BSN Pharmacology and Medication Administration 1 — Questions and Answers
Question 1: A nurse is preparing to administer digoxin to a patient. Which assessment finding should prompt the nurse to withhold the medication and notify the provider?
- Apical pulse of 58 bpm (Correct answer)
- Blood pressure of 118/76 mmHg
- Respiratory rate of 16 breaths/min
- Temperature of 98.8°F
Correct answer: Apical pulse of 58 bpm
Digoxin should be withheld if the apical pulse is below 60 bpm in adults, as bradycardia may indicate toxicity.
Question 2: Which electrolyte imbalance increases a patient's risk for digoxin toxicity?
- Hypokalemia (Correct answer)
- Hypernatremia
- Hyperkalemia
- Hypercalcemia
Correct answer: Hypokalemia
Hypokalemia potentiates digoxin toxicity because low potassium levels increase myocardial sensitivity to the drug.
Question 3: A patient is receiving IV heparin and the aPTT result is 120 seconds (normal therapeutic range 60–100 seconds). What is the nurse's priority action?
- Notify the provider and anticipate a dose reduction (Correct answer)
- Increase the infusion rate per sliding scale
- Administer protamine sulfate immediately
- Draw a repeat aPTT in 2 hours
Correct answer: Notify the provider and anticipate a dose reduction
An aPTT above the therapeutic range indicates supratherapeutic anticoagulation, so the nurse must notify the provider to adjust the dose.
Question 4: The nurse is teaching a patient about warfarin therapy. Which food should the patient be instructed to consume consistently rather than avoid entirely?
- Foods high in vitamin K such as leafy green vegetables (Correct answer)
- Foods high in vitamin C such as citrus fruits
- High-fiber foods such as whole grains
- High-protein foods such as lean meats
Correct answer: Foods high in vitamin K such as leafy green vegetables
Patients on warfarin should maintain a consistent vitamin K intake rather than eliminating it, because sudden changes alter INR.
Question 5: A patient with type 2 diabetes is prescribed metformin. Which condition is an absolute contraindication to metformin use?
- Renal impairment with GFR below 30 mL/min (Correct answer)
- Mild hypertension controlled with diet
- A history of seasonal allergies
- BMI greater than 30 kg/m²
Correct answer: Renal impairment with GFR below 30 mL/min
Severe renal impairment (GFR < 30 mL/min) contraindicates metformin because the drug accumulates and causes lactic acidosis.
Question 6: Which statement by a patient indicates correct understanding of taking oral iron supplements?
- 'I will take my iron pill with a glass of orange juice.' (Correct answer)
- 'I will take my iron with a glass of milk to prevent stomach upset.'
- 'I should take my iron right before bed with antacids.'
- 'I can take my iron at the same time as my calcium supplement.'
Correct answer: 'I will take my iron pill with a glass of orange juice.'
Vitamin C in orange juice enhances iron absorption, making it the best choice for taking oral iron supplements.
BSN Pharmacology and Medication Administration 1
A nurse is preparing to administer digoxin to a patient.
Which assessment finding should prompt the nurse to withhold the medication and notify the provider?