Pharmacology for Professional Nursing: Exam 2 Review Questions and Answers, Exams of Nursing

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NUR 2474 Exam 2 Pharmacology for Professional

Nursing Exam 2 (Latest 2025) Rasmussen College

Chapter-

Questions 1.ID: 3772679757 A patient is brought to the emergency department with shortness of breath, a respiratory rate of 30 breaths per minute, intercostal retractions, and frothy, pink sputum. The nurse caring for this patient will expect to administer which drug? Furosemide [Lasix] Correct Hydrochlorothiazide [HydroDIURIL] Mannitol [Osmitrol] Spironolactone [Aldactone] 2.ID: 3772679749 A patient who is taking digoxin is admitted to the hospital for treatment of congestive heart failure. The prescriber has ordered furosemide [Lasix]. The nurse notes an irregular heart rate of 86 beats per minute, a respiratory rate of 22 breaths per minute, and a blood pressure of 130/82 mm Hg. The nurse auscultates crackles in both lungs. Which laboratory value causes the nurse the most concern? Blood glucose level of 120 mg/dL Oxygen saturation of 90% Potassium level of 3.5 mEq/L Correct Sodium level of 140 mEq/L 3.ID: 3772679751 A patient has 2+ pitting edema of the lower extremities bilaterally. Auscultation of the lungs reveals crackles bilaterally, and the serum potassium level is 6 mEq/L. Which diuretic agent ordered by the prescriber should the nurse question? Bumetanide [Bumex] Furosemide [Lasix] Spironolactone [Aldactone] Correct Hydrochlorothiazide [HydroDIURIL] 4.ID: 3772679741 A nurse preparing to administer morning medications notes that a patient with a history of hypertension has been prescribed spironolactone [Aldactone]. The nurse assesses the patient and notes dyspnea, bilateral crackles, and pitting edema in both feet. Which intervention is appropriate? Administer the medications as ordered. Ask the patient about the use of salt substitutes. Contact the provider to request an order for serum electrolytes. Request an order for furosemide [Lasix]. Correct 5.ID: 3772679753

10.ID: 3772679747

Besides having diuretic effects for patients with congestive heart failure, thiazides are also used to treat what? (Select all that apply.) Diabetes insipidus Correct Hepatic failure Correct Increased intracranial pressure Intraocular pressure Postmenopausal osteoporosis Correct

Chapter-

1. A patient who is a chronic alcoholic is admitted to the hospital. Admission laboratory work reveals a magnesium level of 1.2 mEq/L. The prescriber orders intravenous magnesium sulfate in a 10% solution at a rate of 10 mL/min. What will the nurse do? Administer the IV dose as ordered and have calcium gluconate on hand. Administer the IV dose and make preparations for mechanical ventilation. Hold the IV dose until the infusion rate has been clarified with the provider. Correct Request an order for renal function tests before administering the IV dose. 2.ID: 3772725808 A patient who was injured at home is brought to the emergency department. The nurse caring for this patient notes a respiratory rate of 32 breaths per minute and a heart rate of 90 beats per minute. The injuries are minor, but the patient is inconsolable and hysterical. The nurse expects that initial management will include: administering a gas mixture of 5% carbon dioxide (CO2). Correct providing 100% oxygen via nasal cannula. giving sodium bicarbonate IV. providing sedatives to calm the patient. 3.ID: 3772723694 A child who ingested a handful of aspirin tablets from a medicine cabinet at home is brought to the emergency department. The nurse caring for the child notes a respiratory rate of 48 breaths per minute. The nurse understands that this child’s respiratory rate is the result of the body’s attempt to compensate for: metabolic acidosis. Correct metabolic alkalosis. respiratory acidosis. respiratory alkalosis. 4.ID: 3772725804 A patient with congestive heart failure is admitted to the hospital. During the admission assessment, the nurse learns that the patient is taking a thiazide diuretic. The nurse notes that the admission electrolyte levels include a sodium level of 142 mEq/L, a chloride level of 95 mEq/L, and a potassium level of 3 mEq/L. The

prescriber has ordered digoxin to be given immediately. What will the nurse do initially? Give the digoxin and maintain close cardiac monitoring. Hold the digoxin and report the laboratory values to the provider. Correct Hold the thiazide diuretic and give the digoxin. Request an order for an electrocardiogram (ECG). 5.ID: 3772725816 A patient collapses after running a marathon on a hot day and is brought to the emergency department to be treated for dehydration. The nurse will expect to provide which therapy? Intravenous hypertonic fluids given slowly over several hours Intravenous hypotonic fluids administered in stages Correct Intravenous isotonic fluids given as a rapid bolus Oral electrolyte replacement fluids with potassium 6.ID: 3772725802 A nurse is caring for a child whose respirations are shallow and marked by a prolonged expiratory phase. The nurse auscultates wheezes and poor air movement bilaterally. The child’s respiratory rate is 26 breaths per minute, and the oxygen saturation is 89%. What does the nurse suspect? Metabolic acidosis Metabolic alkalosis Respiratory acidosis Correct Respiratory alkalosis 7.ID: 3772723696 A nurse is caring for a postoperative patient who has a nasogastric tube with continuous suction. The nurse notes that the patient has shallow respirations and suspects that this patient has developed: metabolic acidosis. metabolic alkalosis. Correct respiratory acidosis. respiratory alkalosis. 8.ID: 3772725810 While performing an admission assessment on a patient, the nurse learns that the patient is taking furosemide [Lasix], digoxin, and spironolactone [Aldactone]. A diet history reveals the use of salt substitutes. The patient is confused and dyspneic and complains of hand and foot tingling. Which is an appropriate nursing action for this patient? Contact the provider to request orders for an electrocardiogram and serum electrolyte levels. Correct Evaluate the patient’s urine output and request an order for intravenous potassium. Hold the next dose of furosemide and request an order for intravenous magnesium sulfate. Request an order for intravenous insulin to help this patient regulate extracellular potassium. 9.ID: 3772723698

myocardial contractility. Correct venous return. 2.ID: 3772712928 A nurse is caring for a patient who is receiving a drug that causes constriction of arterioles. The nurse expects to observe which effect from this drug? Decreased stroke volume Correct Increased stroke volume Decreased myocardial contractility Increased myocardial contractility 3.ID: 3772712930 A patient with a history of hypertension is admitted for a procedure. If the patient’s arterial pressure decreases, which clinical manifestation would the nurse expect to see? Decreased heart rate Increased heart rate Correct Decreased blood pressure Syncope 4.ID: 3772712936 A nurse is teaching a nursing student how blood can return to the heart when pressure in the venous capillary beds is very low. Which statement by the student indicates a need for further teaching? “Constriction of small muscles in the venous wall increases venous pressure.” “Negative pressure in the left atrium draws blood toward the heart.” “Skeletal muscles relax to allow the free flow of blood.” Correct “Venous valves help prevent the backflow of blood.” 5.ID: 3772712932 A nurse is assessing a patient who has heart failure. The patient complains of shortness of breath, and the nurse auscultates crackles in both lungs. The nurse understands that these symptoms are the result of: decreased force of ventricular contraction. Correct increased force of ventricular contraction. decreased ventricular filling. increased ventricular filling. 6.ID: 3772712934 A patient with hypertension is admitted to the hospital. On admission the patient’s heart rate is 72 beats per minute, and the blood pressure is 140/95 mm Hg. After administering an antihypertensive medication, the nurse notes a heart rate of 85 beats per minute and a blood pressure of 130/80 mm Hg. What does the nurse expect to occur? A decrease in the heart rate back to baseline in 1 to 2 days Correct An increase in the blood pressure within a few days An increase in potassium retention in 1 to 2 days A decrease in fluid retention within a week 7.ID: 3772712940 A patient is taking a drug that interferes with venous constriction. The nurse will tell the patient to:

ask for assistance when getting out of bed. Correct expect bradycardia for a few days. notify the provider if headache occurs. report shortness of breath.

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1.ID: 3772694079

A patient with hypertension is prescribed an angiotensin-converting enzyme (ACE) inhibitor. The nurse reviewing this patient’s chart before administering the medication will be most concerned about which other disease process? Bronchial asthma Coronary artery disease Diabetes mellitus Renal artery stenosis Correct 2.ID: 3772694069 A nurse administers an ACE inhibitor to a patient who is taking the drug for the first time. What will the nurse do? Instruct the patient not to get up without assistance. Correct Make sure the patient takes a potassium supplement. Report the presence of a dry cough to the prescriber. Request an order for a diuretic to counter the side effects of the ACE inhibitor. 3.ID: 3772694073 A patient who has been taking an antihypertensive medication for several years is recovering from a myocardial infarction. The prescriber changes the patient’s medication to an ACE inhibitor. The patient asks the nurse why a new drug is necessary. What is the nurse’s response? “ACE inhibitors can prevent or reverse pathologic changes in the heart’s structure.” Correct “ACE inhibitors help lower LDL cholesterol and raise HDL cholesterol.” “ACE inhibitors increase venous return to the heart, improving cardiac output.” “ACE inhibitors regulate electrolytes that affect the cardiac rhythm.” 4.ID: 3772694053 A prescriber orders ramipril [Altace] for an obese patient with type 2 diabetes mellitus who has developed hypertension. The nurse provides teaching before dismissing the patient home. Which statement by the patient indicates understanding of the teaching? “I am less likely to develop diabetic nephropathy when taking this medication.” “I should check my blood sugar more often, because hyperglycemia is a side effect of this drug.” “Taking this medication helps reduce my risk of stroke and heart attack.” Correct “This medication will probably prevent the development of diabetic retinopathy.” 5.ID: 3772694061

“I should take this medication 1 hour before sitting down to a meal.” Correct 11.ID: 3772694059 A female patient who begins taking spironolactone [Aldactone] as an adjunct to furosemide [Lasix] complains that her voice is deepening. What will the nurse do? Contact the provider to obtain an order for a complete blood count (CBC) and liver function tests. Explain that this drug binds with receptors for steroid hormones, causing this effect. Correct Report this side effect to the provider and request another medication for this patient. Teach the patient to report any associated cough, which may indicate a more severe side effect. 12.ID: 3772694057 A female patient taking an ACE inhibitor learns that she is pregnant. What will the nurse tell this patient? The fetus most likely will have serious congenital defects. The fetus must be monitored closely while the patient is taking this drug. The patient’s prescriber probably will change her medication to an ARB. The patient should stop taking the medication and contact her provider immediately. Correct

Chapter-

1.ID: 3772688335

A nurse is caring for a patient who is receiving verapamil [Calan] for hypertension and digoxin [Lanoxin] for heart failure. The nurse will observe this patient for: AV blockade. Correct gingival hyperplasia. migraine headaches. reflex tachycardia. 2.ID: 3772688337 A patient begins taking nifedipine [Procardia], along with metoprolol, to treat hypertension. The nurse understands that metoprolol is used to: reduce flushing. minimize gingival hyperplasia. prevent constipation. prevent reflex tachycardia. Correct 3.ID: 3772688345 A nurse is teaching a patient who will begin taking verapamil [Calan] for hypertension about the drug’s side effects. Which statement by the patient indicates understanding of the teaching? “I may become constipated, so I should increase fluids and fiber.” Correct “I may experience a rapid heart rate as a result of taking this drug.” “I may have swelling of my hands and feet, but this will subside.”

“I may need to increase my digoxin dose while taking this drug.” 4.ID: 3772688339 A nurse is preparing to assist a nursing student to administer intravenous verapamil to a patient who also receives a beta blocker. The nurse asks the nursing student to discuss the plan of care for this patient. Which statement by the student indicates a need for further teaching? “I will check to see when the last dose of the beta blocker was given.” “I will monitor vital signs closely to assess for hypotension.” “I will monitor the heart rate frequently to assess for reflex tachycardia.” Correct “I will prepare to administer intravenous norepinephrine if necessary.” 5.ID: 3772688343 A patient who took an overdose of verapamil has been treated with gastric lavage and a cathartic. The emergency department nurse assesses the patient and notes a heart rate of 50 beats per minute and a blood pressure of 90/50 mm Hg. The nurse will anticipate: administering intravenous norepinephrine (NE) and atropine and glucagon. Correct assisting with direct-current (DC) cardioversion. placing the patient in an upright position. preparing to administer a beta blocker. 6.ID: 3772688341 A patient who has been taking verapamil [Calan] for hypertension complains of constipation. The patient will begin taking amlodipine [Norvasc] to avoid this side effect. The nurse provides teaching about the difference between the two drugs. Which statement by the patient indicates that further teaching is needed? “I can expect dizziness and facial flushing with nifedipine.” “I should notify the provider if I have swelling of my hands and feet.” “I will need to take a beta blocker to prevent reflex tachycardia.” Correct “I will need to take this drug once a day.” 7.ID: 3772688333 Which are therapeutic uses for verapamil? (Select all that apply.) Angina of effort Correct Cardiac dysrhythmias Correct Essential hypertension Correct Sick sinus syndrome Suppression of preterm labor

Chapter-

1.ID: 3772691343

A nurse is administering a vasodilator that dilates resistance vessels. The nurse understands that this drug will have which effect on the patient? Decreased cardiac preload Decreased cardiac output Increased tissue perfusion Correct Increased ventricular contraction

Noting the presence of hypertrichosis Obtaining a blood glucose 8.ID: 3772691388 A patient is admitted with severe hypertensive crisis. The nurse will anticipate administering which medication? Captopril PO Hydralazine [Apresoline] 25 mg PO Minoxidil 20 mg PO Sodium nitroprusside [Nitropress] IV Correct 9.ID: 3772692600 A nursing student asks a nurse why a patient in hypertensive crisis is receiving both intravenous sodium nitroprusside [Nitropress] and oral hydralazine. The nurse will explain that this is done to prevent: cyanide poisoning. fluid retention. rebound hypertension. Correct reflex tachycardia. 10.ID: 3772691354 Which medications are most likely to cause postural hypotension? (Select all that apply.) Minoxidil Diltiazem [Cardizem] Prazosin [Minipress] Correct Captopril [Capoten] Correct Losartan [Cozaar] Correct 11.ID: 3772691396 Which patients may receive hydralazine to treat hypertension? (Select all that apply.) A 1-month-old infant Correct A 5-year-old child Correct A pregnant woman A mother breast-feeding a newborn An older adult Correct

Chapter-

1.ID: 3772706419

A patient has had blood pressures of 150/95 mm Hg and 148/90 mm Hg on two separate office visits. The patient reports a blood pressure of 145/92 mm Hg taken in an ambulatory setting. The patient’s diagnostic tests are all normal. The nurse will expect this patient’s provider to order: a beta blocker. a loop diuretic and spironolactone. a thiazide diuretic. Correct counseling on lifestyle changes.

2.ID: 3772706424

A patient with diabetes develops hypertension. The nurse will anticipate administering which type of medication to treat hypertension in this patient? ACE inhibitors Correct Beta blockers Direct-acting vasodilators Thiazide diuretics 3.ID: 3772706430 A patient has three separate blood pressure (BP) readings of 120/100 mm Hg, 138/92 mm Hg, and 126/96 mm Hg. Which category describes this patient’s BP? Hypertension Correct Isolated systolic hypertension Normal Prehypertension 4.ID: 3772706426 A nurse checks a patient’s vital signs in the hospital and notes a blood pressure of 146/ mm Hg. What will the nurse do? Instruct the patient to consume a low-sodium diet. Prepare the patient for an electrocardiogram and blood tests. Recheck the patient’s blood pressure in the other arm. Correct Request an order for a thiazide diuretic. 5.ID: 3772706450 A patient who does not consume alcohol or nicotine products reports a strong family history of hypertension and cardiovascular disease. The patient has a blood pressure of 126/82 and a normal weight and body mass index for height and age. The nurse will expect to teach this patient about: ACE inhibitors and calcium channel blocker medications. the DASH diet, sodium restriction, and exercise. Correct increased calcium and potassium supplements. thiazide diuretics and lifestyle changes. 6.ID: 3772706467 A patient with hypertension with a blood pressure of 168/110 mm Hg begins taking hydrochlorothiazide and verapamil. The patient returns to the clinic after 2 weeks of drug therapy, and the nurse notes a blood pressure of 140/85 mm Hg and a heart rate of 98 beats per minute. What will the nurse do? Notify the provider and ask about adding a beta blocker medication. Correct Reassure the patient that the medications are working. Remind the patient to move slowly from sitting to standing. Request an order for an electrocardiogram. 7.ID: 3772706475 A patient has been taking chlorthalidone to treat hypertension. The patient’s prescriber has just ordered the addition of spironolactone to the patient’s drug regimen. Which statement by the patient indicates a need for further teaching? “I should continue following the DASH diet when adding this drug.” “I should not take an ACE inhibitor when adding this drug.” “I will need to take potassium supplements when adding this drug.” Correct

Hydralazine and minoxidil Spironolactone and amiloride Trichlormethiazide and hydrochlorothiazide 14.ID: 3772706421 A nursing student asks the nurse why multi-drug therapy is often used to treat hypertension. Which statement by the student indicates a need for further teaching? “Multi-drug therapy often means that drugs may be given in lower doses.” “Some agents are used to offset adverse effects of other agents.” “Treatment of hypertension via different mechanisms increases success.” “Two or more drugs will lower blood pressure more quickly.” Correct 15.ID: 3772706415 A patient with a recent onset of nephrosclerosis has been taking an ACE inhibitor and a thiazide diuretic. The patient’s initial blood pressure was 148/100 mm Hg. After 1 month of drug therapy, the patient’s blood pressure is 130/90 mm Hg. The nurse will contact the provider to discuss: adding a calcium channel blocker to this patient’s drug regimen. Correct lowering doses of the antihypertensive medications. ordering a high-potassium diet. adding spironolactone to the drug regimen. 16.ID: 3772706432 A 5-year-old patient seen in an outpatient clinic is noted to have hypertension on three separate visits. Ambulatory blood pressure monitoring confirms that the child has hypertension. As an initial intervention with the child’s parents, the nurse will expect to: perform a detailed health history on the child. Correct provide teaching about antihypertensive medications. reassure the parents that their child may outgrow this condition. teach the parents about lifestyle changes and a special diet. 17.ID: 3772706452 The nurse is caring for a pregnant patient who is in labor. The woman reports having had mild preeclampsia with a previous pregnancy. The nurse notes that the woman has a blood pressure of 168/102 mm Hg. The nurse will contact the provider to request an order for which drug? Angiotensin-converting enzyme (ACE) inhibitor Hydralazine (Apresoline) Correct Magnesium sulfate Sodium nitroprusside 18.ID: 3772706434 A nurse has provided education for a patient newly diagnosed with hypertension who is just beginning therapy with antihypertensive medications. Which statement by the patient indicates a need for further teaching? “I may experience serious long-term problems even if I am not having symptoms.” “I should report side effects to the provider since other drugs may be substituted.” “I will need to take medications on a long-term basis.” “When my symptoms subside, I may discontinue the medications.” Correct 19.ID: 3772706440

A 60-year-old African American patient has a blood pressure of 120/80 mm Hg and reports a family history of hypertension. The patient has a body mass index of 22.3. The patient reports consuming alcohol occasionally. Which therapeutic lifestyle change will the nurse expect to teach this patient? Alcohol cessation Potassium supplementation Sodium restriction Correct Weight loss

Chapter-

1.ID: 3772645413

A patient is taking enalapril [Vasotec]. The nurse understands that patients taking this type of drug for heart failure need to be monitored carefully for: hypernatremia. hypertension. hyperkalemia. Correct hypokalemia. 2.ID: 3772645415 A nurse is discussing heart failure with a group of nursing students. Which statement by a student reflects an understanding of how compensatory mechanisms can compound existing problems in patients with heart failure? “An increase in arteriolar tone to improve tissue perfusion can decrease resistance.” “An increase in contractility to increase cardiac output can cause pulmonary edema.” “When the heart rate increases to increase cardiac output, it can prevent adequate filling of the ventricles.” Correct “When venous tone increases to increase ventricular filling, an increase in arterial pressure occurs.” 3.ID: 3772645423 A patient with chronic hypertension is admitted to the hospital. During the admission assessment, the nurse notes a heart rate of 96 beats per minute, a blood pressure of 150/90 mm Hg, bibasilar crackles, 2+ pitting edema of the ankles, and distension of the jugular veins. The nurse will contact the provider to request an order for which medication? ACE inhibitor Digoxin [Lanoxin] Furosemide [Lasix] Correct Spironolactone [Aldactone] 4.ID: 3772645425 A patient newly diagnosed with heart failure is admitted to the hospital. The nurse notes a pulse of 90 beats per minute. The nurse will observe this patient closely for: decreased urine output. Correct increased blood pressure.

Increasing diuresis Reducing venous pressure Reducing afterload 11.ID: 3772645439 A nurse prepares to administer a scheduled dose of digoxin. The nurse finds a new laboratory report showing a plasma digoxin level of 0.7 ng/mL. What action should the nurse take? Withhold the drug for an hour and reassess the level. Withhold the drug and notify the prescriber immediately. Administer Digibind to counteract the toxicity. Check the patient’s apical pulse, and if it is within a safe range, administer the digoxin. Correct 12.ID: 3772645407 A patient asks a nurse why he cannot use digoxin [Lanoxin] for his heart failure, because both of his parents used it for HF. The nurse will explain that digoxin is not the first-line therapy for which reason? It causes tachycardia and increases the cardiac workload. It does not correct the underlying pathology of heart failure. Correct It has a wide therapeutic range that makes dosing difficult. It may actually shorten the patient’s life expectancy. 13.ID: 3772645403 A nurse is preparing to administer digoxin [Lanoxin] to a patient. The patient’s heart rate is 62 beats per minute, and the blood pressure is 120/60 mm Hg. The last serum electrolyte value showed a potassium level of 5.2 mEq/L. What will the nurse do? Contact the provider to request an increased dose of digoxin. Give the dose of digoxin and notify the provider of the potassium level. Correct Request an order for a diuretic. Withhold the dose and notify the provider of the heart rate. 14.ID: 3772645431 A patient with heart failure who has been given digoxin [Lanoxin] daily for a week complains of nausea. Before giving the next dose, the nurse will: assess the heart rate (HR) and give the dose if the HR is greater than 60 beats per minute. Correct contact the provider to report digoxin toxicity. request an order for a decreased dose of digoxin. review the serum electrolyte values and withhold the dose if the potassium level is greater than 3.5 mEq/L. 15.ID: 3772645417 A patient is taking a thiazide diuretic for hypertension and quinidine to treat a dysrhythmia. The prescriber orders digoxin 0.125 mg to improve this patient’s cardiac output. The nurse should contact the provider to request: adding spironolactone [Aldactone]. reducing the dose of digoxin. discontinuing the quinidine. Correct giving potassium supplements.

16.ID: 3772645409

A patient with heart failure who takes a thiazide diuretic and digoxin [Lanoxin] is admitted for shortness of breath. The patient’s heart rate is 66 beats per minute, and the blood pressure is 130/88 mm Hg. The serum potassium level is 3.8 mEq/L, and the digoxin level is 0.8 ng/mL. The nurse admitting this patient understands that the patient: has digoxin toxicity. is showing signs of renal failure. is experiencing worsening of the disease. Correct needs a potassium-sparing diuretic. 17.ID: 3772645405 An 88-year-old patient with heart failure has progressed to Stage D and is hospitalized for the third time in a month. The nurse will expect to discuss which topic with the patient’s family? Antidysrhythmic medications End-of-life care Correct Heart transplantation Implantable mechanical assist devices 18.ID: 3772645419 A patient has been taking digoxin [Lanoxin] 0.25 mg, and furosemide [Lasix] 40 mg, daily. Upon routine assessment by the nurse, the patient states, “I see yellow halos around the lights.” The nurse should perform which action based on this assessment? Check the patient for other symptoms of digitalis toxicity. Correct Withhold the next dose of furosemide. Continue to monitor the patient for heart failure. Document the findings and reassess in 1 hour. 19.ID: 3772645435 Which medications are included in first-line therapy for heart failure? (Select all that apply.) Agents that inhibit the renin-angiotensin-aldosterone system (RAAS) Correct Aldosterone antagonists Beta blockers Correct Cardiac glycosides Diuretics Correct 20.ID: 3772645421 Which are expected effects of cardiac glycosides? (Select all that apply.) Decreased cardiac output Decreased force of contraction Decreased heart rate Correct Modulation of neurohormonal systems Correct Positive inotropic effects Correct