1|Page
NUR 635 FINAL REVIEW TYLER/SARHAN EXAM BANK AND
A NEW UPDATED STUDY GUIDE 2026/2027 ALL COMPLETE
ACTUAL QUESTIONS AND CORRECT VERIFIED ANSWERS
(A NEW UPDATED VERSION) |GUARANTEED PASS A+
(BRAND NEW!) FULL REVISED
1. A 68-year-old patient with hyperlipidemia asks why niacin is no longer routinely
added to a statin simply to further reduce cardiovascular events. Which response
by the FNP is most appropriate?
A. Niacin has no effect on lipid concentrations
B. Niacin is contraindicated in every patient receiving a statin
C. Its adverse-effect burden and lack of additional cardiovascular benefit in many
statin-treated patients limit routine use
D. Niacin always causes severe renal failure
Answer: C
Rationale: Although niacin can modify lipid parameters, routine addition to
effective statin therapy has limited cardiovascular benefit and can produce
significant adverse effects, making it inappropriate for many patients.
2. A patient taking simvastatin reports new severe generalized muscle pain and
weakness. Which laboratory test should the FNP prioritize when significant statin-
associated muscle injury is suspected?
A. Creatine kinase
B. Serum amylase
C. INR
D. Serum lipase
Answer: A
Rationale: Significant muscle symptoms while taking a statin warrant evaluation
for myopathy or rhabdomyolysis, for which creatine kinase is an important
laboratory assessment.
3. A 54-year-old patient with hypertension is prescribed lisinopril. Which finding
requires the most immediate attention during follow-up?
A. Mild fatigue during the first week
B. Persistent dry cough
C. Swelling of the lips and tongue with difficulty breathing
D. Increased urinary frequency
Answer: C
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Rationale: ACE inhibitors can cause potentially life-threatening angioedema.
Facial, tongue, or airway swelling requires immediate emergency management and
discontinuation of the offending drug.
4. A patient taking an ACE inhibitor develops a persistent dry cough but has no
respiratory distress. Which medication is an appropriate alternative when renin-
angiotensin system blockade remains indicated?
A. An ARB
B. A short-acting beta agonist
C. A loop diuretic only
D. A nitrate
Answer: A
Rationale: ARBs provide renin-angiotensin system blockade without the same
degree of bradykinin accumulation responsible for the characteristic ACE-inhibitor
cough.
5. A patient taking spironolactone for heart failure has potassium of 6.1 mEq/L and
increasing weakness. What is the priority?
A. Increase the spironolactone dose
B. Evaluate and urgently treat hyperkalemia
C. Encourage potassium-rich foods
D. Add a potassium supplement
Answer: B
Rationale: Spironolactone is potassium-sparing. Significant hyperkalemia can
produce fatal cardiac dysrhythmias and requires urgent assessment and treatment.
6. A patient receiving furosemide for heart failure develops muscle weakness and
an irregular pulse. Which electrolyte abnormality should be suspected?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Loop diuretics increase renal potassium excretion. Hypokalemia can
produce weakness and clinically important cardiac dysrhythmias.
7. A patient taking digoxin for heart failure reports anorexia, nausea, visual
disturbances, and palpitations. Which action is most appropriate?
A. Increase the dose
B. Suspect digoxin toxicity and obtain an appropriate evaluation
,3|Page
C. Add potassium restriction
D. Administer another cardiac glycoside
Answer: B
Rationale: GI symptoms, visual changes, and dysrhythmias are classic warning
signs of digoxin toxicity. Evaluation should include medication review, renal
function, electrolytes, ECG, and an appropriately timed digoxin concentration
when indicated.
8. A patient receiving digoxin develops toxicity in the setting of severe renal
impairment. Why is renal function particularly important when prescribing this
medication?
A. Digoxin is primarily eliminated through the kidneys
B. Digoxin is exclusively metabolized by the lungs
C. Renal impairment prevents all drug absorption
D. Kidney function has no effect on digoxin exposure
Answer: A
Rationale: Digoxin has substantial renal elimination, so impaired kidney function
can increase drug exposure and toxicity risk.
9. A patient with asthma asks why a long-acting beta-agonist should not be used as
the sole controller medication for persistent asthma. Which explanation is best?
A. LABAs permanently reduce lung capacity
B. LABA monotherapy does not adequately address airway inflammation and is
associated with safety concerns
C. LABAs have no bronchodilator effect
D. LABAs are antibiotics
Answer: B
Rationale: Persistent asthma requires anti-inflammatory controller therapy.
LABAs should be used in combination with an inhaled corticosteroid rather than as
monotherapy.
10. A patient using an inhaled corticosteroid asks how to reduce the risk of oral
candidiasis. Which instruction is most appropriate?
A. Avoid drinking water after administration
B. Rinse the mouth after each use
C. Take the medication only when experiencing an acute attack
D. Double the dose during asymptomatic periods
Answer: B
Rationale: Rinsing the mouth after inhaled corticosteroid administration decreases
medication deposition in the oropharynx and reduces the risk of thrush.
, 4|Page
11. A patient with COPD is prescribed tiotropium. Which statement accurately
describes the medication?
A. It is a long-acting muscarinic antagonist used for maintenance bronchodilation
B. It is a short-acting systemic corticosteroid
C. It is an antibiotic used to eradicate COPD
D. It is a rescue opioid
Answer: A
Rationale: Tiotropium is a long-acting muscarinic antagonist used as maintenance
bronchodilator therapy in COPD.
12. A patient prescribed montelukast for asthma asks what important safety issue
should be reported promptly. Which response is best?
A. New mood or behavioral changes
B. Mild thirst after exercise
C. Temporary increased appetite after breakfast
D. Increased hair growth
Answer: A
Rationale: Montelukast carries an important neuropsychiatric warning. New
depression, agitation, abnormal behavior, suicidal thoughts, or other significant
behavioral changes warrant prompt evaluation.
13. A patient with moderate generalized anxiety disorder asks about a
nonbenzodiazepine medication that can be used without the same degree of
dependence associated with benzodiazepines. Which medication is appropriate to
consider?
A. Buspirone
B. Alprazolam
C. Diazepam
D. Phenobarbital
Answer: A
Rationale: Buspirone is a nonbenzodiazepine anxiolytic used for generalized
anxiety disorder and has a substantially different dependence profile from
benzodiazepines.
14. A patient taking an SSRI is prescribed another serotonergic medication. Which
combination of symptoms should prompt concern for serotonin syndrome?
A. Constipation, dry mouth, and urinary retention
B. Hyperreflexia, clonus, agitation, diaphoresis, and fever
C. Bradycardia and hypothermia
D. Isolated mild fatigue
NUR 635 FINAL REVIEW TYLER/SARHAN EXAM BANK AND
A NEW UPDATED STUDY GUIDE 2026/2027 ALL COMPLETE
ACTUAL QUESTIONS AND CORRECT VERIFIED ANSWERS
(A NEW UPDATED VERSION) |GUARANTEED PASS A+
(BRAND NEW!) FULL REVISED
1. A 68-year-old patient with hyperlipidemia asks why niacin is no longer routinely
added to a statin simply to further reduce cardiovascular events. Which response
by the FNP is most appropriate?
A. Niacin has no effect on lipid concentrations
B. Niacin is contraindicated in every patient receiving a statin
C. Its adverse-effect burden and lack of additional cardiovascular benefit in many
statin-treated patients limit routine use
D. Niacin always causes severe renal failure
Answer: C
Rationale: Although niacin can modify lipid parameters, routine addition to
effective statin therapy has limited cardiovascular benefit and can produce
significant adverse effects, making it inappropriate for many patients.
2. A patient taking simvastatin reports new severe generalized muscle pain and
weakness. Which laboratory test should the FNP prioritize when significant statin-
associated muscle injury is suspected?
A. Creatine kinase
B. Serum amylase
C. INR
D. Serum lipase
Answer: A
Rationale: Significant muscle symptoms while taking a statin warrant evaluation
for myopathy or rhabdomyolysis, for which creatine kinase is an important
laboratory assessment.
3. A 54-year-old patient with hypertension is prescribed lisinopril. Which finding
requires the most immediate attention during follow-up?
A. Mild fatigue during the first week
B. Persistent dry cough
C. Swelling of the lips and tongue with difficulty breathing
D. Increased urinary frequency
Answer: C
,2|Page
Rationale: ACE inhibitors can cause potentially life-threatening angioedema.
Facial, tongue, or airway swelling requires immediate emergency management and
discontinuation of the offending drug.
4. A patient taking an ACE inhibitor develops a persistent dry cough but has no
respiratory distress. Which medication is an appropriate alternative when renin-
angiotensin system blockade remains indicated?
A. An ARB
B. A short-acting beta agonist
C. A loop diuretic only
D. A nitrate
Answer: A
Rationale: ARBs provide renin-angiotensin system blockade without the same
degree of bradykinin accumulation responsible for the characteristic ACE-inhibitor
cough.
5. A patient taking spironolactone for heart failure has potassium of 6.1 mEq/L and
increasing weakness. What is the priority?
A. Increase the spironolactone dose
B. Evaluate and urgently treat hyperkalemia
C. Encourage potassium-rich foods
D. Add a potassium supplement
Answer: B
Rationale: Spironolactone is potassium-sparing. Significant hyperkalemia can
produce fatal cardiac dysrhythmias and requires urgent assessment and treatment.
6. A patient receiving furosemide for heart failure develops muscle weakness and
an irregular pulse. Which electrolyte abnormality should be suspected?
A. Hypernatremia
B. Hypercalcemia
C. Hypokalemia
D. Hypermagnesemia
Answer: C
Rationale: Loop diuretics increase renal potassium excretion. Hypokalemia can
produce weakness and clinically important cardiac dysrhythmias.
7. A patient taking digoxin for heart failure reports anorexia, nausea, visual
disturbances, and palpitations. Which action is most appropriate?
A. Increase the dose
B. Suspect digoxin toxicity and obtain an appropriate evaluation
,3|Page
C. Add potassium restriction
D. Administer another cardiac glycoside
Answer: B
Rationale: GI symptoms, visual changes, and dysrhythmias are classic warning
signs of digoxin toxicity. Evaluation should include medication review, renal
function, electrolytes, ECG, and an appropriately timed digoxin concentration
when indicated.
8. A patient receiving digoxin develops toxicity in the setting of severe renal
impairment. Why is renal function particularly important when prescribing this
medication?
A. Digoxin is primarily eliminated through the kidneys
B. Digoxin is exclusively metabolized by the lungs
C. Renal impairment prevents all drug absorption
D. Kidney function has no effect on digoxin exposure
Answer: A
Rationale: Digoxin has substantial renal elimination, so impaired kidney function
can increase drug exposure and toxicity risk.
9. A patient with asthma asks why a long-acting beta-agonist should not be used as
the sole controller medication for persistent asthma. Which explanation is best?
A. LABAs permanently reduce lung capacity
B. LABA monotherapy does not adequately address airway inflammation and is
associated with safety concerns
C. LABAs have no bronchodilator effect
D. LABAs are antibiotics
Answer: B
Rationale: Persistent asthma requires anti-inflammatory controller therapy.
LABAs should be used in combination with an inhaled corticosteroid rather than as
monotherapy.
10. A patient using an inhaled corticosteroid asks how to reduce the risk of oral
candidiasis. Which instruction is most appropriate?
A. Avoid drinking water after administration
B. Rinse the mouth after each use
C. Take the medication only when experiencing an acute attack
D. Double the dose during asymptomatic periods
Answer: B
Rationale: Rinsing the mouth after inhaled corticosteroid administration decreases
medication deposition in the oropharynx and reduces the risk of thrush.
, 4|Page
11. A patient with COPD is prescribed tiotropium. Which statement accurately
describes the medication?
A. It is a long-acting muscarinic antagonist used for maintenance bronchodilation
B. It is a short-acting systemic corticosteroid
C. It is an antibiotic used to eradicate COPD
D. It is a rescue opioid
Answer: A
Rationale: Tiotropium is a long-acting muscarinic antagonist used as maintenance
bronchodilator therapy in COPD.
12. A patient prescribed montelukast for asthma asks what important safety issue
should be reported promptly. Which response is best?
A. New mood or behavioral changes
B. Mild thirst after exercise
C. Temporary increased appetite after breakfast
D. Increased hair growth
Answer: A
Rationale: Montelukast carries an important neuropsychiatric warning. New
depression, agitation, abnormal behavior, suicidal thoughts, or other significant
behavioral changes warrant prompt evaluation.
13. A patient with moderate generalized anxiety disorder asks about a
nonbenzodiazepine medication that can be used without the same degree of
dependence associated with benzodiazepines. Which medication is appropriate to
consider?
A. Buspirone
B. Alprazolam
C. Diazepam
D. Phenobarbital
Answer: A
Rationale: Buspirone is a nonbenzodiazepine anxiolytic used for generalized
anxiety disorder and has a substantially different dependence profile from
benzodiazepines.
14. A patient taking an SSRI is prescribed another serotonergic medication. Which
combination of symptoms should prompt concern for serotonin syndrome?
A. Constipation, dry mouth, and urinary retention
B. Hyperreflexia, clonus, agitation, diaphoresis, and fever
C. Bradycardia and hypothermia
D. Isolated mild fatigue
