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Exam (elaborations)

NU641 Full Study Content – 2024/2025 Exams with Answers

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NU641 Full Study Content – 2024/2025 Exams with Answers

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1. A client with myasthenia gravis is prescribed
neostigmine.
Which finding indicates underdosing?
A. Bradycardia
B. Muscle weakness
C. Diarrhea
D. Excessive salivation
Answer: B
Rationale: Muscle weakness could indicate myasthenic
crisis,
requiring dosage adjustment.

2. A client prescribed clopidogrel should avoid which overthe
counter medication?
A. Acetaminophen
B. Ibuprofen
C. Famotidine
D. Guaifenesin
Answer: B
Rationale: NSAIDs like ibuprofen increase bleeding risk
when
combined with antiplatelet agents like clopidogrel.

3. A client taking carbidopa/levodopa reports facial
twitching
and eye spasms. What should the nurse do?
A. Reassure the client this is expected
B. Hold the dose and notify the provider
C. Administer diphenhydramine
D. Document and continue monitoring
Answer: B
Rationale: Facial twitching and spasms are signs of toxicity.
Notify
the provider to adjust dosage.

4. A nurse is preparing to administer metoprolol. Which
assessment is priority?
A. Respiratory rate
B. Heart rate
C. Oxygen saturation
D. Blood glucose
Answer: B
Rationale: Metoprolol can cause bradycardia. Always check
HR
before administering.

5. A nurse is reviewing a client’s chart who is prescribed
gentamicin. Which finding should concern the nurse most?

, A. Tinnitus
B. WBC 10,000
C. Urine output 50 mL/hr
D. Temperature 100.2°F
Answer: A
Rationale: Tinnitus is a sign of ototoxicity, a serious adverse
effect
of gentamicin.

6. A nurse is educating a client on atorvastatin. What side
effect
should the client report immediately?
A. Headache
B. Muscle pain
C. Drowsiness
D. Constipation
Answer: B
Rationale: Myopathy can occur with statins and may
progress to
rhabdomyolysis. Report muscle pain immediately.

7. A client taking warfarin has an INR of 4.2. Which action
should
the nurse take?
A. Administer the next dose of warfarin
B. Hold the dose and notify the provider
C. Give vitamin K IV immediately
D. Prepare for platelet transfusion
Answer: B
Rationale: An INR >3.0 indicates increased bleeding risk.
The
nurse should hold the medication and notify the provider.

8. A nurse is administering digoxin to a client. Which finding
requires immediate action?
A. HR 62 bpm
B. Blurred vision with yellow halos
C. BP 140/88 mmHg
D. Urine output 400 mL in 8 hours
Answer: B
Rationale: Visual disturbances and halos are signs of
digoxin
toxicity, especially when paired with bradycardia.

9. A client taking furosemide reports muscle cramps.
Which lab
value correlates with this symptom?
A. Sodium 142
B. Potassium 2.9
C. Chloride 101

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