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WEST COAST UNIVERSITY NURS 350 –
PHARMACOLOGY AND THERAPEUTICS
COMPREHENSIVE PRACTICE EXAM 2 QUESTIONS
WITH ANSWERS AND RATIONALES |100% PASS
|GRADED A+ 2026/27
1. A client is prescribed warfarin (Coumadin). Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
a) aPTT
b) INR
c) Platelet count
d) Bleeding time
Verified Answer: b
Rationale: Warfarin is monitored using the International Normalized
Ratio (INR). The therapeutic goal for warfarin is typically an INR of 2-3
for most indications. aPTT is used to monitor heparin therapy. Platelet
count is monitored for heparin-induced thrombocytopenia.
2. The nurse is administering digoxin to a client with heart failure.
Which finding indicates digoxin toxicity?
a) Tachycardia and hypertension
b) Nausea, vomiting, and visual disturbances
c) Hyperkalemia
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d) Weight gain
Verified Answer: b
Rationale: Digoxin toxicity presents with gastrointestinal symptoms
(nausea, vomiting, anorexia), visual disturbances (yellow-green halos,
blurred vision), and cardiac dysrhythmias (bradycardia, heart block).
Hypokalemia increases the risk of digoxin toxicity, not hyperkalemia.
3. A client with asthma is prescribed albuterol (Proventil). What is the
primary mechanism of action of this medication?
a) Beta-2 adrenergic agonist (bronchodilation)
b) Beta-1 adrenergic agonist
c) Muscarinic receptor antagonist
d) Leukotriene receptor antagonist
Verified Answer: a
Rationale: Albuterol is a short-acting beta-2 adrenergic agonist (SABA)
that selectively stimulates beta-2 receptors in the bronchial smooth
muscle, causing bronchodilation. It is used for acute asthma
exacerbations. Beta-1 agonists affect the heart. Muscarinic antagonists
are anticholinergics. Leukotriene receptor antagonists are used for
maintenance therapy.
4. The nurse is administering furosemide (Lasix) to a client with heart
failure. Which electrolyte imbalance is a priority to monitor?
a) Hyperkalemia
b) Hypokalemia
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c) Hypermagnesemia
d) Hypercalcemia
Verified Answer: b
Rationale: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, leading to
increased excretion of sodium, chloride, and potassium. Hypokalemia is
a significant adverse effect that can lead to cardiac dysrhythmias,
especially in clients taking digoxin.
5. A client is prescribed morphine sulfate for severe pain. Which side
effect is the nurse most concerned about?
a) Constipation
b) Nausea
c) Respiratory depression
d) Urinary retention
Verified Answer: c
Rationale: Morphine is an opioid analgesic that can cause respiratory
depression by depressing the medullary respiratory center. This is the
most serious and life-threatening adverse effect. Constipation, nausea,
and urinary retention are common but not life-threatening.
6. The nurse is administering heparin subcutaneously. Which technique
is correct?
a) Massage the site after injection
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b) Aspirate before injection
c) Inject into the abdomen with a 45-90 degree angle
d) Use a 22-gauge needle
Verified Answer: c
Rationale: Heparin is administered subcutaneously into the abdomen (at
least 2 inches from the umbilicus) using a 45-90 degree angle with a
small-gauge needle (25-26 gauge). The site should not be massaged after
injection to prevent hematoma formation. Aspiration is not
recommended for subcutaneous heparin.
7. A client is prescribed metformin (Glucophage) for type 2 diabetes.
Which serious adverse effect should the nurse monitor for?
a) Lactic acidosis
b) Hypoglycemia
c) Weight gain
d) Hyperkalemia
Verified Answer: a
Rationale: Metformin can cause lactic acidosis, a rare but serious
adverse effect characterized by weakness, fatigue, muscle pain, and
respiratory distress. It is more common in clients with renal impairment,
liver disease, or dehydration. Metformin does not typically cause
hypoglycemia when used alone.
8. The nurse is teaching a client about nitroglycerin sublingual tablets.
Which instruction is correct?
WEST COAST UNIVERSITY NURS 350 –
PHARMACOLOGY AND THERAPEUTICS
COMPREHENSIVE PRACTICE EXAM 2 QUESTIONS
WITH ANSWERS AND RATIONALES |100% PASS
|GRADED A+ 2026/27
1. A client is prescribed warfarin (Coumadin). Which laboratory value
should the nurse monitor to evaluate therapeutic effectiveness?
a) aPTT
b) INR
c) Platelet count
d) Bleeding time
Verified Answer: b
Rationale: Warfarin is monitored using the International Normalized
Ratio (INR). The therapeutic goal for warfarin is typically an INR of 2-3
for most indications. aPTT is used to monitor heparin therapy. Platelet
count is monitored for heparin-induced thrombocytopenia.
2. The nurse is administering digoxin to a client with heart failure.
Which finding indicates digoxin toxicity?
a) Tachycardia and hypertension
b) Nausea, vomiting, and visual disturbances
c) Hyperkalemia
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d) Weight gain
Verified Answer: b
Rationale: Digoxin toxicity presents with gastrointestinal symptoms
(nausea, vomiting, anorexia), visual disturbances (yellow-green halos,
blurred vision), and cardiac dysrhythmias (bradycardia, heart block).
Hypokalemia increases the risk of digoxin toxicity, not hyperkalemia.
3. A client with asthma is prescribed albuterol (Proventil). What is the
primary mechanism of action of this medication?
a) Beta-2 adrenergic agonist (bronchodilation)
b) Beta-1 adrenergic agonist
c) Muscarinic receptor antagonist
d) Leukotriene receptor antagonist
Verified Answer: a
Rationale: Albuterol is a short-acting beta-2 adrenergic agonist (SABA)
that selectively stimulates beta-2 receptors in the bronchial smooth
muscle, causing bronchodilation. It is used for acute asthma
exacerbations. Beta-1 agonists affect the heart. Muscarinic antagonists
are anticholinergics. Leukotriene receptor antagonists are used for
maintenance therapy.
4. The nurse is administering furosemide (Lasix) to a client with heart
failure. Which electrolyte imbalance is a priority to monitor?
a) Hyperkalemia
b) Hypokalemia
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c) Hypermagnesemia
d) Hypercalcemia
Verified Answer: b
Rationale: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, leading to
increased excretion of sodium, chloride, and potassium. Hypokalemia is
a significant adverse effect that can lead to cardiac dysrhythmias,
especially in clients taking digoxin.
5. A client is prescribed morphine sulfate for severe pain. Which side
effect is the nurse most concerned about?
a) Constipation
b) Nausea
c) Respiratory depression
d) Urinary retention
Verified Answer: c
Rationale: Morphine is an opioid analgesic that can cause respiratory
depression by depressing the medullary respiratory center. This is the
most serious and life-threatening adverse effect. Constipation, nausea,
and urinary retention are common but not life-threatening.
6. The nurse is administering heparin subcutaneously. Which technique
is correct?
a) Massage the site after injection
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b) Aspirate before injection
c) Inject into the abdomen with a 45-90 degree angle
d) Use a 22-gauge needle
Verified Answer: c
Rationale: Heparin is administered subcutaneously into the abdomen (at
least 2 inches from the umbilicus) using a 45-90 degree angle with a
small-gauge needle (25-26 gauge). The site should not be massaged after
injection to prevent hematoma formation. Aspiration is not
recommended for subcutaneous heparin.
7. A client is prescribed metformin (Glucophage) for type 2 diabetes.
Which serious adverse effect should the nurse monitor for?
a) Lactic acidosis
b) Hypoglycemia
c) Weight gain
d) Hyperkalemia
Verified Answer: a
Rationale: Metformin can cause lactic acidosis, a rare but serious
adverse effect characterized by weakness, fatigue, muscle pain, and
respiratory distress. It is more common in clients with renal impairment,
liver disease, or dehydration. Metformin does not typically cause
hypoglycemia when used alone.
8. The nurse is teaching a client about nitroglycerin sublingual tablets.
Which instruction is correct?
