NUR 2474 FINAL EXAM LATEST 2026 RASMUSSEN
COLLEGE ACTUAL 150 QUESTIONS CORRECTLY
ANSWERED ALREADY GRADED A+ WITH
RATIONALE
1. A nurse is caring for a patient and her newborn immediately after delivery. The patient's
medication history includes prenatal vitamins throughout pregnancy, one or two glasses of
wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last
trimester, and intravenous morphine during labor. What will the nurse expect to do?
a. Administer opioids to the infant to prevent withdrawal syndrome.
b. Monitor the infant's respirations closely and prepare to administer oxygen.
c. Note a high-pitched cry and irritability in the infant.
d. Prepare the patient for motor delays in the infant caused by the alcohol use.
b. Monitor the infant's respirations closely and prepare to administer oxygen.
*if respiratory depression is observed due to prenatal opioid use.
2. A patient who has just learned she is pregnant has stopped using a prescription
medication that she takes for asthma because she doesn't want to harm her baby. What will
the nurse tell her?
a. That asthma medications will not affect the fetus
b. That her baby's health is dependent on hers
c. To avoid taking medications during her pregnancy
d. To resume the medication in her second trimester
b. That her baby's health is dependent on hers
*Uncontrolled asthma can pose risks to both the mother and the fetus. Benefit outweighs the risk.
3. A pregnant patient asks the nurse about the safe use of medications during the third
trimester. What will the nurse tell her about drugs taken at this stage?
a. They may need to be given in higher doses if they undergo renal clearance.
b. They require lower doses if they are metabolized by the liver.
c. They are less likely to cross the placenta and affect the fetus.
d. They are more likely to cause anatomical defects if they are teratogenic.
,c. They are less likely to cross the placenta and affect the fetus.
*the placental barrier becomes thicker and more protective as pregnancy progresses.
4. A breast-feeding patient must take a prescription medication for 2 weeks. The medication
is safe, but the patient wants to make sure her baby receives as little of the drug as possible.
What will the nurse tell the patient?
a. To give the baby formula as long as the mother is taking the medication
b. To take the medication immediately after breast-feeding
c. To pump breast milk and feed the baby by bottled. To take the medication 1 hour before
breast-feeding
b. To take the medication immediately after breast-feeding
*reduces the amount of the drug present in breast milk when the next feeding occurs.
5. Which type of drug taken by a pregnant patient is more likely to have effects on a fetus?
a. Drug that is highly polar
b. Ionized drug
c. Lipid-soluble drug
d. Protein-bound drug
c. Lipid-soluble drug
*These drugs can easily traverse cell membranes, including the placental barrier, and reach the
developing fetus.
6. A nurse is concerned about renal function in an 84-year-old patient who is taking several
medications. What should the nurse assess?
a. Creatinine clearance
b. Sodium levels
c. Potassium levels
d. Serum creatinine
a. Creatinine clearance
*provides an estimate of the glomerular filtration rate (GFR) and can help determine how well the
kidneys are filtering waste products from the blood.
,7. Based on changes in hepatic function in older adult patients, which adjustment should the
nurse expect for oral medications that undergo extensive first pass metabolism?
a. A higher dose should be used with the same time schedule.
b. The interval between doses should be increased.
c. No change is necessary metabolism will not be affected.
d. The interval between doses should be reduced.
b. The interval between doses should be increased.
*can affect the metabolism of drugs that undergo extensive first-pass metabolism and often need to
increase the interval. A higher dose causes increased adverse effects.
8. A nurse is preparing to give medications to four geriatric patients who are all taking
multiple medications. Which patient is most likely to have an adverse drug reaction related
to increased drug effects?
a. Obese patient
b. Patient with decreased serum creatinine c. Patient with chronic diarrhea
d. Thin patient with a chronically low appetite
b. Patient with decreased serum creatinine
*may indicate reduced renal function. Since many drugs are eliminated by the kidneys, impaired
renal function can lead to the accumulation of drugs in the body, increasing the risk of adverse drug
reactions.
9. A nurse is teaching a group of nursing students about administering medications to older
adult patients. Which statement by a student indicates a need for further teaching?
a. "Alteration in hepatic function requires more frequent drug dosing."
b. "Changes in GI function in older adult patients lead to lower serum drug levels."
c. "Most adverse drug reactions in older adult patients are related to altered renal function."
d. "Most nonadherence among older adult patients is intentional."
a. "Alteration in hepatic function requires more frequent drug dosing."
*This requires further education because it usually involves a need to decrease the dose or increase
the dosing interval to prevent drug toxicity. Increasing the frequency of drug dosing may lead to
increased drug levels and a higher risk of adverse effects.
, 10. A nurse is teaching a patient who has been diagnosed with hypothyroidism about
levothyroxine (Synthroid). Which statement by the patient indicates a need for further
teaching?
a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider." c. "If I
take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
*this statement is incorrect since calcium interferes with the absorption of Synthroid, it may need
to be increased not decreased.
11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse
assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per
minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The
nurse will contact the provider to request an order for which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole)
c. Intravenous levothyroxine
*IV allows for a more rapid correction of thyroid hormone levels especially hypothyroidism with
symptoms of myxedema coma or severe hypothyroidism. This is considered a medical emergency.
12. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The
nurse learns that the patient also takes warfarin (Coumadin). The nurse will notify the
provider to discuss _____ the _____ dose.
a. reducing levothyroxine
b. reducing warfarin
c. increasing levothyroxine
d. increasing warfarin
b. reducing warfarin
*Levothyroxine (Synthroid) can potentially increase the effects of warfarin, leading to an increased
risk of bleeding.
COLLEGE ACTUAL 150 QUESTIONS CORRECTLY
ANSWERED ALREADY GRADED A+ WITH
RATIONALE
1. A nurse is caring for a patient and her newborn immediately after delivery. The patient's
medication history includes prenatal vitamins throughout pregnancy, one or two glasses of
wine before knowing she was pregnant, occasional use of an albuterol inhaler in her last
trimester, and intravenous morphine during labor. What will the nurse expect to do?
a. Administer opioids to the infant to prevent withdrawal syndrome.
b. Monitor the infant's respirations closely and prepare to administer oxygen.
c. Note a high-pitched cry and irritability in the infant.
d. Prepare the patient for motor delays in the infant caused by the alcohol use.
b. Monitor the infant's respirations closely and prepare to administer oxygen.
*if respiratory depression is observed due to prenatal opioid use.
2. A patient who has just learned she is pregnant has stopped using a prescription
medication that she takes for asthma because she doesn't want to harm her baby. What will
the nurse tell her?
a. That asthma medications will not affect the fetus
b. That her baby's health is dependent on hers
c. To avoid taking medications during her pregnancy
d. To resume the medication in her second trimester
b. That her baby's health is dependent on hers
*Uncontrolled asthma can pose risks to both the mother and the fetus. Benefit outweighs the risk.
3. A pregnant patient asks the nurse about the safe use of medications during the third
trimester. What will the nurse tell her about drugs taken at this stage?
a. They may need to be given in higher doses if they undergo renal clearance.
b. They require lower doses if they are metabolized by the liver.
c. They are less likely to cross the placenta and affect the fetus.
d. They are more likely to cause anatomical defects if they are teratogenic.
,c. They are less likely to cross the placenta and affect the fetus.
*the placental barrier becomes thicker and more protective as pregnancy progresses.
4. A breast-feeding patient must take a prescription medication for 2 weeks. The medication
is safe, but the patient wants to make sure her baby receives as little of the drug as possible.
What will the nurse tell the patient?
a. To give the baby formula as long as the mother is taking the medication
b. To take the medication immediately after breast-feeding
c. To pump breast milk and feed the baby by bottled. To take the medication 1 hour before
breast-feeding
b. To take the medication immediately after breast-feeding
*reduces the amount of the drug present in breast milk when the next feeding occurs.
5. Which type of drug taken by a pregnant patient is more likely to have effects on a fetus?
a. Drug that is highly polar
b. Ionized drug
c. Lipid-soluble drug
d. Protein-bound drug
c. Lipid-soluble drug
*These drugs can easily traverse cell membranes, including the placental barrier, and reach the
developing fetus.
6. A nurse is concerned about renal function in an 84-year-old patient who is taking several
medications. What should the nurse assess?
a. Creatinine clearance
b. Sodium levels
c. Potassium levels
d. Serum creatinine
a. Creatinine clearance
*provides an estimate of the glomerular filtration rate (GFR) and can help determine how well the
kidneys are filtering waste products from the blood.
,7. Based on changes in hepatic function in older adult patients, which adjustment should the
nurse expect for oral medications that undergo extensive first pass metabolism?
a. A higher dose should be used with the same time schedule.
b. The interval between doses should be increased.
c. No change is necessary metabolism will not be affected.
d. The interval between doses should be reduced.
b. The interval between doses should be increased.
*can affect the metabolism of drugs that undergo extensive first-pass metabolism and often need to
increase the interval. A higher dose causes increased adverse effects.
8. A nurse is preparing to give medications to four geriatric patients who are all taking
multiple medications. Which patient is most likely to have an adverse drug reaction related
to increased drug effects?
a. Obese patient
b. Patient with decreased serum creatinine c. Patient with chronic diarrhea
d. Thin patient with a chronically low appetite
b. Patient with decreased serum creatinine
*may indicate reduced renal function. Since many drugs are eliminated by the kidneys, impaired
renal function can lead to the accumulation of drugs in the body, increasing the risk of adverse drug
reactions.
9. A nurse is teaching a group of nursing students about administering medications to older
adult patients. Which statement by a student indicates a need for further teaching?
a. "Alteration in hepatic function requires more frequent drug dosing."
b. "Changes in GI function in older adult patients lead to lower serum drug levels."
c. "Most adverse drug reactions in older adult patients are related to altered renal function."
d. "Most nonadherence among older adult patients is intentional."
a. "Alteration in hepatic function requires more frequent drug dosing."
*This requires further education because it usually involves a need to decrease the dose or increase
the dosing interval to prevent drug toxicity. Increasing the frequency of drug dosing may lead to
increased drug levels and a higher risk of adverse effects.
, 10. A nurse is teaching a patient who has been diagnosed with hypothyroidism about
levothyroxine (Synthroid). Which statement by the patient indicates a need for further
teaching?
a. "I should not take heartburn medication without consulting my provider."
b. "I should report insomnia, tremors, and an increased heart rate to my provider." c. "If I
take a multivitamin with iron, I should take it 4 hours after the Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
d."If I take calcium supplements, I may need to decrease my dose of Synthroid."
*this statement is incorrect since calcium interferes with the absorption of Synthroid, it may need
to be increased not decreased.
11. A patient with hypothyroidism begins taking PO levothyroxine (Synthroid). The nurse
assesses the patient at the beginning of the shift and notes a heart rate of 62 beats per
minute and a temperature of 97.2° F. The patient is lethargic and difficult to arouse. The
nurse will contact the provider to request an order for which drug?
a. Beta blocker
b. Increased dose of PO levothyroxine
c. Intravenous levothyroxine
d. Methimazole (Tapazole)
c. Intravenous levothyroxine
*IV allows for a more rapid correction of thyroid hormone levels especially hypothyroidism with
symptoms of myxedema coma or severe hypothyroidism. This is considered a medical emergency.
12. A patient is admitted to the hospital and will begin taking levothyroxine (Synthroid). The
nurse learns that the patient also takes warfarin (Coumadin). The nurse will notify the
provider to discuss _____ the _____ dose.
a. reducing levothyroxine
b. reducing warfarin
c. increasing levothyroxine
d. increasing warfarin
b. reducing warfarin
*Levothyroxine (Synthroid) can potentially increase the effects of warfarin, leading to an increased
risk of bleeding.
