PNR 105/PNR105 Exam 3 V1 |
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following actions should the nurse take before administration?
A. Measure the client’s blood pressure in both arms.
B. Auscultate the apical pulse for one full minute.
C. Encourage the client to increase their intake of high-potassium foods.
D. Administer the medication with an antacid to prevent gastric upset.
Correct Answer: B
Expert Explanation: The nurse must auscultate the apical pulse for a full 60 seconds prior
to administering digoxin to ensure the heart rate is at a safe level. If the apical pulse is less
than 60 beats per minute, the medication should be withheld and the provider notified.
This safety measure prevents the exacerbation of digoxin-induced bradycardia and toxicity.
2. A client is prescribed lisinopril for hypertension. The nurse should monitor the client for
which of the following common adverse effects?
A. Dry, persistent cough
B. Peripheral edema in the lower extremities
C. Hyperglycemia and increased thirst
,D. Yellow-tinged vision
Correct Answer: A
Expert Explanation: Lisinopril is an ACE inhibitor that commonly causes a dry,
nonproductive cough due to the accumulation of bradykinin in the lungs. This side effect is
often a reason for patients to switch to an Angiotensin II Receptor Blocker (ARB). It is
important for the nurse to document this symptom and explain that it is a known reaction
to the medication class.
3. A nurse is teaching a client about a new prescription for nitroglycerin sublingual tablets for
stable angina. Which instruction should be included?
A. Swallow the tablet with a full glass of water.
B. Place the tablet under the tongue and let it dissolve completely.
C. Store the tablets in a clear plastic container for easy viewing.
D. Take one tablet every 15 minutes until the chest pain subsides.
Correct Answer: B
Expert Explanation: Sublingual nitroglycerin must be placed under the tongue to allow for
rapid absorption through the oral mucosa and into the systemic circulation. Patients should
be taught not to swallow or chew the tablet as this significantly reduces the drug’s
effectiveness. The medication should also be kept in its original dark glass bottle to protect
it from light and moisture.
, 4. A client with a history of deep vein thrombosis is receiving a heparin infusion. Which
laboratory value is used to monitor the effectiveness of heparin?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Activated partial thromboplastin time (aPTT)
Correct Answer: D
Expert Explanation: The activated partial thromboplastin time (aPTT) is the standard
laboratory test used to monitor the therapeutic level of heparin and adjust the infusion
rate. A therapeutic aPTT is typically 1.5 to 2.5 times the normal control value. Nurses must
monitor this value closely to ensure the client is adequately anticoagulated without being
at excessive risk for hemorrhage.
5. A nurse is providing discharge teaching for a client prescribed warfarin. Which of the
following foods should the nurse instruct the client to consume in consistent amounts?
A. Red meats and poultry
B. Citrus fruits and juices
C. Green leafy vegetables like spinach
D. Whole grain breads and cereals
Correct Answer: C
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following actions should the nurse take before administration?
A. Measure the client’s blood pressure in both arms.
B. Auscultate the apical pulse for one full minute.
C. Encourage the client to increase their intake of high-potassium foods.
D. Administer the medication with an antacid to prevent gastric upset.
Correct Answer: B
Expert Explanation: The nurse must auscultate the apical pulse for a full 60 seconds prior
to administering digoxin to ensure the heart rate is at a safe level. If the apical pulse is less
than 60 beats per minute, the medication should be withheld and the provider notified.
This safety measure prevents the exacerbation of digoxin-induced bradycardia and toxicity.
2. A client is prescribed lisinopril for hypertension. The nurse should monitor the client for
which of the following common adverse effects?
A. Dry, persistent cough
B. Peripheral edema in the lower extremities
C. Hyperglycemia and increased thirst
,D. Yellow-tinged vision
Correct Answer: A
Expert Explanation: Lisinopril is an ACE inhibitor that commonly causes a dry,
nonproductive cough due to the accumulation of bradykinin in the lungs. This side effect is
often a reason for patients to switch to an Angiotensin II Receptor Blocker (ARB). It is
important for the nurse to document this symptom and explain that it is a known reaction
to the medication class.
3. A nurse is teaching a client about a new prescription for nitroglycerin sublingual tablets for
stable angina. Which instruction should be included?
A. Swallow the tablet with a full glass of water.
B. Place the tablet under the tongue and let it dissolve completely.
C. Store the tablets in a clear plastic container for easy viewing.
D. Take one tablet every 15 minutes until the chest pain subsides.
Correct Answer: B
Expert Explanation: Sublingual nitroglycerin must be placed under the tongue to allow for
rapid absorption through the oral mucosa and into the systemic circulation. Patients should
be taught not to swallow or chew the tablet as this significantly reduces the drug’s
effectiveness. The medication should also be kept in its original dark glass bottle to protect
it from light and moisture.
, 4. A client with a history of deep vein thrombosis is receiving a heparin infusion. Which
laboratory value is used to monitor the effectiveness of heparin?
A. Prothrombin time (PT)
B. International Normalized Ratio (INR)
C. Platelet count
D. Activated partial thromboplastin time (aPTT)
Correct Answer: D
Expert Explanation: The activated partial thromboplastin time (aPTT) is the standard
laboratory test used to monitor the therapeutic level of heparin and adjust the infusion
rate. A therapeutic aPTT is typically 1.5 to 2.5 times the normal control value. Nurses must
monitor this value closely to ensure the client is adequately anticoagulated without being
at excessive risk for hemorrhage.
5. A nurse is providing discharge teaching for a client prescribed warfarin. Which of the
following foods should the nurse instruct the client to consume in consistent amounts?
A. Red meats and poultry
B. Citrus fruits and juices
C. Green leafy vegetables like spinach
D. Whole grain breads and cereals
Correct Answer: C
