Western Governors University
CCN: HLTH 2422
Course Number: D398
Course Title: Introduction to Pharmacology
Exam: Objective Assessment
Date:2026
A 72-year-old patient with chronic heart failure is prescribed spironolactone. Which adverse effect
should the nurse monitor most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic that reduces potassium excretion, increasing
the risk of hyperkalemia.
---
A patient receiving intravenous vancomycin develops flushing of the face, neck, and upper torso during
infusion. This reaction is most likely caused by:
A. IgE-mediated anaphylaxis
B. Histamine release due to rapid infusion
C. Nephrotoxicity
D. Ototoxicity
Answer: B. Histamine release due to rapid infusion
,Rationale: Rapid vancomycin infusion may cause “red man syndrome,” a histamine-mediated infusion
reaction.
---
True/False: A drug’s onset of action refers to the time required to reach peak plasma concentration.
Answer: False
Rationale: Onset of action refers to the time until the drug first produces a therapeutic effect, not peak
concentration.
---
A patient with atrial fibrillation is prescribed amiodarone. Which assessment finding requires immediate
follow-up?
A. Mild constipation
B. Yellow-brown skin discoloration
C. Progressive shortness of breath
D. Reduced appetite
Answer: C. Progressive shortness of breath
Rationale: Amiodarone may cause pulmonary toxicity, which can present as dyspnea and requires
urgent evaluation.
---
Fill in the blank: The movement of a drug from the bloodstream into tissues is called __________.
Answer: Distribution
Rationale: Distribution refers to the reversible transfer of drug from circulation into tissues and body
fluids.
---
,A patient taking insulin becomes confused, diaphoretic, and tachycardic. Which medication should the
nurse anticipate administering first?
A. Regular insulin
B. Glucagon
C. Potassium chloride
D. Sodium bicarbonate
Answer: B. Glucagon
Rationale: These are signs of hypoglycemia. Glucagon rapidly increases blood glucose when oral intake is
not possible.
---
A nurse is teaching a patient prescribed nitroglycerin sublingual tablets. Which instruction is correct?
A. Swallow with water
B. Store in a light-exposed container
C. Take after chest pain subsides
D. Place under the tongue until dissolved
Answer: D. Place under the tongue until dissolved
Rationale: Sublingual nitroglycerin is rapidly absorbed through oral mucosa for acute angina relief.
---
True/False: Drugs that are highly protein-bound are more likely to cause toxicity if displaced by another
drug.
Answer: True
Rationale: Displacement increases the free active fraction of the drug, increasing toxicity risk.
---
, Fill in the blank: The study of how genetic variation influences drug response is called __________.
Answer: Pharmacogenetics
Rationale: Pharmacogenetics examines inherited differences in drug metabolism and response.
---
A patient receiving furosemide reports muscle cramps and weakness. Which electrolyte imbalance is
most likely?
A. Hypermagnesemia
B. Hypokalemia
C. Hypernatremia
D. Hyperphosphatemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase urinary potassium loss.
---
A patient with peptic ulcer disease is prescribed omeprazole. What is the primary mechanism of action?
A. Neutralizes gastric acid
B. Blocks histamine receptors
C. Inhibits the proton pump
D. Forms a mucosal barrier
Answer: C. Inhibits the proton pump
Rationale: Omeprazole suppresses gastric acid secretion by irreversibly inhibiting H+/K+-ATPase.
---
True/False: Intramuscular administration bypasses the absorption phase completely.
CCN: HLTH 2422
Course Number: D398
Course Title: Introduction to Pharmacology
Exam: Objective Assessment
Date:2026
A 72-year-old patient with chronic heart failure is prescribed spironolactone. Which adverse effect
should the nurse monitor most closely?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Answer: B. Hyperkalemia
Rationale: Spironolactone is a potassium-sparing diuretic that reduces potassium excretion, increasing
the risk of hyperkalemia.
---
A patient receiving intravenous vancomycin develops flushing of the face, neck, and upper torso during
infusion. This reaction is most likely caused by:
A. IgE-mediated anaphylaxis
B. Histamine release due to rapid infusion
C. Nephrotoxicity
D. Ototoxicity
Answer: B. Histamine release due to rapid infusion
,Rationale: Rapid vancomycin infusion may cause “red man syndrome,” a histamine-mediated infusion
reaction.
---
True/False: A drug’s onset of action refers to the time required to reach peak plasma concentration.
Answer: False
Rationale: Onset of action refers to the time until the drug first produces a therapeutic effect, not peak
concentration.
---
A patient with atrial fibrillation is prescribed amiodarone. Which assessment finding requires immediate
follow-up?
A. Mild constipation
B. Yellow-brown skin discoloration
C. Progressive shortness of breath
D. Reduced appetite
Answer: C. Progressive shortness of breath
Rationale: Amiodarone may cause pulmonary toxicity, which can present as dyspnea and requires
urgent evaluation.
---
Fill in the blank: The movement of a drug from the bloodstream into tissues is called __________.
Answer: Distribution
Rationale: Distribution refers to the reversible transfer of drug from circulation into tissues and body
fluids.
---
,A patient taking insulin becomes confused, diaphoretic, and tachycardic. Which medication should the
nurse anticipate administering first?
A. Regular insulin
B. Glucagon
C. Potassium chloride
D. Sodium bicarbonate
Answer: B. Glucagon
Rationale: These are signs of hypoglycemia. Glucagon rapidly increases blood glucose when oral intake is
not possible.
---
A nurse is teaching a patient prescribed nitroglycerin sublingual tablets. Which instruction is correct?
A. Swallow with water
B. Store in a light-exposed container
C. Take after chest pain subsides
D. Place under the tongue until dissolved
Answer: D. Place under the tongue until dissolved
Rationale: Sublingual nitroglycerin is rapidly absorbed through oral mucosa for acute angina relief.
---
True/False: Drugs that are highly protein-bound are more likely to cause toxicity if displaced by another
drug.
Answer: True
Rationale: Displacement increases the free active fraction of the drug, increasing toxicity risk.
---
, Fill in the blank: The study of how genetic variation influences drug response is called __________.
Answer: Pharmacogenetics
Rationale: Pharmacogenetics examines inherited differences in drug metabolism and response.
---
A patient receiving furosemide reports muscle cramps and weakness. Which electrolyte imbalance is
most likely?
A. Hypermagnesemia
B. Hypokalemia
C. Hypernatremia
D. Hyperphosphatemia
Answer: B. Hypokalemia
Rationale: Loop diuretics increase urinary potassium loss.
---
A patient with peptic ulcer disease is prescribed omeprazole. What is the primary mechanism of action?
A. Neutralizes gastric acid
B. Blocks histamine receptors
C. Inhibits the proton pump
D. Forms a mucosal barrier
Answer: C. Inhibits the proton pump
Rationale: Omeprazole suppresses gastric acid secretion by irreversibly inhibiting H+/K+-ATPase.
---
True/False: Intramuscular administration bypasses the absorption phase completely.
