NR 293 Exam 3 Questions and Correct Answers plus
Rationale | Latest Update 2026-2027 | Graded A+
1. A nurse is teaching a client about sublingual nitroglycerin. Which instruction
should the nurse include?
A) Swallow the tablet with a full glass of water.
B) Take a tablet every 5 minutes for up to three doses if chest pain persists.
C) Store the tablets in a clear glass container.
D) Discard the medication if it does not produce a tingling sensation.
Correct Answer: Take a tablet every 5 minutes for up to three doses if chest pain
persists.
Rationale: Clients should take one tablet sublingually at the first sign of chest pain
and may repeat every 5 minutes for a maximum of three doses if pain is
unrelieved. Swallowing the tablet defeats the purpose of sublingual absorption,
and tablets should be stored in the original dark container, not a clear glass one.
2. Which laboratory value should the nurse monitor to evaluate the
effectiveness of a continuous heparin infusion?
A) PT
B) INR
C) aPTT
D) Hemoglobin
Correct Answer: aPTT
Rationale: The activated partial thromboplastin time (aPTT) is the standard
laboratory test used to monitor heparin therapy. PT and INR are used to monitor
warfarin, and hemoglobin assesses for anemia or bleeding but does not reflect
heparin's anticoagulant effect.
3. A client taking digoxin reports seeing yellow-green halos around lights. The
nurse should recognize this as a manifestation of which condition?
A) Ocular hypertension
B) Hypokalemia
, C) Digoxin toxicity
D) A normal drug effect
Correct Answer: Digoxin toxicity
Rationale: Visual disturbances such as yellow-green halos are a classic sign of
digoxin toxicity and may be accompanied by anorexia, nausea, and bradycardia.
Hypokalemia can potentiate digoxin toxicity but is not the direct cause of the
visual changes.
4. A nurse is reviewing laboratory results for a client taking furosemide daily.
Which result should the nurse report to the provider?
A) Sodium 140 mEq/L
B) Potassium 3.2 mEq/L
C) Glucose 100 mg/dL
D) Calcium 9.5 mg/dL
Correct Answer: Potassium 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that promotes potassium excretion, and a
potassium level of 3.2 mEq/L indicates hypokalemia, which can precipitate cardiac
dysrhythmias. The other values are within normal limits and do not require
immediate reporting.
5. A client is prescribed levothyroxine for hypothyroidism. The nurse should
instruct the client to take this medication in which manner?
A) With a glass of milk to prevent GI upset
B) With a full meal at midday
C) At bedtime with a snack
D) In the morning, 30 to 60 minutes before breakfast
Correct Answer: In the morning, 30 to 60 minutes before breakfast
Rationale: Levothyroxine should be taken on an empty stomach in the morning to
maximize absorption and avoid insomnia. Dairy products and food can interfere
with absorption, making the other options incorrect.
6. A nurse is preparing to administer albuterol to a client with asthma. Which
side effect should the nurse monitor for?
A) Tachycardia
, B) Bradycardia
C) Lethargy
D) Hypoglycemia
Correct Answer: Tachycardia
Rationale: Albuterol is a sympathomimetic bronchodilator that can stimulate
beta-1 receptors, leading to tachycardia and tremors. Bradycardia, lethargy, and
hypoglycemia are not typical adverse effects of albuterol.
7. Which medication is the antidote for a warfarin overdose?
A) Protamine sulfate
B) Vitamin K
C) Naloxone
D) Acetylcysteine
Correct Answer: Vitamin K
Rationale: Vitamin K is the specific antagonist for warfarin and is used to reverse
its anticoagulant effect. Protamine sulfate reverses heparin, naloxone reverses
opioids, and acetylcysteine is the antidote for acetaminophen toxicity.
8. A nurse is teaching a client about using a spacer with a metered-dose
inhaler (MDI). What is the primary purpose of the spacer?
A) To increase the dose delivered to the lungs
B) To reduce the amount of drug deposited in the oropharynx
C) To eliminate the need for hand-breath coordination
D) To speed up the delivery of the medication
Correct Answer: To reduce the amount of drug deposited in the oropharynx
Rationale: A spacer reduces the deposition of medication in the mouth and
throat, increasing the amount that reaches the lungs and decreasing the risk of
oral candidiasis with inhaled corticosteroids. It also reduces the need for perfect
hand-breath coordination but does not increase the dose or speed delivery.
9. A client with heart failure is started on milrinone. Which assessment is most
important for the nurse to monitor during infusion?
A) Blood glucose
B) Cardiac status
, C) Liver function
D) Thyroid function
Correct Answer: Cardiac status
Rationale: Milrinone is a phosphodiesterase inhibitor that increases cardiac
contractility and can cause ventricular dysrhythmias. Close monitoring of cardiac
status, including heart rhythm and blood pressure, is essential during infusion.
10.A nurse is caring for a client receiving digoxin. Which action is appropriate
before administering the medication?
A) Hold the dose if the apical pulse is below 60 beats per minute.
B) Administer the dose regardless of the heart rate.
C) Hold the dose if the radial pulse is above 100 beats per minute.
D) Administer the dose only if the client reports chest pain.
Correct Answer: Hold the dose if the apical pulse is below 60 beats per minute.
Rationale: Digoxin slows the heart rate, and an apical pulse below 60 beats per
minute in an adult may indicate excessive bradycardia or toxicity. The nurse should
hold the dose and notify the provider. Administering regardless of heart rate is
unsafe, and the other options do not reflect standard digoxin administration
guidelines.
11.Which class of medications is associated with a dry, persistent cough as a
common adverse effect?
A) Angiotensin II receptor blockers (ARBs)
B) Angiotensin-converting enzyme (ACE) inhibitors
C) Beta-blockers
D) Calcium channel blockers
Correct Answer: Angiotensin-converting enzyme (ACE) inhibitors
Rationale: ACE inhibitors such as lisinopril cause a dry, persistent cough in a
significant proportion of clients due to the accumulation of bradykinin. ARBs,
beta-blockers, and calcium channel blockers are not typically associated with this
effect.
12.A client is prescribed metoprolol. Which adverse effect should the nurse
monitor for most closely?
Rationale | Latest Update 2026-2027 | Graded A+
1. A nurse is teaching a client about sublingual nitroglycerin. Which instruction
should the nurse include?
A) Swallow the tablet with a full glass of water.
B) Take a tablet every 5 minutes for up to three doses if chest pain persists.
C) Store the tablets in a clear glass container.
D) Discard the medication if it does not produce a tingling sensation.
Correct Answer: Take a tablet every 5 minutes for up to three doses if chest pain
persists.
Rationale: Clients should take one tablet sublingually at the first sign of chest pain
and may repeat every 5 minutes for a maximum of three doses if pain is
unrelieved. Swallowing the tablet defeats the purpose of sublingual absorption,
and tablets should be stored in the original dark container, not a clear glass one.
2. Which laboratory value should the nurse monitor to evaluate the
effectiveness of a continuous heparin infusion?
A) PT
B) INR
C) aPTT
D) Hemoglobin
Correct Answer: aPTT
Rationale: The activated partial thromboplastin time (aPTT) is the standard
laboratory test used to monitor heparin therapy. PT and INR are used to monitor
warfarin, and hemoglobin assesses for anemia or bleeding but does not reflect
heparin's anticoagulant effect.
3. A client taking digoxin reports seeing yellow-green halos around lights. The
nurse should recognize this as a manifestation of which condition?
A) Ocular hypertension
B) Hypokalemia
, C) Digoxin toxicity
D) A normal drug effect
Correct Answer: Digoxin toxicity
Rationale: Visual disturbances such as yellow-green halos are a classic sign of
digoxin toxicity and may be accompanied by anorexia, nausea, and bradycardia.
Hypokalemia can potentiate digoxin toxicity but is not the direct cause of the
visual changes.
4. A nurse is reviewing laboratory results for a client taking furosemide daily.
Which result should the nurse report to the provider?
A) Sodium 140 mEq/L
B) Potassium 3.2 mEq/L
C) Glucose 100 mg/dL
D) Calcium 9.5 mg/dL
Correct Answer: Potassium 3.2 mEq/L
Rationale: Furosemide is a loop diuretic that promotes potassium excretion, and a
potassium level of 3.2 mEq/L indicates hypokalemia, which can precipitate cardiac
dysrhythmias. The other values are within normal limits and do not require
immediate reporting.
5. A client is prescribed levothyroxine for hypothyroidism. The nurse should
instruct the client to take this medication in which manner?
A) With a glass of milk to prevent GI upset
B) With a full meal at midday
C) At bedtime with a snack
D) In the morning, 30 to 60 minutes before breakfast
Correct Answer: In the morning, 30 to 60 minutes before breakfast
Rationale: Levothyroxine should be taken on an empty stomach in the morning to
maximize absorption and avoid insomnia. Dairy products and food can interfere
with absorption, making the other options incorrect.
6. A nurse is preparing to administer albuterol to a client with asthma. Which
side effect should the nurse monitor for?
A) Tachycardia
, B) Bradycardia
C) Lethargy
D) Hypoglycemia
Correct Answer: Tachycardia
Rationale: Albuterol is a sympathomimetic bronchodilator that can stimulate
beta-1 receptors, leading to tachycardia and tremors. Bradycardia, lethargy, and
hypoglycemia are not typical adverse effects of albuterol.
7. Which medication is the antidote for a warfarin overdose?
A) Protamine sulfate
B) Vitamin K
C) Naloxone
D) Acetylcysteine
Correct Answer: Vitamin K
Rationale: Vitamin K is the specific antagonist for warfarin and is used to reverse
its anticoagulant effect. Protamine sulfate reverses heparin, naloxone reverses
opioids, and acetylcysteine is the antidote for acetaminophen toxicity.
8. A nurse is teaching a client about using a spacer with a metered-dose
inhaler (MDI). What is the primary purpose of the spacer?
A) To increase the dose delivered to the lungs
B) To reduce the amount of drug deposited in the oropharynx
C) To eliminate the need for hand-breath coordination
D) To speed up the delivery of the medication
Correct Answer: To reduce the amount of drug deposited in the oropharynx
Rationale: A spacer reduces the deposition of medication in the mouth and
throat, increasing the amount that reaches the lungs and decreasing the risk of
oral candidiasis with inhaled corticosteroids. It also reduces the need for perfect
hand-breath coordination but does not increase the dose or speed delivery.
9. A client with heart failure is started on milrinone. Which assessment is most
important for the nurse to monitor during infusion?
A) Blood glucose
B) Cardiac status
, C) Liver function
D) Thyroid function
Correct Answer: Cardiac status
Rationale: Milrinone is a phosphodiesterase inhibitor that increases cardiac
contractility and can cause ventricular dysrhythmias. Close monitoring of cardiac
status, including heart rhythm and blood pressure, is essential during infusion.
10.A nurse is caring for a client receiving digoxin. Which action is appropriate
before administering the medication?
A) Hold the dose if the apical pulse is below 60 beats per minute.
B) Administer the dose regardless of the heart rate.
C) Hold the dose if the radial pulse is above 100 beats per minute.
D) Administer the dose only if the client reports chest pain.
Correct Answer: Hold the dose if the apical pulse is below 60 beats per minute.
Rationale: Digoxin slows the heart rate, and an apical pulse below 60 beats per
minute in an adult may indicate excessive bradycardia or toxicity. The nurse should
hold the dose and notify the provider. Administering regardless of heart rate is
unsafe, and the other options do not reflect standard digoxin administration
guidelines.
11.Which class of medications is associated with a dry, persistent cough as a
common adverse effect?
A) Angiotensin II receptor blockers (ARBs)
B) Angiotensin-converting enzyme (ACE) inhibitors
C) Beta-blockers
D) Calcium channel blockers
Correct Answer: Angiotensin-converting enzyme (ACE) inhibitors
Rationale: ACE inhibitors such as lisinopril cause a dry, persistent cough in a
significant proportion of clients due to the accumulation of bradykinin. ARBs,
beta-blockers, and calcium channel blockers are not typically associated with this
effect.
12.A client is prescribed metoprolol. Which adverse effect should the nurse
monitor for most closely?
