AESC 2050 EXAM 200 ACTUAL QUESTIONS AND CORRECT
ANSWERS WITH RATIONALE LATEST 2026 ALREADY
GRADED A+
This comprehensive collection of 200 unique questions is specifically designed
to mirror the clinical rigour and format of nursing examinations such as
AESC 2050, NSG 3130, NR 567, and the NZ NCAP. Each question presents a
distinct, real-world clinical scenario that tests critical nursing competencies
across pharmacology, pathophysiology, and priority-setting. The questions
cover a wide spectrum of conditions, medications, and patient populations,
ensuring broad revision coverage. Every entry includes the correct answer
and a detailed, evidence-based rationale that explains the underlying clinical
reasoning, pharmacokinetics, or nursing priority, making this an effective
self-assessment and high-yield learning tool for exam preparation and clinical
practice.
1 A patient with a history of chronic obstructive pulmonary disease presents with
worsening dyspnoea, productive cough with purulent sputum, and fever. The nurse
notes decreased breath sounds and crackles in the lung bases. What is the priority
nursing intervention?
A) Administer prescribed bronchodilators and antibiotics
B) Position the patient in a supine position to promote rest
C) Restrict oral fluids to reduce secretions
D) Apply a cold compress to the chest
Answer: A
Rationale: The patient is experiencing an acute exacerbation of COPD with
infection. Bronchodilators open the airways, and antibiotics target the infection.
Positioning should be upright to facilitate breathing, fluids should be encouraged to
thin secretions, and cold compresses are not indicated.
2 A patient with a history of heart failure is admitted with acute pulmonary
oedema. The patient is extremely dyspnoeic, has crackles throughout the lung
fields, and is producing pink frothy sputum. What is the nurse's immediate
priority?
A) Administer oral diuretics
B) Position the patient in high Fowler's position and apply oxygen
,C) Restrict all oral fluids
D) Prepare for chest physiotherapy
Answer: B
Rationale: High Fowler's position reduces venous return and decreases pulmonary
congestion. Oxygen therapy is essential to correct hypoxaemia. IV diuretics are
needed, not oral, and chest physiotherapy is contraindicated in acute pulmonary
oedema.
3 A patient with a history of type 2 diabetes is prescribed metformin. The patient is
scheduled for a contrast-enhanced CT scan. What should the nurse do?
A) Administer the metformin as usual on the day of the scan
B) Hold the metformin 48 hours before and 48 hours after the scan
C) Increase the dose of metformin to compensate
D) Administer metformin with a full glass of water
Answer: B
Rationale: Metformin should be held before and after contrast studies to prevent
lactic acidosis, especially in patients with renal impairment. The contrast dye can
affect renal function, increasing the risk of lactic acidosis.
4 A patient with a history of seizures is prescribed phenytoin. The nurse notes that
the patient has nystagmus, ataxia, and confusion. What is the priority nursing
action?
A) Administer the next dose of phenytoin as scheduled
B) Notify the prescriber and obtain a serum phenytoin level
C) Reassure the patient that these are expected side effects
D) Administer a benzodiazepine
Answer: B
Rationale: Nystagmus, ataxia, and confusion are signs of phenytoin toxicity. The
prescriber should be notified and a serum level obtained to guide dose adjustment.
Benzodiazepines are not indicated for toxicity.
5 A patient with a history of hypertension is prescribed lisinopril. The patient
develops a persistent dry cough. What is the most appropriate nursing action?
A) Advise the patient to stop the medication immediately
B) Notify the prescriber to consider switching to an angiotensin receptor blocker
C) Administer an antitussive medication
D) Reassure the patient that this will resolve with continued use
Answer: B
Rationale: A persistent dry cough is a common side effect of ACE inhibitors due to
bradykinin accumulation. Switching to an ARB, which does not cause cough, is
,appropriate. The patient should not stop the medication abruptly without prescriber
guidance.
6 A patient with chronic kidney disease has a serum potassium of 6.8 mmol/L. The
electrocardiogram shows tall peaked T waves. What is the priority nursing action?
A) Restrict dietary potassium
B) Administer oral kayexalate
C) Administer IV calcium gluconate and notify the prescriber
D) Prepare for routine haemodialysis
Answer: C
Rationale: Hyperkalaemia with ECG changes is a medical emergency. IV calcium
gluconate stabilises the cardiac membrane. The prescriber should be notified
immediately for further interventions such as insulin/dextrose, kayexalate, or
urgent dialysis.
7 A patient with a new diagnosis of heart failure is prescribed furosemide. Which
assessment finding indicates the medication is having the desired therapeutic
effect?
A) Weight gain of 2kg in 24 hours
B) Increased jugular venous distension
C) Weight loss of 1kg in 24 hours and decreased dyspnoea
D) Blood pressure of 150/90 mmHg
Answer: C
Rationale: Furosemide is a loop diuretic used to reduce fluid overload. Desired
effects include weight loss, reduced oedema, decreased dyspnoea, and improved
breathing. Worsening oedema and elevated JVD indicate failure of therapy.
8 A patient with a history of asthma is prescribed salbutamol inhaler. The nurse
should instruct the patient to use this medication:
A) Daily to prevent asthma attacks
B) When experiencing shortness of breath or wheezing
C) Only at bedtime to prevent nocturnal symptoms
D) In place of their corticosteroid inhaler
Answer: B
Rationale: Salbutamol is a short-acting beta-agonist used as a rescue medication
for acute symptoms. It is not a controller medication and should not replace
inhaled corticosteroids.
9 A patient with a head injury has a Glasgow Coma Scale score of 7. What is the
most important nursing action?
, A) Document the score and continue monitoring
B) Place the patient in a supine position
C) Assess the airway and prepare for possible intubation
D) Administer analgesia for pain
Answer: C
Rationale: A GCS of 8 or less indicates severe brain injury and the patient is at
high risk for airway compromise. The priority is airway assessment and
preparation for intubation to protect the airway.
10 A patient with a new colostomy is distressed and refuses to look at the stoma.
What is the most appropriate nursing response?
A) You will get used to it in time
B) It is normal to feel this way; we can work together when you are ready
C) You need to accept this as part of your body now
D) Let me show you how to change the pouch first
Answer: B
Rationale: This response validates the patient's feelings and offers support without
pressure. It respects the patient's readiness and promotes a therapeutic relationship.
11 A patient with pneumonia has a fever of 39.5°C and is shivering. What is the
priority nursing intervention?
A) Apply cold packs to the axillae and groin
B) Administer antipyretics as prescribed and remove excess blankets
C) Cover the patient with warm blankets to stop the shivering
D) Increase the room temperature
Answer: B
Rationale: Shivering indicates the body is trying to generate heat. Antipyretics help
lower the set point, and removing excess blankets allows heat to dissipate. Cold
packs can cause shivering and are not first-line.
12 A patient with a history of deep vein thrombosis is on enoxaparin. Which site is
most appropriate for subcutaneous injection?
A) The deltoid muscle
B) The anterolateral abdominal wall
C) The ventrogluteal site
D) The dorsogluteal site
Answer: B
Rationale: Enoxaparin is given subcutaneously in the abdominal wall. The skin is
pinched to create a fold, and the needle is inserted at a 45-90 degree angle without
aspiration.
ANSWERS WITH RATIONALE LATEST 2026 ALREADY
GRADED A+
This comprehensive collection of 200 unique questions is specifically designed
to mirror the clinical rigour and format of nursing examinations such as
AESC 2050, NSG 3130, NR 567, and the NZ NCAP. Each question presents a
distinct, real-world clinical scenario that tests critical nursing competencies
across pharmacology, pathophysiology, and priority-setting. The questions
cover a wide spectrum of conditions, medications, and patient populations,
ensuring broad revision coverage. Every entry includes the correct answer
and a detailed, evidence-based rationale that explains the underlying clinical
reasoning, pharmacokinetics, or nursing priority, making this an effective
self-assessment and high-yield learning tool for exam preparation and clinical
practice.
1 A patient with a history of chronic obstructive pulmonary disease presents with
worsening dyspnoea, productive cough with purulent sputum, and fever. The nurse
notes decreased breath sounds and crackles in the lung bases. What is the priority
nursing intervention?
A) Administer prescribed bronchodilators and antibiotics
B) Position the patient in a supine position to promote rest
C) Restrict oral fluids to reduce secretions
D) Apply a cold compress to the chest
Answer: A
Rationale: The patient is experiencing an acute exacerbation of COPD with
infection. Bronchodilators open the airways, and antibiotics target the infection.
Positioning should be upright to facilitate breathing, fluids should be encouraged to
thin secretions, and cold compresses are not indicated.
2 A patient with a history of heart failure is admitted with acute pulmonary
oedema. The patient is extremely dyspnoeic, has crackles throughout the lung
fields, and is producing pink frothy sputum. What is the nurse's immediate
priority?
A) Administer oral diuretics
B) Position the patient in high Fowler's position and apply oxygen
,C) Restrict all oral fluids
D) Prepare for chest physiotherapy
Answer: B
Rationale: High Fowler's position reduces venous return and decreases pulmonary
congestion. Oxygen therapy is essential to correct hypoxaemia. IV diuretics are
needed, not oral, and chest physiotherapy is contraindicated in acute pulmonary
oedema.
3 A patient with a history of type 2 diabetes is prescribed metformin. The patient is
scheduled for a contrast-enhanced CT scan. What should the nurse do?
A) Administer the metformin as usual on the day of the scan
B) Hold the metformin 48 hours before and 48 hours after the scan
C) Increase the dose of metformin to compensate
D) Administer metformin with a full glass of water
Answer: B
Rationale: Metformin should be held before and after contrast studies to prevent
lactic acidosis, especially in patients with renal impairment. The contrast dye can
affect renal function, increasing the risk of lactic acidosis.
4 A patient with a history of seizures is prescribed phenytoin. The nurse notes that
the patient has nystagmus, ataxia, and confusion. What is the priority nursing
action?
A) Administer the next dose of phenytoin as scheduled
B) Notify the prescriber and obtain a serum phenytoin level
C) Reassure the patient that these are expected side effects
D) Administer a benzodiazepine
Answer: B
Rationale: Nystagmus, ataxia, and confusion are signs of phenytoin toxicity. The
prescriber should be notified and a serum level obtained to guide dose adjustment.
Benzodiazepines are not indicated for toxicity.
5 A patient with a history of hypertension is prescribed lisinopril. The patient
develops a persistent dry cough. What is the most appropriate nursing action?
A) Advise the patient to stop the medication immediately
B) Notify the prescriber to consider switching to an angiotensin receptor blocker
C) Administer an antitussive medication
D) Reassure the patient that this will resolve with continued use
Answer: B
Rationale: A persistent dry cough is a common side effect of ACE inhibitors due to
bradykinin accumulation. Switching to an ARB, which does not cause cough, is
,appropriate. The patient should not stop the medication abruptly without prescriber
guidance.
6 A patient with chronic kidney disease has a serum potassium of 6.8 mmol/L. The
electrocardiogram shows tall peaked T waves. What is the priority nursing action?
A) Restrict dietary potassium
B) Administer oral kayexalate
C) Administer IV calcium gluconate and notify the prescriber
D) Prepare for routine haemodialysis
Answer: C
Rationale: Hyperkalaemia with ECG changes is a medical emergency. IV calcium
gluconate stabilises the cardiac membrane. The prescriber should be notified
immediately for further interventions such as insulin/dextrose, kayexalate, or
urgent dialysis.
7 A patient with a new diagnosis of heart failure is prescribed furosemide. Which
assessment finding indicates the medication is having the desired therapeutic
effect?
A) Weight gain of 2kg in 24 hours
B) Increased jugular venous distension
C) Weight loss of 1kg in 24 hours and decreased dyspnoea
D) Blood pressure of 150/90 mmHg
Answer: C
Rationale: Furosemide is a loop diuretic used to reduce fluid overload. Desired
effects include weight loss, reduced oedema, decreased dyspnoea, and improved
breathing. Worsening oedema and elevated JVD indicate failure of therapy.
8 A patient with a history of asthma is prescribed salbutamol inhaler. The nurse
should instruct the patient to use this medication:
A) Daily to prevent asthma attacks
B) When experiencing shortness of breath or wheezing
C) Only at bedtime to prevent nocturnal symptoms
D) In place of their corticosteroid inhaler
Answer: B
Rationale: Salbutamol is a short-acting beta-agonist used as a rescue medication
for acute symptoms. It is not a controller medication and should not replace
inhaled corticosteroids.
9 A patient with a head injury has a Glasgow Coma Scale score of 7. What is the
most important nursing action?
, A) Document the score and continue monitoring
B) Place the patient in a supine position
C) Assess the airway and prepare for possible intubation
D) Administer analgesia for pain
Answer: C
Rationale: A GCS of 8 or less indicates severe brain injury and the patient is at
high risk for airway compromise. The priority is airway assessment and
preparation for intubation to protect the airway.
10 A patient with a new colostomy is distressed and refuses to look at the stoma.
What is the most appropriate nursing response?
A) You will get used to it in time
B) It is normal to feel this way; we can work together when you are ready
C) You need to accept this as part of your body now
D) Let me show you how to change the pouch first
Answer: B
Rationale: This response validates the patient's feelings and offers support without
pressure. It respects the patient's readiness and promotes a therapeutic relationship.
11 A patient with pneumonia has a fever of 39.5°C and is shivering. What is the
priority nursing intervention?
A) Apply cold packs to the axillae and groin
B) Administer antipyretics as prescribed and remove excess blankets
C) Cover the patient with warm blankets to stop the shivering
D) Increase the room temperature
Answer: B
Rationale: Shivering indicates the body is trying to generate heat. Antipyretics help
lower the set point, and removing excess blankets allows heat to dissipate. Cold
packs can cause shivering and are not first-line.
12 A patient with a history of deep vein thrombosis is on enoxaparin. Which site is
most appropriate for subcutaneous injection?
A) The deltoid muscle
B) The anterolateral abdominal wall
C) The ventrogluteal site
D) The dorsogluteal site
Answer: B
Rationale: Enoxaparin is given subcutaneously in the abdominal wall. The skin is
pinched to create a fold, and the needle is inserted at a 45-90 degree angle without
aspiration.
