BSN315 Exam 4 Actual Exam Style V3 |
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A patient diagnosed with bipolar disorder is prescribed Lithium Carbonate. Which
laboratory value should the nurse prioritize for monitoring to prevent lithium toxicity?
A. Serum sodium levels
B. Serum calcium levels
C. Liver enzymes (ALT/AST)
D. Hemoglobin A1c
Correct Answer: A
Expert Explanation: Lithium is a salt and has an inverse relationship with sodium in the
renal tubules. When sodium levels are low, the kidneys retain lithium to compensate,
leading to toxic levels in the blood. The nurse must monitor for hyponatremia and advise
the patient to maintain consistent salt intake.
2. A patient is receiving intravenous Heparin for a deep vein thrombosis (DVT). Which
laboratory result indicates that the medication is within the therapeutic range?
A. INR of 2.5
B. aPTT of 60 to 80 seconds
C. Platelet count of 150,000
,D. Prothrombin time (PT) of 12 seconds
Correct Answer: B
Expert Explanation: The activated partial thromboplastin time (aPTT) is the primary lab
used to monitor Heparin therapy. A therapeutic range is typically 1.5 to 2.5 times the
control value, which usually falls between 60 and 80 seconds. In contrast, INR is used for
Warfarin monitoring, and PT is not specific enough for Heparin titration.
3. A nurse is preparing to administer Digoxin to a patient with heart failure. Which clinical
finding would require the nurse to withhold the medication and notify the provider?
A. Blood pressure of 140/90 mmHg
B. Respiratory rate of 16 breaths/min
C. Apical heart rate of 52 beats/min
D. Serum potassium level of 4.5 mEq/L
Correct Answer: C
Expert Explanation: Digoxin is a cardiac glycoside that slows the heart rate while
increasing contractility. If the apical pulse is less than 60 beats per minute, the dose should
be held to prevent bradycardia. The nurse must also monitor for signs of digoxin toxicity,
such as visual disturbances or anorexia.
4. A patient is starting a course of Phenytoin for seizure control. What is a critical teaching
point regarding oral hygiene for this patient?
A. Floss vigorously to remove any plaque accumulation.
, B. Avoid using soft-bristled toothbrushes to prevent bleeding.
C. Perform frequent dental checkups and gum massages.
D. Use an alcohol-based mouthwash after every meal.
Correct Answer: C
Expert Explanation: Gingival hyperplasia is a common side effect of long-term Phenytoin
use. Regular dental care and soft gum massage can help reduce the severity of this
condition. Patients should be taught to report any gum swelling or bleeding to their
healthcare provider immediately.
5. A patient receiving chemotherapy is at risk for neutropenia. Which nursing intervention is
most appropriate for this patient during the nadir?
A. Implement strict handwashing and limit visitors.
B. Administer an antiemetic 30 minutes before meals.
C. Encourage the patient to eat fresh fruits and vegetables.
D. Advise the patient to use a straight razor for shaving.
Correct Answer: A
Expert Explanation: The nadir is the point at which blood cell counts are at their lowest
after chemotherapy, making the patient highly susceptible to infection. Neutropenic
precautions include strict hand hygiene, avoiding crowds, and eliminating fresh flowers or
BSN 315 HESI RN Specialty Pharmacology
Exam | Nightingale
1. A patient diagnosed with bipolar disorder is prescribed Lithium Carbonate. Which
laboratory value should the nurse prioritize for monitoring to prevent lithium toxicity?
A. Serum sodium levels
B. Serum calcium levels
C. Liver enzymes (ALT/AST)
D. Hemoglobin A1c
Correct Answer: A
Expert Explanation: Lithium is a salt and has an inverse relationship with sodium in the
renal tubules. When sodium levels are low, the kidneys retain lithium to compensate,
leading to toxic levels in the blood. The nurse must monitor for hyponatremia and advise
the patient to maintain consistent salt intake.
2. A patient is receiving intravenous Heparin for a deep vein thrombosis (DVT). Which
laboratory result indicates that the medication is within the therapeutic range?
A. INR of 2.5
B. aPTT of 60 to 80 seconds
C. Platelet count of 150,000
,D. Prothrombin time (PT) of 12 seconds
Correct Answer: B
Expert Explanation: The activated partial thromboplastin time (aPTT) is the primary lab
used to monitor Heparin therapy. A therapeutic range is typically 1.5 to 2.5 times the
control value, which usually falls between 60 and 80 seconds. In contrast, INR is used for
Warfarin monitoring, and PT is not specific enough for Heparin titration.
3. A nurse is preparing to administer Digoxin to a patient with heart failure. Which clinical
finding would require the nurse to withhold the medication and notify the provider?
A. Blood pressure of 140/90 mmHg
B. Respiratory rate of 16 breaths/min
C. Apical heart rate of 52 beats/min
D. Serum potassium level of 4.5 mEq/L
Correct Answer: C
Expert Explanation: Digoxin is a cardiac glycoside that slows the heart rate while
increasing contractility. If the apical pulse is less than 60 beats per minute, the dose should
be held to prevent bradycardia. The nurse must also monitor for signs of digoxin toxicity,
such as visual disturbances or anorexia.
4. A patient is starting a course of Phenytoin for seizure control. What is a critical teaching
point regarding oral hygiene for this patient?
A. Floss vigorously to remove any plaque accumulation.
, B. Avoid using soft-bristled toothbrushes to prevent bleeding.
C. Perform frequent dental checkups and gum massages.
D. Use an alcohol-based mouthwash after every meal.
Correct Answer: C
Expert Explanation: Gingival hyperplasia is a common side effect of long-term Phenytoin
use. Regular dental care and soft gum massage can help reduce the severity of this
condition. Patients should be taught to report any gum swelling or bleeding to their
healthcare provider immediately.
5. A patient receiving chemotherapy is at risk for neutropenia. Which nursing intervention is
most appropriate for this patient during the nadir?
A. Implement strict handwashing and limit visitors.
B. Administer an antiemetic 30 minutes before meals.
C. Encourage the patient to eat fresh fruits and vegetables.
D. Advise the patient to use a straight razor for shaving.
Correct Answer: A
Expert Explanation: The nadir is the point at which blood cell counts are at their lowest
after chemotherapy, making the patient highly susceptible to infection. Neutropenic
precautions include strict hand hygiene, avoiding crowds, and eliminating fresh flowers or
