PNR 105/PNR105 Exam 2 V1 |
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is reviewing the laboratory results for a patient receiving heparin by continuous IV
infusion. Which of the following laboratory values should the nurse report to the provider?
A. aPTT of 70 seconds
B. aPTT of 30 seconds
C. INR of 1.1
D. Platelets of 150,000/mm3
Correct Answer: B
Expert Explanation: The expected therapeutic range for aPTT while on heparin is 1.5 to 2
times the normal reference range, which is typically 60 to 80 seconds. An aPTT of 30
seconds is too low and indicates the patient is not adequately anticoagulated. The nurse
must adjust the infusion rate according to the hospital protocol to prevent clot formation.
2. A patient is prescribed lisinopril for hypertension. Which of the following adverse effects
should the nurse instruct the patient to report to the provider immediately?
A. Persistent dry cough
B. Swelling of the tongue or lips
C. Occasional dizziness when standing
,D. Increased urination
Correct Answer: B
Expert Explanation: Swelling of the tongue or lips is a sign of angioedema, a life-
threatening adverse effect of ACE inhibitors. This condition requires immediate medical
intervention to prevent airway obstruction. While a dry cough is common, it is not as
urgent as the risk of respiratory distress associated with angioedema.
3. A nurse is teaching a patient who has a new prescription for sublingual nitroglycerin. Which
of the following instructions should the nurse include?
A. Discard unused tablets after 12 months
B. Store the medication in a clear plastic bottle
C. Take a dose every 15 minutes for up to three doses
D. Stop activity and sit down if chest pain occurs
Correct Answer: D
Expert Explanation: When chest pain occurs, the patient should immediately stop activity
and sit down to reduce cardiac oxygen demand. One tablet should be placed under the
tongue and allowed to dissolve completely. If the pain is not relieved after the first dose,
the patient should call emergency services before taking subsequent doses.
4. A patient with heart failure is taking digoxin. Which of the following laboratory values
increases the risk of digoxin toxicity?
A. Magnesium 2.0 mEq/L
, B. Calcium 9.5 mg/dL
C. Sodium 140 mEq/L
D. Potassium 3.2 mEq/L
Correct Answer: D
Expert Explanation: Hypokalemia, defined as a potassium level below 3.5 mEq/L,
sensitizes the myocardium to digoxin and increases the risk of toxicity. The nurse should
monitor the patient for symptoms such as nausea, vomiting, and visual changes. It is
essential to ensure the patient is consuming enough potassium, especially if they are also
taking a loop diuretic.
5. A nurse is preparing to administer furosemide to a patient. Which of the following
assessments is the priority before giving the medication?
A. Check the patient’s weight
B. Assess the patient’s skin turgor
C. Check the patient’s blood pressure
D. Review the patient’s intake and output
Correct Answer: C
Expert Explanation: Furosemide is a potent loop diuretic that can cause a significant drop
in blood pressure due to rapid fluid loss. The nurse must assess the patient’s blood
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is reviewing the laboratory results for a patient receiving heparin by continuous IV
infusion. Which of the following laboratory values should the nurse report to the provider?
A. aPTT of 70 seconds
B. aPTT of 30 seconds
C. INR of 1.1
D. Platelets of 150,000/mm3
Correct Answer: B
Expert Explanation: The expected therapeutic range for aPTT while on heparin is 1.5 to 2
times the normal reference range, which is typically 60 to 80 seconds. An aPTT of 30
seconds is too low and indicates the patient is not adequately anticoagulated. The nurse
must adjust the infusion rate according to the hospital protocol to prevent clot formation.
2. A patient is prescribed lisinopril for hypertension. Which of the following adverse effects
should the nurse instruct the patient to report to the provider immediately?
A. Persistent dry cough
B. Swelling of the tongue or lips
C. Occasional dizziness when standing
,D. Increased urination
Correct Answer: B
Expert Explanation: Swelling of the tongue or lips is a sign of angioedema, a life-
threatening adverse effect of ACE inhibitors. This condition requires immediate medical
intervention to prevent airway obstruction. While a dry cough is common, it is not as
urgent as the risk of respiratory distress associated with angioedema.
3. A nurse is teaching a patient who has a new prescription for sublingual nitroglycerin. Which
of the following instructions should the nurse include?
A. Discard unused tablets after 12 months
B. Store the medication in a clear plastic bottle
C. Take a dose every 15 minutes for up to three doses
D. Stop activity and sit down if chest pain occurs
Correct Answer: D
Expert Explanation: When chest pain occurs, the patient should immediately stop activity
and sit down to reduce cardiac oxygen demand. One tablet should be placed under the
tongue and allowed to dissolve completely. If the pain is not relieved after the first dose,
the patient should call emergency services before taking subsequent doses.
4. A patient with heart failure is taking digoxin. Which of the following laboratory values
increases the risk of digoxin toxicity?
A. Magnesium 2.0 mEq/L
, B. Calcium 9.5 mg/dL
C. Sodium 140 mEq/L
D. Potassium 3.2 mEq/L
Correct Answer: D
Expert Explanation: Hypokalemia, defined as a potassium level below 3.5 mEq/L,
sensitizes the myocardium to digoxin and increases the risk of toxicity. The nurse should
monitor the patient for symptoms such as nausea, vomiting, and visual changes. It is
essential to ensure the patient is consuming enough potassium, especially if they are also
taking a loop diuretic.
5. A nurse is preparing to administer furosemide to a patient. Which of the following
assessments is the priority before giving the medication?
A. Check the patient’s weight
B. Assess the patient’s skin turgor
C. Check the patient’s blood pressure
D. Review the patient’s intake and output
Correct Answer: C
Expert Explanation: Furosemide is a potent loop diuretic that can cause a significant drop
in blood pressure due to rapid fluid loss. The nurse must assess the patient’s blood
