Pharmacology Mastery Test Bank: Medications & Dosages
1. A 68-year-old man with a history of heart failure is
admitted with worsening dyspnea and peripheral edema.
He is prescribed furosemide 40 mg IV bolus once. Which of
the following assessment findings most clearly indicates an
immediate therapeutic effect of the medication?
A. Decrease in heart rate from 92 to 84 bpm
B. Increase in urine output from 20 mL/hr to 120 mL/hr
within 1 hour
C. Reduction in serum creatinine from 1.8 mg/dL to 1.4
mg/dL over 24 hours
D. Drop in blood pressure from 138/82 mm Hg to 122/70
mm Hg after 30 minutes
Correct answer: B
Rationale:
Furosemide is a loop diuretic; an immediate expected
therapeutic effect after IV bolus is increased urine output due
to diuresis. An increase from 20 mL/hr to 120 mL/hr within 1
hour demonstrates acute diuretic action and volume removal.
Option A (heart rate change) is not a direct, immediate
indicator of diuresis. Option C (creatinine improvement over 24
hours) may reflect renal perfusion but is not an immediate
effect and could lag. Option D (BP drop) can occur with diuresis
,but is less specific and may be due to other factors; moreover a
significant BP drop could be adverse.
Safety/teaching tip: Monitor urine output, daily weights,
orthostatic vitals, and electrolytes (especially potassium and
magnesium). Teach the patient to report lightheadedness or
muscle cramps.
Difficulty: Moderate
Bloom’s level: Application
NCLEX category: Physiological Integrity — Pharmacological and
Parenteral Therapies
2. A 24-year-old female with type 1 diabetes is admitted with
blood glucose 320 mg/dL and ordered regular insulin IV
infusion at 0.1 units/kg/hr. Her weight is 60.0 kg. What is
the correct infusion rate in units per hour and how many
units will she receive in 6 hours? (Show full math.)
A. 6.0 units/hr; 36 units in 6 hours
B. 0.6 units/hr; 3.6 units in 6 hours
C. 6.00 units/hr; 36.00 units in 6 hours
D. 60 units/hr; 360 units in 6 hours
Correct answer: C
Rationale:
Step-by-step math (digit-by-digit): Ordered rate = 0.1
units/kg/hr. Weight = 60.0 kg. Multiply: 0.1 × 60.0 = 6.0 units/hr.
Compute total for 6 hours: 6.0 units/hr × 6 hr = 36.0 units.
,Therefore the infusion rate is 6.00 units/hr and total over 6
hours 36.00 units. (Options A and C give same numeric result; C
shows two decimal places as in many infusion pump displays —
either A or C could be considered numerically correct, but C
matches common documentation format.)
Option B is an incorrect decimal placement (0.6 results from
0.01 × 60). Option D is off by a factor of 10.
Safety/teaching tip: Monitor bedside glucose hourly per
protocol and watch for hypoglycemia; have IV dextrose
available and adjust infusion based on sliding-scale orders.
Difficulty: Moderate
Bloom’s level: Application
NCLEX category: Physiological Integrity — Pharmacological and
Parenteral Therapies
3. A patient receiving gentamicin for severe infection has a
trough level drawn 30 minutes before the 4th dose and is
reported as 2.8 mcg/mL (therapeutic trough target <2
mcg/mL). Which action should the nurse take first?
A. Hold the next dose and notify the prescriber.
B. Give the next dose as scheduled — trough is within
acceptable range.
C. Increase the dose to achieve peak concentration.
D. Draw an additional trough in 12 hours to confirm level.
Correct answer: A
, Rationale:
Gentamicin has narrow therapeutic index; a trough above
target (>2 mcg/mL) increases risk of ototoxicity and
nephrotoxicity. The safest immediate action is to hold the next
dose and notify the prescriber to adjust dosing or interval.
Option B is unsafe because the trough is elevated. Option C
(increase dose) would worsen toxicity risk. Option D delays
intervention; while repeat levels may be ordered, holding dose
and notifying prescriber is priority.
Safety/teaching tip: Observe for tinnitus, vertigo, and changes
in urine output; ensure hydration and review renal function
before dosing.
Difficulty: Moderate
Bloom’s level: Application
NCLEX category: Physiological Integrity — Reduction of Risk
Potential
4. A 55-year-old man with chronic atrial fibrillation is started
on warfarin and discharged with INR target 2.0–3.0. He
asks which foods may affect his medication. Which
statement indicates correct understanding?
A. “I should avoid leafy green vegetables to prevent
decreased warfarin effect.”
B. “I should eat grapefruits daily to enhance the
medication.”
C. “I can take over-the-counter aspirin anytime for
1. A 68-year-old man with a history of heart failure is
admitted with worsening dyspnea and peripheral edema.
He is prescribed furosemide 40 mg IV bolus once. Which of
the following assessment findings most clearly indicates an
immediate therapeutic effect of the medication?
A. Decrease in heart rate from 92 to 84 bpm
B. Increase in urine output from 20 mL/hr to 120 mL/hr
within 1 hour
C. Reduction in serum creatinine from 1.8 mg/dL to 1.4
mg/dL over 24 hours
D. Drop in blood pressure from 138/82 mm Hg to 122/70
mm Hg after 30 minutes
Correct answer: B
Rationale:
Furosemide is a loop diuretic; an immediate expected
therapeutic effect after IV bolus is increased urine output due
to diuresis. An increase from 20 mL/hr to 120 mL/hr within 1
hour demonstrates acute diuretic action and volume removal.
Option A (heart rate change) is not a direct, immediate
indicator of diuresis. Option C (creatinine improvement over 24
hours) may reflect renal perfusion but is not an immediate
effect and could lag. Option D (BP drop) can occur with diuresis
,but is less specific and may be due to other factors; moreover a
significant BP drop could be adverse.
Safety/teaching tip: Monitor urine output, daily weights,
orthostatic vitals, and electrolytes (especially potassium and
magnesium). Teach the patient to report lightheadedness or
muscle cramps.
Difficulty: Moderate
Bloom’s level: Application
NCLEX category: Physiological Integrity — Pharmacological and
Parenteral Therapies
2. A 24-year-old female with type 1 diabetes is admitted with
blood glucose 320 mg/dL and ordered regular insulin IV
infusion at 0.1 units/kg/hr. Her weight is 60.0 kg. What is
the correct infusion rate in units per hour and how many
units will she receive in 6 hours? (Show full math.)
A. 6.0 units/hr; 36 units in 6 hours
B. 0.6 units/hr; 3.6 units in 6 hours
C. 6.00 units/hr; 36.00 units in 6 hours
D. 60 units/hr; 360 units in 6 hours
Correct answer: C
Rationale:
Step-by-step math (digit-by-digit): Ordered rate = 0.1
units/kg/hr. Weight = 60.0 kg. Multiply: 0.1 × 60.0 = 6.0 units/hr.
Compute total for 6 hours: 6.0 units/hr × 6 hr = 36.0 units.
,Therefore the infusion rate is 6.00 units/hr and total over 6
hours 36.00 units. (Options A and C give same numeric result; C
shows two decimal places as in many infusion pump displays —
either A or C could be considered numerically correct, but C
matches common documentation format.)
Option B is an incorrect decimal placement (0.6 results from
0.01 × 60). Option D is off by a factor of 10.
Safety/teaching tip: Monitor bedside glucose hourly per
protocol and watch for hypoglycemia; have IV dextrose
available and adjust infusion based on sliding-scale orders.
Difficulty: Moderate
Bloom’s level: Application
NCLEX category: Physiological Integrity — Pharmacological and
Parenteral Therapies
3. A patient receiving gentamicin for severe infection has a
trough level drawn 30 minutes before the 4th dose and is
reported as 2.8 mcg/mL (therapeutic trough target <2
mcg/mL). Which action should the nurse take first?
A. Hold the next dose and notify the prescriber.
B. Give the next dose as scheduled — trough is within
acceptable range.
C. Increase the dose to achieve peak concentration.
D. Draw an additional trough in 12 hours to confirm level.
Correct answer: A
, Rationale:
Gentamicin has narrow therapeutic index; a trough above
target (>2 mcg/mL) increases risk of ototoxicity and
nephrotoxicity. The safest immediate action is to hold the next
dose and notify the prescriber to adjust dosing or interval.
Option B is unsafe because the trough is elevated. Option C
(increase dose) would worsen toxicity risk. Option D delays
intervention; while repeat levels may be ordered, holding dose
and notifying prescriber is priority.
Safety/teaching tip: Observe for tinnitus, vertigo, and changes
in urine output; ensure hydration and review renal function
before dosing.
Difficulty: Moderate
Bloom’s level: Application
NCLEX category: Physiological Integrity — Reduction of Risk
Potential
4. A 55-year-old man with chronic atrial fibrillation is started
on warfarin and discharged with INR target 2.0–3.0. He
asks which foods may affect his medication. Which
statement indicates correct understanding?
A. “I should avoid leafy green vegetables to prevent
decreased warfarin effect.”
B. “I should eat grapefruits daily to enhance the
medication.”
C. “I can take over-the-counter aspirin anytime for
