Prophecy Relias Pharmacology RN A Latest
2024 Actual Exam Questions and Correct
Detailed Answers with Rationales | Graded
A+
1. A patient is prescribed Lisinopril. The nurse should monitor for which major potential side
effect?
A) Hypoglycemia
B) Hyperkalemia ✓
C) Bradycardia
D) Diarrhea
Rationale: ACE inhibitors like Lisinopril block the conversion of angiotensin I to angiotensin II,
which can lead to decreased aldosterone secretion. Aldosterone promotes potassium excretion;
therefore, inhibiting it can cause potassium retention and hyperkalemia.
2. A patient taking Metformin (Glucophage) should be instructed to report which symptom
immediately?
A) Dry mouth
B) Mild nausea
C) Unusual muscle pain or weakness ✓
D) Headache
Rationale: While GI upset is common, unusual muscle pain or weakness can be a sign of lactic
acidosis, a rare but serious and potentially fatal complication of Metformin.
3. When administering Furosemide (Lasix), the nurse should assess for which electrolyte
imbalance?
A) Hypernatremia
B) Hypercalcemia
C) Hypokalemia ✓
D) Hyperphosphatemia
Rationale: Furosemide is a loop diuretic that acts on the ascending loop of Henle, causing
significant loss of potassium, sodium, and chloride. Hypokalemia is a common and dangerous
side effect.
,4. A patient receiving Heparin via continuous IV infusion should be monitored using which
laboratory test?
A) Prothrombin Time (PT)
B) International Normalized Ratio (INR)
C) Activated Partial Thromboplastin Time (aPTT) ✓
D) Platelet count
Rationale: The aPTT is used to monitor the therapeutic effect of unfractionated Heparin. The
PT/INR is used to monitor warfarin (Coumadin) therapy.
5. Which medication requires frequent monitoring of thyroid function?
A) Atorvastatin (Lipitor)
B) Amiodarone (Cordarone) ✓
C) Metoprolol (Lopressor)
D) Sertraline (Zoloft)
Rationale: Amiodarone is an antiarrhythmic that contains iodine and can cause both
hypothyroidism and hyperthyroidism. Baseline and periodic thyroid function tests are essential.
6. The nurse administers Digoxin (Lanoxin). Before giving the next dose, the nurse should
assess for which of the following?
A) Apical heart rate for one full minute ✓
B) Blood pressure in both arms
C) Oxygen saturation
D) Radial pulse for 15 seconds
Rationale: Digoxin slows the heart rate. If the heart rate is too low (e.g., below 60 bpm in an
adult), the nurse should hold the dose and notify the provider to avoid dangerous bradycardia
or heart block.
7. Which instruction is most important for a patient starting on Warfarin (Coumadin)?
A) "Take the medication on an empty stomach."
B) "Avoid significant changes in your intake of vitamin K-rich foods." ✓
C) "Crush the tablet if you have trouble swallowing."
D) "Take a double dose if you miss one."
Rationale: Vitamin K is essential for the production of clotting factors. Fluctuations in dietary
vitamin K (found in green leafy vegetables) can antagonize the effects of warfarin, making the
INR unstable.
8. A patient is about to receive the first dose of Penicillin. The nurse's priority action is to:
A) Ask the patient about any known allergies to Penicillin. ✓
B) Check the patient's temperature.
,C) Administer the medication with food.
D) Assess the patient's pain level.
Rationale: Penicillin allergies can cause severe, life-threatening anaphylactic reactions. Verifying
allergy history is the highest priority before the first dose.
9. The therapeutic blood level for Lithium is narrow. A level of 2.0 mEq/L indicates:
A) Sub-therapeutic level
B) Therapeutic level
C) Toxic level ✓
D) Lethal level
Rationale: The therapeutic range for Lithium is typically 0.6-1.2 mEq/L for maintenance. A level
of 2.0 mEq/L is considered toxic and requires immediate intervention.
10. Which medication is a direct thrombin inhibitor?
A) Enoxaparin (Lovenox)
B) Clopidogrel (Plavix)
C) Dabigatran (Pradaxa) ✓
D) Warfarin (Coumadin)
Rationale: Dabigatran is a direct thrombin inhibitor. Enoxaparin is a low molecular weight
heparin, Clopidogrel is an antiplatelet agent, and Warfarin is a vitamin K antagonist.
11. A patient with Parkinson's disease is taking Carbidopa/Levodopa. The nurse should teach
the patient to avoid taking the medication with:
A) Grapefruit juice
B) High-protein meals ✓
C) Carbonated beverages
D) Dairy products
Rationale: High-protein meals can compete with the absorption of Levodopa in the small
intestine, reducing its effectiveness.
12. Which medication is used to reverse the effects of Opioid overdose?
A) Flumazenil (Romazicon)
B) Naloxone (Narcan) ✓
C) Protamine Sulfate
D) Vitamin K
Rationale: Naloxone is a competitive antagonist at opioid receptors, rapidly reversing
respiratory depression caused by opioid overdose.
13. A patient on Isoniazid (INH) for tuberculosis is at risk for which vitamin deficiency?
A) Vitamin A
, B) Vitamin B6 (Pyridoxine) ✓
C) Vitamin C
D) Vitamin D
Rationale: INH can cause peripheral neuropathy by interfering with Vitamin B6 metabolism.
Pyridoxine supplements are often given concurrently to prevent this.
14. The nurse should administer Albuterol, a beta-2 agonist, for which primary purpose?
A) Reduce inflammation
B) Break up mucus
C) Relieve bronchospasm ✓
D) Treat infection
Rationale: Albuterol stimulates beta-2 receptors in the bronchial smooth muscle, causing
relaxation and bronchodilation to relieve acute asthma symptoms or bronchospasm.
15. Which finding in a patient taking Spironolactone (Aldactone) requires immediate
intervention?
A) Blood pressure 118/76 mmHg
B) Heart rate 72 bpm
C) Serum potassium 5.8 mEq/L ✓
D) Serum sodium 138 mEq/L
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.8 mEq/L is
hyperkalemia, which can lead to fatal cardiac arrhythmias.
16. A patient receiving Vancomycin should be monitored for which serious adverse effect?
A) Ototoxicity and Nephrotoxicity ✓
B) Hepatotoxicity
C) Cardiotoxicity
D) Pulmonary fibrosis
Rationale: Vancomycin is associated with both ototoxicity (hearing loss) and nephrotoxicity
(kidney damage). Trough levels are monitored to reduce this risk.
17. Which medication is classified as an Angiotensin II Receptor Blocker (ARB)?
A) Lisinopril
B) Losartan ✓
C) Metoprolol
D) Diltiazem
Rationale: Losartan is an ARB. Lisinopril is an ACE inhibitor, Metoprolol is a beta-blocker, and
Diltiazem is a calcium channel blocker.
2024 Actual Exam Questions and Correct
Detailed Answers with Rationales | Graded
A+
1. A patient is prescribed Lisinopril. The nurse should monitor for which major potential side
effect?
A) Hypoglycemia
B) Hyperkalemia ✓
C) Bradycardia
D) Diarrhea
Rationale: ACE inhibitors like Lisinopril block the conversion of angiotensin I to angiotensin II,
which can lead to decreased aldosterone secretion. Aldosterone promotes potassium excretion;
therefore, inhibiting it can cause potassium retention and hyperkalemia.
2. A patient taking Metformin (Glucophage) should be instructed to report which symptom
immediately?
A) Dry mouth
B) Mild nausea
C) Unusual muscle pain or weakness ✓
D) Headache
Rationale: While GI upset is common, unusual muscle pain or weakness can be a sign of lactic
acidosis, a rare but serious and potentially fatal complication of Metformin.
3. When administering Furosemide (Lasix), the nurse should assess for which electrolyte
imbalance?
A) Hypernatremia
B) Hypercalcemia
C) Hypokalemia ✓
D) Hyperphosphatemia
Rationale: Furosemide is a loop diuretic that acts on the ascending loop of Henle, causing
significant loss of potassium, sodium, and chloride. Hypokalemia is a common and dangerous
side effect.
,4. A patient receiving Heparin via continuous IV infusion should be monitored using which
laboratory test?
A) Prothrombin Time (PT)
B) International Normalized Ratio (INR)
C) Activated Partial Thromboplastin Time (aPTT) ✓
D) Platelet count
Rationale: The aPTT is used to monitor the therapeutic effect of unfractionated Heparin. The
PT/INR is used to monitor warfarin (Coumadin) therapy.
5. Which medication requires frequent monitoring of thyroid function?
A) Atorvastatin (Lipitor)
B) Amiodarone (Cordarone) ✓
C) Metoprolol (Lopressor)
D) Sertraline (Zoloft)
Rationale: Amiodarone is an antiarrhythmic that contains iodine and can cause both
hypothyroidism and hyperthyroidism. Baseline and periodic thyroid function tests are essential.
6. The nurse administers Digoxin (Lanoxin). Before giving the next dose, the nurse should
assess for which of the following?
A) Apical heart rate for one full minute ✓
B) Blood pressure in both arms
C) Oxygen saturation
D) Radial pulse for 15 seconds
Rationale: Digoxin slows the heart rate. If the heart rate is too low (e.g., below 60 bpm in an
adult), the nurse should hold the dose and notify the provider to avoid dangerous bradycardia
or heart block.
7. Which instruction is most important for a patient starting on Warfarin (Coumadin)?
A) "Take the medication on an empty stomach."
B) "Avoid significant changes in your intake of vitamin K-rich foods." ✓
C) "Crush the tablet if you have trouble swallowing."
D) "Take a double dose if you miss one."
Rationale: Vitamin K is essential for the production of clotting factors. Fluctuations in dietary
vitamin K (found in green leafy vegetables) can antagonize the effects of warfarin, making the
INR unstable.
8. A patient is about to receive the first dose of Penicillin. The nurse's priority action is to:
A) Ask the patient about any known allergies to Penicillin. ✓
B) Check the patient's temperature.
,C) Administer the medication with food.
D) Assess the patient's pain level.
Rationale: Penicillin allergies can cause severe, life-threatening anaphylactic reactions. Verifying
allergy history is the highest priority before the first dose.
9. The therapeutic blood level for Lithium is narrow. A level of 2.0 mEq/L indicates:
A) Sub-therapeutic level
B) Therapeutic level
C) Toxic level ✓
D) Lethal level
Rationale: The therapeutic range for Lithium is typically 0.6-1.2 mEq/L for maintenance. A level
of 2.0 mEq/L is considered toxic and requires immediate intervention.
10. Which medication is a direct thrombin inhibitor?
A) Enoxaparin (Lovenox)
B) Clopidogrel (Plavix)
C) Dabigatran (Pradaxa) ✓
D) Warfarin (Coumadin)
Rationale: Dabigatran is a direct thrombin inhibitor. Enoxaparin is a low molecular weight
heparin, Clopidogrel is an antiplatelet agent, and Warfarin is a vitamin K antagonist.
11. A patient with Parkinson's disease is taking Carbidopa/Levodopa. The nurse should teach
the patient to avoid taking the medication with:
A) Grapefruit juice
B) High-protein meals ✓
C) Carbonated beverages
D) Dairy products
Rationale: High-protein meals can compete with the absorption of Levodopa in the small
intestine, reducing its effectiveness.
12. Which medication is used to reverse the effects of Opioid overdose?
A) Flumazenil (Romazicon)
B) Naloxone (Narcan) ✓
C) Protamine Sulfate
D) Vitamin K
Rationale: Naloxone is a competitive antagonist at opioid receptors, rapidly reversing
respiratory depression caused by opioid overdose.
13. A patient on Isoniazid (INH) for tuberculosis is at risk for which vitamin deficiency?
A) Vitamin A
, B) Vitamin B6 (Pyridoxine) ✓
C) Vitamin C
D) Vitamin D
Rationale: INH can cause peripheral neuropathy by interfering with Vitamin B6 metabolism.
Pyridoxine supplements are often given concurrently to prevent this.
14. The nurse should administer Albuterol, a beta-2 agonist, for which primary purpose?
A) Reduce inflammation
B) Break up mucus
C) Relieve bronchospasm ✓
D) Treat infection
Rationale: Albuterol stimulates beta-2 receptors in the bronchial smooth muscle, causing
relaxation and bronchodilation to relieve acute asthma symptoms or bronchospasm.
15. Which finding in a patient taking Spironolactone (Aldactone) requires immediate
intervention?
A) Blood pressure 118/76 mmHg
B) Heart rate 72 bpm
C) Serum potassium 5.8 mEq/L ✓
D) Serum sodium 138 mEq/L
Rationale: Spironolactone is a potassium-sparing diuretic. A potassium level of 5.8 mEq/L is
hyperkalemia, which can lead to fatal cardiac arrhythmias.
16. A patient receiving Vancomycin should be monitored for which serious adverse effect?
A) Ototoxicity and Nephrotoxicity ✓
B) Hepatotoxicity
C) Cardiotoxicity
D) Pulmonary fibrosis
Rationale: Vancomycin is associated with both ototoxicity (hearing loss) and nephrotoxicity
(kidney damage). Trough levels are monitored to reduce this risk.
17. Which medication is classified as an Angiotensin II Receptor Blocker (ARB)?
A) Lisinopril
B) Losartan ✓
C) Metoprolol
D) Diltiazem
Rationale: Losartan is an ARB. Lisinopril is an ACE inhibitor, Metoprolol is a beta-blocker, and
Diltiazem is a calcium channel blocker.
