NSG527 / NSG 527 MIDTERM EXAM
REVIEW 2024/2025 – ACTUAL
QUESTIONS AND VERIFIED
ANSWERS | 100% CORRECT | A
RATED CLINICAL
1. A patient with heart failure is prescribed furosemide. What is the primary mechanism of
action of this medication?
A. Increases cardiac contractility
B. Inhibits sodium and chloride reabsorption in the loop of Henle
C. Blocks calcium channels in vascular smooth muscle
D. Enhances potassium retention in the distal tubule
Correct Answer: B
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption
in the loop of Henle, promoting diuresis and reducing fluid overload in heart failure.
2. A nurse is assessing a patient with suspected hypokalemia. Which symptom is most
indicative of this condition?
A. Muscle weakness
B. Hypertension
C. Increased deep tendon reflexes
D. Peripheral edema
Correct Answer: A
Rationale: Hypokalemia causes decreased excitability of muscles, leading to weakness.
Hypertension and edema are not typical, and reflexes are usually diminished.
3. A patient with type 2 diabetes is prescribed metformin. What is the primary therapeutic
effect of this drug?
A. Stimulates insulin release from the pancreas
B. Decreases hepatic glucose production
C. Increases peripheral glucose uptake
D. Inhibits glucagon secretion
Correct Answer: B
Rationale: Metformin primarily reduces hepatic glucose production, helping to lower
blood glucose levels in type 2 diabetes.
4. Which laboratory value should a nurse monitor closely in a patient receiving heparin
therapy?
A. International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Platelet count
D. Prothrombin time (PT)
Correct Answer: B
, Rationale: Heparin’s anticoagulant effect is monitored using aPTT, which reflects the
drug’s impact on the intrinsic clotting pathway. INR and PT are used for warfarin.
5. A patient with chronic obstructive pulmonary disease (COPD) is prescribed albuterol.
What is the drug’s primary action?
A. Reduces airway inflammation
B. Dilates bronchial smooth muscle
C. Inhibits mucus production
D. Enhances ciliary motility
Correct Answer: B
Rationale: Albuterol is a beta-2 agonist that relaxes bronchial smooth muscle, leading to
bronchodilation and improved airflow in COPD.
6. A nurse is caring for a patient with suspected digoxin toxicity. Which electrolyte
imbalance exacerbates this condition?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypokalemia increases the risk of digoxin toxicity by enhancing the drug’s
binding to cardiac cells, potentially leading to arrhythmias.
7. A patient with hypertension is prescribed lisinopril. What is the mechanism of action of
this medication?
A. Blocks beta-adrenergic receptors
B. Inhibits angiotensin-converting enzyme (ACE)
C. Dilates peripheral veins
D. Inhibits sodium-potassium ATPase
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that prevents the conversion of angiotensin I to
angiotensin II, reducing vasoconstriction and blood pressure.
8. What is the most common adverse effect of ACE inhibitors like lisinopril?
A. Hyperkalemia
B. Dry cough
C. Hypoglycemia
D. Bradycardia
Correct Answer: B
Rationale: ACE inhibitors commonly cause a dry, nonproductive cough due to increased
bradykinin levels, which irritate the respiratory tract.
9. A patient with asthma is prescribed a leukotriene receptor antagonist. Which medication
is an example of this class?
A. Montelukast
B. Fluticasone
C. Salmeterol
D. Ipratropium
Correct Answer: A
Rationale: Montelukast is a leukotriene receptor antagonist that reduces inflammation
and bronchoconstriction in asthma.
, 10. A nurse is administering insulin glargine to a patient with diabetes. When is the peak
action of this insulin?
A. 1–2 hours
B. 4–6 hours
C. No peak (long-acting)
D. 12–14 hours
Correct Answer: C
Rationale: Insulin glargine is a long-acting insulin with a steady release and no distinct
peak, providing basal glucose control over 24 hours.
11. Which assessment finding in a patient on warfarin indicates a need for immediate
intervention?
A. INR of 2.5
B. INR of 4.8
C. Platelet count of 150,000/mm³
D. Hemoglobin of 12 g/dL
Correct Answer: B
Rationale: An INR of 4.8 indicates excessive anticoagulation, increasing the risk of
bleeding, and requires immediate intervention, such as dose adjustment or vitamin K
administration.
12. A patient with gastroesophageal reflux disease (GERD) is prescribed omeprazole. What
is its mechanism of action?
A. Neutralizes gastric acid
B. Inhibits proton pump in parietal cells
C. Enhances gastric motility
D. Forms a protective barrier in the stomach
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor that blocks acid production by
inhibiting the H+/K+ ATPase pump in gastric parietal cells.
13. A patient is receiving intravenous vancomycin. Which adverse effect should the nurse
monitor for?
A. Red man syndrome
B. Hyperglycemia
C. Photosensitivity
D. Hypokalemia
Correct Answer: A
Rationale: Vancomycin can cause red man syndrome, a histamine-mediated reaction
characterized by flushing and hypotension, especially with rapid infusion.
14. A nurse is educating a patient on selective serotonin reuptake inhibitors (SSRIs). Which
medication is an example of this class?
A. Sertraline
B. Amitriptyline
C. Phenelzine
D. Bupropion
Correct Answer: A
Rationale: Sertraline is an SSRI that increases serotonin levels to treat depression and
REVIEW 2024/2025 – ACTUAL
QUESTIONS AND VERIFIED
ANSWERS | 100% CORRECT | A
RATED CLINICAL
1. A patient with heart failure is prescribed furosemide. What is the primary mechanism of
action of this medication?
A. Increases cardiac contractility
B. Inhibits sodium and chloride reabsorption in the loop of Henle
C. Blocks calcium channels in vascular smooth muscle
D. Enhances potassium retention in the distal tubule
Correct Answer: B
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption
in the loop of Henle, promoting diuresis and reducing fluid overload in heart failure.
2. A nurse is assessing a patient with suspected hypokalemia. Which symptom is most
indicative of this condition?
A. Muscle weakness
B. Hypertension
C. Increased deep tendon reflexes
D. Peripheral edema
Correct Answer: A
Rationale: Hypokalemia causes decreased excitability of muscles, leading to weakness.
Hypertension and edema are not typical, and reflexes are usually diminished.
3. A patient with type 2 diabetes is prescribed metformin. What is the primary therapeutic
effect of this drug?
A. Stimulates insulin release from the pancreas
B. Decreases hepatic glucose production
C. Increases peripheral glucose uptake
D. Inhibits glucagon secretion
Correct Answer: B
Rationale: Metformin primarily reduces hepatic glucose production, helping to lower
blood glucose levels in type 2 diabetes.
4. Which laboratory value should a nurse monitor closely in a patient receiving heparin
therapy?
A. International Normalized Ratio (INR)
B. Activated partial thromboplastin time (aPTT)
C. Platelet count
D. Prothrombin time (PT)
Correct Answer: B
, Rationale: Heparin’s anticoagulant effect is monitored using aPTT, which reflects the
drug’s impact on the intrinsic clotting pathway. INR and PT are used for warfarin.
5. A patient with chronic obstructive pulmonary disease (COPD) is prescribed albuterol.
What is the drug’s primary action?
A. Reduces airway inflammation
B. Dilates bronchial smooth muscle
C. Inhibits mucus production
D. Enhances ciliary motility
Correct Answer: B
Rationale: Albuterol is a beta-2 agonist that relaxes bronchial smooth muscle, leading to
bronchodilation and improved airflow in COPD.
6. A nurse is caring for a patient with suspected digoxin toxicity. Which electrolyte
imbalance exacerbates this condition?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hypokalemia increases the risk of digoxin toxicity by enhancing the drug’s
binding to cardiac cells, potentially leading to arrhythmias.
7. A patient with hypertension is prescribed lisinopril. What is the mechanism of action of
this medication?
A. Blocks beta-adrenergic receptors
B. Inhibits angiotensin-converting enzyme (ACE)
C. Dilates peripheral veins
D. Inhibits sodium-potassium ATPase
Correct Answer: B
Rationale: Lisinopril is an ACE inhibitor that prevents the conversion of angiotensin I to
angiotensin II, reducing vasoconstriction and blood pressure.
8. What is the most common adverse effect of ACE inhibitors like lisinopril?
A. Hyperkalemia
B. Dry cough
C. Hypoglycemia
D. Bradycardia
Correct Answer: B
Rationale: ACE inhibitors commonly cause a dry, nonproductive cough due to increased
bradykinin levels, which irritate the respiratory tract.
9. A patient with asthma is prescribed a leukotriene receptor antagonist. Which medication
is an example of this class?
A. Montelukast
B. Fluticasone
C. Salmeterol
D. Ipratropium
Correct Answer: A
Rationale: Montelukast is a leukotriene receptor antagonist that reduces inflammation
and bronchoconstriction in asthma.
, 10. A nurse is administering insulin glargine to a patient with diabetes. When is the peak
action of this insulin?
A. 1–2 hours
B. 4–6 hours
C. No peak (long-acting)
D. 12–14 hours
Correct Answer: C
Rationale: Insulin glargine is a long-acting insulin with a steady release and no distinct
peak, providing basal glucose control over 24 hours.
11. Which assessment finding in a patient on warfarin indicates a need for immediate
intervention?
A. INR of 2.5
B. INR of 4.8
C. Platelet count of 150,000/mm³
D. Hemoglobin of 12 g/dL
Correct Answer: B
Rationale: An INR of 4.8 indicates excessive anticoagulation, increasing the risk of
bleeding, and requires immediate intervention, such as dose adjustment or vitamin K
administration.
12. A patient with gastroesophageal reflux disease (GERD) is prescribed omeprazole. What
is its mechanism of action?
A. Neutralizes gastric acid
B. Inhibits proton pump in parietal cells
C. Enhances gastric motility
D. Forms a protective barrier in the stomach
Correct Answer: B
Rationale: Omeprazole is a proton pump inhibitor that blocks acid production by
inhibiting the H+/K+ ATPase pump in gastric parietal cells.
13. A patient is receiving intravenous vancomycin. Which adverse effect should the nurse
monitor for?
A. Red man syndrome
B. Hyperglycemia
C. Photosensitivity
D. Hypokalemia
Correct Answer: A
Rationale: Vancomycin can cause red man syndrome, a histamine-mediated reaction
characterized by flushing and hypotension, especially with rapid infusion.
14. A nurse is educating a patient on selective serotonin reuptake inhibitors (SSRIs). Which
medication is an example of this class?
A. Sertraline
B. Amitriptyline
C. Phenelzine
D. Bupropion
Correct Answer: A
Rationale: Sertraline is an SSRI that increases serotonin levels to treat depression and
