NUR 521 Exam 4 Blueprint Practice Questions and Answers
| 2026 Updates
1. A patient is prescribed an antibiotic to treat a urinary tract infection. What
statement by the patient indicates a need for further teaching?
A. "I will drink more fluids to help clear up the infection."
B. "I can stop the medication as soon as the symptoms have disappeared."
C. "I will stop the medication and contact the doctor if I develop a rash."
D. "I should immediately report vaginal itching or discharge."
o Rationale: Patients must complete the entire course of antibiotics, even if symptoms
resolve, to prevent resistance .
2. Condition in which the body adapts to a drug and requires subsequently higher
dosage to achieve the same effect:
A. Dependence
B. Withdrawal
C. Addiction
D. Tolerance
o Rationale: Tolerance is a physiologic state where higher doses are needed to produce
the same effect .
, 3. The CDC recommends that before entering a patient's room, the nurse should
do what?
A. Wash hands with an antibacterial soap and water.
B. Wash hands with cold water.
C. Use an alcohol-based hand rub.
D. Wash hands with chlorhexidine and water.
o Rationale: The CDC recommends alcohol-based hand rub for routine hand antisepsis
unless hands are visibly soiled .
💊 Rheumatoid Arthritis, Gout & Osteoporosis (Key Blueprint
Topic)
4. A patient is prescribed Methotrexate for Rheumatoid Arthritis. Which
supplement should the nurse expect to be added to the therapy?
A. Vitamin B12
B. Folic Acid
C. Calcium
D. Vitamin D
o Rationale: Methotrexate is a folate antagonist; folic acid is given to reduce side effects
like GI upset and mouth sores .
5. When should a DMARD (Disease-Modifying Antirheumatic Drug) ideally be
started given a new diagnosis for rheumatoid arthritis?
A. After NSAIDs fail for 6 months
B. Only after joint deformity is visible
C. Early, within 3 months of RA diagnosis
D. During a acute flare only
, o Rationale: Early intervention with DMARDs slows disease progression and prevents joint
damage .
6. A patient is prescribed Allopurinol (Zyloprim) for chronic gout. What labs
should the nurse monitor?
A. Blood glucose and HbA1c
B. Kidney and liver function
C. Cardiac enzymes
D. INR and aPTT
o Rationale: Allopurinol can cause hepatotoxicity and nephrotoxicity; baseline and periodic
LFTs and renal function are required .
7. A patient with a history of gout is prescribed Colchicine. To avoid the risk of
rhabdomyolysis, the nurse should check their medication list for which class of
drug?
A. Penicillins
B. Beta-blockers
C. Statins (e.g., Atorvastatin, Simvastatin)
D. Loop Diuretics
o Rationale: The interaction between colchicine and statins significantly increases the risk
of myopathy and rhabdomyolysis .
8. Which medication is used to treat osteoporosis?
A. Methotrexate
B. Alendronate (Fosamax)
C. Colchicine
D. Etanercept
o Rationale: Alendronate is a bisphosphonate that inhibits bone resorption and is a first-
line treatment for osteoporosis .
| 2026 Updates
1. A patient is prescribed an antibiotic to treat a urinary tract infection. What
statement by the patient indicates a need for further teaching?
A. "I will drink more fluids to help clear up the infection."
B. "I can stop the medication as soon as the symptoms have disappeared."
C. "I will stop the medication and contact the doctor if I develop a rash."
D. "I should immediately report vaginal itching or discharge."
o Rationale: Patients must complete the entire course of antibiotics, even if symptoms
resolve, to prevent resistance .
2. Condition in which the body adapts to a drug and requires subsequently higher
dosage to achieve the same effect:
A. Dependence
B. Withdrawal
C. Addiction
D. Tolerance
o Rationale: Tolerance is a physiologic state where higher doses are needed to produce
the same effect .
, 3. The CDC recommends that before entering a patient's room, the nurse should
do what?
A. Wash hands with an antibacterial soap and water.
B. Wash hands with cold water.
C. Use an alcohol-based hand rub.
D. Wash hands with chlorhexidine and water.
o Rationale: The CDC recommends alcohol-based hand rub for routine hand antisepsis
unless hands are visibly soiled .
💊 Rheumatoid Arthritis, Gout & Osteoporosis (Key Blueprint
Topic)
4. A patient is prescribed Methotrexate for Rheumatoid Arthritis. Which
supplement should the nurse expect to be added to the therapy?
A. Vitamin B12
B. Folic Acid
C. Calcium
D. Vitamin D
o Rationale: Methotrexate is a folate antagonist; folic acid is given to reduce side effects
like GI upset and mouth sores .
5. When should a DMARD (Disease-Modifying Antirheumatic Drug) ideally be
started given a new diagnosis for rheumatoid arthritis?
A. After NSAIDs fail for 6 months
B. Only after joint deformity is visible
C. Early, within 3 months of RA diagnosis
D. During a acute flare only
, o Rationale: Early intervention with DMARDs slows disease progression and prevents joint
damage .
6. A patient is prescribed Allopurinol (Zyloprim) for chronic gout. What labs
should the nurse monitor?
A. Blood glucose and HbA1c
B. Kidney and liver function
C. Cardiac enzymes
D. INR and aPTT
o Rationale: Allopurinol can cause hepatotoxicity and nephrotoxicity; baseline and periodic
LFTs and renal function are required .
7. A patient with a history of gout is prescribed Colchicine. To avoid the risk of
rhabdomyolysis, the nurse should check their medication list for which class of
drug?
A. Penicillins
B. Beta-blockers
C. Statins (e.g., Atorvastatin, Simvastatin)
D. Loop Diuretics
o Rationale: The interaction between colchicine and statins significantly increases the risk
of myopathy and rhabdomyolysis .
8. Which medication is used to treat osteoporosis?
A. Methotrexate
B. Alendronate (Fosamax)
C. Colchicine
D. Etanercept
o Rationale: Alendronate is a bisphosphonate that inhibits bone resorption and is a first-
line treatment for osteoporosis .
