Nur 257 Exam 1 Galen College Of Nursing
Questions And Answers Latest Update 2026
,1. A patient is receiving intravenous (IV) vancomycin for a severe methicillin-
resistant Staphylococcus aureus (MRSA) infection. The nurse monitors for which
of the following serious adverse effects that requires immediate intervention?
a) Red man syndrome
b) Ototoxicity
c) Nephrotoxicity
d) Seizures
- answer: C) Nephrotoxicity
• Rationale: Vancomycin can cause nephrotoxicity, which is a serious adverse
effect that can lead to acute kidney injury. While red man syndrome (an
infusion-related reaction) is common and managed by slowing the infusion,
and ototoxicity can occur, nephrotoxicity is more immediately life-
threatening and requires close monitoring of renal function and serum
vancomycin levels. Seizures are not typically associated with vancomycin.
2. A patient with heart failure is prescribed furosemide 40 mg IV twice daily.
Which finding by the nurse indicates the medication is effective?
a) Decreased blood pressure
b) Increased urine output
c) Weight gain of 1 kg in 24 hours
d) Serum potassium level of 3.2 mEq/L
- answer: B) Increased urine output
• Rationale: Furosemide is a loop diuretic that promotes diuresis, so
increased urine output is the desired effect. Decreased blood pressure may
occur but is not the primary goal; it could be a side effect. Weight gain
indicates fluid retention, which is opposite to the desired effect.
Hypokalemia (low potassium) is a common side effect but not an indicator
of effectiveness.
3. A patient is admitted with acute pancreatitis. The nurse anticipates
administering which of the following medications to manage pain?
, a) Morphine
b) Meperidine
c) Acetaminophen
d) Ibuprofen
- answer: B) Meperidine
• Rationale: Meperidine (Demerol) has been traditionally used for
pancreatitis because it causes less spasm of the sphincter of Oddi
compared to morphine. However, note that practice may vary, and some
guidelines now recommend other opioids with careful monitoring.
Morphine can increase sphincter of Oddi pressure and potentially worsen
pain. Acetaminophen and ibuprofen may not be sufficient for severe
pancreatitis pain and could have contraindications (e.g., liver dysfunction
with acetaminophen, inflammation with NSAIDs).
4. A patient with type 2 diabetes is started on metformin. The nurse should
include which instruction in the teaching plan?
a) "Take this medication with food to minimize gastrointestinal upset."
b) "You will need to check your blood sugar once a week."
c) "This medication can cause hypoglycemia, so carry a source of sugar with you."
d) "Avoid all alcohol consumption while taking this medication."
- answer: A) "Take this medication with food to minimize gastrointestinal
upset."
• Rationale: Metformin commonly causes GI side effects (diarrhea, nausea,
abdominal pain) which can be minimized by taking with food.
Hypoglycemia is not typical with metformin alone; it is more common with
insulin or sulfonylureas. While alcohol should be avoided due to the risk of
lactic acidosis, complete avoidance is not always necessary but excessive
consumption is dangerous. Blood sugar monitoring frequency depends on
individual patient factors but typically more than once a week.
5. The nurse is caring for a patient receiving a blood transfusion. The patient
develops chills, fever, headache, and flushing. What is the nurse's priority
action?
a) Administer antipyretic medication as ordered.
Questions And Answers Latest Update 2026
,1. A patient is receiving intravenous (IV) vancomycin for a severe methicillin-
resistant Staphylococcus aureus (MRSA) infection. The nurse monitors for which
of the following serious adverse effects that requires immediate intervention?
a) Red man syndrome
b) Ototoxicity
c) Nephrotoxicity
d) Seizures
- answer: C) Nephrotoxicity
• Rationale: Vancomycin can cause nephrotoxicity, which is a serious adverse
effect that can lead to acute kidney injury. While red man syndrome (an
infusion-related reaction) is common and managed by slowing the infusion,
and ototoxicity can occur, nephrotoxicity is more immediately life-
threatening and requires close monitoring of renal function and serum
vancomycin levels. Seizures are not typically associated with vancomycin.
2. A patient with heart failure is prescribed furosemide 40 mg IV twice daily.
Which finding by the nurse indicates the medication is effective?
a) Decreased blood pressure
b) Increased urine output
c) Weight gain of 1 kg in 24 hours
d) Serum potassium level of 3.2 mEq/L
- answer: B) Increased urine output
• Rationale: Furosemide is a loop diuretic that promotes diuresis, so
increased urine output is the desired effect. Decreased blood pressure may
occur but is not the primary goal; it could be a side effect. Weight gain
indicates fluid retention, which is opposite to the desired effect.
Hypokalemia (low potassium) is a common side effect but not an indicator
of effectiveness.
3. A patient is admitted with acute pancreatitis. The nurse anticipates
administering which of the following medications to manage pain?
, a) Morphine
b) Meperidine
c) Acetaminophen
d) Ibuprofen
- answer: B) Meperidine
• Rationale: Meperidine (Demerol) has been traditionally used for
pancreatitis because it causes less spasm of the sphincter of Oddi
compared to morphine. However, note that practice may vary, and some
guidelines now recommend other opioids with careful monitoring.
Morphine can increase sphincter of Oddi pressure and potentially worsen
pain. Acetaminophen and ibuprofen may not be sufficient for severe
pancreatitis pain and could have contraindications (e.g., liver dysfunction
with acetaminophen, inflammation with NSAIDs).
4. A patient with type 2 diabetes is started on metformin. The nurse should
include which instruction in the teaching plan?
a) "Take this medication with food to minimize gastrointestinal upset."
b) "You will need to check your blood sugar once a week."
c) "This medication can cause hypoglycemia, so carry a source of sugar with you."
d) "Avoid all alcohol consumption while taking this medication."
- answer: A) "Take this medication with food to minimize gastrointestinal
upset."
• Rationale: Metformin commonly causes GI side effects (diarrhea, nausea,
abdominal pain) which can be minimized by taking with food.
Hypoglycemia is not typical with metformin alone; it is more common with
insulin or sulfonylureas. While alcohol should be avoided due to the risk of
lactic acidosis, complete avoidance is not always necessary but excessive
consumption is dangerous. Blood sugar monitoring frequency depends on
individual patient factors but typically more than once a week.
5. The nurse is caring for a patient receiving a blood transfusion. The patient
develops chills, fever, headache, and flushing. What is the nurse's priority
action?
a) Administer antipyretic medication as ordered.
