, Question 1
A patient with a new diagnosis of generalized anxiety disorder is started on
buspirone. Which statement by the patient indicates a need for further
teaching?
A. I should take this medication consistently every day, even when I feel
fine.
B. I can expect to feel the full effects within the first few days of taking it.
C. I should avoid drinking grapefruit juice while on this medication.
D. I need to avoid taking this with an MAO inhibitor.
Correct Answer: B - I can expect to feel the full effects within the
first few days of taking it.
RATIONALE
Buspirone requires 2-4 weeks for full anxiolytic effect, so expecting
effects within days is incorrect. It must be taken consistently, is
metabolized by CYP3A4 (grapefruit interaction), and is
contraindicated with MAOIs. The other statements are accurate.
Question 2
A patient with type 1 diabetes mellitus is found unresponsive with a blood
glucose of 42 mg/dL. After administering glucagon, which assessment finding
indicates the most immediate concern?
A. Blood glucose 68 mg/dL
B. Nausea and vomiting
C. Heart rate 118 bpm
D. Diaphoresis
Correct Answer: B - Nausea and vomiting
Page 2
, RATIONALE
Nausea and vomiting after glucagon can lead to aspiration and indicate
the need for repositioning and possible airway management. While
glucose is rising, tachycardia and diaphoresis are expected. Vomiting
is the priority due to risk of aspiration.
Question 3
A nurse is reviewing the medication list of a patient with chronic kidney
disease (stage 4). Which medication requires immediate clarification with the
provider?
A. Metformin 500 mg BID
B. Epoetin alfa 100 units/kg IV three times weekly
C. Calcium acetate 667 mg with meals
D. Sodium bicarbonate 650 mg daily
Correct Answer: A - Metformin 500 mg BID
RATIONALE
Metformin is contraindicated in stage 4 CKD (eGFR <30) due to risk
of lactic acidosis. Epoetin, calcium acetate, and sodium bicarbonate
are commonly used in CKD management. Immediate clarification is
needed for metformin.
Question 4
A nurse is planning care for a patient with a new tracheostomy. Which action
should the nurse take first?
A. Suction the tracheostomy every 2 hours.
B. Ensure a manual resuscitation bag and spare tracheostomy tube are at
the bedside.
C. Change the tracheostomy ties daily.
D. Deflate the cuff to check for air leak every shift.
Correct Answer: B - Ensure a manual resuscitation bag and spare
Page 3
, tracheostomy tube are at the bedside.
RATIONALE
Safety priority is ensuring emergency equipment is immediately
available. Suctioning is only as needed, ties are changed when soiled,
and cuff deflation is not routine. The correct answer reflects standard
safety protocol.
Question 5
A nurse is evaluating the effectiveness of a new fall prevention program.
Which metric best reflects the program's impact?
A. Number of fall risk assessments completed
B. Incidence rate of falls per 1,000 patient days
C. Percentage of staff trained in fall prevention
D. Number of bed alarms in use
Correct Answer: B - Incidence rate of falls per 1,000 patient days
RATIONALE
The incidence rate of falls per 1,000 patient days directly measures
patient outcomes and program effectiveness. The other metrics are
process measures, not outcome measures. The goal is to reduce actual
falls.
Question 6
A patient with a history of alcohol use disorder is admitted with confusion,
ataxia, and ophthalmoplegia. Which intervention is the priority?
A. Administer intravenous thiamine.
B. Administer intravenous glucose.
C. Administer intravenous lorazepam.
D. Administer intravenous folic acid.
Correct Answer: A - Administer intravenous thiamine.
Page 4
A patient with a new diagnosis of generalized anxiety disorder is started on
buspirone. Which statement by the patient indicates a need for further
teaching?
A. I should take this medication consistently every day, even when I feel
fine.
B. I can expect to feel the full effects within the first few days of taking it.
C. I should avoid drinking grapefruit juice while on this medication.
D. I need to avoid taking this with an MAO inhibitor.
Correct Answer: B - I can expect to feel the full effects within the
first few days of taking it.
RATIONALE
Buspirone requires 2-4 weeks for full anxiolytic effect, so expecting
effects within days is incorrect. It must be taken consistently, is
metabolized by CYP3A4 (grapefruit interaction), and is
contraindicated with MAOIs. The other statements are accurate.
Question 2
A patient with type 1 diabetes mellitus is found unresponsive with a blood
glucose of 42 mg/dL. After administering glucagon, which assessment finding
indicates the most immediate concern?
A. Blood glucose 68 mg/dL
B. Nausea and vomiting
C. Heart rate 118 bpm
D. Diaphoresis
Correct Answer: B - Nausea and vomiting
Page 2
, RATIONALE
Nausea and vomiting after glucagon can lead to aspiration and indicate
the need for repositioning and possible airway management. While
glucose is rising, tachycardia and diaphoresis are expected. Vomiting
is the priority due to risk of aspiration.
Question 3
A nurse is reviewing the medication list of a patient with chronic kidney
disease (stage 4). Which medication requires immediate clarification with the
provider?
A. Metformin 500 mg BID
B. Epoetin alfa 100 units/kg IV three times weekly
C. Calcium acetate 667 mg with meals
D. Sodium bicarbonate 650 mg daily
Correct Answer: A - Metformin 500 mg BID
RATIONALE
Metformin is contraindicated in stage 4 CKD (eGFR <30) due to risk
of lactic acidosis. Epoetin, calcium acetate, and sodium bicarbonate
are commonly used in CKD management. Immediate clarification is
needed for metformin.
Question 4
A nurse is planning care for a patient with a new tracheostomy. Which action
should the nurse take first?
A. Suction the tracheostomy every 2 hours.
B. Ensure a manual resuscitation bag and spare tracheostomy tube are at
the bedside.
C. Change the tracheostomy ties daily.
D. Deflate the cuff to check for air leak every shift.
Correct Answer: B - Ensure a manual resuscitation bag and spare
Page 3
, tracheostomy tube are at the bedside.
RATIONALE
Safety priority is ensuring emergency equipment is immediately
available. Suctioning is only as needed, ties are changed when soiled,
and cuff deflation is not routine. The correct answer reflects standard
safety protocol.
Question 5
A nurse is evaluating the effectiveness of a new fall prevention program.
Which metric best reflects the program's impact?
A. Number of fall risk assessments completed
B. Incidence rate of falls per 1,000 patient days
C. Percentage of staff trained in fall prevention
D. Number of bed alarms in use
Correct Answer: B - Incidence rate of falls per 1,000 patient days
RATIONALE
The incidence rate of falls per 1,000 patient days directly measures
patient outcomes and program effectiveness. The other metrics are
process measures, not outcome measures. The goal is to reduce actual
falls.
Question 6
A patient with a history of alcohol use disorder is admitted with confusion,
ataxia, and ophthalmoplegia. Which intervention is the priority?
A. Administer intravenous thiamine.
B. Administer intravenous glucose.
C. Administer intravenous lorazepam.
D. Administer intravenous folic acid.
Correct Answer: A - Administer intravenous thiamine.
Page 4
