NR 545 Exam 3 COMPLETE QUESTIONS WITH 100% RATED CORRECT ANSWERS 100%
GUARANTEED PASS GET IT CORRECT!!2025 LATEST UPDATED
Question 1
A 68-year-old male with a history of atrial fibrillation is prescribed dabigatran (Pradaxa). Which
of the following is the most critical patient education point for this medication?
A) Take with food to prevent GI upset.
B) Avoid grapefruit juice.
C) Do not crush, chew, or open capsules.
D) Report any muscle pain immediately.
E) Take at bedtime for best efficacy.
Correct Answer: C) Do not crush, chew, or open capsules.
Rationale: Dabigatran's bioavailability is significantly altered if the capsules are opened,
crushed, or chewed, leading to increased absorption and potential for bleeding. This is a
critical safety instruction.
Question 2
Which of the following classes of antibiotics is associated with a risk of QTc prolongation and
should be used cautiously in patients with pre-existing cardiac arrhythmias?
A) Penicillins
B) Cephalosporins
C) Macrolides (e.g., azithromycin)
D) Tetracyclines
E) Aminoglycosides
Correct Answer: C) Macrolides (e.g., azithromycin)
Rationale: Macrolide antibiotics are known to prolong the QTc interval, increasing the risk of
Torsades de Pointes, especially in patients with other risk factors for arrhythmias or on other
QTc-prolonging drugs.
Question 3
A patient with Type 2 Diabetes Mellitus is prescribed metformin. Which of the following is a
potential serious adverse effect that requires immediate discontinuation of the drug and
medical evaluation?
A) Nausea and diarrhea.
B) Metallic taste in mouth.
C) Weight loss.
D) Lactic acidosis.
E) Vitamin B12 deficiency.
Correct Answer: D) Lactic acidosis.
Rationale: Lactic acidosis is a rare but life-threatening complication of metformin, particularly
,in patients with renal impairment, liver disease, or heart failure. Symptoms include muscle
pain, weakness, unusual sleepiness, and trouble breathing.
Question 4
Which of the following is a key monitoring parameter for a patient receiving spironolactone for
heart failure?
A) Serum glucose.
B) Serum potassium.
C) Liver enzymes.
D) Thyroid function tests.
E) International Normalized Ratio (INR).
Correct Answer: B) Serum potassium.
Rationale: Spironolactone is a potassium-sparing diuretic. While beneficial in heart failure, it
can cause hyperkalemia (elevated potassium levels), which can be dangerous and lead to
cardiac arrhythmias. Regular potassium monitoring is essential.
Question 5
A 55-year-old male is diagnosed with Helicobacter pylori infection. The standard treatment
regimen often includes:
A) A single antibiotic (e.g., amoxicillin).
B) A proton pump inhibitor (PPI) alone.
C) Dual therapy with two antibiotics.
D) Triple therapy with a PPI and two antibiotics.
E) Triple therapy with an H2 blocker and two antibiotics.
Correct Answer: D) Triple therapy with a PPI and two antibiotics.
Rationale: Standard eradication regimens for H. pylori typically involve triple therapy,
combining a proton pump inhibitor (PPI) with two antibiotics (e.g., amoxicillin and
clarithromycin, or metronidazole and clarithromycin) for 10-14 days.
Question 6
Which of the following is a contraindication for the use of nonsteroidal anti-inflammatory drugs
(NSAIDs) like ibuprofen?
A) Mild headache.
B) Osteoarthritis.
C) History of peptic ulcer disease.
D) Muscle sprain.
E) Fever.
Correct Answer: C) History of peptic ulcer disease.
Rationale: NSAIDs can cause gastrointestinal irritation and bleeding, and their use is
, contraindicated or requires extreme caution in patients with a history of peptic ulcer disease
due to the increased risk of ulcer recurrence or GI hemorrhage.
Question 7
A patient on warfarin therapy for deep vein thrombosis (DVT) needs dental surgery. What is the
most appropriate action regarding their anticoagulant therapy?
A) Discontinue warfarin 24 hours before surgery.
B) Double the warfarin dose the day before surgery.
C) Bridge with unfractionated heparin or low molecular weight heparin (LMWH) per protocol.
D) Advise the patient to take aspirin instead of warfarin.
E) Continue warfarin as usual, as dental procedures are low risk.
Correct Answer: C) Bridge with unfractionated heparin or low molecular weight heparin
(LMWH) per protocol.
Rationale: For procedures with a high bleeding risk, warfarin often needs to be interrupted. To
prevent thrombotic events during this interruption, patients are often "bridged" with a
shorter-acting anticoagulant like LMWH, which can be stopped closer to the procedure time.
Question 8
Which class of antihypertensive medications is generally contraindicated in pregnancy due to
the risk of fetal harm?
A) Beta-blockers.
B) Calcium channel blockers.
C) ACE inhibitors (e.g., lisinopril).
D) Thiazide diuretics.
E) Alpha-blockers.
Correct Answer: C) ACE inhibitors (e.g., lisinopril).
Rationale: ACE inhibitors and ARBs (Angiotensin Receptor Blockers) are contraindicated in the
second and third trimesters of pregnancy due to the risk of severe fetal renal damage and
oligohydramnios.
Question 9
A patient with an acute gout flare is prescribed colchicine. What is a common and important
adverse effect to educate the patient about?
A) Headache.
B) Rash.
C) Diarrhea.
D) Insomnia.
E) Peripheral neuropathy.
Correct Answer: C) Diarrhea.
GUARANTEED PASS GET IT CORRECT!!2025 LATEST UPDATED
Question 1
A 68-year-old male with a history of atrial fibrillation is prescribed dabigatran (Pradaxa). Which
of the following is the most critical patient education point for this medication?
A) Take with food to prevent GI upset.
B) Avoid grapefruit juice.
C) Do not crush, chew, or open capsules.
D) Report any muscle pain immediately.
E) Take at bedtime for best efficacy.
Correct Answer: C) Do not crush, chew, or open capsules.
Rationale: Dabigatran's bioavailability is significantly altered if the capsules are opened,
crushed, or chewed, leading to increased absorption and potential for bleeding. This is a
critical safety instruction.
Question 2
Which of the following classes of antibiotics is associated with a risk of QTc prolongation and
should be used cautiously in patients with pre-existing cardiac arrhythmias?
A) Penicillins
B) Cephalosporins
C) Macrolides (e.g., azithromycin)
D) Tetracyclines
E) Aminoglycosides
Correct Answer: C) Macrolides (e.g., azithromycin)
Rationale: Macrolide antibiotics are known to prolong the QTc interval, increasing the risk of
Torsades de Pointes, especially in patients with other risk factors for arrhythmias or on other
QTc-prolonging drugs.
Question 3
A patient with Type 2 Diabetes Mellitus is prescribed metformin. Which of the following is a
potential serious adverse effect that requires immediate discontinuation of the drug and
medical evaluation?
A) Nausea and diarrhea.
B) Metallic taste in mouth.
C) Weight loss.
D) Lactic acidosis.
E) Vitamin B12 deficiency.
Correct Answer: D) Lactic acidosis.
Rationale: Lactic acidosis is a rare but life-threatening complication of metformin, particularly
,in patients with renal impairment, liver disease, or heart failure. Symptoms include muscle
pain, weakness, unusual sleepiness, and trouble breathing.
Question 4
Which of the following is a key monitoring parameter for a patient receiving spironolactone for
heart failure?
A) Serum glucose.
B) Serum potassium.
C) Liver enzymes.
D) Thyroid function tests.
E) International Normalized Ratio (INR).
Correct Answer: B) Serum potassium.
Rationale: Spironolactone is a potassium-sparing diuretic. While beneficial in heart failure, it
can cause hyperkalemia (elevated potassium levels), which can be dangerous and lead to
cardiac arrhythmias. Regular potassium monitoring is essential.
Question 5
A 55-year-old male is diagnosed with Helicobacter pylori infection. The standard treatment
regimen often includes:
A) A single antibiotic (e.g., amoxicillin).
B) A proton pump inhibitor (PPI) alone.
C) Dual therapy with two antibiotics.
D) Triple therapy with a PPI and two antibiotics.
E) Triple therapy with an H2 blocker and two antibiotics.
Correct Answer: D) Triple therapy with a PPI and two antibiotics.
Rationale: Standard eradication regimens for H. pylori typically involve triple therapy,
combining a proton pump inhibitor (PPI) with two antibiotics (e.g., amoxicillin and
clarithromycin, or metronidazole and clarithromycin) for 10-14 days.
Question 6
Which of the following is a contraindication for the use of nonsteroidal anti-inflammatory drugs
(NSAIDs) like ibuprofen?
A) Mild headache.
B) Osteoarthritis.
C) History of peptic ulcer disease.
D) Muscle sprain.
E) Fever.
Correct Answer: C) History of peptic ulcer disease.
Rationale: NSAIDs can cause gastrointestinal irritation and bleeding, and their use is
, contraindicated or requires extreme caution in patients with a history of peptic ulcer disease
due to the increased risk of ulcer recurrence or GI hemorrhage.
Question 7
A patient on warfarin therapy for deep vein thrombosis (DVT) needs dental surgery. What is the
most appropriate action regarding their anticoagulant therapy?
A) Discontinue warfarin 24 hours before surgery.
B) Double the warfarin dose the day before surgery.
C) Bridge with unfractionated heparin or low molecular weight heparin (LMWH) per protocol.
D) Advise the patient to take aspirin instead of warfarin.
E) Continue warfarin as usual, as dental procedures are low risk.
Correct Answer: C) Bridge with unfractionated heparin or low molecular weight heparin
(LMWH) per protocol.
Rationale: For procedures with a high bleeding risk, warfarin often needs to be interrupted. To
prevent thrombotic events during this interruption, patients are often "bridged" with a
shorter-acting anticoagulant like LMWH, which can be stopped closer to the procedure time.
Question 8
Which class of antihypertensive medications is generally contraindicated in pregnancy due to
the risk of fetal harm?
A) Beta-blockers.
B) Calcium channel blockers.
C) ACE inhibitors (e.g., lisinopril).
D) Thiazide diuretics.
E) Alpha-blockers.
Correct Answer: C) ACE inhibitors (e.g., lisinopril).
Rationale: ACE inhibitors and ARBs (Angiotensin Receptor Blockers) are contraindicated in the
second and third trimesters of pregnancy due to the risk of severe fetal renal damage and
oligohydramnios.
Question 9
A patient with an acute gout flare is prescribed colchicine. What is a common and important
adverse effect to educate the patient about?
A) Headache.
B) Rash.
C) Diarrhea.
D) Insomnia.
E) Peripheral neuropathy.
Correct Answer: C) Diarrhea.
