,NSG 3130 Exam 2 – Fundamental Concepts & Skills for
Nursing Practice II – Actual Q&A (GCN) (Updated PDF)
1. A patient with chronic kidney disease is prescribed multiple medications. The
nurse should closely monitor for drug toxicity because impaired renal function
primarily affects which pharmacokinetic phase?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Correct Answer: D) Excretion
Rationale: Excretion, primarily via the kidneys, is the phase most affected in
kidney disease. Accumulation of drug metabolites can lead to toxicity.
Absorption and distribution are less directly impacted; metabolism occurs
mainly in the liver.
2. The nurse is preparing to administer a PRN analgesic to a patient reporting
severe pain. When should the nurse document the medication administration?
A) Before preparing the medication
B) Immediately after administration
C) At the end of the shift
D) Only if the pain is relieved
Correct Answer: B) Immediately after administration
,Rationale: Documentation must occur right after giving the medication to verify
administration, prevent accidental duplicate dosing, and provide an accurate
record. Delaying documentation risks omission or double-dosing.
3. A patient is receiving digoxin, which has a narrow therapeutic index. What is
the most important nursing action to ensure safety?
A) Administer with food
B) Assess heart rate for 30 seconds
C) Monitor serum drug levels regularly
D) Teach the patient to report blurred vision
Correct Answer: C) Monitor serum drug levels regularly
Rationale: Because the margin between therapeutic and toxic doses is small,
regular monitoring of serum levels guides dosing and prevents toxicity. While
assessing heart rate and teaching side effects are important, monitoring drug
levels is the most direct safety measure.
4. A patient who has been using crutches for two weeks is evaluated for proper
fit. Which finding indicates correct crutch adjustment?
A) Elbow bends about 30 degrees when gripping the hand grips
B) Hand grips are level with the mid-forearm
C) Weight is borne on the axillary pads during ambulation
D) There is no space between the axillae and crutch rest pads
Correct Answer: A) Elbow bends about 30 degrees when gripping the hand grips
, Rationale: Proper fit includes a 2-3 finger-width gap between the axillae and
crutch pads, elbow flexion at about 30 degrees, and weight placed on the hands,
not the axillae. Hand grips should align with the hip line.
5. A nurse is evaluating a patient's cane use. Which observation indicates the
cane is properly fitted?
A) The arm holding the cane is flexed at 40 degrees
B) The top of the cane is level with the greater trochanter
C) There is a 2-inch gap between the cane top and axilla
D) The cane is held on the same side as the weak leg
Correct Answer: B) The top of the cane is level with the greater trochanter
Rationale: The cane handle should align with the greater trochanter or wrist
crease, allowing 15-30 degrees of elbow flexion. Holding the cane on the
opposite side of the weak leg provides support. Axillary measurement is not
used for canes.
6. The nurse is teaching a patient to use a walker. Which finding demonstrates
correct walker fitting?
A) When standing, the patient's elbows flex 15-30 degrees while gripping the
handles
B) The walker's crossbar is at hip level
C) The hand grips are positioned at the wrist crease
D) The walker is 2 inches in front of the patient
Nursing Practice II – Actual Q&A (GCN) (Updated PDF)
1. A patient with chronic kidney disease is prescribed multiple medications. The
nurse should closely monitor for drug toxicity because impaired renal function
primarily affects which pharmacokinetic phase?
A) Absorption
B) Distribution
C) Metabolism
D) Excretion
Correct Answer: D) Excretion
Rationale: Excretion, primarily via the kidneys, is the phase most affected in
kidney disease. Accumulation of drug metabolites can lead to toxicity.
Absorption and distribution are less directly impacted; metabolism occurs
mainly in the liver.
2. The nurse is preparing to administer a PRN analgesic to a patient reporting
severe pain. When should the nurse document the medication administration?
A) Before preparing the medication
B) Immediately after administration
C) At the end of the shift
D) Only if the pain is relieved
Correct Answer: B) Immediately after administration
,Rationale: Documentation must occur right after giving the medication to verify
administration, prevent accidental duplicate dosing, and provide an accurate
record. Delaying documentation risks omission or double-dosing.
3. A patient is receiving digoxin, which has a narrow therapeutic index. What is
the most important nursing action to ensure safety?
A) Administer with food
B) Assess heart rate for 30 seconds
C) Monitor serum drug levels regularly
D) Teach the patient to report blurred vision
Correct Answer: C) Monitor serum drug levels regularly
Rationale: Because the margin between therapeutic and toxic doses is small,
regular monitoring of serum levels guides dosing and prevents toxicity. While
assessing heart rate and teaching side effects are important, monitoring drug
levels is the most direct safety measure.
4. A patient who has been using crutches for two weeks is evaluated for proper
fit. Which finding indicates correct crutch adjustment?
A) Elbow bends about 30 degrees when gripping the hand grips
B) Hand grips are level with the mid-forearm
C) Weight is borne on the axillary pads during ambulation
D) There is no space between the axillae and crutch rest pads
Correct Answer: A) Elbow bends about 30 degrees when gripping the hand grips
, Rationale: Proper fit includes a 2-3 finger-width gap between the axillae and
crutch pads, elbow flexion at about 30 degrees, and weight placed on the hands,
not the axillae. Hand grips should align with the hip line.
5. A nurse is evaluating a patient's cane use. Which observation indicates the
cane is properly fitted?
A) The arm holding the cane is flexed at 40 degrees
B) The top of the cane is level with the greater trochanter
C) There is a 2-inch gap between the cane top and axilla
D) The cane is held on the same side as the weak leg
Correct Answer: B) The top of the cane is level with the greater trochanter
Rationale: The cane handle should align with the greater trochanter or wrist
crease, allowing 15-30 degrees of elbow flexion. Holding the cane on the
opposite side of the weak leg provides support. Axillary measurement is not
used for canes.
6. The nurse is teaching a patient to use a walker. Which finding demonstrates
correct walker fitting?
A) When standing, the patient's elbows flex 15-30 degrees while gripping the
handles
B) The walker's crossbar is at hip level
C) The hand grips are positioned at the wrist crease
D) The walker is 2 inches in front of the patient
