,NSG 318 EXAM 3 – COMPLETE TE ST BANK
NGN-Style Questions & Case Scenari os | 250 Quest ions with
Answers & Rationales
Grand Canyon University | 2026 Edit ion | 100% Pass
Guarantee
EXAM BLUEPRINT
NSG 318 Exam 3 at Grand Canyon University focuses on pharmacology w ith an
emphasis on Next Generation NCLEX (NGN) style qu estions and case scen arios.
Topic Area Percentage Approximate Questions
Cardiovascular & Anticoagulant Medications 20% 50
Respiratory Medications 15% 38
Neurological & CNS Medications 15% 38
Pain Management & Opioid Analgesics 15% 38
Antibiotics, Antivirals & Antifungals 15% 38
Psychiatric Medications 10% 25
Endocrine Medications 5% 13
NGN Case Scenarios (Integrated) 5% 10
,SECTION 1: CARDIOVASCULAR & ANTICOAGULANT
MEDICATIONS (Questions 1–50)
1. A patient with heart failure is prescribed digoxin. Which finding indicates a
therapeutic effect?
A) Decreased heart rate
B) Increased cardiac output
C) Decreased peripheral edema
D) All of the above
Answer: D) All of the above
Rationale: Digoxin increases cardiac contractility, decreases heart rate, and improves
symptoms of heart failure (edema, dyspnea). Therapeutic effects include increased
cardiac output, decreased heart rate, and reduced edema.
2. A patient is receiving IV heparin. Which laboratory value should the nurse monitor to
evaluate therapeutic effectiveness?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
Answer: B) aPTT
Rationale: Heparin therapy is monitored using activated partial thromboplastin time
, (aPTT), with a therapeutic goal of 1.5–2.5 times the normal value. INR (A) is used for
warfarin. Platelet count (C) is monitored for heparin-induced thrombocytopenia.
3. A patient on warfarin has an INR of 4.5. The patient is not bleeding. What is the
priority nursing action?
A) Administer vitamin K
B) Hold the warfarin and notify the provider
C) Administer protamine sulfate
D) Continue the warfarin as ordered
Answer: B) Hold the warfarin and notify the provider
Rationale: Therapeutic INR for most indications is 2–3. An INR of 4.5 is elevated and
increases bleeding risk. The warfarin should be held, and the provider notified. Vitamin K
(A) is used for bleeding or INR >5. Protamine sulfate (C) is for heparin reversal.
4. A patient is prescribed clopidogrel (Plavix). Which adverse effect should the nurse
monitor for?
A) Bleeding
B) Hypertension
C) Bradycardia
D) Hyperglycemia
Answer: A) Bleeding
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation,
increasing the risk of bleeding. The nurse should monitor for signs of bleeding such as
bruising, petechiae, and GI bleeding.
NGN-Style Questions & Case Scenari os | 250 Quest ions with
Answers & Rationales
Grand Canyon University | 2026 Edit ion | 100% Pass
Guarantee
EXAM BLUEPRINT
NSG 318 Exam 3 at Grand Canyon University focuses on pharmacology w ith an
emphasis on Next Generation NCLEX (NGN) style qu estions and case scen arios.
Topic Area Percentage Approximate Questions
Cardiovascular & Anticoagulant Medications 20% 50
Respiratory Medications 15% 38
Neurological & CNS Medications 15% 38
Pain Management & Opioid Analgesics 15% 38
Antibiotics, Antivirals & Antifungals 15% 38
Psychiatric Medications 10% 25
Endocrine Medications 5% 13
NGN Case Scenarios (Integrated) 5% 10
,SECTION 1: CARDIOVASCULAR & ANTICOAGULANT
MEDICATIONS (Questions 1–50)
1. A patient with heart failure is prescribed digoxin. Which finding indicates a
therapeutic effect?
A) Decreased heart rate
B) Increased cardiac output
C) Decreased peripheral edema
D) All of the above
Answer: D) All of the above
Rationale: Digoxin increases cardiac contractility, decreases heart rate, and improves
symptoms of heart failure (edema, dyspnea). Therapeutic effects include increased
cardiac output, decreased heart rate, and reduced edema.
2. A patient is receiving IV heparin. Which laboratory value should the nurse monitor to
evaluate therapeutic effectiveness?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
Answer: B) aPTT
Rationale: Heparin therapy is monitored using activated partial thromboplastin time
, (aPTT), with a therapeutic goal of 1.5–2.5 times the normal value. INR (A) is used for
warfarin. Platelet count (C) is monitored for heparin-induced thrombocytopenia.
3. A patient on warfarin has an INR of 4.5. The patient is not bleeding. What is the
priority nursing action?
A) Administer vitamin K
B) Hold the warfarin and notify the provider
C) Administer protamine sulfate
D) Continue the warfarin as ordered
Answer: B) Hold the warfarin and notify the provider
Rationale: Therapeutic INR for most indications is 2–3. An INR of 4.5 is elevated and
increases bleeding risk. The warfarin should be held, and the provider notified. Vitamin K
(A) is used for bleeding or INR >5. Protamine sulfate (C) is for heparin reversal.
4. A patient is prescribed clopidogrel (Plavix). Which adverse effect should the nurse
monitor for?
A) Bleeding
B) Hypertension
C) Bradycardia
D) Hyperglycemia
Answer: A) Bleeding
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation,
increasing the risk of bleeding. The nurse should monitor for signs of bleeding such as
bruising, petechiae, and GI bleeding.
