NUR 3300 Exam 1 WPU Nursing Practice II – (2026/2027)
Actual Questions, Verified Answers with Rationales |
Guarantee Pass
Medication Administration & Safety
1. A patient with a documented penicillin allergy is prescribed an antibiotic.
Which medication order would be most concerning for the nurse to administer?
• A) Clindamycin
• B) Vancomycin
• C) Cephalexin (Keflex)
• D) Metronidazole (Flagyl)
Correct Answer: C) Cephalexin (Keflex)
Rationale: Cephalexin is a cephalosporin antibiotic. There is a known risk of cross-
sensitivity between penicillins and cephalosporins, estimated at approximately 1–
10% in patients with a penicillin allergy. It should be used with extreme caution or
avoided entirely in these patients.
2. A nurse is teaching a patient about a new prescription for warfarin
(Coumadin). Which statement indicates a need for further teaching?
• A) "I will have my blood drawn regularly to check my INR."
• B) "I will be careful when shaving and brushing my teeth."
• C) "I will take an over-the-counter medication for headaches as needed."
• D) "I will call my provider if I notice blood in my urine or stool."
Correct Answer: C) "I will take an over-the-counter medication for headaches as
needed."
Rationale: Many over-the-counter medications, especially those containing
aspirin or NSAIDs, significantly increase bleeding risk when taken with warfarin.
The patient should always consult the provider before taking any OTC medication.
,3. A patient is prescribed digoxin (Lanoxin). Which finding would require the
nurse to hold the medication and contact the healthcare provider?
• A) Heart rate of 58 beats per minute
• B) Serum potassium level of 4.2 mEq/L
• C) Patient complains of nausea and blurred vision
• D) Blood pressure of 110/70 mm Hg
Correct Answer: C) Patient complains of nausea and blurred vision
Rationale: Nausea, anorexia, fatigue, and visual changes (such as blurred or
yellow/green halos) are early signs of digoxin toxicity, a potentially life-
threatening condition. The nurse should hold the medication, assess the apical
pulse, and notify the provider immediately.
4. A nurse is caring for a patient receiving furosemide (Lasix) intravenously for
pulmonary edema. Which assessment finding is the priority for the nurse to
monitor?
• A) Blood glucose level
• B) Serum potassium level
• C) Urine output every hour
• D) Pain level
Correct Answer: C) Urine output every hour
Rationale: Furosemide is a potent diuretic, and its primary action causes rapid
fluid loss—the therapeutic goal in treating pulmonary edema. Monitoring urine
output is crucial to assess drug effectiveness and detect complications such as
dehydration or electrolyte imbalance.
5. Which of the following is the most common side effect of angiotensin-
converting enzyme (ACE) inhibitors such as lisinopril?
, • A) Hyperkalemia
• B) Dry, persistent cough
• C) Hypotension
• D) Angioedema
Correct Answer: B) Dry, persistent cough
Rationale: A dry, persistent cough is the most common side effect of ACE
inhibitors, occurring in up to 20% of patients. It is thought to be caused by
increased bradykinin levels and may require switching to an ARB.
6. A patient with a fractured hip is prescribed enoxaparin (Lovenox)
subcutaneously. The nurse explains that this medication is given to:
• A) Dissolve existing clots in the leg
• B) Prevent deep vein thrombosis (DVT)
• C) Treat pain from the fracture
• D) Reduce inflammation at the fracture site
Correct Answer: B) Prevent deep vein thrombosis (DVT)
Rationale: Enoxaparin is a low-molecular-weight heparin used for DVT
prophylaxis, especially in immobilized patients (e.g., after orthopedic surgery). It
does not dissolve existing clots—thrombolytics are used for that purpose.
7. A nurse is teaching a patient about enoxaparin (Lovenox) self-administration.
Which statement indicates understanding?
• A) "I will rub the injection site vigorously to distribute the medication."
• B) "I will inject the medication into my upper arm muscle."
• C) "I will inject into the abdomen, rotating sites, and not rub the area."
• D) "I will inject it into the same spot every time."
, Correct Answer: C) "I will inject into the abdomen, rotating sites, and not rub
the area."
Rationale: Enoxaparin is given subcutaneously in the abdomen, rotating sites to
prevent tissue damage. Rubbing can cause bruising or hematoma formation at
the injection site.
8. A patient is receiving IV fluids and develops crackles in the lungs, dyspnea,
and jugular vein distention. The nurse should:
• A) Increase the IV rate to flush the lungs
• B) Slow the IV rate and notify the provider
• C) Administer a bronchodilator
• D) Continue monitoring
Correct Answer: B) Slow the IV rate and notify the provider
Rationale: These findings indicate fluid overload, a serious complication of IV
therapy. The nurse should slow the infusion rate, elevate the head of the bed, and
notify the provider for further orders.
Infection Control & PPE
9. A patient is on contact precautions for a Clostridioides difficile (C. diff)
infection. Which PPE must the nurse wear when entering the patient's room?
• A) Surgical mask and face shield
• B) N95 respirator and gown
• C) Gown and gloves
• D) Gown, gloves, and eye protection
Correct Answer: C) Gown and gloves
Rationale: Contact precautions require gown and gloves for all interactions with
the patient or the patient's environment. C. diff is spread via the fecal-oral route,
not through respiratory droplets; therefore, a mask is not required.
Actual Questions, Verified Answers with Rationales |
Guarantee Pass
Medication Administration & Safety
1. A patient with a documented penicillin allergy is prescribed an antibiotic.
Which medication order would be most concerning for the nurse to administer?
• A) Clindamycin
• B) Vancomycin
• C) Cephalexin (Keflex)
• D) Metronidazole (Flagyl)
Correct Answer: C) Cephalexin (Keflex)
Rationale: Cephalexin is a cephalosporin antibiotic. There is a known risk of cross-
sensitivity between penicillins and cephalosporins, estimated at approximately 1–
10% in patients with a penicillin allergy. It should be used with extreme caution or
avoided entirely in these patients.
2. A nurse is teaching a patient about a new prescription for warfarin
(Coumadin). Which statement indicates a need for further teaching?
• A) "I will have my blood drawn regularly to check my INR."
• B) "I will be careful when shaving and brushing my teeth."
• C) "I will take an over-the-counter medication for headaches as needed."
• D) "I will call my provider if I notice blood in my urine or stool."
Correct Answer: C) "I will take an over-the-counter medication for headaches as
needed."
Rationale: Many over-the-counter medications, especially those containing
aspirin or NSAIDs, significantly increase bleeding risk when taken with warfarin.
The patient should always consult the provider before taking any OTC medication.
,3. A patient is prescribed digoxin (Lanoxin). Which finding would require the
nurse to hold the medication and contact the healthcare provider?
• A) Heart rate of 58 beats per minute
• B) Serum potassium level of 4.2 mEq/L
• C) Patient complains of nausea and blurred vision
• D) Blood pressure of 110/70 mm Hg
Correct Answer: C) Patient complains of nausea and blurred vision
Rationale: Nausea, anorexia, fatigue, and visual changes (such as blurred or
yellow/green halos) are early signs of digoxin toxicity, a potentially life-
threatening condition. The nurse should hold the medication, assess the apical
pulse, and notify the provider immediately.
4. A nurse is caring for a patient receiving furosemide (Lasix) intravenously for
pulmonary edema. Which assessment finding is the priority for the nurse to
monitor?
• A) Blood glucose level
• B) Serum potassium level
• C) Urine output every hour
• D) Pain level
Correct Answer: C) Urine output every hour
Rationale: Furosemide is a potent diuretic, and its primary action causes rapid
fluid loss—the therapeutic goal in treating pulmonary edema. Monitoring urine
output is crucial to assess drug effectiveness and detect complications such as
dehydration or electrolyte imbalance.
5. Which of the following is the most common side effect of angiotensin-
converting enzyme (ACE) inhibitors such as lisinopril?
, • A) Hyperkalemia
• B) Dry, persistent cough
• C) Hypotension
• D) Angioedema
Correct Answer: B) Dry, persistent cough
Rationale: A dry, persistent cough is the most common side effect of ACE
inhibitors, occurring in up to 20% of patients. It is thought to be caused by
increased bradykinin levels and may require switching to an ARB.
6. A patient with a fractured hip is prescribed enoxaparin (Lovenox)
subcutaneously. The nurse explains that this medication is given to:
• A) Dissolve existing clots in the leg
• B) Prevent deep vein thrombosis (DVT)
• C) Treat pain from the fracture
• D) Reduce inflammation at the fracture site
Correct Answer: B) Prevent deep vein thrombosis (DVT)
Rationale: Enoxaparin is a low-molecular-weight heparin used for DVT
prophylaxis, especially in immobilized patients (e.g., after orthopedic surgery). It
does not dissolve existing clots—thrombolytics are used for that purpose.
7. A nurse is teaching a patient about enoxaparin (Lovenox) self-administration.
Which statement indicates understanding?
• A) "I will rub the injection site vigorously to distribute the medication."
• B) "I will inject the medication into my upper arm muscle."
• C) "I will inject into the abdomen, rotating sites, and not rub the area."
• D) "I will inject it into the same spot every time."
, Correct Answer: C) "I will inject into the abdomen, rotating sites, and not rub
the area."
Rationale: Enoxaparin is given subcutaneously in the abdomen, rotating sites to
prevent tissue damage. Rubbing can cause bruising or hematoma formation at
the injection site.
8. A patient is receiving IV fluids and develops crackles in the lungs, dyspnea,
and jugular vein distention. The nurse should:
• A) Increase the IV rate to flush the lungs
• B) Slow the IV rate and notify the provider
• C) Administer a bronchodilator
• D) Continue monitoring
Correct Answer: B) Slow the IV rate and notify the provider
Rationale: These findings indicate fluid overload, a serious complication of IV
therapy. The nurse should slow the infusion rate, elevate the head of the bed, and
notify the provider for further orders.
Infection Control & PPE
9. A patient is on contact precautions for a Clostridioides difficile (C. diff)
infection. Which PPE must the nurse wear when entering the patient's room?
• A) Surgical mask and face shield
• B) N95 respirator and gown
• C) Gown and gloves
• D) Gown, gloves, and eye protection
Correct Answer: C) Gown and gloves
Rationale: Contact precautions require gown and gloves for all interactions with
the patient or the patient's environment. C. diff is spread via the fecal-oral route,
not through respiratory droplets; therefore, a mask is not required.
