NUR 600 MODULE 3 EXAM – QUESTIONS AND ANSWERS |
UPDATE | 100% CORRECT
1.
A nonresponsive adult patient in ventricular fibrillation (VF) has already received multiple appropriate
defibrillation attempts and epinephrine 1 mg IV per ACLS protocol. The rhythm persists. Which
antiarrhythmic should the NP administer next to improve the likelihood of successful conversion?
A. Lidocaine
B. Procainamide
C. Amiodarone (Cordarone) ✅
D. Adenosine
Rationale:
In refractory VF/pulseless VT, amiodarone is the preferred antiarrhythmic per ACLS guidelines. It
stabilizes myocardial membranes and prolongs repolarization. Lidocaine is an alternative but not first-
line after epinephrine.
2.
A patient with chronic heart failure reports improvement after therapy adjustments. Which assessment
finding most strongly indicates improved cardiac function?
A. Increased appetite
B. Weight gain
C. Using fewer pillows to sleep ✅
D. Increased urine output
Rationale:
Needing fewer pillows suggests reduced orthopnea, a hallmark of improved left ventricular function and
decreased pulmonary congestion.
3.
Which medication is the most appropriate long-term anticoagulant for a patient with a mechanical
heart valve, given the high risk of thromboembolism?
A. Apixaban
B. Dabigatran
,C. Aspirin
D. Warfarin ✅
Rationale:
DOACs are contraindicated in mechanical valves. Warfarin remains the standard due to proven efficacy
in preventing valve thrombosis.
4.
A patient with untreated vitamin B₁₂ deficiency anemia is at risk for which complications?
A. Mild fatigue only
B. Cardiovascular collapse
C. Neurologic deficits, including irreversible nerve damage ✅
D. Hyperkalemia
Rationale:
Vitamin B₁₂ deficiency leads to demyelination → neuropathy, cognitive decline, and potentially
irreversible neurologic damage.
5.
Which medication is commonly prescribed as first-line therapy for hypertension, especially in patients
with diabetes or kidney disease?
A. Metoprolol
B. Amlodipine
C. Hydrochlorothiazide
D. Lisinopril ✅
Rationale:
ACE inhibitors like lisinopril provide renal protection and are first-line in many hypertensive patients.
6.
A patient using a transdermal nitroglycerin patch for angina should be monitored for which common
adverse effect?
A. Bradycardia
B. Hyperkalemia
, C. Headache ✅
D. Constipation
Rationale:
Nitroglycerin causes vasodilation, leading to headaches, the most common side effect.
7.
Which hematocrit value is within the normal range for an adult male?
A. 30%
B. 36%
C. 44% ✅
D. 52%
Rationale:
Normal male hematocrit ≈ 40–50%.
8.
In patients with chronic kidney disease receiving erythropoiesis-stimulating agents, what is the target
hemoglobin level?
A. 8 g/dL
B. 9 g/dL
C. 11 g/dL ✅
D. 14 g/dL
Rationale:
Target is ~10–11 g/dL to reduce cardiovascular risk; higher levels increase thrombosis risk.
9.
What is the initial pharmacologic intervention for a patient presenting with suspected acute coronary
syndrome (ACS)?
A. Nitroglycerin
B. Morphine
C. Oxygen
D. Aspirin ✅
UPDATE | 100% CORRECT
1.
A nonresponsive adult patient in ventricular fibrillation (VF) has already received multiple appropriate
defibrillation attempts and epinephrine 1 mg IV per ACLS protocol. The rhythm persists. Which
antiarrhythmic should the NP administer next to improve the likelihood of successful conversion?
A. Lidocaine
B. Procainamide
C. Amiodarone (Cordarone) ✅
D. Adenosine
Rationale:
In refractory VF/pulseless VT, amiodarone is the preferred antiarrhythmic per ACLS guidelines. It
stabilizes myocardial membranes and prolongs repolarization. Lidocaine is an alternative but not first-
line after epinephrine.
2.
A patient with chronic heart failure reports improvement after therapy adjustments. Which assessment
finding most strongly indicates improved cardiac function?
A. Increased appetite
B. Weight gain
C. Using fewer pillows to sleep ✅
D. Increased urine output
Rationale:
Needing fewer pillows suggests reduced orthopnea, a hallmark of improved left ventricular function and
decreased pulmonary congestion.
3.
Which medication is the most appropriate long-term anticoagulant for a patient with a mechanical
heart valve, given the high risk of thromboembolism?
A. Apixaban
B. Dabigatran
,C. Aspirin
D. Warfarin ✅
Rationale:
DOACs are contraindicated in mechanical valves. Warfarin remains the standard due to proven efficacy
in preventing valve thrombosis.
4.
A patient with untreated vitamin B₁₂ deficiency anemia is at risk for which complications?
A. Mild fatigue only
B. Cardiovascular collapse
C. Neurologic deficits, including irreversible nerve damage ✅
D. Hyperkalemia
Rationale:
Vitamin B₁₂ deficiency leads to demyelination → neuropathy, cognitive decline, and potentially
irreversible neurologic damage.
5.
Which medication is commonly prescribed as first-line therapy for hypertension, especially in patients
with diabetes or kidney disease?
A. Metoprolol
B. Amlodipine
C. Hydrochlorothiazide
D. Lisinopril ✅
Rationale:
ACE inhibitors like lisinopril provide renal protection and are first-line in many hypertensive patients.
6.
A patient using a transdermal nitroglycerin patch for angina should be monitored for which common
adverse effect?
A. Bradycardia
B. Hyperkalemia
, C. Headache ✅
D. Constipation
Rationale:
Nitroglycerin causes vasodilation, leading to headaches, the most common side effect.
7.
Which hematocrit value is within the normal range for an adult male?
A. 30%
B. 36%
C. 44% ✅
D. 52%
Rationale:
Normal male hematocrit ≈ 40–50%.
8.
In patients with chronic kidney disease receiving erythropoiesis-stimulating agents, what is the target
hemoglobin level?
A. 8 g/dL
B. 9 g/dL
C. 11 g/dL ✅
D. 14 g/dL
Rationale:
Target is ~10–11 g/dL to reduce cardiovascular risk; higher levels increase thrombosis risk.
9.
What is the initial pharmacologic intervention for a patient presenting with suspected acute coronary
syndrome (ACS)?
A. Nitroglycerin
B. Morphine
C. Oxygen
D. Aspirin ✅
