PNR 105/PNR105 Exam 2 V3 |
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is preparing to administer digoxin to a client with heart failure. Which assessment
finding would require the nurse to hold the medication and notify the provider?
A. Apical pulse of 52 beats per minute
B. Blood pressure of 110/70 mmHg
C. Respiratory rate of 18 breaths per minute
D. Potassium level of 4.2 mEq/L
Correct Answer: A
Expert Explanation: Digoxin is a cardiac glycoside that slows the heart rate and increases
the force of contraction. Before administration, the nurse must assess the apical pulse for
one full minute. If the heart rate is less than 60 beats per minute in an adult, the dose
should be withheld and the provider notified to prevent further bradycardia.
2. Which electrolyte imbalance significantly increases the risk of digoxin toxicity in a patient
also taking furosemide?
A. Hypokalemia
B. Hypercalcemia
C. Hypernatremia
,D. Hypomagnesemia
Correct Answer: A
Expert Explanation: Hypokalemia, or low serum potassium, sensitizes the myocardium to
digoxin, thereby increasing the risk of toxicity. Furosemide is a loop diuretic that causes
potassium loss through the urine. Monitoring potassium levels is a critical nursing
intervention for patients on this combination therapy to ensure cardiac safety.
3. A patient is prescribed Lisinopril for hypertension. Which common side effect should the
nurse educate the patient about?
A. Yellowing of the skin
B. Increased appetite
C. Persistent dry cough
D. Constipation
Correct Answer: C
Expert Explanation: ACE inhibitors like Lisinopril prevent the breakdown of bradykinin,
which can lead to a persistent, dry, nonproductive cough. This side effect is a frequent
reason for discontinuing the medication. Patients should be instructed to report this to
their provider as they may need to transition to an Angiotensin II Receptor Blocker (ARB).
4. What is the priority nursing assessment for a client receiving a new prescription for an ACE
inhibitor?
A. Blood glucose level
, B. Weight and height
C. Peripheral pulses
D. Blood pressure and pulse
Correct Answer: D
Expert Explanation: The first dose of an ACE inhibitor can cause significant hypotension,
known as the first-dose effect. The nurse must monitor the patient’s blood pressure and
pulse closely to ensure hemodynamic stability. Safety precautions, such as keeping the
patient in bed for a few hours after the first dose, are often implemented.
5. A nurse is teaching a patient about sublingual nitroglycerin. How should the patient be
instructed to store the medication?
A. In the original dark glass bottle
B. In a clear plastic container for visibility
C. In the refrigerator
D. In a daily pill organizer with other meds
Correct Answer: A
Expert Explanation: Nitroglycerin is chemically unstable and highly sensitive to light,
heat, and moisture. It must be kept in its original dark glass container with the cap tightly
closed to maintain its potency. Patients should be advised to replace the bottle every 6
months to ensure the medication remains effective for chest pain relief.
Pharmacology Q&A with Rationale | Fortis
College
1. A nurse is preparing to administer digoxin to a client with heart failure. Which assessment
finding would require the nurse to hold the medication and notify the provider?
A. Apical pulse of 52 beats per minute
B. Blood pressure of 110/70 mmHg
C. Respiratory rate of 18 breaths per minute
D. Potassium level of 4.2 mEq/L
Correct Answer: A
Expert Explanation: Digoxin is a cardiac glycoside that slows the heart rate and increases
the force of contraction. Before administration, the nurse must assess the apical pulse for
one full minute. If the heart rate is less than 60 beats per minute in an adult, the dose
should be withheld and the provider notified to prevent further bradycardia.
2. Which electrolyte imbalance significantly increases the risk of digoxin toxicity in a patient
also taking furosemide?
A. Hypokalemia
B. Hypercalcemia
C. Hypernatremia
,D. Hypomagnesemia
Correct Answer: A
Expert Explanation: Hypokalemia, or low serum potassium, sensitizes the myocardium to
digoxin, thereby increasing the risk of toxicity. Furosemide is a loop diuretic that causes
potassium loss through the urine. Monitoring potassium levels is a critical nursing
intervention for patients on this combination therapy to ensure cardiac safety.
3. A patient is prescribed Lisinopril for hypertension. Which common side effect should the
nurse educate the patient about?
A. Yellowing of the skin
B. Increased appetite
C. Persistent dry cough
D. Constipation
Correct Answer: C
Expert Explanation: ACE inhibitors like Lisinopril prevent the breakdown of bradykinin,
which can lead to a persistent, dry, nonproductive cough. This side effect is a frequent
reason for discontinuing the medication. Patients should be instructed to report this to
their provider as they may need to transition to an Angiotensin II Receptor Blocker (ARB).
4. What is the priority nursing assessment for a client receiving a new prescription for an ACE
inhibitor?
A. Blood glucose level
, B. Weight and height
C. Peripheral pulses
D. Blood pressure and pulse
Correct Answer: D
Expert Explanation: The first dose of an ACE inhibitor can cause significant hypotension,
known as the first-dose effect. The nurse must monitor the patient’s blood pressure and
pulse closely to ensure hemodynamic stability. Safety precautions, such as keeping the
patient in bed for a few hours after the first dose, are often implemented.
5. A nurse is teaching a patient about sublingual nitroglycerin. How should the patient be
instructed to store the medication?
A. In the original dark glass bottle
B. In a clear plastic container for visibility
C. In the refrigerator
D. In a daily pill organizer with other meds
Correct Answer: A
Expert Explanation: Nitroglycerin is chemically unstable and highly sensitive to light,
heat, and moisture. It must be kept in its original dark glass container with the cap tightly
closed to maintain its potency. Patients should be advised to replace the bottle every 6
months to ensure the medication remains effective for chest pain relief.
