BNUR 488 Final Exam Questions And
Already Passed Answers.
The nursing student realizes that she has given a patient a double dose of an antihypertensive
medication. The tablet was supposed to be cut in half, but the student forgot and administered
the entire tablet. The patient's blood pressure just before the dose was 146/98 mm Hg. What
should the student nurse do first?
a. notify the patient's physician
b. notify the clinical faculty or preceptor
c. take the patient's blood pressure
d. continue to monitor the patient - Answer b. notify the clinical faculty or preceptor
The adverse effects of a non-selective B-blocker are likely to be most immediately life-
threatening in which of the following patients
a. patient with type 1 diabetes
b. patient with asthma
c. patient with GERD
d. patient with hypertension - Answer b. patient with asthma Rationale: Beta blockers may
mask signs and symptoms of hypoglycemia, nonselective beta blockers may cause
bronchoconstriction, which would be detrimental to the patient with asthma
A patient with type 2 diabetes is taking a B-blocker as part of a treatment of hypertension.
Which complication is most likely to develop?
a. Hypertension
b. Hyperkalemia
c. Hypoglycemia
d. Angina - Answer c. Hypoglycemia (due to symptom masking)
Prior to administering tolterodine (Detrol) it is most important for the nurse to assess the
patient for a history of which condition?
A) Angle-closure glaucoma
B) Cataracts
,Rationale: Tolterodine (Detrol) may worsen pre-existing angle-closure glaucoma and urinary
retention, so its use should be avoided in patients with these conditions
Glycopyrrolate (Robinul) and an opioid are administered to a patient prior to surgery in the
preoperative area: Robinul is used to...
A) Potentiate the action of the opiod
B) Assess the patient in retaining urine during surgery
C) Control secretions during surgery
D) Prevent nausea - Answer C) Control secretions during surgery
Rationale: Anticholinergics such as glycopyrrolate and atropine are given preoperatively to
reduce or control secretions before and during surgery
A patient who has a myocardial infarction is taking a beta blocker. What is the main benefit of
the b-blocker therapy for this patient?
a. vasodilate coronary arteries
b. increased cardial contractions
c. slowing of the heart rate
d. maintaining adequate blood pressure - Answer Correct answer: C
Rationale: Slowing the heart rate in patients with ischemic heart disease reduces myocardial
oxygen demand and allows the coronary arteries time to fill with oxygen- and nutrient-rich
blood. Beta blockers also block the irritating effects of circulating catecholamines on the heart.
A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension.
Which drug will most likely be ordered
a. clonidine
b. prazosin
c. diltiazem
d. captopril - Answer d. captopril
Explanation: Captopril is not a prodrug; therefore, it does not need to be metabolized by the
liver to be effective. This is an advantage in patients with liver disease.
,b. Cough is more likely to occur than when using ACE inhibitors
c. Chest pain is a common adverse effect
d. Overdose is usually manifested by bradycarida and hypertension - Answer c. Chest pain is a
common adverse effect
A 58-year-old patient is recovering in the ICU after a myocardial infarction (MI). The nurse notes
an order for the beta blocker metoprolol (Lopressor). The purpose of this drug is to...
A) Dilate the coronary arteries
B) Inhibit stimulation of the myocardium by circulating catecholamines
C) Provide a positive inotropic effect
D) Maintain the patient's blood pressure - Answer B) Inhibit stimulation of the myocardium by
circulating catecholamines
Rationale: Studies show increased survival in patients given metoprolol (Lopressor) after
experiencing an MI. Metoprolol has a cardioprotective effect by decreasing the heart's response
to circulating catecholamines resulting from the MI.
A patient wants to take garlic tablets to improve his cholesterol levels. Which condition would
be a contraindication?
a. Hypertension
b. Bowel obstruction
c. Sinus infection
d. Scheduled surgery - Answer d.
Rationale: Garlic has antiplatelet activity, and is contraindicated in patients who will undergo
surgery within 2 weeks and in patients with human immunodeficiency virus infection or
diabetes.
A patient with extremely high blood pressure is in the emergency department. The physician
will be ordering therapy with nitroglycerin to manage the patient's blood pressure. Which form
of nitroglycerin is most appropriate?
a. sublingual spray
b. transdermal patch
, The IV infusion of nitroglycerin will have the fastest effect, and the dose will be titrated to the
patient's response.
A patient is receiving an intravenous infusion of a thrombolytic drug during treatment for an
acute MI. The nurse notices that there is a slight amount of bleeding from the antecubital area
where venous lab work was drawn. What will the nurse do first?
a. monitor the site for further bleeding
b. apply pressure to the site with a gauze pad
c. slow the rate of infusion of the thrombolytic
d. stop the infusion of the thrombolytic - Answer b. apply pressure to the site with a gauze pad
A patient who was walking his dog developed chest pain and sat down. He continues to
experience chest pain when sitting down. When should he call 911?
A. Immediately
B. If the pain becomes more severe
C. If one sublingual tablet does not relieve the pain after 5 minutes
D. If the pain is not relieved after three sublingual tablets, taken 5 minutes apart - Answer
Correct answer: C
Rationale: With sublingual nitroglycerin, the medication should be taken at the first sign of chest
pain and not be delayed until the pain is severe. The patient should sit or lie down and take 1
sublingual tablet. According to current guidelines, if the chest pain or discomfort is not relieved
in 5 minutes after 1 dose, the patient (or family member) should call 911 immediately. The
patient can take 1 more tablet while awaiting emergency care, and a third tablet 5 minutes later,
but no more than 3 tablets total. These guidelines reflect the fact that angina pain that does not
respond to nitroglycerin may indicate a myocardial infarction.
A patient with type II diabetes has a new prescription for the angiotensin-converting enzyme
(ACE) inhibitor lisinopril. She questions this order because her physician has never told her that
she has hypertension. What is the best explanation for this order?
a. The health care provider knows best
b. The patient is confused
c. This medication has cardioprotective properties
d. This medication has a protective effect on the kidneys for patients with type II diabetes. -
Answer d. This medication has a protective effect on the kidneys for patients with type II
diabetes.
Already Passed Answers.
The nursing student realizes that she has given a patient a double dose of an antihypertensive
medication. The tablet was supposed to be cut in half, but the student forgot and administered
the entire tablet. The patient's blood pressure just before the dose was 146/98 mm Hg. What
should the student nurse do first?
a. notify the patient's physician
b. notify the clinical faculty or preceptor
c. take the patient's blood pressure
d. continue to monitor the patient - Answer b. notify the clinical faculty or preceptor
The adverse effects of a non-selective B-blocker are likely to be most immediately life-
threatening in which of the following patients
a. patient with type 1 diabetes
b. patient with asthma
c. patient with GERD
d. patient with hypertension - Answer b. patient with asthma Rationale: Beta blockers may
mask signs and symptoms of hypoglycemia, nonselective beta blockers may cause
bronchoconstriction, which would be detrimental to the patient with asthma
A patient with type 2 diabetes is taking a B-blocker as part of a treatment of hypertension.
Which complication is most likely to develop?
a. Hypertension
b. Hyperkalemia
c. Hypoglycemia
d. Angina - Answer c. Hypoglycemia (due to symptom masking)
Prior to administering tolterodine (Detrol) it is most important for the nurse to assess the
patient for a history of which condition?
A) Angle-closure glaucoma
B) Cataracts
,Rationale: Tolterodine (Detrol) may worsen pre-existing angle-closure glaucoma and urinary
retention, so its use should be avoided in patients with these conditions
Glycopyrrolate (Robinul) and an opioid are administered to a patient prior to surgery in the
preoperative area: Robinul is used to...
A) Potentiate the action of the opiod
B) Assess the patient in retaining urine during surgery
C) Control secretions during surgery
D) Prevent nausea - Answer C) Control secretions during surgery
Rationale: Anticholinergics such as glycopyrrolate and atropine are given preoperatively to
reduce or control secretions before and during surgery
A patient who has a myocardial infarction is taking a beta blocker. What is the main benefit of
the b-blocker therapy for this patient?
a. vasodilate coronary arteries
b. increased cardial contractions
c. slowing of the heart rate
d. maintaining adequate blood pressure - Answer Correct answer: C
Rationale: Slowing the heart rate in patients with ischemic heart disease reduces myocardial
oxygen demand and allows the coronary arteries time to fill with oxygen- and nutrient-rich
blood. Beta blockers also block the irritating effects of circulating catecholamines on the heart.
A patient with a history of pancreatitis and cirrhosis is also being treated for hypertension.
Which drug will most likely be ordered
a. clonidine
b. prazosin
c. diltiazem
d. captopril - Answer d. captopril
Explanation: Captopril is not a prodrug; therefore, it does not need to be metabolized by the
liver to be effective. This is an advantage in patients with liver disease.
,b. Cough is more likely to occur than when using ACE inhibitors
c. Chest pain is a common adverse effect
d. Overdose is usually manifested by bradycarida and hypertension - Answer c. Chest pain is a
common adverse effect
A 58-year-old patient is recovering in the ICU after a myocardial infarction (MI). The nurse notes
an order for the beta blocker metoprolol (Lopressor). The purpose of this drug is to...
A) Dilate the coronary arteries
B) Inhibit stimulation of the myocardium by circulating catecholamines
C) Provide a positive inotropic effect
D) Maintain the patient's blood pressure - Answer B) Inhibit stimulation of the myocardium by
circulating catecholamines
Rationale: Studies show increased survival in patients given metoprolol (Lopressor) after
experiencing an MI. Metoprolol has a cardioprotective effect by decreasing the heart's response
to circulating catecholamines resulting from the MI.
A patient wants to take garlic tablets to improve his cholesterol levels. Which condition would
be a contraindication?
a. Hypertension
b. Bowel obstruction
c. Sinus infection
d. Scheduled surgery - Answer d.
Rationale: Garlic has antiplatelet activity, and is contraindicated in patients who will undergo
surgery within 2 weeks and in patients with human immunodeficiency virus infection or
diabetes.
A patient with extremely high blood pressure is in the emergency department. The physician
will be ordering therapy with nitroglycerin to manage the patient's blood pressure. Which form
of nitroglycerin is most appropriate?
a. sublingual spray
b. transdermal patch
, The IV infusion of nitroglycerin will have the fastest effect, and the dose will be titrated to the
patient's response.
A patient is receiving an intravenous infusion of a thrombolytic drug during treatment for an
acute MI. The nurse notices that there is a slight amount of bleeding from the antecubital area
where venous lab work was drawn. What will the nurse do first?
a. monitor the site for further bleeding
b. apply pressure to the site with a gauze pad
c. slow the rate of infusion of the thrombolytic
d. stop the infusion of the thrombolytic - Answer b. apply pressure to the site with a gauze pad
A patient who was walking his dog developed chest pain and sat down. He continues to
experience chest pain when sitting down. When should he call 911?
A. Immediately
B. If the pain becomes more severe
C. If one sublingual tablet does not relieve the pain after 5 minutes
D. If the pain is not relieved after three sublingual tablets, taken 5 minutes apart - Answer
Correct answer: C
Rationale: With sublingual nitroglycerin, the medication should be taken at the first sign of chest
pain and not be delayed until the pain is severe. The patient should sit or lie down and take 1
sublingual tablet. According to current guidelines, if the chest pain or discomfort is not relieved
in 5 minutes after 1 dose, the patient (or family member) should call 911 immediately. The
patient can take 1 more tablet while awaiting emergency care, and a third tablet 5 minutes later,
but no more than 3 tablets total. These guidelines reflect the fact that angina pain that does not
respond to nitroglycerin may indicate a myocardial infarction.
A patient with type II diabetes has a new prescription for the angiotensin-converting enzyme
(ACE) inhibitor lisinopril. She questions this order because her physician has never told her that
she has hypertension. What is the best explanation for this order?
a. The health care provider knows best
b. The patient is confused
c. This medication has cardioprotective properties
d. This medication has a protective effect on the kidneys for patients with type II diabetes. -
Answer d. This medication has a protective effect on the kidneys for patients with type II
diabetes.
