PRN1381 Principles of Pharmacology Final Exam
2025/2026 - Graded A Questions & Verified
Answers for Rasmussen College
1. A nurse is preparing to give digoxin 0.25 mg PO. The apical pulse is 52 bpm. What is
the appropriate action?
A) Give the drug as scheduled
B) Hold the dose and notify the provider
C) Double the next dose to “catch up”
D) Give IV instead of PO
Answer: B
Rationale: Digoxin slows AV conduction; giving it with a heart rate < 60 bpm risks severe
bradycardia. Hold the dose and follow agency protocol.
2. A patient is prescribed vancomycin 1 g IV every 12 h. Which lab requires monitoring
for dose adjustment?
A) ALT
B) Creatinine
C) INR
D) Hemoglobin
Answer: B
,Rationale: Vancomycin is nephrotoxic; serum creatinine and trough levels guide dosing
to prevent kidney injury.
3. A nurse calculates that 1.5 mL of a pediatric oral liquid is needed. Which device
ensures the most accurate measurement?
A) Household teaspoon
B) 3 mL oral syringe
C) 10 mL cup
D) G-tube
Answer: B
Rationale: Oral syringes measure to 0.1 mL, minimizing dosing errors in pediatric
populations.
4. A patient on morphine PCA reports respiratory rate of 8/min. Which medication
should the nurse have readily available?
A) Flumazenil
B) Naloxone
C) Atropine
D) Epinephrine
Answer: B
Rationale: Naloxone is an opioid antagonist that reverses respiratory depression by
competitive inhibition at mu receptors.
,5. A drug has a half-life of 4 hours. Approximately how long will it take to reach
steady-state with repeated doses?
A) 4 hours
B) 8 hours
C) 16 hours
D) 20 hours
Answer: D
Rationale: Five half-lives (5 × 4 h = 20 h) are required to achieve clinically effective
steady-state plasma levels.
6. A nurse gives a medication 2 hours after scheduled time. Which pharmacokinetic
phase is primarily affected?
A) Absorption
B) Distribution
C) Metabolism
D) Elimination
Answer: A
Rationale: Delayed administration can lead to sub-therapeutic absorption windows,
especially for time-dependent antibiotics.
7. A patient is prescribed both a beta-blocker and a calcium channel blocker. Which
adverse effect is most concerning?
, A) Tachycardia
B) Hyperglycemia
C) Bradycardia
D) Hyperkalemia
Answer: C
Rationale: Both classes slow AV nodal conduction; additive bradycardia and heart block
can occur—monitor HR and ECG.
8. A nurse notes a patient’s BP is 84/50 after first dose of lisinopril. Which action is
best?
A) Encourage stand quickly
B) Hold next dose and notify provider
C) Give double fluid bolus
D) Administer atropine
Answer: B
Rationale: First-dose hypotension is an adverse effect of ACE inhibitors; holding the
dose allows reassessment and possible dosage reduction.
9. A client is ordered 0.3 mg IM epinephrine for anaphylaxis. Which site is preferred?
A) Deltoid
B) Dorsogluteal
2025/2026 - Graded A Questions & Verified
Answers for Rasmussen College
1. A nurse is preparing to give digoxin 0.25 mg PO. The apical pulse is 52 bpm. What is
the appropriate action?
A) Give the drug as scheduled
B) Hold the dose and notify the provider
C) Double the next dose to “catch up”
D) Give IV instead of PO
Answer: B
Rationale: Digoxin slows AV conduction; giving it with a heart rate < 60 bpm risks severe
bradycardia. Hold the dose and follow agency protocol.
2. A patient is prescribed vancomycin 1 g IV every 12 h. Which lab requires monitoring
for dose adjustment?
A) ALT
B) Creatinine
C) INR
D) Hemoglobin
Answer: B
,Rationale: Vancomycin is nephrotoxic; serum creatinine and trough levels guide dosing
to prevent kidney injury.
3. A nurse calculates that 1.5 mL of a pediatric oral liquid is needed. Which device
ensures the most accurate measurement?
A) Household teaspoon
B) 3 mL oral syringe
C) 10 mL cup
D) G-tube
Answer: B
Rationale: Oral syringes measure to 0.1 mL, minimizing dosing errors in pediatric
populations.
4. A patient on morphine PCA reports respiratory rate of 8/min. Which medication
should the nurse have readily available?
A) Flumazenil
B) Naloxone
C) Atropine
D) Epinephrine
Answer: B
Rationale: Naloxone is an opioid antagonist that reverses respiratory depression by
competitive inhibition at mu receptors.
,5. A drug has a half-life of 4 hours. Approximately how long will it take to reach
steady-state with repeated doses?
A) 4 hours
B) 8 hours
C) 16 hours
D) 20 hours
Answer: D
Rationale: Five half-lives (5 × 4 h = 20 h) are required to achieve clinically effective
steady-state plasma levels.
6. A nurse gives a medication 2 hours after scheduled time. Which pharmacokinetic
phase is primarily affected?
A) Absorption
B) Distribution
C) Metabolism
D) Elimination
Answer: A
Rationale: Delayed administration can lead to sub-therapeutic absorption windows,
especially for time-dependent antibiotics.
7. A patient is prescribed both a beta-blocker and a calcium channel blocker. Which
adverse effect is most concerning?
, A) Tachycardia
B) Hyperglycemia
C) Bradycardia
D) Hyperkalemia
Answer: C
Rationale: Both classes slow AV nodal conduction; additive bradycardia and heart block
can occur—monitor HR and ECG.
8. A nurse notes a patient’s BP is 84/50 after first dose of lisinopril. Which action is
best?
A) Encourage stand quickly
B) Hold next dose and notify provider
C) Give double fluid bolus
D) Administer atropine
Answer: B
Rationale: First-dose hypotension is an adverse effect of ACE inhibitors; holding the
dose allows reassessment and possible dosage reduction.
9. A client is ordered 0.3 mg IM epinephrine for anaphylaxis. Which site is preferred?
A) Deltoid
B) Dorsogluteal
