NR 565: ADVANCED PHARMACOLOGY
FINAL EXAM / CHAMBERLAIN ACTUAL
EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES GRADED A+
LATEST
Question 1
A 56-year-old patient with chronic hypertension is prescribed a thiazide diuretic.
Which electrolyte imbalance should the nurse monitor most closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia
Answer: B. Hypokalemia
Rationale: Thiazide diuretics increase renal excretion of sodium and water, which
also increases potassium excretion, leading to hypokalemia. Monitoring potassium
is critical to prevent cardiac dysrhythmias.
Question 2
A patient is prescribed warfarin for atrial fibrillation. Which lab value indicates
therapeutic anticoagulation?
A. aPTT 30 seconds
B. INR 2.5
C. Platelet count 250,000/µL
D. PT 10 seconds
Answer: B. INR 2.5
,Rationale: Warfarin therapy is monitored using the INR (International Normalized
Ratio). For atrial fibrillation, the therapeutic INR range is typically 2.0–3.0. aPTT
monitors heparin therapy, and platelet count and PT alone are insufficient.
Question 3
A patient with chronic pain is prescribed morphine. Which adverse effect is most
important for the nurse to monitor during the first 24 hours?
A. Diarrhea
B. Respiratory depression
C. Hypertension
D. Tachycardia
Answer: B. Respiratory depression
Rationale: Morphine is an opioid agonist that can depress the respiratory center in
the medulla, especially in opioid-naïve patients. Monitoring respiratory rate and
oxygen saturation is essential during initial dosing.
Question 4
A patient taking digoxin for heart failure presents with nausea, vomiting, and
visual disturbances. Which action should the nurse take first?
A. Check serum digoxin level
B. Administer the next dose
C. Encourage fluid intake
D. Document the findings
Answer: A. Check serum digoxin level
Rationale: Nausea, vomiting, and visual disturbances are early signs of digoxin
toxicity. Immediate assessment of serum digoxin levels is essential before further
intervention.
,Question 5
Which drug classification is primarily used to treat neuropathic pain?
A. NSAIDs
B. Opioids
C. Antidepressants
D. Beta-blockers
Answer: C. Antidepressants
Rationale: Certain antidepressants, especially tricyclic antidepressants and SNRIs,
are effective for neuropathic pain due to modulation of serotonin and
norepinephrine pathways. NSAIDs and opioids are less effective for neuropathic
pain.
Question 6
A patient is prescribed an ACE inhibitor. Which side effect requires immediate
discontinuation of the drug?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. Hypotension
Answer: C. Angioedema
Rationale: ACE inhibitors can rarely cause angioedema, a potentially life-
threatening reaction. Immediate discontinuation and emergency treatment are
required. Dry cough and hyperkalemia may require monitoring but are not
emergent.
, Question 7
A patient is receiving a high-dose IV aminoglycoside. Which laboratory test is
most important to monitor for toxicity?
A. Serum potassium
B. Serum creatinine
C. Liver function tests
D. Serum glucose
Answer: B. Serum creatinine
Rationale: Aminoglycosides are nephrotoxic. Monitoring serum creatinine and
BUN is essential to detect early renal impairment. Electrolytes and liver function
are less directly affected by aminoglycosides.
Question 8
A patient taking levothyroxine for hypothyroidism reports palpitations and weight
loss. Which action is appropriate?
A. Increase the dose
B. Discontinue the drug immediately
C. Assess for signs of hyperthyroidism
D. Advise the patient to take with food
Answer: C. Assess for signs of hyperthyroidism
Rationale: Palpitations and weight loss may indicate overreplacement, leading to
hyperthyroidism. The nurse should assess symptoms and communicate with the
provider for potential dose adjustment.
FINAL EXAM / CHAMBERLAIN ACTUAL
EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES GRADED A+
LATEST
Question 1
A 56-year-old patient with chronic hypertension is prescribed a thiazide diuretic.
Which electrolyte imbalance should the nurse monitor most closely?
A. Hyperkalemia
B. Hypokalemia
C. Hypermagnesemia
D. Hypernatremia
Answer: B. Hypokalemia
Rationale: Thiazide diuretics increase renal excretion of sodium and water, which
also increases potassium excretion, leading to hypokalemia. Monitoring potassium
is critical to prevent cardiac dysrhythmias.
Question 2
A patient is prescribed warfarin for atrial fibrillation. Which lab value indicates
therapeutic anticoagulation?
A. aPTT 30 seconds
B. INR 2.5
C. Platelet count 250,000/µL
D. PT 10 seconds
Answer: B. INR 2.5
,Rationale: Warfarin therapy is monitored using the INR (International Normalized
Ratio). For atrial fibrillation, the therapeutic INR range is typically 2.0–3.0. aPTT
monitors heparin therapy, and platelet count and PT alone are insufficient.
Question 3
A patient with chronic pain is prescribed morphine. Which adverse effect is most
important for the nurse to monitor during the first 24 hours?
A. Diarrhea
B. Respiratory depression
C. Hypertension
D. Tachycardia
Answer: B. Respiratory depression
Rationale: Morphine is an opioid agonist that can depress the respiratory center in
the medulla, especially in opioid-naïve patients. Monitoring respiratory rate and
oxygen saturation is essential during initial dosing.
Question 4
A patient taking digoxin for heart failure presents with nausea, vomiting, and
visual disturbances. Which action should the nurse take first?
A. Check serum digoxin level
B. Administer the next dose
C. Encourage fluid intake
D. Document the findings
Answer: A. Check serum digoxin level
Rationale: Nausea, vomiting, and visual disturbances are early signs of digoxin
toxicity. Immediate assessment of serum digoxin levels is essential before further
intervention.
,Question 5
Which drug classification is primarily used to treat neuropathic pain?
A. NSAIDs
B. Opioids
C. Antidepressants
D. Beta-blockers
Answer: C. Antidepressants
Rationale: Certain antidepressants, especially tricyclic antidepressants and SNRIs,
are effective for neuropathic pain due to modulation of serotonin and
norepinephrine pathways. NSAIDs and opioids are less effective for neuropathic
pain.
Question 6
A patient is prescribed an ACE inhibitor. Which side effect requires immediate
discontinuation of the drug?
A. Dry cough
B. Hyperkalemia
C. Angioedema
D. Hypotension
Answer: C. Angioedema
Rationale: ACE inhibitors can rarely cause angioedema, a potentially life-
threatening reaction. Immediate discontinuation and emergency treatment are
required. Dry cough and hyperkalemia may require monitoring but are not
emergent.
, Question 7
A patient is receiving a high-dose IV aminoglycoside. Which laboratory test is
most important to monitor for toxicity?
A. Serum potassium
B. Serum creatinine
C. Liver function tests
D. Serum glucose
Answer: B. Serum creatinine
Rationale: Aminoglycosides are nephrotoxic. Monitoring serum creatinine and
BUN is essential to detect early renal impairment. Electrolytes and liver function
are less directly affected by aminoglycosides.
Question 8
A patient taking levothyroxine for hypothyroidism reports palpitations and weight
loss. Which action is appropriate?
A. Increase the dose
B. Discontinue the drug immediately
C. Assess for signs of hyperthyroidism
D. Advise the patient to take with food
Answer: C. Assess for signs of hyperthyroidism
Rationale: Palpitations and weight loss may indicate overreplacement, leading to
hyperthyroidism. The nurse should assess symptoms and communicate with the
provider for potential dose adjustment.
