NUR 2571 Professional Nursing II Exam with Questions and Answers

It covers key domains which include; Fluid, Electrolyte, and Acid-Base Balance, Gastrointestinal and Nutritional Disorders, Professional Communication and Ethical Care, Pharmacological Interventions and Acute and Chronic Health Alterations (Cardiovascular health and Oncological nursing) Mr John Smith is a 67-year-old patient admitted with a history of chronic heart failure, atrial fibrillation, and type 2 diabetes mellitus. He has been prescribed digoxin, furosemide, and metformin. Over the past 24 hours, he reports nausea, blurred vision, and episodes of dizziness. His apical pulse is 52 beats per minute and irregular. Serum potassium is 3.1 mmol/L. The nurse is reviewing his medications and symptoms during morning rounds. Which nursing intervention is the priority? a. Administer the scheduled digoxin dose to maintain therapeutic effect b. Encourage increased dietary potassium intake and continue monitoring c. Hold digoxin and notify the healthcare provider immediately d. Administer an antiemetic to manage nausea and reassess later Correct Answer: c Rationale: Digoxin toxicity is strongly suspected due to bradycardia, visual disturbances, gastrointestinal symptoms, and hypokalemia (K+ 3.1). Hypokalemia increases digoxin sensitivity and risk of toxicity. The priority nursing action is to withhold digoxin and notify the healthcare provider for further evaluation and possible serum digoxin level testing. Continuing the medication or treating symptoms alone without addressing the underlying toxicity risk could lead to life-threatening arrhythmias. Which nursing intervention is most appropriate for a patient diagnosed with syndrome of inappropriate antidiuretic hormone secretion (SIADH) who presents with serum sodium of 121 mEq/L? A. Encourage oral free water intake B. Implement fluid restriction as prescribed C. Administer hypotonic IV fluids D. Provide high-sodium diet without restriction Correct Answer: B Rationale: In SIADH, excessive antidiuretic hormone leads to water retention and dilutional hyponatremia. The primary intervention is fluid restriction to reduce further dilution of serum sodium and prevent worsening cerebral edema. Encouraging fluids or giving hypotonic IV solutions would exacerbate hyponatremia, while dietary sodium alone is insufficient without controlling free water intake.