NURS 676 MIDTERM EXAM 2025/2026
NURS 676 MIDTERM EXAM 2 2025/2026
WEST COAST UNIVERSITY ADVANCED
PHARMACOLOGY SPRING/SUMMER
EXAM COMPLETE TEST BANK VERIFIED
QUESTIONS AND CORRECT ANSWERS with
DETAILED RATIONALES GRADED A+
GUARANTEED PASS- ACE YOUR EXAM
A+ TEST BANK 1
, NURS 676 MIDTERM EXAM 2025/2026
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for
atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the
client. Which finding requires the most immediate intervention?
a) Heartburn.
b) Headache.
c) Constipation.
d) Vomiting.
Rationale: D
Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity. Since Lipitor increases
the risk for digitalis toxicity, this finding requires the most immediate intervention by the nurse.
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to
another type of anti-infective agent should the nurse ask the client about when taking the nursing
history?
a) Aminoglycosides.
b) Cephalosporins.
c) Sulfonamides.
d) Tetracyclines.
Rationale: B
If a client has a history of being allergic to penicillin (PCN); there is appears to be a cross sensitivity
between penicillins and 1st generation cephalosporins. According to research, there appears to be no
cross sensitivity between PCN and 3rd or 4th generation cephalosporins.
A category X drug is prescribed for a young adult female client. Which instruction is most important for
the nurse to teach this client?
a) Use a reliable form of birth control.
b) Avoid exposure to ultra violet light.
c) Refuse this medication if planning pregnancy.
d) Abstain from intercourse while on this drug.
Rationale: A
Drugs classified in the category X place a client who is in the first trimester of pregnancy at risk for
teratogenesis, so women in the childbearing years should be counseled to use a reliable form of birth
control during drug therapy. If the client is planning to become pregnant, she should be encouraged
to discuss plans for pregnancy with the healthcare provider, so a safer alternative prescription can be
provided if pregnancy occurs.
A+ TEST BANK 2
, NURS 676 MIDTERM EXAM 2025/2026
A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse anticipates an
increase in which laboratory value as the result of this medication?
a) Serum glucose.
b) Serum calcium.
c) Red blood cells.
d) Serum potassium.
Rationale: A
Solu-Medrol is a corticosteroid with glucocorticoid and mineralocorticoid actions. These effects can
lead to hyperglycemia which is reflected as an increase in the serum glucose value. The client taking
Solu-Medrol is also at risk for hypocalcemia and hypokalemia which result in a decrease in the serum
calcium and serum potassium levels. These medications also alter the some of the body's immune
responses by suppressing the migration of white blood cells decreasing inflammation response.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication administration. Which morning schedule would indicate to
the nurse that the client teaching has been effective?
a) Take medication, go for a 30 minute morning walk, then eat breakfast.
b) Take medication, rest in bed for 30 minutes, eat breakfast, go for morning walk.
c) Take medication with breakfast, then take a 30 minute morning walk.
d) Go for a 30 minute morning walk, eat breakfast, then take medication.
Rationale: A
Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the morning. The
client should also be advised to remain in an upright position for at least thirty minutes after taking the
medication to reduce the risk of esophageal reflux and irritation.
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the
action of this drug is to
a) decrease the amount of thyroid-stimulating hormone circulating in the blood.
b) increase the amount of thyroid-stimulating hormone circulating in the blood.
c) increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
d) inhibit synthesis of T3 and T4 by the thyroid gland.
Rationale: D
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of thyroid
hormones. It is often prescribed in preparation for thyroidectomy or radioactive iodine therapy.
A postoperative client has been receiving a continuous IV infusion of meperidine (Demerol) 35 mg/hr
for four days. The client has a PRN prescription for Demerol 100 mg PO q3h. The nurse notes that the
A+ TEST BANK 3
, NURS 676 MIDTERM EXAM 2025/2026
client has become increasingly restless, irritable and confused, stating that there are bugs all over the
walls. What action should the nurse take first?
a) Administer a PRN dose of the PO meperidine (Demerol).
b) Administer naloxone (Narcan) IV per PRN protocol.
c) Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
d) Notify the healthcare provider of the client's confusion and hallucinations.
Rationale: C. Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
The client is exhibiting symptoms of Demerol toxicity which is consistent with the large doses of
Demerol received over four days. Decreasing the infusion rate of the Demerol as per protocol is the
most effective action to immediately decrease the amount of serum Demerol. The next nursing action
is for the nurse to notify the healthcare provider.
Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor
antagonist valsartan (Diovan) has been achieved?
a) Dependent edema reduced from +3 to +1.
b) Serum HDL increased from 35 to 55 mg/dl.
c) Pulse rate reduced from 150 to 90 beats/minute.
d) Blood pressure reduced from 160/90 to 130/80.
Rationale: D
Diovan is an angiotensin receptor blocker, prescribed for the treatment of hypertension. The desired
effect is a decrease in blood pressure.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which
intervention should the nurse implement prior to administering the digoxin?
a) Observe respiratory rate and depth.
b) Assess the serum potassium level.
c) Obtain the client's blood pressure.
d) Monitor the serum glucose level.
Rationale: B
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving
digoxin. The nurse should monitor the client's serum potassium levels. Blood pressure and respiratory
rate will not inform the nurse about potential safety issues with digitalis.
Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription
for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which
diagnostic test monitored regularly after discharge?
a) Perfusion scan.
A+ TEST BANK 4
NURS 676 MIDTERM EXAM 2 2025/2026
WEST COAST UNIVERSITY ADVANCED
PHARMACOLOGY SPRING/SUMMER
EXAM COMPLETE TEST BANK VERIFIED
QUESTIONS AND CORRECT ANSWERS with
DETAILED RATIONALES GRADED A+
GUARANTEED PASS- ACE YOUR EXAM
A+ TEST BANK 1
, NURS 676 MIDTERM EXAM 2025/2026
A client with coronary artery disease who is taking digoxin (Lanoxin) receives a new prescription for
atorvastatin (Lipitor). Two weeks after initiation of the Lipitor prescription, the nurse assesses the
client. Which finding requires the most immediate intervention?
a) Heartburn.
b) Headache.
c) Constipation.
d) Vomiting.
Rationale: D
Vomiting, anorexia and abdominal pain are early indications of digitalis toxicity. Since Lipitor increases
the risk for digitalis toxicity, this finding requires the most immediate intervention by the nurse.
While taking a nursing history, the client states, "I am allergic to penicillin." What related allergy to
another type of anti-infective agent should the nurse ask the client about when taking the nursing
history?
a) Aminoglycosides.
b) Cephalosporins.
c) Sulfonamides.
d) Tetracyclines.
Rationale: B
If a client has a history of being allergic to penicillin (PCN); there is appears to be a cross sensitivity
between penicillins and 1st generation cephalosporins. According to research, there appears to be no
cross sensitivity between PCN and 3rd or 4th generation cephalosporins.
A category X drug is prescribed for a young adult female client. Which instruction is most important for
the nurse to teach this client?
a) Use a reliable form of birth control.
b) Avoid exposure to ultra violet light.
c) Refuse this medication if planning pregnancy.
d) Abstain from intercourse while on this drug.
Rationale: A
Drugs classified in the category X place a client who is in the first trimester of pregnancy at risk for
teratogenesis, so women in the childbearing years should be counseled to use a reliable form of birth
control during drug therapy. If the client is planning to become pregnant, she should be encouraged
to discuss plans for pregnancy with the healthcare provider, so a safer alternative prescription can be
provided if pregnancy occurs.
A+ TEST BANK 2
, NURS 676 MIDTERM EXAM 2025/2026
A client is receiving methylprednisolone (Solu-Medrol) 40 mg IV daily. The nurse anticipates an
increase in which laboratory value as the result of this medication?
a) Serum glucose.
b) Serum calcium.
c) Red blood cells.
d) Serum potassium.
Rationale: A
Solu-Medrol is a corticosteroid with glucocorticoid and mineralocorticoid actions. These effects can
lead to hyperglycemia which is reflected as an increase in the serum glucose value. The client taking
Solu-Medrol is also at risk for hypocalcemia and hypokalemia which result in a decrease in the serum
calcium and serum potassium levels. These medications also alter the some of the body's immune
responses by suppressing the migration of white blood cells decreasing inflammation response.
A client is being treated for osteoporosis with alendronate (Fosamax), and the nurse has completed
discharge teaching regarding medication administration. Which morning schedule would indicate to
the nurse that the client teaching has been effective?
a) Take medication, go for a 30 minute morning walk, then eat breakfast.
b) Take medication, rest in bed for 30 minutes, eat breakfast, go for morning walk.
c) Take medication with breakfast, then take a 30 minute morning walk.
d) Go for a 30 minute morning walk, eat breakfast, then take medication.
Rationale: A
Alendronate (Fosamax) is best absorbed when taken thirty minutes before eating in the morning. The
client should also be advised to remain in an upright position for at least thirty minutes after taking the
medication to reduce the risk of esophageal reflux and irritation.
A client is being treated for hyperthyroidism with propylthiouracil (PTU). The nurse knows that the
action of this drug is to
a) decrease the amount of thyroid-stimulating hormone circulating in the blood.
b) increase the amount of thyroid-stimulating hormone circulating in the blood.
c) increase the amount of T4 and decrease the amount of T3 produced by the thyroid.
d) inhibit synthesis of T3 and T4 by the thyroid gland.
Rationale: D
PTU is an adjunct therapy used to control hyperthyroidism by inhibiting production of thyroid
hormones. It is often prescribed in preparation for thyroidectomy or radioactive iodine therapy.
A postoperative client has been receiving a continuous IV infusion of meperidine (Demerol) 35 mg/hr
for four days. The client has a PRN prescription for Demerol 100 mg PO q3h. The nurse notes that the
A+ TEST BANK 3
, NURS 676 MIDTERM EXAM 2025/2026
client has become increasingly restless, irritable and confused, stating that there are bugs all over the
walls. What action should the nurse take first?
a) Administer a PRN dose of the PO meperidine (Demerol).
b) Administer naloxone (Narcan) IV per PRN protocol.
c) Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
d) Notify the healthcare provider of the client's confusion and hallucinations.
Rationale: C. Decrease the IV infusion rate of the meperidine (Demerol) per protocol.
The client is exhibiting symptoms of Demerol toxicity which is consistent with the large doses of
Demerol received over four days. Decreasing the infusion rate of the Demerol as per protocol is the
most effective action to immediately decrease the amount of serum Demerol. The next nursing action
is for the nurse to notify the healthcare provider.
Which change in data indicates to the nurse that the desired effect of the angiotensin II receptor
antagonist valsartan (Diovan) has been achieved?
a) Dependent edema reduced from +3 to +1.
b) Serum HDL increased from 35 to 55 mg/dl.
c) Pulse rate reduced from 150 to 90 beats/minute.
d) Blood pressure reduced from 160/90 to 130/80.
Rationale: D
Diovan is an angiotensin receptor blocker, prescribed for the treatment of hypertension. The desired
effect is a decrease in blood pressure.
The healthcare provider prescribes digitalis (Digoxin) for a client diagnosed with heart failure. Which
intervention should the nurse implement prior to administering the digoxin?
a) Observe respiratory rate and depth.
b) Assess the serum potassium level.
c) Obtain the client's blood pressure.
d) Monitor the serum glucose level.
Rationale: B
Hypokalemia (decreased serum potassium) will precipitate digitalis toxicity in persons receiving
digoxin. The nurse should monitor the client's serum potassium levels. Blood pressure and respiratory
rate will not inform the nurse about potential safety issues with digitalis.
Following heparin treatment for a pulmonary embolism, a client is being discharged with a prescription
for warfarin (Coumadin). In conducting discharge teaching, the nurse advises the client to have which
diagnostic test monitored regularly after discharge?
a) Perfusion scan.
A+ TEST BANK 4
