PHARMACOLOGY MIDTERM EXAM
1. A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hour. The
nurse determines that the client is receiving the therapeutic effect based on which results?
Activated partial thromboplastin time of 60 seconds
2. A nurse provides discharge instructions to a postoperative client who is taking warfarin sodium
(Coumadin). Which statement made by the client reflects the need for further teaching?
"I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."
3. A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3 mEq/L and is
complaining of anorexia. The health care provider prescribes determination of the serum digoxin
level to rule out digoxin toxicity. The nurse checks the results, knowing that which value is the
therapeutic serum level (range) for digoxin?
0.5 to 2 ng/mL
4. What is the most important for the nurse to teach the patient in taking Digoxin?
Take the apical pulse before taking the medicine
5.A loading dose of Digoxin 0.5 mg PO is administered and followed by 0.25mg PO daily. The
positive Inotropic and negative chronotropic effect is reflected by the sets of data:
BP 130/80mmHg, HR 60beats/min, RR 22/min, increase in urine output
6. A nurse is caring for a client receiving heparin intravenous (IV) infusion. The nurse anticipates
that which laboratory study will be prescribed to monitor the therapeutic effect of heparin?
Activated partial thromboplastin time (APTT)
7. A client is diagnosed with an acute myocardial infarction and receiving tissue plasminogen
activator, Alteplase. Which action is a priority nursing intervention?
Monitor for signs of bleeding
8. Intravenous heparin therapy is ordered for a client. While implementing this order, a nurse ensures
that which of the following medication is available on the nursing unit?
Protamine sulfate
9. When a client is receiving anticoagulants and thrombolytics, the nursing care personnel should
include observations for the following clinical manifestations? SATA
Epistaxis
Hemoptysis
Gingival hyperplasia
Hematoma
10. Digoxin is administered intravenously to a client with heart failure, primarily because the drug
acts to
Increase myocardial contractility
11. A 66 year old client complaining of not feeling well is seen in a clinic. The client is taking several
medications for the control of heart disease and hypertension. These medications include atenolol
(Tenormin), digoxin (lanoxin), and chlorothiazide (Diuril). A tentative diagnosis of digoxin toxicity
,12. Mona Leeza is being treated for acute congestive heart failure with intravenously administered
bumetanide (Bumex). The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96
beats/min; and respirations, 24 breaths/min. After the initial dose, which of the following is the
priority assessment?
Monitoring blood pressure
13. Mona’s physician has also ordered a laboratory tests for the patient as she has complained of
experiencing tremors and seeing halos and the doctor suspects of digitalis toxicity. Which particular
electrolyte might have predisposed this condition?
Potassium
14. Some antiarrythmic drugs have a direct effect on the conduction property of the heart. Which of
the following sequences shows proper conduction & transmission of impulses?
SA node – AV node – bundle of His – Purkinje fibers
15. A client who has myocardial infarction is in the coronary unit on a cardiac monitor. The nurse
observes ventricular irritability on the screen. The nurse observes ventricular irritability on the
screen.
Lidocaine (Xylocaine)
16. Which of the following is a contraindication for digoxin administration?
Heart rate below 60
17. Which is the MOST appropriate action for the nurse to take before administering digoxin?
Monitor potassium level
18. The therapeutic drug level for digoxin is:
0.5-2.0 ng/mg
19. Blurred vision or halos are signs of:
Digoxin toxicity
20. When administering an antiarrhythmic agent, which of the following assessment parameters is
the most important for the nurse to evaluate?
ECG
21. A patient is prescribed Pravastatin. This medication is known as a _______?
HMG-CoA Reductase Inhibitor
22. Your patient is prescribed a statin medication for the treatment of hyperlipidemia. What
medication below may increase the patient’s risk of developing rhabdomyolysis if taken with a
statin?
Gemfibrozil
23. Which statement below accurately describes how statin medications work to lower cholesterol
levels?
Statins inhibit HMG-CoA reductase which in turn hinders cholesterol synthesis in the liver.
24. Your patient who is taking a statin develops yellowing of the skin, abdominal pain in the right
upper quadrant, and nausea. What lab result below correlates with this finding?
Elevated aminotransferase (ALT) and aspartate aminotransferase (AST)
25. A patient who recently started therapy with an HMG-CoA reductase inhibitor asks the nurse,
,A reduction usually is seen within 2 weeks
26. A patient presents to the clinic with complaints of muscle aches, muscle pain, and weakness.
Upon review of the individual’s medications, the nurse notes that the patient is concurrently taking
gemfibrozil (Lopid) and atorvastatin (Lipitor). The nurse should assess the patient for the
development of:
Myopathy
27. A nurse is instructing a patient receiving a cholesterol-lowering agent. Which information should
the nurse include in the patient education?
“You should continue your exercises program to increase your HDL serum levels.”
28. Which patients below would be at a HIGH risk for developing adverse effects of Heparin drug
therapy? Select all that apply:
A 55-year-old male patient who is post-op day 1 from brain surgery.
A 36-year-old male patient with active peptic ulcer disease.
29. Your patient is started on a Heparin drip. You administer a bolus of Heparin and start the drip per
protocol as ordered by the physician. What will be your next important nursing action?
Collect an aPTT level in 6 hours per protocol.
A patient is ordered to start an IV continuous Heparin drip. Prior to starting the medication, the nurse
would
Ensure what information is gathered correctly before initiation the drip?
Answer: Weight
What is the antidote for heparin?
Answer: Protamine sulfate
You’re providing care to a patient who has been receiving long-term doses of Heparin. What finding
in this
Patent may be experiencing a complication that can occur due to long-term use of this drug?
Answer: Bone fractures.
A client with deep vein thrombosis is receiving Streptokinase (Streptase). The nurse would notify the
Physician if which of the following assessment is noted?
Answer: A blood pressure of my 185/110 mm Hg
A nurse giving instruction to a client who is receiving Cholestyramine (Question) for the treatment of
Hyperlipidemia. Which of the following statements made by the client indicates the need for further
instructions?
Answer: I will continue taking nicotinic acid as a part of the treatment
When administering niacin, the nurse need to monitor need or which adverse effect?
Answer: Cutaneous flushing
When is the best time to take in nicotinic acid?
Answer: at bedtime
Which of these medications increases serum levels of uric acid and may predispose patients to the
development of gout.
Answer: Niacin(Niaspan)
, Answer: This medication blocks the enzyme that ads in the synthesis of the cholesterol.
Which of the medications is also indicated for patents with pruritus associated with partial biliary
obstruction?
Answer: Cholestyramine
Which of these medications act directly on smooth muscle of the blood vessels to cause relaxation
and to depress muscle tone thus lowering systemic blood pressure because of a drop in resistance?
Answer: Nitrates
In a 50-year-oold widower who had a transient ischemic attack, what is the most common
vasodilator used for his treatment?
Answer: Nitroprusside (Nitropress)
A physician writes a new medication order for a patient who has cardiovascular disease. The
medication is an angiotensin ll receptor blocker (ARB). What new medication on the patent’s
scheduled medication list is an ARB?
Answer: Losartan
Select all the pharmacodynamic effects of angiotensin ll receptor blockers (ARBs):
Answer: Vasodilation
Sodium excretion
Water excretion
What conditions are Angiotensin ll Receptor Blockers (ARBs) used to treat? Select all that apply:
Answer: Hypertension
Diabetic nephropathy in type 2 diabetics
Heart failure
A patient is taking an Angiotensin ll Receptor Blocker (ARB). What finding below is an adverse side
effect of this medication and should be reported the physician?
Answer: Potassium 6.8mEq/L
As the nurse you know to tell patient that the best way to PREVENT rebound hypertension while
taking an Angiotensin ll Receptor Blocker (ARB) is to?
Answer: never abruptly stop taking medication
You’re providing discharge teaching to a patient that will be taking an Angiotensin ll Receptor
Blocker (ARB) at home. What statement by the patient requires you to re-educate them about this
medication?
Answer: This medication can decrease potassium levels. So I will consume a det rich in
potassium to help keep my level normal.”
Your patent is prescribed an Angiotensin ll Receptor Blocker (ARB) for the treatment of blood
pressure
management. Which statement below Best describes how this medication will manage blood
pressure in a patient?
Answer: This medication will decrease systemic vascular resistance (SVR) and decrease blood
pressure, while decreasing blood volume through the excretion of the sodium and water.”
Your patient is prescribed a calcium channel blocker. As the nurse you know that these medication
works
to block calcium channels in what areas of the body? Select all that apply:
Answer: Vascular smooth muscle
1. A client with atrial fibrillation is receiving a continuous heparin infusion at 1000 units/hour. The
nurse determines that the client is receiving the therapeutic effect based on which results?
Activated partial thromboplastin time of 60 seconds
2. A nurse provides discharge instructions to a postoperative client who is taking warfarin sodium
(Coumadin). Which statement made by the client reflects the need for further teaching?
"I will take Ecotrin (enteric-coated aspirin) for my headaches because it is coated."
3. A client who is receiving digoxin (Lanoxin) daily has a serum potassium level of 3 mEq/L and is
complaining of anorexia. The health care provider prescribes determination of the serum digoxin
level to rule out digoxin toxicity. The nurse checks the results, knowing that which value is the
therapeutic serum level (range) for digoxin?
0.5 to 2 ng/mL
4. What is the most important for the nurse to teach the patient in taking Digoxin?
Take the apical pulse before taking the medicine
5.A loading dose of Digoxin 0.5 mg PO is administered and followed by 0.25mg PO daily. The
positive Inotropic and negative chronotropic effect is reflected by the sets of data:
BP 130/80mmHg, HR 60beats/min, RR 22/min, increase in urine output
6. A nurse is caring for a client receiving heparin intravenous (IV) infusion. The nurse anticipates
that which laboratory study will be prescribed to monitor the therapeutic effect of heparin?
Activated partial thromboplastin time (APTT)
7. A client is diagnosed with an acute myocardial infarction and receiving tissue plasminogen
activator, Alteplase. Which action is a priority nursing intervention?
Monitor for signs of bleeding
8. Intravenous heparin therapy is ordered for a client. While implementing this order, a nurse ensures
that which of the following medication is available on the nursing unit?
Protamine sulfate
9. When a client is receiving anticoagulants and thrombolytics, the nursing care personnel should
include observations for the following clinical manifestations? SATA
Epistaxis
Hemoptysis
Gingival hyperplasia
Hematoma
10. Digoxin is administered intravenously to a client with heart failure, primarily because the drug
acts to
Increase myocardial contractility
11. A 66 year old client complaining of not feeling well is seen in a clinic. The client is taking several
medications for the control of heart disease and hypertension. These medications include atenolol
(Tenormin), digoxin (lanoxin), and chlorothiazide (Diuril). A tentative diagnosis of digoxin toxicity
,12. Mona Leeza is being treated for acute congestive heart failure with intravenously administered
bumetanide (Bumex). The vital signs are as follows: blood pressure, 100/60 mm Hg; pulse, 96
beats/min; and respirations, 24 breaths/min. After the initial dose, which of the following is the
priority assessment?
Monitoring blood pressure
13. Mona’s physician has also ordered a laboratory tests for the patient as she has complained of
experiencing tremors and seeing halos and the doctor suspects of digitalis toxicity. Which particular
electrolyte might have predisposed this condition?
Potassium
14. Some antiarrythmic drugs have a direct effect on the conduction property of the heart. Which of
the following sequences shows proper conduction & transmission of impulses?
SA node – AV node – bundle of His – Purkinje fibers
15. A client who has myocardial infarction is in the coronary unit on a cardiac monitor. The nurse
observes ventricular irritability on the screen. The nurse observes ventricular irritability on the
screen.
Lidocaine (Xylocaine)
16. Which of the following is a contraindication for digoxin administration?
Heart rate below 60
17. Which is the MOST appropriate action for the nurse to take before administering digoxin?
Monitor potassium level
18. The therapeutic drug level for digoxin is:
0.5-2.0 ng/mg
19. Blurred vision or halos are signs of:
Digoxin toxicity
20. When administering an antiarrhythmic agent, which of the following assessment parameters is
the most important for the nurse to evaluate?
ECG
21. A patient is prescribed Pravastatin. This medication is known as a _______?
HMG-CoA Reductase Inhibitor
22. Your patient is prescribed a statin medication for the treatment of hyperlipidemia. What
medication below may increase the patient’s risk of developing rhabdomyolysis if taken with a
statin?
Gemfibrozil
23. Which statement below accurately describes how statin medications work to lower cholesterol
levels?
Statins inhibit HMG-CoA reductase which in turn hinders cholesterol synthesis in the liver.
24. Your patient who is taking a statin develops yellowing of the skin, abdominal pain in the right
upper quadrant, and nausea. What lab result below correlates with this finding?
Elevated aminotransferase (ALT) and aspartate aminotransferase (AST)
25. A patient who recently started therapy with an HMG-CoA reductase inhibitor asks the nurse,
,A reduction usually is seen within 2 weeks
26. A patient presents to the clinic with complaints of muscle aches, muscle pain, and weakness.
Upon review of the individual’s medications, the nurse notes that the patient is concurrently taking
gemfibrozil (Lopid) and atorvastatin (Lipitor). The nurse should assess the patient for the
development of:
Myopathy
27. A nurse is instructing a patient receiving a cholesterol-lowering agent. Which information should
the nurse include in the patient education?
“You should continue your exercises program to increase your HDL serum levels.”
28. Which patients below would be at a HIGH risk for developing adverse effects of Heparin drug
therapy? Select all that apply:
A 55-year-old male patient who is post-op day 1 from brain surgery.
A 36-year-old male patient with active peptic ulcer disease.
29. Your patient is started on a Heparin drip. You administer a bolus of Heparin and start the drip per
protocol as ordered by the physician. What will be your next important nursing action?
Collect an aPTT level in 6 hours per protocol.
A patient is ordered to start an IV continuous Heparin drip. Prior to starting the medication, the nurse
would
Ensure what information is gathered correctly before initiation the drip?
Answer: Weight
What is the antidote for heparin?
Answer: Protamine sulfate
You’re providing care to a patient who has been receiving long-term doses of Heparin. What finding
in this
Patent may be experiencing a complication that can occur due to long-term use of this drug?
Answer: Bone fractures.
A client with deep vein thrombosis is receiving Streptokinase (Streptase). The nurse would notify the
Physician if which of the following assessment is noted?
Answer: A blood pressure of my 185/110 mm Hg
A nurse giving instruction to a client who is receiving Cholestyramine (Question) for the treatment of
Hyperlipidemia. Which of the following statements made by the client indicates the need for further
instructions?
Answer: I will continue taking nicotinic acid as a part of the treatment
When administering niacin, the nurse need to monitor need or which adverse effect?
Answer: Cutaneous flushing
When is the best time to take in nicotinic acid?
Answer: at bedtime
Which of these medications increases serum levels of uric acid and may predispose patients to the
development of gout.
Answer: Niacin(Niaspan)
, Answer: This medication blocks the enzyme that ads in the synthesis of the cholesterol.
Which of the medications is also indicated for patents with pruritus associated with partial biliary
obstruction?
Answer: Cholestyramine
Which of these medications act directly on smooth muscle of the blood vessels to cause relaxation
and to depress muscle tone thus lowering systemic blood pressure because of a drop in resistance?
Answer: Nitrates
In a 50-year-oold widower who had a transient ischemic attack, what is the most common
vasodilator used for his treatment?
Answer: Nitroprusside (Nitropress)
A physician writes a new medication order for a patient who has cardiovascular disease. The
medication is an angiotensin ll receptor blocker (ARB). What new medication on the patent’s
scheduled medication list is an ARB?
Answer: Losartan
Select all the pharmacodynamic effects of angiotensin ll receptor blockers (ARBs):
Answer: Vasodilation
Sodium excretion
Water excretion
What conditions are Angiotensin ll Receptor Blockers (ARBs) used to treat? Select all that apply:
Answer: Hypertension
Diabetic nephropathy in type 2 diabetics
Heart failure
A patient is taking an Angiotensin ll Receptor Blocker (ARB). What finding below is an adverse side
effect of this medication and should be reported the physician?
Answer: Potassium 6.8mEq/L
As the nurse you know to tell patient that the best way to PREVENT rebound hypertension while
taking an Angiotensin ll Receptor Blocker (ARB) is to?
Answer: never abruptly stop taking medication
You’re providing discharge teaching to a patient that will be taking an Angiotensin ll Receptor
Blocker (ARB) at home. What statement by the patient requires you to re-educate them about this
medication?
Answer: This medication can decrease potassium levels. So I will consume a det rich in
potassium to help keep my level normal.”
Your patent is prescribed an Angiotensin ll Receptor Blocker (ARB) for the treatment of blood
pressure
management. Which statement below Best describes how this medication will manage blood
pressure in a patient?
Answer: This medication will decrease systemic vascular resistance (SVR) and decrease blood
pressure, while decreasing blood volume through the excretion of the sodium and water.”
Your patient is prescribed a calcium channel blocker. As the nurse you know that these medication
works
to block calcium channels in what areas of the body? Select all that apply:
Answer: Vascular smooth muscle
