NUR 2474 EXAM SCRIPT 2026 DETAILED
QUESTIONS GRADED A+
◉ A patient who is taking digoxin is admitted to the hospital for
treatment of congestive heart failure. The prescriber has ordered
furosemide (Lasix). The nurse notes an irregular heart rate of 86 beats
per minute, a respiratory rate of 22 breaths per minute, and a blood
pressure of 130/82 mm Hg. The nurse auscultates crackles in both
lungs. Which laboratory value causes the nurse the most concern?
a.Blood glucose level of 120 mg/dL
b.Oxygen saturation of 90%
c.Potassium level of 3.5 mEq/L
d.Sodium level of 140 mEq/L. Answer: c.Potassium level of 3.5
mEq/L
This patient has an irregular, rapid heartbeat that might be caused by a
dysrhythmia. This patient's serum potassium level is low, which can
trigger fatal dysrhythmias, especially in patients taking digoxin.
Furosemide contributes to loss of potassium through its effects on the
distal nephron. Potassium-sparing diuretics often are used in
conjunction with furosemide to prevent this complication. This
patient's serum glucose and sodium levels are normal and of no
concern at this point, although they can be affected by furosemide.
The oxygen saturation is somewhat low and needs to be monitored,
although it may improve with diuresis.
,◉ A patient has 2+ pitting edema of the lower extremities bilaterally.
Auscultation of the lungs reveals crackles bilaterally, and the serum
potassium level is 6 mEq/L. Which diuretic agent ordered by the
prescriber should the nurse question?
a.Bumetanide (Bumex)
b.Furosemide (Lasix)
c.Spironolactone (Aldactone)
d.Hydrochlorothiazide (HydroDIURIL). Answer: c.Spironolactone
(Aldactone)
Spironolactone is a non-potassium-wasting diuretic; therefore, if the
patient has a serum potassium level of 6 mEq/L, indicating
hyperkalemia, an order for this drug should be questioned.
Bumetanide, furosemide, and hydrochlorothiazide are potassium-
wasting diuretics and would be appropriate to administer in a patient
with hyperkalemia.
◉ A nurse preparing to administer morning medications notes that a
patient with a history of hypertension has been prescribed the
angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten)
concurrently with spironolactone (Aldactone). Morning laboratory
results reveal a serum sodium level of 144 mg/dL, a serum potassium
level of 5.1 mEq/L, and a blood glucose level of 128 mg/dL. Which
intervention is appropriate?
a.Administer the medications as ordered.
b.Ask the patient about the use of salt substitutes.
,c.Contact the provider to report the laboratory values.
d.Request an order for furosemide (Lasix).. Answer: c.Contact the
provider to report the laboratory values.
Spironolactone should not be administered with ACE inhibitors,
which can also elevate potassium levels. Because the potassium level
is elevated, the nurse should not administer the medication and should
obtain clarification of the order. There is no need to repeat the
potassium level test that was just done this morning. Requesting an
order for furosemide is appropriate only after the provider has been
notified of the laboratory values.
◉ A patient with hypertension is taking furosemide (Lasix) for
congestive heart failure. The prescriber orders digoxin to help
increase cardiac output. What other medication will the nurse expect
to be ordered for this patient?
a.Bumetanide (Bumex)
b.Chlorothiazide (Diuril)
c.Hydrochlorothiazide (HydroDIURIL)
d.Spironolactone (Aldactone). Answer: d.Spironolactone (Aldactone)
Spironolactone is used in conjunction with furosemide because of its
potassium-sparing effects. Furosemide can contribute to hypokalemia,
which can increase the risk of fatal dysrhythmias, especially with
digoxin administration. The other diuretics listed are all potassium-
wasting diuretics.
, ◉ A patient is taking gentamicin (Garamycin) and furosemide
(Lasix). The nurse should counsel this patient to report which
symptom?
a.Frequent nocturia
b.Headaches
c.Ringing in the ears
d.Urinary retention. Answer: c.Ringing in the ears
Patients taking furosemide should be advised that the risk of
furosemide-induced hearing loss can be increased when other ototoxic
drugs, such as gentamicin, are also taken. Patients should be told to
report tinnitus or dizziness or hearing loss. Nocturia may be an
expected effect of furosemide. Headaches are not likely to occur with
concomitant use of gentamicin and furosemide. Urinary retention is
not an expected side effect.
◉ An older adult patient with congestive heart failure develops
crackles in both lungs and pitting edema of all extremities. The
physician orders hydrochlorothiazide (HydroDIURIL). Before
administering this medication, the nurse reviews the patient's chart.
Which laboratory value causes the nurse the most concern?
a.Elevated creatinine clearance
b.Elevated serum potassium level
c.Normal blood glucose level
QUESTIONS GRADED A+
◉ A patient who is taking digoxin is admitted to the hospital for
treatment of congestive heart failure. The prescriber has ordered
furosemide (Lasix). The nurse notes an irregular heart rate of 86 beats
per minute, a respiratory rate of 22 breaths per minute, and a blood
pressure of 130/82 mm Hg. The nurse auscultates crackles in both
lungs. Which laboratory value causes the nurse the most concern?
a.Blood glucose level of 120 mg/dL
b.Oxygen saturation of 90%
c.Potassium level of 3.5 mEq/L
d.Sodium level of 140 mEq/L. Answer: c.Potassium level of 3.5
mEq/L
This patient has an irregular, rapid heartbeat that might be caused by a
dysrhythmia. This patient's serum potassium level is low, which can
trigger fatal dysrhythmias, especially in patients taking digoxin.
Furosemide contributes to loss of potassium through its effects on the
distal nephron. Potassium-sparing diuretics often are used in
conjunction with furosemide to prevent this complication. This
patient's serum glucose and sodium levels are normal and of no
concern at this point, although they can be affected by furosemide.
The oxygen saturation is somewhat low and needs to be monitored,
although it may improve with diuresis.
,◉ A patient has 2+ pitting edema of the lower extremities bilaterally.
Auscultation of the lungs reveals crackles bilaterally, and the serum
potassium level is 6 mEq/L. Which diuretic agent ordered by the
prescriber should the nurse question?
a.Bumetanide (Bumex)
b.Furosemide (Lasix)
c.Spironolactone (Aldactone)
d.Hydrochlorothiazide (HydroDIURIL). Answer: c.Spironolactone
(Aldactone)
Spironolactone is a non-potassium-wasting diuretic; therefore, if the
patient has a serum potassium level of 6 mEq/L, indicating
hyperkalemia, an order for this drug should be questioned.
Bumetanide, furosemide, and hydrochlorothiazide are potassium-
wasting diuretics and would be appropriate to administer in a patient
with hyperkalemia.
◉ A nurse preparing to administer morning medications notes that a
patient with a history of hypertension has been prescribed the
angiotensin-converting enzyme (ACE) inhibitor captopril (Capoten)
concurrently with spironolactone (Aldactone). Morning laboratory
results reveal a serum sodium level of 144 mg/dL, a serum potassium
level of 5.1 mEq/L, and a blood glucose level of 128 mg/dL. Which
intervention is appropriate?
a.Administer the medications as ordered.
b.Ask the patient about the use of salt substitutes.
,c.Contact the provider to report the laboratory values.
d.Request an order for furosemide (Lasix).. Answer: c.Contact the
provider to report the laboratory values.
Spironolactone should not be administered with ACE inhibitors,
which can also elevate potassium levels. Because the potassium level
is elevated, the nurse should not administer the medication and should
obtain clarification of the order. There is no need to repeat the
potassium level test that was just done this morning. Requesting an
order for furosemide is appropriate only after the provider has been
notified of the laboratory values.
◉ A patient with hypertension is taking furosemide (Lasix) for
congestive heart failure. The prescriber orders digoxin to help
increase cardiac output. What other medication will the nurse expect
to be ordered for this patient?
a.Bumetanide (Bumex)
b.Chlorothiazide (Diuril)
c.Hydrochlorothiazide (HydroDIURIL)
d.Spironolactone (Aldactone). Answer: d.Spironolactone (Aldactone)
Spironolactone is used in conjunction with furosemide because of its
potassium-sparing effects. Furosemide can contribute to hypokalemia,
which can increase the risk of fatal dysrhythmias, especially with
digoxin administration. The other diuretics listed are all potassium-
wasting diuretics.
, ◉ A patient is taking gentamicin (Garamycin) and furosemide
(Lasix). The nurse should counsel this patient to report which
symptom?
a.Frequent nocturia
b.Headaches
c.Ringing in the ears
d.Urinary retention. Answer: c.Ringing in the ears
Patients taking furosemide should be advised that the risk of
furosemide-induced hearing loss can be increased when other ototoxic
drugs, such as gentamicin, are also taken. Patients should be told to
report tinnitus or dizziness or hearing loss. Nocturia may be an
expected effect of furosemide. Headaches are not likely to occur with
concomitant use of gentamicin and furosemide. Urinary retention is
not an expected side effect.
◉ An older adult patient with congestive heart failure develops
crackles in both lungs and pitting edema of all extremities. The
physician orders hydrochlorothiazide (HydroDIURIL). Before
administering this medication, the nurse reviews the patient's chart.
Which laboratory value causes the nurse the most concern?
a.Elevated creatinine clearance
b.Elevated serum potassium level
c.Normal blood glucose level
