NUR 210 Exam 3: Principles of Pharmacology - Galen
College of Nursing Updated and Latest Questions and
Correct Answers with Rationale
1. A patient is prescribed Lithium carbonate for the management of bipolar disorder. Which instruction is
most critical for the nurse to include in the teaching plan?
A. Avoid all dairy products while taking this medication.
B. Limit fluid intake to less than 1 liter per day to prevent edema.
C. Take the medication only during manic episodes to avoid toxicity.
D. Maintain a consistent intake of dietary sodium and fluids.
Correct Answer: D
Rationale: Lithium is a mood stabilizer with a very narrow therapeutic index. The kidneys handle
lithium and sodium in a similar manner, meaning low sodium levels can lead to lithium retention and
toxicity. Patients must maintain a consistent salt intake and drink 2 to 3 liters of water daily. If a patient
becomes dehydrated or salt-depleted, lithium levels will rise dangerously. Teaching should emphasize
reporting symptoms like coarse tremors, vomiting, or diarrhea immediately.
2. A client is starting Clozapine for treatment-resistant schizophrenia. Which laboratory value must the
nurse monitor most closely throughout therapy?
A. Serum potassium levels
B. Prothrombin time (PT)
C. Blood urea nitrogen (BUN)
D. White blood cell (WBC) count
Correct Answer: D
,Rationale: Clozapine is an atypical antipsychotic that carries a significant risk of agranulocytosis. This
condition involves a dangerous drop in the white blood cell count, leaving the patient vulnerable to
infection. Protocols require weekly or biweekly monitoring of the WBC and absolute neutrophil count.
Treatment must be interrupted if the count falls below a specific threshold defined by safety guidelines.
Patients are instructed to report any signs of infection, such as fever or sore throat, immediately.
3. The nurse is preparing to administer Phenytoin to a client with a history of tonic-clonic seizures. What is
the priority nursing assessment before administration?
A. Inspect the oral mucosa for signs of bleeding.
B. Assess the patient’s current blood pressure and heart rate.
C. Check the most recent serum phenytoin levels.
D. Monitor the patient for sudden weight gain or loss.
Correct Answer: C
Rationale: Phenytoin is an antiepileptic drug that requires therapeutic blood monitoring to ensure
efficacy and avoid toxicity. The typical therapeutic range is 10 to 20 mcg/mL, and levels above this can
cause CNS depression. Signs of toxicity include nystagmus, ataxia, and slurred speech which the nurse
should assess. Long-term use is also associated with gingival hyperplasia, requiring regular dental
checkups. Administering the drug when levels are already toxic can lead to severe neurological
consequences.
4. A client with heart failure is receiving Digoxin. Which finding would indicate a potential complication of
the therapy?
A. Increased urinary output
B. Patient reports seeing yellow-green halos around lights.
, C. A heart rate of 88 beats per minute
D. A serum potassium level of 4.5 mEq/L
Correct Answer: B
Rationale: Digoxin toxicity is a serious condition that often presents with visual disturbances like yellow
or green halos. This cardiac glycoside has a narrow therapeutic range of 0.5 to 2.0 ng/mL. Hypokalemia
increases the risk of digoxin toxicity, making potassium monitoring essential for safety. The nurse should
always check the apical pulse for one full minute before administration to ensure it is at least 60 bpm.
Other signs of toxicity include anorexia, nausea, and various cardiac arrhythmias.
5. An adult patient is experiencing an acute asthma attack. Which medication should the nurse prepare to
administer first?
A. Salmeterol (long-acting bronchodilator)
B. Albuterol (short-acting bronchodilator)
C. Fluticasone (inhaled corticosteroid)
D. Montelukast (leukotriene modifier)
Correct Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) categorized as a rescue medication for acute
bronchospasm. It works rapidly to relax smooth muscles in the airway and improve ventilation during an
attack. Long-acting agonists and corticosteroids are intended for maintenance and do not provide
immediate relief. The nurse should monitor the patient for side effects like tachycardia and tremors after
administration. Evaluation of lung sounds and oxygen saturation is required to determine the
effectiveness of the treatment.
College of Nursing Updated and Latest Questions and
Correct Answers with Rationale
1. A patient is prescribed Lithium carbonate for the management of bipolar disorder. Which instruction is
most critical for the nurse to include in the teaching plan?
A. Avoid all dairy products while taking this medication.
B. Limit fluid intake to less than 1 liter per day to prevent edema.
C. Take the medication only during manic episodes to avoid toxicity.
D. Maintain a consistent intake of dietary sodium and fluids.
Correct Answer: D
Rationale: Lithium is a mood stabilizer with a very narrow therapeutic index. The kidneys handle
lithium and sodium in a similar manner, meaning low sodium levels can lead to lithium retention and
toxicity. Patients must maintain a consistent salt intake and drink 2 to 3 liters of water daily. If a patient
becomes dehydrated or salt-depleted, lithium levels will rise dangerously. Teaching should emphasize
reporting symptoms like coarse tremors, vomiting, or diarrhea immediately.
2. A client is starting Clozapine for treatment-resistant schizophrenia. Which laboratory value must the
nurse monitor most closely throughout therapy?
A. Serum potassium levels
B. Prothrombin time (PT)
C. Blood urea nitrogen (BUN)
D. White blood cell (WBC) count
Correct Answer: D
,Rationale: Clozapine is an atypical antipsychotic that carries a significant risk of agranulocytosis. This
condition involves a dangerous drop in the white blood cell count, leaving the patient vulnerable to
infection. Protocols require weekly or biweekly monitoring of the WBC and absolute neutrophil count.
Treatment must be interrupted if the count falls below a specific threshold defined by safety guidelines.
Patients are instructed to report any signs of infection, such as fever or sore throat, immediately.
3. The nurse is preparing to administer Phenytoin to a client with a history of tonic-clonic seizures. What is
the priority nursing assessment before administration?
A. Inspect the oral mucosa for signs of bleeding.
B. Assess the patient’s current blood pressure and heart rate.
C. Check the most recent serum phenytoin levels.
D. Monitor the patient for sudden weight gain or loss.
Correct Answer: C
Rationale: Phenytoin is an antiepileptic drug that requires therapeutic blood monitoring to ensure
efficacy and avoid toxicity. The typical therapeutic range is 10 to 20 mcg/mL, and levels above this can
cause CNS depression. Signs of toxicity include nystagmus, ataxia, and slurred speech which the nurse
should assess. Long-term use is also associated with gingival hyperplasia, requiring regular dental
checkups. Administering the drug when levels are already toxic can lead to severe neurological
consequences.
4. A client with heart failure is receiving Digoxin. Which finding would indicate a potential complication of
the therapy?
A. Increased urinary output
B. Patient reports seeing yellow-green halos around lights.
, C. A heart rate of 88 beats per minute
D. A serum potassium level of 4.5 mEq/L
Correct Answer: B
Rationale: Digoxin toxicity is a serious condition that often presents with visual disturbances like yellow
or green halos. This cardiac glycoside has a narrow therapeutic range of 0.5 to 2.0 ng/mL. Hypokalemia
increases the risk of digoxin toxicity, making potassium monitoring essential for safety. The nurse should
always check the apical pulse for one full minute before administration to ensure it is at least 60 bpm.
Other signs of toxicity include anorexia, nausea, and various cardiac arrhythmias.
5. An adult patient is experiencing an acute asthma attack. Which medication should the nurse prepare to
administer first?
A. Salmeterol (long-acting bronchodilator)
B. Albuterol (short-acting bronchodilator)
C. Fluticasone (inhaled corticosteroid)
D. Montelukast (leukotriene modifier)
Correct Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) categorized as a rescue medication for acute
bronchospasm. It works rapidly to relax smooth muscles in the airway and improve ventilation during an
attack. Long-acting agonists and corticosteroids are intended for maintenance and do not provide
immediate relief. The nurse should monitor the patient for side effects like tachycardia and tremors after
administration. Evaluation of lung sounds and oxygen saturation is required to determine the
effectiveness of the treatment.
