NUR 210 | NUR210 Exam 2 V2 – Updated and Latest Questions and
Correct Answers with Rationale – Galen College of Nursing
1. A nurse is caring for a patient experiencing an acute asthma attack. Which medication
should the nurse administer first for immediate bronchodilation?
A. Salmeterol
B. Fluticasone
C. Albuterol
D. Tiotropium
Answer: C
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid relief of
bronchospasm during acute attacks. Unlike long-acting agents like salmeterol, albuterol
works within minutes to relax airway smooth muscle. The nurse must assess the heart rate
as tachycardia is a common side effect of beta-adrenergic stimulation. Patients should be
taught to use this as a rescue inhaler rather than for daily maintenance. This drug is the
priority intervention to restore oxygenation in an emergency scenario.
2. A patient is prescribed oral prednisone for a severe exacerbation of COPD. What is the
most important nursing intervention when completing the therapy?
A. Discontinue the drug immediately once symptoms improve
B. Increase the dose if the patient develops a cough
C. Switch to an inhaled corticosteroid without overlapping doses
D. Gradually taper the dose over several days
Answer: D
Rationale: Corticosteroids must be tapered slowly to allow the adrenal glands to resume
normal endogenous cortisol production. Abrupt withdrawal can lead to adrenal
insufficiency, which is a life-threatening medical emergency. The nurse should monitor for
symptoms like hypotension and fatigue during the tapering process. Patients should be
educated that long-term use requires monitoring for hyperglycemia and osteoporosis.
Tapering ensures the body maintains hormonal balance during the transition off the
medication.
3. The nurse is preparing to administer bethanechol to a post-operative patient. Which
assessment finding is an absolute contraindication for this medication?
A. Urinary retention
B. Heart rate of 90 beats/min
,C. Dry mouth
D. Intestinal obstruction
Answer: D
Rationale: Bethanechol is a cholinergic agonist used to treat non-obstructive urinary
retention by stimulating the detrusor muscle. If a patient has a physical intestinal or
urinary obstruction, the increased pressure could cause tissue rupture. The nurse must
verify the absence of obstructions via physical exam or diagnostic imaging before
administration. Common side effects include bradycardia, increased salivation, and
diarrhea due to parasympathetic activation. Monitoring bowel sounds and voiding patterns
is essential for determining therapeutic efficacy.
4. A patient with a history of myasthenia gravis is suspected of having a cholinergic crisis.
Which medication should the nurse have readily available as an antidote?
A. Atropine
B. Neostigmine
C. Edrophonium
D. Pancuronium
Answer: A
Rationale: Atropine is an anticholinergic agent that serves as the specific antidote for
cholinergic crisis by blocking excess acetylcholine. A cholinergic crisis often presents with
severe muscle weakness, bradycardia, and excessive secretions. The nurse must distinguish
this from a myasthenic crisis, which requires more cholinergic stimulation. Respiratory
support equipment should also be at the bedside in case of ventilatory failure. Atropine
works by competitively inhibiting muscarinic receptors to reverse life-threatening
parasympathetic overstimulation.
5. A patient is receiving gentamicin IV for a systemic infection. Which laboratory result should
the nurse prioritize to prevent serious toxicity?
A. Serum creatinine
B. Serum potassium
C. White blood cell count
D. Prothrombin time
Answer: A
Rationale: Gentamicin is an aminoglycoside known for its significant nephrotoxic and
ototoxic potential. Serum creatinine and Blood Urea Nitrogen (BUN) are critical indicators
of renal function and drug clearance. The nurse must also monitor peak and trough levels
to ensure the dose remains within a safe therapeutic range. If creatinine levels rise
, significantly, the dose may need to be adjusted or discontinued to prevent permanent
kidney damage. Monitoring urine output is another key nursing assessment for patients on
aminoglycoside therapy.
6. A patient is prescribed tetracycline for the treatment of acne. What should the nurse
include in the discharge teaching?
A. Use sunscreen and wear protective clothing outdoors
B. Take the medication with a full glass of milk
C. This medication is safe to use during pregnancy
D. Stop taking the drug as soon as the skin clears
Answer: A
Rationale: Tetracycline causes significant photosensitivity, increasing the risk of severe
sunburn even with minimal exposure. The patient must avoid dairy products, antacids, and
iron supplements as they chelate the drug and prevent absorption. It is strictly
contraindicated in pregnancy and children under 8 because it causes permanent tooth
discoloration. The nurse should emphasize finishing the entire course to prevent antibiotic
resistance. Taking the drug with a full glass of water while sitting up helps prevent
esophageal irritation.
7. A patient who is taking metronidazole for a bacterial infection asks if they can have a glass
of wine. What is the nurse’s best response?
A. One glass of wine is acceptable if taken with food
B. Alcohol will increase the effectiveness of the medication
C. Avoid alcohol as it causes a severe disulfiram-like reaction
D. Wine is fine, but avoid hard liquor during therapy
Answer: C
Rationale: Metronidazole combined with alcohol leads to a disulfiram-like reaction
characterized by severe vomiting, flushing, and tachycardia. This reaction can occur even
with small amounts of alcohol found in mouthwash or cough syrups. The nurse should
instruct the patient to avoid alcohol for at least 48 to 72 hours after the final dose.
Education must include reading labels for hidden alcohol content to ensure safety. This
pharmacological interaction is a high-priority safety topic in patient discharge planning.
8. A patient is receiving vancomycin IV for MRSA. The nurse notes the patient’s neck and
chest are becoming bright red. What is the priority action?
A. Administer epinephrine immediately
B. Stop the infusion and notify the provider
C. Apply cold compresses to the affected areas
Correct Answers with Rationale – Galen College of Nursing
1. A nurse is caring for a patient experiencing an acute asthma attack. Which medication
should the nurse administer first for immediate bronchodilation?
A. Salmeterol
B. Fluticasone
C. Albuterol
D. Tiotropium
Answer: C
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid relief of
bronchospasm during acute attacks. Unlike long-acting agents like salmeterol, albuterol
works within minutes to relax airway smooth muscle. The nurse must assess the heart rate
as tachycardia is a common side effect of beta-adrenergic stimulation. Patients should be
taught to use this as a rescue inhaler rather than for daily maintenance. This drug is the
priority intervention to restore oxygenation in an emergency scenario.
2. A patient is prescribed oral prednisone for a severe exacerbation of COPD. What is the
most important nursing intervention when completing the therapy?
A. Discontinue the drug immediately once symptoms improve
B. Increase the dose if the patient develops a cough
C. Switch to an inhaled corticosteroid without overlapping doses
D. Gradually taper the dose over several days
Answer: D
Rationale: Corticosteroids must be tapered slowly to allow the adrenal glands to resume
normal endogenous cortisol production. Abrupt withdrawal can lead to adrenal
insufficiency, which is a life-threatening medical emergency. The nurse should monitor for
symptoms like hypotension and fatigue during the tapering process. Patients should be
educated that long-term use requires monitoring for hyperglycemia and osteoporosis.
Tapering ensures the body maintains hormonal balance during the transition off the
medication.
3. The nurse is preparing to administer bethanechol to a post-operative patient. Which
assessment finding is an absolute contraindication for this medication?
A. Urinary retention
B. Heart rate of 90 beats/min
,C. Dry mouth
D. Intestinal obstruction
Answer: D
Rationale: Bethanechol is a cholinergic agonist used to treat non-obstructive urinary
retention by stimulating the detrusor muscle. If a patient has a physical intestinal or
urinary obstruction, the increased pressure could cause tissue rupture. The nurse must
verify the absence of obstructions via physical exam or diagnostic imaging before
administration. Common side effects include bradycardia, increased salivation, and
diarrhea due to parasympathetic activation. Monitoring bowel sounds and voiding patterns
is essential for determining therapeutic efficacy.
4. A patient with a history of myasthenia gravis is suspected of having a cholinergic crisis.
Which medication should the nurse have readily available as an antidote?
A. Atropine
B. Neostigmine
C. Edrophonium
D. Pancuronium
Answer: A
Rationale: Atropine is an anticholinergic agent that serves as the specific antidote for
cholinergic crisis by blocking excess acetylcholine. A cholinergic crisis often presents with
severe muscle weakness, bradycardia, and excessive secretions. The nurse must distinguish
this from a myasthenic crisis, which requires more cholinergic stimulation. Respiratory
support equipment should also be at the bedside in case of ventilatory failure. Atropine
works by competitively inhibiting muscarinic receptors to reverse life-threatening
parasympathetic overstimulation.
5. A patient is receiving gentamicin IV for a systemic infection. Which laboratory result should
the nurse prioritize to prevent serious toxicity?
A. Serum creatinine
B. Serum potassium
C. White blood cell count
D. Prothrombin time
Answer: A
Rationale: Gentamicin is an aminoglycoside known for its significant nephrotoxic and
ototoxic potential. Serum creatinine and Blood Urea Nitrogen (BUN) are critical indicators
of renal function and drug clearance. The nurse must also monitor peak and trough levels
to ensure the dose remains within a safe therapeutic range. If creatinine levels rise
, significantly, the dose may need to be adjusted or discontinued to prevent permanent
kidney damage. Monitoring urine output is another key nursing assessment for patients on
aminoglycoside therapy.
6. A patient is prescribed tetracycline for the treatment of acne. What should the nurse
include in the discharge teaching?
A. Use sunscreen and wear protective clothing outdoors
B. Take the medication with a full glass of milk
C. This medication is safe to use during pregnancy
D. Stop taking the drug as soon as the skin clears
Answer: A
Rationale: Tetracycline causes significant photosensitivity, increasing the risk of severe
sunburn even with minimal exposure. The patient must avoid dairy products, antacids, and
iron supplements as they chelate the drug and prevent absorption. It is strictly
contraindicated in pregnancy and children under 8 because it causes permanent tooth
discoloration. The nurse should emphasize finishing the entire course to prevent antibiotic
resistance. Taking the drug with a full glass of water while sitting up helps prevent
esophageal irritation.
7. A patient who is taking metronidazole for a bacterial infection asks if they can have a glass
of wine. What is the nurse’s best response?
A. One glass of wine is acceptable if taken with food
B. Alcohol will increase the effectiveness of the medication
C. Avoid alcohol as it causes a severe disulfiram-like reaction
D. Wine is fine, but avoid hard liquor during therapy
Answer: C
Rationale: Metronidazole combined with alcohol leads to a disulfiram-like reaction
characterized by severe vomiting, flushing, and tachycardia. This reaction can occur even
with small amounts of alcohol found in mouthwash or cough syrups. The nurse should
instruct the patient to avoid alcohol for at least 48 to 72 hours after the final dose.
Education must include reading labels for hidden alcohol content to ensure safety. This
pharmacological interaction is a high-priority safety topic in patient discharge planning.
8. A patient is receiving vancomycin IV for MRSA. The nurse notes the patient’s neck and
chest are becoming bright red. What is the priority action?
A. Administer epinephrine immediately
B. Stop the infusion and notify the provider
C. Apply cold compresses to the affected areas
