NURS 180 Pharmacology Comprehensive Week 14 Quiz 2026 |WCU
1. A patient is receiving Lithium carbonate for bipolar disorder. The laboratory
reports a serum lithium level of 1.8 mEq/L. Which clinical manifestation should
the nurse prioritize?
A. Mild thirst and polyuria
B. Fine hand tremors and nausea
C. Weight gain and acne
D. Confusion, ataxia, and coarse tremors
Answer: D
Rationale: A lithium level of 1.8 mEq/L indicates moderate toxicity. Symptoms include
blurred vision, ataxia, persistent gastrointestinal upset, and mental confusion. Mild tremors
and thirst are common at therapeutic levels (0.6-1.2 mEq/L).
2. A patient is prescribed both Digoxin and Furosemide. Which electrolyte
imbalance should the nurse monitor most closely to prevent Digoxin toxicity?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hypomagnesemia
Answer: A
Rationale: Furosemide is a loop diuretic that can cause potassium depletion. Low
potassium levels (hypokalemia) significantly increase the sensitivity of the myocardium to
digoxin, leading to toxicity even with therapeutic digoxin levels.
,3. While administering intravenous Vancomycin, the patient develops flushing
of the face, neck, and upper torso. What is the nurse’s immediate priority
action?
A. Slow the infusion rate to be administered over at least 60 to 90 minutes
B. Stop the infusion and notify the provider of an anaphylactic reaction
C. Administer subcutaneous epinephrine
D. Discontinue the medication and document an allergy to Vancomycin
Answer: A
Rationale: This reaction is known as ‘Red Man Syndrome,’ which is a rate-related infusion
reaction, not a true allergy. Slowing the infusion rate typically resolves the symptoms.
4. A patient on Warfarin therapy has an International Normalized Ratio (INR) of
5.0. The patient reports no active bleeding. Which medication does the nurse
anticipate administering?
A. Protamine sulfate
B. Enoxaparin
C. Vitamin K
D. Activated charcoal
Answer: C
Rationale: Vitamin K is the specific antidote for Warfarin-induced coagulopathy. An INR of
5.0 is above the typical therapeutic range (2.0-3.0) and requires reversal or dose
adjustment.
, 5. A patient taking Phenelzine (an MAOI) is admitted with a blood pressure of
210/110 mmHg. Which dietary item most likely contributed to this hypertensive
crisis?
A. Smoked salami and aged cheddar cheese
B. Cottage cheese and fresh fruit
C. Boiled eggs and toast
D. Grilled chicken and steamed broccoli
Answer: A
Rationale: MAOIs interact with tyramine-rich foods (aged cheeses, cured meats, fermented
products) to cause a massive release of norepinephrine, leading to a hypertensive crisis.
6. A patient newly prescribed Lisinopril develops a dry, non-productive cough.
What is the physiological mechanism behind this adverse effect?
A. Bronchoconstriction caused by beta-blockade
B. Accumulation of bradykinin in the lungs
C. Alveolar fluid overload
D. Inhibition of surfactant production
Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin and substance P, leading
to their accumulation in the respiratory tract, which triggers a persistent dry cough.
7. A nurse is providing discharge teaching for a patient prescribed Phenytoin for
a seizure disorder. Which instruction is critical for long-term therapy?
A. Expect the urine to turn dark orange
B. Maintain strict oral hygiene and see a dentist regularly
C. Stop the medication immediately if a rash occurs
D. Take the medication with an antacid to prevent GI upset
Answer: B
1. A patient is receiving Lithium carbonate for bipolar disorder. The laboratory
reports a serum lithium level of 1.8 mEq/L. Which clinical manifestation should
the nurse prioritize?
A. Mild thirst and polyuria
B. Fine hand tremors and nausea
C. Weight gain and acne
D. Confusion, ataxia, and coarse tremors
Answer: D
Rationale: A lithium level of 1.8 mEq/L indicates moderate toxicity. Symptoms include
blurred vision, ataxia, persistent gastrointestinal upset, and mental confusion. Mild tremors
and thirst are common at therapeutic levels (0.6-1.2 mEq/L).
2. A patient is prescribed both Digoxin and Furosemide. Which electrolyte
imbalance should the nurse monitor most closely to prevent Digoxin toxicity?
A. Hypokalemia
B. Hypernatremia
C. Hypercalcemia
D. Hypomagnesemia
Answer: A
Rationale: Furosemide is a loop diuretic that can cause potassium depletion. Low
potassium levels (hypokalemia) significantly increase the sensitivity of the myocardium to
digoxin, leading to toxicity even with therapeutic digoxin levels.
,3. While administering intravenous Vancomycin, the patient develops flushing
of the face, neck, and upper torso. What is the nurse’s immediate priority
action?
A. Slow the infusion rate to be administered over at least 60 to 90 minutes
B. Stop the infusion and notify the provider of an anaphylactic reaction
C. Administer subcutaneous epinephrine
D. Discontinue the medication and document an allergy to Vancomycin
Answer: A
Rationale: This reaction is known as ‘Red Man Syndrome,’ which is a rate-related infusion
reaction, not a true allergy. Slowing the infusion rate typically resolves the symptoms.
4. A patient on Warfarin therapy has an International Normalized Ratio (INR) of
5.0. The patient reports no active bleeding. Which medication does the nurse
anticipate administering?
A. Protamine sulfate
B. Enoxaparin
C. Vitamin K
D. Activated charcoal
Answer: C
Rationale: Vitamin K is the specific antidote for Warfarin-induced coagulopathy. An INR of
5.0 is above the typical therapeutic range (2.0-3.0) and requires reversal or dose
adjustment.
, 5. A patient taking Phenelzine (an MAOI) is admitted with a blood pressure of
210/110 mmHg. Which dietary item most likely contributed to this hypertensive
crisis?
A. Smoked salami and aged cheddar cheese
B. Cottage cheese and fresh fruit
C. Boiled eggs and toast
D. Grilled chicken and steamed broccoli
Answer: A
Rationale: MAOIs interact with tyramine-rich foods (aged cheeses, cured meats, fermented
products) to cause a massive release of norepinephrine, leading to a hypertensive crisis.
6. A patient newly prescribed Lisinopril develops a dry, non-productive cough.
What is the physiological mechanism behind this adverse effect?
A. Bronchoconstriction caused by beta-blockade
B. Accumulation of bradykinin in the lungs
C. Alveolar fluid overload
D. Inhibition of surfactant production
Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin and substance P, leading
to their accumulation in the respiratory tract, which triggers a persistent dry cough.
7. A nurse is providing discharge teaching for a patient prescribed Phenytoin for
a seizure disorder. Which instruction is critical for long-term therapy?
A. Expect the urine to turn dark orange
B. Maintain strict oral hygiene and see a dentist regularly
C. Stop the medication immediately if a rash occurs
D. Take the medication with an antacid to prevent GI upset
Answer: B
