NURS 711 Final Exam – Pharmacotherapies
(2026) Actual Questions & Verified
Answers | University of South Carolina
A patient taking warfarin is prescribed trimethoprim-sulfamethoxazole for a
urinary tract infection. Which laboratory value requires the closest monitoring?
A. Serum sodium
B. INR
C. Hemoglobin A1c
D. Serum calcium
Answer: B. INR
Rationale: Trimethoprim-sulfamethoxazole can increase the anticoagulant effect
of warfarin, substantially increasing bleeding risk. The INR should therefore be
monitored closely, with therapy adjusted as clinically indicated.
A patient with hypertension is prescribed lisinopril. Which laboratory value is most
important to monitor after initiation?
A. Serum potassium
B. Serum calcium
C. Serum amylase
D. Hemoglobin
Answer: A. Serum potassium
Rationale: ACE inhibitors decrease aldosterone activity and can increase serum
potassium. Renal function and potassium should be assessed after initiation and
following dose changes.
A patient taking an ACE inhibitor develops swelling of the lips and tongue. What
is the priority action?
,A. Administer the next scheduled dose
B. Encourage oral fluids
C. Discontinue the medication and evaluate urgently
D. Administer an antacid
Answer: C. Discontinue the medication and evaluate urgently
Rationale: Angioedema involving the lips or tongue can rapidly compromise the
airway. The ACE inhibitor should be stopped and the patient evaluated
immediately for airway and emergency management.
A patient with type 2 diabetes is prescribed metformin. Which condition would
make metformin therapy particularly concerning?
A. Mild seasonal allergies
B. Severe renal impairment
C. Controlled hypertension
D. Iron-deficiency anemia
Answer: B. Severe renal impairment
Rationale: Metformin is eliminated through the kidneys, and significant renal
impairment increases the risk of drug accumulation and lactic acidosis. Renal
function should be assessed before and during therapy.
A patient taking a statin reports severe muscle pain and weakness. Which
laboratory test is most appropriate to evaluate suspected statin-associated muscle
injury?
A. Creatine kinase
B. Serum sodium
C. INR
D. Troponin only
Answer: A. Creatine kinase
Rationale: Significant muscle pain or weakness during statin therapy can
indicate myopathy or, rarely, rhabdomyolysis. Creatine kinase can help assess
muscle injury, particularly when symptoms are substantial.
,A patient receiving digoxin develops nausea, visual disturbances, and an irregular
heart rhythm. What should the clinician suspect?
A. Therapeutic drug response
B. Digoxin toxicity
C. Iron deficiency
D. Hyperthyroidism
Answer: B. Digoxin toxicity
Rationale: Gastrointestinal symptoms, visual changes, and dysrhythmias are
classic manifestations of digoxin toxicity. Serum digoxin concentration, renal
function, and electrolytes should be evaluated.
Which electrolyte abnormality increases the risk of digoxin toxicity?
A. Hypokalemia
B. Hypernatremia
C. Hyperchloremia
D. Mild hypermagnesemia
Answer: A. Hypokalemia
Rationale: Low serum potassium increases binding of digoxin to myocardial
Na+/K+-ATPase receptors and can increase the risk of toxicity. Potassium
should therefore be monitored carefully in patients receiving digoxin.
A patient taking furosemide reports weakness and muscle cramps. Which
laboratory abnormality is most likely?
A. Hypokalemia
B. Hypercalcemia
C. Hypermagnesemia
D. Hypernatremia
Answer: A. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary sodium and
potassium excretion. Hypokalemia can cause weakness, cramps, and cardiac
dysrhythmias.
, A patient taking spironolactone should be monitored most closely for which
adverse effect?
A. Hypokalemia
B. Hyperkalemia
C. Severe hypocalcemia
D. Neutropenia
Answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic and aldosterone
antagonist. It can increase serum potassium, especially in patients with renal
impairment or those receiving other potassium-raising medications.
Which medication is generally contraindicated during pregnancy because of its
potential effects on the developing fetus?
A. Lisinopril
B. Acetaminophen
C. Penicillin V
D. Calcium carbonate
Answer: A. Lisinopril
Rationale: ACE inhibitors can cause significant fetal toxicity, particularly later
in pregnancy, including fetal renal dysfunction and oligohydramnios. They
should not be used during pregnancy.
A patient taking levothyroxine asks when the medication should generally be taken
for consistent absorption. Which instruction is most appropriate?
A. Take it on an empty stomach consistently
B. Take it only with a high-calcium meal
C. Take it whenever symptoms occur
D. Take it with an iron supplement
Answer: A. Take it on an empty stomach consistently
Rationale: Levothyroxine absorption is affected by food and several supplements
and medications. Taking it consistently on an empty stomach helps maintain
predictable absorption.
(2026) Actual Questions & Verified
Answers | University of South Carolina
A patient taking warfarin is prescribed trimethoprim-sulfamethoxazole for a
urinary tract infection. Which laboratory value requires the closest monitoring?
A. Serum sodium
B. INR
C. Hemoglobin A1c
D. Serum calcium
Answer: B. INR
Rationale: Trimethoprim-sulfamethoxazole can increase the anticoagulant effect
of warfarin, substantially increasing bleeding risk. The INR should therefore be
monitored closely, with therapy adjusted as clinically indicated.
A patient with hypertension is prescribed lisinopril. Which laboratory value is most
important to monitor after initiation?
A. Serum potassium
B. Serum calcium
C. Serum amylase
D. Hemoglobin
Answer: A. Serum potassium
Rationale: ACE inhibitors decrease aldosterone activity and can increase serum
potassium. Renal function and potassium should be assessed after initiation and
following dose changes.
A patient taking an ACE inhibitor develops swelling of the lips and tongue. What
is the priority action?
,A. Administer the next scheduled dose
B. Encourage oral fluids
C. Discontinue the medication and evaluate urgently
D. Administer an antacid
Answer: C. Discontinue the medication and evaluate urgently
Rationale: Angioedema involving the lips or tongue can rapidly compromise the
airway. The ACE inhibitor should be stopped and the patient evaluated
immediately for airway and emergency management.
A patient with type 2 diabetes is prescribed metformin. Which condition would
make metformin therapy particularly concerning?
A. Mild seasonal allergies
B. Severe renal impairment
C. Controlled hypertension
D. Iron-deficiency anemia
Answer: B. Severe renal impairment
Rationale: Metformin is eliminated through the kidneys, and significant renal
impairment increases the risk of drug accumulation and lactic acidosis. Renal
function should be assessed before and during therapy.
A patient taking a statin reports severe muscle pain and weakness. Which
laboratory test is most appropriate to evaluate suspected statin-associated muscle
injury?
A. Creatine kinase
B. Serum sodium
C. INR
D. Troponin only
Answer: A. Creatine kinase
Rationale: Significant muscle pain or weakness during statin therapy can
indicate myopathy or, rarely, rhabdomyolysis. Creatine kinase can help assess
muscle injury, particularly when symptoms are substantial.
,A patient receiving digoxin develops nausea, visual disturbances, and an irregular
heart rhythm. What should the clinician suspect?
A. Therapeutic drug response
B. Digoxin toxicity
C. Iron deficiency
D. Hyperthyroidism
Answer: B. Digoxin toxicity
Rationale: Gastrointestinal symptoms, visual changes, and dysrhythmias are
classic manifestations of digoxin toxicity. Serum digoxin concentration, renal
function, and electrolytes should be evaluated.
Which electrolyte abnormality increases the risk of digoxin toxicity?
A. Hypokalemia
B. Hypernatremia
C. Hyperchloremia
D. Mild hypermagnesemia
Answer: A. Hypokalemia
Rationale: Low serum potassium increases binding of digoxin to myocardial
Na+/K+-ATPase receptors and can increase the risk of toxicity. Potassium
should therefore be monitored carefully in patients receiving digoxin.
A patient taking furosemide reports weakness and muscle cramps. Which
laboratory abnormality is most likely?
A. Hypokalemia
B. Hypercalcemia
C. Hypermagnesemia
D. Hypernatremia
Answer: A. Hypokalemia
Rationale: Furosemide is a loop diuretic that increases urinary sodium and
potassium excretion. Hypokalemia can cause weakness, cramps, and cardiac
dysrhythmias.
, A patient taking spironolactone should be monitored most closely for which
adverse effect?
A. Hypokalemia
B. Hyperkalemia
C. Severe hypocalcemia
D. Neutropenia
Answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic and aldosterone
antagonist. It can increase serum potassium, especially in patients with renal
impairment or those receiving other potassium-raising medications.
Which medication is generally contraindicated during pregnancy because of its
potential effects on the developing fetus?
A. Lisinopril
B. Acetaminophen
C. Penicillin V
D. Calcium carbonate
Answer: A. Lisinopril
Rationale: ACE inhibitors can cause significant fetal toxicity, particularly later
in pregnancy, including fetal renal dysfunction and oligohydramnios. They
should not be used during pregnancy.
A patient taking levothyroxine asks when the medication should generally be taken
for consistent absorption. Which instruction is most appropriate?
A. Take it on an empty stomach consistently
B. Take it only with a high-calcium meal
C. Take it whenever symptoms occur
D. Take it with an iron supplement
Answer: A. Take it on an empty stomach consistently
Rationale: Levothyroxine absorption is affected by food and several supplements
and medications. Taking it consistently on an empty stomach helps maintain
predictable absorption.
