Ivy Tech Pharm FINAL EXAM Questions With Complete Solutions

Ivy Tech Pharm FINAL EXAM
Questions With Complete
Solutions
Course
Pharmacology
Question 1
A nurse is preparing to administer digoxin to a patient with heart failure. Before giving the
medication, which assessment is the priority?
A. Measure blood glucose level
B. Assess bowel sounds
C. Check the apical pulse for one full minute
D. Measure urine output
Correct Answer: C. Check the apical pulse for one full minute
Solution:
Digoxin slows conduction through the atrioventricular (AV) node and can cause bradycardia. The
nurse should assess the apical pulse for one full minute before administration. If the heart rate is
below the provider's prescribed parameter (commonly less than 60 bpm in adults), the
medication should be withheld and the provider notified.
Key Points:
 Therapeutic range: 0.5–2.0 ng/mL (often 0.5–0.9 ng/mL for heart failure)
 Monitor potassium levels because hypokalemia increases toxicity risk.
 Signs of toxicity include nausea, vomiting, anorexia, confusion, and yellow-green vision
changes.


Question 2
A patient taking warfarin asks why regular blood tests are necessary. The nurse should explain
that the tests monitor:
A. Serum potassium
B. White blood cell count
C. INR (International Normalized Ratio)
D. Blood glucose

,Correct Answer: C. INR (International Normalized Ratio)
Solution:
Warfarin requires INR monitoring to ensure therapeutic anticoagulation while minimizing
bleeding risk.
 Typical therapeutic INR: 2.0–3.0
 Mechanical heart valves may require higher targets.
Patients should maintain consistent vitamin K intake and report signs of bleeding immediately.


Question 3
Which adverse effect should the nurse monitor for in a patient receiving lisinopril?
A. Hypoglycemia
B. Persistent dry cough
C. Hearing loss
D. Constipation
Correct Answer: B. Persistent dry cough
Solution:
ACE inhibitors commonly cause a persistent dry cough due to increased bradykinin levels.
Other important adverse effects:
 Hyperkalemia
 Hypotension
 Angioedema (medical emergency)


Question 4
A nurse is teaching a patient about nitroglycerin sublingual tablets. Which statement by the
patient indicates correct understanding?
A. "I should swallow the tablet with water."
B. "I should place the tablet under my tongue."
C. "I can chew the tablet."

,D. "I should take it after every meal."
Correct Answer: B. "I should place the tablet under my tongue."
Solution:
Nitroglycerin is absorbed rapidly through the oral mucosa when placed under the tongue.
Patient teaching includes:
 Sit down before taking it.
 If chest pain persists after one dose, call emergency services after 5 minutes.
 Up to three doses may be taken five minutes apart if instructed.


Question 5
A patient receiving insulin glargine asks when it reaches its peak. The nurse responds:
A. 1 hour
B. 4 hours
C. 8 hours
D. It has no pronounced peak
Correct Answer: D. It has no pronounced peak
Solution:
Insulin glargine is a long-acting basal insulin with approximately 24-hour duration and
essentially no peak.

Insulin Peak

Lispro ~1 hour

Regular 2–4 hours

NPH 4–12 hours

Glargine No significant peak



Question 6
Which laboratory value is most important before administering furosemide?
A. Hemoglobin

, B. Potassium
C. Platelet count
D. Bilirubin
Correct Answer: B. Potassium
Solution:
Furosemide is a loop diuretic that increases potassium excretion, placing patients at risk for
hypokalemia.
Monitor:
 Potassium
 Blood pressure
 Daily weight
 Kidney function
 Intake and output


Question 7
A patient prescribed metformin should be instructed to:
A. Take it on an empty stomach.
B. Take it with meals.
C. Stop taking it when glucose improves.
D. Double the dose if a dose is missed.
Correct Answer: B. Take it with meals.
Solution:
Taking metformin with meals reduces gastrointestinal side effects such as nausea and diarrhea.
Additional teaching:
 Avoid excessive alcohol.
 Temporarily discontinue before iodinated contrast studies if directed.
 Monitor kidney function.