NU 578 Exam 4 Practice Questions and
Answers
1. A patient with chronic kidney disease is prescribed epoetin alfa. Which lab value
should the nurse monitor most closely to evaluate effectiveness?
A. Serum creatinine
B. Hemoglobin
C. Potassium
D. Blood urea nitrogen
Answer: B. Hemoglobin
2. A nurse is caring for a client with COPD who is receiving oxygen at 4 L/min via
nasal cannula. Which action is most appropriate?
A. Maintain oxygen at 4 L/min
B. Increase oxygen to 6 L/min if SpO₂ < 90%
C. Reduce oxygen flow to 2 L/min
D. Switch to non-rebreather mask
Answer: C. Reduce oxygen flow to 2 L/min
3. A client receiving digoxin reports nausea and blurred vision. Which lab value is
most concerning?
A. Potassium 3.0 mEq/L
B. Sodium 140 mEq/L
C. Calcium 9.5 mg/dL
D. Magnesium 2.0 mg/dL
Answer: A. Potassium 3.0 mEq/L
4. A nurse is prioritizing care for four clients. Which client should be assessed first?
A. Post-op patient with pain rated 8/10
B. Patient with new onset confusion and restlessness
C. Patient requesting assistance to ambulate
D. Patient with blood glucose of 150 mg/dL
Answer: B. Patient with new onset confusion and restlessness
5. A client with type 2 diabetes is prescribed metformin. Which teaching point is
most important?
A. Avoid alcohol while taking this medication
B. Take medication with meals to reduce GI upset
C. Report weight gain of 2 lbs in 24 hours
D. Monitor blood pressure daily
Answer: A. Avoid alcohol while taking this medication
6. A nurse is caring for a patient with heart failure prescribed furosemide. Which
finding requires immediate intervention?
A. Weight loss of 2 lbs in 24 hours
,B. Potassium 2.8 mEq/L
C. Urine output of 1,200 mL in 24 hours
D. Blood pressure 110/70 mmHg
Answer: B. Potassium 2.8 mEq/L
7. A client with asthma is prescribed albuterol. Which teaching is most important?
A. Use medication daily at bedtime
B. Rinse mouth after each use
C. Carry inhaler at all times
D. Take with food to reduce GI upset
Answer: C. Carry inhaler at all times
8. A nurse is preparing to administer insulin glargine. Which instruction is correct?
A. Mix with regular insulin before injection
B. Administer once daily at the same time
C. Hold if blood glucose is < 200 mg/dL
D. Give via IV infusion
Answer: B. Administer once daily at the same time
9. A patient with cirrhosis develops ascites. Which intervention is priority?
A. Encourage high-protein diet
B. Measure abdominal girth daily
C. Restrict sodium intake
D. Administer lactulose
Answer: C. Restrict sodium intake
10. A nurse is teaching a client about warfarin. Which food should be avoided?
A. Bananas
B. Spinach
C. Apples
D. Milk
Answer: B. Spinach
11. A client with pneumonia is receiving IV antibiotics. Which finding indicates
improvement?
A. Respiratory rate 28/min
B. SpO₂ 95% on room air
C. Productive cough with green sputum
D. Temperature 101°F
Answer: B. SpO₂ 95% on room air
12. A nurse is caring for a client with a chest tube. Which action is appropriate?
A. Clamp the tube during ambulation
B. Keep drainage system below chest level
C. Strip the tubing every 2 hours
D. Empty drainage into toilet
Answer: B. Keep drainage system below chest level
, 13. A client with diabetes reports sweating, tremors, and confusion. What is the
nurse’s first action?
A. Check blood glucose
B. Administer insulin
C. Provide orange juice
D. Notify provider
Answer: A. Check blood glucose
14. A nurse is caring for a client with a tracheostomy. Which action prevents
infection?
A. Suction every 2 hours routinely
B. Change ties daily using sterile technique
C. Keep inner cannula in place for 7 days
D. Avoid humidification
Answer: B. Change ties daily using sterile technique
15. A patient with hypertension is prescribed lisinopril. Which side effect should be
reported immediately?
A. Dry cough
B. Dizziness
C. Angioedema
D. Fatigue
Answer: C. Angioedema
16. A nurse is teaching about nitroglycerin. Which statement indicates
understanding?
A. “I will take it with meals.”
B. “I will stop if I get a headache.”
C. “I will sit down before taking it.”
D. “I will store it in the bathroom.”
Answer: C. “I will sit down before taking it.”
17. A client with tuberculosis is prescribed isoniazid. Which teaching is essential?
A. Avoid alcohol
B. Take with antacids
C. Limit fluid intake
D. Avoid dairy products
Answer: A. Avoid alcohol
18. A nurse is caring for a client with hypocalcemia. Which finding is expected?
A. Positive Chvostek’s sign
B. Bradycardia
C. Constipation
D. Hypotension
Answer: A. Positive Chvostek’s sign
19. A patient with a spinal cord injury develops sudden hypertension and
bradycardia. What is the priority action?
Answers
1. A patient with chronic kidney disease is prescribed epoetin alfa. Which lab value
should the nurse monitor most closely to evaluate effectiveness?
A. Serum creatinine
B. Hemoglobin
C. Potassium
D. Blood urea nitrogen
Answer: B. Hemoglobin
2. A nurse is caring for a client with COPD who is receiving oxygen at 4 L/min via
nasal cannula. Which action is most appropriate?
A. Maintain oxygen at 4 L/min
B. Increase oxygen to 6 L/min if SpO₂ < 90%
C. Reduce oxygen flow to 2 L/min
D. Switch to non-rebreather mask
Answer: C. Reduce oxygen flow to 2 L/min
3. A client receiving digoxin reports nausea and blurred vision. Which lab value is
most concerning?
A. Potassium 3.0 mEq/L
B. Sodium 140 mEq/L
C. Calcium 9.5 mg/dL
D. Magnesium 2.0 mg/dL
Answer: A. Potassium 3.0 mEq/L
4. A nurse is prioritizing care for four clients. Which client should be assessed first?
A. Post-op patient with pain rated 8/10
B. Patient with new onset confusion and restlessness
C. Patient requesting assistance to ambulate
D. Patient with blood glucose of 150 mg/dL
Answer: B. Patient with new onset confusion and restlessness
5. A client with type 2 diabetes is prescribed metformin. Which teaching point is
most important?
A. Avoid alcohol while taking this medication
B. Take medication with meals to reduce GI upset
C. Report weight gain of 2 lbs in 24 hours
D. Monitor blood pressure daily
Answer: A. Avoid alcohol while taking this medication
6. A nurse is caring for a patient with heart failure prescribed furosemide. Which
finding requires immediate intervention?
A. Weight loss of 2 lbs in 24 hours
,B. Potassium 2.8 mEq/L
C. Urine output of 1,200 mL in 24 hours
D. Blood pressure 110/70 mmHg
Answer: B. Potassium 2.8 mEq/L
7. A client with asthma is prescribed albuterol. Which teaching is most important?
A. Use medication daily at bedtime
B. Rinse mouth after each use
C. Carry inhaler at all times
D. Take with food to reduce GI upset
Answer: C. Carry inhaler at all times
8. A nurse is preparing to administer insulin glargine. Which instruction is correct?
A. Mix with regular insulin before injection
B. Administer once daily at the same time
C. Hold if blood glucose is < 200 mg/dL
D. Give via IV infusion
Answer: B. Administer once daily at the same time
9. A patient with cirrhosis develops ascites. Which intervention is priority?
A. Encourage high-protein diet
B. Measure abdominal girth daily
C. Restrict sodium intake
D. Administer lactulose
Answer: C. Restrict sodium intake
10. A nurse is teaching a client about warfarin. Which food should be avoided?
A. Bananas
B. Spinach
C. Apples
D. Milk
Answer: B. Spinach
11. A client with pneumonia is receiving IV antibiotics. Which finding indicates
improvement?
A. Respiratory rate 28/min
B. SpO₂ 95% on room air
C. Productive cough with green sputum
D. Temperature 101°F
Answer: B. SpO₂ 95% on room air
12. A nurse is caring for a client with a chest tube. Which action is appropriate?
A. Clamp the tube during ambulation
B. Keep drainage system below chest level
C. Strip the tubing every 2 hours
D. Empty drainage into toilet
Answer: B. Keep drainage system below chest level
, 13. A client with diabetes reports sweating, tremors, and confusion. What is the
nurse’s first action?
A. Check blood glucose
B. Administer insulin
C. Provide orange juice
D. Notify provider
Answer: A. Check blood glucose
14. A nurse is caring for a client with a tracheostomy. Which action prevents
infection?
A. Suction every 2 hours routinely
B. Change ties daily using sterile technique
C. Keep inner cannula in place for 7 days
D. Avoid humidification
Answer: B. Change ties daily using sterile technique
15. A patient with hypertension is prescribed lisinopril. Which side effect should be
reported immediately?
A. Dry cough
B. Dizziness
C. Angioedema
D. Fatigue
Answer: C. Angioedema
16. A nurse is teaching about nitroglycerin. Which statement indicates
understanding?
A. “I will take it with meals.”
B. “I will stop if I get a headache.”
C. “I will sit down before taking it.”
D. “I will store it in the bathroom.”
Answer: C. “I will sit down before taking it.”
17. A client with tuberculosis is prescribed isoniazid. Which teaching is essential?
A. Avoid alcohol
B. Take with antacids
C. Limit fluid intake
D. Avoid dairy products
Answer: A. Avoid alcohol
18. A nurse is caring for a client with hypocalcemia. Which finding is expected?
A. Positive Chvostek’s sign
B. Bradycardia
C. Constipation
D. Hypotension
Answer: A. Positive Chvostek’s sign
19. A patient with a spinal cord injury develops sudden hypertension and
bradycardia. What is the priority action?
