MSN 571 MIDTERM EXAM STUDY GUIDE 2026
– FULL CONCEPT REVIEW & PREPARATION
RESOURCE
Description (150 words):
The MSN 571 Midterm Exam Study Guide 2026 – Full Concept Review & Preparation Resource
is a structured academic support document designed to help graduate nursing students
strengthen their understanding of key advanced practice concepts emphasized throughout the
MSN 571 curriculum. This guide provides clear explanations and organized summaries of
essential topics such as pharmacotherapeutics, pathophysiology integration, diagnostic
reasoning, patient assessment, clinical decision-making, and evidence-based management of
common acute and chronic conditions. Learners will find focused coverage of core terminology,
conceptual frameworks, clinical guidelines, and practice-oriented principles to reinforce
understanding without supplying actual exam questions. The material is crafted to enhance
critical thinking, promote safe and effective clinical judgement, and support mastery of
foundational concepts needed for midterm preparation. With its concise layout and emphasis
on real-world application, this resource helps students refine their knowledge base and
approach the exam with greater confidence and clarity.
Keywords (10):
1. Pharmacotherapeutics
2. Diagnostic reasoning
3. Clinical assessment
4. Pathophysiology
5. Evidence-based practice
6. Advanced nursing concepts
7. Clinical guidelines
8. Patient management
9. Acute and chronic conditions
10. Clinical decision-making
MSN 571 Advanced Pharmacology: Comprehensive Practice Exam
,Instructions: For each question, choose the single best answer.
1. A patient with a history of heart failure is prescribed Furosemide. The nurse should monitor
for which electrolyte imbalance as a primary concern?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: C. Hypokalemia
Rationale: Loop diuretics like furosemide cause significant potassium wasting in the distal
tubule, making hypokalemia a common and dangerous adverse effect.
2. When initiating therapy with Lisinopril, an ACE inhibitor, it is essential to educate the
patient to immediately report which side effect?
A. Dry, persistent cough
B. Peripheral edema
C. Angioedema
D. Headache
Answer: C. Angioedema
Rationale: While a cough is common, angioedema (swelling of the face, lips, tongue, or throat)
is a rare but life-threatening adverse reaction that requires immediate medical attention.
3. A patient taking Metformin for Type 2 Diabetes is scheduled for a coronary angiogram using
IV contrast. The most appropriate action by the nurse is to:
A. Administer the Metformin as scheduled to maintain glycemic control.
B. Hold the Metformin the day of the procedure and for 48 hours after.
C. Double the Metformin dose the night before to prevent hyperglycemia.
D. Switch to sliding scale insulin only after the procedure.
Answer: B. Hold the Metformin the day of the procedure and for 48 hours after.
Rationale: IV contrast can impair renal function, increasing the risk of metformin-induced lactic
acidosis, a serious complication. Metformin should be withheld peri-procedure.
4. Which laboratory value is most critical to monitor for a patient on long-term, high-dose
Valproic acid therapy?
A. Serum Creatinine
B. Thyroid-Stimulating Hormone (TSH)
C. Alanine Aminotransferase (ALT)
D. International Normalized Ratio (INR)
Answer: C. Alanine Aminotransferase (ALT)
,Rationale: Valproic acid can cause hepatotoxicity. Regular monitoring of liver enzymes (like ALT)
is essential for early detection.
5. The therapeutic action of SSRI antidepressants like Sertraline is primarily to:
A. Block serotonin receptors in the prefrontal cortex.
B. Inhibit the reuptake of serotonin into the presynaptic neuron.
C. Increase the production of monoamine oxidase.
D. Enhance the degradation of norepinephrine.
Answer: B. Inhibit the reuptake of serotonin into the presynaptic neuron.
Rationale: SSRIs (Selective Serotonin Reuptake Inhibitors) work by blocking the serotonin
transporter, increasing serotonin levels in the synaptic cleft.
6. A patient receiving Vancomycin has a trough level drawn of 25 mcg/mL. The nurse
interprets this as:
A. Within the therapeutic range.
B. Subtherapeutic.
C. Supratherapeutic (toxic).
D. Irrelevant without a peak level.
Answer: C. Supratherapeutic (toxic).
*Rationale: For most infections, a vancomycin trough of 15-20 mcg/mL is targeted. A level of 25
mcg/mL increases the risk of nephrotoxicity and ototoxicity.*
7. Which medication is a direct thrombin inhibitor used as an alternative to warfarin for
stroke prevention in non-valvular atrial fibrillation?
A. Clopidogrel
B. Enoxaparin
C. Dabigatran
D. Aspirin
Answer: C. Dabigatran
Rationale: Dabigatran is a direct oral anticoagulant (DOAC) that directly inhibits thrombin
(Factor IIa).
8. The nurse administers Naloxone to a patient with suspected opioid overdose. Which
assessment finding indicates the medication is effective?
A. Heart rate decreases from 120 to 80 bpm.
B. Respiratory rate increases from 6 to 14 breaths per minute.
C. Blood pressure stabilizes at 80/40 mmHg.
D. Pupils remain pinpoint.
Answer: B. Respiratory rate increases from 6 to 14 breaths per minute.
, Rationale: Naloxone is an opioid antagonist that reverses life-threatening respiratory
depression, its primary intended effect.
9. When teaching a patient about taking Levothyroxine, the nurse should emphasize:
A. Take it at bedtime with a snack.
B. Take it on an empty stomach with a full glass of water.
C. Take it with orange juice to enhance absorption.
D. Take it with an antacid to prevent GI upset.
Answer: B. Take it on an empty stomach with a full glass of water.
*Rationale: Absorption of levothyroxine is decreased by food, calcium, iron, and antacids. It
should be taken on an empty stomach, 30-60 minutes before breakfast.*
10. A patient prescribed Clozapine must be enrolled in a national registry because of the risk
for which fatal adverse effect?
A. Hepatotoxicity
B. Agranulocytosis
C. Rhabdomyolysis
D. Torsades de Pointes
Answer: B. Agranulocytosis
Rationale: Clozapine carries a significant risk of severe neutropenia/agranulocytosis. The
Clozapine REMS (Risk Evaluation and Mitigation Strategy) program mandates absolute
neutrophil count (ANC) monitoring.
11. Which class of antihypertensive is contraindicated in pregnancy due to the risk of fetal
injury?
A. Beta-blockers (e.g., Metoprolol)
B. ACE Inhibitors (e.g., Lisinopril)
C. Thiazide Diuretics (e.g., Hydrochlorothiazide)
D. Calcium Channel Blockers (e.g., Amlodipine)
Answer: B. ACE Inhibitors (e.g., Lisinopril)
Rationale: ACE inhibitors can cause fetal oligohydramnios, anuria, and hypoplastic lung
development, especially in the second and third trimesters.
12. The primary reason for administering allopurinol to a patient undergoing chemotherapy
for leukemia is to prevent:
A. Tumor Lysis Syndrome-induced hyperuricemia.
B. Chemotherapy-induced nausea and vomiting.
C. Hemorrhagic cystitis.
D. Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Answer: A. Tumor Lysis Syndrome-induced hyperuricemia.
– FULL CONCEPT REVIEW & PREPARATION
RESOURCE
Description (150 words):
The MSN 571 Midterm Exam Study Guide 2026 – Full Concept Review & Preparation Resource
is a structured academic support document designed to help graduate nursing students
strengthen their understanding of key advanced practice concepts emphasized throughout the
MSN 571 curriculum. This guide provides clear explanations and organized summaries of
essential topics such as pharmacotherapeutics, pathophysiology integration, diagnostic
reasoning, patient assessment, clinical decision-making, and evidence-based management of
common acute and chronic conditions. Learners will find focused coverage of core terminology,
conceptual frameworks, clinical guidelines, and practice-oriented principles to reinforce
understanding without supplying actual exam questions. The material is crafted to enhance
critical thinking, promote safe and effective clinical judgement, and support mastery of
foundational concepts needed for midterm preparation. With its concise layout and emphasis
on real-world application, this resource helps students refine their knowledge base and
approach the exam with greater confidence and clarity.
Keywords (10):
1. Pharmacotherapeutics
2. Diagnostic reasoning
3. Clinical assessment
4. Pathophysiology
5. Evidence-based practice
6. Advanced nursing concepts
7. Clinical guidelines
8. Patient management
9. Acute and chronic conditions
10. Clinical decision-making
MSN 571 Advanced Pharmacology: Comprehensive Practice Exam
,Instructions: For each question, choose the single best answer.
1. A patient with a history of heart failure is prescribed Furosemide. The nurse should monitor
for which electrolyte imbalance as a primary concern?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Hypocalcemia
Answer: C. Hypokalemia
Rationale: Loop diuretics like furosemide cause significant potassium wasting in the distal
tubule, making hypokalemia a common and dangerous adverse effect.
2. When initiating therapy with Lisinopril, an ACE inhibitor, it is essential to educate the
patient to immediately report which side effect?
A. Dry, persistent cough
B. Peripheral edema
C. Angioedema
D. Headache
Answer: C. Angioedema
Rationale: While a cough is common, angioedema (swelling of the face, lips, tongue, or throat)
is a rare but life-threatening adverse reaction that requires immediate medical attention.
3. A patient taking Metformin for Type 2 Diabetes is scheduled for a coronary angiogram using
IV contrast. The most appropriate action by the nurse is to:
A. Administer the Metformin as scheduled to maintain glycemic control.
B. Hold the Metformin the day of the procedure and for 48 hours after.
C. Double the Metformin dose the night before to prevent hyperglycemia.
D. Switch to sliding scale insulin only after the procedure.
Answer: B. Hold the Metformin the day of the procedure and for 48 hours after.
Rationale: IV contrast can impair renal function, increasing the risk of metformin-induced lactic
acidosis, a serious complication. Metformin should be withheld peri-procedure.
4. Which laboratory value is most critical to monitor for a patient on long-term, high-dose
Valproic acid therapy?
A. Serum Creatinine
B. Thyroid-Stimulating Hormone (TSH)
C. Alanine Aminotransferase (ALT)
D. International Normalized Ratio (INR)
Answer: C. Alanine Aminotransferase (ALT)
,Rationale: Valproic acid can cause hepatotoxicity. Regular monitoring of liver enzymes (like ALT)
is essential for early detection.
5. The therapeutic action of SSRI antidepressants like Sertraline is primarily to:
A. Block serotonin receptors in the prefrontal cortex.
B. Inhibit the reuptake of serotonin into the presynaptic neuron.
C. Increase the production of monoamine oxidase.
D. Enhance the degradation of norepinephrine.
Answer: B. Inhibit the reuptake of serotonin into the presynaptic neuron.
Rationale: SSRIs (Selective Serotonin Reuptake Inhibitors) work by blocking the serotonin
transporter, increasing serotonin levels in the synaptic cleft.
6. A patient receiving Vancomycin has a trough level drawn of 25 mcg/mL. The nurse
interprets this as:
A. Within the therapeutic range.
B. Subtherapeutic.
C. Supratherapeutic (toxic).
D. Irrelevant without a peak level.
Answer: C. Supratherapeutic (toxic).
*Rationale: For most infections, a vancomycin trough of 15-20 mcg/mL is targeted. A level of 25
mcg/mL increases the risk of nephrotoxicity and ototoxicity.*
7. Which medication is a direct thrombin inhibitor used as an alternative to warfarin for
stroke prevention in non-valvular atrial fibrillation?
A. Clopidogrel
B. Enoxaparin
C. Dabigatran
D. Aspirin
Answer: C. Dabigatran
Rationale: Dabigatran is a direct oral anticoagulant (DOAC) that directly inhibits thrombin
(Factor IIa).
8. The nurse administers Naloxone to a patient with suspected opioid overdose. Which
assessment finding indicates the medication is effective?
A. Heart rate decreases from 120 to 80 bpm.
B. Respiratory rate increases from 6 to 14 breaths per minute.
C. Blood pressure stabilizes at 80/40 mmHg.
D. Pupils remain pinpoint.
Answer: B. Respiratory rate increases from 6 to 14 breaths per minute.
, Rationale: Naloxone is an opioid antagonist that reverses life-threatening respiratory
depression, its primary intended effect.
9. When teaching a patient about taking Levothyroxine, the nurse should emphasize:
A. Take it at bedtime with a snack.
B. Take it on an empty stomach with a full glass of water.
C. Take it with orange juice to enhance absorption.
D. Take it with an antacid to prevent GI upset.
Answer: B. Take it on an empty stomach with a full glass of water.
*Rationale: Absorption of levothyroxine is decreased by food, calcium, iron, and antacids. It
should be taken on an empty stomach, 30-60 minutes before breakfast.*
10. A patient prescribed Clozapine must be enrolled in a national registry because of the risk
for which fatal adverse effect?
A. Hepatotoxicity
B. Agranulocytosis
C. Rhabdomyolysis
D. Torsades de Pointes
Answer: B. Agranulocytosis
Rationale: Clozapine carries a significant risk of severe neutropenia/agranulocytosis. The
Clozapine REMS (Risk Evaluation and Mitigation Strategy) program mandates absolute
neutrophil count (ANC) monitoring.
11. Which class of antihypertensive is contraindicated in pregnancy due to the risk of fetal
injury?
A. Beta-blockers (e.g., Metoprolol)
B. ACE Inhibitors (e.g., Lisinopril)
C. Thiazide Diuretics (e.g., Hydrochlorothiazide)
D. Calcium Channel Blockers (e.g., Amlodipine)
Answer: B. ACE Inhibitors (e.g., Lisinopril)
Rationale: ACE inhibitors can cause fetal oligohydramnios, anuria, and hypoplastic lung
development, especially in the second and third trimesters.
12. The primary reason for administering allopurinol to a patient undergoing chemotherapy
for leukemia is to prevent:
A. Tumor Lysis Syndrome-induced hyperuricemia.
B. Chemotherapy-induced nausea and vomiting.
C. Hemorrhagic cystitis.
D. Syndrome of Inappropriate Antidiuretic Hormone (SIADH).
Answer: A. Tumor Lysis Syndrome-induced hyperuricemia.
