NUR 210 Final Exam V3 | NUR 210 Pharmacology |
Actual Q&A with Rationale (NUR 210 Final Exam) |
Galen
1. A nurse is preparing to administer digoxin to a client with heart failure. Which clinical
finding would require the nurse to withhold the medication and notify the provider?
A. Blood pressure of 110/70 mmHg
B. Respiratory rate of 18 breaths/min
C. Apical pulse rate of 52 beats/min
D. Digoxin level of 1.2 ng/mL
Correct Answer: C
Explanation: Digoxin is a cardiac glycoside that increases myocardial contractility but
slows the heart rate. The nurse must assess the apical pulse for a full minute prior to
administration. If the pulse is below 60 beats/min in an adult, the dose should be withheld
to prevent further bradycardia and potential toxicity.
2. A client is prescribed lisinopril for hypertension. The nurse should instruct the client to seek
immediate medical attention for which adverse effect?
A. A persistent dry cough
B. A metallic taste in the mouth
C. Occasional lightheadedness when standing
,D. Swelling of the tongue and lips
Correct Answer: D
Explanation: Angioedema is a life-threatening adverse effect of ACE inhibitors like
lisinopril that involves swelling of the airway and face. While a dry cough is common, it is
not an emergency, whereas angioedema requires immediate intervention to ensure airway
patency. The nurse must educate the client to recognize these symptoms early to prevent
respiratory failure.
3. Which lab value is the priority for a nurse monitoring a client receiving a continuous
intravenous heparin infusion for a pulmonary embolism?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
Correct Answer: A
Explanation: The aPTT is used to monitor the effectiveness and safety of heparin therapy,
with a therapeutic range typically being 1.5 to 2.5 times the control value. Monitoring this
value ensures the client remains anticoagulated without increasing the risk of spontaneous
hemorrhage. PT and INR are used primarily for monitoring oral anticoagulants like
warfarin.
, 4. A client with type 1 diabetes mellitus is prescribed NPH insulin and Regular insulin to be
administered at 0730. When should the nurse expect the NPH insulin to reach its peak effect?
A. 1330 to 1930
B. 1000 to 1100
C. 0800 to 0900
D. 2200 to 0000
Correct Answer: A
Explanation: NPH is an intermediate-acting insulin with an onset of 1-2 hours and a peak
occurring 6-14 hours after administration. Regular insulin peaks much earlier, typically
within 2-4 hours. Understanding peak times is crucial for the nurse to anticipate when the
client is at the highest risk for hypoglycemia.
5. A nurse is caring for a client who is taking spironolactone. Which dietary instruction is most
important for the nurse to provide?
A. Increase intake of bananas and orange juice
B. Avoid salt substitutes containing potassium
C. Limit intake of dairy products
D. Take the medication on an empty stomach
Correct Answer: B
Actual Q&A with Rationale (NUR 210 Final Exam) |
Galen
1. A nurse is preparing to administer digoxin to a client with heart failure. Which clinical
finding would require the nurse to withhold the medication and notify the provider?
A. Blood pressure of 110/70 mmHg
B. Respiratory rate of 18 breaths/min
C. Apical pulse rate of 52 beats/min
D. Digoxin level of 1.2 ng/mL
Correct Answer: C
Explanation: Digoxin is a cardiac glycoside that increases myocardial contractility but
slows the heart rate. The nurse must assess the apical pulse for a full minute prior to
administration. If the pulse is below 60 beats/min in an adult, the dose should be withheld
to prevent further bradycardia and potential toxicity.
2. A client is prescribed lisinopril for hypertension. The nurse should instruct the client to seek
immediate medical attention for which adverse effect?
A. A persistent dry cough
B. A metallic taste in the mouth
C. Occasional lightheadedness when standing
,D. Swelling of the tongue and lips
Correct Answer: D
Explanation: Angioedema is a life-threatening adverse effect of ACE inhibitors like
lisinopril that involves swelling of the airway and face. While a dry cough is common, it is
not an emergency, whereas angioedema requires immediate intervention to ensure airway
patency. The nurse must educate the client to recognize these symptoms early to prevent
respiratory failure.
3. Which lab value is the priority for a nurse monitoring a client receiving a continuous
intravenous heparin infusion for a pulmonary embolism?
A. Activated partial thromboplastin time (aPTT)
B. International Normalized Ratio (INR)
C. Prothrombin time (PT)
D. Platelet count
Correct Answer: A
Explanation: The aPTT is used to monitor the effectiveness and safety of heparin therapy,
with a therapeutic range typically being 1.5 to 2.5 times the control value. Monitoring this
value ensures the client remains anticoagulated without increasing the risk of spontaneous
hemorrhage. PT and INR are used primarily for monitoring oral anticoagulants like
warfarin.
, 4. A client with type 1 diabetes mellitus is prescribed NPH insulin and Regular insulin to be
administered at 0730. When should the nurse expect the NPH insulin to reach its peak effect?
A. 1330 to 1930
B. 1000 to 1100
C. 0800 to 0900
D. 2200 to 0000
Correct Answer: A
Explanation: NPH is an intermediate-acting insulin with an onset of 1-2 hours and a peak
occurring 6-14 hours after administration. Regular insulin peaks much earlier, typically
within 2-4 hours. Understanding peak times is crucial for the nurse to anticipate when the
client is at the highest risk for hypoglycemia.
5. A nurse is caring for a client who is taking spironolactone. Which dietary instruction is most
important for the nurse to provide?
A. Increase intake of bananas and orange juice
B. Avoid salt substitutes containing potassium
C. Limit intake of dairy products
D. Take the medication on an empty stomach
Correct Answer: B
