Kaplan Pharmacology Integrated
EXAM LATEST 2026-2027 80
QUESTIONS AND ANSWERS
SECTION 1: CARDIOVASCULAR PHARMACOLOGY (Questions 1-20)
Q1. A nurse is administering intravenous morphine sulfate to a postoperative
patient. Which assessment finding requires immediate action?
A) Respiratory rate of 18 breaths/min
B) Pain rating of 3 on a 0–10 scale
C) Blood pressure 110/70 mm Hg
D) Respiratory rate of 8 breaths/min
Rationale: A respiratory rate of 8 breaths/min indicates respiratory depression, a
life-threatening opioid adverse effect. Naloxone may be needed to reverse this
effect. The other findings are within acceptable ranges.
Q2. A patient with heart failure is prescribed furosemide 40 mg orally twice
daily. Which laboratory value should the nurse monitor most closely?
A) Serum sodium of 138 mEq/L
B) Serum potassium of 3.1 mEq/L
C) Serum calcium of 9.2 mg/dL
D) Serum magnesium of 2.1 mg/dL
,Rationale: Furosemide is a loop diuretic that causes hypokalemia (potassium loss).
A potassium of 3.1 mEq/L is below the normal range (3.5-5.0 mEq/L) and
increases the risk for cardiac dysrhythmias, especially in patients taking digoxin.
Q3. A nurse is teaching a patient about digoxin therapy. Which statement
indicates understanding?
A) "I will take an extra dose if I miss one."
B) "I can stop taking digoxin if I feel better."
C) "I will check my pulse daily before taking the medication."
D) "I will take digoxin with antacids for stomach upset."
Rationale: Digoxin has a narrow therapeutic index. Bradycardia (pulse <60/min in
adults) requires holding the dose and notifying the provider. Extra dosing increases
toxicity risk. Antacids decrease digoxin absorption.
Q4. The male client asks the nurse, "Why am I experiencing erectile
dysfunction (ED)?" The nurse reviews the client's medications. Which
classification increases the risk for ED?
A) Non-steroidal anti-inflammatory drugs
B) Antihypertensive medications
C) Anticoagulant medications
D) Histamine H2 inhibitors
Rationale: Antihypertensive medications, particularly beta-blockers and thiazide
diuretics, are commonly associated with erectile dysfunction as a side effect.
,Q5. A patient receiving warfarin has an international normalized ratio (INR)
of 4.5. Which intervention is most important?
A) Hold the next dose and notify the healthcare provider
B) Administer the dose as prescribed
C) Decrease the dose to 2.5 mg
D) Repeat the INR in 4 hours
Rationale: A therapeutic INR for most indications is 2-3. An INR of 4.5 indicates
an increased risk of bleeding. The nurse should hold the dose and notify the
provider for further instructions.
Q6. A nurse is caring for a client receiving IV vancomycin. Which assessment
finding requires immediate intervention?
A) Mild flushing of the neck and face (Red Man Syndrome)
B) Tinnitus and complaints of hearing loss
C) Serum creatinine of 0.9 mg/dL
D) Infiltration of the IV site with swelling
Rationale: Tinnitus and hearing loss indicate ototoxicity, a serious adverse effect
of vancomycin that can be irreversible. Red Man Syndrome (flushing) is common
but usually managed by slowing the infusion rate.
, Q7. A client taking atorvastatin (Lipitor) reports muscle pain and weakness.
Which laboratory test should the nurse request?
A) Creatine kinase (CK)
B) Troponin
C) Complete blood count
D) Liver function tests
Rationale: Statin-induced myopathy can progress to rhabdomyolysis. CK levels
are elevated in muscle injury. Liver function tests are also monitored, but muscle
pain specifically indicates CK assessment.
Q8. A patient is receiving a continuous heparin infusion. Which laboratory
value indicates a therapeutic effect?
A) INR of 2.5
B) aPTT of 70 seconds (control 30 seconds)
C) Platelet count 250,000/mm³
D) PT of 12 seconds
Rationale: Heparin therapy is monitored by aPTT (activated partial
thromboplastin time). The therapeutic goal is 1.5-2.5 times the control value
(approximately 60-80 seconds when control is 30 seconds). INR monitors
warfarin.
Q9. A client is receiving amiodarone IV for ventricular tachycardia. The
nurse should monitor for which adverse effect?
EXAM LATEST 2026-2027 80
QUESTIONS AND ANSWERS
SECTION 1: CARDIOVASCULAR PHARMACOLOGY (Questions 1-20)
Q1. A nurse is administering intravenous morphine sulfate to a postoperative
patient. Which assessment finding requires immediate action?
A) Respiratory rate of 18 breaths/min
B) Pain rating of 3 on a 0–10 scale
C) Blood pressure 110/70 mm Hg
D) Respiratory rate of 8 breaths/min
Rationale: A respiratory rate of 8 breaths/min indicates respiratory depression, a
life-threatening opioid adverse effect. Naloxone may be needed to reverse this
effect. The other findings are within acceptable ranges.
Q2. A patient with heart failure is prescribed furosemide 40 mg orally twice
daily. Which laboratory value should the nurse monitor most closely?
A) Serum sodium of 138 mEq/L
B) Serum potassium of 3.1 mEq/L
C) Serum calcium of 9.2 mg/dL
D) Serum magnesium of 2.1 mg/dL
,Rationale: Furosemide is a loop diuretic that causes hypokalemia (potassium loss).
A potassium of 3.1 mEq/L is below the normal range (3.5-5.0 mEq/L) and
increases the risk for cardiac dysrhythmias, especially in patients taking digoxin.
Q3. A nurse is teaching a patient about digoxin therapy. Which statement
indicates understanding?
A) "I will take an extra dose if I miss one."
B) "I can stop taking digoxin if I feel better."
C) "I will check my pulse daily before taking the medication."
D) "I will take digoxin with antacids for stomach upset."
Rationale: Digoxin has a narrow therapeutic index. Bradycardia (pulse <60/min in
adults) requires holding the dose and notifying the provider. Extra dosing increases
toxicity risk. Antacids decrease digoxin absorption.
Q4. The male client asks the nurse, "Why am I experiencing erectile
dysfunction (ED)?" The nurse reviews the client's medications. Which
classification increases the risk for ED?
A) Non-steroidal anti-inflammatory drugs
B) Antihypertensive medications
C) Anticoagulant medications
D) Histamine H2 inhibitors
Rationale: Antihypertensive medications, particularly beta-blockers and thiazide
diuretics, are commonly associated with erectile dysfunction as a side effect.
,Q5. A patient receiving warfarin has an international normalized ratio (INR)
of 4.5. Which intervention is most important?
A) Hold the next dose and notify the healthcare provider
B) Administer the dose as prescribed
C) Decrease the dose to 2.5 mg
D) Repeat the INR in 4 hours
Rationale: A therapeutic INR for most indications is 2-3. An INR of 4.5 indicates
an increased risk of bleeding. The nurse should hold the dose and notify the
provider for further instructions.
Q6. A nurse is caring for a client receiving IV vancomycin. Which assessment
finding requires immediate intervention?
A) Mild flushing of the neck and face (Red Man Syndrome)
B) Tinnitus and complaints of hearing loss
C) Serum creatinine of 0.9 mg/dL
D) Infiltration of the IV site with swelling
Rationale: Tinnitus and hearing loss indicate ototoxicity, a serious adverse effect
of vancomycin that can be irreversible. Red Man Syndrome (flushing) is common
but usually managed by slowing the infusion rate.
, Q7. A client taking atorvastatin (Lipitor) reports muscle pain and weakness.
Which laboratory test should the nurse request?
A) Creatine kinase (CK)
B) Troponin
C) Complete blood count
D) Liver function tests
Rationale: Statin-induced myopathy can progress to rhabdomyolysis. CK levels
are elevated in muscle injury. Liver function tests are also monitored, but muscle
pain specifically indicates CK assessment.
Q8. A patient is receiving a continuous heparin infusion. Which laboratory
value indicates a therapeutic effect?
A) INR of 2.5
B) aPTT of 70 seconds (control 30 seconds)
C) Platelet count 250,000/mm³
D) PT of 12 seconds
Rationale: Heparin therapy is monitored by aPTT (activated partial
thromboplastin time). The therapeutic goal is 1.5-2.5 times the control value
(approximately 60-80 seconds when control is 30 seconds). INR monitors
warfarin.
Q9. A client is receiving amiodarone IV for ventricular tachycardia. The
nurse should monitor for which adverse effect?
