Rasmussen Pharmacology EXAM QUESTIONS AND
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The nurse is administering intravenous lidocaine to a patient with a ventricular dysrhythmia. What is the
priority nursing intervention to prevent a potential complication with this drug?
A. Monitor the electrocardiogram (ECG).
B. Obtain a complete blood count.
C. Instruct to report any chest pain.
D. Keep naloxone [Narcan] at the bedside. - ANSWER-A. Monitor the electrocardiogram (ECG)
Continuous ECG monitoring is required during lidocaine infusions to evaluate cardiac response and
adjust dosage accordingly and detect toxicity. Blood counts are not necessary, because lidocaine is not
linked to blood dyscrasias. Lidocaine preferably is given intravenously (IV) rather than intramuscularly
(IM). Sudden onset of chest pain is a sign of arterial embolism, which is a possible adverse effect of
quinidine, not lidocaine. Naloxone is a reversal agent for opioids and is not used with lidocaine.
The nurse is caring for a group of patients taking warfarin. Which patients are at moderate to high risk
for harm as a result of warfarin therapy? Select all that apply.
A. A patient with variant genes that code for VKORC1 and CYP2CP
B. A patient with a current INR of 2.2 treated for deep vein thrombosis
C. A woman with a new onset of symptoms of a pulmonary embolus
D. A patient on day 4 after hip replacement with a new order for warfarin
E. A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the
regimen - ANSWER-A, C, E
Patients with genetic alterations in VKORC1 and CYP2CP are at increased risk of warfarin-induced
bleeding. An INR of 2.2 indicates a therapeutic warfarin level. Warfarin can cause fetal hemorrhage and
is listed as Pregnancy Risk Category X. Warfarin could be prescribed for the prevention of deep vein
thrombosis after hip replacement surgery. The day of prescription would not likely be a day to expect a
dangerous adverse effect from warfarin, because its half-life is 1.5 to 2 days. Warfarin interacts with
many other agents. The greatest risk for harm is when an interacting drug is being added to or deleted
from the regimen.
,The nurse is caring for a patient prescribed a cholesterol-lowering drug. Which drug is least likely to
cause systemic side effects?
A. Simvastatin
B. Colesevelam
C. Nicotinic acid
D. Gemfibrozil - ANSWER-B. Colesevelam
Colesevelam, a bile acid sequestrant, is a nonabsorbable resin that works directly in the gastrointestinal
tract. Because it and other bile acid sequestrants (e.g., cholestyramine and colestipol) are not absorbed,
they do not have systemic effects. The bile acid sequestrants' most common complication is
constipation. The other agents have potential systemic adverse effects.
The nurse is caring for a patient prescribed aliskiren. How does this medication lower blood pressure?
A. It blocks the conversion of angiotensin I to angiotensin II
B. It prevents angiotensin II from binding to its receptors
C. It inhibits the conversion of angiotensinogen into angiotensin I
D. It selectively blocks aldosterone receptors to the kidneys - ANSWER-C. It inhibits the conversion of
angiotensinogen into angiotensin I
Aliskiren is the first direct renin inhibitor on the market. It binds with renin and thus inhibits the
conversion of angiotensinogen to angiotensin I.
The nurse is caring for a patient prescribed digoxin [Lanoxin] for heart failure. Which finding would
require immediate attention by the nurse?
A. Potassium level of 3.7 mEq/L
B. Digoxin level of 0.7 ng/mL
C. Vomiting and diarrhea
D. Heart rate of 68 beats/min - ANSWER-C. Vomiting and diarrhea
Vomiting and diarrhea can lead to hypokalemia, which increases the risk of digoxin toxicity. These
symptoms, along with nausea, fatigue, and visual disturbances, also may precede digoxin toxicity and
,warrant further attention. The heart rate, potassium level, and digoxin level are within the normal
range.
The nurse is caring for a patient prescribed gemfibrozil. For which patient should the nurse question the
use of this drug?
A. A patient with cardiovascular disease and elevated triglycerides
B. A patient with elevated very-low-density lipoprotein (VLDL) levels
C. A patient with elevated triglycerides who has not responded to dietary changes
D. A patient with history of gallstones and elevated triglycerides - ANSWER-D. A patient with history of
gallstones and elevated triglycerides
Gemfibrozil is indicated to reduce elevated triglycerides and very-low-density lipoprotein levels primarily
in patients who have not responded adequately to diet modification. It can also raise HDL but does not
reduce LDL to a significant degree. Gemfibrozil increases the risk of gallstone formation and should not
be used in patients with preexisting gallbladder disease.
The nurse is caring for a patient prescribed quinidine for a supraventricular dysrhythmia. What is a
common adverse effect of this drug?
A. Constipation
B. Urinary retention
C. Diarrhea
D. Blurred vision - ANSWER-C. Diarrhea
Diarrhea and other gastrointestinal problems occur in approximately one third of patients who take
quinidine. This is the most common reason patients stop taking this drug.
The nurse is caring for a patient receiving amiodarone. Which body system should the nurse assess for
serious adverse effects of this medication?
A. Musculoskeletal
B. Respiratory
C. Integumentary
D. Gastrointestinal - ANSWER-B. Respiratory
, Pulmonary toxicity is the most serious potential adverse effect of amiodarone. It may manifest as
pneumonitis or pulmonary fibrosis, with symptoms such as dyspnea, cough, and chest pain
The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is
responsible for the relief of anginal pain with nitrates?
A. Vasoconstriction leads to improved cardiac output.
B. Decreased force of contraction leads to decreased oxygen demand.
C. Vasodilation leads to decreased preload, which decreases oxygen demand.
D. Influx of calcium ions leads to relaxation of vascular smooth muscle. - ANSWER-C. Vasodilation leads
to decreased preload, which decreases oxygen demand
The primary action of nitroglycerin is vasodilation, which leads to decreased venous return, decreased
ventricular filling, and decreased preload, thus reducing oxygen demand on the heart.
The nurse is caring for a patient who has diabetes and hypertension. Which medication is most likely to
be prescribed to treat this patient's hypertension?
A. Hydrochlorothiazide
B. Enalapril
C. Propranolol
D. Methyldopa - ANSWER-B. Enalapril
Preferred antihypertensives for patients with diabetes include ACE inhibitors (enalapril), ARBs, and
calcium channel blockers. ACE inhibitors are particularly useful, because they slow the progression of
diabetic nephropathy in addition to lowering blood pressure. Thiazide diuretics promote hyperglycemia
and are used with caution.
The nurse is caring for a patient who takes spironolactone [Aldactone] and quinapril [Accupril] for
treatment of heart failure. What finding indicates a potential interaction between these two drugs?
A. Elevated serum quinapril level
B. Heart rate of 58 beats/min
C. Potassium level of 5.7 mEq/L
VERIFIED ACCURATE SOLUTION |GET IT 100%
ACCURATE
The nurse is administering intravenous lidocaine to a patient with a ventricular dysrhythmia. What is the
priority nursing intervention to prevent a potential complication with this drug?
A. Monitor the electrocardiogram (ECG).
B. Obtain a complete blood count.
C. Instruct to report any chest pain.
D. Keep naloxone [Narcan] at the bedside. - ANSWER-A. Monitor the electrocardiogram (ECG)
Continuous ECG monitoring is required during lidocaine infusions to evaluate cardiac response and
adjust dosage accordingly and detect toxicity. Blood counts are not necessary, because lidocaine is not
linked to blood dyscrasias. Lidocaine preferably is given intravenously (IV) rather than intramuscularly
(IM). Sudden onset of chest pain is a sign of arterial embolism, which is a possible adverse effect of
quinidine, not lidocaine. Naloxone is a reversal agent for opioids and is not used with lidocaine.
The nurse is caring for a group of patients taking warfarin. Which patients are at moderate to high risk
for harm as a result of warfarin therapy? Select all that apply.
A. A patient with variant genes that code for VKORC1 and CYP2CP
B. A patient with a current INR of 2.2 treated for deep vein thrombosis
C. A woman with a new onset of symptoms of a pulmonary embolus
D. A patient on day 4 after hip replacement with a new order for warfarin
E. A patient with a prosthetic heart valve, for whom an interacting drug is being deleted from the
regimen - ANSWER-A, C, E
Patients with genetic alterations in VKORC1 and CYP2CP are at increased risk of warfarin-induced
bleeding. An INR of 2.2 indicates a therapeutic warfarin level. Warfarin can cause fetal hemorrhage and
is listed as Pregnancy Risk Category X. Warfarin could be prescribed for the prevention of deep vein
thrombosis after hip replacement surgery. The day of prescription would not likely be a day to expect a
dangerous adverse effect from warfarin, because its half-life is 1.5 to 2 days. Warfarin interacts with
many other agents. The greatest risk for harm is when an interacting drug is being added to or deleted
from the regimen.
,The nurse is caring for a patient prescribed a cholesterol-lowering drug. Which drug is least likely to
cause systemic side effects?
A. Simvastatin
B. Colesevelam
C. Nicotinic acid
D. Gemfibrozil - ANSWER-B. Colesevelam
Colesevelam, a bile acid sequestrant, is a nonabsorbable resin that works directly in the gastrointestinal
tract. Because it and other bile acid sequestrants (e.g., cholestyramine and colestipol) are not absorbed,
they do not have systemic effects. The bile acid sequestrants' most common complication is
constipation. The other agents have potential systemic adverse effects.
The nurse is caring for a patient prescribed aliskiren. How does this medication lower blood pressure?
A. It blocks the conversion of angiotensin I to angiotensin II
B. It prevents angiotensin II from binding to its receptors
C. It inhibits the conversion of angiotensinogen into angiotensin I
D. It selectively blocks aldosterone receptors to the kidneys - ANSWER-C. It inhibits the conversion of
angiotensinogen into angiotensin I
Aliskiren is the first direct renin inhibitor on the market. It binds with renin and thus inhibits the
conversion of angiotensinogen to angiotensin I.
The nurse is caring for a patient prescribed digoxin [Lanoxin] for heart failure. Which finding would
require immediate attention by the nurse?
A. Potassium level of 3.7 mEq/L
B. Digoxin level of 0.7 ng/mL
C. Vomiting and diarrhea
D. Heart rate of 68 beats/min - ANSWER-C. Vomiting and diarrhea
Vomiting and diarrhea can lead to hypokalemia, which increases the risk of digoxin toxicity. These
symptoms, along with nausea, fatigue, and visual disturbances, also may precede digoxin toxicity and
,warrant further attention. The heart rate, potassium level, and digoxin level are within the normal
range.
The nurse is caring for a patient prescribed gemfibrozil. For which patient should the nurse question the
use of this drug?
A. A patient with cardiovascular disease and elevated triglycerides
B. A patient with elevated very-low-density lipoprotein (VLDL) levels
C. A patient with elevated triglycerides who has not responded to dietary changes
D. A patient with history of gallstones and elevated triglycerides - ANSWER-D. A patient with history of
gallstones and elevated triglycerides
Gemfibrozil is indicated to reduce elevated triglycerides and very-low-density lipoprotein levels primarily
in patients who have not responded adequately to diet modification. It can also raise HDL but does not
reduce LDL to a significant degree. Gemfibrozil increases the risk of gallstone formation and should not
be used in patients with preexisting gallbladder disease.
The nurse is caring for a patient prescribed quinidine for a supraventricular dysrhythmia. What is a
common adverse effect of this drug?
A. Constipation
B. Urinary retention
C. Diarrhea
D. Blurred vision - ANSWER-C. Diarrhea
Diarrhea and other gastrointestinal problems occur in approximately one third of patients who take
quinidine. This is the most common reason patients stop taking this drug.
The nurse is caring for a patient receiving amiodarone. Which body system should the nurse assess for
serious adverse effects of this medication?
A. Musculoskeletal
B. Respiratory
C. Integumentary
D. Gastrointestinal - ANSWER-B. Respiratory
, Pulmonary toxicity is the most serious potential adverse effect of amiodarone. It may manifest as
pneumonitis or pulmonary fibrosis, with symptoms such as dyspnea, cough, and chest pain
The nurse is caring for a patient receiving nitrates for relief of angina. What pharmacodynamic action is
responsible for the relief of anginal pain with nitrates?
A. Vasoconstriction leads to improved cardiac output.
B. Decreased force of contraction leads to decreased oxygen demand.
C. Vasodilation leads to decreased preload, which decreases oxygen demand.
D. Influx of calcium ions leads to relaxation of vascular smooth muscle. - ANSWER-C. Vasodilation leads
to decreased preload, which decreases oxygen demand
The primary action of nitroglycerin is vasodilation, which leads to decreased venous return, decreased
ventricular filling, and decreased preload, thus reducing oxygen demand on the heart.
The nurse is caring for a patient who has diabetes and hypertension. Which medication is most likely to
be prescribed to treat this patient's hypertension?
A. Hydrochlorothiazide
B. Enalapril
C. Propranolol
D. Methyldopa - ANSWER-B. Enalapril
Preferred antihypertensives for patients with diabetes include ACE inhibitors (enalapril), ARBs, and
calcium channel blockers. ACE inhibitors are particularly useful, because they slow the progression of
diabetic nephropathy in addition to lowering blood pressure. Thiazide diuretics promote hyperglycemia
and are used with caution.
The nurse is caring for a patient who takes spironolactone [Aldactone] and quinapril [Accupril] for
treatment of heart failure. What finding indicates a potential interaction between these two drugs?
A. Elevated serum quinapril level
B. Heart rate of 58 beats/min
C. Potassium level of 5.7 mEq/L
