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PN2002 Final Exam Study Guide (2025/2026)
1. What is the nurse’s primary responsibility when administering digoxin to a
patient with heart failure?
Answer:
The nurse must check the patient’s apical pulse for a full minute before
administration. If the pulse is below 60 bpm, the medication should be withheld,
and the physician should be notified. Monitoring for signs of digoxin toxicity, such
as nausea, visual disturbances, or arrhythmias, is also essential.
2. A patient with COPD is placed on 4L/min of oxygen by nasal cannula. What
complication should the nurse anticipate?
Answer:
High-flow oxygen can reduce the hypoxic drive to breathe in COPD patients,
leading to respiratory depression or CO₂ retention. The nurse should closely
monitor oxygen saturation, respiratory rate, and mental status, keeping oxygen at
the lowest effective concentration.
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3. When preparing to administer an intramuscular injection to an adult,
which site is safest and why?
Answer:
The ventrogluteal site is considered the safest because it avoids major blood
vessels and nerves, particularly the sciatic nerve. It is appropriate for larger
medication volumes and provides consistent absorption.
4. A patient on warfarin presents with gum bleeding and easy bruising. What
is the nurse’s priority action?
Answer:
The nurse should report the findings immediately and anticipate an order for
prothrombin time (PT) or INR testing. Vitamin K may be administered as an
antidote if bleeding is significant. The nurse should also review medication
adherence and dietary intake of vitamin K-rich foods.
5. What nursing interventions help prevent pressure injuries in immobile
patients?
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Answer:
Key interventions include:
• Repositioning the patient every 2 hours
• Using pressure-relieving devices (e.g., special mattresses or cushions)
• Keeping the skin clean and dry
• Ensuring adequate nutrition and hydration
These reduce prolonged pressure, friction, and shear that lead to tissue
breakdown.
6. A patient with type 1 diabetes is found unconscious, sweating, and
trembling. What immediate action should the nurse take?
Answer:
The nurse should suspect hypoglycemia and administer glucagon (IM) or IV
dextrose if available. If the patient regains consciousness and can swallow, provide
a rapid source of glucose, such as juice or glucose tablets. Vital signs and blood
glucose should be monitored closely.
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7. Why is the Z-track method used when giving certain IM medications such
as iron dextran?
Answer:
The Z-track method prevents the medication from leaking into subcutaneous
tissue, which can cause irritation, pain, and staining of the skin. It ensures the drug
is deposited deeply into the muscle for proper absorption.
8. A nurse observes slurred speech and right-sided weakness in a patient.
What is the priority intervention?
Answer:
The patient may be experiencing a stroke (CVA). The nurse should activate the
stroke protocol immediately, which includes calling a rapid response team and
preparing the patient for diagnostic imaging. Timely recognition and treatment are
critical to minimize permanent damage.
9. What precautions should a nurse take when caring for a patient with active
tuberculosis?
PN2002 Final Exam Study Guide (2025/2026)
1. What is the nurse’s primary responsibility when administering digoxin to a
patient with heart failure?
Answer:
The nurse must check the patient’s apical pulse for a full minute before
administration. If the pulse is below 60 bpm, the medication should be withheld,
and the physician should be notified. Monitoring for signs of digoxin toxicity, such
as nausea, visual disturbances, or arrhythmias, is also essential.
2. A patient with COPD is placed on 4L/min of oxygen by nasal cannula. What
complication should the nurse anticipate?
Answer:
High-flow oxygen can reduce the hypoxic drive to breathe in COPD patients,
leading to respiratory depression or CO₂ retention. The nurse should closely
monitor oxygen saturation, respiratory rate, and mental status, keeping oxygen at
the lowest effective concentration.
, 2
3. When preparing to administer an intramuscular injection to an adult,
which site is safest and why?
Answer:
The ventrogluteal site is considered the safest because it avoids major blood
vessels and nerves, particularly the sciatic nerve. It is appropriate for larger
medication volumes and provides consistent absorption.
4. A patient on warfarin presents with gum bleeding and easy bruising. What
is the nurse’s priority action?
Answer:
The nurse should report the findings immediately and anticipate an order for
prothrombin time (PT) or INR testing. Vitamin K may be administered as an
antidote if bleeding is significant. The nurse should also review medication
adherence and dietary intake of vitamin K-rich foods.
5. What nursing interventions help prevent pressure injuries in immobile
patients?
, 3
Answer:
Key interventions include:
• Repositioning the patient every 2 hours
• Using pressure-relieving devices (e.g., special mattresses or cushions)
• Keeping the skin clean and dry
• Ensuring adequate nutrition and hydration
These reduce prolonged pressure, friction, and shear that lead to tissue
breakdown.
6. A patient with type 1 diabetes is found unconscious, sweating, and
trembling. What immediate action should the nurse take?
Answer:
The nurse should suspect hypoglycemia and administer glucagon (IM) or IV
dextrose if available. If the patient regains consciousness and can swallow, provide
a rapid source of glucose, such as juice or glucose tablets. Vital signs and blood
glucose should be monitored closely.
, 4
7. Why is the Z-track method used when giving certain IM medications such
as iron dextran?
Answer:
The Z-track method prevents the medication from leaking into subcutaneous
tissue, which can cause irritation, pain, and staining of the skin. It ensures the drug
is deposited deeply into the muscle for proper absorption.
8. A nurse observes slurred speech and right-sided weakness in a patient.
What is the priority intervention?
Answer:
The patient may be experiencing a stroke (CVA). The nurse should activate the
stroke protocol immediately, which includes calling a rapid response team and
preparing the patient for diagnostic imaging. Timely recognition and treatment are
critical to minimize permanent damage.
9. What precautions should a nurse take when caring for a patient with active
tuberculosis?
