NURS 251 Pharmacology Module 6 Exam
Portage Learning ACTUAL EXAM 2026/2027 |
Portage NURS 251 Module 6 | Verified Q&A |
Pass Guaranteed - A+ Graded
Section A: Multiple Choice (Questions 1–35)
Q1: A client with heart failure is prescribed digoxin 0.25 mg PO daily. Before administering the dose, the
nurse counts the apical pulse and notes a rate of 52 beats per minute. Which action should the nurse
take?
A. Administer the dose and document the pulse
B. Hold the dose and notify the provider [CORRECT]
C. Administer the dose with a beta-blocker to increase heart rate
D. Check the radial pulse for 30 seconds and administer if regular
Correct Answer: B
Rationale: Digoxin has a narrow therapeutic index and slows AV nodal conduction. An apical pulse
below 60 bpm in adults indicates bradycardia and potential toxicity; the nurse must hold the dose and
notify the provider. Re-checking with a shorter assessment or co-administering beta-blockers would
exacerbate bradycardia and increase the risk of dangerous dysrhythmias
.
Q2: A client receiving furosemide 40 mg IV twice daily for acute pulmonary edema reports muscle
weakness and palpitations. Which laboratory value should the nurse review first?
A. Serum sodium
B. Serum potassium [CORRECT]
C. Serum calcium
D. Blood glucose
Correct Answer: B
Rationale: Loop diuretics like furosemide inhibit the Na-K-2Cl cotransporter in the thick ascending limb
,of Henle, causing significant potassium wasting. Hypokalemia is the most dangerous electrolyte
imbalance from loop diuretics, manifesting as muscle weakness, palpitations, and cardiac dysrhythmias.
The nurse must prioritize potassium assessment to prevent life-threatening arrhythmias
.
Q3: A client with atrial fibrillation is prescribed warfarin 5 mg PO daily. The client asks which vegetable is
safest to include regularly. Which response by the nurse is most appropriate?
A. "Spinach is an excellent choice for iron content."
B. "Kale provides important antioxidants for heart health."
C. "Iceberg lettuce is acceptable in moderate, consistent amounts." [CORRECT]
D. "Broccoli should be eaten daily for fiber and vitamin K."
Correct Answer: C
Rationale: Warfarin antagonizes vitamin K-dependent clotting factors (II, VII, IX, X). Clients must
maintain consistent vitamin K intake rather than avoid it entirely. Iceberg lettuce contains minimal
vitamin K compared to dark leafy greens like spinach, kale, and broccoli, making it the safest choice for
maintaining stable INR levels without requiring significant dose adjustments
.
Q4: A client with deep vein thrombosis is receiving a heparin infusion at 1,200 units/hour. The nurse
notes the aPTT is 95 seconds (control 30–40 seconds). Which action should the nurse take?
A. Increase the infusion rate to achieve therapeutic anticoagulation
B. Continue the current rate and recheck in 4 hours
C. Stop the infusion for 1 hour, then restart at a reduced rate per protocol [CORRECT]
D. Administer protamine sulfate immediately
Correct Answer: C
Rationale: The therapeutic aPTT range for heparin is typically 1.5–2.5 times the control (45–100
seconds). A value of 95 seconds is at the upper limit of therapeutic range; per most protocols, the nurse
should hold the infusion briefly and restart at a reduced rate to prevent bleeding complications while
maintaining anticoagulation. Protamine is reserved for life-threatening hemorrhage
.
Q5: A client with hyperlipidemia is prescribed atorvastatin 40 mg PO daily. Which dietary instruction is
most important for the nurse to provide?
, A. "Take the medication with grapefruit juice to improve absorption."
B. "Avoid grapefruit juice and sour orange juice during therapy." [CORRECT]
C. "Increase your intake of vitamin K-rich foods."
D. "Take the medication on an empty stomach for best results."
Correct Answer: B
Rationale: Grapefruit contains furanocoumarins that irreversibly inhibit intestinal CYP3A4, the enzyme
that metabolizes atorvastatin. This inhibition increases statin blood levels 3–15 times normal,
dramatically increasing the risk of rhabdomyolysis, myopathy, and hepatotoxicity. The effect persists
until new enzymes are synthesized
.
Q6: A client with heart failure and reduced ejection fraction is prescribed lisinopril. Which laboratory
parameters should the nurse monitor before starting therapy and at follow-up?
A. Liver function tests and complete blood count
B. Serum potassium and serum creatinine [CORRECT]
C. Thyroid function tests and calcium levels
D. Magnesium and phosphate levels
Correct Answer: B
Rationale: ACE inhibitors block angiotensin II formation, reducing aldosterone and impairing potassium
excretion, which can cause hyperkalemia. They also dilate efferent arterioles in the kidney, potentially
reducing glomerular filtration rate and increasing creatinine. Baseline and periodic monitoring of
potassium and renal function is essential for safe ACE inhibitor therapy
.
Q7: A client with ventricular tachycardia is receiving amiodarone IV infusion. The nurse notes the client
has developed a dry cough and bilateral crackles. Which complication should the nurse suspect?
A. Digoxin toxicity
B. Amiodarone-induced pulmonary toxicity [CORRECT]
C. ACE inhibitor-induced angioedema
D. Beta-blocker bronchospasm
Correct Answer: B
Rationale: Amiodarone carries a black box warning for fatal toxicities including pulmonary toxicity,
which can present as cough, dyspnea, and crackles due to interstitial pneumonitis or pulmonary fibrosis.
Portage Learning ACTUAL EXAM 2026/2027 |
Portage NURS 251 Module 6 | Verified Q&A |
Pass Guaranteed - A+ Graded
Section A: Multiple Choice (Questions 1–35)
Q1: A client with heart failure is prescribed digoxin 0.25 mg PO daily. Before administering the dose, the
nurse counts the apical pulse and notes a rate of 52 beats per minute. Which action should the nurse
take?
A. Administer the dose and document the pulse
B. Hold the dose and notify the provider [CORRECT]
C. Administer the dose with a beta-blocker to increase heart rate
D. Check the radial pulse for 30 seconds and administer if regular
Correct Answer: B
Rationale: Digoxin has a narrow therapeutic index and slows AV nodal conduction. An apical pulse
below 60 bpm in adults indicates bradycardia and potential toxicity; the nurse must hold the dose and
notify the provider. Re-checking with a shorter assessment or co-administering beta-blockers would
exacerbate bradycardia and increase the risk of dangerous dysrhythmias
.
Q2: A client receiving furosemide 40 mg IV twice daily for acute pulmonary edema reports muscle
weakness and palpitations. Which laboratory value should the nurse review first?
A. Serum sodium
B. Serum potassium [CORRECT]
C. Serum calcium
D. Blood glucose
Correct Answer: B
Rationale: Loop diuretics like furosemide inhibit the Na-K-2Cl cotransporter in the thick ascending limb
,of Henle, causing significant potassium wasting. Hypokalemia is the most dangerous electrolyte
imbalance from loop diuretics, manifesting as muscle weakness, palpitations, and cardiac dysrhythmias.
The nurse must prioritize potassium assessment to prevent life-threatening arrhythmias
.
Q3: A client with atrial fibrillation is prescribed warfarin 5 mg PO daily. The client asks which vegetable is
safest to include regularly. Which response by the nurse is most appropriate?
A. "Spinach is an excellent choice for iron content."
B. "Kale provides important antioxidants for heart health."
C. "Iceberg lettuce is acceptable in moderate, consistent amounts." [CORRECT]
D. "Broccoli should be eaten daily for fiber and vitamin K."
Correct Answer: C
Rationale: Warfarin antagonizes vitamin K-dependent clotting factors (II, VII, IX, X). Clients must
maintain consistent vitamin K intake rather than avoid it entirely. Iceberg lettuce contains minimal
vitamin K compared to dark leafy greens like spinach, kale, and broccoli, making it the safest choice for
maintaining stable INR levels without requiring significant dose adjustments
.
Q4: A client with deep vein thrombosis is receiving a heparin infusion at 1,200 units/hour. The nurse
notes the aPTT is 95 seconds (control 30–40 seconds). Which action should the nurse take?
A. Increase the infusion rate to achieve therapeutic anticoagulation
B. Continue the current rate and recheck in 4 hours
C. Stop the infusion for 1 hour, then restart at a reduced rate per protocol [CORRECT]
D. Administer protamine sulfate immediately
Correct Answer: C
Rationale: The therapeutic aPTT range for heparin is typically 1.5–2.5 times the control (45–100
seconds). A value of 95 seconds is at the upper limit of therapeutic range; per most protocols, the nurse
should hold the infusion briefly and restart at a reduced rate to prevent bleeding complications while
maintaining anticoagulation. Protamine is reserved for life-threatening hemorrhage
.
Q5: A client with hyperlipidemia is prescribed atorvastatin 40 mg PO daily. Which dietary instruction is
most important for the nurse to provide?
, A. "Take the medication with grapefruit juice to improve absorption."
B. "Avoid grapefruit juice and sour orange juice during therapy." [CORRECT]
C. "Increase your intake of vitamin K-rich foods."
D. "Take the medication on an empty stomach for best results."
Correct Answer: B
Rationale: Grapefruit contains furanocoumarins that irreversibly inhibit intestinal CYP3A4, the enzyme
that metabolizes atorvastatin. This inhibition increases statin blood levels 3–15 times normal,
dramatically increasing the risk of rhabdomyolysis, myopathy, and hepatotoxicity. The effect persists
until new enzymes are synthesized
.
Q6: A client with heart failure and reduced ejection fraction is prescribed lisinopril. Which laboratory
parameters should the nurse monitor before starting therapy and at follow-up?
A. Liver function tests and complete blood count
B. Serum potassium and serum creatinine [CORRECT]
C. Thyroid function tests and calcium levels
D. Magnesium and phosphate levels
Correct Answer: B
Rationale: ACE inhibitors block angiotensin II formation, reducing aldosterone and impairing potassium
excretion, which can cause hyperkalemia. They also dilate efferent arterioles in the kidney, potentially
reducing glomerular filtration rate and increasing creatinine. Baseline and periodic monitoring of
potassium and renal function is essential for safe ACE inhibitor therapy
.
Q7: A client with ventricular tachycardia is receiving amiodarone IV infusion. The nurse notes the client
has developed a dry cough and bilateral crackles. Which complication should the nurse suspect?
A. Digoxin toxicity
B. Amiodarone-induced pulmonary toxicity [CORRECT]
C. ACE inhibitor-induced angioedema
D. Beta-blocker bronchospasm
Correct Answer: B
Rationale: Amiodarone carries a black box warning for fatal toxicities including pulmonary toxicity,
which can present as cough, dyspnea, and crackles due to interstitial pneumonitis or pulmonary fibrosis.
