KAPLAN PHARMACOLOGY D NGN QUESTIONS AND
ANSWERS WITH RATIONALES COMPLETE AND WELL
EXPLAINED 100% CORRECTLY VERIFIED BY
EXPERTS AND GRADED A+ LATEST UPDATE
1. A client with heart failure is prescribed digoxin. Which finding warrants
immediate notification of the healthcare provider?
A. Apical pulse of 62 bpm in an adult
B. Serum digoxin level of 1.2 ng/mL
C. New-onset nausea and yellow-tinged vision
D. Weight gain of 1 pound in 24 hours
Rationale: Nausea and yellow-tinged vision are classic signs of digoxin toxicity.
Normal digoxin level is 0.5–2 ng/mL; a pulse below 60 bpm in adults is a concern,
but 62 bpm is acceptable. Weight gain may indicate worsening HF but is not as
urgent as toxicity.
2. A nurse is teaching a client about rifampin for tuberculosis. Which
statement by the client indicates understanding?
A. "I should avoid grapefruit juice."
B. "My urine may turn orange, and that’s normal."
C. "I can stop the medication when I feel better."
D. "This drug will cure my TB in 2 weeks."
Rationale: Rifampin causes harmless orange-red discoloration of urine, sweat, and
tears. Grapefruit juice is not a concern. TB treatment requires 6+ months; stopping
early causes resistance.
3. A nurse reviews a client’s lab report after cyclophosphamide
administration. Which value requires immediate reporting?
A. Hemoglobin 12 g/dL
B. White blood cells 5,000/mm³
,C. Platelets 40,000/mm³
D. Serum creatinine 0.8 mg/dL
Rationale: Platelets 40,000/mm³ indicate severe thrombocytopenia (normal
150,000–450,000), increasing bleeding risk. Cyclophosphamide causes
myelosuppression. The other values are normal.
4. A nurse is administering digoxin to an infant with heart failure. What is the
priority assessment before administration?
A. Respiratory rate
B. Blood pressure
C. Apical pulse for 1 full minute
D. Oxygen saturation
Rationale: In infants, digoxin toxicity is more common. The apical pulse must be
counted for 1 minute before each dose. Hold if infant pulse is below 90–100 bpm
(depending on age).
5. A client receiving cyclophosphamide reports hematuria. Which nursing
action is most appropriate?
A. Encourage increased fluid intake
B. Administer vitamin K
C. Hold the next dose of cyclophosphamide
D. Apply ice to the suprapubic area
Rationale: Cyclophosphamide can cause hemorrhagic cystitis. High fluid intake
and frequent voiding reduce bladder irritation. Mesna may be given
prophylactically.
6. A nurse provides education about rifampin. Which adverse effect should
the client report immediately?
A. Red-orange urine
B. Fever and jaundice
C. Gastrointestinal upset
D. Headache
, Rationale: Fever and jaundice may indicate hepatotoxicity, a serious adverse
effect of rifampin. Orange urine is benign. GI upset and headache are common but
not emergent.
7. A client with atrial fibrillation is started on digoxin. Which finding suggests
therapeutic effect?
A. Apical pulse 70–80 bpm and regular
B. Serum digoxin level 2.5 ng/mL
C. Weight gain of 3 pounds in 2 days
D. Blood pressure 90/60 mm Hg
Rationale: Therapeutic digoxin slows AV conduction, controlling ventricular rate
in a-fib (target 60–100 bpm at rest). Level >2 ng/mL is toxic. Weight gain suggests
HF exacerbation.
8. A nurse assesses a 3-month-old infant receiving digoxin. The apical pulse is
85 bpm. What is the priority action?
A. Withhold digoxin and notify provider
B. Administer the dose as ordered
C. Repeat the pulse in 30 minutes
D. Give the dose with a calcium channel blocker
Rationale: Normal infant pulse (newborn) is 100–170 bpm. 85 bpm is
bradycardic; digoxin should be withheld. Calcium channel blockers increase risk of
heart block.
9. A client with Hodgkin’s lymphoma receiving cyclophosphamide develops
fever and sore throat. What is the priority intervention?
A. Obtain a complete blood count (CBC)
B. Administer acetaminophen
C. Swab the throat for culture
D. Start empiric antibiotics
Rationale: Cyclophosphamide causes neutropenia. Fever may indicate life-
threatening infection. CBC with differential is priority; antibiotics may follow but
require lab confirmation.
ANSWERS WITH RATIONALES COMPLETE AND WELL
EXPLAINED 100% CORRECTLY VERIFIED BY
EXPERTS AND GRADED A+ LATEST UPDATE
1. A client with heart failure is prescribed digoxin. Which finding warrants
immediate notification of the healthcare provider?
A. Apical pulse of 62 bpm in an adult
B. Serum digoxin level of 1.2 ng/mL
C. New-onset nausea and yellow-tinged vision
D. Weight gain of 1 pound in 24 hours
Rationale: Nausea and yellow-tinged vision are classic signs of digoxin toxicity.
Normal digoxin level is 0.5–2 ng/mL; a pulse below 60 bpm in adults is a concern,
but 62 bpm is acceptable. Weight gain may indicate worsening HF but is not as
urgent as toxicity.
2. A nurse is teaching a client about rifampin for tuberculosis. Which
statement by the client indicates understanding?
A. "I should avoid grapefruit juice."
B. "My urine may turn orange, and that’s normal."
C. "I can stop the medication when I feel better."
D. "This drug will cure my TB in 2 weeks."
Rationale: Rifampin causes harmless orange-red discoloration of urine, sweat, and
tears. Grapefruit juice is not a concern. TB treatment requires 6+ months; stopping
early causes resistance.
3. A nurse reviews a client’s lab report after cyclophosphamide
administration. Which value requires immediate reporting?
A. Hemoglobin 12 g/dL
B. White blood cells 5,000/mm³
,C. Platelets 40,000/mm³
D. Serum creatinine 0.8 mg/dL
Rationale: Platelets 40,000/mm³ indicate severe thrombocytopenia (normal
150,000–450,000), increasing bleeding risk. Cyclophosphamide causes
myelosuppression. The other values are normal.
4. A nurse is administering digoxin to an infant with heart failure. What is the
priority assessment before administration?
A. Respiratory rate
B. Blood pressure
C. Apical pulse for 1 full minute
D. Oxygen saturation
Rationale: In infants, digoxin toxicity is more common. The apical pulse must be
counted for 1 minute before each dose. Hold if infant pulse is below 90–100 bpm
(depending on age).
5. A client receiving cyclophosphamide reports hematuria. Which nursing
action is most appropriate?
A. Encourage increased fluid intake
B. Administer vitamin K
C. Hold the next dose of cyclophosphamide
D. Apply ice to the suprapubic area
Rationale: Cyclophosphamide can cause hemorrhagic cystitis. High fluid intake
and frequent voiding reduce bladder irritation. Mesna may be given
prophylactically.
6. A nurse provides education about rifampin. Which adverse effect should
the client report immediately?
A. Red-orange urine
B. Fever and jaundice
C. Gastrointestinal upset
D. Headache
, Rationale: Fever and jaundice may indicate hepatotoxicity, a serious adverse
effect of rifampin. Orange urine is benign. GI upset and headache are common but
not emergent.
7. A client with atrial fibrillation is started on digoxin. Which finding suggests
therapeutic effect?
A. Apical pulse 70–80 bpm and regular
B. Serum digoxin level 2.5 ng/mL
C. Weight gain of 3 pounds in 2 days
D. Blood pressure 90/60 mm Hg
Rationale: Therapeutic digoxin slows AV conduction, controlling ventricular rate
in a-fib (target 60–100 bpm at rest). Level >2 ng/mL is toxic. Weight gain suggests
HF exacerbation.
8. A nurse assesses a 3-month-old infant receiving digoxin. The apical pulse is
85 bpm. What is the priority action?
A. Withhold digoxin and notify provider
B. Administer the dose as ordered
C. Repeat the pulse in 30 minutes
D. Give the dose with a calcium channel blocker
Rationale: Normal infant pulse (newborn) is 100–170 bpm. 85 bpm is
bradycardic; digoxin should be withheld. Calcium channel blockers increase risk of
heart block.
9. A client with Hodgkin’s lymphoma receiving cyclophosphamide develops
fever and sore throat. What is the priority intervention?
A. Obtain a complete blood count (CBC)
B. Administer acetaminophen
C. Swab the throat for culture
D. Start empiric antibiotics
Rationale: Cyclophosphamide causes neutropenia. Fever may indicate life-
threatening infection. CBC with differential is priority; antibiotics may follow but
require lab confirmation.
