ATI PN PHARMACOLOGY NGN- br br br
STYLE EXAM QUESTIONS AND CORRECT ANSW br br br br br
ERS WITH RATIONALES GRADED A+ LATEST br br br br br
Case Study 1: Cardiovascular Pharmacology
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A 68-year-br
old client with a history of hypertension and heart failure is admitted with shortness o
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f breath and bilateral ankle edema. Current prescriptions include furosemide, lisinopri
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l, and digoxin.
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Question 1 (NGN – Select All That Apply) br br br br br br br
Which findings indicate the furosemide is having a therapeutic effect?
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A. Decreased peripheral edema br br
B. Increased urine output br br
C. Serum potassium of 2.9 mEq/L br br br br
D. Decreased crackles in lung bases br br br br
E. Blood pressure 88/54 mm Hg br br br br
Correct Answers: A, B, D br br br br
Rationale:
Furosemide is a loop diuretic used to reduce fluid overload. Decreased edema, increased
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urine output, and improved lung sounds indicate effectiveness.
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Hypokalemia and hypotension are adverse effects, not therapeutic outcomes.
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,Question 2 (NGN – Bow-Tie Item) br br br br br
Condition: Worsening heart failure Acti br br br br
on: Administer digoxin Parameters to
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Monitor:
Heart rate below 60 bpm
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Serum potassium level br br
Apical pulse br
Digoxin level br
Correct Bow-Tie Mapping: br br
Condition: Worsening heart failure br br br
Action: Administer digoxin br br
Monitor: Apical pulse, serum potassium, digoxin level
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Rationale:
Digoxin improves cardiac contractility. Bradycardia, electrolyte imbalance, and elevated
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digoxin levels increase toxicity risk and must be monitored.
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Case Study 2: Endocrine – Insulin Therapy
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A 45-year-old client with type 1 diabetes receives insulin lispro at 0730 before breakfast.
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Question 3 (NGN – Multiple Choice) br br br br br
When should the nurse anticipate peak insulin action?
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A. 0800–0830
B. 0900–1000
C. 1200–1400
D. 1600–1800
Correct Answer: B br br
,Rationale:
Insulin lispro is rapid-acting, with peak effects occurring 1–
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2 hours after administration.
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Question 4 (NGN – Cloze / Drop-Down) br br br br br br
The nurse should monitor the client most closely for signs of hypoglycemia during th
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e time period of peak insulin action.
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Correct Drop-Downs: br
Hypoglycemia
Peak insulin action br br
Rationale:
Hypoglycemia is the primary risk during peak insulin activity. br br br br br br br br
Case Study 3: Antibiotic Therapy
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A client is prescribed vancomycin IV for MRSA.
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Question 5 (NGN – Select All That Apply) br br br br br br br
Which assessments are priority before administering vancomycin?
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A. Renal function labs br br
B. Hearing assessment br
C. Blood glucose level br br
D. Trough drug level br br
E. White blood cell count br br br
Correct Answers: A, B, D br br br br
Rationale:
Vancomycin can cause nephrotoxicity and ototoxicity. Monitoring trough levels prevents
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toxicity. WBC trends evaluate infection response but are not a pre-
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administration priority.
br br
, Question 6 (NGN – Multiple Response) br br br br br
Which findings indicate vancomycin toxicity?
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A. Tinnitus
B. Decreased urine output br br
C. Hypotension during infusion br br
D. Red, flushed upper body
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E. Elevated creatinine br
Correct Answers: A, B, E br br br br
Rationale:
Ototoxicity (tinnitus) and nephrotoxicity (oliguria, elevated creatinine) are major toxi
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c effects. Flushing and hypotension may indicate Red Man Syndrome, an infusion re
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action.
Case Study 4: CNS – Opioid Analgesics
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A postoperative client receives morphine IV.
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Question 7 (NGN – Multiple Choice) br br br br br
Which assessment requires immediate intervention?
br br br br
A. Respiratory rate 10/min br br
B. Pain score 3/10 br br
C. Blood pressure 110/70 br br
D. Pupils 2 mm br br
Correct Answer: A br br
Rationale:
Respiratory depression is a life- br br br br
threatening adverse effect of opioids and requires prompt intervention.
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STYLE EXAM QUESTIONS AND CORRECT ANSW br br br br br
ERS WITH RATIONALES GRADED A+ LATEST br br br br br
Case Study 1: Cardiovascular Pharmacology
br br br br
A 68-year-br
old client with a history of hypertension and heart failure is admitted with shortness o
br br br br br br br br br br br br br br
f breath and bilateral ankle edema. Current prescriptions include furosemide, lisinopri
br br br br br br br br br br
l, and digoxin.
br br
Question 1 (NGN – Select All That Apply) br br br br br br br
Which findings indicate the furosemide is having a therapeutic effect?
br br br br br br br br br
A. Decreased peripheral edema br br
B. Increased urine output br br
C. Serum potassium of 2.9 mEq/L br br br br
D. Decreased crackles in lung bases br br br br
E. Blood pressure 88/54 mm Hg br br br br
Correct Answers: A, B, D br br br br
Rationale:
Furosemide is a loop diuretic used to reduce fluid overload. Decreased edema, increased
br br br br br br br br br br br br br
urine output, and improved lung sounds indicate effectiveness.
br br br br br br br
Hypokalemia and hypotension are adverse effects, not therapeutic outcomes.
br br br br br br br br
,Question 2 (NGN – Bow-Tie Item) br br br br br
Condition: Worsening heart failure Acti br br br br
on: Administer digoxin Parameters to
br br br br br
Monitor:
Heart rate below 60 bpm
br br br br
Serum potassium level br br
Apical pulse br
Digoxin level br
Correct Bow-Tie Mapping: br br
Condition: Worsening heart failure br br br
Action: Administer digoxin br br
Monitor: Apical pulse, serum potassium, digoxin level
br br br br br br
Rationale:
Digoxin improves cardiac contractility. Bradycardia, electrolyte imbalance, and elevated
br br br br br br br br b
digoxin levels increase toxicity risk and must be monitored.
r br br br br br br br br
Case Study 2: Endocrine – Insulin Therapy
br br br br br br
A 45-year-old client with type 1 diabetes receives insulin lispro at 0730 before breakfast.
br br br br br br br br br br br br br
Question 3 (NGN – Multiple Choice) br br br br br
When should the nurse anticipate peak insulin action?
br br br br br br br
A. 0800–0830
B. 0900–1000
C. 1200–1400
D. 1600–1800
Correct Answer: B br br
,Rationale:
Insulin lispro is rapid-acting, with peak effects occurring 1–
br br br br br br br br
2 hours after administration.
br br br
Question 4 (NGN – Cloze / Drop-Down) br br br br br br
The nurse should monitor the client most closely for signs of hypoglycemia during th
br br br br br br br br br br br br br
e time period of peak insulin action.
br br br br br br
Correct Drop-Downs: br
Hypoglycemia
Peak insulin action br br
Rationale:
Hypoglycemia is the primary risk during peak insulin activity. br br br br br br br br
Case Study 3: Antibiotic Therapy
br br br br
A client is prescribed vancomycin IV for MRSA.
br br br br br br br
Question 5 (NGN – Select All That Apply) br br br br br br br
Which assessments are priority before administering vancomycin?
br br br br br br
A. Renal function labs br br
B. Hearing assessment br
C. Blood glucose level br br
D. Trough drug level br br
E. White blood cell count br br br
Correct Answers: A, B, D br br br br
Rationale:
Vancomycin can cause nephrotoxicity and ototoxicity. Monitoring trough levels prevents
br br br br br br br br br
toxicity. WBC trends evaluate infection response but are not a pre-
br br br br br br br br br br br
administration priority.
br br
, Question 6 (NGN – Multiple Response) br br br br br
Which findings indicate vancomycin toxicity?
br br br br
A. Tinnitus
B. Decreased urine output br br
C. Hypotension during infusion br br
D. Red, flushed upper body
br br br
E. Elevated creatinine br
Correct Answers: A, B, E br br br br
Rationale:
Ototoxicity (tinnitus) and nephrotoxicity (oliguria, elevated creatinine) are major toxi
br br br br br br br br br
c effects. Flushing and hypotension may indicate Red Man Syndrome, an infusion re
br br br br br br br br br br br br
action.
Case Study 4: CNS – Opioid Analgesics
br br br br br br
A postoperative client receives morphine IV.
br br br br br
Question 7 (NGN – Multiple Choice) br br br br br
Which assessment requires immediate intervention?
br br br br
A. Respiratory rate 10/min br br
B. Pain score 3/10 br br
C. Blood pressure 110/70 br br
D. Pupils 2 mm br br
Correct Answer: A br br
Rationale:
Respiratory depression is a life- br br br br
threatening adverse effect of opioids and requires prompt intervention.
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