NURS 6521 ADVANCED PHARMACOLOGY
MIDTERM & FINAL EXAM PRACTICE
Fundamentals of Nursing (Questions 1-50)
1. A client with a history of heart failure is prescribed digoxin. Which
assessment finding indicates digoxin toxicity?
A) Heart rate of 72 bpm
B) Serum potassium of 4.0 mEq/L
C) Yellow-green halos around lights
D) Blood pressure of 120/80 mmHg
Correct Answer: C
Rationale: Yellow-green halos around lights are a classic sign of digoxin
toxicity. Other signs include nausea, vomiting, and cardiac dysrhythmias.
Option A is a normal heart rate, option B is normal potassium, and option D is
normal blood pressure, none of which indicate toxicity.
---
2. A nurse is providing post-operative care to a client following abdominal
surgery. Which assessment finding requires immediate intervention?
A) Heart rate of 88 bpm
B) Respiratory rate of 18 breaths/min
C) Wound edges that are well-approximated
,D) Wound dehiscence with visible bowel loops
Correct Answer: D
Rationale: Wound dehiscence with visible bowel loops is a surgical emergency
requiring immediate intervention to prevent evisceration. Options A, B, and C
are normal findings in a post-operative client.
---
3. A client with diabetes mellitus type 2 has a fasting blood glucose of 250
mg/dL. Which symptom would the nurse expect to find?
A) Polyuria
B) Bradycardia
C) Hypertension
D) Constipation
Correct Answer: A
Rationale: Polyuria is a classic symptom of hyperglycemia as the body
attempts to eliminate excess glucose through urine. Bradycardia,
hypertension, and constipation are not typically associated with
hyperglycemia.
---
4. The nurse is preparing to administer an intramuscular injection in the
ventrogluteal site. Which anatomical landmark is used to locate this site?
A) Greater trochanter and iliac crest
,B) Acromion process
C) Xiphoid process
D) Patella
Correct Answer: A
Rationale: The ventrogluteal site is located by placing the palm over the
greater trochanter and the index finger on the anterior superior iliac spine,
with the middle finger pointing toward the iliac crest. The acromion process is
for deltoid injections, and the xiphoid process and patella are not injection
landmarks.
---
5. A client is receiving total parenteral nutrition (TPN). Which assessment
finding indicates a complication?
A) Weight gain of 1 lb per week
B) Blood glucose of 120 mg/dL
C) Crackles auscultated in lung bases
D) Serum albumin of 3.8 g/dL
Correct Answer: C
Rationale: Crackles in lung bases indicate fluid overload, a complication of
TPN administration. Weight gain of 1 lb per week is expected, blood glucose of
120 mg/dL is within normal limits, and serum albumin of 3.8 g/dL is normal.
---
, 6. The nurse is caring for a client with a nasogastric tube set to low
intermittent suction. Which electrolyte imbalance is the client at risk for
developing?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Correct Answer: B
Rationale: Nasogastric suctioning removes gastric contents, which are rich in
potassium, leading to hypokalemia. Hypernatremia, hypercalcemia, and
hypermagnesemia are not typically associated with NG suctioning.
---
7. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88%. Which action should the nurse take first?
A) Administer oxygen at 2 L/min via nasal cannula
B) Encourage deep breathing exercises
C) Position the client in a high-Fowler's position
D) Notify the healthcare provider immediately
Correct Answer: A
Rationale: Administering oxygen at 2 L/min via nasal cannula is the priority to
improve oxygenation in a client with COPD. Deep breathing and positioning
are important but secondary to oxygen administration. While notification of
the provider may be needed, immediate action to oxygenate is the priority.
MIDTERM & FINAL EXAM PRACTICE
Fundamentals of Nursing (Questions 1-50)
1. A client with a history of heart failure is prescribed digoxin. Which
assessment finding indicates digoxin toxicity?
A) Heart rate of 72 bpm
B) Serum potassium of 4.0 mEq/L
C) Yellow-green halos around lights
D) Blood pressure of 120/80 mmHg
Correct Answer: C
Rationale: Yellow-green halos around lights are a classic sign of digoxin
toxicity. Other signs include nausea, vomiting, and cardiac dysrhythmias.
Option A is a normal heart rate, option B is normal potassium, and option D is
normal blood pressure, none of which indicate toxicity.
---
2. A nurse is providing post-operative care to a client following abdominal
surgery. Which assessment finding requires immediate intervention?
A) Heart rate of 88 bpm
B) Respiratory rate of 18 breaths/min
C) Wound edges that are well-approximated
,D) Wound dehiscence with visible bowel loops
Correct Answer: D
Rationale: Wound dehiscence with visible bowel loops is a surgical emergency
requiring immediate intervention to prevent evisceration. Options A, B, and C
are normal findings in a post-operative client.
---
3. A client with diabetes mellitus type 2 has a fasting blood glucose of 250
mg/dL. Which symptom would the nurse expect to find?
A) Polyuria
B) Bradycardia
C) Hypertension
D) Constipation
Correct Answer: A
Rationale: Polyuria is a classic symptom of hyperglycemia as the body
attempts to eliminate excess glucose through urine. Bradycardia,
hypertension, and constipation are not typically associated with
hyperglycemia.
---
4. The nurse is preparing to administer an intramuscular injection in the
ventrogluteal site. Which anatomical landmark is used to locate this site?
A) Greater trochanter and iliac crest
,B) Acromion process
C) Xiphoid process
D) Patella
Correct Answer: A
Rationale: The ventrogluteal site is located by placing the palm over the
greater trochanter and the index finger on the anterior superior iliac spine,
with the middle finger pointing toward the iliac crest. The acromion process is
for deltoid injections, and the xiphoid process and patella are not injection
landmarks.
---
5. A client is receiving total parenteral nutrition (TPN). Which assessment
finding indicates a complication?
A) Weight gain of 1 lb per week
B) Blood glucose of 120 mg/dL
C) Crackles auscultated in lung bases
D) Serum albumin of 3.8 g/dL
Correct Answer: C
Rationale: Crackles in lung bases indicate fluid overload, a complication of
TPN administration. Weight gain of 1 lb per week is expected, blood glucose of
120 mg/dL is within normal limits, and serum albumin of 3.8 g/dL is normal.
---
, 6. The nurse is caring for a client with a nasogastric tube set to low
intermittent suction. Which electrolyte imbalance is the client at risk for
developing?
A) Hypernatremia
B) Hypokalemia
C) Hypercalcemia
D) Hypermagnesemia
Correct Answer: B
Rationale: Nasogastric suctioning removes gastric contents, which are rich in
potassium, leading to hypokalemia. Hypernatremia, hypercalcemia, and
hypermagnesemia are not typically associated with NG suctioning.
---
7. A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 88%. Which action should the nurse take first?
A) Administer oxygen at 2 L/min via nasal cannula
B) Encourage deep breathing exercises
C) Position the client in a high-Fowler's position
D) Notify the healthcare provider immediately
Correct Answer: A
Rationale: Administering oxygen at 2 L/min via nasal cannula is the priority to
improve oxygenation in a client with COPD. Deep breathing and positioning
are important but secondary to oxygen administration. While notification of
the provider may be needed, immediate action to oxygenate is the priority.
