NUR2474 Pharmacology for Professional
Nursing
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. Case Study: A 70‑year‑old patient with congestive heart failure and
atrial fibrillation is receiving digoxin. The patient presents with nausea,
blurred vision, and an irregular heartbeat. Laboratory findings reveal
hypokalemia. Which of the following best explains these findings?
a) Progression of heart failure
b) Digoxin-induced toxicity exacerbated by hypokalemia
c) Inadequate dosing of diuretics
d) Unrelated gastrointestinal upset
- Correct ANS: b) Digoxin-induced toxicity exacerbated by
hypokalemia
- Rationale: Hypokalemia increases digoxin’s binding to the
Na⁺/K⁺‑ATPase receptor, predisposing the patient to toxicity. Signs such
as nausea, visual changes, and arrhythmias are classic for digoxin toxicity.
2. Case Study: A 65‑year‑old female with hypertension and
hyperlipidemia is started on a statin for cholesterol control. Two weeks
later, she complains of muscle aches and weakness. Which laboratory
test would be most appropriate to assess for a statin‑induced adverse
effect?
a) Serum creatinine
b) Creatine kinase (CK) level
c) Liver function tests
d) Electrolyte panel
- Correct ANS: b) Creatine kinase (CK) level
- Rationale: Elevated CK levels suggest muscle injury (myopathy), which
is a recognized adverse effect of statins.
3. Case Study: A 58‑year‑old patient with type II diabetes is initiated on
a glucagon‑like peptide‑1 (GLP‑1) receptor agonist for improved glycemic
control. Which adverse effect is most commonly associated with this
drug class?
a) Hypoglycemia
©2025
, b) Gastrointestinal upset (nausea, vomiting)
c) Weight gain
d) Hypertension
- Correct ANS: b) Gastrointestinal upset (nausea, vomiting)
- Rationale: GLP‑1 receptor agonists commonly cause gastrointestinal
side effects, such as nausea and vomiting, due to delayed gastric
emptying.
4. Case Study: A patient with gastroesophageal reflux disease (GERD) is
started on a proton pump inhibitor (PPI) long‑term. Which adverse effect
should the nurse monitor for over time?
a) Increased bone fracture risk due to decreased calcium absorption
b) Hypertensive crisis
c) Bronchospasm
d) Acute kidney injury from immediate hypersensitivity
- Correct ANS: a) Increased bone fracture risk due to decreased
calcium absorption
- Rationale: Long‑term PPI use has been linked to reduced calcium
absorption, which may over time increase the risk for osteoporosis and
related fractures.
5. Case Study: A patient receiving opioid analgesia for severe
postoperative pain develops respiratory depression. The physician orders
naloxone. What is the primary mechanism by which naloxone reverses
opioid toxicity?
a) Enhances opioid metabolism
b) Acts as a competitive antagonist at mu‑opioid receptors
c) Inhibits opioid synthesis
d) Blocks opioid receptors permanently
- Correct ANS: b) Acts as a competitive antagonist at mu‑opioid
receptors
- Rationale: Naloxone competitively binds to mu‑opioid receptors
without activating them, thereby displacing opioids and reversing their
effects, including respiratory depression.
©2025
Nursing
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. Case Study: A 70‑year‑old patient with congestive heart failure and
atrial fibrillation is receiving digoxin. The patient presents with nausea,
blurred vision, and an irregular heartbeat. Laboratory findings reveal
hypokalemia. Which of the following best explains these findings?
a) Progression of heart failure
b) Digoxin-induced toxicity exacerbated by hypokalemia
c) Inadequate dosing of diuretics
d) Unrelated gastrointestinal upset
- Correct ANS: b) Digoxin-induced toxicity exacerbated by
hypokalemia
- Rationale: Hypokalemia increases digoxin’s binding to the
Na⁺/K⁺‑ATPase receptor, predisposing the patient to toxicity. Signs such
as nausea, visual changes, and arrhythmias are classic for digoxin toxicity.
2. Case Study: A 65‑year‑old female with hypertension and
hyperlipidemia is started on a statin for cholesterol control. Two weeks
later, she complains of muscle aches and weakness. Which laboratory
test would be most appropriate to assess for a statin‑induced adverse
effect?
a) Serum creatinine
b) Creatine kinase (CK) level
c) Liver function tests
d) Electrolyte panel
- Correct ANS: b) Creatine kinase (CK) level
- Rationale: Elevated CK levels suggest muscle injury (myopathy), which
is a recognized adverse effect of statins.
3. Case Study: A 58‑year‑old patient with type II diabetes is initiated on
a glucagon‑like peptide‑1 (GLP‑1) receptor agonist for improved glycemic
control. Which adverse effect is most commonly associated with this
drug class?
a) Hypoglycemia
©2025
, b) Gastrointestinal upset (nausea, vomiting)
c) Weight gain
d) Hypertension
- Correct ANS: b) Gastrointestinal upset (nausea, vomiting)
- Rationale: GLP‑1 receptor agonists commonly cause gastrointestinal
side effects, such as nausea and vomiting, due to delayed gastric
emptying.
4. Case Study: A patient with gastroesophageal reflux disease (GERD) is
started on a proton pump inhibitor (PPI) long‑term. Which adverse effect
should the nurse monitor for over time?
a) Increased bone fracture risk due to decreased calcium absorption
b) Hypertensive crisis
c) Bronchospasm
d) Acute kidney injury from immediate hypersensitivity
- Correct ANS: a) Increased bone fracture risk due to decreased
calcium absorption
- Rationale: Long‑term PPI use has been linked to reduced calcium
absorption, which may over time increase the risk for osteoporosis and
related fractures.
5. Case Study: A patient receiving opioid analgesia for severe
postoperative pain develops respiratory depression. The physician orders
naloxone. What is the primary mechanism by which naloxone reverses
opioid toxicity?
a) Enhances opioid metabolism
b) Acts as a competitive antagonist at mu‑opioid receptors
c) Inhibits opioid synthesis
d) Blocks opioid receptors permanently
- Correct ANS: b) Acts as a competitive antagonist at mu‑opioid
receptors
- Rationale: Naloxone competitively binds to mu‑opioid receptors
without activating them, thereby displacing opioids and reversing their
effects, including respiratory depression.
©2025
