MSNCB Pharmacology & Medication Management 2

Question 1

A patient receiving warfarin has an INR of 4.8. Which action should the nurse take first?

Accepted Answer

Notify the provider immediately

Answer

An INR of 4.8 is supratherapeutic and places the patient at high bleeding risk, requiring immediate provider notification.

Question 2

Which electrolyte imbalance is most associated with digoxin toxicity?

Accepted Answer

Hypokalemia

Answer

Hypokalemia potentiates digoxin toxicity by increasing drug binding to myocardial cells and reducing renal elimination.

Question 3

A nurse is preparing to administer metformin. Which condition is an absolute contraindication?

Accepted Answer

Chronic kidney disease with eGFR 25 mL/min

Answer

Metformin is contraindicated when eGFR is <30 mL/min/1.73 m² due to risk of lactic acidosis from drug accumulation.

Question 4

Which medication classification requires a baseline hearing assessment before initiation?

Accepted Answer

Aminoglycosides

Answer

Aminoglycosides are ototoxic and can cause irreversible sensorineural hearing loss, necessitating baseline and ongoing audiologic monitoring.

Question 5

A patient on heparin infusion develops sudden onset of thrombocytopenia and new clots on day 7 of therapy. The nurse suspects:

Accepted Answer

Heparin-induced thrombocytopenia (HIT)

Answer

HIT classically presents with thrombocytopenia and paradoxical thrombosis 5–10 days after heparin initiation due to immune-mediated platelet activation.

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

(MSNCB) Medical-Surgical Nursing Certification Board Practice Test

MSNCB Pharmacology & Medication Management 2