NURS 5334 Advanced Pharmacology Exam 2 | Questions and
Answers + Rationales | 2026/27 Updates | 100% Correct | UTA
A 55-year-old patient with chronic heart failure is prescribed digoxin. Which of the following
symptoms would indicate digoxin toxicity?
A) Tachycardia, hypertension, flushing
B) Bradycardia, nausea, visual disturbances (yellow halos)
C) Hyperactivity, insomnia, tremors
D) Hypoglycemia, weight gain, dry mouth
Correct Answer: Bradycardia, nausea, visual disturbances (yellow halos)
Rationale: Digoxin has a narrow therapeutic index, making toxicity a significant concern . Classic
signs of toxicity include gastrointestinal symptoms like nausea and vomiting, cardiac effects such
as bradycardia and dysrhythmias, and visual disturbances, including yellow-green halos .
Hypokalemia, often caused by loop diuretics like furosemide, increases the risk of digoxin
toxicity .
A patient with asthma requires a beta-blocker for a cardiac condition. Which agent is the most
cardioselective and therefore the preferred choice?
A) Propranolol
B) Metoprolol
C) Carvedilol
D) Labetalol
Correct Answer: Metoprolol
Rationale: Metoprolol is a cardioselective beta-1 blocker, primarily affecting the heart with
minimal effect on pulmonary beta-2 receptors . Non-selective beta-blockers like propranolol can
,cause bronchospasm in patients with asthma and should be avoided . Carvedilol and labetalol
are non-selective beta-blockers that also have alpha-blocking properties .
A patient on warfarin presents with an INR of 6.0 and minor bleeding. What is the most
appropriate immediate action?
A) Increase the warfarin dose
B) Hold warfarin and administer vitamin K
C) Continue the current dose and monitor
D) Administer aspirin
Correct Answer: Hold warfarin and administer vitamin K
Rationale: An INR above 5.0 significantly increases bleeding risk. The most appropriate
immediate action for an INR of 6.0 with minor bleeding is to hold the warfarin and administer
vitamin K to reverse the anticoagulation . Continuing the drug or giving aspirin would worsen
bleeding and is incorrect.
A patient is started on an ACE inhibitor for hypertension. Which adverse effect requires
immediate discontinuation?
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) Mild hypotension
Correct Answer: Angioedema
Rationale: Although a dry cough and hyperkalemia are common side effects of ACE inhibitors
requiring monitoring, angioedema is a rare but life-threatening reaction that requires
,immediate discontinuation of the drug . Mild hypotension is often transient and can be
managed. Angioedema presents as swelling of the face, lips, tongue, or throat and can
compromise the airway.
Which anticoagulant is the preferred choice in a patient diagnosed with heparin-induced
thrombocytopenia (HIT)?
A) Warfarin
B) Low molecular weight heparin
C) Argatroban
D) Aspirin
Correct Answer: Argatroban
Rationale: HIT is an immune-mediated reaction to heparin, necessitating the use of a non-
heparin anticoagulant . Direct thrombin inhibitors, such as argatroban, are a safe and effective
alternative in this setting. Warfarin is contraindicated as initial therapy due to the risk of venous
limb gangrene.
Which class of diuretics is the most effective for rapid fluid removal in a patient with acute
pulmonary edema?
A) Thiazide diuretics
B) Loop diuretics
C) Potassium-sparing diuretics
D) Carbonic anhydrase inhibitors
Correct Answer: Loop diuretics
, Rationale: Loop diuretics, such as furosemide, are potent and act on the ascending loop of
Henle, making them the preferred agents for rapid diuresis in acute pulmonary edema .
Thiazides are less potent and lose efficacy when the GFR falls, making them unsuitable in this
emergency.
A patient with asthma is prescribed theophylline. Which sign is indicative of theophylline
toxicity?
A) Bradycardia, hypotension, dizziness
B) Tachycardia, nausea, tremors, seizures
C) Sedation and hypoglycemia
D) Weight gain and edema
Correct Answer: Tachycardia, nausea, tremors, seizures
Rationale: Theophylline has a narrow therapeutic window, and toxicity is common with serum
levels above 20 mcg/mL . Symptoms of toxicity include tachycardia, arrhythmias, nausea,
vomiting, tremors, and seizures. These are classic signs of a dangerous drug level.
A patient with chronic kidney disease (CKD) requires a potent diuretic. Which agent is preferred
because it remains effective even when renal function is impaired?
A) Hydrochlorothiazide
B) Furosemide
C) Spironolactone
D) Acetazolamide
Correct Answer: Furosemide
Answers + Rationales | 2026/27 Updates | 100% Correct | UTA
A 55-year-old patient with chronic heart failure is prescribed digoxin. Which of the following
symptoms would indicate digoxin toxicity?
A) Tachycardia, hypertension, flushing
B) Bradycardia, nausea, visual disturbances (yellow halos)
C) Hyperactivity, insomnia, tremors
D) Hypoglycemia, weight gain, dry mouth
Correct Answer: Bradycardia, nausea, visual disturbances (yellow halos)
Rationale: Digoxin has a narrow therapeutic index, making toxicity a significant concern . Classic
signs of toxicity include gastrointestinal symptoms like nausea and vomiting, cardiac effects such
as bradycardia and dysrhythmias, and visual disturbances, including yellow-green halos .
Hypokalemia, often caused by loop diuretics like furosemide, increases the risk of digoxin
toxicity .
A patient with asthma requires a beta-blocker for a cardiac condition. Which agent is the most
cardioselective and therefore the preferred choice?
A) Propranolol
B) Metoprolol
C) Carvedilol
D) Labetalol
Correct Answer: Metoprolol
Rationale: Metoprolol is a cardioselective beta-1 blocker, primarily affecting the heart with
minimal effect on pulmonary beta-2 receptors . Non-selective beta-blockers like propranolol can
,cause bronchospasm in patients with asthma and should be avoided . Carvedilol and labetalol
are non-selective beta-blockers that also have alpha-blocking properties .
A patient on warfarin presents with an INR of 6.0 and minor bleeding. What is the most
appropriate immediate action?
A) Increase the warfarin dose
B) Hold warfarin and administer vitamin K
C) Continue the current dose and monitor
D) Administer aspirin
Correct Answer: Hold warfarin and administer vitamin K
Rationale: An INR above 5.0 significantly increases bleeding risk. The most appropriate
immediate action for an INR of 6.0 with minor bleeding is to hold the warfarin and administer
vitamin K to reverse the anticoagulation . Continuing the drug or giving aspirin would worsen
bleeding and is incorrect.
A patient is started on an ACE inhibitor for hypertension. Which adverse effect requires
immediate discontinuation?
A) Dry cough
B) Hyperkalemia
C) Angioedema
D) Mild hypotension
Correct Answer: Angioedema
Rationale: Although a dry cough and hyperkalemia are common side effects of ACE inhibitors
requiring monitoring, angioedema is a rare but life-threatening reaction that requires
,immediate discontinuation of the drug . Mild hypotension is often transient and can be
managed. Angioedema presents as swelling of the face, lips, tongue, or throat and can
compromise the airway.
Which anticoagulant is the preferred choice in a patient diagnosed with heparin-induced
thrombocytopenia (HIT)?
A) Warfarin
B) Low molecular weight heparin
C) Argatroban
D) Aspirin
Correct Answer: Argatroban
Rationale: HIT is an immune-mediated reaction to heparin, necessitating the use of a non-
heparin anticoagulant . Direct thrombin inhibitors, such as argatroban, are a safe and effective
alternative in this setting. Warfarin is contraindicated as initial therapy due to the risk of venous
limb gangrene.
Which class of diuretics is the most effective for rapid fluid removal in a patient with acute
pulmonary edema?
A) Thiazide diuretics
B) Loop diuretics
C) Potassium-sparing diuretics
D) Carbonic anhydrase inhibitors
Correct Answer: Loop diuretics
, Rationale: Loop diuretics, such as furosemide, are potent and act on the ascending loop of
Henle, making them the preferred agents for rapid diuresis in acute pulmonary edema .
Thiazides are less potent and lose efficacy when the GFR falls, making them unsuitable in this
emergency.
A patient with asthma is prescribed theophylline. Which sign is indicative of theophylline
toxicity?
A) Bradycardia, hypotension, dizziness
B) Tachycardia, nausea, tremors, seizures
C) Sedation and hypoglycemia
D) Weight gain and edema
Correct Answer: Tachycardia, nausea, tremors, seizures
Rationale: Theophylline has a narrow therapeutic window, and toxicity is common with serum
levels above 20 mcg/mL . Symptoms of toxicity include tachycardia, arrhythmias, nausea,
vomiting, tremors, and seizures. These are classic signs of a dangerous drug level.
A patient with chronic kidney disease (CKD) requires a potent diuretic. Which agent is preferred
because it remains effective even when renal function is impaired?
A) Hydrochlorothiazide
B) Furosemide
C) Spironolactone
D) Acetazolamide
Correct Answer: Furosemide
