NURS 354 QUIZ 4 | QUESTIONS
AND ANSWERS | 2026 UPDATE |
100% CORRECT - ULL.
LATEST MOCK PRACTICE SET
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NURS 354 QUIZ 4 | QUESTIONS AND ANSWERS | 2026 UPDATE | 100% CORRECT - ULL.. It contains 190
carefully selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NURS 354 4 AND 2026 Update 100 Correct - ULL Nursing Medical-surgical
Pharmacology AND Critical CARE Undergraduate YEAR 4 Senior
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Health Promotion AND 1-32 Receiving, Infusion, Stage, Finding, Acute
Maintenance
Psychosocial Integrity 33-64 Finding, Intervention, Appropriate, Receiving, Prevent
Basic CARE AND Comfort 65-96 Appropriate, Acute, Finding, Kidney, Syndrome
Pharmacological Therapies 97-128 Finding, Receiving, Appropriate, Pressure, Infusion
Reduction OF RISK Potential 129-160 Change, Finding, Weeks Gestation, Acute, Nursing
Physiological Adaptation 161-190 Receiving, Prescribed, Therapy, Medication, Nursing
TOTAL 190 All questions include answers and detailed rationales
,Section A - Health Promotion AND Maintenance
Q1.
A patient receiving a continuous infusion of heparin for a pulmonary embolism has an
aPTT of 110 seconds (therapeutic range 60-80). The nurse notes new hematuria and a drop
in hemoglobin. Which action is most appropriate?
A. Administer protamine sulfate as B. Stop the heparin infusion and notify the
prescribed. provider.
C. Decrease the heparin infusion rate by D. Continue the infusion and monitor for
25%. further bleeding.
Correct: B - Stop the heparin infusion and notify the provider.
Rationale:An aPTT above therapeutic range with signs of bleeding indicates heparin
overdose. The nurse should stop the infusion immediately and notify the provider; protamine
may be given but typically requires a specific dose based on heparin received and is not
initiated independently. Decreasing the rate may not be sufficient, and continuing would
worsen bleeding.
Q2.
A patient with chronic kidney disease (stage 4) is prescribed metformin for type 2
diabetes. Which consideration is most important for the nurse to evaluate?
A. Metformin is safe because it is not renally B. The risk of lactic acidosis increases with
cleared. declining renal function.
C. Metformin should be held on the day of D. The dose should be doubled to achieve
dialysis only. glycemic control.
Correct: B - The risk of lactic acidosis increases with declining renal function.
Rationale:Metformin is contraindicated in significant renal impairment due to the risk of lactic
acidosis. The nurse should assess renal function (eGFR) before administration. It is renally
cleared, not safe, and dosing adjustments or alternative therapy are needed.
Q3.
Which electrocardiographic change is most indicative of hyperkalemia?
A. Prolonged PR interval with a normal QRS B. Tall, peaked T waves with a widened
complex. QRS complex.
C. ST-segment depression with a prominent D. Shortened QT interval with a delta wave.
U wave.
Correct: B - Tall, peaked T waves with a widened QRS complex.
Page 3
, Section A - Health Promotion AND Maintenance
Rationale: Hyperkalemia classically presents with tall, peaked T waves and, as severity
increases, QRS widening and sine wave pattern. Prolonged PR and U waves are associated
with hypokalemia, and delta waves are seen in WPW syndrome.
Q4.
A nurse is caring for a patient with heart failure who is receiving digoxin and furosemide.
Which laboratory value places the patient at highest risk for digoxin toxicity?
A. Serum potassium of 3.0 mEq/L B. Serum sodium of 135 mEq/L
C. Serum calcium of 9.5 mg/dL D. Serum magnesium of 1.8 mEq/L
Correct: A - Serum potassium of 3.0 mEq/L
Rationale:Hypokalemia increases the risk of digoxin toxicity by enhancing the drug's effect on
the Na+/K+ ATPase pump. Furosemide can cause potassium loss. Normal sodium, calcium,
and magnesium levels are less directly associated with digoxin toxicity.
Q5.
In a patient with sepsis, which hemodynamic finding is most consistent with the early
(warm) phase of septic shock?
A. Decreased cardiac output with increased B. Increased cardiac output with decreased
systemic vascular resistance. systemic vascular resistance.
C. Decreased cardiac output with decreased D. Increased cardiac output with increased
central venous pressure. pulmonary artery wedge pressure.
Correct: B - Increased cardiac output with decreased systemic vascular resistance.
Rationale:Early septic shock is hyperdynamic: systemic vasodilation leads to decreased
SVR, and the heart compensates with increased cardiac output. This manifests as warm,
flushed skin and bounding pulses. Later, cardiac output may fall as myocardial depression
ensues.
Q6.
A patient is prescribed enoxaparin 1 mg/kg subcutaneously every 12 hours for treatment
of DVT. The patient weighs 70 kg. The pharmacy supplies enoxaparin in a 100 mg/mL
prefilled syringe. How many mL should the nurse administer per dose?
A. 0.7 mL B. 1.4 mL
C. 0.35 mL D. 1.0 mL
Correct: A - 0.7 mL
Page 4
AND ANSWERS | 2026 UPDATE |
100% CORRECT - ULL.
LATEST MOCK PRACTICE SET
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NURS 354 QUIZ 4 | QUESTIONS AND ANSWERS | 2026 UPDATE | 100% CORRECT - ULL.. It contains 190
carefully selected questions that reflect the most current exam content and testing strategies. Each question is
accompanied by a correct answer and a detailed rationale that explains the underlying pathophysiology,
pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NURS 354 4 AND 2026 Update 100 Correct - ULL Nursing Medical-surgical
Pharmacology AND Critical CARE Undergraduate YEAR 4 Senior
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Health Promotion AND 1-32 Receiving, Infusion, Stage, Finding, Acute
Maintenance
Psychosocial Integrity 33-64 Finding, Intervention, Appropriate, Receiving, Prevent
Basic CARE AND Comfort 65-96 Appropriate, Acute, Finding, Kidney, Syndrome
Pharmacological Therapies 97-128 Finding, Receiving, Appropriate, Pressure, Infusion
Reduction OF RISK Potential 129-160 Change, Finding, Weeks Gestation, Acute, Nursing
Physiological Adaptation 161-190 Receiving, Prescribed, Therapy, Medication, Nursing
TOTAL 190 All questions include answers and detailed rationales
,Section A - Health Promotion AND Maintenance
Q1.
A patient receiving a continuous infusion of heparin for a pulmonary embolism has an
aPTT of 110 seconds (therapeutic range 60-80). The nurse notes new hematuria and a drop
in hemoglobin. Which action is most appropriate?
A. Administer protamine sulfate as B. Stop the heparin infusion and notify the
prescribed. provider.
C. Decrease the heparin infusion rate by D. Continue the infusion and monitor for
25%. further bleeding.
Correct: B - Stop the heparin infusion and notify the provider.
Rationale:An aPTT above therapeutic range with signs of bleeding indicates heparin
overdose. The nurse should stop the infusion immediately and notify the provider; protamine
may be given but typically requires a specific dose based on heparin received and is not
initiated independently. Decreasing the rate may not be sufficient, and continuing would
worsen bleeding.
Q2.
A patient with chronic kidney disease (stage 4) is prescribed metformin for type 2
diabetes. Which consideration is most important for the nurse to evaluate?
A. Metformin is safe because it is not renally B. The risk of lactic acidosis increases with
cleared. declining renal function.
C. Metformin should be held on the day of D. The dose should be doubled to achieve
dialysis only. glycemic control.
Correct: B - The risk of lactic acidosis increases with declining renal function.
Rationale:Metformin is contraindicated in significant renal impairment due to the risk of lactic
acidosis. The nurse should assess renal function (eGFR) before administration. It is renally
cleared, not safe, and dosing adjustments or alternative therapy are needed.
Q3.
Which electrocardiographic change is most indicative of hyperkalemia?
A. Prolonged PR interval with a normal QRS B. Tall, peaked T waves with a widened
complex. QRS complex.
C. ST-segment depression with a prominent D. Shortened QT interval with a delta wave.
U wave.
Correct: B - Tall, peaked T waves with a widened QRS complex.
Page 3
, Section A - Health Promotion AND Maintenance
Rationale: Hyperkalemia classically presents with tall, peaked T waves and, as severity
increases, QRS widening and sine wave pattern. Prolonged PR and U waves are associated
with hypokalemia, and delta waves are seen in WPW syndrome.
Q4.
A nurse is caring for a patient with heart failure who is receiving digoxin and furosemide.
Which laboratory value places the patient at highest risk for digoxin toxicity?
A. Serum potassium of 3.0 mEq/L B. Serum sodium of 135 mEq/L
C. Serum calcium of 9.5 mg/dL D. Serum magnesium of 1.8 mEq/L
Correct: A - Serum potassium of 3.0 mEq/L
Rationale:Hypokalemia increases the risk of digoxin toxicity by enhancing the drug's effect on
the Na+/K+ ATPase pump. Furosemide can cause potassium loss. Normal sodium, calcium,
and magnesium levels are less directly associated with digoxin toxicity.
Q5.
In a patient with sepsis, which hemodynamic finding is most consistent with the early
(warm) phase of septic shock?
A. Decreased cardiac output with increased B. Increased cardiac output with decreased
systemic vascular resistance. systemic vascular resistance.
C. Decreased cardiac output with decreased D. Increased cardiac output with increased
central venous pressure. pulmonary artery wedge pressure.
Correct: B - Increased cardiac output with decreased systemic vascular resistance.
Rationale:Early septic shock is hyperdynamic: systemic vasodilation leads to decreased
SVR, and the heart compensates with increased cardiac output. This manifests as warm,
flushed skin and bounding pulses. Later, cardiac output may fall as myocardial depression
ensues.
Q6.
A patient is prescribed enoxaparin 1 mg/kg subcutaneously every 12 hours for treatment
of DVT. The patient weighs 70 kg. The pharmacy supplies enoxaparin in a 100 mg/mL
prefilled syringe. How many mL should the nurse administer per dose?
A. 0.7 mL B. 1.4 mL
C. 0.35 mL D. 1.0 mL
Correct: A - 0.7 mL
Page 4
