NUR 226 Practice Exam Questions and
Correct Answers
Nitrate isosorbide dinitrate (isordil) px to a client with angina. Pt instruction during d/c
teaching? ✅- do not get up quickly, rise slowly
- nitrates can cause orthostatic hypotension
Vomiting pathophysiological response ✅- spasmodic reflex of resp and gastric
movements results from the stimulation of the chemoreceptor trigger zone
Assessment for a client with a tension pneumothorax ✅- deviation of the trachea
toward the side opposite the pneumothorax
Which indicates that the client has siadh ✅-weight gain
- low serum sodium
Which type of lung cancer is a pt who has never smoked but has had copd for 5 years
✅- adenocarcinoma
Client has myxedema (deficiency of thyroid hormone synthesis). Which med is
contraindicated in this client ✅- pentobarbital sodium for sleep
- persons with myxedema hypersensitive to narcotics, barbirates (pentobarbital) and
anesthetics
Client admitted to coronary care unit with dx of acute mi. Which med decreases both
preload and afterload? ✅- nitroglycerin
Nitrates cause ✅- peripheral vasodilation and decreases contractility
- decreases both preload and afterload
Client taking naproxen 2x daily to treat osteoarthritis. Drug not working after 3 weeks.
Nurses best response ✅- another type of nsaid may be indicated
Dosing schedule for nurse to teach a client to observe for a controlled release
oxycodone prescription ✅- q 12 hours
- controlled release provide long acting analgesia to relieve moderate to severe pain
Side effect that is most likely to persist during long term opioid use ✅- constipation
Method of med admin that provides greatest first pass effect ✅- oral
,Hcp px narcan (naloxone) to a client in the er. Which assessment data indicates
naloxone has been effective/ ✅rr is 16 bpm
Instruction to give to a female receiving prescript for oral metranidazole (flagyl) ✅-
increase fluid intake (cranberry juice)
- avoid drinking alcohol while taking this med
- use condoms until treatment is completed
- ensure all sexual partners are treated at the same time
Nurse is preparing 0900 dose of losartan (cozaar)[arb] for a client with htn and hf. Lab
result show serum k+ level of 5.9. Which action should the nurse take first ✅- withhold
the scheduled dose
Angiotensin ii receptor blockers (arbs) meds ✅- losartan (cozaar)
- valsartan (diovan)
Hyperkalemia and arbs ✅- hyperkalemia can happen from the use of hf medications
including arbs
- hyperkalemia can lead to cardiac dysrrhythmia.
-
Angiotensin ii receptor antagonist (arb) - valsartan (diovam) is effective when what is
achieved ✅- blood pressure reduced from 160-90 to 130/80
Why are angiotensin receptor blockers like valsartan or losartan prescribed
✅treatment of htn
Adverse effects associated with thyroid hormone toxicity? ✅- tachycardia and chest
pain
Female client with arthritis takes ibuprofen po 4x days. To prevent gi bleeding she is px
misoprostol (cytotec) po. Which information is imp for the nurse to include during client
teaching ✅- use contraceptives during intercourse
Misoprostol (cytotec) ✅- pregnancy category x
- synthetic form of a prostaglanding
- abortifacient
The purpose of antacid (maaloz) is to ✅- maintain gastric ph of 3.5 or above
Client receiving albuterol (proventil) tablets complaints of nausea every evening with her
does. What action can the nurse take to alleviate this side effect? ✅- administer the
dose with a snack
- administering oral doses with food helps minimize gi discomfort
,Client receiving digoxin for the onset of supraventricular tachycardia (svt). Which lab
findings should the nurse identify that places this client at risk ✅- hypokalemia
Hypokalemia effects ✅- affects myocardial contractility
- places pt at risk for cardiac dysrhythmia that can be unresponsive to drug therapy
Client with hyperlipidemia receives prescription for niacin (niaspan). Which teaching is
most imp for rn to provide? ✅- expected duration of flushing
Niacin side effects ✅- flushing of the face and neck lasting up to an hour
- frequent reason for d/c niacin
- inclusion of this effect in teaching may promote compliance in taking the med
Which med should the nurse caution the client about taking while receiving an opioid
analgesic ✅- benzodiasepine
Respiratory depression can be cause by ✅- opioid analgesic
- other central nervous system depressant agents (alcohol, barbiturates and
benzodiazepine)
Which symptoms are serious effects of beta adrenergic blockers such as propranolol
(inderal) ✅- wheezing
- hypotension
- av block
Client ask nurse if glipizide (glucotrol) is an oral insulin. Which response should the
nurse provide? ✅- no it is not oral insulin
- can be used only when beta cell function is present
Glipizide (glucotrol) action ✅oral hypoglycemic agent that enhances pancreatic
production of insulin
Client taking levodopa to control symptoms of parkinsons disease has a new
prescription for levodopa/carbidopa (sinemet). Client took levodopa at 0800. Which
instruction should the nurse include in the teaching plan for the client ✅- take sinemet
this evening
- do not take any more levodopa
Client with osteoarthritis receives new prescription for celexib (celebrex) orally for
symptom management. Nurse notes that the client is allergic to sulfa. Which action is
most important for rn to implement prior to administering the first dose? ✅- notify the
hcp
Celecoxib (celebrex) and allergic rxn ✅- celebrex contains sulfur molecules
, - can lead to allergic rxn to pt sensitive to sulfonamides
Client given a prescription for scopolamine patch (transderm scop) to prevent motion
sickness while on acruise. Which info should the rn provide? ✅- apply patch at least 4
hours prior to departure
Scopolamine drug card ✅- anticholinergic agent
- peak onset in 6 hours
- duration 72 hours
- blocks muscarinic receptors in the inner ear and to the vomiting center
- area of application behind the ear
When assessing an adolescent who recently overdosed on acetaminophen (tylenol). It
is most important for the nurse to assess for pain in which area of the body? ✅-
abdomen
Which client should the rn identify as being at highest risk for complication during the
use of an opioid analgesic> ✅- young adult with ibs (inflammatory bowel disease)
Postop client has been receiving iv infusion of meperidine (demerol) 35 mg/hour for 4
days. Client has prx for demerol 100 mg po q3h. Rn notes that ppt has become
increasingly restless, irritable and confused stating that there are bugs all over the walls.
What action should the rn take first? ✅- decrease iv infusion rate of the meripidine
(demerol) per protocol
Dobutamine (dobutrex) is an emergency drug most commonly prx for client with which
condition ✅- hf
Dobutamine action ✅- beta adrenergic agonist
- indicated for short term use in cardiac decompensation or hf
Which drug is used as a palliative treatment for a client with tumor induced spinal cord
compression ✅- dexamethasone (decadron)
Dexamethasone action ✅- manages symtoms related to compression d/t tumor growth
Adult client with acute status asthmaticus in the er. In which order should the nurse
administer the prescribed medication ✅1. Albuterol
2. Salmeterold (serevent diskus)
3. Prednisone (deltasone) orally
4. Gentamicin (garamycin) im
Client dx with prescription for warfarin (coumadin). Diagnostic test monitored regularly?
✅- pt
- inr
Correct Answers
Nitrate isosorbide dinitrate (isordil) px to a client with angina. Pt instruction during d/c
teaching? ✅- do not get up quickly, rise slowly
- nitrates can cause orthostatic hypotension
Vomiting pathophysiological response ✅- spasmodic reflex of resp and gastric
movements results from the stimulation of the chemoreceptor trigger zone
Assessment for a client with a tension pneumothorax ✅- deviation of the trachea
toward the side opposite the pneumothorax
Which indicates that the client has siadh ✅-weight gain
- low serum sodium
Which type of lung cancer is a pt who has never smoked but has had copd for 5 years
✅- adenocarcinoma
Client has myxedema (deficiency of thyroid hormone synthesis). Which med is
contraindicated in this client ✅- pentobarbital sodium for sleep
- persons with myxedema hypersensitive to narcotics, barbirates (pentobarbital) and
anesthetics
Client admitted to coronary care unit with dx of acute mi. Which med decreases both
preload and afterload? ✅- nitroglycerin
Nitrates cause ✅- peripheral vasodilation and decreases contractility
- decreases both preload and afterload
Client taking naproxen 2x daily to treat osteoarthritis. Drug not working after 3 weeks.
Nurses best response ✅- another type of nsaid may be indicated
Dosing schedule for nurse to teach a client to observe for a controlled release
oxycodone prescription ✅- q 12 hours
- controlled release provide long acting analgesia to relieve moderate to severe pain
Side effect that is most likely to persist during long term opioid use ✅- constipation
Method of med admin that provides greatest first pass effect ✅- oral
,Hcp px narcan (naloxone) to a client in the er. Which assessment data indicates
naloxone has been effective/ ✅rr is 16 bpm
Instruction to give to a female receiving prescript for oral metranidazole (flagyl) ✅-
increase fluid intake (cranberry juice)
- avoid drinking alcohol while taking this med
- use condoms until treatment is completed
- ensure all sexual partners are treated at the same time
Nurse is preparing 0900 dose of losartan (cozaar)[arb] for a client with htn and hf. Lab
result show serum k+ level of 5.9. Which action should the nurse take first ✅- withhold
the scheduled dose
Angiotensin ii receptor blockers (arbs) meds ✅- losartan (cozaar)
- valsartan (diovan)
Hyperkalemia and arbs ✅- hyperkalemia can happen from the use of hf medications
including arbs
- hyperkalemia can lead to cardiac dysrrhythmia.
-
Angiotensin ii receptor antagonist (arb) - valsartan (diovam) is effective when what is
achieved ✅- blood pressure reduced from 160-90 to 130/80
Why are angiotensin receptor blockers like valsartan or losartan prescribed
✅treatment of htn
Adverse effects associated with thyroid hormone toxicity? ✅- tachycardia and chest
pain
Female client with arthritis takes ibuprofen po 4x days. To prevent gi bleeding she is px
misoprostol (cytotec) po. Which information is imp for the nurse to include during client
teaching ✅- use contraceptives during intercourse
Misoprostol (cytotec) ✅- pregnancy category x
- synthetic form of a prostaglanding
- abortifacient
The purpose of antacid (maaloz) is to ✅- maintain gastric ph of 3.5 or above
Client receiving albuterol (proventil) tablets complaints of nausea every evening with her
does. What action can the nurse take to alleviate this side effect? ✅- administer the
dose with a snack
- administering oral doses with food helps minimize gi discomfort
,Client receiving digoxin for the onset of supraventricular tachycardia (svt). Which lab
findings should the nurse identify that places this client at risk ✅- hypokalemia
Hypokalemia effects ✅- affects myocardial contractility
- places pt at risk for cardiac dysrhythmia that can be unresponsive to drug therapy
Client with hyperlipidemia receives prescription for niacin (niaspan). Which teaching is
most imp for rn to provide? ✅- expected duration of flushing
Niacin side effects ✅- flushing of the face and neck lasting up to an hour
- frequent reason for d/c niacin
- inclusion of this effect in teaching may promote compliance in taking the med
Which med should the nurse caution the client about taking while receiving an opioid
analgesic ✅- benzodiasepine
Respiratory depression can be cause by ✅- opioid analgesic
- other central nervous system depressant agents (alcohol, barbiturates and
benzodiazepine)
Which symptoms are serious effects of beta adrenergic blockers such as propranolol
(inderal) ✅- wheezing
- hypotension
- av block
Client ask nurse if glipizide (glucotrol) is an oral insulin. Which response should the
nurse provide? ✅- no it is not oral insulin
- can be used only when beta cell function is present
Glipizide (glucotrol) action ✅oral hypoglycemic agent that enhances pancreatic
production of insulin
Client taking levodopa to control symptoms of parkinsons disease has a new
prescription for levodopa/carbidopa (sinemet). Client took levodopa at 0800. Which
instruction should the nurse include in the teaching plan for the client ✅- take sinemet
this evening
- do not take any more levodopa
Client with osteoarthritis receives new prescription for celexib (celebrex) orally for
symptom management. Nurse notes that the client is allergic to sulfa. Which action is
most important for rn to implement prior to administering the first dose? ✅- notify the
hcp
Celecoxib (celebrex) and allergic rxn ✅- celebrex contains sulfur molecules
, - can lead to allergic rxn to pt sensitive to sulfonamides
Client given a prescription for scopolamine patch (transderm scop) to prevent motion
sickness while on acruise. Which info should the rn provide? ✅- apply patch at least 4
hours prior to departure
Scopolamine drug card ✅- anticholinergic agent
- peak onset in 6 hours
- duration 72 hours
- blocks muscarinic receptors in the inner ear and to the vomiting center
- area of application behind the ear
When assessing an adolescent who recently overdosed on acetaminophen (tylenol). It
is most important for the nurse to assess for pain in which area of the body? ✅-
abdomen
Which client should the rn identify as being at highest risk for complication during the
use of an opioid analgesic> ✅- young adult with ibs (inflammatory bowel disease)
Postop client has been receiving iv infusion of meperidine (demerol) 35 mg/hour for 4
days. Client has prx for demerol 100 mg po q3h. Rn notes that ppt has become
increasingly restless, irritable and confused stating that there are bugs all over the walls.
What action should the rn take first? ✅- decrease iv infusion rate of the meripidine
(demerol) per protocol
Dobutamine (dobutrex) is an emergency drug most commonly prx for client with which
condition ✅- hf
Dobutamine action ✅- beta adrenergic agonist
- indicated for short term use in cardiac decompensation or hf
Which drug is used as a palliative treatment for a client with tumor induced spinal cord
compression ✅- dexamethasone (decadron)
Dexamethasone action ✅- manages symtoms related to compression d/t tumor growth
Adult client with acute status asthmaticus in the er. In which order should the nurse
administer the prescribed medication ✅1. Albuterol
2. Salmeterold (serevent diskus)
3. Prednisone (deltasone) orally
4. Gentamicin (garamycin) im
Client dx with prescription for warfarin (coumadin). Diagnostic test monitored regularly?
✅- pt
- inr
