RASMUSSEN PHARMACOLOGY FINAL EXAM
PREP HIGH-YIELD QUESTIONS, ANSWERS &
RATIONALES (NUR 2407 - NUR 2474)
This premium, high-yield practice bank features NCLEX-style pharmacology multiple
choice questions designed to match the specific NUR courses at Rasmussen
University. Every question provides an immediate correct answer, a clinical rationale,
and bold-italicised safety guidelines detailing critical assessment parameters and
"when to hold" indicators. It is the ultimate, ready-to-study resource optimized to help
nursing students pass their pharmacology final exams on the first attempt.
1. A nurse is preparing to administer a morning dose of Digoxin to a patient with heart
failure. Which action must the nurse take first?
A. Review the patient's serum potassium level from yesterday.
B. Assess the patient’s apical pulse rate for 1 full minute.
C. Check the patient's blood pressure in a sitting position.
D. Monitor the patient's daily fluid intake and output.
• Answer: B
• Rationale: Before administering digoxin, the nurse must assess the apical pulse
for 1 full minute. The medication must be held and the provider notified if the
heart rate is less than 60 beats per minute in an adult to avoid severe
bradycardia and worsening toxicity.
2. A patient is prescribed Furosemide 40 mg IV push daily. Which laboratory value
should the nurse review immediately before administering this medication?
A. Serum sodium level
B. Blood urea nitrogen (BUN)
C. Serum potassium level
D. Total cholesterol
• Answer: C
, • Rationale: Furosemide is a loop diuretic that causes the excretion of water,
sodium, and potassium. Hypokalemia is a dangerous adverse effect that can
precipitate life-threatening cardiac arrhythmias and increase the risk of digoxin
toxicity.
3. A nurse is caring for a patient who has been taking Levothyroxine for
hypothyroidism. The patient is difficult to arouse, pale, and bradycardic. Which action
should the nurse anticipate next?
A. Administering an additional oral dose of Levothyroxine.
B. Preparing for the emergency administration of IV Levothyroxine.
C. Withholding all thyroid hormone replacements indefinitely.
D. Giving 15 grams of fast-acting oral glucose.
• Answer: B
• Rationale: Severe, untreated hypothyroidism can degrade into a life-threatening
state known as myxedema coma. When a patient becomes lethargic and
profoundly bradycardic, emergency IV levothyroxine administration is required
because oral absorption is highly compromised.
4. A diabetic patient is prescribed long-acting Insulin Glargine (Lantus). Which
administration rule must the nurse follow?
A. Mix the insulin with short-acting Regular insulin to reduce injections.
B. Administer the insulin via IV infusion during episodes of ketoacidosis.
C. Draw up insulin glargine first when mixing with NPH insulin.
D. Administer insulin glargine at the same time daily without mixing it.
• Answer: D
• Rationale: Insulin glargine is a long-acting basal insulin that has no peak and
cannot be mixed in the same syringe with any other insulin type. Mixing it alters
its physical characteristics and destroys its steady release mechanism.
5. A patient is receiving a continuous Heparin infusion for a deep vein thrombosis
(DVT). Which laboratory parameter is used to monitor the therapeutic effectiveness of
Heparin?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count only
• Answer: B
, • Rationale: The aPTT is the gold standard lab value used to titrate and monitor
continuous unfractionated heparin infusions. PT and INR are utilized to monitor
oral Warfarin therapy, while platelet counts help monitor for the complication of
Heparin-Induced Thrombocytopenia.
6. A nurse is reviewing a patient's medication list and notes the patient takes an MAO
Inhibitor (Phenelzine) for depression. Which dietary restriction must the nurse
reinforce?
A. Restricting total daily sodium and fluid intake.
B. Avoiding foods high in tyramine, such as aged cheeses and red wine.
C. Increasing the intake of green leafy vegetables high in Vitamin K.
D. Eliminating citrus juices and grapefruit products.
• Answer: B
• Rationale: Patients taking Monoamine Oxidase Inhibitors (MAOIs) must avoid
tyramine-rich foods to prevent a critical hypertensive crisis. Tyramine causes a
massive release of norepinephrine, causing dangerous vasoconstriction.
7. A nurse is preparing to administer Morphine Sulfate 4 mg IV push to a postoperative
patient. The nurse notes the patient's respiratory rate is 9 breaths per minute. Which
action should the nurse take?
A. Administer the dose slowly over 5 minutes.
B. Hold the morphine and notify the healthcare provider immediately.
C. Administer the medication and reassess the respirations in 15 minutes.
D. Request an order to change the medication to oral oxycodone.
• Answer: B
• Rationale: Opioids are central nervous system depressants. The nurse must
hold opioid medications if the respiratory rate drops below 10 to 12 breaths per
minute to prevent fatal respiratory arrest. Administering an antidote like
Naloxone may also be indicated.
8. A patient is discharged with a prescription for sublingual Nitroglycerin tablets for
stable angina. What should the nurse instruct the patient to do if chest pain occurs at
home?
A. Take 1 tablet every 15 minutes for up to 4 total doses.
B. Swallow the tablet with a full glass of water immediately.
C. Take 1 tablet every 5 minutes, up to a maximum of 3 doses, and call emergency
services if pain persists.
D. Chew the tablet completely before swallowing to speed up absorption.
, • Answer: C
• Rationale: The correct protocol for sublingual nitroglycerin is to place 1 tablet
under the tongue every 5 minutes up to 3 doses. If chest pain is not relieved or
worsens after the first dose, the patient or family should call emergency
services immediately.
9. A patient is initiated on Warfarin (Coumadin) therapy. Which target laboratory value
indicates that the medication is in a therapeutic range?
A. An aPTT of 60 to 80 seconds.
B. An INR value between 2.0 and 3.0.
C. A platelet count above 150,000/mm³.
D. A clotting time below 5 minutes.
• Answer: B
• Rationale: For standard anticoagulation indications like DVT or atrial fibrillation,
an INR target between 2.0 and 3.0 represents a safe and effective therapeutic
range for Warfarin. Values below this increase clot risk; values above increase
bleeding risk.
10. A nurse is administering oral Albuterol and a Beclomethasone (corticosteroid)
inhaler to a patient with asthma. What is the correct sequence of administration?
A. Administer the Beclomethasone first, wait 5 minutes, then administer Albuterol.
B. Administer the Albuterol first, wait 5 minutes, then administer Beclomethasone.
C. Administer both medications simultaneously using two separate spacers.
D. Administer the corticosteroid and have the patient rinse their mouth before taking
the bronchodilator.
• Answer: B
• Rationale: The nurse must always administer the bronchodilator (Albuterol) first
to open up the airways, allowing the subsequent corticosteroid
(Beclomethasone) to penetrate deeper into the lung tissues for maximum
therapeutic effect.
11. After using a corticosteroid metered-dose inhaler, what critical instruction must the
nurse provide to the patient?
A. Avoid drinking fluids for at least 2 hours following the dose.
B. Rinse the mouth thoroughly with water and spit it out.
C. Cough vigorously to clear any residual medication from the throat.
D. Take a deep breath and hold it for 30 seconds after inhalation.
PREP HIGH-YIELD QUESTIONS, ANSWERS &
RATIONALES (NUR 2407 - NUR 2474)
This premium, high-yield practice bank features NCLEX-style pharmacology multiple
choice questions designed to match the specific NUR courses at Rasmussen
University. Every question provides an immediate correct answer, a clinical rationale,
and bold-italicised safety guidelines detailing critical assessment parameters and
"when to hold" indicators. It is the ultimate, ready-to-study resource optimized to help
nursing students pass their pharmacology final exams on the first attempt.
1. A nurse is preparing to administer a morning dose of Digoxin to a patient with heart
failure. Which action must the nurse take first?
A. Review the patient's serum potassium level from yesterday.
B. Assess the patient’s apical pulse rate for 1 full minute.
C. Check the patient's blood pressure in a sitting position.
D. Monitor the patient's daily fluid intake and output.
• Answer: B
• Rationale: Before administering digoxin, the nurse must assess the apical pulse
for 1 full minute. The medication must be held and the provider notified if the
heart rate is less than 60 beats per minute in an adult to avoid severe
bradycardia and worsening toxicity.
2. A patient is prescribed Furosemide 40 mg IV push daily. Which laboratory value
should the nurse review immediately before administering this medication?
A. Serum sodium level
B. Blood urea nitrogen (BUN)
C. Serum potassium level
D. Total cholesterol
• Answer: C
, • Rationale: Furosemide is a loop diuretic that causes the excretion of water,
sodium, and potassium. Hypokalemia is a dangerous adverse effect that can
precipitate life-threatening cardiac arrhythmias and increase the risk of digoxin
toxicity.
3. A nurse is caring for a patient who has been taking Levothyroxine for
hypothyroidism. The patient is difficult to arouse, pale, and bradycardic. Which action
should the nurse anticipate next?
A. Administering an additional oral dose of Levothyroxine.
B. Preparing for the emergency administration of IV Levothyroxine.
C. Withholding all thyroid hormone replacements indefinitely.
D. Giving 15 grams of fast-acting oral glucose.
• Answer: B
• Rationale: Severe, untreated hypothyroidism can degrade into a life-threatening
state known as myxedema coma. When a patient becomes lethargic and
profoundly bradycardic, emergency IV levothyroxine administration is required
because oral absorption is highly compromised.
4. A diabetic patient is prescribed long-acting Insulin Glargine (Lantus). Which
administration rule must the nurse follow?
A. Mix the insulin with short-acting Regular insulin to reduce injections.
B. Administer the insulin via IV infusion during episodes of ketoacidosis.
C. Draw up insulin glargine first when mixing with NPH insulin.
D. Administer insulin glargine at the same time daily without mixing it.
• Answer: D
• Rationale: Insulin glargine is a long-acting basal insulin that has no peak and
cannot be mixed in the same syringe with any other insulin type. Mixing it alters
its physical characteristics and destroys its steady release mechanism.
5. A patient is receiving a continuous Heparin infusion for a deep vein thrombosis
(DVT). Which laboratory parameter is used to monitor the therapeutic effectiveness of
Heparin?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count only
• Answer: B
, • Rationale: The aPTT is the gold standard lab value used to titrate and monitor
continuous unfractionated heparin infusions. PT and INR are utilized to monitor
oral Warfarin therapy, while platelet counts help monitor for the complication of
Heparin-Induced Thrombocytopenia.
6. A nurse is reviewing a patient's medication list and notes the patient takes an MAO
Inhibitor (Phenelzine) for depression. Which dietary restriction must the nurse
reinforce?
A. Restricting total daily sodium and fluid intake.
B. Avoiding foods high in tyramine, such as aged cheeses and red wine.
C. Increasing the intake of green leafy vegetables high in Vitamin K.
D. Eliminating citrus juices and grapefruit products.
• Answer: B
• Rationale: Patients taking Monoamine Oxidase Inhibitors (MAOIs) must avoid
tyramine-rich foods to prevent a critical hypertensive crisis. Tyramine causes a
massive release of norepinephrine, causing dangerous vasoconstriction.
7. A nurse is preparing to administer Morphine Sulfate 4 mg IV push to a postoperative
patient. The nurse notes the patient's respiratory rate is 9 breaths per minute. Which
action should the nurse take?
A. Administer the dose slowly over 5 minutes.
B. Hold the morphine and notify the healthcare provider immediately.
C. Administer the medication and reassess the respirations in 15 minutes.
D. Request an order to change the medication to oral oxycodone.
• Answer: B
• Rationale: Opioids are central nervous system depressants. The nurse must
hold opioid medications if the respiratory rate drops below 10 to 12 breaths per
minute to prevent fatal respiratory arrest. Administering an antidote like
Naloxone may also be indicated.
8. A patient is discharged with a prescription for sublingual Nitroglycerin tablets for
stable angina. What should the nurse instruct the patient to do if chest pain occurs at
home?
A. Take 1 tablet every 15 minutes for up to 4 total doses.
B. Swallow the tablet with a full glass of water immediately.
C. Take 1 tablet every 5 minutes, up to a maximum of 3 doses, and call emergency
services if pain persists.
D. Chew the tablet completely before swallowing to speed up absorption.
, • Answer: C
• Rationale: The correct protocol for sublingual nitroglycerin is to place 1 tablet
under the tongue every 5 minutes up to 3 doses. If chest pain is not relieved or
worsens after the first dose, the patient or family should call emergency
services immediately.
9. A patient is initiated on Warfarin (Coumadin) therapy. Which target laboratory value
indicates that the medication is in a therapeutic range?
A. An aPTT of 60 to 80 seconds.
B. An INR value between 2.0 and 3.0.
C. A platelet count above 150,000/mm³.
D. A clotting time below 5 minutes.
• Answer: B
• Rationale: For standard anticoagulation indications like DVT or atrial fibrillation,
an INR target between 2.0 and 3.0 represents a safe and effective therapeutic
range for Warfarin. Values below this increase clot risk; values above increase
bleeding risk.
10. A nurse is administering oral Albuterol and a Beclomethasone (corticosteroid)
inhaler to a patient with asthma. What is the correct sequence of administration?
A. Administer the Beclomethasone first, wait 5 minutes, then administer Albuterol.
B. Administer the Albuterol first, wait 5 minutes, then administer Beclomethasone.
C. Administer both medications simultaneously using two separate spacers.
D. Administer the corticosteroid and have the patient rinse their mouth before taking
the bronchodilator.
• Answer: B
• Rationale: The nurse must always administer the bronchodilator (Albuterol) first
to open up the airways, allowing the subsequent corticosteroid
(Beclomethasone) to penetrate deeper into the lung tissues for maximum
therapeutic effect.
11. After using a corticosteroid metered-dose inhaler, what critical instruction must the
nurse provide to the patient?
A. Avoid drinking fluids for at least 2 hours following the dose.
B. Rinse the mouth thoroughly with water and spit it out.
C. Cough vigorously to clear any residual medication from the throat.
D. Take a deep breath and hold it for 30 seconds after inhalation.
