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NUR 2474 Pharmacology Final Exam (Newest Exam 2025) - Rasmussen University, Exams of Pharmacology

Rasmussen College - FloridaPharmacology

A set of multiple-choice questions and answers related to pharmacology, specifically focusing on diabetes management and thyroid disorders. It covers topics such as insulin administration, hypoglycemia, hypothyroidism, and drug interactions. Designed for students in a nursing program, particularly those enrolled in nur 2474 at rasmussen university.

Typology: Exams

2024/2025

Available from 01/05/2025

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NUR 2474 PHARMACOLOGY FINAL EXAM (NEWEST
EXAM 2025) | ALL QUESTIONS AND CORRECT
ANSWERS | ALREADY GRADED A+ | VERIFIED
ANSWERS | RASMUSSEN UNIVERSITY
1. The nurse working on a high-acuity medical-surgical unit is prioritizing
care for four patients who were just admitted. Which patient should the
nurse assess first?
a. The NPO patient with a blood glucose level of 80 mg/dL who just
received 20 units of 70/30 Novolin insulin.
b. The patient with a pulse of 58 beats per minute who is about to receive
digoxin (Lanoxin)
c. The patient with a blood pressure of 136/92 mm Hg who complains of
having a headache
d. The patient with an allergy to penicillin who is receiving an infusion of
vancomycin (Vancocin) ---------CORRECT ANSWER-----------------a. The
NPO patient with a blood glucose level of 80 mg/dL who just received 20
units of 70/30 Novolin insulin.
*low/normal BGL and insulin will continue to drop glucose level. At risk for
hypoglycemia.
2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood
sugars are on a sliding scale and are ordered before a meal and at
bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of
insulin should the nurse prepare to administer?
a. No insulin should be administered.
b. NPH
c. 70/30 mix
d. Lispro (Humalog) ---------CORRECT ANSWER-----------------d. Lispro
(Humalog)
*high blood sugar needs rapid acting insulin.
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NUR 2474 PHARMACOLOGY FINAL EXAM (NEWEST

EXAM 2025) | ALL QUESTIONS AND CORRECT

ANSWERS | ALREADY GRADED A+ | VERIFIED

ANSWERS | RASMUSSEN UNIVERSITY

  1. The nurse working on a high-acuity medical-surgical unit is prioritizing care for four patients who were just admitted. Which patient should the nurse assess first? a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin. b. The patient with a pulse of 58 beats per minute who is about to receive digoxin (Lanoxin) c. The patient with a blood pressure of 136/92 mm Hg who complains of having a headache d. The patient with an allergy to penicillin who is receiving an infusion of vancomycin (Vancocin) ---------CORRECT ANSWER-----------------a. The NPO patient with a blood glucose level of 80 mg/dL who just received 20 units of 70/30 Novolin insulin. *low/normal BGL and insulin will continue to drop glucose level. At risk for hypoglycemia.
  2. A patient with type 1 diabetes is eating breakfast at 7:30 AM. Blood sugars are on a sliding scale and are ordered before a meal and at bedtime. The patient's blood sugar level is 317 mg/dL. Which formulation of insulin should the nurse prepare to administer? a. No insulin should be administered. b. NPH c. 70/30 mix d. Lispro (Humalog) ---------CORRECT ANSWER-----------------d. Lispro (Humalog) *high blood sugar needs rapid acting insulin.
  1. A patient with type 1 diabetes recently became pregnant. The nurse plans a blood glucose testing schedule for her. What is the recommended monitoring schedule? a. Before each meal and before bed b. In the morning for a fasting level and at 4 PM for the peak level c. Six or seven times a day d. Three times a day, along with urine glucose testing ---------CORRECT ANSWER-----------------c. Six or seven times a day *pregnancy can effect glucose levels. Frequent monitoring required.
  2. An adolescent patient recently attended a health fair and had a serum glucose test. The patient telephones the nurse and says, "My level was 125 mg/dL. Does that mean I have diabetes?" What is the nurse's most accurate response? a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." b. "At this level, you probably have diabetes. You will need an oral glucose tolerance test this week." c. "This level is conclusive evidence that you have diabetes." d. "This level is conclusive evidence that you do not have diabetes." --------- CORRECT ANSWER-----------------a. "Unless you were fasting for longer than 8 hours, this does not necessarily mean you have diabetes." *could be a normal level without fasting and does not mean diabetes unless it was high for a fasting blood glucose level.
  3. Insulin glargine is prescribed for a hospitalized patient who is diabetic. When will the nurse administer this drug? a. Approximately 15 to 30 minutes before each meal
  1. A nurse counsels a patient with diabetes who is starting therapy with an alpha- glucosidase inhibitor. The patient should be educated about the potential for which adverse reactions? (Select all that apply.) a. Hypoglycemia b. Flatulence c. Elevated iron levels in the blood d. Fluid retention e. Diarrhea ---------CORRECT ANSWER-----------------b. Flatulence e. Diarrhea *due to build up of gasses (flatulence) from to undigested carbohydrates reaching the colon and causing an osmotic effect (diarrhea)
  2. The nurse is caring for a pregnant patient recently diagnosed with hypothyroidism. The patient tells the nurse she does not want to take medications while she is pregnant. What will the nurse explain to this patient? a. Hypothyroidism is a normal effect of pregnancy and usually is of no consequence. b. Neuropsychologic deficits in the fetus can occur if the condition is not treated. c. No danger to the fetus exists until the third trimester. d. Treatment is required only if the patient is experiencing symptoms. ------- --CORRECT ANSWER-----------------b. Neuropsychologic deficits in the fetus can occur if the condition is not treated. *Thyroid hormones are crucial for the normal development of the fetal brain and nervous system and must be treated in pregnancy.
  3. A nurse is teaching a patient who has been diagnosed with hypothyroidism about levothyroxine (Synthroid). Which statement by the patient indicates a need for further teaching? a. "I should not take heartburn medication without consulting my provider."

b. "I should report insomnia, tremors, and an increased heart rate to my provider." c. "If I take a multivitamin with iron, I should take it 4 hours after the Synthroid." d."If I take calcium supplements, I may need to decrease my dose of Synthroid." ---------CORRECT ANSWER-----------------d."If I take calcium supplements, I may need to decrease my dose of Synthroid." *this statement is incorrect since calcium interferes with the absorption of Synthroid, it may need to be increased not decreased.

  1. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The nurse will contact the provider to request an order for which drug? a. Beta blocker b. Increased dose of PO levothyroxine c. Intravenous levothyroxine d. Methimazole (Tapazole) ---------CORRECT ANSWER-----------------c. Intravenous levothyroxine *IV allows for a more rapid correction of thyroid hormone levels especially hypothyroidism with symptoms of myxedema coma or severe hypothyroidism. This is considered a medical emergency.
  2. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The nurse learns that the patient also takes warfarin (Coumadin). The nurse will notify the provider to discuss _____ the _____ dose. a. reducing levothyroxine b. reducing warfarin c. increasing levothyroxine d. increasing warfarin ---------CORRECT ANSWER-----------------b. reducing warfarin

observes signs of redness at the IV insertion site and along the vein. What is the nurse's priority action? a. Apply warm packs to the arm, and infuse the medication at a slower rate. b. Continue the infusion while elevating the arm. c. Select an alternate intravenous site and administer the infusion more slowly. d. Request central venous access. ---------CORRECT ANSWER----- ------------c. Select an alternate intravenous site and administer the infusion more slowly. *infiltration 1 6. A nurse is teaching a nursing student what is meant by "generations" of cephalosporins. Which statement by the student indicates understanding of the teaching? a."Cephalosporins are assigned to generations based on their relative costs to administer." b. "Cephalosporins have increased activity against gram-negative bacteria with each generation. c. "First-generation cephalosporins have better penetration of the cerebrospinal fluid."d. "Later generations of cephalosporins have lower resistance to destruction by beta- lactamases." ---------CORRECT ANSWER-----------------b. "Cephalosporins have increased activity against gram-negative bacteria with each generation. *this statement reflects the general trend seen in cephalosporins

  1. A provider has ordered ceftriaxone 4 gm once daily for a patient with renal impairment. What will the nurse do? a. Administer the medication as prescribed. b. Contact the provider to ask about giving the drug in divided doses. c. Discuss increasing the interval between doses with the provider. d. Discuss reducing the dose with the provider. ---------CORRECT ANSWER-----------------a. Administer the medication as prescribed.
  1. A patient will be discharged home to complete treatment with intravenous cefotetan with the assistance of a home nurse. The home care nurse will include which instruction when teaching the patient about this drug treatment? a. Abstain from alcohol consumption during therapy. b. Avoid dairy products while taking this drug. c. Take an antihistamine if a rash occurs. d. Use nonsteroidal anti-inflammatory drugs (NSAIDs), not acetaminophen, for pain. ---------CORRECT ANSWER-----------------a. Abstain from alcohol consumption during therapy. *consuming alcohol while on this medication can lead to a disulfiram-like reaction with symptoms such as flushing, headache, nausea, vomiting, and an increased heart rate
  2. The nurse is caring for a patient who is receiving vancomycin (Vancocin). The nurse notes that the patient is experiencing flushing, rash, pruritus, and urticaria. The patient's heart rate is 120 beats per minute, and the blood pressure is 92/57 mm Hg. The nurse understands that these findings are consistent with: a. allergic reaction. b. red man syndrome. c. rhabdomyolysis. d. Stevens-Johnson syndrome. ---------CORRECT ANSWER-----------------b. red man syndrome. *associated with the rapid infusion of vancomycin

e. Pharmacokinetics ---------CORRECT ANSWER-----------------a. Adverse effects b. Antimicrobial spectrum e. Pharmacokinetics *brand names and manufacturers will change over time, but the adverse effects, antimicrobial spectrum, and pharmacokinetics are considerations for infection treatment.

  1. A patient has an infection caused by Pseudomonas aeruginosa. The prescriber has ordered piperacillin and amikacin, both to be given intravenously. What will the nurse do? a. Make sure to administer the drugs at different times using different IV tubing. b. Suggest giving larger doses of piperacillin and discontinuing the amikacin. c. Suggest that a fixed-dose combination of piperacillin and tazobactam (Zosyn) be used. d. Watch the patient closely for allergic reactions, because this risk is increased with this combination. ---------CORRECT ANSWER----------------- a. Make sure to administer the drugs at different times using different IV tubing. *they should be administered separately to prevent any potential incompatibilities or interactions.
  2. A nurse assisting a nursing student with medications asks the student to describe how penicillins (PCNs) work to treat bacterial infections. The student is correct in responding that penicillins: a. disinhibit transpeptidases. b. disrupt bacterial cell wall synthesis. c. inhibit autolysins. d. inhibit host cell wall function. ---------CORRECT ANSWER-----------------b. disrupt bacterial cell wall synthesis.

*Penicillins (PCNs) are antibiotics that work by disrupting bacterial cell wall synthesis.

  1. A patient is about to receive penicillin G for an infection that is highly sensitive to this drug. While obtaining the patient's medication history, the nurse learns that the patient experienced a rash when given amoxicillin (Amoxil) as a child 20 years earlier. What will the nurse do? a. Ask the provider to order a cephalosporin. b. Reassure the patient that allergic responses diminish over time. c. Request an order for a skin test to assess the current risk. d. Suggest using a desensitization schedule to administer the drug. --------- CORRECT ANSWER-----------------c. Request an order for a skin test to assess the current risk. *It helps determine whether a patient has developed an allergic sensitivity to penicillin over time or if the previous reaction was an isolated incident.
  2. A patient with no known drug allergies is receiving amoxicillin (Amoxil) PO twice daily. Twenty minutes after being given a dose, the patient complains of shortness of breath. The patient's blood pressure is 100/ mm Hg. What will the nurse do? a. Contact the provider and prepare to administer epinephrine. b. Notify the provider if the patient develops a rash. c. Request an order for a skin test to evaluate possible PCN allergy. d. Withhold the next dose until symptoms subside. ---------CORRECT ANSWER-----------------a. Contact the provider and prepare to administer epinephrine. *Shortness of breath and hypotension are symptoms of anaphylaxis especially after an antibiotic with high risk for allergic reaction

*could indicate pseudomembranous colitis

  1. A patient develops Clostridium difficile-associated diarrhea (CDAD). Which antibiotic is recommended for treating this infection? a. Chloramphenicol b. Clindamycin (Cleocin) c. Linezolid (Zyvox) d. Vancomycin ---------CORRECT ANSWER-----------------d. Vancomycin *Vancomycin is often used as the first-line treatment for CDAD.
  2. A pregnant patient is treated with trimethoprim/sulfamethoxazole (TMP/SMZ) (Bactrim) for a urinary tract infection at 34 weeks' gestation. A week later, the woman delivers her infant prematurely. The nurse will expect to monitor the infant for: a. birth defects. b. hypoglycemia. c. rash. d. scleral jaundice. ---------CORRECT ANSWER-----------------b. hypoglycemia. *at an increased risk of kernicterus (bilirubin staining of the basal ganglia of the brain) in newborns and an increased risk of hypoglycemia.
  3. A patient who is taking immunosuppressants develops a urinary tract infection. The causative organism is sensitive to sulfonamides and to another, more expensive antibiotic. The prescriber orders the more expensive antibiotic. The nursing student assigned to this patient asks the nurse why the more expensive antibiotic is being used. Which response by the nurse is correct?

a. "Immunosuppressed patients are folate deficient." b. "Patients who are immunosuppressed are more likely to develop resistance." c. "Sulfonamides are bacteriostatic and depend on host immunity to work." d. "Sulfonamides intensify the effects of immunosuppression." --------- CORRECT ANSWER-----------------c. "Sulfonamides are bacteriostatic and depend on host immunity to work." *the efficacy of bacteriostatic agents like sulfonamides may be diminished in immunosuppressive patients

  1. A nurse teaches a patient about sulfonamides. Which statement by the patient indicates a need for further teaching? a. "I need to drink extra fluids while taking this medication." b. "I need to use sunscreen when taking this drug." C "I should call my provider if I develop a rash while taking this drug." d. "I should stop taking this drug when my symptoms are gone." --------- CORRECT ANSWER-----------------d. "I should stop taking this drug when my symptoms are gone." *it is crucial to complete the entire course of medication as prescribed
  2. A patient with type 2 diabetes mellitus takes glipizide. The patient develops a urinary tract infection, and the prescriber orders TMP/SMZ. What will the nurse tell the patient? a. Patients with diabetes have an increased risk of an allergic reaction. b. Patients taking TMP/SMZ may need increased doses of glipizide. c. The patient should check the blood glucose level more often while taking TMP/SMZ. d. The patient should stop taking the glipizide while taking the TMP/SMZ. -- -------CORRECT ANSWER-----------------c. The patient should check the blood glucose level more often while taking TMP/SMZ.
  1. A nurse is discussing microbial resistance among sulfonamides and trimethoprim with a nursing student. Which statement by the student indicates a need for further teaching? a. "Bacterial resistance to trimethoprim is relatively uncommon." b. "Resistance among gonococci, streptococci, and meningococci to sulfonamides is high." c. "Resistance to both agents can occur by spontaneous mutation of organisms." d. "Resistance to sulfonamides is less than resistance to trimethoprim." ----- ----CORRECT ANSWER-----------------d. "Resistance to sulfonamides is less than resistance to trimethoprim." *The correct statement should be that resistance to trimethoprim is less common than resistance to sulfonamides.
  2. A patient with bronchitis is taking TMP/SMZ, 106/80 mg orally, twice daily. Before administering the third dose, the nurse notes that the patient has a widespread rash, a temperature of 103° F, and a heart rate of 100 beats per minute. The patient looks ill and reports not feeling well. What will the nurse do? a. Administer the dose and request an order for an antipyretic medication. b. Withhold the dose and request an order for an antihistamine to treat the rash. c. Withhold the dose and notify the provider of the symptoms. d. Request an order for intravenous TMP/SMZ, because the patient is getting worse. ---------CORRECT ANSWER-----------------c. Withhold the dose and notify the provider of the symptoms. *patient is exhibiting signs of a severe reaction, potentially indicating an allergic reaction or a serious adverse effect (needs epi not antihistamine)
  3. A patient with histoplasmosis is being treated with itraconazole (Sporanox). The nurse will teach this patient to report which symptoms?

a. Gynecomastia and decreased libido b. Headache and rash c. Nausea, vomiting, and anorexia d. Visual disturbances ---------CORRECT ANSWER-----------------c. Nausea, vomiting, and anorexia *well tolerated medication, but lowers potassium levels leads to dysrhythmias

  1. A patient who is pregnant has a history of recurrent genital herpesvirus (HSV). The patient asks the nurse what will be done to suppress an outbreak when she is near term. The nurse will tell the patient that: a. antiviral medications are not safe during pregnancy. b. intravenous antiviral agents will be used if an outbreak occurs. c. oral acyclovir (Zovirax) may be used during pregnancy. d.topical acyclovir (Zovirax) must be used to control outbreaks --------- CORRECT ANSWER-----------------c. oral acyclovir (Zovirax) may be used during pregnancy. *is considered safe for use during pregnancy to suppress or treat outbreaks of genital herpes.
  2. The nurse is caring for a patient receiving intravenous acyclovir (Zovirax). To prevent nephrotoxicity associated with intravenous acyclovir, the nurse will: a. hydrate the patient during the infusion and for 2 hours after the infusion. b. increase the patient's intake of foods rich in vitamin C. c. monitor urinary output every 30 minutes. d. provide a low-protein diet for 1 day before and 2 days after the acyclovir infusion. ---------CORRECT ANSWER-----------------a. hydrate the patient during the infusion and for 2 hours after the infusion. *Intravenous acyclovir has the potential to cause nephrotoxicity, and one of the preventive measures is to ensure adequate hydration.

d. Topical medications have fewer side effects than those given by other routes. ---------CORRECT ANSWER-----------------b. Applying this medication to the skin can cause toxicity in this age group. *Infants have a larger body surface area in proportion to their weight, which can lead to increased absorption of the medication through the skin.

  1. The parents of a child with asthma ask the nurse why their child cannot use oral corticosteroids more often, because they are so effective. The nurse will offer which information that is true for children? a. Chronic steroid use can inhibit growth. b. Frequent use of this drug may lead to a decreased response. c. A hypersensitivity reaction to this drug may occur. d. Systemic steroids can be toxic. ---------CORRECT ANSWER----------------- a. Chronic steroid use can inhibit growth. *corticosteroids in children can potentially impact growth.
  2. Parents ask the nurse why an over-the-counter cough suppressant with sedative side effects is not recommended for infants. Which response by the nurse is correct? a. "Babies have a more rapid gastric emptying time and don't absorb drugs well." b. "Cough medicine tastes bad, and infants usually won't take it." c. "Infants are more susceptible to central nervous system effects than are adults." d. "Infants metabolize drugs too rapidly, so drugs aren't as effective." --------
  • CORRECT ANSWER-----------------c. "Infants are more susceptible to central nervous system effects than are adults." *Infants have a heightened susceptibility to CNS depressants / sedatives due to differences in drug metabolism and elimination in infants compared to adults.
  1. A nurse is caring for an infant after a surgical procedure. After ensuring that the ordered dose is appropriate for the infant's age and weight, the nurse administers a narcotic analgesic intravenously. When assessing the infant 15 minutes later, the nurse notes respirations of 22 breaths per minute and a heart rate of 110 beats per minute. The infant is asleep in the parent's arms and does not awaken when vital signs are assessed. The nurse understands that these findings are the result of: a. an allergic reaction to the medication. b. immaturity of the blood-brain barrier in the infant. c. toxic effects of the narcotic, requiring naloxone (Narcan) as an antidote. d. unexpected side effects of medications in infants. ---------CORRECT ANSWER-----------------b. immaturity of the blood-brain barrier in the infant. *allows medications, especially those with central nervous system effects like narcotic analgesics, to penetrate more easily, leading to a higher susceptibility to sedation and respiratory depression.
  2. An infant is receiving a medication that has a narrow therapeutic range. The nurse reviews the medication information and learns that the drug is excreted by the kidneys. When giving the medication, the nurse will assess the infant for: a. decreased effectiveness of the drug. b. shorter period of the drug's effects. c. signs of drug toxicity. d. unusual CNS effects. ---------CORRECT ANSWER-----------------c. signs of drug toxicity. *The potential for toxicity is higher when the drug is not effectively cleared from the body, such as in cases of impaired renal function.
  3. A prescriber has ordered medication for a newborn. The medication is eliminated primarily by hepatic metabolism. The nurse expects the prescriber to: