Complete Solutions
Course
NURS 328
Question 1 (Q1):
A nurse is caring for a patient with heart failure who is prescribed furosemide. Which laboratory
result requires immediate intervention?
A. Potassium 3.0 mEq/L
B. Sodium 138 mEq/L
C. BUN 18 mg/dL
D. Creatinine 0.9 mg/dL
Answer: A. Potassium 3.0 mEq/L
Rationale:
Furosemide is a loop diuretic that causes potassium loss. A potassium level below 3.5 mEq/L
increases the risk of arrhythmias, especially in cardiac patients. The nurse should notify the
provider and anticipate potassium supplementation.
Question 2 (Q2):
A postoperative patient is on PCA morphine. Which assessment finding requires immediate
action?
A. Respiratory rate of 8/min
B. Sedation score of 2
C. Oxygen saturation of 96%
D. Pain rating of 4/10
Answer: A. Respiratory rate of 8/min
Rationale:
A respiratory rate <10 indicates respiratory depression, a life-threatening opioid side effect. The
nurse must stop PCA and administer naloxone per protocol.
Question 3 (Q3):
A patient with type 2 diabetes reports shakiness, sweating, and confusion. Blood glucose is 54
mg/dL. What is the priority nursing action?
A. Administer 15 g of oral glucose
B. Give the scheduled insulin
C. Notify the provider
D. Recheck glucose in 4 hours
,Answer: A. Administer 15 g of oral glucose
Rationale:
Symptoms indicate hypoglycemia. The priority is to raise blood glucose quickly using the “15-15
rule” — give 15 g glucose and recheck in 15 minutes.
Question 4 (Q4):
Which of the following medications should the nurse question for a patient with asthma?
A. Albuterol
B. Montelukast
C. Propranolol
D. Fluticasone
Answer: C. Propranolol
Rationale:
Nonselective beta-blockers like propranolol can cause bronchoconstriction by blocking β2
receptors, worsening asthma symptoms.
Question 5 (Q5):
A nurse prepares to administer digoxin 0.25 mg to a patient. The apical pulse is 52 bpm. What
should the nurse do?
A. Hold the dose and notify the provider
B. Administer the dose
C. Recheck the pulse in 30 minutes
D. Give with extra fluids
Answer: A. Hold the dose and notify the provider
Rationale:
Digoxin should be held if the apical pulse is below 60 bpm due to risk of bradycardia and
toxicity.
Question 6 (Q6):
A nurse caring for a patient receiving a blood transfusion notes chills and back pain. What is the
first nursing action?
A. Stop the transfusion
B. Notify the provider
C. Administer diphenhydramine
D. Flush the IV line with normal saline
,Answer: A. Stop the transfusion
Rationale:
Chills and back pain indicate an acute hemolytic reaction. The transfusion must be stopped
immediately, and normal saline should be infused using new tubing.
Question 7 (Q7):
Which teaching point is most important for a patient starting warfarin?
A. Avoid green leafy vegetables
B. Report bleeding or bruising immediately
C. Take the medication on an empty stomach
D. Stop if you feel dizzy
Answer: B. Report bleeding or bruising immediately
Rationale:
Bleeding is the most dangerous complication of warfarin therapy. Patients should monitor for
unusual bleeding and avoid abrupt dietary vitamin K changes.
Question 8 (Q8):
A patient with COPD is on 2 L/min oxygen. The nurse notes increasing drowsiness and CO₂
retention. What is the appropriate action?
A. Reduce oxygen flow rate
B. Increase oxygen to 6 L/min
C. Place patient in Trendelenburg position
D. Encourage fluid intake
Answer: A. Reduce oxygen flow rate
Rationale:
High oxygen in COPD can suppress the hypoxic drive, causing CO₂ retention. Maintain the
lowest O₂ flow that keeps SpO₂ around 88–92%.
Question 9 (Q9):
A patient receiving chemotherapy reports mouth sores and difficulty eating. What is the best
nursing action?
A. Offer soft, bland foods
B. Provide acidic juices
C. Encourage spicy foods
D. Brush with a firm toothbrush
, Answer: A. Offer soft, bland foods
Rationale:
Mucositis causes painful ulcerations. Bland, soft foods and gentle oral hygiene prevent irritation
and infection.
Question 10 (Q10):
Which finding indicates the need for immediate intervention in a patient with DVT?
A. Sudden shortness of breath
B. Swelling in one leg
C. Warmth at the calf site
D. Positive Homans’ sign
Answer: A. Sudden shortness of breath
Rationale:
This may indicate a pulmonary embolism — a medical emergency. Notify the provider and
prepare for oxygen and possible anticoagulation therapy.
✅ Set Summary
Focus: Adult health and pharmacology nursing
Question types: Application, prioritization, and safety
Difficulty: Intermediate–Upper (Level 3/4 Bloom’s taxonomy)
Q11.
A patient with cirrhosis has ascites and is prescribed spironolactone. Which statement shows
correct understanding of the medication?
A. “I should avoid foods high in potassium.”
B. “I’ll increase my salt intake.”
C. “This drug will increase my urine potassium.”
D. “I need to drink more orange juice.”
Answer: A. “I should avoid foods high in potassium.”
Rationale:
Spironolactone is a potassium-sparing diuretic. Extra potassium can cause hyperkalemia, leading
to arrhythmias. Patients should avoid high-potassium foods (bananas, oranges, potatoes).
Q12.