassium, renal function, and notify provider.
10.A beta-blocker (metoprolol) is prescribed for hypertension. Which
condition warrants caution or avoidance?
A. Asthma with active bronchospasm
B. Hyperthyroidism
C. Stage 1 hypertension only
D. Migraine headaches
Answer: A. Asthma with active bronchospasm
Nonselective beta-blockers can precipitate bronchospasm; cardioselective
agents may still cause issues at higher doses—use with caution in reactive
airway disease.
11.A patient receives amphotericin B and develops fever, chills, and
hypotension during infusion. The nurse should:
A. Stop infusion, notify provider, and administer antipyretic/IV fluids as
ordered
B. Slow infusion rate only
C. Ignore; these effects are unrelated
D. Administer naloxone
Answer: A. Stop infusion, notify provider, and administer antipyretic/IV
fluids as ordered
Amphotericin B can cause infusion reactions and hypotension; stop and
treat per protocol—consider premedication for future doses.
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NSG 3253 — PHARMACOTHERAPEUTICS FOR
NURSING PRACTICE II PRACTICE EXAM —
(MIDTERM REVIEW) QUESTIONS AND
CORRECT ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2025|2026 Q&A | INSTANT
DOWNLOAD PDF
1. A patient starts on a new ACE inhibitor for hypertension. The nurse should
teach the patient to report which common early adverse effect?
A. Constipation
B. Dry cough
C. Bradycardia
D. Peripheral edema
Answer: B. Dry cough
ACE inhibitors commonly cause a persistent dry cough due to increased
bradykinin; report to provider if bothersome.
2. A patient on warfarin (Coumadin) has an INR of 5.2 and no bleeding. The
nurse anticipates which action?
A. Continue current dose
B. Give vitamin K orally and hold warfarin
C. Immediately administer fresh frozen plasma
D. Give protamine sulfate
Answer: B. Give vitamin K orally and hold warfarin
An INR >5 with no bleeding often requires holding warfarin and giving low-
dose oral vitamin K; FFP or PCC reserved for major bleeding. Protamine
reverses heparin, not warfarin.
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3. A provider orders nitroglycerin sublingual for chest pain. Key teaching point
for the patient:
A. Take while lying down only
B. Place tablet under tongue and let it dissolve; expect tingling/HA
C. Chew and swallow tablet for faster effect
D. Store tablet in medication blister packs in bathroom cabinet
Answer: B. Place tablet under tongue and let it dissolve; expect
tingling/HA
Sublingual nitroglycerin is absorbed rapidly under the tongue; common side
effects include headache and flushing. Keep in original container, away
from heat/moisture.
4. A patient with bacterial pneumonia is prescribed a broad-spectrum
cephalosporin. Which allergy history is most concerning?
A. Seasonal pollen allergy
B. Penicillin allergy with anaphylaxis 2 years ago
C. Sulfa drug rash in childhood
D. Mild acetaminophen intolerance
Answer: B. Penicillin allergy with anaphylaxis 2 years ago
Cross-reactivity exists between penicillins and some cephalosporins; a
history of anaphylaxis raises concern—consult provider for alternatives or
allergy testing.
5. A patient receiving morphine reports respiratory rate 8 breaths/min and
somnolence. The nurse should first:
A. Increase morphine dose for pain control
B. Administer naloxone per protocol
C. Encourage deep breathing exercises
D. Document and reassess in 30 minutes
Answer: B. Administer naloxone per protocol
Respiratory depression is a life-threatening opioid effect; naloxone is the
opioid antagonist and should be given per protocol immediately.
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6. A person with Type 1 diabetes is prescribed insulin glargine (Lantus). Which
statement indicates correct understanding?
A. It is rapid-acting and used at mealtime.
B. It provides a steady basal insulin level for 24 hours.
C. It should be mixed with regular insulin in the same syringe.
D. It peaks at 1–2 hours.
Answer: B. It provides a steady basal insulin level for 24 hours.
Insulin glargine is long-acting basal insulin with minimal peak; do not mix
with other insulins in same syringe.
7. A patient on heparin infusion has a platelet count drop of >50% from
baseline. The nurse suspects:
A. Heparin-induced thrombocytopenia (HIT)
B. Simple lab error—ignore
C. Normal side effect without consequence
D. Allergic reaction to heparin
Answer: A. Heparin-induced thrombocytopenia (HIT)
A significant platelet drop while on heparin suggests HIT, a prothrombotic
condition requiring immediate cessation of heparin and alternative
anticoagulation.
8. Which antibiotic requires monitoring of peak and trough levels to prevent
toxicity?
A. Azithromycin
B. Gentamicin
C. Ciprofloxacin
D. Doxycycline
Answer: B. Gentamicin
Aminoglycosides (e.g., gentamicin) are nephrotoxic and ototoxic;
therapeutic drug monitoring with peaks/troughs is necessary.
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9. A patient on digoxin reports nausea, visual halos, and confusion. The nurse
recognizes these as signs of:
A. Digoxin toxicity
B. Hypoglycemia
C. Early heart failure symptoms
D. Benign side effects—no action needed
Answer: A. Digoxin toxicity
GI and visual disturbances plus CNS changes are classic for digoxin
toxicity—check level, potassium, renal function, and notify provider.
10.A beta-blocker (metoprolol) is prescribed for hypertension. Which
condition warrants caution or avoidance?
A. Asthma with active bronchospasm
B. Hyperthyroidism
C. Stage 1 hypertension only
D. Migraine headaches
Answer: A. Asthma with active bronchospasm
Nonselective beta-blockers can precipitate bronchospasm; cardioselective
agents may still cause issues at higher doses—use with caution in reactive
airway disease.
11.A patient receives amphotericin B and develops fever, chills, and
hypotension during infusion. The nurse should:
A. Stop infusion, notify provider, and administer antipyretic/IV fluids as
ordered
B. Slow infusion rate only
C. Ignore; these effects are unrelated
D. Administer naloxone
Answer: A. Stop infusion, notify provider, and administer antipyretic/IV
fluids as ordered
Amphotericin B can cause infusion reactions and hypotension; stop and
treat per protocol—consider premedication for future doses.
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