N180 | N180 Final Exam: Pharmacology - WCU
Updated and Latest Questions and Correct
Answers with Rationale
1. A patient with type 2 diabetes is prescribed metformin. Which mechanism of action
correctly describes how this drug lowers blood glucose levels?
A. It stimulates the pancreas to secrete more insulin into the bloodstream.
B. It inhibits the absorption of carbohydrates in the small intestine.
C. It decreases hepatic glucose production and increases insulin sensitivity.
D. It promotes the excretion of glucose through the renal system.
Correct Answer: C
Rationale: Metformin is a biguanide that primarily works by decreasing the amount of
glucose produced by the liver. It also improves the sensitivity of peripheral tissues to
existing insulin already in the body. Unlike sulfonylureas, it does not stimulate the pancreas
to release more insulin directly. This mechanism helps lower fasting and postprandial
blood glucose levels effectively. Patients should be monitored for renal function while
taking this medication to avoid complications.
2. A nurse is caring for a patient taking lisinopril for hypertension. Which side effect should
the nurse specifically monitor for that is unique to ACE inhibitors?
A. Persistent dry cough
B. Tachycardia
C. Hypokalemia
D. Constipation
Correct Answer: A
Rationale: ACE inhibitors like lisinopril prevent the breakdown of bradykinin in the lungs.
This accumulation of bradykinin often leads to a persistent and nonproductive dry cough.
Patients frequently report this symptom as a reason for wanting to switch medications. If
the cough becomes intolerable, the healthcare provider may prescribe an ARB instead.
Nurses must distinguish this side effect from signs of respiratory infection or heart failure.
3. A patient on warfarin therapy has an International Normalized Ratio (INR) of 7.0. Which
medication should the nurse expect the provider to order?
A. Protamine sulfate
B. Enoxaparin
C. Vitamin K
,D. Glucagon
Correct Answer: C
Rationale: Vitamin K is the specific antidote used to reverse the anticoagulant effects of
warfarin. An INR of 7.0 indicates a high risk for spontaneous bleeding and requires
intervention. The nurse should assess the patient for any signs of active hemorrhage
immediately. Depending on the clinical situation, Vitamin K can be administered orally or
intravenously. It works by promoting the synthesis of clotting factors in the liver.
4. A nurse is assessing a patient for digoxin toxicity. Which of the following symptoms is a
classic sign of this condition?
A. Hyperactivity and insomnia
B. Visual disturbances such as yellow-green halos
C. Increased urinary output
D. Hypertension
Correct Answer: B
Rationale: Digoxin has a narrow therapeutic index, making toxicity a significant clinical
concern for patients. Visual disturbances, particularly seeing yellow, green, or white halos
around lights, are hallmark signs. Other early symptoms include nausea, vomiting, and
profound anorexia. Bradycardia and various cardiac dysrhythmias can also occur as the
toxicity level increases. The nurse must check the apical pulse for one full minute before
administration.
5. A patient is receiving furosemide for the treatment of peripheral edema. Which laboratory
value is the priority for the nurse to monitor?
A. Serum sodium
B. Serum calcium
C. Serum potassium
D. Hemoglobin
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes the body to excrete significant
amounts of potassium. Hypokalemia is a frequent and dangerous adverse effect that can
lead to cardiac arrhythmias. The nurse must monitor the patient’s serum potassium levels
regularly throughout the therapy. Patients are often encouraged to consume potassium-
rich foods or take supplements as prescribed. If the level drops too low, the medication
might need to be temporarily held.
, 6. Which instruction should the nurse include when teaching a patient about taking
levothyroxine for hypothyroidism?
A. Take the medication on an empty stomach in the morning.
B. Take the medication with a high-calcium snack.
C. Take the medication right before going to bed.
D. Stop the medication once energy levels return to normal.
Correct Answer: A
Rationale: Levothyroxine absorption is most effective when the stomach is empty and free
of interfering substances. Patients are advised to take it at least 30 to 60 minutes before
breakfast. Calcium and other minerals can bind to the drug and prevent proper absorption
in the gut. Consistency in the time of administration is also vital for maintaining stable
thyroid levels. This medication is usually a lifelong replacement therapy and should not be
stopped abruptly.
7. A patient is receiving gentamicin intravenously. The nurse should be most concerned about
which adverse effect?
A. Orange discoloration of urine
B. Tinnitus and hearing loss
C. Gingival hyperplasia
D. Increased appetite
Correct Answer: B
Rationale: Gentamicin is an aminoglycoside antibiotic known for its potential to cause
severe ototoxicity. Tinnitus, or ringing in the ears, is often the first sign of damage to the
auditory nerve. It is also highly nephrotoxic, requiring frequent monitoring of BUN and
creatinine levels. Peak and trough levels are measured to ensure the drug stays within a
safe range. If hearing changes occur, the nurse must notify the provider to prevent
permanent deafness.
8. A nurse is teaching a patient how to use sublingual nitroglycerin for chest pain. What
should the patient do if the pain is not relieved after the first dose?
A. Take a second dose and call 911 immediately.
B. Wait 15 minutes and then call the doctor.
C. Exercise to improve blood flow to the heart.
D. Take two doses at once to ensure relief.
Correct Answer: A
Updated and Latest Questions and Correct
Answers with Rationale
1. A patient with type 2 diabetes is prescribed metformin. Which mechanism of action
correctly describes how this drug lowers blood glucose levels?
A. It stimulates the pancreas to secrete more insulin into the bloodstream.
B. It inhibits the absorption of carbohydrates in the small intestine.
C. It decreases hepatic glucose production and increases insulin sensitivity.
D. It promotes the excretion of glucose through the renal system.
Correct Answer: C
Rationale: Metformin is a biguanide that primarily works by decreasing the amount of
glucose produced by the liver. It also improves the sensitivity of peripheral tissues to
existing insulin already in the body. Unlike sulfonylureas, it does not stimulate the pancreas
to release more insulin directly. This mechanism helps lower fasting and postprandial
blood glucose levels effectively. Patients should be monitored for renal function while
taking this medication to avoid complications.
2. A nurse is caring for a patient taking lisinopril for hypertension. Which side effect should
the nurse specifically monitor for that is unique to ACE inhibitors?
A. Persistent dry cough
B. Tachycardia
C. Hypokalemia
D. Constipation
Correct Answer: A
Rationale: ACE inhibitors like lisinopril prevent the breakdown of bradykinin in the lungs.
This accumulation of bradykinin often leads to a persistent and nonproductive dry cough.
Patients frequently report this symptom as a reason for wanting to switch medications. If
the cough becomes intolerable, the healthcare provider may prescribe an ARB instead.
Nurses must distinguish this side effect from signs of respiratory infection or heart failure.
3. A patient on warfarin therapy has an International Normalized Ratio (INR) of 7.0. Which
medication should the nurse expect the provider to order?
A. Protamine sulfate
B. Enoxaparin
C. Vitamin K
,D. Glucagon
Correct Answer: C
Rationale: Vitamin K is the specific antidote used to reverse the anticoagulant effects of
warfarin. An INR of 7.0 indicates a high risk for spontaneous bleeding and requires
intervention. The nurse should assess the patient for any signs of active hemorrhage
immediately. Depending on the clinical situation, Vitamin K can be administered orally or
intravenously. It works by promoting the synthesis of clotting factors in the liver.
4. A nurse is assessing a patient for digoxin toxicity. Which of the following symptoms is a
classic sign of this condition?
A. Hyperactivity and insomnia
B. Visual disturbances such as yellow-green halos
C. Increased urinary output
D. Hypertension
Correct Answer: B
Rationale: Digoxin has a narrow therapeutic index, making toxicity a significant clinical
concern for patients. Visual disturbances, particularly seeing yellow, green, or white halos
around lights, are hallmark signs. Other early symptoms include nausea, vomiting, and
profound anorexia. Bradycardia and various cardiac dysrhythmias can also occur as the
toxicity level increases. The nurse must check the apical pulse for one full minute before
administration.
5. A patient is receiving furosemide for the treatment of peripheral edema. Which laboratory
value is the priority for the nurse to monitor?
A. Serum sodium
B. Serum calcium
C. Serum potassium
D. Hemoglobin
Correct Answer: C
Rationale: Furosemide is a loop diuretic that causes the body to excrete significant
amounts of potassium. Hypokalemia is a frequent and dangerous adverse effect that can
lead to cardiac arrhythmias. The nurse must monitor the patient’s serum potassium levels
regularly throughout the therapy. Patients are often encouraged to consume potassium-
rich foods or take supplements as prescribed. If the level drops too low, the medication
might need to be temporarily held.
, 6. Which instruction should the nurse include when teaching a patient about taking
levothyroxine for hypothyroidism?
A. Take the medication on an empty stomach in the morning.
B. Take the medication with a high-calcium snack.
C. Take the medication right before going to bed.
D. Stop the medication once energy levels return to normal.
Correct Answer: A
Rationale: Levothyroxine absorption is most effective when the stomach is empty and free
of interfering substances. Patients are advised to take it at least 30 to 60 minutes before
breakfast. Calcium and other minerals can bind to the drug and prevent proper absorption
in the gut. Consistency in the time of administration is also vital for maintaining stable
thyroid levels. This medication is usually a lifelong replacement therapy and should not be
stopped abruptly.
7. A patient is receiving gentamicin intravenously. The nurse should be most concerned about
which adverse effect?
A. Orange discoloration of urine
B. Tinnitus and hearing loss
C. Gingival hyperplasia
D. Increased appetite
Correct Answer: B
Rationale: Gentamicin is an aminoglycoside antibiotic known for its potential to cause
severe ototoxicity. Tinnitus, or ringing in the ears, is often the first sign of damage to the
auditory nerve. It is also highly nephrotoxic, requiring frequent monitoring of BUN and
creatinine levels. Peak and trough levels are measured to ensure the drug stays within a
safe range. If hearing changes occur, the nurse must notify the provider to prevent
permanent deafness.
8. A nurse is teaching a patient how to use sublingual nitroglycerin for chest pain. What
should the patient do if the pain is not relieved after the first dose?
A. Take a second dose and call 911 immediately.
B. Wait 15 minutes and then call the doctor.
C. Exercise to improve blood flow to the heart.
D. Take two doses at once to ensure relief.
Correct Answer: A
