NUR2474 | NUR2474 Pharmacology for
Professional Nursing Final Exam v3 | Questions
with Correct Answers and Expert Explanation for
Each Question | Rasmussen
1. A patient is prescribed a medication that undergoes a significant first-pass effect.
Which route of administration should the nurse expect to have the highest dose?
A. Intravenous
B. Oral
C. Sublingual
D. Subcutaneous
Correct Answer: B
Expert Explanation: The first-pass effect occurs when a drug is metabolized in the
liver before reaching systemic circulation. This primarily affects medications taken
orally as they pass through the portal vein. Consequently, higher oral doses are
required compared to parenteral routes to achieve the same therapeutic level.
2. A patient taking Lisinopril for hypertension develops a persistent, dry cough. What
is the nurse’s best action?
A. Notify the provider as the medication may need to be changed.
B. Instruct the patient to use an over-the-counter cough suppressant.
,C. Advise the patient to take the medication with food.
D. Reassure the patient that this is a temporary side effect.
Correct Answer: A
Expert Explanation: A dry cough is a common side effect of ACE inhibitors like
Lisinopril due to the accumulation of bradykinin. This side effect usually does not
subside and can be very bothersome for the patient. The provider will typically
switch the patient to an Angiotensin II Receptor Blocker (ARB) which does not cause
this specific issue.
3. Which lab value is most important for a nurse to monitor in a patient receiving
Gentamicin?
A. Serum Potassium
B. Prothrombin Time (PT)
C. Hemoglobin A1c
D. Serum Creatinine
Correct Answer: D
Expert Explanation: Gentamicin is an aminoglycoside antibiotic known for its
nephrotoxic potential. Monitoring serum creatinine and blood urea nitrogen (BUN)
,is essential to detect early signs of kidney damage. The nurse should also monitor
for ototoxicity, which is another serious adverse effect of this drug class.
4. A patient is diagnosed with Digoxin toxicity. Which electrolyte imbalance most
likely contributed to this condition?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypomagnesemia
Correct Answer: C
Expert Explanation: Hypokalemia increases the risk of Digoxin toxicity because
low potassium levels enhance the drug’s effects on the heart. Digoxin binds to the
same site as potassium on the sodium-potassium ATPase pump. Therefore,
maintaining normal potassium levels is a critical nursing priority for patients on
Digoxin therapy.
5. When administering Warfarin, which of the following is the primary laboratory test
used for monitoring therapeutic levels?
A. Activated Partial Thromboplastin Time (aPTT)
B. Platelet Count
, C. International Normalized Ratio (INR)
D. Bleeding Time
Correct Answer: C
Expert Explanation: The INR is the standardized test used to monitor the
effectiveness of Warfarin therapy. A therapeutic range is typically between 2.0 and
3.0 for most conditions like atrial fibrillation. The aPTT is used for monitoring
Heparin therapy, not Warfarin.
6. A patient is prescribed rapid-acting insulin (Lispro) before breakfast. When should
the nurse administer this medication?
A. 30 to 60 minutes before the meal
B. 15 minutes before the meal or when food is present
C. Immediately after the patient finishes eating
D. At bedtime to cover morning glucose levels
Correct Answer: B
Expert Explanation: Lispro is a rapid-acting insulin with an onset of action within
15 minutes. It must be administered very close to mealtime to prevent
hypoglycemia. The nurse should ensure the meal tray is present or arriving shortly
before giving the injection.
Professional Nursing Final Exam v3 | Questions
with Correct Answers and Expert Explanation for
Each Question | Rasmussen
1. A patient is prescribed a medication that undergoes a significant first-pass effect.
Which route of administration should the nurse expect to have the highest dose?
A. Intravenous
B. Oral
C. Sublingual
D. Subcutaneous
Correct Answer: B
Expert Explanation: The first-pass effect occurs when a drug is metabolized in the
liver before reaching systemic circulation. This primarily affects medications taken
orally as they pass through the portal vein. Consequently, higher oral doses are
required compared to parenteral routes to achieve the same therapeutic level.
2. A patient taking Lisinopril for hypertension develops a persistent, dry cough. What
is the nurse’s best action?
A. Notify the provider as the medication may need to be changed.
B. Instruct the patient to use an over-the-counter cough suppressant.
,C. Advise the patient to take the medication with food.
D. Reassure the patient that this is a temporary side effect.
Correct Answer: A
Expert Explanation: A dry cough is a common side effect of ACE inhibitors like
Lisinopril due to the accumulation of bradykinin. This side effect usually does not
subside and can be very bothersome for the patient. The provider will typically
switch the patient to an Angiotensin II Receptor Blocker (ARB) which does not cause
this specific issue.
3. Which lab value is most important for a nurse to monitor in a patient receiving
Gentamicin?
A. Serum Potassium
B. Prothrombin Time (PT)
C. Hemoglobin A1c
D. Serum Creatinine
Correct Answer: D
Expert Explanation: Gentamicin is an aminoglycoside antibiotic known for its
nephrotoxic potential. Monitoring serum creatinine and blood urea nitrogen (BUN)
,is essential to detect early signs of kidney damage. The nurse should also monitor
for ototoxicity, which is another serious adverse effect of this drug class.
4. A patient is diagnosed with Digoxin toxicity. Which electrolyte imbalance most
likely contributed to this condition?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypomagnesemia
Correct Answer: C
Expert Explanation: Hypokalemia increases the risk of Digoxin toxicity because
low potassium levels enhance the drug’s effects on the heart. Digoxin binds to the
same site as potassium on the sodium-potassium ATPase pump. Therefore,
maintaining normal potassium levels is a critical nursing priority for patients on
Digoxin therapy.
5. When administering Warfarin, which of the following is the primary laboratory test
used for monitoring therapeutic levels?
A. Activated Partial Thromboplastin Time (aPTT)
B. Platelet Count
, C. International Normalized Ratio (INR)
D. Bleeding Time
Correct Answer: C
Expert Explanation: The INR is the standardized test used to monitor the
effectiveness of Warfarin therapy. A therapeutic range is typically between 2.0 and
3.0 for most conditions like atrial fibrillation. The aPTT is used for monitoring
Heparin therapy, not Warfarin.
6. A patient is prescribed rapid-acting insulin (Lispro) before breakfast. When should
the nurse administer this medication?
A. 30 to 60 minutes before the meal
B. 15 minutes before the meal or when food is present
C. Immediately after the patient finishes eating
D. At bedtime to cover morning glucose levels
Correct Answer: B
Expert Explanation: Lispro is a rapid-acting insulin with an onset of action within
15 minutes. It must be administered very close to mealtime to prevent
hypoglycemia. The nurse should ensure the meal tray is present or arriving shortly
before giving the injection.
