PNR 105/PNR105 Exam 4 V3 |
Pharmacology Q&A with Rationale | Fortis
College
1. A patient is prescribed Insulin Glargine for the management of type 1 diabetes mellitus.
Which statement by the nurse best describes the pharmacokinetic profile of this medication?
A. It has a peak effect occurring 4 to 12 hours after subcutaneous injection.
B. It should be administered 15 minutes before meals to cover postprandial glucose.
C. It is a long-acting insulin with no peak and a duration of 24 hours.
D. It can be safely mixed in the same syringe with Regular insulin.
Correct Answer: C
Expert Explanation: Insulin Glargine is classified as a long-acting insulin that provides a
steady basal rate of insulin over a 24-hour period. Unlike NPH or Regular insulin, it does
not have a distinct peak, which significantly reduces the risk of hypoglycemia. It must never
be mixed with other insulins in the same syringe as this can alter its pH and absorption
rate.
2. A nurse is preparing to administer Digoxin to a patient with heart failure. Which
assessment finding would require the nurse to withhold the medication and notify the
provider?
A. Blood pressure of 110/70 mmHg.
,B. Respiratory rate of 18 breaths per minute.
C. Apical pulse of 52 beats per minute.
D. Serum potassium level of 4.5 mEq/L.
Correct Answer: C
Expert Explanation: Before administering Digoxin, the nurse must assess the apical pulse
for one full minute to ensure it is within safe parameters. Generally, the medication is
withheld if the heart rate is less than 60 beats per minute in adults because Digoxin slows
the heart rate via its negative chronotropic effect. Failing to monitor the pulse increases the
risk of worsening bradycardia and digoxin toxicity.
3. A patient is starting therapy with Lisinopril for hypertension. Which adverse effect is most
characteristic of ACE inhibitors and should be reported to the provider?
A. Increased urinary frequency and urgency.
B. A persistent, dry, non-productive cough.
C. Yellow-green visual disturbances.
D. Peripheral edema and weight gain.
Correct Answer: B
Expert Explanation: ACE inhibitors like Lisinopril commonly cause a dry cough due to the
accumulation of bradykinin in the lungs. This side effect is often the reason patients are
switched to Angiotensin II Receptor Blockers (ARBs). If the cough becomes intolerable or if
,the patient develops angioedema, the medication must be discontinued immediately to
ensure safety.
4. A patient receiving Furosemide therapy for congestive heart failure is at risk for which
electrolyte imbalance?
A. Hyperkalemia
B. Hypercalcemia
C. Hypokalemia
D. Hyponatremia only
Correct Answer: C
Expert Explanation: Furosemide is a loop diuretic that inhibits the reabsorption of sodium
and chloride in the loop of Henle, leading to increased excretion of potassium. Hypokalemia
is a dangerous side effect that can lead to cardiac dysrhythmias and muscle weakness.
Nurses should monitor serum potassium levels and encourage the intake of potassium-rich
foods or supplements as prescribed.
5. Which medication is the antidote for a patient experiencing a heparin overdose with active
bleeding?
A. Vitamin K
B. Glucagon
C. Protamine Sulfate
, D. Acetylcysteine
Correct Answer: C
Expert Explanation: Protamine Sulfate is the specific pharmacological antagonist used to
reverse the anticoagulant effects of Heparin. It works by forming a stable salt with Heparin,
effectively neutralizing its ability to thin the blood. For patients on Warfarin, Vitamin K is
the appropriate reversal agent, not Protamine Sulfate.
6. A patient is prescribed Spironolactone. Which dietary instruction is most important for the
nurse to provide?
A. Avoid salt substitutes that contain potassium.
B. Increase intake of bananas and orange juice.
C. Maintain a diet high in calcium and dairy products.
D. Drink at least 3 liters of water per day.
Correct Answer: A
Expert Explanation: Spironolactone is a potassium-sparing diuretic that can lead to
hyperkalemia by retaining potassium in the kidneys. Salt substitutes often use potassium
chloride instead of sodium chloride, which significantly increases the risk of potassium
toxicity. Patients must be taught to avoid high-potassium foods and supplements to
prevent life-threatening cardiac complications.
Pharmacology Q&A with Rationale | Fortis
College
1. A patient is prescribed Insulin Glargine for the management of type 1 diabetes mellitus.
Which statement by the nurse best describes the pharmacokinetic profile of this medication?
A. It has a peak effect occurring 4 to 12 hours after subcutaneous injection.
B. It should be administered 15 minutes before meals to cover postprandial glucose.
C. It is a long-acting insulin with no peak and a duration of 24 hours.
D. It can be safely mixed in the same syringe with Regular insulin.
Correct Answer: C
Expert Explanation: Insulin Glargine is classified as a long-acting insulin that provides a
steady basal rate of insulin over a 24-hour period. Unlike NPH or Regular insulin, it does
not have a distinct peak, which significantly reduces the risk of hypoglycemia. It must never
be mixed with other insulins in the same syringe as this can alter its pH and absorption
rate.
2. A nurse is preparing to administer Digoxin to a patient with heart failure. Which
assessment finding would require the nurse to withhold the medication and notify the
provider?
A. Blood pressure of 110/70 mmHg.
,B. Respiratory rate of 18 breaths per minute.
C. Apical pulse of 52 beats per minute.
D. Serum potassium level of 4.5 mEq/L.
Correct Answer: C
Expert Explanation: Before administering Digoxin, the nurse must assess the apical pulse
for one full minute to ensure it is within safe parameters. Generally, the medication is
withheld if the heart rate is less than 60 beats per minute in adults because Digoxin slows
the heart rate via its negative chronotropic effect. Failing to monitor the pulse increases the
risk of worsening bradycardia and digoxin toxicity.
3. A patient is starting therapy with Lisinopril for hypertension. Which adverse effect is most
characteristic of ACE inhibitors and should be reported to the provider?
A. Increased urinary frequency and urgency.
B. A persistent, dry, non-productive cough.
C. Yellow-green visual disturbances.
D. Peripheral edema and weight gain.
Correct Answer: B
Expert Explanation: ACE inhibitors like Lisinopril commonly cause a dry cough due to the
accumulation of bradykinin in the lungs. This side effect is often the reason patients are
switched to Angiotensin II Receptor Blockers (ARBs). If the cough becomes intolerable or if
,the patient develops angioedema, the medication must be discontinued immediately to
ensure safety.
4. A patient receiving Furosemide therapy for congestive heart failure is at risk for which
electrolyte imbalance?
A. Hyperkalemia
B. Hypercalcemia
C. Hypokalemia
D. Hyponatremia only
Correct Answer: C
Expert Explanation: Furosemide is a loop diuretic that inhibits the reabsorption of sodium
and chloride in the loop of Henle, leading to increased excretion of potassium. Hypokalemia
is a dangerous side effect that can lead to cardiac dysrhythmias and muscle weakness.
Nurses should monitor serum potassium levels and encourage the intake of potassium-rich
foods or supplements as prescribed.
5. Which medication is the antidote for a patient experiencing a heparin overdose with active
bleeding?
A. Vitamin K
B. Glucagon
C. Protamine Sulfate
, D. Acetylcysteine
Correct Answer: C
Expert Explanation: Protamine Sulfate is the specific pharmacological antagonist used to
reverse the anticoagulant effects of Heparin. It works by forming a stable salt with Heparin,
effectively neutralizing its ability to thin the blood. For patients on Warfarin, Vitamin K is
the appropriate reversal agent, not Protamine Sulfate.
6. A patient is prescribed Spironolactone. Which dietary instruction is most important for the
nurse to provide?
A. Avoid salt substitutes that contain potassium.
B. Increase intake of bananas and orange juice.
C. Maintain a diet high in calcium and dairy products.
D. Drink at least 3 liters of water per day.
Correct Answer: A
Expert Explanation: Spironolactone is a potassium-sparing diuretic that can lead to
hyperkalemia by retaining potassium in the kidneys. Salt substitutes often use potassium
chloride instead of sodium chloride, which significantly increases the risk of potassium
toxicity. Patients must be taught to avoid high-potassium foods and supplements to
prevent life-threatening cardiac complications.
