NURS 180 Pharmacology Module Exam 4 (Week 12) Comprehensive
Test 2026 |WCU
1. A patient with heart failure is receiving Digoxin. Which laboratory result
would most significantly increase the risk for digoxin toxicity?
A. Serum sodium level of 138 mEq/L
B. Serum potassium level of 3.2 mEq/L
C. Serum calcium level of 9.5 mg/dL
D. Serum magnesium level of 2.0 mg/dL
Answer: B
Rationale: Hypokalemia (low potassium) sensitizes the myocardium to digoxin,
significantly increasing the risk of toxicity even if the digoxin level is within the therapeutic
range.
2. When administering intravenous Heparin, the nurse should monitor which
laboratory value to adjust the dosage?
A. International Normalized Ratio (INR)
B. Activated Partial Thromboplastin Time (aPTT)
C. Prothrombin Time (PT)
D. Platelet count
Answer: B
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
heparin therapy and adjust the continuous infusion rate.
,3. A patient is prescribed Warfarin for atrial fibrillation. Which of the following
statements by the patient indicates a need for further teaching?
A. I will use a soft-bristled toothbrush.
B. I will report any unusual bruising to my doctor.
C. I will increase my intake of spinach and kale to stay healthy.
D. I need to have my blood checked regularly for the INR level.
Answer: C
Rationale: Dark green leafy vegetables like spinach and kale are high in Vitamin K, which is
the antagonist to Warfarin. Sudden increases in Vitamin K intake can decrease the
effectiveness of the medication.
4. Which medication is the antidote for a patient experiencing a respiratory rate
of 6 breaths per minute after receiving Morphine Sulfate?
A. Naloxone
B. Acetylcysteine
C. Protamine Sulfate
D. Flumazenil
Answer: A
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory
depression.
5. A patient is diagnosed with Type 2 Diabetes and is scheduled for a CT scan
with intravenous contrast dye. Which medication must be held 48 hours before
and after the procedure?
A. Pioglitazone
B. Glyburide
C. Metformin
D. Sitagliptin
Answer: C
, Rationale: Metformin must be held to prevent the risk of lactic acidosis, as both the
contrast dye and metformin are cleared by the kidneys, and the dye can cause temporary
renal impairment.
6. A nurse is preparing to administer Lisinopril to a patient. Which of the
following is a potentially life-threatening adverse effect of this medication?
A. Angioedema
B. Dry, non-productive cough
C. Hyperuricemia
D. Hypokalemia
Answer: A
Rationale: Angioedema (swelling of the lips, tongue, and glottis) is a medical emergency
associated with ACE inhibitors like Lisinopril.
7. A patient with a history of asthma is admitted with hypertension. Which
beta-blocker should the nurse clarify with the provider?
A. Metoprolol
B. Atenolol
C. Propranolol
D. Bisoprolol
Answer: C
Rationale: Propranolol is a non-selective beta-blocker that can cause bronchoconstriction
by blocking Beta-2 receptors in the lungs, making it contraindicated for patients with
asthma.
Test 2026 |WCU
1. A patient with heart failure is receiving Digoxin. Which laboratory result
would most significantly increase the risk for digoxin toxicity?
A. Serum sodium level of 138 mEq/L
B. Serum potassium level of 3.2 mEq/L
C. Serum calcium level of 9.5 mg/dL
D. Serum magnesium level of 2.0 mg/dL
Answer: B
Rationale: Hypokalemia (low potassium) sensitizes the myocardium to digoxin,
significantly increasing the risk of toxicity even if the digoxin level is within the therapeutic
range.
2. When administering intravenous Heparin, the nurse should monitor which
laboratory value to adjust the dosage?
A. International Normalized Ratio (INR)
B. Activated Partial Thromboplastin Time (aPTT)
C. Prothrombin Time (PT)
D. Platelet count
Answer: B
Rationale: The aPTT is the standard laboratory test used to monitor the effectiveness of
heparin therapy and adjust the continuous infusion rate.
,3. A patient is prescribed Warfarin for atrial fibrillation. Which of the following
statements by the patient indicates a need for further teaching?
A. I will use a soft-bristled toothbrush.
B. I will report any unusual bruising to my doctor.
C. I will increase my intake of spinach and kale to stay healthy.
D. I need to have my blood checked regularly for the INR level.
Answer: C
Rationale: Dark green leafy vegetables like spinach and kale are high in Vitamin K, which is
the antagonist to Warfarin. Sudden increases in Vitamin K intake can decrease the
effectiveness of the medication.
4. Which medication is the antidote for a patient experiencing a respiratory rate
of 6 breaths per minute after receiving Morphine Sulfate?
A. Naloxone
B. Acetylcysteine
C. Protamine Sulfate
D. Flumazenil
Answer: A
Rationale: Naloxone is an opioid antagonist used to reverse opioid-induced respiratory
depression.
5. A patient is diagnosed with Type 2 Diabetes and is scheduled for a CT scan
with intravenous contrast dye. Which medication must be held 48 hours before
and after the procedure?
A. Pioglitazone
B. Glyburide
C. Metformin
D. Sitagliptin
Answer: C
, Rationale: Metformin must be held to prevent the risk of lactic acidosis, as both the
contrast dye and metformin are cleared by the kidneys, and the dye can cause temporary
renal impairment.
6. A nurse is preparing to administer Lisinopril to a patient. Which of the
following is a potentially life-threatening adverse effect of this medication?
A. Angioedema
B. Dry, non-productive cough
C. Hyperuricemia
D. Hypokalemia
Answer: A
Rationale: Angioedema (swelling of the lips, tongue, and glottis) is a medical emergency
associated with ACE inhibitors like Lisinopril.
7. A patient with a history of asthma is admitted with hypertension. Which
beta-blocker should the nurse clarify with the provider?
A. Metoprolol
B. Atenolol
C. Propranolol
D. Bisoprolol
Answer: C
Rationale: Propranolol is a non-selective beta-blocker that can cause bronchoconstriction
by blocking Beta-2 receptors in the lungs, making it contraindicated for patients with
asthma.
