WGU D116 ADVANCED PHARMACOLOGY OBJECTIVE ASSESSMENT ACTUAL EXAM 2025/2026 VERIFIED QUESTIONS WITH CORRECT DETAILED SOLUTIONS || 100% GUARANTEED PASS BRAND NEW VERSION

A patient with hypertension is taking furosemide for congestive heart failure. The prescriber orders digoxin to help increase cardiac output. What other medication should be ordered for this patient? - Answer️Spironolactone (Potassium-sparing) Spironolactone is used in conjunction with furosemide because of being potassium sparing. Hydrochlorothiazide, bumetanide, chlorothiazide all (potassium-wasting) A patient begins taking nifedipine, along with metoprolol, to treat hypertension. The metoprolol is used to __________. - Answer️Prevent reflex tachycardia Beta-blockers do not reduce flushing, minimize gingival hyperplasia, or prevent constipation Beta-blockers reduce adverse cardiac effects of nifedipine Explain what verapamil does? - Answer️Used to treat both vasospastic angina and angina of effort Slows ventricular rate in patients with a flutter, a fib, and paroxysmal supraventricular tachycardia First-line drug for the tx of essential htn A nurse is caring for a patient who is receiving verapamil for hypertension and digoxin for heart failure. What should the provider ask the nurse to observe this patient for? - Answer️AV Blockade Verapamil and digoxin both suppress impulse conduction through the AV node; when used together the risk of AV blockade is increased Verapamil and digoxin both suppress heart rate Nifedipine causes reflex tachycardia A patient is admitted with severe hypertensive crisis. Which medication should the provider order? - Answer️Sodium nitroprusside IV Drug of choice for hypertensive emergencies and is given IV. A patient asks the provider how nitroglycerin works to relieve anginal pain. Which statement is a correct response from the provider? - Answer️"Nitroglycerin promotes vasodilation, which reduces preload and oxygen demand" Dilates the veins, which reduces venous return to the heart, which in turn decreases ventricular filling A patient with angina who is taking ranolazine has developed a respiratory infection and a dysrhythmia. The provider has ordered azithromycin for the infection and amlodipine for the dysrhythmia. A nursing student caring for this patient tells the nurse that the patient's heart rate is 70 beats per minute and the blood pressure is 128/80 mm Hg. The nurse asks the student to discuss the plan for this patient's care. Which action is correct? - Answer️Question the order for azithromycin Azithromycin is CYP3A4 inhibitor which will decrease metabolism and enhance effects of ranolazine-puts pt at risk for torsades A patient with volume overload begins taking a thiazide diuretic. The provider tells the patient to expect which outcome when taking this drug? - Answer️Improved exercise tolerance Diuretics help reduce fluid volume overload, which can improve exercise tolerance by reducing pulmonary edema A nurse is discussing heart failure with a group of nursing students. Which statement by a student reflects an understanding of how compensatory mechanisms can compound existing problems in patients with heart failure? - Answer️"When the heart rate increases to increase cardiac output, it can prevent adequate filling of the ventricles" Increase in arteriole tone improves tissue perfusion but also increases both the resistance to the pumping of the heart and the cardiac workload Increased contractility helps improve cardiac output but is detrimental because it increases the oxygen demand of the heart Increase in venous tone improves ventricular filling, but as the ventricles fail, blood can back up and cause pulmonary edema A patient newly diagnosed with heart failure is admitted to the hospital. The nurse notes a pulse of 90 beats per minute. What should the nurse observe closely in this patient? - Answer️Decreased urine output as heart rate increases, ventricular filling decreases, and cardiac output and renal perfusion decrease A patient with diabetes develops ventricular tachycardia and is in the hospital for evaluation of this condition. The nurse reviews the history and learns that the patient takes mexiletine for pain caused by peripheral neuropathy. What should the nurse do? - Answer️Notify the provider to request that another drug be used for peripheral neuropathy pain mexiletine is an antidysrhythmic medication that can also cause dysrhythmias A nurse is teaching a group of nursing students about antidysrhythmic medications. Which statement by a student indicates understanding of the teaching? - Answer️Antidysrhythmic drugs can cause new dysrhythmias or worsen existing ones Most adverse effects are cardiac related Increased mortality with these drugs A patient will be taking amiodarone. Which baseline tests are necessary before this medication is started? (Select three.) - Answer️Chest radiograph and pulmonary function tests Ophthalmologic examination Thyroid function tests Amiodarone has many potential side effects which are pulmonary toxicity, ophthalmic effects, and thyroid toxicity A nurse is providing patient education about colesevelam, a bile acid sequestrant. Which statement made by the patient demonstrates a need for further teaching? - Answer️"I will need to take supplements of fat-soluble vitamins" Colesevelam does not reduce absorption of fat-soluble vitamins as do other bile avid sequestrants, no need for supplements Colesevelam reduces the LDL cholesterol level A patient taking gemfibrozil and rosuvastatin concurrently begins to complain of muscle aches, fatigue, and weakness. What should the nurse monitor? - Answer️The patient's creatine kinase levels Creatine kinase levels are the best laboratory indicator of myopathy and rhabdomyloysis, which may lead to renal failure A patient has begun taking an HMG-COA reductase inhibitor (statin). Which statement about this class of drugs made by the nurse during patient education would be inappropriate? - Answer️"You should come into the clinic for liver enzymes in one month" Baseline liver enzyme tests should be done before starting on a statin. Should be measured again 6-12 months unless pt has poor liver function A nurse has just received an order for tenecteplase for a patient experiencing an acute myocardial infarction. The nurse should administer this drug __________. - Answer️By bolus injection tPA must be infused over 90 mins A nursing student who is preparing to care for a postoperative patient with deep vein thrombosis asks the nurse why the patient must take heparin rather than warfarin. Which response by the nurse is correct? - Answer️"The onset of warfarin is delayed" Warfarin is not useful for treating existing thromboses or for emergencies because the onset of action is delayed. Heparin has a shorter half-life and has more side effects Warfarin does not prevent platelet aggregation A patient is brought to the emergency department after accidentally taking too much warfarin. The patient's heart rate is 78 beats per minute and the blood pressure is 120/80 mm Hg. A dipstick urinalysis is normal. The patient does not have any obvious hematoma or petechiae and does not complain of pain. What should the provider place an order for? - Answer️A prothrombin time and international normalized ratio PT and INR Those should be drawn to evaluate the anticoagulant effects Protamine sulfate is given for heparin overdose Vitamin K for warfarin overdose A child is receiving a combination albuterol/ipratropium inhalation treatment. The patient complains of a dry mouth and sore throat. What should the nurse do? - Answer️Reassure the pt that these are expected side effects A patient with asthma will be using a metered-dose inhaler (MDI) for delivery of an inhaled medication. The provider has ordered two puffs to be given twice daily. It is important for the nurse to teach this patient to __________. - Answer️Wait one minute between puffs Which medication should be used for asthma patients as part of step 1 management? - Answer️Short-acting beta2 agonists (SABAs) Pts needing step 1 management have intermittent mild symptoms and can be managed with a SABA as needed. Inhaled low-dose glucocorticoids are used for step 2 management Combination inhaled glucocorticoids and long-acting beta-agonist (LABAs) are used for step 3. A patient with severe chronic obstructive pulmonary disease (COPD) uses an inhaled LABA/glucocorticoid but continues to have frequent exacerbation of symptoms. The nurse should contact the provider to discuss __________. - Answer️Adding roflumilast once daily For patients with chronic COPD, risk of exacerbations may be reduced with roflumilast A patient has just received a prescription for fluticasone/salmeterol. What should the nurse include as part of the teaching for this patient about the use of this device? - Answer️"You do not need good hang-lung coordination to use this device" Talking about advair it is a dry powder and is activated by inhalation No need for a spacer Use this medication: one inhalation twice daily morning and night A patient with stable COPD is prescribed a bronchodilator medication. Which type of bronchodilator is preferred for this patient? - Answer️Long-acting inhaled beta2 agonist pt is looking to control the chronic aspect of their asthma. What is the appropriate drug to give? - Answer️Corticosteroid Tx for chronic inflammation of asthma Slow-onset S/E related to suppressed immune system Pt is experiencing an acute asthma attack while in the hospital. What is the best medication to administer? - Answer️Beta2 adrenergic agonist Ideal for emergency/acute asthma attacks Quick onset Don't tend to have much effect on digestive system A pt was administered an asthmatic drug. The effects on the body system are bronchioles are dilated with good airflow and there is a decrease in peristalsis: bowel sounds are hypoactive, and the pt complains of dry mouth. What drug was given? - Answer️Anticholinergic drug They Dilate the bronchioles, suppress digestive function, results in s/e of dry mouth A patient who uses an inhaled glucocorticoid for chronic asthma calls the nurse to report hoarseness. What should the nurse do? - Answer️Ask whether the patient is rinsing the mouth after each dose Most common side effects of inhaled glucocorticoids are oropharyngeal candidiasis and dysphonia (hoarseness). To minimize those effects pts should be educated to gargle after each administration. Antifungal meds are used after a fungal infection has been dx. Hoarseness is not a sign of a bronchial infection What is ipratropium bromide? - Answer️An anticholinergic used for allergic rhinitis and colds, and asthma Reduces rhinorrhea A patient who has a viral upper respiratory infection reports having a runny nose and a cough that prevents sleep and asks the nurse to recommend an over-the-counter medication. Which medication should the provider recommend? - Answer️Diphenhydramine (Benadryl) Effective in suppressing cough and has sedative effects when used in doses to suppress cough A parent asks the provider about giving diphenhydramine to a child to relieve cold symptoms. Which response by the provider is correct? - Answer️"Because histamine does not cause cold symptoms, benadryl would not be effective" Histamine does not contribute to symptoms of infectious rhinitis; histamines are of no use in treating cold symptoms A patient who has seasonal allergies in the spring and fall asks the provider about oral antihistamines. Which response by the provider is correct? - Answer️"You should take oral antihistamines daily during each allergy season to get maximum effects" Antihistamines are most effective when they are taken prophylactically Should be administered on a regular basis throughout the allergy season, even when s/s are not present Less helpful when taken after symptoms appear 2nd-generation antihistamines have fewer anticholinergic effects A nurse is preparing to give an antibiotic to a patient who reports being allergic to antibiotics. Before giving the medication, what should the nurse do? - Answer️Ask whether the patient has taken this abx for other infections A patient is taking a drug that has known toxic side effects. Which action should the nurse take? - Answer️Monitor the function of all organs potentially affected by the drug A patient is taking sertraline for depression, and the provider orders azithromycin to treat an infection. Which action should the nurse take? - Answer️Contact the provider to discuss an alternative to azithromycin Sertraline and azitrho prolong the QT interval and taken together can cause dysrhythmias The U.S. Food and Drug Administration (FDA) recommends genetic testing of patients receiving certain medications. What does genetic testing help providers with? - Answer️Determining whether a patient is a rapid or slow metabolizer of the drug A provider is teaching a group of women about medications. The women want to know why so many drugs have unpredictable effects in women. What should the provider communicate to the women? - Answer️Most known drug effects are based on drug trials in men Which items should be avoided if a pt is taking warfarin sodium after experiencing a MI? - Answer️Prunes Spinach Kale Green tea Anything high in vitamin k When injecting heparin, which of the following are correct practices to minimize adverse effects of this drug? - Answer️Heparin is only given via the parenteral route With injection, aspiration should not be performed The aPTT is a lab test that measure how well the drug is working A peds pt dx with Kawasaki's disease requires antiplatelet therapy. Which one of the following meds is appropriate for this patient? - Answer️Aspirin-antiplatelet medication What is coumadin? - Answer️A vitamin K antagonist What is alteplase? - Answer️Thrombolytic What is enoxaparin? - Answer️Low-molecular weight heparin What is edoxaban? - Answer️factor Xa inhibitor The INR results for a pt receiving warfarin sodium are 5.0. The provider adjusts the dose in attempt to decrease the INR. When should the provider expect the INR to decrease following the change in dose? - Answer️48 hours Onset of action: 2-7 days A pt is taking xarelto following a dx of PE arrives to the ED following a MVA with suspected TBI. To avoid internal hemorrhage, which of the following would reverse the effects of xarelto? - Answer️Andexxa approved by FDA in 2018 Which of the following drugs may cause hypokalemia? - Answer️Hydrochlorothiazide Torsemide ACE inhibitors results in which of the following outcomes? - Answer️Vasodilation ADH inhibited Increased urination After starting a new drug for HR, the pt develops a harsh, dry cough. Which drug causes this reaction? - Answer️Ace inhibitors Ie: Lisinopril ,"pril" affects bradykinin One of the first s/s of digoxin toxicity is? - Answer️Anorexia is one of the first Others are... bradycardia, visual disturbances, chest palpitations Which medication may hide symptoms of hypoglycemia in a patient with type 1 DM? - Answer️Beta blockers Which s/s would change the bronchitis from uncomplicated to complicated and, therefore, require antibiotics? - Answer️Green purulent sputum: indicative of bacterial infection and needs to be treated a 12 year old pt who has been successfully controlling his asthma with a rescue inhaler now c/o awakening with coughing and SOB at night. Which med might you add to his treatment plan? - Answer️Qvar (beclomethasone) Inhaled corticosteroid low-dose For pts with COPD, long-acting bronchodilators are recommended as? - Answer️Regular maintenance therapy for pts with moderate to severe COPD LABAS decrease s/s, improve lung hyperinflation, increase physical activity, reduce exacerbations A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. Which drug should the provider administer for this patient? - Answer️Furosemide (Lasix) Furosemide, a potent diuretic, is used when rapid or massive mobilization of fluids is needed. Pt shows severe signs of CHF and respiratory distress and pulmonary edema and needs immediate mobilization of fluids. Hydrochlorothiazide and spironolactone are not indicated for pulmonary edema because their diuretic effects are less rapid A patient with a recent onset of nephrosclerosis has been taking an ACE inhibitor and a thiazide diuretic. The patient's initial blood pressure was 148/100 mm Hg. After one month of drug therapy, the patient's blood pressure is 130/90 mm Hg. What should the nurse discuss with the provider? - Answer️Adding a CCB to this patient's drug regimen