NURS 498 Midterm 2 Exam Questions with Correct Answers Latest Update 2026/2027
The nurse obtains the following information about a client before the administration of
metformin. Which of the following findings indicate a need to contact the health care provider
before giving the metformin? - Answers - The client's blood urea nitrogen (BUN) level is 21.4
mmol/L.
- The BUN indicates impending renal failure and metformin should not be used in clients with
renal or hepatic impairment.
The nurse should teach a patient taking an oral corticosteroid to take the medication at what
time? - Answers - 0800 hours
- Oral corticosteroids should be taken in the morning to minimize adrenal suppression
A client is being treated with a medication to block the effect of the antidiuretic hormone to
control the symptoms of the syndrome of inappropriate antidiuretic hormone (SIADH). Which of
the following findings indicates that the medication is effective? - Answers - Increased urinary
output
- Agents that block the effect of ADH on the renal tubules may be prescribed, allowing more
dilution of urine leading to increased urine output.
A client with systemic lupus erythematosus has a prescription for 2 weeks of high-dose
prednisone therapy. When teaching the client about prednisone, which of the following
information is most important for the nurse to include? - Answers - Do not stop taking the
prednisone suddenly; it should be decreased gradually.
- Acute adrenal insufficiency may occur if exogenous corticosteroids are suddenly stopped.
Which of the following information should the nurse include when teaching a client who has
type 2 diabetes about glyburide? - Answers - Glyburide stimulates insulin production and release
from the pancreas.
- The sulphonylureas stimulate the production and release of insulin from the pancreas.
The nurse is caring for a client with type 2 diabetes who has sensory neuropathy of the feet and
legs and peripheral arterial disease. Which of the following information will the nurse include in
client teaching? - Answers - Choose flat-soled leather shoes.
- The client is taught to avoid high heels and that leather shoes are preferred.
The nurse is caring for a client who had radical neck surgery and develops hypoparathyroidism.
Which of the following information should the nurse include in the teaching plan? - Answers -
Take calcium supplementation to normalize serum calcium levels.
- Oral calcium supplements are used to maintain the serum calcium in the normal range and
,prevent the complications of hypocalcemia.
A client with type 2 diabetes that is well-controlled with metformin develops an allergic rash to
an antibiotic and the health care provider prescribes prednisone. Which of the following
information should the nurse anticipate while the client is taking the prednisone? - Answers -
Administration of insulin
- Glucose levels increase when clients are taking corticosteroids, and insulin may be required to
control blood glucose.
Which of the following laboratory values, noted by the nurse when reviewing the chart of a
hospitalized client with diabetes, indicates the need for rapid assessment of the client? -
Answers - Noon blood glucose of 2.9 mmol/L
- The nurse should assess the client with a blood glucose level of 2.9 mmol/L for symptoms of
hypoglycemia as the normal range is 4-6 mmol/L.
A patient who has been receiving antipsychotic medication for 6 weeks tells the nurse that the
hallucinations are nearly gone and that concentration has improved. When the patient reports
flulike symptoms including a fever and a very sore throat, what is the priority nursing action?
a. Suggest that the patient take something for her fever and get extra rest
b. Consider recommending a change of antipsychotic medication
c. Arrange for the patient to have blood drawn for a white blood cell count
d. Advise the physician that the patient should be admitted to the hospital - Answers c. Arrange
for the patient to have blood drawn for a white blood cell count
The patient is preparing for discharge. The patient tells the nurse, "Dr. Jacobson is putting me
on some medication called naltrexone (ReVia). How will that help me?" Which response
indicates that medication teaching has been effective?
a. "It helps my mood so that I don't feel the need to do drugs."
b. "It keeps me from experiencing flashbacks."
c. "It is a sedative that will help me sleep at night."
d. "It helps reduce my cravings." - Answers d. "It helps reduce my cravings."
Which of the following is the most helpful message to transmit about relapse to the patient
recovering from alcohol abuse?
a. Relapses result from a lack of good situational support.
b. Relapses are an indicator of treatment failure
, c. Relapses are caused by physiological changes.
d. Relapses can be learning situations to prolong sobriety. - Answers a. Relapses result from
lack of good situational support.
An appropriate initial outcome for a patient recovering from substance abuse would be that the
patient will do which of the following?
a. Discuss the addiction with significant others
b. Contemplate a life abstaining from the substance of abuse
c. Demonstrate commitment to control the substance use
d. Substitute a less addicting drug for the present drug - Answers c. Demonstrate commitment
to control the substance use
Which of the following factors is the most important for the nurse to consider when planning
interventions? (Select all that apply.)
a. Readiness for change
b. Risk of relapse
c. Financial ability
d. Availability of support system - Answers a. Readiness for change
d. Availability of support system
An anorexic patient is admitted to the hospital with electrocardiogram changes, hypokalemia,
hyponatremia, and dental caries. What is the nurse's priority of care?
a. Administer intravenous potassium chloride
b. Stabilize the patient's weight
c. Interrupt the cycle of binge eating and purging
d. Assess suicidal ideation - Answers a. Administer intravenous potassium chloride
A patient diagnosed with obsessive-compulsive personality disorder takes the nurse aside and
mentions, "I've observed you interacting with that new patient. You are not approaching him
properly. You should be more forceful with him." Which of the following would be the best
response for the nurse?
a. "I will be continuing to follow the care plan for the patient."
b. "I see you are trying to control that patient's therapy as well as your own."
The nurse obtains the following information about a client before the administration of
metformin. Which of the following findings indicate a need to contact the health care provider
before giving the metformin? - Answers - The client's blood urea nitrogen (BUN) level is 21.4
mmol/L.
- The BUN indicates impending renal failure and metformin should not be used in clients with
renal or hepatic impairment.
The nurse should teach a patient taking an oral corticosteroid to take the medication at what
time? - Answers - 0800 hours
- Oral corticosteroids should be taken in the morning to minimize adrenal suppression
A client is being treated with a medication to block the effect of the antidiuretic hormone to
control the symptoms of the syndrome of inappropriate antidiuretic hormone (SIADH). Which of
the following findings indicates that the medication is effective? - Answers - Increased urinary
output
- Agents that block the effect of ADH on the renal tubules may be prescribed, allowing more
dilution of urine leading to increased urine output.
A client with systemic lupus erythematosus has a prescription for 2 weeks of high-dose
prednisone therapy. When teaching the client about prednisone, which of the following
information is most important for the nurse to include? - Answers - Do not stop taking the
prednisone suddenly; it should be decreased gradually.
- Acute adrenal insufficiency may occur if exogenous corticosteroids are suddenly stopped.
Which of the following information should the nurse include when teaching a client who has
type 2 diabetes about glyburide? - Answers - Glyburide stimulates insulin production and release
from the pancreas.
- The sulphonylureas stimulate the production and release of insulin from the pancreas.
The nurse is caring for a client with type 2 diabetes who has sensory neuropathy of the feet and
legs and peripheral arterial disease. Which of the following information will the nurse include in
client teaching? - Answers - Choose flat-soled leather shoes.
- The client is taught to avoid high heels and that leather shoes are preferred.
The nurse is caring for a client who had radical neck surgery and develops hypoparathyroidism.
Which of the following information should the nurse include in the teaching plan? - Answers -
Take calcium supplementation to normalize serum calcium levels.
- Oral calcium supplements are used to maintain the serum calcium in the normal range and
,prevent the complications of hypocalcemia.
A client with type 2 diabetes that is well-controlled with metformin develops an allergic rash to
an antibiotic and the health care provider prescribes prednisone. Which of the following
information should the nurse anticipate while the client is taking the prednisone? - Answers -
Administration of insulin
- Glucose levels increase when clients are taking corticosteroids, and insulin may be required to
control blood glucose.
Which of the following laboratory values, noted by the nurse when reviewing the chart of a
hospitalized client with diabetes, indicates the need for rapid assessment of the client? -
Answers - Noon blood glucose of 2.9 mmol/L
- The nurse should assess the client with a blood glucose level of 2.9 mmol/L for symptoms of
hypoglycemia as the normal range is 4-6 mmol/L.
A patient who has been receiving antipsychotic medication for 6 weeks tells the nurse that the
hallucinations are nearly gone and that concentration has improved. When the patient reports
flulike symptoms including a fever and a very sore throat, what is the priority nursing action?
a. Suggest that the patient take something for her fever and get extra rest
b. Consider recommending a change of antipsychotic medication
c. Arrange for the patient to have blood drawn for a white blood cell count
d. Advise the physician that the patient should be admitted to the hospital - Answers c. Arrange
for the patient to have blood drawn for a white blood cell count
The patient is preparing for discharge. The patient tells the nurse, "Dr. Jacobson is putting me
on some medication called naltrexone (ReVia). How will that help me?" Which response
indicates that medication teaching has been effective?
a. "It helps my mood so that I don't feel the need to do drugs."
b. "It keeps me from experiencing flashbacks."
c. "It is a sedative that will help me sleep at night."
d. "It helps reduce my cravings." - Answers d. "It helps reduce my cravings."
Which of the following is the most helpful message to transmit about relapse to the patient
recovering from alcohol abuse?
a. Relapses result from a lack of good situational support.
b. Relapses are an indicator of treatment failure
, c. Relapses are caused by physiological changes.
d. Relapses can be learning situations to prolong sobriety. - Answers a. Relapses result from
lack of good situational support.
An appropriate initial outcome for a patient recovering from substance abuse would be that the
patient will do which of the following?
a. Discuss the addiction with significant others
b. Contemplate a life abstaining from the substance of abuse
c. Demonstrate commitment to control the substance use
d. Substitute a less addicting drug for the present drug - Answers c. Demonstrate commitment
to control the substance use
Which of the following factors is the most important for the nurse to consider when planning
interventions? (Select all that apply.)
a. Readiness for change
b. Risk of relapse
c. Financial ability
d. Availability of support system - Answers a. Readiness for change
d. Availability of support system
An anorexic patient is admitted to the hospital with electrocardiogram changes, hypokalemia,
hyponatremia, and dental caries. What is the nurse's priority of care?
a. Administer intravenous potassium chloride
b. Stabilize the patient's weight
c. Interrupt the cycle of binge eating and purging
d. Assess suicidal ideation - Answers a. Administer intravenous potassium chloride
A patient diagnosed with obsessive-compulsive personality disorder takes the nurse aside and
mentions, "I've observed you interacting with that new patient. You are not approaching him
properly. You should be more forceful with him." Which of the following would be the best
response for the nurse?
a. "I will be continuing to follow the care plan for the patient."
b. "I see you are trying to control that patient's therapy as well as your own."
