• NUR 445 EXAM 09/20/2026
NUR 445 EXAM 2025 ACTUAL EXAM
COMPLETE 100 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+/ARIZONA COLLEGE
OF NURSING
A patient has been taking the same medication for several months. The patient reports, "It doesn't seem to
work like it used to, so I think I need more." Which concept should the nurse recognize?
A. Antagonism B. Drug tolerance C. Anaphylaxis D. Idiosyncratic response - Correct Answer :Answer: B — Drug
tolerance
P 1
, • NUR 445 EXAM 09/20/2026
Rationale: Drug tolerance occurs when the body becomes accustomed to a medication, resulting in a decreased
response. The patient may require a higher dose to achieve the same effect. The nurse should not independently
increase the dose; the provider should determine whether an adjustment is appropriate.
A patient taking two medications experiences a stronger-than-expected therapeutic effect. The nurse
determines that both medications enhance each other's effects. Which phenomenon is occurring?
A. Antagonism B. Toxicity C. Synergism D. Tolerance - Correct Answer :Answer: C — Synergism
Rationale: Synergism occurs when two drugs work together to produce a stronger effect than either medication
alone. This is important because the combined effect can sometimes become excessive and require monitoring.
The nurse is teaching a pregnant patient about medication safety. Which considerations are appropriate? Select
all that apply.
A. Medication dose B. Route of administration C. Timing of administration D. Potential fetal effects E. Whether
the medication is teratogenic F. Pregnancy automatically makes all medications contraindicated - Correct
Answer :Answers: A, B, C, D, E
Rationale: The notes emphasize considering the patient, medication, dose, route, time, and documentation, and
specifically recognizing teratogenic substances as potentially harmful during pregnancy. Pregnancy does not
automatically mean every medication is contraindicated.
The nurse receives a medication order that appears inconsistent with the patient's current treatment. What is
the nurse's best action?
A. Administer the medication and reassess later B. Ask another nurse to administer it C. Clarify the order before
administering the medication D. Hold the medication permanently - Correct Answer :Answer: C — Clarify the
order before administering
Rationale: A questionable medication order should be clarified before administration. Administering a potentially
incorrect medication could result in harm. The nurse should not independently change, discontinue, or
permanently hold the medication.
The nurse identifies that a medication error occurred. Which actions are appropriate? Select all that apply.
A. Assess the patient's condition B. Observe for adverse effects C. Notify the appropriate nurse/provider D.
Document the error and patient's response E. Complete required facility documentation F. Alter the MAR so the
error is not obvious G. Wait until the end of the shift to assess the patient - Correct Answer :Answers: A, B, C, D,
E
Rationale: The notes specifically identify immediate assessment, observing for adverse effects, notifying the
nurse manager/provider, documenting the error and remedial actions on the MAR, and completing facility-
required forms. Hiding or delaying documentation is unsafe.
P 2
, • NUR 445 EXAM 09/20/2026
The nurse scans a medication and discovers that the patient's name does not match the medication
administration record. What should the nurse do first?
A. Administer the medication because the dose is correct B. Stop and verify the patient's identity and medication
order C. Ask the patient whether they normally take the medication D. Document the medication as refused -
Correct Answer :Answer: B — Stop and verify
Rationale: Patient identification is a critical safety step. The nurse should not administer a medication when the
identity/order cannot be verified. Asking the patient can provide additional information but does not replace
verification.
Which finding represents a medication administration error?
A. Administering a medication at the prescribed time B. Administering a PRN medication after verifying the
indication C. Administering medication through the wrong route D. Documenting the medication immediately
after administration - Correct Answer :Answer: C — Administering through the wrong route
Rationale: The notes list wrong route, wrong rate, extra/omitted doses, wrong patient, wrong time, improper
preparation, improper technique, and administering altered medication as medication errors.
The nurse is completing medication administration checks. Which actions are part of the three checks described
in the notes? Select all that apply.
A. Compare the medication with the MAR when obtaining it B. Compare the medication with the MAR after
retrieval C. Compare the medication before administering it to the patient D. Check the medication only after
administration E. Verify the medication against the order/MAR - Correct Answer :Answers: A, B, C, E
Rationale: The notes identify three checks: when obtaining the medication and comparing it to the MAR, after
retrieval/before preparation, and before giving/administering it at the bedside. These checks help catch errors
before the patient receives the medication.
A medication is ordered to be absorbed through the gastrointestinal tract using a feeding tube. Which route is
the nurse using?
A. Parenteral B. Enteral C. Transdermal D. Intradermal - Correct Answer :Answer: B — Enteral
Rationale: Enteral medications enter through the GI tract. The notes specifically describe enteral medication as
being given through a feeding tube. Parenteral medications are administered through injection.
A nurse places a medication between a patient's tongue and cheek for absorption. Which route is being used?
A. Sublingual B. Buccal C. Enteral D. Transdermal - Correct Answer :Answer: B — Buccal
P 3
, • NUR 445 EXAM 09/20/2026
Rationale: Buccal medication is placed between the tongue and cheek. Sublingual medication is placed under
the tongue.
A patient has a medication prescribed for prolonged absorption through the skin. Which location would be most
appropriate based on the notes?
A. Inside the mouth B. Upper torso/chest C. Directly into muscle D. Into the dermis - Correct Answer :Answer: B
— Upper torso/chest
Rationale: The notes describe prolonged medication applied through the skin, with application to the upper
torso/chest, upper arms, back, or behind the sacrum.
Which medications/routes are considered topical according to the notes? Select all that apply.
A. Ophthalmic B. Otic C. Vaginal D. Rectal E. Transdermal F. Intramuscular - Correct Answer :Answers: A, B, C, D,
E
Rationale: The notes classify topical administration as medication applied directly to skin or mucous membranes
and include ophthalmic, otic, vaginal, rectal, respiratory, and transdermal routes. IM administration is parenteral.
The nurse is preparing an intradermal injection. Which technique is most appropriate?
A. Insert the needle at 90° B. Insert the needle at 45-90° C. Insert the needle at approximately 15° D. Insert the
needle at 180° - Correct Answer :Answer: C — Approximately 15°
Rationale: Intradermal injections are placed into the dermis, which is immediately beneath the epidermis. The
notes specify approximately 15° for ID injections.
The nurse is preparing a subcutaneous injection for a small patient. Which angle is most appropriate based on
the notes?
A. 15° B. 30° C. 45° D. 180° - Correct Answer :Answer: C — 45°
Rationale: The notes identify a 45-90° angle for subcutaneous injections and specifically state 45° for a small
patient.
A nurse must select equipment for an injection. Which factors should guide the selection?
A. Patient's favorite injection site only B. Medication viscosity, quantity, body size, and medication type C. Nurse
preference only D. Needle color only - Correct Answer :Answer: B
Rationale: Needle/equipment selection is based on the route, viscosity of the solution, quantity, body size, and
type of medication.
P 4
NUR 445 EXAM 2025 ACTUAL EXAM
COMPLETE 100 QUESTIONS AND CORRECT
DETAILED ANSWERS (VERIFIED ANSWERS)
|ALREADY GRADED A+/ARIZONA COLLEGE
OF NURSING
A patient has been taking the same medication for several months. The patient reports, "It doesn't seem to
work like it used to, so I think I need more." Which concept should the nurse recognize?
A. Antagonism B. Drug tolerance C. Anaphylaxis D. Idiosyncratic response - Correct Answer :Answer: B — Drug
tolerance
P 1
, • NUR 445 EXAM 09/20/2026
Rationale: Drug tolerance occurs when the body becomes accustomed to a medication, resulting in a decreased
response. The patient may require a higher dose to achieve the same effect. The nurse should not independently
increase the dose; the provider should determine whether an adjustment is appropriate.
A patient taking two medications experiences a stronger-than-expected therapeutic effect. The nurse
determines that both medications enhance each other's effects. Which phenomenon is occurring?
A. Antagonism B. Toxicity C. Synergism D. Tolerance - Correct Answer :Answer: C — Synergism
Rationale: Synergism occurs when two drugs work together to produce a stronger effect than either medication
alone. This is important because the combined effect can sometimes become excessive and require monitoring.
The nurse is teaching a pregnant patient about medication safety. Which considerations are appropriate? Select
all that apply.
A. Medication dose B. Route of administration C. Timing of administration D. Potential fetal effects E. Whether
the medication is teratogenic F. Pregnancy automatically makes all medications contraindicated - Correct
Answer :Answers: A, B, C, D, E
Rationale: The notes emphasize considering the patient, medication, dose, route, time, and documentation, and
specifically recognizing teratogenic substances as potentially harmful during pregnancy. Pregnancy does not
automatically mean every medication is contraindicated.
The nurse receives a medication order that appears inconsistent with the patient's current treatment. What is
the nurse's best action?
A. Administer the medication and reassess later B. Ask another nurse to administer it C. Clarify the order before
administering the medication D. Hold the medication permanently - Correct Answer :Answer: C — Clarify the
order before administering
Rationale: A questionable medication order should be clarified before administration. Administering a potentially
incorrect medication could result in harm. The nurse should not independently change, discontinue, or
permanently hold the medication.
The nurse identifies that a medication error occurred. Which actions are appropriate? Select all that apply.
A. Assess the patient's condition B. Observe for adverse effects C. Notify the appropriate nurse/provider D.
Document the error and patient's response E. Complete required facility documentation F. Alter the MAR so the
error is not obvious G. Wait until the end of the shift to assess the patient - Correct Answer :Answers: A, B, C, D,
E
Rationale: The notes specifically identify immediate assessment, observing for adverse effects, notifying the
nurse manager/provider, documenting the error and remedial actions on the MAR, and completing facility-
required forms. Hiding or delaying documentation is unsafe.
P 2
, • NUR 445 EXAM 09/20/2026
The nurse scans a medication and discovers that the patient's name does not match the medication
administration record. What should the nurse do first?
A. Administer the medication because the dose is correct B. Stop and verify the patient's identity and medication
order C. Ask the patient whether they normally take the medication D. Document the medication as refused -
Correct Answer :Answer: B — Stop and verify
Rationale: Patient identification is a critical safety step. The nurse should not administer a medication when the
identity/order cannot be verified. Asking the patient can provide additional information but does not replace
verification.
Which finding represents a medication administration error?
A. Administering a medication at the prescribed time B. Administering a PRN medication after verifying the
indication C. Administering medication through the wrong route D. Documenting the medication immediately
after administration - Correct Answer :Answer: C — Administering through the wrong route
Rationale: The notes list wrong route, wrong rate, extra/omitted doses, wrong patient, wrong time, improper
preparation, improper technique, and administering altered medication as medication errors.
The nurse is completing medication administration checks. Which actions are part of the three checks described
in the notes? Select all that apply.
A. Compare the medication with the MAR when obtaining it B. Compare the medication with the MAR after
retrieval C. Compare the medication before administering it to the patient D. Check the medication only after
administration E. Verify the medication against the order/MAR - Correct Answer :Answers: A, B, C, E
Rationale: The notes identify three checks: when obtaining the medication and comparing it to the MAR, after
retrieval/before preparation, and before giving/administering it at the bedside. These checks help catch errors
before the patient receives the medication.
A medication is ordered to be absorbed through the gastrointestinal tract using a feeding tube. Which route is
the nurse using?
A. Parenteral B. Enteral C. Transdermal D. Intradermal - Correct Answer :Answer: B — Enteral
Rationale: Enteral medications enter through the GI tract. The notes specifically describe enteral medication as
being given through a feeding tube. Parenteral medications are administered through injection.
A nurse places a medication between a patient's tongue and cheek for absorption. Which route is being used?
A. Sublingual B. Buccal C. Enteral D. Transdermal - Correct Answer :Answer: B — Buccal
P 3
, • NUR 445 EXAM 09/20/2026
Rationale: Buccal medication is placed between the tongue and cheek. Sublingual medication is placed under
the tongue.
A patient has a medication prescribed for prolonged absorption through the skin. Which location would be most
appropriate based on the notes?
A. Inside the mouth B. Upper torso/chest C. Directly into muscle D. Into the dermis - Correct Answer :Answer: B
— Upper torso/chest
Rationale: The notes describe prolonged medication applied through the skin, with application to the upper
torso/chest, upper arms, back, or behind the sacrum.
Which medications/routes are considered topical according to the notes? Select all that apply.
A. Ophthalmic B. Otic C. Vaginal D. Rectal E. Transdermal F. Intramuscular - Correct Answer :Answers: A, B, C, D,
E
Rationale: The notes classify topical administration as medication applied directly to skin or mucous membranes
and include ophthalmic, otic, vaginal, rectal, respiratory, and transdermal routes. IM administration is parenteral.
The nurse is preparing an intradermal injection. Which technique is most appropriate?
A. Insert the needle at 90° B. Insert the needle at 45-90° C. Insert the needle at approximately 15° D. Insert the
needle at 180° - Correct Answer :Answer: C — Approximately 15°
Rationale: Intradermal injections are placed into the dermis, which is immediately beneath the epidermis. The
notes specify approximately 15° for ID injections.
The nurse is preparing a subcutaneous injection for a small patient. Which angle is most appropriate based on
the notes?
A. 15° B. 30° C. 45° D. 180° - Correct Answer :Answer: C — 45°
Rationale: The notes identify a 45-90° angle for subcutaneous injections and specifically state 45° for a small
patient.
A nurse must select equipment for an injection. Which factors should guide the selection?
A. Patient's favorite injection site only B. Medication viscosity, quantity, body size, and medication type C. Nurse
preference only D. Needle color only - Correct Answer :Answer: B
Rationale: Needle/equipment selection is based on the route, viscosity of the solution, quantity, body size, and
type of medication.
P 4
