Exam Questions |
20 Original NGN & ATI-Style Practice MCQs
with Rationales
Question 1
Clinical Scenario
A 58-year-old man with newly diagnosed hypertension is
prescribed lisinopril. His blood pressure is 168/96 mm Hg.
Laboratory results include potassium 4.3 mEq/L and
creatinine 1.0 mg/dL.
Question Stem
Which statement by the client indicates correct
understanding of medication teaching?
A. "I should avoid foods containing potassium substitutes."
B. "I should stop the medication if I develop a dry cough."
C. "I should take ibuprofen daily for headaches."
D. "I should expect my blood pressure to normalize
immediately."
Correct Answer
,A. "I should avoid foods containing potassium
substitutes."
Detailed Rationale
Lisinopril is an angiotensin-converting enzyme (ACE)
inhibitor that decreases angiotensin II and aldosterone
production, resulting in vasodilation and reduced sodium
retention. Reduced aldosterone can cause potassium
retention and increase the risk of hyperkalemia. Clients
should avoid potassium supplements and salt substitutes
containing potassium.
Option B is incorrect because a dry cough is a common
adverse effect of ACE inhibitors and should be reported to
the provider but not discontinued independently. Option C is
incorrect because NSAIDs may reduce antihypertensive
effectiveness and worsen renal function. Option D is
incorrect because therapeutic blood pressure reduction
may require several weeks.
Nurses should monitor blood pressure, serum potassium,
and renal function during therapy. Patients should also be
taught to change positions slowly due to orthostatic
hypotension.
Learning Objectives
, After completing this question, the learner should be able
to:
• Identify common adverse effects of ACE inhibitors.
• Recognize the risk of hyperkalemia.
• Teach patients about dietary precautions.
• Monitor renal function during therapy.
Medication Safety Focus
Patient education
Question 2
Clinical Scenario
A nurse prepares to administer digoxin to an 82-year-old
client with heart failure. Assessment findings include apical
pulse 54/min, potassium 3.1 mEq/L, and complaints of
nausea.
Question Stem
Which action should the nurse take first?
A. Administer the medication with food.
B. Hold digoxin and notify the provider.
C. Recheck blood pressure in 30 minutes.
D. Encourage increased fluid intake.