NU 150 Final Exam – Pharmacology –
(2026) Actual Questions & Answers
(Galen College of Nursing)
1. A patient with bipolar disorder is prescribed lithium. What finding
indicates the patient may be experiencing lithium toxicity?
• A. Mild thirst and dry mouth
• B. Tremors, confusion, and nausea
• C. Increased appetite and weight gain
• D. Constipation and insomnia
Expert Rationale: Early signs of lithium toxicity include tremors, nausea,
vomiting, confusion, and unsteady gait; levels must be checked immediately. Mild
thirst and dry mouth are common side effects at therapeutic levels.
2. Which patient statement indicates a need for further teaching about
sildenafil?
• A. "I should not take this medication with nitrates."
• B. "This medication may cause flushing or a headache."
• C. "This medication will protect me from sexually transmitted
infections."
• D. "I should contact my provider if I have an erection lasting more than 4
hours."
Expert Rationale: Sildenafil treats erectile dysfunction and does not protect
against STIs; believing it does indicates misunderstanding. Nitrates are
contraindicated due to severe hypotension risk.
,3. A patient prescribed lorazepam for anxiety asks about its side effects. What
is the nurse’s best response?
• A. "This medication will not affect your alertness."
• B. "You may feel drowsy, so avoid driving until you know how it affects
you."
• C. "You may feel more energetic right away."
• D. "You can safely drink alcohol with this medication."
Expert Rationale: Lorazepam, a benzodiazepine, causes CNS depression and
drowsiness; patients must avoid driving or hazardous activities until they know
their response. Alcohol potentiates CNS depression.
4. Which side effect should the nurse monitor for in a patient taking
amitriptyline?
• A. Bradycardia
• B. Orthostatic hypotension
• C. Hyperglycemia
• D. Urinary frequency
Expert Rationale: Tricyclic antidepressants like amitriptyline can cause
significant orthostatic hypotension, increasing fall risk, especially in older adults.
They also cause anticholinergic effects (dry mouth, constipation, urinary
retention).
5. A patient with Parkinson's disease is prescribed levodopa/carbidopa. Which
statement by the patient indicates the need for further teaching?
• A. "I should change positions slowly to avoid dizziness."
• B. "I should take this medication with a high-protein meal."
• C. "I may notice darkening of my urine."
• D. "This medication may take some time before I notice improvement."
,Expert Rationale: High-protein foods interfere with the absorption of levodopa,
reducing its effectiveness. Protein intake should be consistent and often separated
from the medication dose. Dark urine is a harmless side effect.
6. A patient on phenytoin for epilepsy reports gingival hyperplasia. What is
the nurse's priority teaching?
• A. "Stop taking the medication immediately."
• B. "Practice good oral hygiene, including regular flossing and dental
checkups."
• C. "Avoid all citrus fruits."
• D. "Increase your dose when the seizures worsen."
Expert Rationale: Phenytoin can cause gum overgrowth; good oral hygiene and
regular dental care help minimize this adverse effect. Abrupt withdrawal can
precipitate seizures.
7. What instruction should the nurse provide to a patient taking alendronate
for osteoporosis?
• A. "Take this medication with milk at bedtime."
• B. "Remain upright for at least 30 minutes after taking the
medication."
• C. "Crush the tablet and take it with applesauce."
• D. "Lie down if you feel stomach discomfort."
Expert Rationale: Alendronate can cause esophageal irritation; remaining upright
and not lying down for at least 30 minutes reduces this risk. Take with plain water
on an empty stomach.
8. A patient taking warfarin has an INR of 4.5. Which finding requires
immediate intervention?
• A. Bruising on the arms
, • B. Blood in the urine
• C. Mild gum bleeding after flossing
• D. Nosebleed that stops after 2 minutes
Expert Rationale: An INR of 4.5 with blood in the urine indicates serious
bleeding risk. The target INR for most indications is 2-3. Bruising and mild gum
bleeding are common.
9. Which medication is contraindicated in a patient with severe asthma who
uses albuterol?
• A. Metoprolol
• B. Lisinopril
• C. Propranolol
• D. Amlodipine
Expert Rationale: Non-selective beta-blockers like propranolol can cause
bronchospasm and are contraindicated in asthma. Metoprolol is beta-1 selective but
still used with caution.
10. A patient on metformin for type 2 diabetes develops lactic acidosis. Which
preexisting condition most increases this risk?
• A. Hypertension
• B. Chronic kidney disease (eGFR <30)
• C. Hyperlipidemia
• D. Osteoarthritis
Expert Rationale: Metformin is contraindicated in advanced CKD (eGFR <30)
due to risk of lactic acidosis. Other risk factors include liver disease, heart failure,
and heavy alcohol use.
(2026) Actual Questions & Answers
(Galen College of Nursing)
1. A patient with bipolar disorder is prescribed lithium. What finding
indicates the patient may be experiencing lithium toxicity?
• A. Mild thirst and dry mouth
• B. Tremors, confusion, and nausea
• C. Increased appetite and weight gain
• D. Constipation and insomnia
Expert Rationale: Early signs of lithium toxicity include tremors, nausea,
vomiting, confusion, and unsteady gait; levels must be checked immediately. Mild
thirst and dry mouth are common side effects at therapeutic levels.
2. Which patient statement indicates a need for further teaching about
sildenafil?
• A. "I should not take this medication with nitrates."
• B. "This medication may cause flushing or a headache."
• C. "This medication will protect me from sexually transmitted
infections."
• D. "I should contact my provider if I have an erection lasting more than 4
hours."
Expert Rationale: Sildenafil treats erectile dysfunction and does not protect
against STIs; believing it does indicates misunderstanding. Nitrates are
contraindicated due to severe hypotension risk.
,3. A patient prescribed lorazepam for anxiety asks about its side effects. What
is the nurse’s best response?
• A. "This medication will not affect your alertness."
• B. "You may feel drowsy, so avoid driving until you know how it affects
you."
• C. "You may feel more energetic right away."
• D. "You can safely drink alcohol with this medication."
Expert Rationale: Lorazepam, a benzodiazepine, causes CNS depression and
drowsiness; patients must avoid driving or hazardous activities until they know
their response. Alcohol potentiates CNS depression.
4. Which side effect should the nurse monitor for in a patient taking
amitriptyline?
• A. Bradycardia
• B. Orthostatic hypotension
• C. Hyperglycemia
• D. Urinary frequency
Expert Rationale: Tricyclic antidepressants like amitriptyline can cause
significant orthostatic hypotension, increasing fall risk, especially in older adults.
They also cause anticholinergic effects (dry mouth, constipation, urinary
retention).
5. A patient with Parkinson's disease is prescribed levodopa/carbidopa. Which
statement by the patient indicates the need for further teaching?
• A. "I should change positions slowly to avoid dizziness."
• B. "I should take this medication with a high-protein meal."
• C. "I may notice darkening of my urine."
• D. "This medication may take some time before I notice improvement."
,Expert Rationale: High-protein foods interfere with the absorption of levodopa,
reducing its effectiveness. Protein intake should be consistent and often separated
from the medication dose. Dark urine is a harmless side effect.
6. A patient on phenytoin for epilepsy reports gingival hyperplasia. What is
the nurse's priority teaching?
• A. "Stop taking the medication immediately."
• B. "Practice good oral hygiene, including regular flossing and dental
checkups."
• C. "Avoid all citrus fruits."
• D. "Increase your dose when the seizures worsen."
Expert Rationale: Phenytoin can cause gum overgrowth; good oral hygiene and
regular dental care help minimize this adverse effect. Abrupt withdrawal can
precipitate seizures.
7. What instruction should the nurse provide to a patient taking alendronate
for osteoporosis?
• A. "Take this medication with milk at bedtime."
• B. "Remain upright for at least 30 minutes after taking the
medication."
• C. "Crush the tablet and take it with applesauce."
• D. "Lie down if you feel stomach discomfort."
Expert Rationale: Alendronate can cause esophageal irritation; remaining upright
and not lying down for at least 30 minutes reduces this risk. Take with plain water
on an empty stomach.
8. A patient taking warfarin has an INR of 4.5. Which finding requires
immediate intervention?
• A. Bruising on the arms
, • B. Blood in the urine
• C. Mild gum bleeding after flossing
• D. Nosebleed that stops after 2 minutes
Expert Rationale: An INR of 4.5 with blood in the urine indicates serious
bleeding risk. The target INR for most indications is 2-3. Bruising and mild gum
bleeding are common.
9. Which medication is contraindicated in a patient with severe asthma who
uses albuterol?
• A. Metoprolol
• B. Lisinopril
• C. Propranolol
• D. Amlodipine
Expert Rationale: Non-selective beta-blockers like propranolol can cause
bronchospasm and are contraindicated in asthma. Metoprolol is beta-1 selective but
still used with caution.
10. A patient on metformin for type 2 diabetes develops lactic acidosis. Which
preexisting condition most increases this risk?
• A. Hypertension
• B. Chronic kidney disease (eGFR <30)
• C. Hyperlipidemia
• D. Osteoarthritis
Expert Rationale: Metformin is contraindicated in advanced CKD (eGFR <30)
due to risk of lactic acidosis. Other risk factors include liver disease, heart failure,
and heavy alcohol use.
