NUR 354 EXAM 3 PRACTICE QUESTIONS REVIEW
1. A client receiving IV amiodarone for ventricular tachycardia develops HR 48 bpm, BP 86/50
mmHg, dizziness, and prolonged QT on telemetry. Which action should the nurse take first?
a. Stop the infusion and notify the provider
b. Decrease the dose by 50%
c. Give IV magnesium sulfate
d. Administer IV atropine
2. A client on warfarin has an INR of 5.4, abdominal bruising, and melena. Which medication
should the nurse anticipate?
a. Vitamin K
b. Protamine sulfate
c. Idarucizumab
d. Aminocaproic acid
3. The nurse prepares to administer atorvastatin. Which lab result requires holding the dose?
a. LDL 195 mg/dL
b. Total cholesterol 298 mg/dL
c. ALT 212 U/L
d. HDL 38 mg/dL
4. A client on digoxin reports nausea and yellow halos. HR 52 bpm; K⁺ 2.9 mEq/L. Which factor
most increased toxicity risk?
a. Hypokalemia
b. Normal renal function
c. Low digoxin dosage
d. Concomitant beta-blocker use
5. A client on IV heparin has: aPTT 142 sec, platelets 65,000/mm³. What should the nurse
suspect?
a. Heparin-induced thrombocytopenia
b. Warfarin potentiation
c. Hypercoagulability syndrome
d. Fluid overload
6. A client with atrial fibrillation is started on diltiazem. Which finding indicates effectiveness?
a. HR decreased from 142 to 88 bpm
b. BP increased from 102/68 to 150/88
c. Potassium increased to 5.4 mEq/L
d. QT interval lengthened
,7. A client taking niacin reports severe flushing. What instruction should the nurse provide?
a. Take aspirin 30 minutes before dose
b. Take dose with grapefruit juice
c. Double the bedtime dose
d. Stop the medication immediately
8. A client prescribed spironolactone has K⁺ 6.1 mEq/L. Which assessment is priority?
a. Cardiac rhythm changes
b. Temperature
c. Bilateral breath sounds
d. Capillary refill
9. A client receiving alteplase for ischemic stroke develops sudden severe headache and BP
190/102 mmHg. What is the priority action?
a. Stop the infusion
b. Increase IV fluids
c. Lower head of bed
d. Administer aspirin
10. The nurse teaches a client about gemfibrozil. Which statement needs further teaching?
a. “I will take this drug 30 minutes before breakfast and dinner.”
b. “I should report muscle tenderness.”
c. “I can take this with my statin every day.”
d. “This drug helps lower triglycerides.”
11. A client on amiodarone reports dyspnea and persistent dry cough. Which adverse effect
does this suggest?
a. Pulmonary toxicity
b. Thyroid dysfunction
c. Liver failure
d. Optic neuropathy
12. A client on warfarin reports sudden flank pain; INR = 3.1. Which complication is most likely?
a. Retroperitoneal bleeding
b. Kidney stone
c. Rhabdomyolysis
d. Acute tubular necrosis
13. A client on lisinopril has serum K⁺ 5.9 mEq/L. Which medication likely contributed?
a. Spironolactone
,b. Atorvastatin
c. Digoxin
d. Warfarin
14. A client on atorvastatin reports muscle pain and dark urine. Which lab is priority?
a. Creatine kinase
b. Hemoglobin
c. BUN
d. INR
15. The provider orders IV diltiazem for rapid atrial fibrillation. Which history requires
questioning this order?
a. Heart failure with reduced ejection fraction
b. Mild hypertension
c. Migraine headaches
d. Hyperlipidemia
16. A client on furosemide has: K⁺ 2.7 mEq/L; Mg²⁺ 1.1 mg/dL; BP 102/66. Which action is
priority?
a. Replace electrolytes
b. Increase diuretic dose
c. Restrict fluids
d. Administer digoxin
17. Which finding indicates digoxin is effective for heart failure?
a. Decreased crackles and improved activity tolerance
b. Increased heart rate
c. Decreased potassium
d. Elevated BNP
18. A client receiving rivaroxaban should avoid which OTC medication?
a. Ibuprofen
b. Loratadine
c. Calcium carbonate
d. Famotidine
19. A client receiving lidocaine for ventricular dysrhythmias develops confusion and tremors.
What should the nurse suspect?
a. Neurotoxicity
b. Fluid overload
, c. Hypoglycemia
d. Hypernatremia
20. A client on metoprolol for heart failure reports worsening fatigue and bradycardia. Which
action is appropriate?
a. Hold medication and notify provider
b. Increase the dose
c. Give dose late at night
d. Administer with grapefruit juice
21. A client receiving warfarin therapy is started on amiodarone. What adjustment may be
required?
a. Reduce warfarin dose
b. Increase warfarin dose
c. Discontinue warfarin
d. Add heparin infusion
22. A client on spironolactone reports muscle weakness. Serum K⁺ = 6.3 mEq/L. Which
medication would the nurse expect to administer?
a. Sodium polystyrene sulfonate
b. Potassium chloride
c. Lactated Ringer’s
d. Magnesium sulfate
23. A client on atorvastatin has new-onset jaundice. Which complication is suspected?
a. Hepatotoxicity
b. Myopathy
c. Nephrotoxicity
d. Anaphylaxis
24. The nurse is administering adenosine for SVT. Which effect should the nurse expect?
a. Brief asystole
b. Prolonged tachycardia
c. Hypertension
d. Chest wall rigidity
25. A client on dabigatran reports dark stools. What is the nurse’s priority action?
a. Test stool for occult blood
b. Hold dose for 12 hours
1. A client receiving IV amiodarone for ventricular tachycardia develops HR 48 bpm, BP 86/50
mmHg, dizziness, and prolonged QT on telemetry. Which action should the nurse take first?
a. Stop the infusion and notify the provider
b. Decrease the dose by 50%
c. Give IV magnesium sulfate
d. Administer IV atropine
2. A client on warfarin has an INR of 5.4, abdominal bruising, and melena. Which medication
should the nurse anticipate?
a. Vitamin K
b. Protamine sulfate
c. Idarucizumab
d. Aminocaproic acid
3. The nurse prepares to administer atorvastatin. Which lab result requires holding the dose?
a. LDL 195 mg/dL
b. Total cholesterol 298 mg/dL
c. ALT 212 U/L
d. HDL 38 mg/dL
4. A client on digoxin reports nausea and yellow halos. HR 52 bpm; K⁺ 2.9 mEq/L. Which factor
most increased toxicity risk?
a. Hypokalemia
b. Normal renal function
c. Low digoxin dosage
d. Concomitant beta-blocker use
5. A client on IV heparin has: aPTT 142 sec, platelets 65,000/mm³. What should the nurse
suspect?
a. Heparin-induced thrombocytopenia
b. Warfarin potentiation
c. Hypercoagulability syndrome
d. Fluid overload
6. A client with atrial fibrillation is started on diltiazem. Which finding indicates effectiveness?
a. HR decreased from 142 to 88 bpm
b. BP increased from 102/68 to 150/88
c. Potassium increased to 5.4 mEq/L
d. QT interval lengthened
,7. A client taking niacin reports severe flushing. What instruction should the nurse provide?
a. Take aspirin 30 minutes before dose
b. Take dose with grapefruit juice
c. Double the bedtime dose
d. Stop the medication immediately
8. A client prescribed spironolactone has K⁺ 6.1 mEq/L. Which assessment is priority?
a. Cardiac rhythm changes
b. Temperature
c. Bilateral breath sounds
d. Capillary refill
9. A client receiving alteplase for ischemic stroke develops sudden severe headache and BP
190/102 mmHg. What is the priority action?
a. Stop the infusion
b. Increase IV fluids
c. Lower head of bed
d. Administer aspirin
10. The nurse teaches a client about gemfibrozil. Which statement needs further teaching?
a. “I will take this drug 30 minutes before breakfast and dinner.”
b. “I should report muscle tenderness.”
c. “I can take this with my statin every day.”
d. “This drug helps lower triglycerides.”
11. A client on amiodarone reports dyspnea and persistent dry cough. Which adverse effect
does this suggest?
a. Pulmonary toxicity
b. Thyroid dysfunction
c. Liver failure
d. Optic neuropathy
12. A client on warfarin reports sudden flank pain; INR = 3.1. Which complication is most likely?
a. Retroperitoneal bleeding
b. Kidney stone
c. Rhabdomyolysis
d. Acute tubular necrosis
13. A client on lisinopril has serum K⁺ 5.9 mEq/L. Which medication likely contributed?
a. Spironolactone
,b. Atorvastatin
c. Digoxin
d. Warfarin
14. A client on atorvastatin reports muscle pain and dark urine. Which lab is priority?
a. Creatine kinase
b. Hemoglobin
c. BUN
d. INR
15. The provider orders IV diltiazem for rapid atrial fibrillation. Which history requires
questioning this order?
a. Heart failure with reduced ejection fraction
b. Mild hypertension
c. Migraine headaches
d. Hyperlipidemia
16. A client on furosemide has: K⁺ 2.7 mEq/L; Mg²⁺ 1.1 mg/dL; BP 102/66. Which action is
priority?
a. Replace electrolytes
b. Increase diuretic dose
c. Restrict fluids
d. Administer digoxin
17. Which finding indicates digoxin is effective for heart failure?
a. Decreased crackles and improved activity tolerance
b. Increased heart rate
c. Decreased potassium
d. Elevated BNP
18. A client receiving rivaroxaban should avoid which OTC medication?
a. Ibuprofen
b. Loratadine
c. Calcium carbonate
d. Famotidine
19. A client receiving lidocaine for ventricular dysrhythmias develops confusion and tremors.
What should the nurse suspect?
a. Neurotoxicity
b. Fluid overload
, c. Hypoglycemia
d. Hypernatremia
20. A client on metoprolol for heart failure reports worsening fatigue and bradycardia. Which
action is appropriate?
a. Hold medication and notify provider
b. Increase the dose
c. Give dose late at night
d. Administer with grapefruit juice
21. A client receiving warfarin therapy is started on amiodarone. What adjustment may be
required?
a. Reduce warfarin dose
b. Increase warfarin dose
c. Discontinue warfarin
d. Add heparin infusion
22. A client on spironolactone reports muscle weakness. Serum K⁺ = 6.3 mEq/L. Which
medication would the nurse expect to administer?
a. Sodium polystyrene sulfonate
b. Potassium chloride
c. Lactated Ringer’s
d. Magnesium sulfate
23. A client on atorvastatin has new-onset jaundice. Which complication is suspected?
a. Hepatotoxicity
b. Myopathy
c. Nephrotoxicity
d. Anaphylaxis
24. The nurse is administering adenosine for SVT. Which effect should the nurse expect?
a. Brief asystole
b. Prolonged tachycardia
c. Hypertension
d. Chest wall rigidity
25. A client on dabigatran reports dark stools. What is the nurse’s priority action?
a. Test stool for occult blood
b. Hold dose for 12 hours
