NUR 5461/NUR5461 Final Exam V2 |
Comprehensive Final Exam Covering All
Modules Q&A with Rationale | William
Paterson University
1. A patient with chronic heart failure is prescribed Digoxin. Which laboratory result is most
critical for the nurse to monitor to prevent Digoxin toxicity?
A. Serum Sodium level
B. Blood Urea Nitrogen (BUN)
C. Serum Calcium level
D. Serum Potassium level
Correct Answer: D
Expert Explanation: Hypokalemia significantly increases the risk of Digoxin toxicity by
allowing more Digoxin to bind to the Na+/K+ ATPase pump. The nurse must ensure the
patient’s potassium level remains within the normal range of 3.5 to 5.0 mEq/L. Regular
monitoring of electrolytes is a standard of care for patients on diuretic therapy combined
with cardiac glycosides.
2. Which of the following is the primary mechanism of action for ACE Inhibitors such as
Lisinopril?
A. Inhibiting the conversion of Angiotensin I to Angiotensin II
,B. Directly blocking Beta-1 receptors in the heart
C. Blocking the entry of calcium into vascular smooth muscle cells
D. Antagonizing aldosterone receptors in the distal tubule
Correct Answer: A
Expert Explanation: ACE inhibitors prevent the formation of Angiotensin II, which is a
potent vasoconstrictor. This reduction leads to systemic vasodilation and decreased
aldosterone secretion, effectively lowering blood pressure. These medications are
particularly beneficial for protecting renal function in patients with diabetes mellitus.
3. When educating a patient newly prescribed Warfarin (Coumadin), which dietary instruction
is most important?
A. Avoid all foods containing Vitamin K
B. Maintain a consistent intake of green leafy vegetables
C. Increase intake of grapefruit juice to enhance absorption
D. Limit protein intake to once per day
Correct Answer: B
Expert Explanation: Vitamin K is the direct antagonist to Warfarin, and sudden changes in
its intake can cause the INR to fluctuate dangerously. Patients do not need to avoid Vitamin
K entirely but must maintain a steady, consistent daily amount. Rapid increases in leafy
greens can lead to subtherapeutic INR levels and an increased risk of clotting.
, 4. A patient is experiencing an acute asthma attack. Which medication should the advanced
practice nurse prioritize for immediate bronchodilation?
A. Albuterol (Proventil)
B. Fluticasone (Flovent)
C. Salmeterol (Serevent)
D. Montelukast (Singulair)
Correct Answer: A
Expert Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
relief of bronchospasm during an acute exacerbation. In contrast, Salmeterol is long-acting
and not indicated for rescue use, while Fluticasone is an inhaled corticosteroid used for
chronic inflammation. Immediate pharmacological intervention with a SABA is the
standard protocol for acute respiratory distress.
5. Which side effect of Metformin is considered a rare but life-threatening complication,
requiring immediate discontinuation?
A. Gastrointestinal upset and diarrhea
B. Hypoglycemia
C. Vitamin B12 deficiency
D. Lactic Acidosis
Correct Answer: D
Comprehensive Final Exam Covering All
Modules Q&A with Rationale | William
Paterson University
1. A patient with chronic heart failure is prescribed Digoxin. Which laboratory result is most
critical for the nurse to monitor to prevent Digoxin toxicity?
A. Serum Sodium level
B. Blood Urea Nitrogen (BUN)
C. Serum Calcium level
D. Serum Potassium level
Correct Answer: D
Expert Explanation: Hypokalemia significantly increases the risk of Digoxin toxicity by
allowing more Digoxin to bind to the Na+/K+ ATPase pump. The nurse must ensure the
patient’s potassium level remains within the normal range of 3.5 to 5.0 mEq/L. Regular
monitoring of electrolytes is a standard of care for patients on diuretic therapy combined
with cardiac glycosides.
2. Which of the following is the primary mechanism of action for ACE Inhibitors such as
Lisinopril?
A. Inhibiting the conversion of Angiotensin I to Angiotensin II
,B. Directly blocking Beta-1 receptors in the heart
C. Blocking the entry of calcium into vascular smooth muscle cells
D. Antagonizing aldosterone receptors in the distal tubule
Correct Answer: A
Expert Explanation: ACE inhibitors prevent the formation of Angiotensin II, which is a
potent vasoconstrictor. This reduction leads to systemic vasodilation and decreased
aldosterone secretion, effectively lowering blood pressure. These medications are
particularly beneficial for protecting renal function in patients with diabetes mellitus.
3. When educating a patient newly prescribed Warfarin (Coumadin), which dietary instruction
is most important?
A. Avoid all foods containing Vitamin K
B. Maintain a consistent intake of green leafy vegetables
C. Increase intake of grapefruit juice to enhance absorption
D. Limit protein intake to once per day
Correct Answer: B
Expert Explanation: Vitamin K is the direct antagonist to Warfarin, and sudden changes in
its intake can cause the INR to fluctuate dangerously. Patients do not need to avoid Vitamin
K entirely but must maintain a steady, consistent daily amount. Rapid increases in leafy
greens can lead to subtherapeutic INR levels and an increased risk of clotting.
, 4. A patient is experiencing an acute asthma attack. Which medication should the advanced
practice nurse prioritize for immediate bronchodilation?
A. Albuterol (Proventil)
B. Fluticasone (Flovent)
C. Salmeterol (Serevent)
D. Montelukast (Singulair)
Correct Answer: A
Expert Explanation: Albuterol is a short-acting beta-2 agonist (SABA) that provides rapid
relief of bronchospasm during an acute exacerbation. In contrast, Salmeterol is long-acting
and not indicated for rescue use, while Fluticasone is an inhaled corticosteroid used for
chronic inflammation. Immediate pharmacological intervention with a SABA is the
standard protocol for acute respiratory distress.
5. Which side effect of Metformin is considered a rare but life-threatening complication,
requiring immediate discontinuation?
A. Gastrointestinal upset and diarrhea
B. Hypoglycemia
C. Vitamin B12 deficiency
D. Lactic Acidosis
Correct Answer: D
