Clinical Nurse Specialist Clinical Nurse Specialist Pharmacology & Medication Management 2

Question 1

A CNS is reconciling medications for a patient admitted with a digoxin level of 3.2 ng/mL. Which symptom is most consistent with digoxin toxicity?

Accepted Answer

Bradycardia and visual disturbances

Answer

Digoxin toxicity classically presents with bradycardia, heart block, nausea, and yellow-green visual disturbances (xanthopsia).

Question 2

When initiating heparin infusion for a patient with a PE, which laboratory value guides dose adjustments?

Accepted Answer

Anti-Xa level or aPTT

Answer

The aPTT (or anti-Xa level) is used to titrate unfractionated heparin infusions to maintain therapeutic anticoagulation per weight-based nomograms.

Question 3

A CNS notes that a patient's blood glucose is persistently elevated despite insulin therapy. What medication on the patient's list is most likely contributing?

Accepted Answer

Prednisone

Answer

Corticosteroids such as prednisone cause steroid-induced hyperglycemia by increasing hepatic glucose production and inducing insulin resistance.

Question 4

A CNS is counseling a patient prescribed warfarin about dietary interactions. Which food should be consumed consistently rather than avoided entirely?

Accepted Answer

Vitamin K-rich foods like leafy greens

Answer

Patients on warfarin should maintain consistent (not eliminate) intake of vitamin K-rich foods because fluctuations alter INR more than steady consumption.

Question 5

Which antiepileptic drug requires monitoring for hyponatremia due to its SIADH-like effect?

Accepted Answer

Carbamazepine

Answer

Carbamazepine can cause SIADH, leading to hyponatremia, and sodium levels must be monitored especially in elderly patients.

Clinical Nurse Specialist Practice Test

Clinical Nurse Specialist Practice Test

Clinical Nurse Specialist Clinical Nurse Specialist Pharmacology & Medication Management 2