Ecpi, Charleston Nur 138 pharmacology
FINAL!!! Questions With Complete Solutions
Course
Nur 138
1. A nurse is administering lisinopril to a client with hypertension. What adverse
effect is most concerning?
A. Headache
B. Dry cough
C. Dizziness
D. Swelling of the tongue and lips
✅ Correct Answer: D. Swelling of the tongue and lips
Rationale: This indicates angioedema, a rare but life-threatening reaction to ACE inhibitors.
Requires immediate discontinuation.
2. Which medication requires peak and trough levels?
A. Ceftriaxone
B. Vancomycin
C. Metronidazole
D. Azithromycin
✅ Correct Answer: B. Vancomycin
Rationale: Vancomycin has a narrow therapeutic index. Monitor peak (toxicity) and trough
(efficacy) levels to prevent nephrotoxicity and ototoxicity.
3. A client taking levothyroxine asks when to take it. What is the best response?
A. “Take it with food in the evening.”
B. “Take it once weekly after dinner.”
C. “Take it every morning on an empty stomach.”
D. “Take it at bedtime with milk.”
✅ Correct Answer: C. “Take it every morning on an empty stomach.”
Rationale: Food interferes with absorption. Best taken 30–60 minutes before breakfast.
4. Which lab value should the nurse monitor when a client is taking furosemide?
,A. Platelets
B. Glucose
C. Potassium
D. AST/ALT
✅ Correct Answer: C. Potassium
Rationale: Loop diuretics like furosemide can cause hypokalemia, leading to dysrhythmias.
5. Which symptom should be reported immediately in a client taking clozapine?
A. Weight gain
B. Drowsiness
C. Constipation
D. Sore throat and fever
✅ Correct Answer: D. Sore throat and fever
Rationale: Clozapine can cause agranulocytosis. Signs of infection (fever, sore throat) must be
reported and evaluated with a CBC.
6. A nurse is preparing to give insulin glargine. Which statement is correct?
A. “This insulin is mixed with regular insulin.”
B. “It peaks at 2 hours.”
C. “It has no peak and is given once daily.”
D. “It is used for hypoglycemia emergencies.”
✅ Correct Answer: C. “It has no peak and is given once daily.”
Rationale: Insulin glargine (Lantus) is a long-acting insulin with no pronounced peak,
providing steady baseline coverage.
7. What finding indicates digoxin toxicity?
A. Nausea and blurred vision
B. Tachycardia
C. Weight gain
D. Increased appetite
✅ Correct Answer: A. Nausea and blurred vision
Rationale: Early signs of digoxin toxicity include GI symptoms (nausea, vomiting), visual
changes (yellow/green halos), and bradycardia.
,8. A client taking lithium develops vomiting and diarrhea. What should the nurse
do first?
A. Administer antiemetic and antidiarrheal
B. Encourage fluid intake
C. Notify the provider immediately
D. Document and reassess in 2 hours
✅ Correct Answer: C. Notify the provider immediately
Rationale: These are signs of lithium toxicity, especially if dehydration occurs. Lithium has a
narrow therapeutic range (0.6–1.2 mEq/L).
9. Which client statement indicates understanding about nitroglycerin sublingual
tablets?
A. “I’ll take one tablet daily to prevent chest pain.”
B. “I’ll swallow the tablet with a full glass of water.”
C. “I can take one tablet every 5 minutes, up to three doses.”
D. “I should lie down after taking it due to headache.”
✅ Correct Answer: C. “I can take one tablet every 5 minutes, up to three doses.”
Rationale: Sublingual nitroglycerin is taken at symptom onset, up to 3 times, with
emergency help sought if no relief after first dose.
10. What should the nurse monitor for in a client taking prednisone long term?
A. Hyperkalemia
B. Weight loss
C. Osteoporosis and hyperglycemia
D. Insomnia and hypotension
✅ Correct Answer: C. Osteoporosis and hyperglycemia
Rationale: Long-term corticosteroid use suppresses bone formation, increases blood sugar,
and raises risk of infection.
11. A client is prescribed warfarin. Which lab value is most important to monitor?
A. INR
B. aPTT
, C. Platelet count
D. Hemoglobin A1C
✅ Correct Answer: A. INR
Rationale: Warfarin (Coumadin) effectiveness is measured by INR. Therapeutic range: 2.0–
3.0 for most conditions.
12. What is a critical teaching point for a client starting phenytoin (Dilantin)?
A. Avoid caffeine
B. Take on an empty stomach
C. Expect reddish-brown urine
D. Maintain good oral hygiene and see a dentist regularly
✅ Correct Answer: D. Maintain good oral hygiene and see a dentist regularly
Rationale: Gingival hyperplasia is a known side effect. Oral hygiene and regular dental
visits are essential.
13. The nurse is giving metformin. What finding requires immediate intervention?
A. Creatinine 1.8 mg/dL
B. Blood glucose 120 mg/dL
C. Nausea
D. Diarrhea
✅ Correct Answer: A. Creatinine 1.8 mg/dL
Rationale: Metformin is contraindicated in renal impairment due to risk of lactic acidosis.
Hold and notify the provider.
14. What is the purpose of administering naloxone?
A. Treat opioid withdrawal
B. Treat opioid overdose
C. Enhance morphine’s effects
D. Prevent opioid addiction
✅ Correct Answer: B. Treat opioid overdose
Rationale: Naloxone (Narcan) is an opioid antagonist that rapidly reverses respiratory
depression.
FINAL!!! Questions With Complete Solutions
Course
Nur 138
1. A nurse is administering lisinopril to a client with hypertension. What adverse
effect is most concerning?
A. Headache
B. Dry cough
C. Dizziness
D. Swelling of the tongue and lips
✅ Correct Answer: D. Swelling of the tongue and lips
Rationale: This indicates angioedema, a rare but life-threatening reaction to ACE inhibitors.
Requires immediate discontinuation.
2. Which medication requires peak and trough levels?
A. Ceftriaxone
B. Vancomycin
C. Metronidazole
D. Azithromycin
✅ Correct Answer: B. Vancomycin
Rationale: Vancomycin has a narrow therapeutic index. Monitor peak (toxicity) and trough
(efficacy) levels to prevent nephrotoxicity and ototoxicity.
3. A client taking levothyroxine asks when to take it. What is the best response?
A. “Take it with food in the evening.”
B. “Take it once weekly after dinner.”
C. “Take it every morning on an empty stomach.”
D. “Take it at bedtime with milk.”
✅ Correct Answer: C. “Take it every morning on an empty stomach.”
Rationale: Food interferes with absorption. Best taken 30–60 minutes before breakfast.
4. Which lab value should the nurse monitor when a client is taking furosemide?
,A. Platelets
B. Glucose
C. Potassium
D. AST/ALT
✅ Correct Answer: C. Potassium
Rationale: Loop diuretics like furosemide can cause hypokalemia, leading to dysrhythmias.
5. Which symptom should be reported immediately in a client taking clozapine?
A. Weight gain
B. Drowsiness
C. Constipation
D. Sore throat and fever
✅ Correct Answer: D. Sore throat and fever
Rationale: Clozapine can cause agranulocytosis. Signs of infection (fever, sore throat) must be
reported and evaluated with a CBC.
6. A nurse is preparing to give insulin glargine. Which statement is correct?
A. “This insulin is mixed with regular insulin.”
B. “It peaks at 2 hours.”
C. “It has no peak and is given once daily.”
D. “It is used for hypoglycemia emergencies.”
✅ Correct Answer: C. “It has no peak and is given once daily.”
Rationale: Insulin glargine (Lantus) is a long-acting insulin with no pronounced peak,
providing steady baseline coverage.
7. What finding indicates digoxin toxicity?
A. Nausea and blurred vision
B. Tachycardia
C. Weight gain
D. Increased appetite
✅ Correct Answer: A. Nausea and blurred vision
Rationale: Early signs of digoxin toxicity include GI symptoms (nausea, vomiting), visual
changes (yellow/green halos), and bradycardia.
,8. A client taking lithium develops vomiting and diarrhea. What should the nurse
do first?
A. Administer antiemetic and antidiarrheal
B. Encourage fluid intake
C. Notify the provider immediately
D. Document and reassess in 2 hours
✅ Correct Answer: C. Notify the provider immediately
Rationale: These are signs of lithium toxicity, especially if dehydration occurs. Lithium has a
narrow therapeutic range (0.6–1.2 mEq/L).
9. Which client statement indicates understanding about nitroglycerin sublingual
tablets?
A. “I’ll take one tablet daily to prevent chest pain.”
B. “I’ll swallow the tablet with a full glass of water.”
C. “I can take one tablet every 5 minutes, up to three doses.”
D. “I should lie down after taking it due to headache.”
✅ Correct Answer: C. “I can take one tablet every 5 minutes, up to three doses.”
Rationale: Sublingual nitroglycerin is taken at symptom onset, up to 3 times, with
emergency help sought if no relief after first dose.
10. What should the nurse monitor for in a client taking prednisone long term?
A. Hyperkalemia
B. Weight loss
C. Osteoporosis and hyperglycemia
D. Insomnia and hypotension
✅ Correct Answer: C. Osteoporosis and hyperglycemia
Rationale: Long-term corticosteroid use suppresses bone formation, increases blood sugar,
and raises risk of infection.
11. A client is prescribed warfarin. Which lab value is most important to monitor?
A. INR
B. aPTT
, C. Platelet count
D. Hemoglobin A1C
✅ Correct Answer: A. INR
Rationale: Warfarin (Coumadin) effectiveness is measured by INR. Therapeutic range: 2.0–
3.0 for most conditions.
12. What is a critical teaching point for a client starting phenytoin (Dilantin)?
A. Avoid caffeine
B. Take on an empty stomach
C. Expect reddish-brown urine
D. Maintain good oral hygiene and see a dentist regularly
✅ Correct Answer: D. Maintain good oral hygiene and see a dentist regularly
Rationale: Gingival hyperplasia is a known side effect. Oral hygiene and regular dental
visits are essential.
13. The nurse is giving metformin. What finding requires immediate intervention?
A. Creatinine 1.8 mg/dL
B. Blood glucose 120 mg/dL
C. Nausea
D. Diarrhea
✅ Correct Answer: A. Creatinine 1.8 mg/dL
Rationale: Metformin is contraindicated in renal impairment due to risk of lactic acidosis.
Hold and notify the provider.
14. What is the purpose of administering naloxone?
A. Treat opioid withdrawal
B. Treat opioid overdose
C. Enhance morphine’s effects
D. Prevent opioid addiction
✅ Correct Answer: B. Treat opioid overdose
Rationale: Naloxone (Narcan) is an opioid antagonist that rapidly reverses respiratory
depression.
