RN Registered Nurse: Pharmacological & Parenteral Therapies 2 — Questions and Answers
Question 1: A patient on warfarin has an INR of 5.8. Which intervention is most appropriate?
- Administer vitamin K as ordered (Correct answer)
- Increase the warfarin dose
- Apply a warm compress to bleeding sites
- Administer heparin as a bridge
Correct answer: Administer vitamin K as ordered
An INR of 5.8 is supratherapeutic, indicating excessive anticoagulation; vitamin K reverses warfarin's effect.
Question 2: Which electrolyte imbalance is most associated with loop diuretic use?
- Hypernatremia
- Hyperkalemia
- Hypokalemia (Correct answer)
- Hypercalcemia
Correct answer: Hypokalemia
Loop diuretics inhibit reabsorption in the loop of Henle, causing potassium wasting and hypokalemia.
Question 3: A nurse is preparing to administer insulin glargine. Which statement is correct?
- It can be mixed with regular insulin
- It has no defined peak and provides basal coverage (Correct answer)
- It is given 30 minutes before meals
- It acts within 15 minutes of injection
Correct answer: It has no defined peak and provides basal coverage
Insulin glargine is a long-acting basal insulin with no pronounced peak, providing steady 24-hour coverage.
Question 4: A patient receiving vancomycin develops flushing and erythema of the face and neck during infusion. The nurse should:
- Discontinue vancomycin permanently
- Slow the infusion rate and notify the provider (Correct answer)
- Administer epinephrine immediately
- Document as a normal finding and continue
Correct answer: Slow the infusion rate and notify the provider
Red man syndrome from vancomycin is managed by slowing the infusion rate; it is not a true allergic reaction.
Question 5: Which medication requires the nurse to monitor QTc interval on an ECG?
- Amoxicillin
- Metoprolol
- Ondansetron (Correct answer)
- Omeprazole
Correct answer: Ondansetron
Ondansetron (Zofran) can prolong the QT interval, increasing the risk for torsades de pointes.
Question 6: When administering potassium chloride IV, the nurse knows to:
- Give it as a rapid IV push to restore levels quickly
- Dilute it and infuse no faster than 10-20 mEq/hr (Correct answer)
- Mix it with normal saline in a 1:1 ratio and give bolus
- Administer it through a peripheral line as a concentrated solution
Correct answer: Dilute it and infuse no faster than 10-20 mEq/hr
Concentrated or rapidly infused IV potassium can cause fatal cardiac arrhythmias; safe infusion is ≤10-20 mEq/hr.
Question 7: A nurse is educating a patient newly prescribed metformin. Which adverse effect should the patient monitor for and report immediately?
- Weight gain
- Muscle pain and weakness with dark urine (Correct answer)
- Increased appetite
- Facial flushing after meals
Correct answer: Muscle pain and weakness with dark urine
Lactic acidosis is a rare but serious metformin complication; muscle pain and dark urine are warning signs.
RN Registered Nurse: Pharmacological & Parenteral Therapies 2
A patient on warfarin has an INR of 5.8.
Which intervention is most appropriate?