Next Next Pharmacology and Medication Management 1 — Questions and Answers
Question 1: A patient is prescribed warfarin. Which laboratory value is the PRIMARY indicator used to monitor therapeutic dosing?
- Platelet count
- Partial thromboplastin time (PTT)
- International Normalized Ratio (INR) (Correct answer)
- Complete blood count (CBC)
Correct answer: International Normalized Ratio (INR)
The INR is the standardized test used to monitor warfarin anticoagulation therapy, with a target range of 2.0–3.0 for most indications.
Question 2: Which statement about enteric-coated medications is correct?
- They may be crushed to ease swallowing
- They are designed to dissolve in the stomach
- They must be swallowed whole to protect the stomach lining (Correct answer)
- They should be opened and sprinkled on food
Correct answer: They must be swallowed whole to protect the stomach lining
Enteric-coated medications must be swallowed whole because crushing destroys the coating designed to prevent gastric irritation and ensure intestinal absorption.
Question 3: A nurse is administering IV potassium chloride. Which action is essential for patient safety?
- Administer undiluted by IV push for rapid correction
- Infuse no faster than 10 mEq/hr via peripheral IV (Correct answer)
- Warm the bag before administration to speed infusion
- Always administer via the fastest available IV site
Correct answer: Infuse no faster than 10 mEq/hr via peripheral IV
IV potassium must never be given by IV push; the maximum safe infusion rate via peripheral IV is 10 mEq/hr to prevent fatal cardiac dysrhythmias.
Question 4: Which medication requires the nurse to assess the apical pulse for one full minute BEFORE administration?
- Metformin
- Digoxin (Correct answer)
- Lisinopril
- Omeprazole
Correct answer: Digoxin
Digoxin is withheld and the prescriber notified if the apical pulse is below 60 bpm, as digoxin further slows heart rate and can cause toxicity.
Question 5: A patient taking lithium reports nausea, tremors, and confusion. The nurse should first:
- Administer the next dose as scheduled
- Check the serum lithium level and notify the prescriber (Correct answer)
- Give the patient more fluid and continue monitoring
- Reassure the patient these are normal side effects
Correct answer: Check the serum lithium level and notify the prescriber
Nausea, tremors, and confusion are signs of lithium toxicity; the serum lithium level must be checked immediately and the prescriber notified because the therapeutic window is very narrow.
Question 6: Which five rights of medication administration are considered the traditional standard?
- Right patient, right drug, right dose, right route, right time (Correct answer)
- Right patient, right drug, right dose, right form, right documentation
- Right drug, right dose, right time, right nurse, right order
- Right patient, right route, right time, right documentation, right reason
Correct answer: Right patient, right drug, right dose, right route, right time
The five traditional rights are right patient, right drug, right dose, right route, and right time — these form the foundational safety check for every medication administration.
Next Next Pharmacology and Medication Management 1
A patient is prescribed warfarin.
Which laboratory value is the PRIMARY indicator used to monitor therapeutic dosing?