, Question 1
A patient with heart failure is prescribed both furosemide and digoxin. Which
pathophysiologic consequence best explains the increased risk of digoxin
toxicity in this scenario?
A. Furosemide-induced hypokalemia enhances digoxin binding to
Na+/K+-ATPase.
B. Furosemide increases renal clearance of digoxin, requiring dose
escalation.
C. Furosemide competitively inhibits digoxin at the Na+/K+-ATPase site.
D. Furosemide-induced hypercalcemia potentiates digoxin's inotropic
effect.
Correct Answer: A - Furosemide-induced hypokalemia enhances
digoxin binding to Na+/K+-ATPase.
RATIONALE
Furosemide causes potassium loss, and hypokalemia increases
digoxin's affinity for Na+/K+-ATPase, amplifying toxicity.
Furosemide does not increase digoxin clearance or competitively
inhibit the pump, and it typically causes hypocalcemia, not
hypercalcemia.
Question 2
Which statement best reflects the core principle of the AACN Essentials for
advancing nursing practice?
A. Nursing practice should remain focused on acute care hospital settings.
B. Advanced practice nurses should lead interprofessional teams to
improve population health.
C. Graduate nursing education should prioritize procedural skills over
systems thinking.
D. Nursing research should be conducted independently of other
disciplines.
Page 2
,Correct Answer: B - Advanced practice nurses should lead
interprofessional teams to improve population health.
RATIONALE
The AACN Essentials emphasize that advanced practice nurses must
lead interprofessional collaboration to enhance population health
outcomes. The other options contradict the Essentials' focus on
systems thinking, broad practice settings, and interdisciplinary
research.
Question 3
A patient with a known CYP2D6 poor metabolizer phenotype is prescribed
codeine for pain. Which adverse effect is most likely due to this genetic
variant?
A. Reduced analgesic efficacy because codeine is not converted to
morphine.
B. Increased risk of respiratory depression due to rapid morphine
accumulation.
C. Enhanced analgesic effect with no risk of toxicity.
D. No effect, as codeine's action is independent of CYP2D6.
Correct Answer: A - Reduced analgesic efficacy because codeine
is not converted to morphine.
RATIONALE
CYP2D6 poor metabolizers convert little codeine to morphine, leading
to inadequate analgesia. Rapid accumulation and toxicity occur in
ultrarapid metabolizers, not poor metabolizers, and codeine's efficacy
is CYP2D6-dependent.
Question 4
Which of the following best describes the purpose of a root cause analysis
(RCA) in a healthcare setting?
Page 3
, A. To identify and punish individuals responsible for adverse events.
B. To determine the underlying system failures that contributed to an
adverse event.
C. To calculate the financial cost of a medical error.
D. To satisfy regulatory requirements without changing practice.
Correct Answer: B - To determine the underlying system failures
that contributed to an adverse event.
RATIONALE
RCA is a systematic process for identifying underlying system
vulnerabilities that lead to adverse events, with the goal of preventing
recurrence. It is not punitive, financial, or merely compliance-driven.
Question 5
A patient presents with sudden-onset severe abdominal pain, hypotension, and
a pulsatile abdominal mass. Which diagnostic study is most appropriate to
confirm the suspected diagnosis?
A. Contrast-enhanced CT angiography
B. Abdominal ultrasound
C. Plain abdominal radiograph
D. Magnetic resonance cholangiopancreatography
Correct Answer: A - Contrast-enhanced CT angiography
RATIONALE
The presentation suggests a ruptured abdominal aortic aneurysm; CT
angiography is the gold standard for rapid diagnosis and surgical
planning. Ultrasound is limited in emergent rupture, plain films are
nonspecific, and MRCP evaluates biliary/pancreatic ducts.
Question 6
Which of the following is the most accurate definition of evidence-based
practice (EBP) in nursing?
Page 4
A patient with heart failure is prescribed both furosemide and digoxin. Which
pathophysiologic consequence best explains the increased risk of digoxin
toxicity in this scenario?
A. Furosemide-induced hypokalemia enhances digoxin binding to
Na+/K+-ATPase.
B. Furosemide increases renal clearance of digoxin, requiring dose
escalation.
C. Furosemide competitively inhibits digoxin at the Na+/K+-ATPase site.
D. Furosemide-induced hypercalcemia potentiates digoxin's inotropic
effect.
Correct Answer: A - Furosemide-induced hypokalemia enhances
digoxin binding to Na+/K+-ATPase.
RATIONALE
Furosemide causes potassium loss, and hypokalemia increases
digoxin's affinity for Na+/K+-ATPase, amplifying toxicity.
Furosemide does not increase digoxin clearance or competitively
inhibit the pump, and it typically causes hypocalcemia, not
hypercalcemia.
Question 2
Which statement best reflects the core principle of the AACN Essentials for
advancing nursing practice?
A. Nursing practice should remain focused on acute care hospital settings.
B. Advanced practice nurses should lead interprofessional teams to
improve population health.
C. Graduate nursing education should prioritize procedural skills over
systems thinking.
D. Nursing research should be conducted independently of other
disciplines.
Page 2
,Correct Answer: B - Advanced practice nurses should lead
interprofessional teams to improve population health.
RATIONALE
The AACN Essentials emphasize that advanced practice nurses must
lead interprofessional collaboration to enhance population health
outcomes. The other options contradict the Essentials' focus on
systems thinking, broad practice settings, and interdisciplinary
research.
Question 3
A patient with a known CYP2D6 poor metabolizer phenotype is prescribed
codeine for pain. Which adverse effect is most likely due to this genetic
variant?
A. Reduced analgesic efficacy because codeine is not converted to
morphine.
B. Increased risk of respiratory depression due to rapid morphine
accumulation.
C. Enhanced analgesic effect with no risk of toxicity.
D. No effect, as codeine's action is independent of CYP2D6.
Correct Answer: A - Reduced analgesic efficacy because codeine
is not converted to morphine.
RATIONALE
CYP2D6 poor metabolizers convert little codeine to morphine, leading
to inadequate analgesia. Rapid accumulation and toxicity occur in
ultrarapid metabolizers, not poor metabolizers, and codeine's efficacy
is CYP2D6-dependent.
Question 4
Which of the following best describes the purpose of a root cause analysis
(RCA) in a healthcare setting?
Page 3
, A. To identify and punish individuals responsible for adverse events.
B. To determine the underlying system failures that contributed to an
adverse event.
C. To calculate the financial cost of a medical error.
D. To satisfy regulatory requirements without changing practice.
Correct Answer: B - To determine the underlying system failures
that contributed to an adverse event.
RATIONALE
RCA is a systematic process for identifying underlying system
vulnerabilities that lead to adverse events, with the goal of preventing
recurrence. It is not punitive, financial, or merely compliance-driven.
Question 5
A patient presents with sudden-onset severe abdominal pain, hypotension, and
a pulsatile abdominal mass. Which diagnostic study is most appropriate to
confirm the suspected diagnosis?
A. Contrast-enhanced CT angiography
B. Abdominal ultrasound
C. Plain abdominal radiograph
D. Magnetic resonance cholangiopancreatography
Correct Answer: A - Contrast-enhanced CT angiography
RATIONALE
The presentation suggests a ruptured abdominal aortic aneurysm; CT
angiography is the gold standard for rapid diagnosis and surgical
planning. Ultrasound is limited in emergent rupture, plain films are
nonspecific, and MRCP evaluates biliary/pancreatic ducts.
Question 6
Which of the following is the most accurate definition of evidence-based
practice (EBP) in nursing?
Page 4
