NR293 Final Exam Actual Exam Style V3
NR293 Final Exam Actual Exam Style V3
1. A patient is receiving intravenous vancomycin for a severe MRSA infection. Which
assessment finding should the nurse prioritize and report immediately to the provider?
A. A red, itchy rash on the face and neck
B. Occasional nausea during the infusion
C. Patient complaint of a metallic taste
D. Increasing serum creatinine levels
Correct Answer: D
Expert Explanation: Vancomycin is a glycopeptide antibiotic that carries a significant risk
of nephrotoxicity. While ‘Red Man Syndrome’ (Option A) is a known infusion reaction, an
increasing serum creatinine indicates potential renal failure which is a more critical
complication. The nurse must monitor renal function tests and trough levels closely to
ensure safe administration.
2. A client is prescribed digoxin for heart failure. Which clinical manifestation most strongly
suggests that the patient is experiencing digoxin toxicity?
A. Heart rate of 82 beats per minute
B. Visual disturbances such as yellow-green halos
,C. Increased urine output
D. Sudden onset of hypertension
Correct Answer: B
Expert Explanation: Visual changes, specifically yellow, green, or white halos around
lights, are classic signs of digoxin toxicity. Other signs include bradycardia, anorexia, and
nausea. The nurse should check the apical pulse for one full minute and hold the
medication if the heart rate is below 60 before notifying the physician.
3. The nurse is preparing to administer lispro insulin to a patient with Type 1 Diabetes. When
is the most appropriate time for the nurse to administer this medication?
A. 15 minutes before the meal tray arrives
B. Immediately after the patient finishes eating
C. 30 to 60 minutes before the meal
D. At bedtime with a small snack
Correct Answer: A
Expert Explanation: Lispro is a rapid-acting insulin with an onset of action between 15 to
30 minutes. It must be administered when the meal is available to prevent profound
hypoglycemia. Proper timing ensures that the insulin peak coincides with the postprandial
glucose peak.
, 4. A patient who has been taking prednisone for several weeks for an autoimmune flare-up is
being discharged. What is the most important instruction for the nurse to provide regarding
this medication?
A. Do not stop taking this medication abruptly
B. Take the medication on an empty stomach for better absorption
C. Avoid all forms of exercise while taking this drug
D. Stop the medication immediately if you develop a fever
Correct Answer: A
Expert Explanation: Long-term use of corticosteroids like prednisone suppresses the
adrenal glands’ natural production of cortisol. Abrupt withdrawal can lead to a life-
threatening adrenal crisis. Patients must be taught to taper the dose gradually under
medical supervision.
5. A patient is starting therapy with an ACE inhibitor for hypertension. Which side effect is
most common and may require switching the patient to an ARB?
A. Significant weight gain
B. Persistent dry cough
C. Permanent hearing loss
D. Orange discoloration of urine
Correct Answer: B
NR293 Final Exam Actual Exam Style V3
1. A patient is receiving intravenous vancomycin for a severe MRSA infection. Which
assessment finding should the nurse prioritize and report immediately to the provider?
A. A red, itchy rash on the face and neck
B. Occasional nausea during the infusion
C. Patient complaint of a metallic taste
D. Increasing serum creatinine levels
Correct Answer: D
Expert Explanation: Vancomycin is a glycopeptide antibiotic that carries a significant risk
of nephrotoxicity. While ‘Red Man Syndrome’ (Option A) is a known infusion reaction, an
increasing serum creatinine indicates potential renal failure which is a more critical
complication. The nurse must monitor renal function tests and trough levels closely to
ensure safe administration.
2. A client is prescribed digoxin for heart failure. Which clinical manifestation most strongly
suggests that the patient is experiencing digoxin toxicity?
A. Heart rate of 82 beats per minute
B. Visual disturbances such as yellow-green halos
,C. Increased urine output
D. Sudden onset of hypertension
Correct Answer: B
Expert Explanation: Visual changes, specifically yellow, green, or white halos around
lights, are classic signs of digoxin toxicity. Other signs include bradycardia, anorexia, and
nausea. The nurse should check the apical pulse for one full minute and hold the
medication if the heart rate is below 60 before notifying the physician.
3. The nurse is preparing to administer lispro insulin to a patient with Type 1 Diabetes. When
is the most appropriate time for the nurse to administer this medication?
A. 15 minutes before the meal tray arrives
B. Immediately after the patient finishes eating
C. 30 to 60 minutes before the meal
D. At bedtime with a small snack
Correct Answer: A
Expert Explanation: Lispro is a rapid-acting insulin with an onset of action between 15 to
30 minutes. It must be administered when the meal is available to prevent profound
hypoglycemia. Proper timing ensures that the insulin peak coincides with the postprandial
glucose peak.
, 4. A patient who has been taking prednisone for several weeks for an autoimmune flare-up is
being discharged. What is the most important instruction for the nurse to provide regarding
this medication?
A. Do not stop taking this medication abruptly
B. Take the medication on an empty stomach for better absorption
C. Avoid all forms of exercise while taking this drug
D. Stop the medication immediately if you develop a fever
Correct Answer: A
Expert Explanation: Long-term use of corticosteroids like prednisone suppresses the
adrenal glands’ natural production of cortisol. Abrupt withdrawal can lead to a life-
threatening adrenal crisis. Patients must be taught to taper the dose gradually under
medical supervision.
5. A patient is starting therapy with an ACE inhibitor for hypertension. Which side effect is
most common and may require switching the patient to an ARB?
A. Significant weight gain
B. Persistent dry cough
C. Permanent hearing loss
D. Orange discoloration of urine
Correct Answer: B
