RN PHARMACOLOGY A RELIAS | CONNECTS TO
NURSING PRACTICE TEST QUESTIONS & VERIFIED
ANSWERS COMPREHENSIVE PRACTICE EXAM
1. A patient with chronic heart failure is prescribed digoxin. Which
laboratory value would place this patient at highest risk for digoxin
toxicity?
A) Serum potassium 3.1 mEq/L
B) Serum sodium 145 mEq/L
C) Serum magnesium 2.3 mEq/L
D) Serum calcium 10.2 mg/dL
Answer: A) Serum potassium 3.1 mEq/L
Rationale: Hypokalemia (potassium < 3.5 mEq/L) significantly increases
the risk of digoxin toxicity. Low potassium levels cause increased binding
of digoxin to cardiac sodium-potassium ATPase pumps, potentiating its
effects and increasing the risk of fatal arrhythmias. Patients on digoxin
should maintain potassium levels between 4.0-5.0 mEq/L.
2. A nurse is preparing to administer warfarin to a patient with atrial
fibrillation. Which laboratory test should be monitored to evaluate
therapeutic effect?
A) aPTT
B) PT/INR
,C) Platelet count
D) Fibrinogen levels
Answer: B) PT/INR
Rationale: Warfarin is a vitamin K antagonist that prolongs the
prothrombin time (PT). The INR (International Normalized Ratio) is the
standardized measurement used to monitor warfarin therapy.
Therapeutic INR for atrial fibrillation is typically 2.0-3.0. aPTT is used to
monitor heparin therapy.
3. A patient receiving intravenous heparin therapy develops bleeding
gums and hematuria. Which medication should the nurse anticipate
administering?
A) Vitamin K
B) Protamine sulfate
C) Aminocaproic acid
D) Tranexamic acid
Answer: B) Protamine sulfate
Rationale: Protamine sulfate is the specific antidote for heparin
overdose or bleeding complications. It binds to heparin to form a stable
complex, neutralizing its anticoagulant effects. Vitamin K is the antidote
for warfarin. Aminocaproic acid and tranexamic acid are
antifibrinolytics used for other bleeding disorders.
,4. A patient with type 2 diabetes mellitus is prescribed metformin.
Which adverse effect is most concerning and requires immediate
nursing intervention?
A) Nausea and diarrhea
B) Metallic taste
C) Lactic acidosis
D) Weight gain
Answer: C) Lactic acidosis
Rationale: Lactic acidosis is a rare but serious adverse effect of
metformin, characterized by elevated blood lactate levels. It can be fatal
and requires immediate discontinuation of the medication. Symptoms
include malaise, respiratory distress, abdominal pain, and hypotension.
Risk factors include renal impairment, liver disease, and conditions that
cause hypoxia or sepsis.
5. An 82-year-old patient is prescribed lorazepam for anxiety. What
teaching is most important for this patient?
A) Take the medication with food to prevent upset stomach
B) Avoid driving or operating machinery due to sedative effects
C) Take the medication only when feeling anxious
D) Increase fluid intake to prevent dehydration
Answer: B) Avoid driving or operating machinery due to sedative
effects
Rationale: Lorazepam is a benzodiazepine that causes significant central
nervous system depression, especially in elderly patients. Sedation,
, dizziness, and confusion can impair motor skills and judgment. Elderly
patients are at higher risk for falls and accidents. The medication should
be taken consistently as prescribed, not PRN only, and may be taken
with or without food.
6. A patient prescribed furosemide (Lasix) for heart failure has a
potassium level of 3.0 mEq/L. Which medication would the nurse
expect to be ordered?
A) Calcium gluconate
B) Sodium bicarbonate
C) Potassium chloride
D) Magnesium sulfate
Answer: C) Potassium chloride
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
A potassium level of 3.0 mEq/L indicates hypokalemia requiring
replacement therapy with potassium chloride. This should be given
cautiously as IV infusion at no more than 10 mEq/hour and in
concentrations not exceeding 40 mEq/L through a peripheral line.
7. The healthcare provider orders 75 mg of a medication. The
pharmacy supplies 25 mg/tablet. How many tablets should the nurse
administer?
A) 1 tablet
B) 2 tablets
NURSING PRACTICE TEST QUESTIONS & VERIFIED
ANSWERS COMPREHENSIVE PRACTICE EXAM
1. A patient with chronic heart failure is prescribed digoxin. Which
laboratory value would place this patient at highest risk for digoxin
toxicity?
A) Serum potassium 3.1 mEq/L
B) Serum sodium 145 mEq/L
C) Serum magnesium 2.3 mEq/L
D) Serum calcium 10.2 mg/dL
Answer: A) Serum potassium 3.1 mEq/L
Rationale: Hypokalemia (potassium < 3.5 mEq/L) significantly increases
the risk of digoxin toxicity. Low potassium levels cause increased binding
of digoxin to cardiac sodium-potassium ATPase pumps, potentiating its
effects and increasing the risk of fatal arrhythmias. Patients on digoxin
should maintain potassium levels between 4.0-5.0 mEq/L.
2. A nurse is preparing to administer warfarin to a patient with atrial
fibrillation. Which laboratory test should be monitored to evaluate
therapeutic effect?
A) aPTT
B) PT/INR
,C) Platelet count
D) Fibrinogen levels
Answer: B) PT/INR
Rationale: Warfarin is a vitamin K antagonist that prolongs the
prothrombin time (PT). The INR (International Normalized Ratio) is the
standardized measurement used to monitor warfarin therapy.
Therapeutic INR for atrial fibrillation is typically 2.0-3.0. aPTT is used to
monitor heparin therapy.
3. A patient receiving intravenous heparin therapy develops bleeding
gums and hematuria. Which medication should the nurse anticipate
administering?
A) Vitamin K
B) Protamine sulfate
C) Aminocaproic acid
D) Tranexamic acid
Answer: B) Protamine sulfate
Rationale: Protamine sulfate is the specific antidote for heparin
overdose or bleeding complications. It binds to heparin to form a stable
complex, neutralizing its anticoagulant effects. Vitamin K is the antidote
for warfarin. Aminocaproic acid and tranexamic acid are
antifibrinolytics used for other bleeding disorders.
,4. A patient with type 2 diabetes mellitus is prescribed metformin.
Which adverse effect is most concerning and requires immediate
nursing intervention?
A) Nausea and diarrhea
B) Metallic taste
C) Lactic acidosis
D) Weight gain
Answer: C) Lactic acidosis
Rationale: Lactic acidosis is a rare but serious adverse effect of
metformin, characterized by elevated blood lactate levels. It can be fatal
and requires immediate discontinuation of the medication. Symptoms
include malaise, respiratory distress, abdominal pain, and hypotension.
Risk factors include renal impairment, liver disease, and conditions that
cause hypoxia or sepsis.
5. An 82-year-old patient is prescribed lorazepam for anxiety. What
teaching is most important for this patient?
A) Take the medication with food to prevent upset stomach
B) Avoid driving or operating machinery due to sedative effects
C) Take the medication only when feeling anxious
D) Increase fluid intake to prevent dehydration
Answer: B) Avoid driving or operating machinery due to sedative
effects
Rationale: Lorazepam is a benzodiazepine that causes significant central
nervous system depression, especially in elderly patients. Sedation,
, dizziness, and confusion can impair motor skills and judgment. Elderly
patients are at higher risk for falls and accidents. The medication should
be taken consistently as prescribed, not PRN only, and may be taken
with or without food.
6. A patient prescribed furosemide (Lasix) for heart failure has a
potassium level of 3.0 mEq/L. Which medication would the nurse
expect to be ordered?
A) Calcium gluconate
B) Sodium bicarbonate
C) Potassium chloride
D) Magnesium sulfate
Answer: C) Potassium chloride
Rationale: Furosemide is a loop diuretic that causes potassium wasting.
A potassium level of 3.0 mEq/L indicates hypokalemia requiring
replacement therapy with potassium chloride. This should be given
cautiously as IV infusion at no more than 10 mEq/hour and in
concentrations not exceeding 40 mEq/L through a peripheral line.
7. The healthcare provider orders 75 mg of a medication. The
pharmacy supplies 25 mg/tablet. How many tablets should the nurse
administer?
A) 1 tablet
B) 2 tablets
