BIO301 | BIO301 Pharmacology Exam 3 Version 1
Questions with Correct Answers and Expert
Explanation for Each Question
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding should lead the nurse to withhold the medication and notify the
provider?
A. Blood pressure of 110/70 mmHg
B. Potassium level of 4.2 mEq/L
C. Respiratory rate of 18 breaths per minute
D. Apical pulse of 52 beats per minute
Correct Answer: D
Expert Explanation: Digoxin is a cardiac glycoside that increases myocardial
contractility but also decreases the heart rate via the vagus nerve. The nurse must
assess the apical pulse for one full minute before administration to ensure cardiac
safety. If the heart rate is below 60 beats per minute in an adult, the medication
should be held to avoid severe bradycardia. This clinical decision is vital because
digoxin has a narrow therapeutic window and slow heart rates can signal toxicity.
The provider must be notified to evaluate the dosage and the patient’s current
cardiac status.
,2. A patient is prescribed lisinopril for hypertension. The patient reports a persistent,
dry, nonproductive cough. Which action should the nurse take?
A. Instruct the patient to use an over-the-counter cough suppressant.
B. Explain that this is a common side effect and will resolve in 48 hours.
C. Advise the patient to increase fluid intake to loosen secretions.
D. Inform the provider so the patient can be switched to an ARB.
Correct Answer: D
Expert Explanation: Lisinopril is an ACE inhibitor that commonly causes a dry
cough due to the accumulation of bradykinin in the lungs. This side effect is often
intolerable and typically does not resolve as long as the medication is continued.
Switching the patient to an Angiotensin II Receptor Blocker (ARB) usually
eliminates the cough while providing similar blood pressure benefits. The nurse
should advocate for this change because compliance is essential for long-term
hypertension management. Patients often find the cough impacts their quality of
life, necessitating a pharmacological alternative.
3. Which electrolyte imbalance should a nurse monitor for in a patient taking
furosemide?
A. Hypokalemia
B. Hyperkalemia
,C. Hypercalcemia
D. Hypocalcemia
Correct Answer: A
Expert Explanation: Furosemide is a potent loop diuretic that inhibits the
reabsorption of sodium and chloride in the loop of Henle. This mechanism leads to
significant excretion of water and potassium into the urine. Low potassium levels
can lead to dangerous cardiac dysrhythmias and muscle weakness in the patient.
Nurses must monitor serum potassium levels frequently to identify hypokalemia
early. Dietary education or potassium supplements are often required to maintain
homeostasis while the patient is on loop diuretics.
4. A patient is prescribed sublingual nitroglycerin for stable angina. What education
should the nurse provide regarding its use?
A. Take one tablet every 5 minutes for up to 3 doses if pain persists.
B. Swallow the tablet with a full glass of water.
C. Store the tablets in a clear plastic container for easy access.
D. Expect the medication to cause immediate hypertension.
Correct Answer: A
, Expert Explanation: Nitroglycerin works by relaxing vascular smooth muscle and
decreasing myocardial oxygen demand during anginal episodes. The sublingual
route allows for rapid absorption directly into the bloodstream for quick symptom
relief. Patients are taught to take one dose every five minutes for a maximum of
three doses. If pain is not relieved after the first dose, the patient should call
emergency services immediately. Proper storage in the original dark glass bottle is
also critical to maintain the drug’s potency.
5. The nurse is reviewing laboratory results for a patient on warfarin. Which value
indicates the drug is within the therapeutic range?
A. INR of 2.5
B. INR of 1.0
C. aPTT of 60 seconds
D. Platelet count of 100,000/mm3
Correct Answer: A
Expert Explanation: Warfarin therapy is monitored using the International
Normalized Ratio (INR) to ensure appropriate anticoagulation levels. For most
conditions like atrial fibrillation or DVT prevention, the target INR is between 2.0
and 3.0. An INR of 1.0 is considered a baseline or sub-therapeutic level for patients
on warfarin. If the INR is too high, the risk of life-threatening bleeding increases
Questions with Correct Answers and Expert
Explanation for Each Question
1. A nurse is preparing to administer digoxin to a patient with heart failure. Which
assessment finding should lead the nurse to withhold the medication and notify the
provider?
A. Blood pressure of 110/70 mmHg
B. Potassium level of 4.2 mEq/L
C. Respiratory rate of 18 breaths per minute
D. Apical pulse of 52 beats per minute
Correct Answer: D
Expert Explanation: Digoxin is a cardiac glycoside that increases myocardial
contractility but also decreases the heart rate via the vagus nerve. The nurse must
assess the apical pulse for one full minute before administration to ensure cardiac
safety. If the heart rate is below 60 beats per minute in an adult, the medication
should be held to avoid severe bradycardia. This clinical decision is vital because
digoxin has a narrow therapeutic window and slow heart rates can signal toxicity.
The provider must be notified to evaluate the dosage and the patient’s current
cardiac status.
,2. A patient is prescribed lisinopril for hypertension. The patient reports a persistent,
dry, nonproductive cough. Which action should the nurse take?
A. Instruct the patient to use an over-the-counter cough suppressant.
B. Explain that this is a common side effect and will resolve in 48 hours.
C. Advise the patient to increase fluid intake to loosen secretions.
D. Inform the provider so the patient can be switched to an ARB.
Correct Answer: D
Expert Explanation: Lisinopril is an ACE inhibitor that commonly causes a dry
cough due to the accumulation of bradykinin in the lungs. This side effect is often
intolerable and typically does not resolve as long as the medication is continued.
Switching the patient to an Angiotensin II Receptor Blocker (ARB) usually
eliminates the cough while providing similar blood pressure benefits. The nurse
should advocate for this change because compliance is essential for long-term
hypertension management. Patients often find the cough impacts their quality of
life, necessitating a pharmacological alternative.
3. Which electrolyte imbalance should a nurse monitor for in a patient taking
furosemide?
A. Hypokalemia
B. Hyperkalemia
,C. Hypercalcemia
D. Hypocalcemia
Correct Answer: A
Expert Explanation: Furosemide is a potent loop diuretic that inhibits the
reabsorption of sodium and chloride in the loop of Henle. This mechanism leads to
significant excretion of water and potassium into the urine. Low potassium levels
can lead to dangerous cardiac dysrhythmias and muscle weakness in the patient.
Nurses must monitor serum potassium levels frequently to identify hypokalemia
early. Dietary education or potassium supplements are often required to maintain
homeostasis while the patient is on loop diuretics.
4. A patient is prescribed sublingual nitroglycerin for stable angina. What education
should the nurse provide regarding its use?
A. Take one tablet every 5 minutes for up to 3 doses if pain persists.
B. Swallow the tablet with a full glass of water.
C. Store the tablets in a clear plastic container for easy access.
D. Expect the medication to cause immediate hypertension.
Correct Answer: A
, Expert Explanation: Nitroglycerin works by relaxing vascular smooth muscle and
decreasing myocardial oxygen demand during anginal episodes. The sublingual
route allows for rapid absorption directly into the bloodstream for quick symptom
relief. Patients are taught to take one dose every five minutes for a maximum of
three doses. If pain is not relieved after the first dose, the patient should call
emergency services immediately. Proper storage in the original dark glass bottle is
also critical to maintain the drug’s potency.
5. The nurse is reviewing laboratory results for a patient on warfarin. Which value
indicates the drug is within the therapeutic range?
A. INR of 2.5
B. INR of 1.0
C. aPTT of 60 seconds
D. Platelet count of 100,000/mm3
Correct Answer: A
Expert Explanation: Warfarin therapy is monitored using the International
Normalized Ratio (INR) to ensure appropriate anticoagulation levels. For most
conditions like atrial fibrillation or DVT prevention, the target INR is between 2.0
and 3.0. An INR of 1.0 is considered a baseline or sub-therapeutic level for patients
on warfarin. If the INR is too high, the risk of life-threatening bleeding increases
