NR 293 Exam 2 Questions and Correct Answers plus
Rationale | Latest Update 2026-2027 | Graded A+
1. Which medication is a cardiac glycoside with a narrow therapeutic index
that requires serum level monitoring?
A) Milrinone
B) Digoxin
C) Valsartan
D) Carvedilol
Correct Answer: Digoxin
Rationale: Digoxin is a cardiac glycoside with a narrow therapeutic index,
requiring careful serum level monitoring to avoid toxicity. Milrinone is a
phosphodiesterase inhibitor, valsartan is an angiotensin II receptor blocker, and
carvedilol is a beta-blocker—none are cardiac glycosides.
2. A patient taking digoxin reports seeing green and yellow halos around
lights. What is the nurse's priority action?
A) Document the finding as an expected side effect
B) Notify the provider of suspected digoxin toxicity
C) Administer the next scheduled dose as prescribed
D) Encourage increased fluid intake to flush the medication
Correct Answer: Notify the provider of suspected digoxin toxicity
Rationale: Visual changes such as green or yellow halos are classic signs of digoxin
toxicity and require immediate provider notification. Documenting the finding as
expected, administering more digoxin, or encouraging fluids does not address the
serious toxicity risk.
3. Which medication is the specific reversal agent for digoxin toxicity?
A) Protamine sulfate
B) Naloxone
C) Digoxin immune Fab
D) Vitamin K
,Correct Answer: Digoxin immune Fab
Rationale: Digoxin immune Fab (Digibind) is the specific antidote for digoxin
toxicity. Protamine sulfate reverses heparin, naloxone reverses opioids, and
vitamin K reverses warfarin—none are indicated for digoxin toxicity.
4. A client with heart failure is started on milrinone. Which adverse effect
should the nurse monitor for most closely?
A) Hypertension
B) Ventricular dysrhythmias
C) Bradycardia
D) Hyperkalemia
Correct Answer: Ventricular dysrhythmias
Rationale: Milrinone, a phosphodiesterase inhibitor, can cause ventricular
dysrhythmias as a serious adverse effect. Hypertension, bradycardia, and
hyperkalemia are not the primary concerns associated with this medication.
5. Which medication is an angiotensin II receptor blocker (ARB) used in the
management of heart failure?
A) Valsartan
B) Lisinopril
C) Metoprolol
D) Digoxin
Correct Answer: Valsartan
Rationale: Valsartan is an angiotensin II receptor blocker (ARB) used in heart
failure. Lisinopril is an ACE inhibitor, metoprolol is a beta-blocker, and digoxin is a
cardiac glycoside—each belongs to a different drug class.
6. A patient with heart failure is prescribed furosemide. Which electrolyte
abnormality should the nurse monitor for most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
,Rationale: Loop diuretics such as furosemide increase renal potassium excretion,
leading to hypokalemia. Hyperkalemia, hypernatremia, and hypercalcemia are not
the primary electrolyte concerns with loop diuretic therapy.
7. Which diuretic is classified as an osmotic diuretic and is used to reduce
intracranial pressure and treat cerebral edema?
A) Mannitol
B) Hydrochlorothiazide
C) Spironolactone
D) Furosemide
Correct Answer: Mannitol
Rationale: Mannitol is an osmotic diuretic indicated for reducing intracranial
pressure and treating cerebral edema. Hydrochlorothiazide is a thiazide diuretic,
spironolactone is a potassium-sparing diuretic, and furosemide is a loop diuretic.
8. A patient is prescribed spironolactone. Which instruction is most important
for the nurse to include?
A) Increase dietary potassium intake
B) Avoid salt substitutes containing potassium
C) Take the medication on an empty stomach
D) Expect increased urination at night
Correct Answer: Avoid salt substitutes containing potassium
Rationale: Spironolactone is a potassium-sparing diuretic that can cause
hyperkalemia. Clients should avoid salt substitutes, which often contain potassium
chloride, to prevent dangerous elevations in serum potassium.
9. Which antibiotic class is associated with ototoxicity and nephrotoxicity and
requires monitoring of serum drug levels?
A) Penicillins
B) Macrolides
C) Aminoglycosides
D) Fluoroquinolones
Correct Answer: Aminoglycosides
, Rationale: Aminoglycosides are associated with ototoxicity and nephrotoxicity,
requiring careful monitoring of serum drug levels (peak and trough) to minimize
these risks. Penicillins, macrolides, and fluoroquinolones have different adverse
effect profiles.
10.A patient is prescribed ciprofloxacin. Which instruction is essential for the
nurse to include?
A) Take the medication with an antacid to reduce GI upset
B) Increase sun exposure to enhance absorption
C) Avoid taking the medication with dairy products or antacids
D) Take the medication with grapefruit juice
Correct Answer: Avoid taking the medication with dairy products or antacids
Rationale: Ciprofloxacin, a fluoroquinolone, chelates with polyvalent cations such
as calcium and magnesium, reducing absorption. Clients should avoid taking it
with dairy products or antacids.
11.Which antibiotic is associated with "red man syndrome" when infused too
rapidly?
A) Vancomycin
B) Gentamicin
C) Amoxicillin
D) Azithromycin
Correct Answer: Vancomycin
Rationale: Vancomycin can cause "red man syndrome," characterized by flushing,
erythema, and hypotension, when infused too rapidly. Slowing the infusion rate
prevents this reaction. Gentamicin is an aminoglycoside, amoxicillin is a penicillin,
and azithromycin is a macrolide.
12.A patient is prescribed isoniazid for tuberculosis. Which vitamin
supplementation is required to prevent peripheral neuropathy?
A) Vitamin B12
B) Vitamin B6 (pyridoxine)
C) Vitamin C
D) Vitamin D
Rationale | Latest Update 2026-2027 | Graded A+
1. Which medication is a cardiac glycoside with a narrow therapeutic index
that requires serum level monitoring?
A) Milrinone
B) Digoxin
C) Valsartan
D) Carvedilol
Correct Answer: Digoxin
Rationale: Digoxin is a cardiac glycoside with a narrow therapeutic index,
requiring careful serum level monitoring to avoid toxicity. Milrinone is a
phosphodiesterase inhibitor, valsartan is an angiotensin II receptor blocker, and
carvedilol is a beta-blocker—none are cardiac glycosides.
2. A patient taking digoxin reports seeing green and yellow halos around
lights. What is the nurse's priority action?
A) Document the finding as an expected side effect
B) Notify the provider of suspected digoxin toxicity
C) Administer the next scheduled dose as prescribed
D) Encourage increased fluid intake to flush the medication
Correct Answer: Notify the provider of suspected digoxin toxicity
Rationale: Visual changes such as green or yellow halos are classic signs of digoxin
toxicity and require immediate provider notification. Documenting the finding as
expected, administering more digoxin, or encouraging fluids does not address the
serious toxicity risk.
3. Which medication is the specific reversal agent for digoxin toxicity?
A) Protamine sulfate
B) Naloxone
C) Digoxin immune Fab
D) Vitamin K
,Correct Answer: Digoxin immune Fab
Rationale: Digoxin immune Fab (Digibind) is the specific antidote for digoxin
toxicity. Protamine sulfate reverses heparin, naloxone reverses opioids, and
vitamin K reverses warfarin—none are indicated for digoxin toxicity.
4. A client with heart failure is started on milrinone. Which adverse effect
should the nurse monitor for most closely?
A) Hypertension
B) Ventricular dysrhythmias
C) Bradycardia
D) Hyperkalemia
Correct Answer: Ventricular dysrhythmias
Rationale: Milrinone, a phosphodiesterase inhibitor, can cause ventricular
dysrhythmias as a serious adverse effect. Hypertension, bradycardia, and
hyperkalemia are not the primary concerns associated with this medication.
5. Which medication is an angiotensin II receptor blocker (ARB) used in the
management of heart failure?
A) Valsartan
B) Lisinopril
C) Metoprolol
D) Digoxin
Correct Answer: Valsartan
Rationale: Valsartan is an angiotensin II receptor blocker (ARB) used in heart
failure. Lisinopril is an ACE inhibitor, metoprolol is a beta-blocker, and digoxin is a
cardiac glycoside—each belongs to a different drug class.
6. A patient with heart failure is prescribed furosemide. Which electrolyte
abnormality should the nurse monitor for most closely?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
Correct Answer: Hypokalemia
,Rationale: Loop diuretics such as furosemide increase renal potassium excretion,
leading to hypokalemia. Hyperkalemia, hypernatremia, and hypercalcemia are not
the primary electrolyte concerns with loop diuretic therapy.
7. Which diuretic is classified as an osmotic diuretic and is used to reduce
intracranial pressure and treat cerebral edema?
A) Mannitol
B) Hydrochlorothiazide
C) Spironolactone
D) Furosemide
Correct Answer: Mannitol
Rationale: Mannitol is an osmotic diuretic indicated for reducing intracranial
pressure and treating cerebral edema. Hydrochlorothiazide is a thiazide diuretic,
spironolactone is a potassium-sparing diuretic, and furosemide is a loop diuretic.
8. A patient is prescribed spironolactone. Which instruction is most important
for the nurse to include?
A) Increase dietary potassium intake
B) Avoid salt substitutes containing potassium
C) Take the medication on an empty stomach
D) Expect increased urination at night
Correct Answer: Avoid salt substitutes containing potassium
Rationale: Spironolactone is a potassium-sparing diuretic that can cause
hyperkalemia. Clients should avoid salt substitutes, which often contain potassium
chloride, to prevent dangerous elevations in serum potassium.
9. Which antibiotic class is associated with ototoxicity and nephrotoxicity and
requires monitoring of serum drug levels?
A) Penicillins
B) Macrolides
C) Aminoglycosides
D) Fluoroquinolones
Correct Answer: Aminoglycosides
, Rationale: Aminoglycosides are associated with ototoxicity and nephrotoxicity,
requiring careful monitoring of serum drug levels (peak and trough) to minimize
these risks. Penicillins, macrolides, and fluoroquinolones have different adverse
effect profiles.
10.A patient is prescribed ciprofloxacin. Which instruction is essential for the
nurse to include?
A) Take the medication with an antacid to reduce GI upset
B) Increase sun exposure to enhance absorption
C) Avoid taking the medication with dairy products or antacids
D) Take the medication with grapefruit juice
Correct Answer: Avoid taking the medication with dairy products or antacids
Rationale: Ciprofloxacin, a fluoroquinolone, chelates with polyvalent cations such
as calcium and magnesium, reducing absorption. Clients should avoid taking it
with dairy products or antacids.
11.Which antibiotic is associated with "red man syndrome" when infused too
rapidly?
A) Vancomycin
B) Gentamicin
C) Amoxicillin
D) Azithromycin
Correct Answer: Vancomycin
Rationale: Vancomycin can cause "red man syndrome," characterized by flushing,
erythema, and hypotension, when infused too rapidly. Slowing the infusion rate
prevents this reaction. Gentamicin is an aminoglycoside, amoxicillin is a penicillin,
and azithromycin is a macrolide.
12.A patient is prescribed isoniazid for tuberculosis. Which vitamin
supplementation is required to prevent peripheral neuropathy?
A) Vitamin B12
B) Vitamin B6 (pyridoxine)
C) Vitamin C
D) Vitamin D
