Nursing Exam Review Questions and
Answers with Rationale 2026/2027
Question 1
A patient who stops taking an ACE inhibitor because of a
persistent dry cough is prescribed an angiotensin II receptor
blocker (ARB) instead. Which side effect common to ACE
inhibitors will not occur with the ARB medication?
A. Angioedema
B. Hypotension
C. Cough
D. Renal failure
Answer: C
Rationale: ARBs do not block the degradation of bradykinin in
the lungs, which is the primary mechanism causing the irritating
dry cough associated with ACE inhibitors. Therefore, a cough
will not occur when transitioning to an ARB.
Question 2
Which of the following laboratory values must a nurse closely
monitor for a client who has been prescribed lithium carbonate
for bipolar disorder?
A. Therapeutic level between 0.8 and 1.4 mEq/L
, B. Therapeutic level between 10 and 20 mEq/L
C. Therapeutic level between 5 and 12 mEq/L
D. Therapeutic level greater than 1.5 mEq/L
Answer: A
Rationale: The maintenance therapeutic plasma level for
lithium generally ranges between 0.8 and 1.4 mEq/L. Levels
exceeding 1.5 mEq/L are considered toxic and can result in
severe, life-threatening manifestations.
Question 3
A nurse is providing discharge instructions to a client prescribed
a new loop diuretic. Which of the following instructions is most
critical for self-management and safety?
A. Take the medication after supper to prevent daytime
frequency.
B. Weigh yourself daily and report any weight gain or loss
exceeding two pounds in 24 hours.
C. Eliminate all potassium-rich foods like bananas and
potatoes from your diet.
D. Restrict fluid intake completely to prevent fluid overload.
Answer: B
Rationale: Daily weight tracking is the most accurate indicator
of fluid shifts. A sudden weight gain or loss of more than two
, pounds within 24 hours must be reported immediately to the
healthcare provider to evaluate fluid balance or diuretic efficacy.
Question 4
Which assessment finding would cause the nurse to immediately
hold a scheduled dose of morphine?
A. Blood pressure of 140/90 mm Hg
B. Heart rate of 110 beats per minute
C. Respiratory rate of 10 breaths per minute and oxygen
saturation of 86%
D. Temperature of 38.2 degrees Celsius
Answer: C
Rationale: Opioids like morphine cause central nervous system
depression, putting the client at risk for severe respiratory
depression. A respiratory rate below 12 breaths per minute or an
oxygen saturation drop requires withholding the medication and
notifying the provider.
Question 5
A client is receiving a continuous intravenous infusion of
heparin for a deep vein thrombosis. Which laboratory result or
clinical manifestation requires immediate reporting by the
nurse?
A. The client reports passing dark, tarry stools.
B. The International Normalized Ratio (INR) is 0.8.