NSG 6440 PREDICTOR FINAL EXAM NEWEST ACTUAL EXAM
COMPLETE 200 QUESTIONS AND CORRECT ANSWERS
Question 1
A 68-year-old client with chronic kidney disease (CKD) is prescribed a new
medication that is primarily excreted renally. Which of the following
pharmacokinetic parameters is most important to consider for dose
adjustment in this client?
A) Absorption rate
B) Distribution volume
C) Metabolism by CYP450 enzymes
D) Elimination half-life and clearance
E) Protein binding
Correct Answer: D) Elimination half-life and clearance
Rationale: In CKD, impaired renal function significantly reduces drug
clearance, leading to a prolonged elimination half-life and increased
risk of accumulation and toxicity. Therefore, dose adjustments are
crucial.
Question 2
Which of the following is an expected pharmacological effect of a non-
selective beta-blocker (e.g., propranolol) that would be a concern in a client
with asthma?
A) Bronchodilation
B) Tachycardia
C) Bronchoconstriction
D) Vasodilation
E) Hyperglycemia
Correct Answer: C) Bronchoconstriction
Rationale: Non-selective beta-blockers block both beta-1 (cardiac)
and beta-2 (pulmonary) adrenergic receptors. Blocking beta-2
receptors in the lungs can cause bronchoconstriction, worsening
asthma or COPD.
,Question 3
A client with Type 2 Diabetes Mellitus is prescribed metformin. Which of the
following is the primary mechanism of action of metformin?
A) Stimulates insulin secretion from pancreatic beta cells.
B) Decreases hepatic glucose production and increases peripheral insulin
sensitivity.
C) Delays carbohydrate absorption in the gut.
D) Increases urinary glucose excretion.
E) Provides exogenous insulin.
Correct Answer: B) Decreases hepatic glucose production and
increases peripheral insulin sensitivity.
Rationale: Metformin, a biguanide, primarily acts by reducing glucose
production by the liver and improving the sensitivity of body tissues
to insulin, leading to lower blood glucose levels.
Question 4
Which of the following antiarrhythmic medications is classified as a Class III
agent and works by blocking potassium channels to prolong repolarization?
A) Lidocaine
B) Verapamil
C) Amiodarone
D) Adenosine
E) Digoxin
Correct Answer: C) Amiodarone
Rationale: Amiodarone is a Class III antiarrhythmic drug that blocks
potassium channels (and to a lesser extent, sodium and calcium
channels and beta receptors), prolonging the action potential
duration and refractoriness.
Question 5
A client is taking warfarin for anticoagulation. The NP should emphasize the
importance of consistent intake of which of the following dietary components
,to avoid fluctuations in INR?
A) Red meat
B) Citrus fruits
C) Vitamin K-rich foods (e.g., leafy green vegetables)
D) Simple carbohydrates
E) Dairy products
Correct Answer: C) Vitamin K-rich foods (e.g., leafy green vegetables)
Rationale: Warfarin inhibits vitamin K-dependent clotting factors.
Inconsistent intake of Vitamin K-rich foods can lead to significant
fluctuations in INR (International Normalized Ratio), affecting
warfarin's therapeutic effect.
Question 6
Which of the following is a common and potentially serious adverse effect
associated with the use of statins (HMG-CoA reductase inhibitors)?
A) Hypertension
B) Rhabdomyolysis and myalgia
C) Peripheral edema
D) Photosensitivity
E) Hypoglycemia
Correct Answer: B) Rhabdomyolysis and myalgia
Rationale: Statins can cause muscle pain (myalgia) and, in rare but
severe cases, rhabdomyolysis (muscle breakdown), which can lead
to acute kidney injury. Liver enzyme elevation is also a concern.
Question 7
A client with heart failure is prescribed furosemide. The NP should monitor
which of the following electrolyte levels closely?
A) Sodium
B) Calcium
C) Magnesium
D) Potassium
, E) Phosphate
Correct Answer: D) Potassium
Rationale: Furosemide is a loop diuretic, which acts on the loop of
Henle to inhibit sodium and chloride reabsorption, leading to
increased excretion of potassium and a significant risk of
hypokalemia.
Question 8
Which of the following medications is a first-line treatment for an acute
asthma exacerbation due to its rapid bronchodilatory effects?
A) Salmeterol
B) Fluticasone
C) Montelukast
D) Albuterol
E) Tiotropium
Correct Answer: D) Albuterol
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that
provides rapid bronchodilation and is the primary "rescue"
medication for acute asthma symptoms.
Question 9
A client is taking a non-steroidal anti-inflammatory drug (NSAID) for chronic
pain. The NP should counsel the client about the increased risk of which
serious adverse effect, especially with long-term use?
A) Hypokalemia
B) Gastrointestinal bleeding and renal impairment
C) Hyperglycemia
D) Bronchoconstriction in all clients
E) Blurred vision
Correct Answer: B) Gastrointestinal bleeding and renal impairment
Rationale: NSAIDs inhibit prostaglandin synthesis, which can reduce
the protective gastric mucus layer (leading to GI bleeding) and
COMPLETE 200 QUESTIONS AND CORRECT ANSWERS
Question 1
A 68-year-old client with chronic kidney disease (CKD) is prescribed a new
medication that is primarily excreted renally. Which of the following
pharmacokinetic parameters is most important to consider for dose
adjustment in this client?
A) Absorption rate
B) Distribution volume
C) Metabolism by CYP450 enzymes
D) Elimination half-life and clearance
E) Protein binding
Correct Answer: D) Elimination half-life and clearance
Rationale: In CKD, impaired renal function significantly reduces drug
clearance, leading to a prolonged elimination half-life and increased
risk of accumulation and toxicity. Therefore, dose adjustments are
crucial.
Question 2
Which of the following is an expected pharmacological effect of a non-
selective beta-blocker (e.g., propranolol) that would be a concern in a client
with asthma?
A) Bronchodilation
B) Tachycardia
C) Bronchoconstriction
D) Vasodilation
E) Hyperglycemia
Correct Answer: C) Bronchoconstriction
Rationale: Non-selective beta-blockers block both beta-1 (cardiac)
and beta-2 (pulmonary) adrenergic receptors. Blocking beta-2
receptors in the lungs can cause bronchoconstriction, worsening
asthma or COPD.
,Question 3
A client with Type 2 Diabetes Mellitus is prescribed metformin. Which of the
following is the primary mechanism of action of metformin?
A) Stimulates insulin secretion from pancreatic beta cells.
B) Decreases hepatic glucose production and increases peripheral insulin
sensitivity.
C) Delays carbohydrate absorption in the gut.
D) Increases urinary glucose excretion.
E) Provides exogenous insulin.
Correct Answer: B) Decreases hepatic glucose production and
increases peripheral insulin sensitivity.
Rationale: Metformin, a biguanide, primarily acts by reducing glucose
production by the liver and improving the sensitivity of body tissues
to insulin, leading to lower blood glucose levels.
Question 4
Which of the following antiarrhythmic medications is classified as a Class III
agent and works by blocking potassium channels to prolong repolarization?
A) Lidocaine
B) Verapamil
C) Amiodarone
D) Adenosine
E) Digoxin
Correct Answer: C) Amiodarone
Rationale: Amiodarone is a Class III antiarrhythmic drug that blocks
potassium channels (and to a lesser extent, sodium and calcium
channels and beta receptors), prolonging the action potential
duration and refractoriness.
Question 5
A client is taking warfarin for anticoagulation. The NP should emphasize the
importance of consistent intake of which of the following dietary components
,to avoid fluctuations in INR?
A) Red meat
B) Citrus fruits
C) Vitamin K-rich foods (e.g., leafy green vegetables)
D) Simple carbohydrates
E) Dairy products
Correct Answer: C) Vitamin K-rich foods (e.g., leafy green vegetables)
Rationale: Warfarin inhibits vitamin K-dependent clotting factors.
Inconsistent intake of Vitamin K-rich foods can lead to significant
fluctuations in INR (International Normalized Ratio), affecting
warfarin's therapeutic effect.
Question 6
Which of the following is a common and potentially serious adverse effect
associated with the use of statins (HMG-CoA reductase inhibitors)?
A) Hypertension
B) Rhabdomyolysis and myalgia
C) Peripheral edema
D) Photosensitivity
E) Hypoglycemia
Correct Answer: B) Rhabdomyolysis and myalgia
Rationale: Statins can cause muscle pain (myalgia) and, in rare but
severe cases, rhabdomyolysis (muscle breakdown), which can lead
to acute kidney injury. Liver enzyme elevation is also a concern.
Question 7
A client with heart failure is prescribed furosemide. The NP should monitor
which of the following electrolyte levels closely?
A) Sodium
B) Calcium
C) Magnesium
D) Potassium
, E) Phosphate
Correct Answer: D) Potassium
Rationale: Furosemide is a loop diuretic, which acts on the loop of
Henle to inhibit sodium and chloride reabsorption, leading to
increased excretion of potassium and a significant risk of
hypokalemia.
Question 8
Which of the following medications is a first-line treatment for an acute
asthma exacerbation due to its rapid bronchodilatory effects?
A) Salmeterol
B) Fluticasone
C) Montelukast
D) Albuterol
E) Tiotropium
Correct Answer: D) Albuterol
Rationale: Albuterol is a short-acting beta-2 agonist (SABA) that
provides rapid bronchodilation and is the primary "rescue"
medication for acute asthma symptoms.
Question 9
A client is taking a non-steroidal anti-inflammatory drug (NSAID) for chronic
pain. The NP should counsel the client about the increased risk of which
serious adverse effect, especially with long-term use?
A) Hypokalemia
B) Gastrointestinal bleeding and renal impairment
C) Hyperglycemia
D) Bronchoconstriction in all clients
E) Blurred vision
Correct Answer: B) Gastrointestinal bleeding and renal impairment
Rationale: NSAIDs inhibit prostaglandin synthesis, which can reduce
the protective gastric mucus layer (leading to GI bleeding) and
