NSG 318 Exam 3 (Grand Canyon University) 2026 | NGN-
Style Questions, Case Scenarios, Rationales & Verified
Answers | Latest Update | Graded A+
,NSG 318 EXAM 3 – COMPLETE TE ST BANK
NGN-Style Questions & Case Scenari os | 250 Quest ions with
Answers & Rationales
Grand Canyon University | 2026 Edit ion | 100% Pass
Guarantee
EXAM BLUEPRINT
NSG 318 Exam 3 at Grand Canyon University focuses on pharmacology w ith an
emphasis on Next Generation NCLEX (NGN) style qu estions and case scen arios.
Topic Area Percentage Approximate Questions
Cardiovascular & Anticoagulant Medications 20% 50
Respiratory Medications 15% 38
Neurological & CNS Medications 15% 38
Pain Management & Opioid Analgesics 15% 38
Antibiotics, Antivirals & Antifungals 15% 38
Psychiatric Medications 10% 25
Endocrine Medications 5% 13
NGN Case Scenarios (Integrated) 5% 10
,SECTION 1: CARDIOVASCULAR & ANTICOAGULANT
MEDICATIONS (Questions 1–50)
1. A patient with heart failure is prescribed digoxin. Which finding indicates a
therapeutic effect?
A) Decreased heart rate
B) Increased cardiac output
C) Decreased peripheral edema
D) All of the above
Answer: D) All of the above
Rationale: Digoxin increases cardiac contractility, decreases heart rate, and improves
symptoms of heart failure (edema, dyspnea). Therapeutic effects include increased
cardiac output, decreased heart rate, and reduced edema.
2. A patient is receiving IV heparin. Which laboratory value should the nurse monitor to
evaluate therapeutic effectiveness?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
Answer: B) aPTT
Rationale: Heparin therapy is monitored using activated partial thromboplastin time
, (aPTT), with a therapeutic goal of 1.5–2.5 times the normal value. INR (A) is used for
warfarin. Platelet count (C) is monitored for heparin-induced thrombocytopenia.
3. A patient on warfarin has an INR of 4.5. The patient is not bleeding. What is the
priority nursing action?
A) Administer vitamin K
B) Hold the warfarin and notify the provider
C) Administer protamine sulfate
D) Continue the warfarin as ordered
Answer: B) Hold the warfarin and notify the provider
Rationale: Therapeutic INR for most indications is 2–3. An INR of 4.5 is elevated and
increases bleeding risk. The warfarin should be held, and the provider notified. Vitamin K
(A) is used for bleeding or INR >5. Protamine sulfate (C) is for heparin reversal.
4. A patient is prescribed clopidogrel (Plavix). Which adverse effect should the nurse
monitor for?
A) Bleeding
B) Hypertension
C) Bradycardia
D) Hyperglycemia
Answer: A) Bleeding
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation,
increasing the risk of bleeding. The nurse should monitor for signs of bleeding such as
bruising, petechiae, and GI bleeding.
Style Questions, Case Scenarios, Rationales & Verified
Answers | Latest Update | Graded A+
,NSG 318 EXAM 3 – COMPLETE TE ST BANK
NGN-Style Questions & Case Scenari os | 250 Quest ions with
Answers & Rationales
Grand Canyon University | 2026 Edit ion | 100% Pass
Guarantee
EXAM BLUEPRINT
NSG 318 Exam 3 at Grand Canyon University focuses on pharmacology w ith an
emphasis on Next Generation NCLEX (NGN) style qu estions and case scen arios.
Topic Area Percentage Approximate Questions
Cardiovascular & Anticoagulant Medications 20% 50
Respiratory Medications 15% 38
Neurological & CNS Medications 15% 38
Pain Management & Opioid Analgesics 15% 38
Antibiotics, Antivirals & Antifungals 15% 38
Psychiatric Medications 10% 25
Endocrine Medications 5% 13
NGN Case Scenarios (Integrated) 5% 10
,SECTION 1: CARDIOVASCULAR & ANTICOAGULANT
MEDICATIONS (Questions 1–50)
1. A patient with heart failure is prescribed digoxin. Which finding indicates a
therapeutic effect?
A) Decreased heart rate
B) Increased cardiac output
C) Decreased peripheral edema
D) All of the above
Answer: D) All of the above
Rationale: Digoxin increases cardiac contractility, decreases heart rate, and improves
symptoms of heart failure (edema, dyspnea). Therapeutic effects include increased
cardiac output, decreased heart rate, and reduced edema.
2. A patient is receiving IV heparin. Which laboratory value should the nurse monitor to
evaluate therapeutic effectiveness?
A) INR
B) aPTT
C) Platelet count
D) Hemoglobin
Answer: B) aPTT
Rationale: Heparin therapy is monitored using activated partial thromboplastin time
, (aPTT), with a therapeutic goal of 1.5–2.5 times the normal value. INR (A) is used for
warfarin. Platelet count (C) is monitored for heparin-induced thrombocytopenia.
3. A patient on warfarin has an INR of 4.5. The patient is not bleeding. What is the
priority nursing action?
A) Administer vitamin K
B) Hold the warfarin and notify the provider
C) Administer protamine sulfate
D) Continue the warfarin as ordered
Answer: B) Hold the warfarin and notify the provider
Rationale: Therapeutic INR for most indications is 2–3. An INR of 4.5 is elevated and
increases bleeding risk. The warfarin should be held, and the provider notified. Vitamin K
(A) is used for bleeding or INR >5. Protamine sulfate (C) is for heparin reversal.
4. A patient is prescribed clopidogrel (Plavix). Which adverse effect should the nurse
monitor for?
A) Bleeding
B) Hypertension
C) Bradycardia
D) Hyperglycemia
Answer: A) Bleeding
Rationale: Clopidogrel is an antiplatelet agent that inhibits platelet aggregation,
increasing the risk of bleeding. The nurse should monitor for signs of bleeding such as
bruising, petechiae, and GI bleeding.
