N180 | N180 Exam 3: Pharmacology - WCU
Updated and Latest Questions and Correct
Answers with Rationale
1. A patient is prescribed levothyroxine for the treatment of hypothyroidism. Which
instruction should the nurse include in the teaching plan?
A. Take the medication with a full meal to avoid GI upset.
B. Wait at least 15 minutes after eating before taking the pill.
C. Take the medication at bedtime with a glass of milk.
D. Take the medication on an empty stomach 30-60 minutes before breakfast.
Correct Answer: D
Rationale: Levothyroxine is best absorbed when taken on an empty stomach in the early
morning. Food can significantly interfere with the absorption of the synthetic thyroid
hormone. Patients should wait at least 30 to 60 minutes before consuming any food or
caffeine. Calcium and iron supplements should be spaced at least 4 hours apart from this
drug. Maintaining a consistent routine is vital for achieving therapeutic hormone levels.
2. A nurse is monitoring a patient receiving intravenous morphine. Which assessment finding
should the nurse prioritize as the most serious adverse effect?
A. Constipation and abdominal distension.
B. Nausea and vomiting following administration.
C. Itching and localized redness at the injection site.
D. A respiratory rate of 8 breaths per minute.
Correct Answer: D
Rationale: Respiratory depression is the most life-threatening adverse effect associated
with opioid analgesics like morphine. A respiratory rate below 10 to 12 breaths per minute
requires immediate nursing intervention. The nurse should be prepared to administer
naloxone if the patient is overly sedated or has significant respiratory compromise. While
constipation is common, it is not an acute emergency like respiratory failure. Frequent
monitoring of vital signs and level of consciousness is mandatory during therapy.
3. A patient is receiving gentamicin for a severe infection. Which laboratory value should the
nurse monitor most closely to prevent toxicity?
A. Serum Creatinine and Blood Urea Nitrogen (BUN).
B. Serum Potassium levels.
C. Alanine Aminotransferase (ALT).
,D. Prothrombin Time (PT).
Correct Answer: A
Rationale: Aminoglycosides like gentamicin carry a high risk for nephrotoxicity and
ototoxicity. Serum creatinine and BUN are the primary indicators of renal function and
must be monitored regularly. If these values rise, it may indicate kidney damage requiring a
dosage adjustment or discontinuation. The nurse should also monitor trough levels to
ensure the drug is clearing the body properly. Maintaining adequate hydration is another
key nursing intervention to protect the kidneys.
4. A patient newly diagnosed with Type 2 Diabetes is started on Metformin. What is the most
common side effect the nurse should discuss?
A. Weight gain and fluid retention.
B. Hypoglycemia in the early morning.
C. Gastrointestinal upset such as diarrhea and nausea.
D. Metallic taste and increased appetite.
Correct Answer: C
Rationale: Metformin often causes gastrointestinal side effects including diarrhea, nausea,
and abdominal cramping. These symptoms are usually dose-related and often improve
over time as the patient adjusts. Taking the medication with food can help minimize these
uncomfortable gastric effects. Metformin is preferred because it typically does not cause
weight gain or significant hypoglycemia. Nurses should educate patients to report
persistent or severe GI distress to the provider.
5. A nurse is preparing to administer insulin lispro to a patient. When should the nurse
instruct the patient to eat?
A. Within 15 minutes of receiving the injection.
B. Exactly 45 minutes after the injection.
C. One hour before the injection is given.
D. Two hours after the injection to allow it to peak.
Correct Answer: A
Rationale: Insulin lispro is a rapid-acting insulin with an onset of action between 15 and
30 minutes. To prevent severe hypoglycemia, the patient must have a meal ready and
consume it shortly after administration. Peak action occurs within 0.5 to 2.5 hours, which
aligns with the rise in postprandial glucose. If the meal is delayed, the patient’s blood sugar
can drop dangerously low very quickly. The nurse must verify the food is present on the
unit before giving the dose.
, 6. A patient is asking about the maximum daily dose of acetaminophen. What is the correct
limit for a healthy adult to prevent hepatotoxicity?
A. 2,000 mg per day.
B. 3,000 mg per day.
C. 5,000 mg per day.
D. 4,000 mg per day.
Correct Answer: D
Rationale: The maximum daily limit for acetaminophen in a healthy adult is generally
4,000 mg. Exceeding this amount can lead to severe, irreversible liver damage or hepatic
failure. Patients with existing liver disease or chronic alcohol use should consume even
lower amounts or avoid it entirely. Many over-the-counter products contain
acetaminophen, so patients must be taught to read labels carefully. The nurse should
emphasize that toxicity can be silent until significant damage has occurred.
7. During an IV infusion of Vancomycin, the patient develops flushing of the neck and chest
and a rash. What is the nurse’s first action?
A. Stop the infusion immediately and notify the physician.
B. Administer an immediate dose of epinephrine.
C. Slow the infusion rate and continue monitoring.
D. Apply a cold compress to the affected area.
Correct Answer: C
Rationale: The symptoms described are consistent with Red Man Syndrome, which is a
rate-dependent reaction to Vancomycin. Unlike a true anaphylactic allergy, this reaction
can usually be managed by slowing the infusion rate. The nurse should slow the rate and
monitor the patient’s blood pressure and heart rate closely. Administering an
antihistamine like diphenhydramine before the next dose can also prevent recurrence. If
symptoms worsen or hemodynamic instability occurs, the infusion must be stopped.
8. A patient has a documented severe anaphylactic allergy to penicillin. Which class of
antibiotics should be used with extreme caution due to cross-sensitivity?
A. Cephalosporins.
B. Tetracyclines.
C. Macrolides.
D. Fluoroquinolones.
Correct Answer: A
Updated and Latest Questions and Correct
Answers with Rationale
1. A patient is prescribed levothyroxine for the treatment of hypothyroidism. Which
instruction should the nurse include in the teaching plan?
A. Take the medication with a full meal to avoid GI upset.
B. Wait at least 15 minutes after eating before taking the pill.
C. Take the medication at bedtime with a glass of milk.
D. Take the medication on an empty stomach 30-60 minutes before breakfast.
Correct Answer: D
Rationale: Levothyroxine is best absorbed when taken on an empty stomach in the early
morning. Food can significantly interfere with the absorption of the synthetic thyroid
hormone. Patients should wait at least 30 to 60 minutes before consuming any food or
caffeine. Calcium and iron supplements should be spaced at least 4 hours apart from this
drug. Maintaining a consistent routine is vital for achieving therapeutic hormone levels.
2. A nurse is monitoring a patient receiving intravenous morphine. Which assessment finding
should the nurse prioritize as the most serious adverse effect?
A. Constipation and abdominal distension.
B. Nausea and vomiting following administration.
C. Itching and localized redness at the injection site.
D. A respiratory rate of 8 breaths per minute.
Correct Answer: D
Rationale: Respiratory depression is the most life-threatening adverse effect associated
with opioid analgesics like morphine. A respiratory rate below 10 to 12 breaths per minute
requires immediate nursing intervention. The nurse should be prepared to administer
naloxone if the patient is overly sedated or has significant respiratory compromise. While
constipation is common, it is not an acute emergency like respiratory failure. Frequent
monitoring of vital signs and level of consciousness is mandatory during therapy.
3. A patient is receiving gentamicin for a severe infection. Which laboratory value should the
nurse monitor most closely to prevent toxicity?
A. Serum Creatinine and Blood Urea Nitrogen (BUN).
B. Serum Potassium levels.
C. Alanine Aminotransferase (ALT).
,D. Prothrombin Time (PT).
Correct Answer: A
Rationale: Aminoglycosides like gentamicin carry a high risk for nephrotoxicity and
ototoxicity. Serum creatinine and BUN are the primary indicators of renal function and
must be monitored regularly. If these values rise, it may indicate kidney damage requiring a
dosage adjustment or discontinuation. The nurse should also monitor trough levels to
ensure the drug is clearing the body properly. Maintaining adequate hydration is another
key nursing intervention to protect the kidneys.
4. A patient newly diagnosed with Type 2 Diabetes is started on Metformin. What is the most
common side effect the nurse should discuss?
A. Weight gain and fluid retention.
B. Hypoglycemia in the early morning.
C. Gastrointestinal upset such as diarrhea and nausea.
D. Metallic taste and increased appetite.
Correct Answer: C
Rationale: Metformin often causes gastrointestinal side effects including diarrhea, nausea,
and abdominal cramping. These symptoms are usually dose-related and often improve
over time as the patient adjusts. Taking the medication with food can help minimize these
uncomfortable gastric effects. Metformin is preferred because it typically does not cause
weight gain or significant hypoglycemia. Nurses should educate patients to report
persistent or severe GI distress to the provider.
5. A nurse is preparing to administer insulin lispro to a patient. When should the nurse
instruct the patient to eat?
A. Within 15 minutes of receiving the injection.
B. Exactly 45 minutes after the injection.
C. One hour before the injection is given.
D. Two hours after the injection to allow it to peak.
Correct Answer: A
Rationale: Insulin lispro is a rapid-acting insulin with an onset of action between 15 and
30 minutes. To prevent severe hypoglycemia, the patient must have a meal ready and
consume it shortly after administration. Peak action occurs within 0.5 to 2.5 hours, which
aligns with the rise in postprandial glucose. If the meal is delayed, the patient’s blood sugar
can drop dangerously low very quickly. The nurse must verify the food is present on the
unit before giving the dose.
, 6. A patient is asking about the maximum daily dose of acetaminophen. What is the correct
limit for a healthy adult to prevent hepatotoxicity?
A. 2,000 mg per day.
B. 3,000 mg per day.
C. 5,000 mg per day.
D. 4,000 mg per day.
Correct Answer: D
Rationale: The maximum daily limit for acetaminophen in a healthy adult is generally
4,000 mg. Exceeding this amount can lead to severe, irreversible liver damage or hepatic
failure. Patients with existing liver disease or chronic alcohol use should consume even
lower amounts or avoid it entirely. Many over-the-counter products contain
acetaminophen, so patients must be taught to read labels carefully. The nurse should
emphasize that toxicity can be silent until significant damage has occurred.
7. During an IV infusion of Vancomycin, the patient develops flushing of the neck and chest
and a rash. What is the nurse’s first action?
A. Stop the infusion immediately and notify the physician.
B. Administer an immediate dose of epinephrine.
C. Slow the infusion rate and continue monitoring.
D. Apply a cold compress to the affected area.
Correct Answer: C
Rationale: The symptoms described are consistent with Red Man Syndrome, which is a
rate-dependent reaction to Vancomycin. Unlike a true anaphylactic allergy, this reaction
can usually be managed by slowing the infusion rate. The nurse should slow the rate and
monitor the patient’s blood pressure and heart rate closely. Administering an
antihistamine like diphenhydramine before the next dose can also prevent recurrence. If
symptoms worsen or hemodynamic instability occurs, the infusion must be stopped.
8. A patient has a documented severe anaphylactic allergy to penicillin. Which class of
antibiotics should be used with extreme caution due to cross-sensitivity?
A. Cephalosporins.
B. Tetracyclines.
C. Macrolides.
D. Fluoroquinolones.
Correct Answer: A
