NSG 3600 Exam 2 ACTUAL Exam 2026-2027 BANK
QUESTIONS WITH DETAILED VERIFIED ANSWERS
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1. A patient with heart failure is prescribed furosemide. Which
laboratory value is most important to monitor?
A) Serum sodium
B) Serum potassium
C) Serum calcium
D) Serum magnesium
Answer: B) Serum potassium
Explanation: Furosemide is a loop diuretic that inhibits sodium and
chloride reabsorption in the ascending loop of Henle, leading to
increased excretion of potassium. Hypokalemia can precipitate cardiac
arrhythmias, especially in patients on digitalis, making serum potassium
the most critical value to monitor.
2. Which finding is most indicative of digoxin toxicity?
A) Tachycardia and hypertension
B) Blurred yellow vision and nausea
C) Bradycardia and hypotension
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D) Polyuria and polydipsia
Answer: B) Blurred yellow vision and nausea
Explanation: Classic signs of digoxin toxicity include gastrointestinal
symptoms like nausea and vomiting, as well as visual disturbances such
as yellow-green halos (xanthopsia). Cardiac dysrhythmias, including
bradycardia, are also common, but visual and GI symptoms are
hallmark early indicators.
3. A patient on heparin therapy develops bleeding. Which antidote
should the nurse anticipate?
A) Vitamin K
B) Protamine sulfate
C) Naloxone
D) Flumazenil
Answer: B) Protamine sulfate
Explanation: Protamine sulfate is a specific antidote for heparin, binding
to heparin to form a stable complex that neutralizes its anticoagulant
effect. Vitamin K is used for warfarin, naloxone for opioids, and
flumazenil for benzodiazepines.
4. Which dietary instruction is most appropriate for a patient taking
warfarin?
A) Increase intake of leafy green vegetables
B) Maintain consistent intake of vitamin K-rich foods
C) Avoid all foods containing vitamin K
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D) Take warfarin with high-fat meals
Answer: B) Maintain consistent intake of vitamin K-rich foods
Explanation: Warfarin works by inhibiting vitamin K-dependent clotting
factors. A sudden increase or decrease in dietary vitamin K can alter INR
levels, so patients should keep their intake of foods like spinach and kale
consistent rather than avoiding them entirely.
5. A patient with angina reports chest pain unrelieved by three
sublingual nitroglycerin tablets taken five minutes apart. What is the
priority nursing action?
A) Administer a fourth tablet
B) Call the healthcare provider
C) Apply a nitroglycerin patch
D) Obtain a 12-lead ECG
Answer: B) Call the healthcare provider
Explanation: The standard protocol for angina is to take up to three
sublingual nitroglycerin tablets at five-minute intervals. If pain persists
after the third dose, this indicates possible unstable angina or
myocardial infarction, and immediate medical intervention is required.
6. Which beta-blocker is considered cardioselective?
A) Propranolol
B) Metoprolol
C) Nadolol
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D) Timolol
Answer: B) Metoprolol
Explanation: Metoprolol is a beta-1 selective blocker, preferentially
affecting cardiac receptors at therapeutic doses. Propranolol, nadolol,
and timolol are non-selective, affecting both beta-1 and beta-2
receptors, which increases the risk of bronchospasm.
7. A patient prescribed an ACE inhibitor develops a persistent dry
cough. What is the most appropriate nursing action?
A) Instruct the patient to take an over-the-counter cough suppressant
B) Notify the healthcare provider for possible medication change
C) Reassure the patient that this side effect is harmless
D) Increase the dose to suppress the cough
Answer: B) Notify the healthcare provider for possible medication
change
Explanation: A dry cough is a common side effect of ACE inhibitors due
to bradykinin accumulation. While not immediately dangerous, it can be
intolerable, and the prescriber may switch to an angiotensin II receptor
blocker (ARB), which does not cause this effect.
8. Which laboratory test is used to monitor therapeutic levels of
lithium?
A) Complete blood count
B) Serum creatinine
C) Serum lithium level