Kaplan Pharmacology Integrated Exam
(Forms A, B, C, D) | NGN Questions with
Correct Answers,
**Q1. A client with heart failure is prescribed digoxin 0.25 mg daily.
Which finding indicates the client is experiencing digoxin toxicity?**
A) Heart rate of 72 beats per minute
B) Blood pressure of 120/80 mm Hg
C) Yellow-green halos around lights
D) Serum digoxin level of 1.0 ng/mL
**Correct Answer: C**
**Rationale:** Yellow-green halos (xanthopsia) are a classic visual
disturbance of digoxin toxicity. The therapeutic range is 0.5-2.0 ng/mL,
so a level of 1.0 is therapeutic. Bradycardia (not a heart rate of 72) is
also a sign of toxicity .
---
**Q2. A client is prescribed warfarin for atrial fibrillation. Which
statement by the client indicates a need for further teaching?**
,A) "I will use a soft toothbrush to prevent gum bleeding."
B) "I will avoid eating large amounts of spinach and kale."
C) "I will take ibuprofen for my headaches."
D) "I will report any unusual bruising to my provider."
**Correct Answer: C**
**Rationale:** Ibuprofen (NSAID) increases bleeding risk when taken
with warfarin and should be avoided. Acetaminophen is a safer
alternative. Soft toothbrush use, consistent vitamin K intake, and
reporting bruising are all correct statements .
---
**Q3. A client receiving IV heparin has an aPTT of 110 seconds (control
30 seconds). What is the priority nursing action?**
A) Continue the infusion at the same rate
B) Increase the infusion rate
C) Stop the infusion and notify the provider
D) Decrease the infusion rate
,**Correct Answer: C**
**Rationale:** Therapeutic aPTT is 1.5-2.5 times control (45-75
seconds). An aPTT of 110 seconds (3.7 times control) indicates
excessive anticoagulation and bleeding risk. The infusion should be
stopped and the provider notified .
---
**Q4. A client is prescribed lisinopril for hypertension. Which finding
requires immediate intervention?**
A) Dry, hacking cough
B) Blood pressure of 130/80 mm Hg
C) Swelling of the tongue and lips
D) Serum potassium of 4.0 mEq/L
**Correct Answer: C**
**Rationale:** Swelling of the tongue and lips indicates angioedema, a
life-threatening allergic reaction to ACE inhibitors requiring immediate
intervention. Dry cough is a common side effect but not life-threatening
.
, ---
**Q5. A nurse is about to administer digoxin. Which finding requires
holding the dose?**
A) Heart rate 58 beats per minute
B) Blood pressure 130/80 mm Hg
C) Respiratory rate 18 breaths/min
D) Temperature 98.6°F
**Correct Answer: A**
**Rationale:** Bradycardia (heart rate below 60 bpm) increases
digoxin toxicity risk. The medication should be held and the provider
notified .
---
**Q6. Which lab value must be monitored with furosemide therapy?**
A) Sodium
B) Potassium
C) Calcium only
(Forms A, B, C, D) | NGN Questions with
Correct Answers,
**Q1. A client with heart failure is prescribed digoxin 0.25 mg daily.
Which finding indicates the client is experiencing digoxin toxicity?**
A) Heart rate of 72 beats per minute
B) Blood pressure of 120/80 mm Hg
C) Yellow-green halos around lights
D) Serum digoxin level of 1.0 ng/mL
**Correct Answer: C**
**Rationale:** Yellow-green halos (xanthopsia) are a classic visual
disturbance of digoxin toxicity. The therapeutic range is 0.5-2.0 ng/mL,
so a level of 1.0 is therapeutic. Bradycardia (not a heart rate of 72) is
also a sign of toxicity .
---
**Q2. A client is prescribed warfarin for atrial fibrillation. Which
statement by the client indicates a need for further teaching?**
,A) "I will use a soft toothbrush to prevent gum bleeding."
B) "I will avoid eating large amounts of spinach and kale."
C) "I will take ibuprofen for my headaches."
D) "I will report any unusual bruising to my provider."
**Correct Answer: C**
**Rationale:** Ibuprofen (NSAID) increases bleeding risk when taken
with warfarin and should be avoided. Acetaminophen is a safer
alternative. Soft toothbrush use, consistent vitamin K intake, and
reporting bruising are all correct statements .
---
**Q3. A client receiving IV heparin has an aPTT of 110 seconds (control
30 seconds). What is the priority nursing action?**
A) Continue the infusion at the same rate
B) Increase the infusion rate
C) Stop the infusion and notify the provider
D) Decrease the infusion rate
,**Correct Answer: C**
**Rationale:** Therapeutic aPTT is 1.5-2.5 times control (45-75
seconds). An aPTT of 110 seconds (3.7 times control) indicates
excessive anticoagulation and bleeding risk. The infusion should be
stopped and the provider notified .
---
**Q4. A client is prescribed lisinopril for hypertension. Which finding
requires immediate intervention?**
A) Dry, hacking cough
B) Blood pressure of 130/80 mm Hg
C) Swelling of the tongue and lips
D) Serum potassium of 4.0 mEq/L
**Correct Answer: C**
**Rationale:** Swelling of the tongue and lips indicates angioedema, a
life-threatening allergic reaction to ACE inhibitors requiring immediate
intervention. Dry cough is a common side effect but not life-threatening
.
, ---
**Q5. A nurse is about to administer digoxin. Which finding requires
holding the dose?**
A) Heart rate 58 beats per minute
B) Blood pressure 130/80 mm Hg
C) Respiratory rate 18 breaths/min
D) Temperature 98.6°F
**Correct Answer: A**
**Rationale:** Bradycardia (heart rate below 60 bpm) increases
digoxin toxicity risk. The medication should be held and the provider
notified .
---
**Q6. Which lab value must be monitored with furosemide therapy?**
A) Sodium
B) Potassium
C) Calcium only
