,SET 1 (Questions 1–50) – Pharmacology II
1. A client with heart failure is prescribed digoxin. Which finding
requires immediate intervention?
A) Heart rate 62 bpm
B) New onset of yellow vision
C) Serum potassium 4.0 mEq/L
D) Anorexia
Rationale: Yellow vision (xanthopsia) is a sign of digoxin toxicity;
other options are expected or normal.
2. A client taking warfarin has an INR of 4.5. The client has no
bleeding. The nurse should anticipate:
A) Administering vitamin K intramuscularly
B) Holding the next dose and notifying the provider
C) Increasing the warfarin dose
D) Administering protamine sulfate
*Rationale: INR 4.5 is above therapeutic range (2-3 for most
indications); holding dose is appropriate; vitamin K is for active
bleeding or very high INR.*
3. A client is prescribed lisinopril. Which adverse effect is most
important to teach the client to report immediately?
A) Dry cough
B) Dizziness
,C) Swelling of the lips or tongue
D) Fatigue
Rationale: Angioedema (swelling of lips/tongue) is a life-
threatening adverse effect of ACE inhibitors requiring emergency
care.
4. A client with type 2 diabetes is started on metformin. Which
instruction should the nurse include?
A) “Take this medication only when your blood sugar is high”
B) “Take this medication with meals to reduce gastrointestinal
upset”
C) “You may experience weight gain as a side effect”
D) “Monitor for hypoglycemia as the most common side effect”
Rationale: Metformin commonly causes GI upset; taking with meals
reduces symptoms. It does not cause weight gain or significant
hypoglycemia.
5. A client receives furosemide 40 mg IV. Which laboratory value
should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Rationale: Furosemide is a loop diuretic that causes potassium
wasting (hypokalemia).
, 6. A client is prescribed albuterol via metered-dose inhaler for
asthma. Which statement indicates correct understanding?
A) “I will use this inhaler every day to prevent attacks”
B) “I will use this inhaler when I feel short of breath”
C) “I will wait 10 minutes between puffs”
D) “I will store the inhaler in the refrigerator”
Rationale: Albuterol is a rescue bronchodilator used for acute
symptoms, not daily prevention.
7. A client taking levothyroxine reports palpitations and weight loss.
The nurse suspects:
A) Inadequate dosing
B) Excessive dosing (hyperthyroidism)
C) Normal therapeutic response
D) Allergic reaction
Rationale: Palpitations and weight loss indicate excessive thyroid
hormone replacement (iatrogenic hyperthyroidism).
8. A client is prescribed enoxaparin (Lovenox) subcutaneously. Which
technique is correct?
A) Expel the air bubble before injection
B) Inject into the abdomen while pinching a fold of skin
C) Massage the site after injection
D) Use a 1.5-inch needle
1. A client with heart failure is prescribed digoxin. Which finding
requires immediate intervention?
A) Heart rate 62 bpm
B) New onset of yellow vision
C) Serum potassium 4.0 mEq/L
D) Anorexia
Rationale: Yellow vision (xanthopsia) is a sign of digoxin toxicity;
other options are expected or normal.
2. A client taking warfarin has an INR of 4.5. The client has no
bleeding. The nurse should anticipate:
A) Administering vitamin K intramuscularly
B) Holding the next dose and notifying the provider
C) Increasing the warfarin dose
D) Administering protamine sulfate
*Rationale: INR 4.5 is above therapeutic range (2-3 for most
indications); holding dose is appropriate; vitamin K is for active
bleeding or very high INR.*
3. A client is prescribed lisinopril. Which adverse effect is most
important to teach the client to report immediately?
A) Dry cough
B) Dizziness
,C) Swelling of the lips or tongue
D) Fatigue
Rationale: Angioedema (swelling of lips/tongue) is a life-
threatening adverse effect of ACE inhibitors requiring emergency
care.
4. A client with type 2 diabetes is started on metformin. Which
instruction should the nurse include?
A) “Take this medication only when your blood sugar is high”
B) “Take this medication with meals to reduce gastrointestinal
upset”
C) “You may experience weight gain as a side effect”
D) “Monitor for hypoglycemia as the most common side effect”
Rationale: Metformin commonly causes GI upset; taking with meals
reduces symptoms. It does not cause weight gain or significant
hypoglycemia.
5. A client receives furosemide 40 mg IV. Which laboratory value
should the nurse monitor most closely?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Rationale: Furosemide is a loop diuretic that causes potassium
wasting (hypokalemia).
, 6. A client is prescribed albuterol via metered-dose inhaler for
asthma. Which statement indicates correct understanding?
A) “I will use this inhaler every day to prevent attacks”
B) “I will use this inhaler when I feel short of breath”
C) “I will wait 10 minutes between puffs”
D) “I will store the inhaler in the refrigerator”
Rationale: Albuterol is a rescue bronchodilator used for acute
symptoms, not daily prevention.
7. A client taking levothyroxine reports palpitations and weight loss.
The nurse suspects:
A) Inadequate dosing
B) Excessive dosing (hyperthyroidism)
C) Normal therapeutic response
D) Allergic reaction
Rationale: Palpitations and weight loss indicate excessive thyroid
hormone replacement (iatrogenic hyperthyroidism).
8. A client is prescribed enoxaparin (Lovenox) subcutaneously. Which
technique is correct?
A) Expel the air bubble before injection
B) Inject into the abdomen while pinching a fold of skin
C) Massage the site after injection
D) Use a 1.5-inch needle
