COMPLETE QUESTIONS WITH EXPERT
SOLUTIONS | 2026 LATEST UPDATED |
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1. A client with chronic heart failure is prescribed digoxin (Lanoxin). Which finding would i
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ndicate to the nurse that the medication is having a therapeutic effect?
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• A. Increased heart rate and decreased blood pressure.
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• B. Decreased dyspnea and increased urinary output.
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• C. Increased jugular venous distention and peripheral edema.
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• D. Decreased cardiac output and increased fatigue.
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Correct Answer: B jh jh
Rationale: Digoxin is a positive inotrope and negative chronotrope. A therapeutic effect is seen as
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improved cardiac output, leading to decreased symptoms of heart failure such as dyspnea (due to
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less pulmonary congestion) and increased urinary output (due to improved renal perfusion). Opti
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on A is incorrect because digoxin decreases heart rate. Options C and D indicate worsening heart f
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ailure.
2. The healthcare provider prescribes 1000 mL of 0.9% Normal Saline to infuse over 8 hours
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. The IV tubing has a drop factor of 15 gtt/mL. At what rate in gtt/min should the nurse set
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the infusion? jh
• A. 31 gtt/min
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• B. 125 gtt/min
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• C. 21 gtt/min
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• D. 15 gtt/min
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Correct Answer: A jh jh
Rationale: Use the formula: (Total volume in mL / Total time in minutes) x Drop factor.
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• Total time in minutes: 8 hours x 60 minutes = 480 minutes.
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• (1000 mL / 480 min) x 15 gtt/mL = 2.083 mL/min x 15 = 31.25 gtt/min. Round down to 31 g
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tt/min.
,3. A client is receiving a continuous intravenous infusion of heparin. Which laboratory valu
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e is the most important for the nurse to monitor?
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• A. Prothrombin Time (PT)
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• B. International Normalized Ratio (INR)
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• C. Activated Partial Thromboplastin Time (aPTT)
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• D. Platelet count
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Correct Answer: C jh jh
Rationale: Heparin’s therapeutic effect and safety are monitored by the aPTT. The therapeutic go
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al for a client on heparin is typically 1.5 to 2.5 times the normal control value. PT and INR are used
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to monitor warfarin (Coumadin) therapy. Platelet count is monitored to assess for the complicatio
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n of Heparin-
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Induced Thrombocytopenia (HIT), but the aPTT is the primary lab for monitoring the drug's antico
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agulant effect. jh
4. A client with tuberculosis is prescribed a combination of isoniazid (INH), rifampin, and p
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yrazinamide. The client reports that their urine and tears have turned an orange-
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red color. What is the nurse's best response?
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• A. "This is a sign of liver toxicity and you need to stop the medication immediately."
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• B. "This is a harmless side effect of the medication, but you should avoid wearing contact l
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enses."
• C. "This is expected due to the isoniazid. It will resolve on its own."
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• D. "I will notify the healthcare provider to change your prescription."
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Correct Answer: B jh jh
Rationale: Rifampin is known to cause a harmless, reddish-
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orange discoloration of body fluids, including urine, tears, sweat, and saliva. This is a benign side e
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ffect but can permanently stain soft contact lenses, hence the warning. It is not a sign of liver toxici
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ty.
5. Prior to administering a scheduled dose of furosemide (Lasix), which assessment finding
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should be the nurse's priority?
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• A. Serum potassium level of 3.2 mEq/L
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, • B. Blood pressure of 140/88 mmHg
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• C. Weight gain of 1 pound since yesterday
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• D. Respiratory rate of 20 breaths/min
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Correct Answer: A jh jh
Rationale: Furosemide is a loop diuretic that can cause significant potassium wasting. A serum po
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tassium level of 3.2 mEq/L is below the normal range (3.5-
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5.0 mEq/L) and indicates hypokalemia. Administering furosemide could further deplete potassium
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, leading to dangerous cardiac dysrhythmias. This is a priority assessment before administration.
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6. A client on an MAOI (Monoamine Oxidase Inhibitor) is being discharged. Which over-
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the-counter medication should the nurse instruct the client to avoid? jh jh jh jh jh jh jh jh jh
• A. Acetaminophen (Tylenol)
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• B. Pseudoephedrine (Sudafed)
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• C. Ibuprofen (Advil)
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• D. Diphenhydramine (Benadryl)
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Correct Answer: B jh jh
Rationale: MAOIs can cause a severe hypertensive crisis when taken with sympathomimetic agent
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s, which increase blood pressure and heart rate. Pseudoephedrine is a sympathomimetic deconge
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stant and is therefore contraindicated.
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7. The nurse is providing education to a client prescribed warfarin (Coumadin). Which state
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ment by the client indicates a need for further teaching?
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• A. "I will need to have my blood drawn regularly to check my levels."
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• B. "I can take ibuprofen for a headache instead of acetaminophen."
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• C. "I should use a soft toothbrush and an electric razor."
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• D. "I will watch for signs of bleeding like dark, tarry stools."
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Correct Answer: B jh jh
Rationale: Warfarin is an anticoagulant. Ibuprofen (an NSAID) increases the risk of gastrointestina
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l bleeding and can interfere with platelet function, significantly increasing the risk of bleeding whe
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n taken with warfarin. Acetaminophen is the preferred analgesic for pain/fever, though even it sho
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uld be limited, as high doses can potentiate warfarin's effect. Options A, C, and D are correct state
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ments about warfarin therapy. jh jh jh
, 8. A healthcare provider orders 0.25 mg of digoxin (Lanoxin) IV push. The available vial is la
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beled 0.5 mg/2 mL. How many mL will the nurse administer?
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• A. 1 mL
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• B. 0.5 mL
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• C. 2 mL
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• D. 4 mLjh jh
Correct Answer: A jh jh
Rationale: Use the formula: (Desired dose / Available dose) x Volume.
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• (0.25 mg / 0.5 mg) x 2 mL = 0.5 x 2 mL = 1 mL.
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9. A client with asthma is prescribed a beta2-
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adrenergic agonist (albuterol) and an inhaled corticosteroid (fluticasone). Which instructio
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n should the nurse provide regarding the sequence of administration?
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• A. Administer the corticosteroid first to open the airways, then the beta2-agonist.
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• B. Administer the beta2-agonist first, wait 5 minutes, then administer the corticosteroid.
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• C. Administer both medications at the same time to maximize effect.
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• D. It does not matter which medication is administered first.
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Correct Answer: B jh jh
Rationale: A beta2- jh jh
agonist (bronchodilator) should be administered first to open up the airways, allowing for better p
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enetration and deposition of the corticosteroid. The client should wait about 5 minutes between p
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uffs to allow the first drug to take effect before using the second inhaler.
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10. An elderly client is prescribed a new medication. Which physiological change associated
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with aging should the nurse consider when calculating the dosage?
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• A. Increased glomerular filtration rate
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• B. Increased hepatic blood flow
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• C. Decreased percentage of body fat
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• D. Decreased renal function
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