NUR 2474 Pharmacology Final Exam
Questions and Well Graded Solutions with
Rationales Updated 2026-2027
Ace your Rasmussen University NUR 2474 Pharmacology Final Exam with this comprehensive
study bundle. Features authentic multiple-choice questions, highlighted answers, and detailed
clinical rationales. Covers critical high-alert drug classes, legal nursing interventions, dosage
safety, and NCLEX-style prioritization protocols. Perfect for active recall and quick revision to
guarantee a passing grade. Download the ultimate nursing school resource today and
approach exam day with total confidence!
Question 1
A nurse is preparing to administer albuterol to a patient experiencing an acute
asthma attack. Which side effect should the nurse monitor for?
A) Bradycardia
B) Tachycardia
C) Hypoglycemia
D) Bradypnea
1|Page
,Answer: B) Tachycardia
Rationale: Albuterol is a short-acting beta-2 agonist. It stimulates the sympathetic
nervous system, commonly causing tachycardia, tremors, and anxiety.
Question 2
A patient is prescribed both a fluticasone inhaler and an albuterol inhaler. What
instruction should the nurse provide?
A) Use the fluticasone inhaler first.
B) Use the albuterol inhaler first.
C) Mix both medications together.
D) Wait 30 minutes between inhalers.
Answer: B) Use the albuterol inhaler first.
Rationale: The bronchodilator (albuterol) must be used first to open the airways. This
maximizes the absorption of the corticosteroid (fluticasone) given 5 minutes later.
Question 3
The nurse teaches a patient about using a corticosteroid metered-dose inhaler.
Which instruction is vital to prevent oral candidiasis?
A) Use a spacer and rinse the mouth with water after use.
B) Drink a full glass of milk before administration.
C) Brush teeth immediately before inhalation.
D) Inhale slowly over 30 seconds.
Answer: A) Use a spacer and rinse the mouth with water after use.
Rationale: Rinsing the mouth and spitting out the water removes residual steroid
particles from the oral mucosa, preventing the overgrowth of oral yeast (thrush).
Question 4
A patient on warfarin therapy has an International Normalized Ratio (INR) of 5.5 and
notes spontaneous epistaxis. The nurse anticipates administering which antidote?
A) Protamine sulfate
B) Acetylcysteine
C) Vitamin K
D) Flumazenil
Answer: C) Vitamin K
Rationale: Vitamin K is the specific reversal agent for warfarin. Protamine sulfate
reverses heparin, acetylcysteine reverses acetaminophen, and flumazenil reverses
benzodiazepines.
Question 5
A patient is receiving a continuous intravenous infusion of heparin. Which laboratory
value must the nurse closely monitor to adjust the dosage?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
C) International Normalized Ratio (INR)
D) Platelet count only
2|Page
,Answer: B) Activated partial thromboplastin time (aPTT)
Rationale: Therapeutic heparin therapy is strictly monitored using aPTT levels. PT
and INR are utilized to manage and monitor oral warfarin therapy.
Question 6
Prior to administering a ordered dose of digoxin, the nurse checks the patient’s vital
signs. Which parameter requires holding the medication?
A) Blood pressure 142/90 mmHg
B) Respiratory rate 14 breaths/minute
C) Apical pulse 52 beats/minute
D) Temperature 99.1°F
Answer: C) Apical pulse 52 beats/minute
Rationale: Digoxin is a positive inotrope and negative chronotrope. It slows the heart
rate, so it must be held if the apical pulse falls below 60 beats/minute in adults.
Question 7
A patient taking digoxin reports seeing yellow-green halos around lights and
experiences severe nausea. What should the nurse suspect?
A) Normal therapeutic effect
B) Digoxin toxicity
C) Acute myocardial infarction
D) Hypokalemia recovery
Answer: B) Digoxin toxicity
Rationale: Gastrointestinal upset (nausea, vomiting) and visual changes (yellow-
green halos, blurred vision) are classic, definitive clinical signs of digoxin toxicity.
Question 8
A nurse is preparing to administer lisinopril to a patient. Which laboratory value
should be evaluated prior to administration?
A) Serum sodium
B) Serum potassium
C) Prothrombin time
D) Serum calcium
Answer: B) Serum potassium
Rationale: Angiotensin-converting enzyme (ACE) inhibitors block aldosterone
release, which can lead to potassium retention. The nurse must check for
hyperkalemia before administering.
Question 9
A patient taking captopril develops a persistent, dry, hacking cough and requests a
cough syrup. What is the nurse's best action?
A) Instruct the patient to take an over-the-counter antitussive.
B) Explain that this is a known side effect and notify the provider.
C) Tell the patient to increase fluid intake to thin secretions.
D) Hold the next dose and prepare to administer epinephrine.
Answer: B) Explain that this is a known side effect and notify the provider.
Rationale: The accumulation of bradykinin caused by ACE inhibitors leads to a
3|Page
, persistent dry cough. It does not respond to antitussives and requires switching to an
ARB.
Question 10
The nurse is caring for a patient who is scheduled for a CT scan with intravenous
iodinated contrast media. Which medication must be held for 48 hours before and
after?
A) Metformin
B) Glyburide
C) Glargine insulin
D) Atorvastatin
Answer: A) Metformin
Rationale: Metformin combined with iodinated contrast media poses a severe risk of
induced acute renal failure, which can accumulate metformin and trigger fatal lactic
acidosis.
Question 11
A nurse prepares to administer insulin glargine and regular insulin at 0730. How
should the nurse proceed?
A) Draw up the regular insulin first, then the glargine in one syringe.
B) Draw up the glargine first, then the regular insulin in one syringe.
C) Administer the medications in two separate injections.
D) Mix them together and let the solution sit for 10 minutes.
Answer: C) Administer the medications in two separate injections.
Rationale: Insulin glargine is a long-acting insulin with a low pH. It cannot be mixed
in the same syringe with any other insulin because mixing alters its onset and
duration.
Question 12
A patient with type 1 diabetes is prescribed propranolol for hypertension. What
crucial education should the nurse provide?
A) Propranolol will cure your diabetes over time.
B) Propranolol can mask the early warning signs of hypoglycemia.
C) Increase your carbohydrate intake while taking this drug.
D) Stop taking the medication if your blood sugar is over 200 mg/dL.
Answer: B) Propranolol can mask the early warning signs of hypoglycemia.
Rationale: Beta-blockers blunt the adrenergic response to hypoglycemia, masking
symptoms like tachycardia, tremors, and palpitations. Sweating remains the only
unmasked sign.
Question 13
A nurse is assessing a patient receiving a morphine PCA pump. The respiratory rate
is 8 breaths/minute. Which action should the nurse take first?
A) Check the patient's blood pressure.
B) Administer naloxone intravenously.
C) Stop the pump and stimulate the patient.
D) Notify the healthcare provider.
4|Page
Questions and Well Graded Solutions with
Rationales Updated 2026-2027
Ace your Rasmussen University NUR 2474 Pharmacology Final Exam with this comprehensive
study bundle. Features authentic multiple-choice questions, highlighted answers, and detailed
clinical rationales. Covers critical high-alert drug classes, legal nursing interventions, dosage
safety, and NCLEX-style prioritization protocols. Perfect for active recall and quick revision to
guarantee a passing grade. Download the ultimate nursing school resource today and
approach exam day with total confidence!
Question 1
A nurse is preparing to administer albuterol to a patient experiencing an acute
asthma attack. Which side effect should the nurse monitor for?
A) Bradycardia
B) Tachycardia
C) Hypoglycemia
D) Bradypnea
1|Page
,Answer: B) Tachycardia
Rationale: Albuterol is a short-acting beta-2 agonist. It stimulates the sympathetic
nervous system, commonly causing tachycardia, tremors, and anxiety.
Question 2
A patient is prescribed both a fluticasone inhaler and an albuterol inhaler. What
instruction should the nurse provide?
A) Use the fluticasone inhaler first.
B) Use the albuterol inhaler first.
C) Mix both medications together.
D) Wait 30 minutes between inhalers.
Answer: B) Use the albuterol inhaler first.
Rationale: The bronchodilator (albuterol) must be used first to open the airways. This
maximizes the absorption of the corticosteroid (fluticasone) given 5 minutes later.
Question 3
The nurse teaches a patient about using a corticosteroid metered-dose inhaler.
Which instruction is vital to prevent oral candidiasis?
A) Use a spacer and rinse the mouth with water after use.
B) Drink a full glass of milk before administration.
C) Brush teeth immediately before inhalation.
D) Inhale slowly over 30 seconds.
Answer: A) Use a spacer and rinse the mouth with water after use.
Rationale: Rinsing the mouth and spitting out the water removes residual steroid
particles from the oral mucosa, preventing the overgrowth of oral yeast (thrush).
Question 4
A patient on warfarin therapy has an International Normalized Ratio (INR) of 5.5 and
notes spontaneous epistaxis. The nurse anticipates administering which antidote?
A) Protamine sulfate
B) Acetylcysteine
C) Vitamin K
D) Flumazenil
Answer: C) Vitamin K
Rationale: Vitamin K is the specific reversal agent for warfarin. Protamine sulfate
reverses heparin, acetylcysteine reverses acetaminophen, and flumazenil reverses
benzodiazepines.
Question 5
A patient is receiving a continuous intravenous infusion of heparin. Which laboratory
value must the nurse closely monitor to adjust the dosage?
A) Prothrombin time (PT)
B) Activated partial thromboplastin time (aPTT)
C) International Normalized Ratio (INR)
D) Platelet count only
2|Page
,Answer: B) Activated partial thromboplastin time (aPTT)
Rationale: Therapeutic heparin therapy is strictly monitored using aPTT levels. PT
and INR are utilized to manage and monitor oral warfarin therapy.
Question 6
Prior to administering a ordered dose of digoxin, the nurse checks the patient’s vital
signs. Which parameter requires holding the medication?
A) Blood pressure 142/90 mmHg
B) Respiratory rate 14 breaths/minute
C) Apical pulse 52 beats/minute
D) Temperature 99.1°F
Answer: C) Apical pulse 52 beats/minute
Rationale: Digoxin is a positive inotrope and negative chronotrope. It slows the heart
rate, so it must be held if the apical pulse falls below 60 beats/minute in adults.
Question 7
A patient taking digoxin reports seeing yellow-green halos around lights and
experiences severe nausea. What should the nurse suspect?
A) Normal therapeutic effect
B) Digoxin toxicity
C) Acute myocardial infarction
D) Hypokalemia recovery
Answer: B) Digoxin toxicity
Rationale: Gastrointestinal upset (nausea, vomiting) and visual changes (yellow-
green halos, blurred vision) are classic, definitive clinical signs of digoxin toxicity.
Question 8
A nurse is preparing to administer lisinopril to a patient. Which laboratory value
should be evaluated prior to administration?
A) Serum sodium
B) Serum potassium
C) Prothrombin time
D) Serum calcium
Answer: B) Serum potassium
Rationale: Angiotensin-converting enzyme (ACE) inhibitors block aldosterone
release, which can lead to potassium retention. The nurse must check for
hyperkalemia before administering.
Question 9
A patient taking captopril develops a persistent, dry, hacking cough and requests a
cough syrup. What is the nurse's best action?
A) Instruct the patient to take an over-the-counter antitussive.
B) Explain that this is a known side effect and notify the provider.
C) Tell the patient to increase fluid intake to thin secretions.
D) Hold the next dose and prepare to administer epinephrine.
Answer: B) Explain that this is a known side effect and notify the provider.
Rationale: The accumulation of bradykinin caused by ACE inhibitors leads to a
3|Page
, persistent dry cough. It does not respond to antitussives and requires switching to an
ARB.
Question 10
The nurse is caring for a patient who is scheduled for a CT scan with intravenous
iodinated contrast media. Which medication must be held for 48 hours before and
after?
A) Metformin
B) Glyburide
C) Glargine insulin
D) Atorvastatin
Answer: A) Metformin
Rationale: Metformin combined with iodinated contrast media poses a severe risk of
induced acute renal failure, which can accumulate metformin and trigger fatal lactic
acidosis.
Question 11
A nurse prepares to administer insulin glargine and regular insulin at 0730. How
should the nurse proceed?
A) Draw up the regular insulin first, then the glargine in one syringe.
B) Draw up the glargine first, then the regular insulin in one syringe.
C) Administer the medications in two separate injections.
D) Mix them together and let the solution sit for 10 minutes.
Answer: C) Administer the medications in two separate injections.
Rationale: Insulin glargine is a long-acting insulin with a low pH. It cannot be mixed
in the same syringe with any other insulin because mixing alters its onset and
duration.
Question 12
A patient with type 1 diabetes is prescribed propranolol for hypertension. What
crucial education should the nurse provide?
A) Propranolol will cure your diabetes over time.
B) Propranolol can mask the early warning signs of hypoglycemia.
C) Increase your carbohydrate intake while taking this drug.
D) Stop taking the medication if your blood sugar is over 200 mg/dL.
Answer: B) Propranolol can mask the early warning signs of hypoglycemia.
Rationale: Beta-blockers blunt the adrenergic response to hypoglycemia, masking
symptoms like tachycardia, tremors, and palpitations. Sweating remains the only
unmasked sign.
Question 13
A nurse is assessing a patient receiving a morphine PCA pump. The respiratory rate
is 8 breaths/minute. Which action should the nurse take first?
A) Check the patient's blood pressure.
B) Administer naloxone intravenously.
C) Stop the pump and stimulate the patient.
D) Notify the healthcare provider.
4|Page
