NUR 155 Exam 2, 3 and 4 Combined |
Questions and Answers | 2026 Update |
100% Correct – Galen College.
1. A patient with chronic heart failure is receiving furosemide (Lasix). Which
laboratory value is most important for the nurse to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B. Serum potassium
Explanation: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption
in the ascending loop of Henle. It causes significant potassium wasting. Hypokalemia can
lead to cardiac dysrhythmias, especially in patients on digitalis, making potassium
monitoring critical. While sodium, calcium, and magnesium can be affected, potassium
imbalances pose the most immediate and dangerous risk.
2. A patient is 2 days post-operative from an abdominal hysterectomy. The nurse
notes that the wound edges are separated, and the underlying tissue is visible.
What is the correct nursing action?
A. Apply a sterile saline-soaked dressing and notify the physician.
B. Gently push the tissue back into the wound and apply a dry dressing.
C. Cover the wound with a dry gauze dressing.
D. Irrigate the wound with hydrogen peroxide.
Answer: A. Apply a sterile saline-soaked dressing and notify the physician.
Explanation: This describes wound dehiscence. The priority is to protect the exposed tissue.
A sterile saline-moistened dressing should be applied to prevent drying and further
damage to the tissue. The nurse must then notify the surgeon immediately. Pushing tissue
,back is not within the nurse's scope of practice. Hydrogen peroxide is cytotoxic and should
not be used in open wounds.
3. The nurse is preparing to administer a blood transfusion. Which IV solution
should be used to prime the tubing?
A. Dextrose 5% in water (D5W)
B. Lactated Ringer's (LR)
C. 0.9% Normal Saline
D. Dextrose 5% in 0.45% Normal Saline
Answer: C. 0.9% Normal Saline
Explanation: Only 0.9% normal saline should be used for blood product administration.
Dextrose solutions can cause red blood cells to hemolyze or clump. Lactated Ringer's
contains calcium, which can activate the clotting cascade and cause the blood to clot in
the tubing, making it unsafe for transfusion.
4. A patient is experiencing an acute asthma exacerbation. The nurse administers
albuterol (Proventil). What is the primary mechanism of action of this medication?
A. Blocks histamine release
B. Reduces airway inflammation
C. Stimulates beta-2 adrenergic receptors to cause bronchodilation
D. Decreases mucous production
Answer: C. Stimulates beta-2 adrenergic receptors to cause bronchodilation
*Explanation: Albuterol is a short-acting beta-2 agonist. Its primary action is to stimulate
beta-2 receptors located in the bronchial smooth muscle, leading to relaxation and
bronchodilation. It is a rescue medication for acute bronchospasm. Corticosteroids are
used to reduce inflammation, and antihistamines block histamine.*
5. A patient is diagnosed with a urinary tract infection (UTI) and prescribed
ciprofloxacin (Cipro). Which adverse effect should the nurse educate the patient
about?
A. Photosensitivity and risk of tendon rupture
B. Ototoxicity
,C. Severe constipation
D. Gray discoloration of teeth
Answer: A. Photosensitivity and risk of tendon rupture
Explanation: Fluoroquinolones like ciprofloxacin have a black box warning for an
increased risk of tendinitis and tendon rupture, particularly in older adults and those on
concurrent corticosteroids. They also cause photosensitivity, and patients must be
instructed to avoid prolonged sunlight. Ototoxicity is a risk with aminoglycosides. Gray
teeth are associated with tetracyclines.
6. A patient with end-stage renal disease (ESRD) is scheduled for hemodialysis.
Which medication should the nurse hold prior to dialysis?
A. Iron supplement
B. Vitamin D supplement
C. Furosemide (Lasix)
D. Epoetin alfa (Epogen)
Answer: C. Furosemide (Lasix)
Explanation: Diuretics are typically held prior to hemodialysis. Since the kidneys are not
functioning, diuretics are ineffective, and they can contribute to hypotension during the
dialysis treatment. Iron, Vitamin D, and Epoetin alfa (erythropoietin) are often
administered in ESRD but are generally given during or after dialysis or at specific times,
but they are not held for the same reason as diuretics.
7. The nurse is caring for a patient with a nasogastric (NG) tube set to low
intermittent suction. Which electrolyte imbalance is this patient at the highest risk
for developing?
A. Hyperkalemia
B. Hypermagnesemia
C. Metabolic acidosis
D. Hypokalemia and metabolic alkalosis
Answer: D. Hypokalemia and metabolic alkalosis
Explanation: NG suction removes gastric juices, which are rich in hydrochloric acid and
, potassium. Loss of acid leads to metabolic alkalosis. The loss of potassium via gastric fluid
increases the risk for hypokalemia. This is a classic and common complication of
prolonged NG suctioning.
8. A patient is receiving continuous enteral feedings via a nasogastric tube. The
nurse checks the gastric residual volume (GRV) and finds it to be 350 mL. What is
the most appropriate nursing action?
A. Discard the residual and increase the feeding rate.
B. Return the residual and continue the feeding as ordered.
C. Return the residual and hold the feeding for 2 hours.
D. Discard the residual and notify the healthcare provider.
Answer: C. Return the residual and hold the feeding for 2 hours.
*Explanation: Current guidelines from the American Society for Parenteral and Enteral
Nutrition (ASPEN) suggest holding enteral feedings if the GRV is high (e.g., >250-500
mL, depending on policy). Returning the residual is preferred over discarding it to
prevent electrolyte loss. Holding the feeding and rechecking in 1-2 hours is the standard
response, as a high GRV can indicate delayed gastric emptying and risk of aspiration.
Discarding the residual is not recommended.*
9. The nurse is teaching a patient about smoking cessation. Which intervention is
most likely to be effective in promoting long-term success?
A. Telling the patient about the dangers of smoking
B. Prescribing a single nicotine patch
C. Providing a referral to a smoking cessation support group and counseling
D. Recommending that the patient switch to a low-tar cigarette
Answer: C. Providing a referral to a smoking cessation support group and
counseling
Explanation: A combination of pharmacotherapy (e.g., nicotine replacement) and
behavioral counseling/support groups has the highest success rates. Education alone is
often insufficient. Switching to low-tar cigarettes does not eliminate the health risks. A
single patch is less effective than a comprehensive plan.
Questions and Answers | 2026 Update |
100% Correct – Galen College.
1. A patient with chronic heart failure is receiving furosemide (Lasix). Which
laboratory value is most important for the nurse to monitor?
A. Serum sodium
B. Serum potassium
C. Serum calcium
D. Serum magnesium
Answer: B. Serum potassium
Explanation: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption
in the ascending loop of Henle. It causes significant potassium wasting. Hypokalemia can
lead to cardiac dysrhythmias, especially in patients on digitalis, making potassium
monitoring critical. While sodium, calcium, and magnesium can be affected, potassium
imbalances pose the most immediate and dangerous risk.
2. A patient is 2 days post-operative from an abdominal hysterectomy. The nurse
notes that the wound edges are separated, and the underlying tissue is visible.
What is the correct nursing action?
A. Apply a sterile saline-soaked dressing and notify the physician.
B. Gently push the tissue back into the wound and apply a dry dressing.
C. Cover the wound with a dry gauze dressing.
D. Irrigate the wound with hydrogen peroxide.
Answer: A. Apply a sterile saline-soaked dressing and notify the physician.
Explanation: This describes wound dehiscence. The priority is to protect the exposed tissue.
A sterile saline-moistened dressing should be applied to prevent drying and further
damage to the tissue. The nurse must then notify the surgeon immediately. Pushing tissue
,back is not within the nurse's scope of practice. Hydrogen peroxide is cytotoxic and should
not be used in open wounds.
3. The nurse is preparing to administer a blood transfusion. Which IV solution
should be used to prime the tubing?
A. Dextrose 5% in water (D5W)
B. Lactated Ringer's (LR)
C. 0.9% Normal Saline
D. Dextrose 5% in 0.45% Normal Saline
Answer: C. 0.9% Normal Saline
Explanation: Only 0.9% normal saline should be used for blood product administration.
Dextrose solutions can cause red blood cells to hemolyze or clump. Lactated Ringer's
contains calcium, which can activate the clotting cascade and cause the blood to clot in
the tubing, making it unsafe for transfusion.
4. A patient is experiencing an acute asthma exacerbation. The nurse administers
albuterol (Proventil). What is the primary mechanism of action of this medication?
A. Blocks histamine release
B. Reduces airway inflammation
C. Stimulates beta-2 adrenergic receptors to cause bronchodilation
D. Decreases mucous production
Answer: C. Stimulates beta-2 adrenergic receptors to cause bronchodilation
*Explanation: Albuterol is a short-acting beta-2 agonist. Its primary action is to stimulate
beta-2 receptors located in the bronchial smooth muscle, leading to relaxation and
bronchodilation. It is a rescue medication for acute bronchospasm. Corticosteroids are
used to reduce inflammation, and antihistamines block histamine.*
5. A patient is diagnosed with a urinary tract infection (UTI) and prescribed
ciprofloxacin (Cipro). Which adverse effect should the nurse educate the patient
about?
A. Photosensitivity and risk of tendon rupture
B. Ototoxicity
,C. Severe constipation
D. Gray discoloration of teeth
Answer: A. Photosensitivity and risk of tendon rupture
Explanation: Fluoroquinolones like ciprofloxacin have a black box warning for an
increased risk of tendinitis and tendon rupture, particularly in older adults and those on
concurrent corticosteroids. They also cause photosensitivity, and patients must be
instructed to avoid prolonged sunlight. Ototoxicity is a risk with aminoglycosides. Gray
teeth are associated with tetracyclines.
6. A patient with end-stage renal disease (ESRD) is scheduled for hemodialysis.
Which medication should the nurse hold prior to dialysis?
A. Iron supplement
B. Vitamin D supplement
C. Furosemide (Lasix)
D. Epoetin alfa (Epogen)
Answer: C. Furosemide (Lasix)
Explanation: Diuretics are typically held prior to hemodialysis. Since the kidneys are not
functioning, diuretics are ineffective, and they can contribute to hypotension during the
dialysis treatment. Iron, Vitamin D, and Epoetin alfa (erythropoietin) are often
administered in ESRD but are generally given during or after dialysis or at specific times,
but they are not held for the same reason as diuretics.
7. The nurse is caring for a patient with a nasogastric (NG) tube set to low
intermittent suction. Which electrolyte imbalance is this patient at the highest risk
for developing?
A. Hyperkalemia
B. Hypermagnesemia
C. Metabolic acidosis
D. Hypokalemia and metabolic alkalosis
Answer: D. Hypokalemia and metabolic alkalosis
Explanation: NG suction removes gastric juices, which are rich in hydrochloric acid and
, potassium. Loss of acid leads to metabolic alkalosis. The loss of potassium via gastric fluid
increases the risk for hypokalemia. This is a classic and common complication of
prolonged NG suctioning.
8. A patient is receiving continuous enteral feedings via a nasogastric tube. The
nurse checks the gastric residual volume (GRV) and finds it to be 350 mL. What is
the most appropriate nursing action?
A. Discard the residual and increase the feeding rate.
B. Return the residual and continue the feeding as ordered.
C. Return the residual and hold the feeding for 2 hours.
D. Discard the residual and notify the healthcare provider.
Answer: C. Return the residual and hold the feeding for 2 hours.
*Explanation: Current guidelines from the American Society for Parenteral and Enteral
Nutrition (ASPEN) suggest holding enteral feedings if the GRV is high (e.g., >250-500
mL, depending on policy). Returning the residual is preferred over discarding it to
prevent electrolyte loss. Holding the feeding and rechecking in 1-2 hours is the standard
response, as a high GRV can indicate delayed gastric emptying and risk of aspiration.
Discarding the residual is not recommended.*
9. The nurse is teaching a patient about smoking cessation. Which intervention is
most likely to be effective in promoting long-term success?
A. Telling the patient about the dangers of smoking
B. Prescribing a single nicotine patch
C. Providing a referral to a smoking cessation support group and counseling
D. Recommending that the patient switch to a low-tar cigarette
Answer: C. Providing a referral to a smoking cessation support group and
counseling
Explanation: A combination of pharmacotherapy (e.g., nicotine replacement) and
behavioral counseling/support groups has the highest success rates. Education alone is
often insufficient. Switching to low-tar cigarettes does not eliminate the health risks. A
single patch is less effective than a comprehensive plan.
