N180 | N180 Exam 2: Pharmacology - WCU
Updated and Latest Questions and Correct
Answers with Rationale
1. A patient is prescribed Digoxin for heart failure. Which clinical manifestation should the
nurse recognize as an early sign of Digoxin toxicity?
A. Hypotension
B. Anorexia and nausea
C. Increased urinary output
D. Tachycardia
Correct Answer: B
Rationale: Digoxin toxicity often presents first with gastrointestinal symptoms like
anorexia, nausea, and vomiting. Visual changes such as yellow-green halos are also
hallmark signs of high drug levels. The nurse must check the serum digoxin level and assess
for hypokalemia which potentiates toxicity. Bradycardia is a more common cardiac finding
than tachycardia in toxic states. It is essential to hold the dose if the apical pulse is less than
sixty.
2. Which laboratory value is most important for a nurse to monitor in a patient receiving
Furosemide (Lasix)?
A. Serum sodium
B. Blood urea nitrogen
C. Serum potassium
D. Serum creatinine
Correct Answer: C
Rationale: Furosemide is a potent loop diuretic that causes significant loss of potassium
through the kidneys. Hypokalemia is a dangerous side effect that can lead to cardiac
dysrhythmias and muscle weakness. Patients are often encouraged to eat potassium-rich
foods or take supplements while on this therapy. Monitoring the serum potassium level
helps prevent life-threatening complications related to electrolyte imbalance. The nurse
should report any value below three point five milliequivalents per liter immediately.
3. A patient taking Lisinopril for hypertension develops a persistent, dry cough. What is the
most likely cause of this symptom?
A. Pulmonary edema
B. Accumulation of bradykinin
,C. Upper respiratory infection
D. Allergic reaction to the drug
Correct Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin in the lungs which leads to
a dry, hacking cough. This side effect is not harmful but can be very annoying to the patient.
If the cough becomes intolerable, the healthcare provider may switch the patient to an ARB.
This cough does not usually respond to typical cough suppressants or antihistamines. It
typically resolves within a few days to weeks after stopping the medication.
4. What is the primary mechanism of action for Albuterol?
A. Suppression of the inflammatory response
B. Beta-2 adrenergic receptor stimulation
C. Inhibition of leukotriene release
D. Blocking of muscarinic receptors
Correct Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist that causes rapid bronchodilation by
relaxing smooth muscle. It is primarily used as a rescue medication for acute asthma
attacks or bronchospasm. Activation of beta-2 receptors in the lungs increases cyclic AMP
levels to facilitate airway opening. Common side effects include tachycardia, tremors, and
nervousness due to slight beta-1 crossover. Patients should be taught to use this inhaler
first before using a corticosteroid inhaler.
5. A patient is starting Omeprazole for GERD. When should the nurse instruct the patient to
take this medication?
A. Immediately after the largest meal of the day
B. At bedtime with a full glass of water
C. Thirty to sixty minutes before breakfast
D. Whenever heartburn symptoms occur
Correct Answer: C
Rationale: Proton pump inhibitors like Omeprazole are most effective when taken on an
empty stomach before meals. This timing allows the drug to inhibit the proton pumps when
they are most active after eating. Long-term use of these medications can lead to risks such
as bone fractures or B12 deficiency. Patients should not crush or chew delayed-release
capsules to ensure proper drug absorption. Consistent daily use is required for maximum
acid suppression rather than as-needed administration.
, 6. Which condition is a significant contraindication for the use of non-selective Beta-blockers
like Propranolol?
A. Hypertension
B. Glaucoma
C. Asthma
D. Tachycardia
Correct Answer: C
Rationale: Non-selective beta-blockers block both beta-1 and beta-2 receptors throughout
the body. Blocking beta-2 receptors in the lungs can cause bronchoconstriction and trigger
asthma attacks. Therefore, these drugs are generally avoided in patients with a history of
reactive airway disease. Selective beta-1 blockers are a safer alternative for cardiac
patients with respiratory issues. Nurses must assess the patient’s respiratory status
carefully after the first dose.
7. The nurse is preparing to administer Nitroglycerin sublingually to a patient with chest pain.
What is the appropriate action if the pain is not relieved after the first dose?
A. Wait 15 minutes and reassess the pain level
B. Give the patient an aspirin and wait for the doctor
C. Administer two more doses simultaneously
D. Administer a second dose and call 911 immediately
Correct Answer: D
Rationale: The standard protocol for sublingual nitroglycerin involves taking one dose at
the onset of chest pain. If pain persists after five minutes, the patient should call emergency
services and take a second dose. A maximum of three doses can be taken, each five minutes
apart, while waiting for help. Nitroglycerin works by dilating coronary arteries and
reducing preload through venous dilation. It is sensitive to light and heat and must be kept
in its original dark glass bottle.
8. Which laboratory test is used to monitor the therapeutic effect of Heparin?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count
Correct Answer: B
Updated and Latest Questions and Correct
Answers with Rationale
1. A patient is prescribed Digoxin for heart failure. Which clinical manifestation should the
nurse recognize as an early sign of Digoxin toxicity?
A. Hypotension
B. Anorexia and nausea
C. Increased urinary output
D. Tachycardia
Correct Answer: B
Rationale: Digoxin toxicity often presents first with gastrointestinal symptoms like
anorexia, nausea, and vomiting. Visual changes such as yellow-green halos are also
hallmark signs of high drug levels. The nurse must check the serum digoxin level and assess
for hypokalemia which potentiates toxicity. Bradycardia is a more common cardiac finding
than tachycardia in toxic states. It is essential to hold the dose if the apical pulse is less than
sixty.
2. Which laboratory value is most important for a nurse to monitor in a patient receiving
Furosemide (Lasix)?
A. Serum sodium
B. Blood urea nitrogen
C. Serum potassium
D. Serum creatinine
Correct Answer: C
Rationale: Furosemide is a potent loop diuretic that causes significant loss of potassium
through the kidneys. Hypokalemia is a dangerous side effect that can lead to cardiac
dysrhythmias and muscle weakness. Patients are often encouraged to eat potassium-rich
foods or take supplements while on this therapy. Monitoring the serum potassium level
helps prevent life-threatening complications related to electrolyte imbalance. The nurse
should report any value below three point five milliequivalents per liter immediately.
3. A patient taking Lisinopril for hypertension develops a persistent, dry cough. What is the
most likely cause of this symptom?
A. Pulmonary edema
B. Accumulation of bradykinin
,C. Upper respiratory infection
D. Allergic reaction to the drug
Correct Answer: B
Rationale: ACE inhibitors prevent the breakdown of bradykinin in the lungs which leads to
a dry, hacking cough. This side effect is not harmful but can be very annoying to the patient.
If the cough becomes intolerable, the healthcare provider may switch the patient to an ARB.
This cough does not usually respond to typical cough suppressants or antihistamines. It
typically resolves within a few days to weeks after stopping the medication.
4. What is the primary mechanism of action for Albuterol?
A. Suppression of the inflammatory response
B. Beta-2 adrenergic receptor stimulation
C. Inhibition of leukotriene release
D. Blocking of muscarinic receptors
Correct Answer: B
Rationale: Albuterol is a short-acting beta-2 agonist that causes rapid bronchodilation by
relaxing smooth muscle. It is primarily used as a rescue medication for acute asthma
attacks or bronchospasm. Activation of beta-2 receptors in the lungs increases cyclic AMP
levels to facilitate airway opening. Common side effects include tachycardia, tremors, and
nervousness due to slight beta-1 crossover. Patients should be taught to use this inhaler
first before using a corticosteroid inhaler.
5. A patient is starting Omeprazole for GERD. When should the nurse instruct the patient to
take this medication?
A. Immediately after the largest meal of the day
B. At bedtime with a full glass of water
C. Thirty to sixty minutes before breakfast
D. Whenever heartburn symptoms occur
Correct Answer: C
Rationale: Proton pump inhibitors like Omeprazole are most effective when taken on an
empty stomach before meals. This timing allows the drug to inhibit the proton pumps when
they are most active after eating. Long-term use of these medications can lead to risks such
as bone fractures or B12 deficiency. Patients should not crush or chew delayed-release
capsules to ensure proper drug absorption. Consistent daily use is required for maximum
acid suppression rather than as-needed administration.
, 6. Which condition is a significant contraindication for the use of non-selective Beta-blockers
like Propranolol?
A. Hypertension
B. Glaucoma
C. Asthma
D. Tachycardia
Correct Answer: C
Rationale: Non-selective beta-blockers block both beta-1 and beta-2 receptors throughout
the body. Blocking beta-2 receptors in the lungs can cause bronchoconstriction and trigger
asthma attacks. Therefore, these drugs are generally avoided in patients with a history of
reactive airway disease. Selective beta-1 blockers are a safer alternative for cardiac
patients with respiratory issues. Nurses must assess the patient’s respiratory status
carefully after the first dose.
7. The nurse is preparing to administer Nitroglycerin sublingually to a patient with chest pain.
What is the appropriate action if the pain is not relieved after the first dose?
A. Wait 15 minutes and reassess the pain level
B. Give the patient an aspirin and wait for the doctor
C. Administer two more doses simultaneously
D. Administer a second dose and call 911 immediately
Correct Answer: D
Rationale: The standard protocol for sublingual nitroglycerin involves taking one dose at
the onset of chest pain. If pain persists after five minutes, the patient should call emergency
services and take a second dose. A maximum of three doses can be taken, each five minutes
apart, while waiting for help. Nitroglycerin works by dilating coronary arteries and
reducing preload through venous dilation. It is sensitive to light and heat and must be kept
in its original dark glass bottle.
8. Which laboratory test is used to monitor the therapeutic effect of Heparin?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International Normalized Ratio (INR)
D. Platelet count
Correct Answer: B
