NURS 676 MIDTERM EXAM 2026
SPRING WCU ACTUAL EXAM
QUESTION AND ANSWER
(SOLVED)
A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of
GERD. Why are H2RAS more effective than H1 receptor antagonists in the treatment of
diseases of the upper GI tract?
The parietal cells of the stomach have H2 receptors but not H1 receptors.
A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the
following will be a priority assessment by the nurse before the patient's first dose?
The amount of alcohol consumption
In light of her recent high blood pressure readings, a patient has been started on a thiazide
diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most
likely rationale for using two medications to address the patient's hypertension?
Using the two drugs to treat a health problem may create a synergistic effect.
A woman with numerous chronic health problems has been diagnosed with a benign gastric
ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points
should the nurse provide to this patient?
"Quitting smoking will significantly increase the chance that this drug will heal your ulcer."
The APRN should educate a diabetic patient that beta blockers may mask the signs and
symptoms of
hypoglycemia
A patient has been prescribed a drug that can be self-administered at home. Which of the
following would be the most important information for the nurse to relate to the patient
concerning self-administration of a drug?
, The therapeutic effects and possible adverse effects
Advanced practice nurse prescribing of scheduled medications is affected most by:
Combined state medical / pharmacy /nursing prescribing board regulations
The APRN is treating a patient with type 2 diabetes. The patient is on the maximum dose of
metformin and glucotrol. Current weight 212 pounds. Labs from this morning indicate a
fasting blood sugar of 312 and HBA1C of 9. The APRN wants to start the patient on Lantus 0.2
unit/kg. What dose and instructions should the APRN provide?
Give 19 units of Lantus subcutaneously prior to bedtime.
A 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse's
assessment reveals that the patient is being treated for rheumatoid arthritis and
hypertension. The patient lives in assisted living and is on a low- sodium diet. Before the
magnesium hydroxide therapy begins, it will be most important for the nurse to assess the
patient's
medication history.
A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit
she reports that since she has been on the drug, she can breathe better and her heart rate
has been around 74 beats per minute. nurse weighs the patient and notices that she has
gained 10 pounds since the digoxin therapy was started. The patient is concerned that the
additional weight will necessitate an increase in the medication. Which of the following is an
appropriate response by the nurse?
"No, the drug dosage will likely stay the same."
A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma.
Which of the following findings would alert the nurse to the need for close monitoring?
Need for additional bronchodilation
A patient has a history of tonic-clonic seizures that have been successfully treated with
phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
decreasing the influx of sodium into neurons.
A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis.
He has been prescribed theophylline by his family doctor. What effect will the patient's
smoking status have on the therapeutic use of theophylline?
SPRING WCU ACTUAL EXAM
QUESTION AND ANSWER
(SOLVED)
A patient has been prescribed a histamine-2 (H2) receptor antagonist for the treatment of
GERD. Why are H2RAS more effective than H1 receptor antagonists in the treatment of
diseases of the upper GI tract?
The parietal cells of the stomach have H2 receptors but not H1 receptors.
A 24-year-old factory worker has been prescribed guaifenesin for the first time. Which of the
following will be a priority assessment by the nurse before the patient's first dose?
The amount of alcohol consumption
In light of her recent high blood pressure readings, a patient has been started on a thiazide
diuretic and metoprolol (Lopressor), which is a beta-adrenergic blocker. What is the most
likely rationale for using two medications to address the patient's hypertension?
Using the two drugs to treat a health problem may create a synergistic effect.
A woman with numerous chronic health problems has been diagnosed with a benign gastric
ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points
should the nurse provide to this patient?
"Quitting smoking will significantly increase the chance that this drug will heal your ulcer."
The APRN should educate a diabetic patient that beta blockers may mask the signs and
symptoms of
hypoglycemia
A patient has been prescribed a drug that can be self-administered at home. Which of the
following would be the most important information for the nurse to relate to the patient
concerning self-administration of a drug?
, The therapeutic effects and possible adverse effects
Advanced practice nurse prescribing of scheduled medications is affected most by:
Combined state medical / pharmacy /nursing prescribing board regulations
The APRN is treating a patient with type 2 diabetes. The patient is on the maximum dose of
metformin and glucotrol. Current weight 212 pounds. Labs from this morning indicate a
fasting blood sugar of 312 and HBA1C of 9. The APRN wants to start the patient on Lantus 0.2
unit/kg. What dose and instructions should the APRN provide?
Give 19 units of Lantus subcutaneously prior to bedtime.
A 75-year-old woman is prescribed magnesium hydroxide for constipation. The nurse's
assessment reveals that the patient is being treated for rheumatoid arthritis and
hypertension. The patient lives in assisted living and is on a low- sodium diet. Before the
magnesium hydroxide therapy begins, it will be most important for the nurse to assess the
patient's
medication history.
A female patient is taking 0.125 mg of digoxin daily for heart failure. At a recent clinic visit
she reports that since she has been on the drug, she can breathe better and her heart rate
has been around 74 beats per minute. nurse weighs the patient and notices that she has
gained 10 pounds since the digoxin therapy was started. The patient is concerned that the
additional weight will necessitate an increase in the medication. Which of the following is an
appropriate response by the nurse?
"No, the drug dosage will likely stay the same."
A 72-year-old man is prescribed theophylline for symptomatic relief of bronchial asthma.
Which of the following findings would alert the nurse to the need for close monitoring?
Need for additional bronchodilation
A patient has a history of tonic-clonic seizures that have been successfully treated with
phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
decreasing the influx of sodium into neurons.
A man who smokes one pack of cigarettes daily has been diagnosed with chronic bronchitis.
He has been prescribed theophylline by his family doctor. What effect will the patient's
smoking status have on the therapeutic use of theophylline?
