NR-541 \ NR541 \ NR 541 Advanced
Pharmacology Final Practice Exam 1 2025
QUESTIONS AND ANSWERS PLUS
RATIONALES| GUARANTEED PASS | LATEST
UPDATE | CHAMBERLAIN UNIVERSITY
1. A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which
laboratory test should the nurse monitor to assess the therapeutic effect of
warfarin?
A) Activated partial thromboplastin time (aPTT)
B) International normalized ratio (INR)
C) Platelet count
D) Prothrombin time (PTT)
Rationale:
Warfarin therapy is monitored primarily by the INR, which standardizes
prothrombin time (PT) results and helps ensure consistent dosing to reduce the
risk of clotting or bleeding.
,2. A patient receiving digoxin therapy shows signs of toxicity, including nausea,
vomiting, and visual disturbances. Which electrolyte imbalance commonly
predisposes patients to digoxin toxicity?
A) Hypercalcemia
B) Hypokalemia
C) Hypermagnesemia
D) Hypernatremia
Rationale:
Hypokalemia increases the risk of digoxin toxicity by enhancing digoxin’s binding
to myocardial cells, increasing its effects and potential for toxicity.
3. Which class of drugs is the first-line treatment for hypertension in patients
with diabetes mellitus due to their renal protective effects?
A) Beta-blockers
B) Calcium channel blockers
C) Angiotensin-converting enzyme inhibitors (ACE inhibitors)
D) Diuretics
Rationale:
ACE inhibitors are preferred in diabetics as they help reduce proteinuria and slow
the progression of diabetic nephropathy, providing renal protection beyond blood
pressure control.
,4. A patient is started on levothyroxine for hypothyroidism. How long does it
generally take for the full therapeutic effect of levothyroxine to be observed?
A) 1–2 days
B) 3–5 days
C) 4–6 weeks
D) Immediately
Rationale:
Levothyroxine has a long half-life, and it typically takes 4–6 weeks to reach steady
state and observe full therapeutic effects.
5. Which of the following medications is contraindicated in pregnancy due to its
teratogenic effects?
A) Acetaminophen
B) Labetalol
C) Warfarin
D) Insulin
Rationale:
Warfarin crosses the placenta and can cause fetal bleeding and teratogenic
effects, thus contraindicated in pregnancy.
6. A nurse is teaching a patient about the administration of alendronate
(Fosamax). Which instruction is most important to prevent esophageal
irritation?
, A) Take the medication with food
B) Take the medication with a full glass of water and remain upright for 30
minutes
C) Take the medication before bedtime
D) Crush the medication if difficulty swallowing
Rationale:
Alendronate can cause esophageal irritation and ulcers if not taken with adequate
water and if the patient lies down too soon after taking it.
7. A patient on phenytoin therapy develops gingival hyperplasia. Which is the
best nursing action?
A) Discontinue the medication immediately
B) Educate the patient on maintaining good oral hygiene
C) Increase the dose of phenytoin
D) Administer a mouth rinse containing steroids
Rationale:
Gingival hyperplasia is a common side effect of phenytoin. Good oral hygiene can
help minimize this effect. The drug should not be stopped without a physician’s
order.
8. Which antibiotic class is known to cause tendon rupture as a serious adverse
effect?
Pharmacology Final Practice Exam 1 2025
QUESTIONS AND ANSWERS PLUS
RATIONALES| GUARANTEED PASS | LATEST
UPDATE | CHAMBERLAIN UNIVERSITY
1. A patient is prescribed warfarin (Coumadin) for atrial fibrillation. Which
laboratory test should the nurse monitor to assess the therapeutic effect of
warfarin?
A) Activated partial thromboplastin time (aPTT)
B) International normalized ratio (INR)
C) Platelet count
D) Prothrombin time (PTT)
Rationale:
Warfarin therapy is monitored primarily by the INR, which standardizes
prothrombin time (PT) results and helps ensure consistent dosing to reduce the
risk of clotting or bleeding.
,2. A patient receiving digoxin therapy shows signs of toxicity, including nausea,
vomiting, and visual disturbances. Which electrolyte imbalance commonly
predisposes patients to digoxin toxicity?
A) Hypercalcemia
B) Hypokalemia
C) Hypermagnesemia
D) Hypernatremia
Rationale:
Hypokalemia increases the risk of digoxin toxicity by enhancing digoxin’s binding
to myocardial cells, increasing its effects and potential for toxicity.
3. Which class of drugs is the first-line treatment for hypertension in patients
with diabetes mellitus due to their renal protective effects?
A) Beta-blockers
B) Calcium channel blockers
C) Angiotensin-converting enzyme inhibitors (ACE inhibitors)
D) Diuretics
Rationale:
ACE inhibitors are preferred in diabetics as they help reduce proteinuria and slow
the progression of diabetic nephropathy, providing renal protection beyond blood
pressure control.
,4. A patient is started on levothyroxine for hypothyroidism. How long does it
generally take for the full therapeutic effect of levothyroxine to be observed?
A) 1–2 days
B) 3–5 days
C) 4–6 weeks
D) Immediately
Rationale:
Levothyroxine has a long half-life, and it typically takes 4–6 weeks to reach steady
state and observe full therapeutic effects.
5. Which of the following medications is contraindicated in pregnancy due to its
teratogenic effects?
A) Acetaminophen
B) Labetalol
C) Warfarin
D) Insulin
Rationale:
Warfarin crosses the placenta and can cause fetal bleeding and teratogenic
effects, thus contraindicated in pregnancy.
6. A nurse is teaching a patient about the administration of alendronate
(Fosamax). Which instruction is most important to prevent esophageal
irritation?
, A) Take the medication with food
B) Take the medication with a full glass of water and remain upright for 30
minutes
C) Take the medication before bedtime
D) Crush the medication if difficulty swallowing
Rationale:
Alendronate can cause esophageal irritation and ulcers if not taken with adequate
water and if the patient lies down too soon after taking it.
7. A patient on phenytoin therapy develops gingival hyperplasia. Which is the
best nursing action?
A) Discontinue the medication immediately
B) Educate the patient on maintaining good oral hygiene
C) Increase the dose of phenytoin
D) Administer a mouth rinse containing steroids
Rationale:
Gingival hyperplasia is a common side effect of phenytoin. Good oral hygiene can
help minimize this effect. The drug should not be stopped without a physician’s
order.
8. Which antibiotic class is known to cause tendon rupture as a serious adverse
effect?
