NR293 Final Exam Actual Exam Style V2
NR293 Final Exam Actual Exam Style V2
1. A patient is prescribed an ACE inhibitor for hypertension. Which assessment finding is most
important for the nurse to report immediately?
A. A persistent dry cough
B. Swelling of the tongue and lips
C. A slightly elevated potassium level of 4.8 mEq/L
D. Occasional lightheadedness when standing
Correct Answer: B
Expert Explanation: Swelling of the tongue and lips indicates angioedema, which is a life-
threatening adverse effect of ACE inhibitors. This condition can lead to airway obstruction
and requires immediate medical intervention. While a dry cough and lightheadedness are
common side effects, they are not as critical as potential respiratory compromise.
2. A nurse is preparing to administer digoxin to a patient with heart failure. Which action
should the nurse take first?
A. Check the patient’s serum potassium level
B. Assess the apical pulse for one full minute
C. Administer the medication with a full glass of water
D. Review the most recent digoxin level
,Correct Answer: B
Expert Explanation: The primary nursing action before administering digoxin is to assess
the apical pulse for a full 60 seconds. If the pulse is below 60 beats per minute, the
medication should be withheld and the provider notified. This assessment ensures the
patient can safely tolerate the drug’s negative chronotropic effect.
3. A patient receiving vancomycin IV begins to develop flushing of the neck and upper body.
What should the nurse do first?
A. Stop the infusion immediately
B. Administer diphenhydramine as ordered
C. Notify the physician of a potential allergic reaction
D. Slow the rate of the infusion
Correct Answer: D
Expert Explanation: The symptoms described are consistent with Red Man Syndrome,
which is often caused by infusing vancomycin too rapidly. Slowing the infusion rate is the
standard intervention to manage this non-allergic histamine release. The nurse should also
monitor the patient’s blood pressure and document the reaction.
4. Which education should the nurse provide to a patient starting levothyroxine for
hypothyroidism?
A. Take the medication on an empty stomach 30-60 minutes before food
B. The medication will take 3 to 4 days to reach full effect
, C. Take the medication with breakfast every morning
D. Discontinue the medication once symptoms improve
Correct Answer: A
Expert Explanation: Levothyroxine must be taken on an empty stomach to ensure optimal
absorption in the gastrointestinal tract. Patients should wait at least 30 to 60 minutes
before eating or drinking anything other than water. This medication is typically lifelong
therapy and should not be stopped without medical supervision.
5. A patient is prescribed furosemide. Which lab value should the nurse monitor most
closely?
A. Sodium
B. Hemoglobin
C. Calcium
D. Potassium
Correct Answer: D
Expert Explanation: Furosemide is a loop diuretic that causes significant loss of potassium
through the urine. Hypokalemia is a dangerous side effect that can lead to cardiac
arrhythmias. The nurse must monitor electrolyte levels frequently to prevent
complications related to potassium depletion.
NR293 Final Exam Actual Exam Style V2
1. A patient is prescribed an ACE inhibitor for hypertension. Which assessment finding is most
important for the nurse to report immediately?
A. A persistent dry cough
B. Swelling of the tongue and lips
C. A slightly elevated potassium level of 4.8 mEq/L
D. Occasional lightheadedness when standing
Correct Answer: B
Expert Explanation: Swelling of the tongue and lips indicates angioedema, which is a life-
threatening adverse effect of ACE inhibitors. This condition can lead to airway obstruction
and requires immediate medical intervention. While a dry cough and lightheadedness are
common side effects, they are not as critical as potential respiratory compromise.
2. A nurse is preparing to administer digoxin to a patient with heart failure. Which action
should the nurse take first?
A. Check the patient’s serum potassium level
B. Assess the apical pulse for one full minute
C. Administer the medication with a full glass of water
D. Review the most recent digoxin level
,Correct Answer: B
Expert Explanation: The primary nursing action before administering digoxin is to assess
the apical pulse for a full 60 seconds. If the pulse is below 60 beats per minute, the
medication should be withheld and the provider notified. This assessment ensures the
patient can safely tolerate the drug’s negative chronotropic effect.
3. A patient receiving vancomycin IV begins to develop flushing of the neck and upper body.
What should the nurse do first?
A. Stop the infusion immediately
B. Administer diphenhydramine as ordered
C. Notify the physician of a potential allergic reaction
D. Slow the rate of the infusion
Correct Answer: D
Expert Explanation: The symptoms described are consistent with Red Man Syndrome,
which is often caused by infusing vancomycin too rapidly. Slowing the infusion rate is the
standard intervention to manage this non-allergic histamine release. The nurse should also
monitor the patient’s blood pressure and document the reaction.
4. Which education should the nurse provide to a patient starting levothyroxine for
hypothyroidism?
A. Take the medication on an empty stomach 30-60 minutes before food
B. The medication will take 3 to 4 days to reach full effect
, C. Take the medication with breakfast every morning
D. Discontinue the medication once symptoms improve
Correct Answer: A
Expert Explanation: Levothyroxine must be taken on an empty stomach to ensure optimal
absorption in the gastrointestinal tract. Patients should wait at least 30 to 60 minutes
before eating or drinking anything other than water. This medication is typically lifelong
therapy and should not be stopped without medical supervision.
5. A patient is prescribed furosemide. Which lab value should the nurse monitor most
closely?
A. Sodium
B. Hemoglobin
C. Calcium
D. Potassium
Correct Answer: D
Expert Explanation: Furosemide is a loop diuretic that causes significant loss of potassium
through the urine. Hypokalemia is a dangerous side effect that can lead to cardiac
arrhythmias. The nurse must monitor electrolyte levels frequently to prevent
complications related to potassium depletion.
