Pharmacology Exam

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Sample questions from Pharmacology Exam

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.A 68-year-old client in the emergency department has crushing chest pain, BP 148/86 mm Hg, HR 88/min, and oxygen saturation 96% on room air. The client took sildenafil 6 hours ago and has a prescription for sublingual nitroglycerin. Which action should the nurse take?

   • A.Administer nitroglycerin and recheck blood pressure in 5 minutes
   • B.Withhold nitroglycerin and notify the provider
   • C.Give the client an extra dose of sildenafil
   • D.Place the client supine and administer nitroglycerin

   Rationale: Sildenafil and nitroglycerin can cause profound hypotension when used within the same 24-hour period, so the nurse should withhold nitroglycerin and notify the provider. Giving nitroglycerin, including while supine, does not remove this interaction risk. Sildenafil is not an appropriate treatment for acute chest pain; the nurse should promptly report the recent dose.

2. 2.A 72-year-old client admitted with heart failure takes digoxin and furosemide. The client reports nausea and seeing yellow halos; the apical pulse is 52/min and potassium is 2.9 mEq/L. What should the nurse do first?

   • A.Administer digoxin with food
   • B.Hold digoxin and notify the provider
   • C.Give the scheduled furosemide
   • D.Encourage a high-fiber snack

   Rationale: The bradycardia, visual changes, nausea, and hypokalemia suggest digoxin toxicity, so the nurse should hold the dose and promptly notify the provider. Giving digoxin could worsen toxicity, and furosemide could further lower potassium. Food or fiber will not address the immediate medication risk.

3. 3.A 59-year-old client with type 1 diabetes is NPO for surgery and has a blood glucose of 168 mg/dL. The morning orders include insulin glargine and insulin lispro with breakfast. Which action is appropriate?

   • A.Hold both insulins because the client is NPO
   • B.Administer the prescribed glargine and hold lispro unless coverage is ordered
   • C.Give the lispro and hold glargine
   • D.Give half of each insulin without consulting the provider

   Rationale: Basal insulin such as glargine is generally continued in type 1 diabetes, even when the client is NPO, while meal-related lispro is held when no meal is eaten unless correction coverage is prescribed. Holding all insulin risks ketoacidosis, and giving meal insulin without food risks hypoglycemia. The nurse should not independently change doses.

4. 4.A 76-year-old client taking warfarin for atrial fibrillation reports black stools and dizziness. The INR is 5.8, BP is 94/58 mm Hg, and HR is 112/min. What is the priority nursing action?

   • A.Administer the scheduled warfarin dose
   • B.Hold warfarin and notify the provider immediately
   • C.Offer a serving of leafy green vegetables
   • D.Recheck the INR at the next routine appointment

   Answer and rationale are in the full material.

5. 5.A 64-year-old client with type 2 diabetes taking metformin is scheduled for a CT scan with IV contrast. The client has an eGFR of 42 mL/min/1.73 m2. Which action should the nurse take?

   • A.Give metformin with a large glass of water before the scan
   • B.Clarify the medication plan and follow instructions to hold metformin around contrast exposure
   • C.Give an additional metformin dose after the scan
   • D.Replace metformin with an over-the-counter supplement

   Answer and rationale are in the full material.