PRN1381 Principles of Pharmacology Final Exam 2025/2026
- Graded A Questions & Verified Answers for Rasmussen
College Nursing
A nurse prepares to administer digoxin 0.25 mg PO. The client's apical pulse is 52
beats/min. Which action is most appropriate?
A) Give the medication as ordered
B) Hold the dose and contact the prescriber
C) Check the radial pulse instead
1. D) Administer half the dose
Answer: B
Rationale: Digoxin is held for apical pulse <60 beats/min due to risk of bradycardia and
heart block from increased vagal tone.
A client receives morphine 4 mg IV for postoperative pain. Which assessment finding
requires immediate intervention?
A) Pain score decreased from 8/10 to 4/10
B) Respiratory rate of 8 breaths/min
C) Blood pressure 110/70 mmHg
2. D) Pupils constricted but reactive
Answer: B
Rationale: Respiratory rate <10 breaths/min indicates morphine-induced respiratory
depression requiring immediate naloxone administration.
A nurse calculates a heparin infusion rate. The order reads 1000 units/hour. The bag
contains 25,000 units in 250 mL D5W. What is the correct infusion rate?
A) 10 mL/hour
B) 25 mL/hour
C) 50 mL/hour
3. D) 100 mL/hour
Answer: A
,Rationale: 25,000 units/250 mL = 100 units/mL. 1000 units/hour ÷ 100 units/mL = 10
mL/hour.
A client on gentamicin therapy has a peak level of 12 mcg/mL and trough of 3 mcg/mL.
Which interpretation is correct?
A) Both levels are therapeutic
B) Peak level is toxic
C) Trough level is toxic
4. D) Both levels are subtherapeutic
Answer: C
Rationale: Gentamicin trough >2 mcg/mL indicates accumulation and
nephrotoxic/ototoxic risk requiring dose reduction.
A nurse administers furosemide 40 mg IV push. Which electrolyte level requires
immediate monitoring?
A) Calcium
B) Potassium
C) Sodium
5. D) Chloride
Answer: B
Rationale: Loop diuretics cause significant potassium wasting leading to hypokalemia
and cardiac dysrhythmias.
A client receives phenytoin 300 mg PO daily. Which serum level indicates toxicity?
A) 5 mcg/mL
B) 10 mcg/mL
C) 15 mcg/mL
6. D) 25 mcg/mL
Answer: D
Rationale: Phenytoin therapeutic range is 10-20 mcg/mL. Levels >20 mcg/mL cause
nystagmus, ataxia, and cognitive impairment.
A nurse prepares insulin for a diabetic client. Which insulin can be given IV?
A) Regular insulin
, B) NPH insulin
C) Insulin glargine
7. D) Insulin detemir
Answer: A
Rationale: Only regular (short-acting) insulin can be given IV for emergency
hyperglycemia or DKA management.
A client receives digoxin and develops nausea, vomiting, and visual disturbances. Which
electrolyte imbalance is likely?
A) Hyponatremia
B) Hypokalemia
C) Hypercalcemia
8. D) Hypophosphatemia
Answer: B
Rationale: Hypokalemia increases digoxin toxicity risk by enhancing its binding to
Na+/K+ ATPase, causing GI and visual symptoms.
A nurse administers vancomycin 1 g IV over 60 minutes. Which adverse reaction is
most concerning?
A) Flushing and hypotension
B) Mild headache
C) Slight nausea
9. D) Local phlebitis
Answer: A
Rationale: Red man syndrome (flushing, hypotension) occurs with rapid vancomycin
infusion due to histamine release.
A client on lithium therapy has a serum level of 2.0 mEq/L. Which action is priority?
A) Increase fluid intake
B) Hold lithium and notify prescriber
C) Give with food next dose
10. D) Monitor for tremors only
Answer: B
- Graded A Questions & Verified Answers for Rasmussen
College Nursing
A nurse prepares to administer digoxin 0.25 mg PO. The client's apical pulse is 52
beats/min. Which action is most appropriate?
A) Give the medication as ordered
B) Hold the dose and contact the prescriber
C) Check the radial pulse instead
1. D) Administer half the dose
Answer: B
Rationale: Digoxin is held for apical pulse <60 beats/min due to risk of bradycardia and
heart block from increased vagal tone.
A client receives morphine 4 mg IV for postoperative pain. Which assessment finding
requires immediate intervention?
A) Pain score decreased from 8/10 to 4/10
B) Respiratory rate of 8 breaths/min
C) Blood pressure 110/70 mmHg
2. D) Pupils constricted but reactive
Answer: B
Rationale: Respiratory rate <10 breaths/min indicates morphine-induced respiratory
depression requiring immediate naloxone administration.
A nurse calculates a heparin infusion rate. The order reads 1000 units/hour. The bag
contains 25,000 units in 250 mL D5W. What is the correct infusion rate?
A) 10 mL/hour
B) 25 mL/hour
C) 50 mL/hour
3. D) 100 mL/hour
Answer: A
,Rationale: 25,000 units/250 mL = 100 units/mL. 1000 units/hour ÷ 100 units/mL = 10
mL/hour.
A client on gentamicin therapy has a peak level of 12 mcg/mL and trough of 3 mcg/mL.
Which interpretation is correct?
A) Both levels are therapeutic
B) Peak level is toxic
C) Trough level is toxic
4. D) Both levels are subtherapeutic
Answer: C
Rationale: Gentamicin trough >2 mcg/mL indicates accumulation and
nephrotoxic/ototoxic risk requiring dose reduction.
A nurse administers furosemide 40 mg IV push. Which electrolyte level requires
immediate monitoring?
A) Calcium
B) Potassium
C) Sodium
5. D) Chloride
Answer: B
Rationale: Loop diuretics cause significant potassium wasting leading to hypokalemia
and cardiac dysrhythmias.
A client receives phenytoin 300 mg PO daily. Which serum level indicates toxicity?
A) 5 mcg/mL
B) 10 mcg/mL
C) 15 mcg/mL
6. D) 25 mcg/mL
Answer: D
Rationale: Phenytoin therapeutic range is 10-20 mcg/mL. Levels >20 mcg/mL cause
nystagmus, ataxia, and cognitive impairment.
A nurse prepares insulin for a diabetic client. Which insulin can be given IV?
A) Regular insulin
, B) NPH insulin
C) Insulin glargine
7. D) Insulin detemir
Answer: A
Rationale: Only regular (short-acting) insulin can be given IV for emergency
hyperglycemia or DKA management.
A client receives digoxin and develops nausea, vomiting, and visual disturbances. Which
electrolyte imbalance is likely?
A) Hyponatremia
B) Hypokalemia
C) Hypercalcemia
8. D) Hypophosphatemia
Answer: B
Rationale: Hypokalemia increases digoxin toxicity risk by enhancing its binding to
Na+/K+ ATPase, causing GI and visual symptoms.
A nurse administers vancomycin 1 g IV over 60 minutes. Which adverse reaction is
most concerning?
A) Flushing and hypotension
B) Mild headache
C) Slight nausea
9. D) Local phlebitis
Answer: A
Rationale: Red man syndrome (flushing, hypotension) occurs with rapid vancomycin
infusion due to histamine release.
A client on lithium therapy has a serum level of 2.0 mEq/L. Which action is priority?
A) Increase fluid intake
B) Hold lithium and notify prescriber
C) Give with food next dose
10. D) Monitor for tremors only
Answer: B
