NUR 176 EXAM 2 STUDY GUIDE 2026 – COMPLETE
CONCEPT REVIEW & PRACTICE MATERIALS (LATEST
EDITION)
1. A patient is prescribed atenolol. The nurse should monitor for which primary therapeutic
effect?
A. Increased heart rate
B. Relief of chest pain (angina)
C. ✓ Reduction in blood pressure and heart rate
D. Prevention of blood clots
2. When teaching a patient about lithium carbonate, it is crucial to emphasize:
A. Taking it on an empty stomach for best absorption.
B. ✓ Maintaining consistent sodium and fluid intake.
C. The medication will cause significant weight loss.
D. It is safe to double the dose if a dose is missed.
3. The nurse administers furosemide 40 mg IV push at 0900. When should the nurse expect
the peak diuretic effect?
A. 0915
B. ✓ 0930
C. 1100
D. 1300
4. A patient on warfarin therapy has an INR of 5.8. The nurse anticipates an order for:
A. Fresh Frozen Plasma (FFP)
B. ✓ Vitamin K
C. Protamine sulfate
D. Calcium gluconate
5. The most serious adverse effect of Clozapine (Clozaril) that requires mandatory blood
monitoring is:
A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. ✓ Agranulocytosis
D. Orthostatic hypotension
,6. Which instruction is most important for a patient starting on a transdermal nitroglycerin
patch?
A. "Apply the patch to the same site daily."
B. "Use a heating pad over the patch if you have chest pain."
C. ✓ "Remove the old patch and apply a new one to a different, hairless area daily."
D. "You may cut the patch in half if the dose is too strong."
7. A patient with Parkinson's disease is taking carbidopa-levodopa. Which food should the
nurse advise the patient to avoid near medication time?
A. Green leafy vegetables
B. ✓ High-protein meals
C. Citrus fruits
D. Dairy products
8. The therapeutic blood level for digoxin is typically:
A. 0.1 - 0.5 ng/mL
B. ✓ 0.8 - 2.0 ng/mL
C. 5 - 10 mcg/mL
D. 50 - 100 ng/mL
9. Which finding in a patient taking hydrochlorothiazide would require immediate nursing
intervention?
A. Blood pressure of 118/76
B. ✓ Serum potassium level of 3.0 mEq/L
C. Report of mild leg cramping
D. +1 pedal edema
10. Before administering Ipratropium bromide (Atrovent) via inhaler, it is essential to assess
for:
A. ✓ History of glaucoma or prostate enlargement
B. A history of tuberculosis
C. The patient's blood glucose level
D. Liver function tests
11. A patient receiving IV Vancomycin suddenly develops flushing, rash, and hypotension. The
nurse's first action should be to:
A. Administer an antihistamine.
B. ✓ Stop the infusion immediately.
C. Slow the infusion rate.
D. Check the patient's allergy band.
,12. Phenytoin (Dilantin) has a narrow therapeutic index. A common sign of toxicity is:
A. Hypertension
B. ✓ Nystagmus and ataxia
C. Bradycardia
D. Diarrhea
13. Which medication should be held if a patient's heart rate is 52 beats/min?
A. Lisinopril
B. ✓ Metoprolol
C. Furosemide
D. Warfarin
14. The nurse is teaching a diabetic patient about NPH insulin. Which statement by the
patient indicates understanding?
A. "I should inject this insulin right before I eat."
B. ✓ "This insulin is cloudy and I need to roll the vial between my hands."
C. "This insulin has no peak and works evenly for 24 hours."
D. "I can mix this with regular insulin in the same syringe only if I draw up the NPH first."
15. Which lab value is most critical to monitor for a patient on long-term, high-dose
corticosteroid therapy (e.g., Prednisone)?
A. Hemoglobin
B. ✓ Blood glucose
C. Prothrombin time
D. Serum creatinine
16. Alendronate (Fosamax) teaching should include:
A. Take at bedtime for best absorption.
B. ✓ Take with a full glass of water and remain upright for 30 minutes.
C. Take with orange juice to enhance absorption.
D. Crush the tablet if you have difficulty swallowing.
17. The primary reason to administer Ondansetron (Zofran) is to:
A. Reduce gastric acid secretion.
B. ✓ Prevent or treat nausea and vomiting.
C. Stimulate appetite.
D. Treat constipation.
18. A patient taking an ACE inhibitor (e.g., lisinopril) reports a persistent, dry cough. The nurse
should:
, A. Instruct the patient to take a cough suppressant.
B. Reassure the patient this is an expected side effect that will subside.
C. ✓ Notify the provider, as this may require a medication change.
D. Assess the patient for signs of infection.
19. Which medication is considered a "rescue" medication for acute asthma attacks?
A. Fluticasone (Flovent)
B. Montelukast (Singulair)
C. ✓ Albuterol (ProAir, Ventolin)
D. Ipratropium (Atrovent)
20. When administering an opioid analgesic, the nurse's priority assessment is:
A. Bowel sounds
B. ✓ Respiratory rate and depth
C. Heart rate
D. Pain level on a 1-10 scale
21. "Tylenol 650 mg PO every 6 hours PRN for temperature > 101.3°F" is ordered. The nurse
knows the primary rationale for this order is:
A. Anti-inflammatory
B. ✓ Antipyretic
C. Analgesic
D. Antiplatelet
22. What is the antidote for benzodiazepine (e.g., midazolam) overdose?
A. Naloxone (Narcan)
B. ✓ Flumazenil (Romazicon)
C. Physostigmine
D. Activated charcoal
23. A patient is receiving a first dose of an antibiotic. The nurse should observe for an allergic
reaction for at least:
A. 5-10 minutes
B. ✓ 15-30 minutes
C. 1 hour
D. 2 hours
24. Spironolactone (Aldactone) is a potassium-sparing diuretic. The nurse should advise the
patient to avoid:
A. ✓ Salt substitutes (which often contain potassium)
CONCEPT REVIEW & PRACTICE MATERIALS (LATEST
EDITION)
1. A patient is prescribed atenolol. The nurse should monitor for which primary therapeutic
effect?
A. Increased heart rate
B. Relief of chest pain (angina)
C. ✓ Reduction in blood pressure and heart rate
D. Prevention of blood clots
2. When teaching a patient about lithium carbonate, it is crucial to emphasize:
A. Taking it on an empty stomach for best absorption.
B. ✓ Maintaining consistent sodium and fluid intake.
C. The medication will cause significant weight loss.
D. It is safe to double the dose if a dose is missed.
3. The nurse administers furosemide 40 mg IV push at 0900. When should the nurse expect
the peak diuretic effect?
A. 0915
B. ✓ 0930
C. 1100
D. 1300
4. A patient on warfarin therapy has an INR of 5.8. The nurse anticipates an order for:
A. Fresh Frozen Plasma (FFP)
B. ✓ Vitamin K
C. Protamine sulfate
D. Calcium gluconate
5. The most serious adverse effect of Clozapine (Clozaril) that requires mandatory blood
monitoring is:
A. Tardive dyskinesia
B. Neuroleptic malignant syndrome
C. ✓ Agranulocytosis
D. Orthostatic hypotension
,6. Which instruction is most important for a patient starting on a transdermal nitroglycerin
patch?
A. "Apply the patch to the same site daily."
B. "Use a heating pad over the patch if you have chest pain."
C. ✓ "Remove the old patch and apply a new one to a different, hairless area daily."
D. "You may cut the patch in half if the dose is too strong."
7. A patient with Parkinson's disease is taking carbidopa-levodopa. Which food should the
nurse advise the patient to avoid near medication time?
A. Green leafy vegetables
B. ✓ High-protein meals
C. Citrus fruits
D. Dairy products
8. The therapeutic blood level for digoxin is typically:
A. 0.1 - 0.5 ng/mL
B. ✓ 0.8 - 2.0 ng/mL
C. 5 - 10 mcg/mL
D. 50 - 100 ng/mL
9. Which finding in a patient taking hydrochlorothiazide would require immediate nursing
intervention?
A. Blood pressure of 118/76
B. ✓ Serum potassium level of 3.0 mEq/L
C. Report of mild leg cramping
D. +1 pedal edema
10. Before administering Ipratropium bromide (Atrovent) via inhaler, it is essential to assess
for:
A. ✓ History of glaucoma or prostate enlargement
B. A history of tuberculosis
C. The patient's blood glucose level
D. Liver function tests
11. A patient receiving IV Vancomycin suddenly develops flushing, rash, and hypotension. The
nurse's first action should be to:
A. Administer an antihistamine.
B. ✓ Stop the infusion immediately.
C. Slow the infusion rate.
D. Check the patient's allergy band.
,12. Phenytoin (Dilantin) has a narrow therapeutic index. A common sign of toxicity is:
A. Hypertension
B. ✓ Nystagmus and ataxia
C. Bradycardia
D. Diarrhea
13. Which medication should be held if a patient's heart rate is 52 beats/min?
A. Lisinopril
B. ✓ Metoprolol
C. Furosemide
D. Warfarin
14. The nurse is teaching a diabetic patient about NPH insulin. Which statement by the
patient indicates understanding?
A. "I should inject this insulin right before I eat."
B. ✓ "This insulin is cloudy and I need to roll the vial between my hands."
C. "This insulin has no peak and works evenly for 24 hours."
D. "I can mix this with regular insulin in the same syringe only if I draw up the NPH first."
15. Which lab value is most critical to monitor for a patient on long-term, high-dose
corticosteroid therapy (e.g., Prednisone)?
A. Hemoglobin
B. ✓ Blood glucose
C. Prothrombin time
D. Serum creatinine
16. Alendronate (Fosamax) teaching should include:
A. Take at bedtime for best absorption.
B. ✓ Take with a full glass of water and remain upright for 30 minutes.
C. Take with orange juice to enhance absorption.
D. Crush the tablet if you have difficulty swallowing.
17. The primary reason to administer Ondansetron (Zofran) is to:
A. Reduce gastric acid secretion.
B. ✓ Prevent or treat nausea and vomiting.
C. Stimulate appetite.
D. Treat constipation.
18. A patient taking an ACE inhibitor (e.g., lisinopril) reports a persistent, dry cough. The nurse
should:
, A. Instruct the patient to take a cough suppressant.
B. Reassure the patient this is an expected side effect that will subside.
C. ✓ Notify the provider, as this may require a medication change.
D. Assess the patient for signs of infection.
19. Which medication is considered a "rescue" medication for acute asthma attacks?
A. Fluticasone (Flovent)
B. Montelukast (Singulair)
C. ✓ Albuterol (ProAir, Ventolin)
D. Ipratropium (Atrovent)
20. When administering an opioid analgesic, the nurse's priority assessment is:
A. Bowel sounds
B. ✓ Respiratory rate and depth
C. Heart rate
D. Pain level on a 1-10 scale
21. "Tylenol 650 mg PO every 6 hours PRN for temperature > 101.3°F" is ordered. The nurse
knows the primary rationale for this order is:
A. Anti-inflammatory
B. ✓ Antipyretic
C. Analgesic
D. Antiplatelet
22. What is the antidote for benzodiazepine (e.g., midazolam) overdose?
A. Naloxone (Narcan)
B. ✓ Flumazenil (Romazicon)
C. Physostigmine
D. Activated charcoal
23. A patient is receiving a first dose of an antibiotic. The nurse should observe for an allergic
reaction for at least:
A. 5-10 minutes
B. ✓ 15-30 minutes
C. 1 hour
D. 2 hours
24. Spironolactone (Aldactone) is a potassium-sparing diuretic. The nurse should advise the
patient to avoid:
A. ✓ Salt substitutes (which often contain potassium)
