NU 578 Units 1–5 Exam (2026/2027) (PDF) | Advanced
Nursing | University of South Alabama
PART 1 – QUESTIONS 1–50
Question 1. A patient is receiving methyldopa (Aldomet) for high blood pressure. When
should the Coomb's test be monitored?
A. At the beginning of treatment only
B. Prior to treatment and at 6 months into therapy
C. At the end of treatment only
D. At 6 months and at the end of treatment
Correct Answer: B
Rationale: Methyldopa can induce autoimmune hemolytic anemia. A Coomb's test
should be performed prior to treatment to establish a baseline and around 6 months
into therapy to detect hemolysis early . Monitoring only at the beginning or end is
insufficient given delayed autoimmune reactions.
Question 2. A patient taking clopidogrel (Plavix) develops heartburn and begins taking
omeprazole (Prilosec). The nurse practitioner knows the interaction between these two
drugs may result in:
A. Complexation of the two drugs in the gut requiring them to be taken 2 hours apart
B. Elevation of omeprazole levels in the blood with enhanced effects
C. Elevation of clopidogrel levels in the blood
D. Decreased effect of clopidogrel due to metabolic inactivation
,Correct Answer: D
Rationale: Omeprazole inhibits CYP2C19, the enzyme responsible for activating
clopidogrel (a prodrug). This interaction reduces clopidogrel's antiplatelet efficacy,
increasing the risk for thrombotic events . Timing does not mitigate this metabolic
interaction.
Question 3. A 29-year-old male with peptic ulcer disease is prescribed an
anticholinergic drug. Upon taking his medication, which assessment finding is most
likely?
A. Dilated pupils
B. Hyperactive bowel sounds
C. Bradycardia
D. Drooling
Correct Answer: A
Rationale: Anticholinergic drugs block parasympathetic activity, causing pupil dilation
(mydriasis), decreased secretions (dry mouth, not drooling), decreased bowel motility
(hypoactive sounds), and tachycardia (not bradycardia) . These are classic anticholinergic
effects resulting from muscarinic receptor blockade.
Question 4. Women prescribed a drug in Pregnancy Category X must be counseled to,
at a minimum:
A. Only take the medications on days during which no intercourse takes place
B. Use a reliable form of birth control
C. Refuse the medication
D. Not worry unless planning to conceive in the near future
Correct Answer: B
Rationale: Category X drugs are contraindicated in pregnancy due to teratogenicity.
Women must use reliable contraception to prevent pregnancy while on these
,medications . Avoiding intercourse or delaying concern is inadequate; refusing
medication depends on clinical necessity and alternatives.
Question 5. A patient with acute heart failure is started on IV nitroglycerin. Within
minutes, the patient reports a severe headache and blood pressure drops to 86/50
mmHg. What is the nurse's priority action?
A. Increase the infusion rate
B. Stop the infusion and notify the provider
C. Administer acetaminophen only
D. Place the patient in Trendelenburg position
Correct Answer: B
Rationale: Hypotension is a serious adverse effect of nitroglycerin; the infusion must be
stopped immediately to prevent shock . Headache is also a common side effect but is
less immediately life-threatening than severe hypotension.
Question 6. A nurse is reviewing ABG results: pH 7.52, PaCO₂ 30 mmHg, HCO₃⁻ 24
mEq/L. What condition is present?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Correct Answer: B
Rationale: High pH (alkalemia) with low PaCO₂ indicates respiratory alkalosis, often
from hyperventilation . The HCO₃⁻ is normal, indicating this is an acute, uncompensated
respiratory alkalosis.
, Question 7. A postoperative patient develops unilateral calf pain, warmth, and swelling.
What is the priority concern?
A. Cellulitis
B. Deep vein thrombosis (DVT)
C. Muscle strain
D. Peripheral neuropathy
Correct Answer: B
Rationale: Classic signs of DVT require immediate intervention to prevent pulmonary
embolism . These clinical findings in a postoperative patient should prompt urgent
diagnostic evaluation.
Question 8. A patient develops sudden shortness of breath, chest pain, and hemoptysis.
What is most likely?
A. Asthma attack
B. Pulmonary embolism
C. Pneumonia
D. Panic attack
Correct Answer: B
Rationale: These are classic signs of pulmonary embolism . The sudden onset and
combination of symptoms differentiate this from other respiratory conditions.
Question 9. A nurse is caring for a patient with increased intracranial pressure (ICP).
Which intervention is contraindicated?
A. Elevating the head of the bed
B. Suctioning frequently
C. Maintaining oxygenation
D. Keeping the neck midline
Correct Answer: B
Nursing | University of South Alabama
PART 1 – QUESTIONS 1–50
Question 1. A patient is receiving methyldopa (Aldomet) for high blood pressure. When
should the Coomb's test be monitored?
A. At the beginning of treatment only
B. Prior to treatment and at 6 months into therapy
C. At the end of treatment only
D. At 6 months and at the end of treatment
Correct Answer: B
Rationale: Methyldopa can induce autoimmune hemolytic anemia. A Coomb's test
should be performed prior to treatment to establish a baseline and around 6 months
into therapy to detect hemolysis early . Monitoring only at the beginning or end is
insufficient given delayed autoimmune reactions.
Question 2. A patient taking clopidogrel (Plavix) develops heartburn and begins taking
omeprazole (Prilosec). The nurse practitioner knows the interaction between these two
drugs may result in:
A. Complexation of the two drugs in the gut requiring them to be taken 2 hours apart
B. Elevation of omeprazole levels in the blood with enhanced effects
C. Elevation of clopidogrel levels in the blood
D. Decreased effect of clopidogrel due to metabolic inactivation
,Correct Answer: D
Rationale: Omeprazole inhibits CYP2C19, the enzyme responsible for activating
clopidogrel (a prodrug). This interaction reduces clopidogrel's antiplatelet efficacy,
increasing the risk for thrombotic events . Timing does not mitigate this metabolic
interaction.
Question 3. A 29-year-old male with peptic ulcer disease is prescribed an
anticholinergic drug. Upon taking his medication, which assessment finding is most
likely?
A. Dilated pupils
B. Hyperactive bowel sounds
C. Bradycardia
D. Drooling
Correct Answer: A
Rationale: Anticholinergic drugs block parasympathetic activity, causing pupil dilation
(mydriasis), decreased secretions (dry mouth, not drooling), decreased bowel motility
(hypoactive sounds), and tachycardia (not bradycardia) . These are classic anticholinergic
effects resulting from muscarinic receptor blockade.
Question 4. Women prescribed a drug in Pregnancy Category X must be counseled to,
at a minimum:
A. Only take the medications on days during which no intercourse takes place
B. Use a reliable form of birth control
C. Refuse the medication
D. Not worry unless planning to conceive in the near future
Correct Answer: B
Rationale: Category X drugs are contraindicated in pregnancy due to teratogenicity.
Women must use reliable contraception to prevent pregnancy while on these
,medications . Avoiding intercourse or delaying concern is inadequate; refusing
medication depends on clinical necessity and alternatives.
Question 5. A patient with acute heart failure is started on IV nitroglycerin. Within
minutes, the patient reports a severe headache and blood pressure drops to 86/50
mmHg. What is the nurse's priority action?
A. Increase the infusion rate
B. Stop the infusion and notify the provider
C. Administer acetaminophen only
D. Place the patient in Trendelenburg position
Correct Answer: B
Rationale: Hypotension is a serious adverse effect of nitroglycerin; the infusion must be
stopped immediately to prevent shock . Headache is also a common side effect but is
less immediately life-threatening than severe hypotension.
Question 6. A nurse is reviewing ABG results: pH 7.52, PaCO₂ 30 mmHg, HCO₃⁻ 24
mEq/L. What condition is present?
A. Metabolic acidosis
B. Respiratory alkalosis
C. Metabolic alkalosis
D. Respiratory acidosis
Correct Answer: B
Rationale: High pH (alkalemia) with low PaCO₂ indicates respiratory alkalosis, often
from hyperventilation . The HCO₃⁻ is normal, indicating this is an acute, uncompensated
respiratory alkalosis.
, Question 7. A postoperative patient develops unilateral calf pain, warmth, and swelling.
What is the priority concern?
A. Cellulitis
B. Deep vein thrombosis (DVT)
C. Muscle strain
D. Peripheral neuropathy
Correct Answer: B
Rationale: Classic signs of DVT require immediate intervention to prevent pulmonary
embolism . These clinical findings in a postoperative patient should prompt urgent
diagnostic evaluation.
Question 8. A patient develops sudden shortness of breath, chest pain, and hemoptysis.
What is most likely?
A. Asthma attack
B. Pulmonary embolism
C. Pneumonia
D. Panic attack
Correct Answer: B
Rationale: These are classic signs of pulmonary embolism . The sudden onset and
combination of symptoms differentiate this from other respiratory conditions.
Question 9. A nurse is caring for a patient with increased intracranial pressure (ICP).
Which intervention is contraindicated?
A. Elevating the head of the bed
B. Suctioning frequently
C. Maintaining oxygenation
D. Keeping the neck midline
Correct Answer: B
