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# NSG-318: PHARMACOLOGY EXAM 2
# QUESTIONS AND VERIFIED ANSWERS | 100%
CORRECT | GRADE A
# GRAND CANYON UNIVERSITY (GCU) | COMPLETE
EXAM PREPARATION GUIDE 2026
## Table of Contents
| Section | Topic | Questions |
|---------|-------|-----------|
| 1 | Cardiovascular Medications | 20 |
| 2 | Respiratory Medications | 15 |
| 3 | Endocrine Medications | 20 |
| 4 | Neurological & Psychiatric Medications | 15 |
| 5 | Antibiotics & Anti-Infectives | 15 |
| 6 | Pain Management & Opioids | 10 |
| 7 | GI & Renal Medications | 10 |
| 8 | Anticoagulants & Antiplatelets | 10 |
| 9 | Comprehensive Mixed Review | 15 |
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# SECTION 1: CARDIOVASCULAR MEDICATIONS
## (Questions 1–20)
**1.** A client with heart failure is prescribed digoxin. Which assessment finding
indicates a therapeutic response to the medication?
A) Increased heart rate and decreased urine output
B) Decreased shortness of breath and decreased peripheral edema
C) Increased appetite and weight gain
D) Decreased blood pressure and increased heart rate
**Answer:** B) Decreased shortness of breath and decreased peripheral edema
**Rationale:** Digoxin increases myocardial contractility (positive inotropic
effect), improving cardiac output. This leads to reduced pulmonary congestion
(less dyspnea) and decreased peripheral edema as the heart pumps more
effectively. Options A, C, and D are inconsistent with therapeutic response and
may indicate adverse effects.
---
**2.** The nurse is administering digoxin to a client with an apical pulse of 52
beats per minute. Which action should the nurse take?
A) Administer the dose and document the finding
B) Administer the dose with food
,3|Page
C) Hold the dose and notify the healthcare provider
D) Administer half the dose and recheck the pulse in one hour
**Answer:** C) Hold the dose and notify the healthcare provider
**Rationale:** Digoxin should be withheld when the apical pulse is below 60
beats/min in adults. Administering the medication could worsen bradycardia and
precipitate serious arrhythmias. The provider must be notified for further direction.
---
**3.** A client with heart failure is prescribed digoxin and furosemide. Which
laboratory value places the client at greatest risk for digoxin toxicity?
A) Serum potassium 3.2 mEq/L
B) Serum sodium 140 mEq/L
C) Serum calcium 9.5 mg/dL
D) Serum magnesium 2.0 mEq/L
**Answer:** A) Serum potassium 3.2 mEq/L
**Rationale:** Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin
toxicity because digoxin binds to the same site on the Na+/K+ ATPase pump as
potassium. Low potassium increases digoxin binding, leading to toxicity even at
therapeutic digoxin levels. Furosemide is a loop diuretic that causes potassium
wasting.
, 4|Page
---
**4.** A client is prescribed furosemide (Lasix) IV push. To prevent ototoxicity,
what is the maximum recommended administration rate?
A) 10 mg/min
B) 20 mg/min
C) 40 mg/min
D) 60 mg/min
**Answer:** B) 20 mg/min
**Rationale:** Furosemide should be administered IV push no faster than 20
mg/min to reduce the risk of ototoxicity (irreversible hearing loss) and
hypotension. Rapid administration can also cause tinnitus and hearing loss.
---
**5.** A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which
laboratory value should the nurse monitor to determine therapeutic effect?
A) aPTT
B) INR
C) Platelet count
# NSG-318: PHARMACOLOGY EXAM 2
# QUESTIONS AND VERIFIED ANSWERS | 100%
CORRECT | GRADE A
# GRAND CANYON UNIVERSITY (GCU) | COMPLETE
EXAM PREPARATION GUIDE 2026
## Table of Contents
| Section | Topic | Questions |
|---------|-------|-----------|
| 1 | Cardiovascular Medications | 20 |
| 2 | Respiratory Medications | 15 |
| 3 | Endocrine Medications | 20 |
| 4 | Neurological & Psychiatric Medications | 15 |
| 5 | Antibiotics & Anti-Infectives | 15 |
| 6 | Pain Management & Opioids | 10 |
| 7 | GI & Renal Medications | 10 |
| 8 | Anticoagulants & Antiplatelets | 10 |
| 9 | Comprehensive Mixed Review | 15 |
,2|Page
# SECTION 1: CARDIOVASCULAR MEDICATIONS
## (Questions 1–20)
**1.** A client with heart failure is prescribed digoxin. Which assessment finding
indicates a therapeutic response to the medication?
A) Increased heart rate and decreased urine output
B) Decreased shortness of breath and decreased peripheral edema
C) Increased appetite and weight gain
D) Decreased blood pressure and increased heart rate
**Answer:** B) Decreased shortness of breath and decreased peripheral edema
**Rationale:** Digoxin increases myocardial contractility (positive inotropic
effect), improving cardiac output. This leads to reduced pulmonary congestion
(less dyspnea) and decreased peripheral edema as the heart pumps more
effectively. Options A, C, and D are inconsistent with therapeutic response and
may indicate adverse effects.
---
**2.** The nurse is administering digoxin to a client with an apical pulse of 52
beats per minute. Which action should the nurse take?
A) Administer the dose and document the finding
B) Administer the dose with food
,3|Page
C) Hold the dose and notify the healthcare provider
D) Administer half the dose and recheck the pulse in one hour
**Answer:** C) Hold the dose and notify the healthcare provider
**Rationale:** Digoxin should be withheld when the apical pulse is below 60
beats/min in adults. Administering the medication could worsen bradycardia and
precipitate serious arrhythmias. The provider must be notified for further direction.
---
**3.** A client with heart failure is prescribed digoxin and furosemide. Which
laboratory value places the client at greatest risk for digoxin toxicity?
A) Serum potassium 3.2 mEq/L
B) Serum sodium 140 mEq/L
C) Serum calcium 9.5 mg/dL
D) Serum magnesium 2.0 mEq/L
**Answer:** A) Serum potassium 3.2 mEq/L
**Rationale:** Hypokalemia (potassium <3.5 mEq/L) increases the risk of digoxin
toxicity because digoxin binds to the same site on the Na+/K+ ATPase pump as
potassium. Low potassium increases digoxin binding, leading to toxicity even at
therapeutic digoxin levels. Furosemide is a loop diuretic that causes potassium
wasting.
, 4|Page
---
**4.** A client is prescribed furosemide (Lasix) IV push. To prevent ototoxicity,
what is the maximum recommended administration rate?
A) 10 mg/min
B) 20 mg/min
C) 40 mg/min
D) 60 mg/min
**Answer:** B) 20 mg/min
**Rationale:** Furosemide should be administered IV push no faster than 20
mg/min to reduce the risk of ototoxicity (irreversible hearing loss) and
hypotension. Rapid administration can also cause tinnitus and hearing loss.
---
**5.** A client is prescribed warfarin (Coumadin) for atrial fibrillation. Which
laboratory value should the nurse monitor to determine therapeutic effect?
A) aPTT
B) INR
C) Platelet count
