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Nursing 354 High-Alert Medications
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
Pdf
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1. Which medication is classified as a high-alert medication because an error
can cause significant patient harm?
A. Acetaminophen
B. Heparin
C. Loratadine
D. Docusate
Answer: Heparin
Rationale: Heparin is a high-alert anticoagulant because dosing errors can result
in serious bleeding or other significant complications.
2. Which nursing action is most appropriate before administering an
intravenous insulin infusion?
A. Administer the medication without checking the concentration
B. Verify the prescription and insulin concentration according to facility policy
,C. Mix insulin with any compatible medication
D. Skip independent verification if the dose is familiar
Answer: Verify the prescription and insulin concentration according to facility
policy
Rationale: Intravenous insulin is a high-alert medication. Verification of the
order, concentration, calculation, and infusion setup helps prevent potentially
serious dosing errors.
3. Which medication requires particularly careful monitoring for
hypoglycemia?
A. Regular insulin
B. Omeprazole
C. Amoxicillin
D. Calcium carbonate
Answer: Regular insulin
Rationale: Insulin lowers blood glucose, and excessive dosing can cause
potentially severe hypoglycemia.
4. A patient receiving intravenous potassium chloride reports burning at the IV
site. What should the nurse do first?
A. Increase the infusion rate
B. Apply a heating pad
C. Assess the IV site and stop the infusion if infiltration or irritation is suspected
D. Flush the line rapidly
Answer: Assess the IV site and stop the infusion if infiltration or irritation is
suspected
Rationale: Intravenous potassium is a high-alert medication. Local pain or
burning requires immediate assessment because tissue injury and other
complications can occur with inappropriate administration.
5. Which statement about concentrated potassium chloride is correct?
,A. It may be administered by IV push when urgently needed
B. It should be diluted and administered according to institutional policy
C. It does not require an infusion pump
D. It is considered a low-risk medication
Answer: It should be diluted and administered according to institutional policy
Rationale: Concentrated potassium chloride is a high-alert medication and
should not be administered by IV push. Safe dilution and controlled
administration are essential.
6. Which laboratory value is most important to monitor in a patient receiving
unfractionated heparin?
A. Hemoglobin A1C
B. Activated partial thromboplastin time
C. Serum calcium only
D. Amylase
Answer: Activated partial thromboplastin time
Rationale: Activated partial thromboplastin time is commonly used to monitor
the anticoagulant effect of unfractionated heparin, according to the institution's
protocol.
7. Which finding in a patient receiving heparin requires prompt nursing
attention?
A. Mild thirst
B. New unexplained bruising and bleeding gums
C. Increased appetite
D. Dry skin
Answer: New unexplained bruising and bleeding gums
Rationale: Unusual bleeding can indicate excessive anticoagulation or a bleeding
complication and should be promptly assessed.
8. Which medication is a high-alert opioid?
, A. Morphine
B. Famotidine
C. Cetirizine
D. Calcium carbonate
Answer: Morphine
Rationale: Opioids such as morphine can cause respiratory depression, excessive
sedation, hypotension, and other serious adverse effects when dosing or
administration errors occur.
9. Before administering IV morphine, which assessment is most important?
A. Respiratory status and level of consciousness
B. Hair color
C. Visual acuity
D. Bowel sounds only
Answer: Respiratory status and level of consciousness
Rationale: Opioids can depress the central nervous system and respiratory drive.
Respiratory rate, oxygenation, and sedation level are important safety
assessments.
10.Which finding after opioid administration is most concerning?
A. Mild drowsiness
B. Respiratory depression with decreased responsiveness
C. Mild nausea
D. Slight decrease in appetite
Answer: Respiratory depression with decreased responsiveness
Rationale: Significant respiratory depression and decreased responsiveness are
serious opioid adverse effects requiring immediate intervention.
11.Which medication is commonly considered high alert because of its narrow
therapeutic range and potential for serious toxicity?
Nursing 354 High-Alert Medications
Practice Exam Questions And Correct
Answers (Verified Answers) Plus
Rationales 2026 Q&A Instant Download
___________________________________________________________________
1. Which medication is classified as a high-alert medication because an error
can cause significant patient harm?
A. Acetaminophen
B. Heparin
C. Loratadine
D. Docusate
Answer: Heparin
Rationale: Heparin is a high-alert anticoagulant because dosing errors can result
in serious bleeding or other significant complications.
2. Which nursing action is most appropriate before administering an
intravenous insulin infusion?
A. Administer the medication without checking the concentration
B. Verify the prescription and insulin concentration according to facility policy
,C. Mix insulin with any compatible medication
D. Skip independent verification if the dose is familiar
Answer: Verify the prescription and insulin concentration according to facility
policy
Rationale: Intravenous insulin is a high-alert medication. Verification of the
order, concentration, calculation, and infusion setup helps prevent potentially
serious dosing errors.
3. Which medication requires particularly careful monitoring for
hypoglycemia?
A. Regular insulin
B. Omeprazole
C. Amoxicillin
D. Calcium carbonate
Answer: Regular insulin
Rationale: Insulin lowers blood glucose, and excessive dosing can cause
potentially severe hypoglycemia.
4. A patient receiving intravenous potassium chloride reports burning at the IV
site. What should the nurse do first?
A. Increase the infusion rate
B. Apply a heating pad
C. Assess the IV site and stop the infusion if infiltration or irritation is suspected
D. Flush the line rapidly
Answer: Assess the IV site and stop the infusion if infiltration or irritation is
suspected
Rationale: Intravenous potassium is a high-alert medication. Local pain or
burning requires immediate assessment because tissue injury and other
complications can occur with inappropriate administration.
5. Which statement about concentrated potassium chloride is correct?
,A. It may be administered by IV push when urgently needed
B. It should be diluted and administered according to institutional policy
C. It does not require an infusion pump
D. It is considered a low-risk medication
Answer: It should be diluted and administered according to institutional policy
Rationale: Concentrated potassium chloride is a high-alert medication and
should not be administered by IV push. Safe dilution and controlled
administration are essential.
6. Which laboratory value is most important to monitor in a patient receiving
unfractionated heparin?
A. Hemoglobin A1C
B. Activated partial thromboplastin time
C. Serum calcium only
D. Amylase
Answer: Activated partial thromboplastin time
Rationale: Activated partial thromboplastin time is commonly used to monitor
the anticoagulant effect of unfractionated heparin, according to the institution's
protocol.
7. Which finding in a patient receiving heparin requires prompt nursing
attention?
A. Mild thirst
B. New unexplained bruising and bleeding gums
C. Increased appetite
D. Dry skin
Answer: New unexplained bruising and bleeding gums
Rationale: Unusual bleeding can indicate excessive anticoagulation or a bleeding
complication and should be promptly assessed.
8. Which medication is a high-alert opioid?
, A. Morphine
B. Famotidine
C. Cetirizine
D. Calcium carbonate
Answer: Morphine
Rationale: Opioids such as morphine can cause respiratory depression, excessive
sedation, hypotension, and other serious adverse effects when dosing or
administration errors occur.
9. Before administering IV morphine, which assessment is most important?
A. Respiratory status and level of consciousness
B. Hair color
C. Visual acuity
D. Bowel sounds only
Answer: Respiratory status and level of consciousness
Rationale: Opioids can depress the central nervous system and respiratory drive.
Respiratory rate, oxygenation, and sedation level are important safety
assessments.
10.Which finding after opioid administration is most concerning?
A. Mild drowsiness
B. Respiratory depression with decreased responsiveness
C. Mild nausea
D. Slight decrease in appetite
Answer: Respiratory depression with decreased responsiveness
Rationale: Significant respiratory depression and decreased responsiveness are
serious opioid adverse effects requiring immediate intervention.
11.Which medication is commonly considered high alert because of its narrow
therapeutic range and potential for serious toxicity?
