8
NURS6521N Midterm Exam
Questions and Answers
1. A nurse is caring for a postsurgical patient who has small tortuous veins and had a
difficult IV insertion. The patient is now receiving IV medications on a regular basis.
What is the best nursing intervention to minimize the adverse effects of this drug therapy?
A) Monitor the patient's bleeding time
B) Check the patient's blood glucose levels
C) Record baseline vital signs
D) Monitor the IV site for redness, swelling, or pain
2. A patient is in the clinic after 6 weeks of taking riluzole (Rilutek) for a recent
diagnosis of amyotrophic lateral sclerosis. The nurse will prioritize assessment for
which of the following?
A) Weight gain
B) Constipation
C) Increased energy
D) Dizziness
3. Which of the following patients demonstrates the clearest indication for
treatment with prednisone?
A) A 66-year-old woman whose history of smoking has culminated in a diagnosis of
emphysema
B) A 70-year-old man whose rheumatoid arthritis has not responded to OTC pain relievers
C) A 12-year-old boy whose long-standing fatigue and malaise have been attributed to
leukemia
D) A 50-year-old woman who is being treated for hypertension with a diuretic and an
ACE inhibitor
[Date]
1
, 8
4. A nurse has been administering a drug to a patient intramuscularly (IM). The
physician discontinued the IM dose and wrote an order for the drug to be given orally.
The nurse notices
that the oral dosage is considerably higher than the parenteral dose and understands
that this is due to
A) passive diffusion.
B) active transport.
C) glomerular filtration.
D) first-pass effect.
5. A cardiac care nurse is monitoring a patient who is receiving lidocaine (Xylocaine)
per IV infusion pump for an acute ventricular arrhythmia associated with an acute
MI. Which of the following patient manifestations would cause the nurse to notify the
physician immediately?
A) Confusion
B) Headache
C) Nausea
D) Leg cramps
6. A nurse is caring for a patient who is admitted into the cardiac care unit with
acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When
preparing for administration of the drug, the nurse will
A) add the reconstituted vial of medication to a 1,000 mL IV bag.
B) shake the vial vigorously to mix the medication for reconstitution.
C) administer the initial IV bolus over approximately 60 seconds.
D) use the reconstituted solution within a 36-hour period.
7. A nurse is discussing with a patient the efficacy of a drug that his physician has
suggested he begin taking. Efficacy of a drug means which of the following?
A) The amount of the drug that must be given to produce a particular response
[Date]
2
, 8
B) How well a drug produces its desired effect
C) A drug's strength of attraction for a receptor site
D) A drug's ability to stimulate its receptor
8. A nurse is conducting a medication resolution of a new resident of a care facility and
notes that the woman has been taking neostigmine. The nurse should recognize that the
woman may have a history of what problem?
A) Alzheimer disease
B) Parkinson disease
C) Myasthenia gravis
D) Multiple sclerosis
9. A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril
(Accupril) and furosemide (Lasix). Which of the following assessment findings would
suggest that the loop diuretic is contributing to a therapeutic effect?
A) The man's glomerular filtration rate and creatinine levels are within reference ranges.
B) The man's heart rate is between 60 and 70 beats per minute with a regular rhythm.
C) The man's potassium and sodium levels remain with reference ranges.
D) The man's chest sounds are clear and his ankle edema is lessened.
10. A nurse explains to a patient that nitroglycerin patches should be applied in the
morning and removed in the evening. This medication schedule reduces the potential for
A) Adverse effects.
B) Nitrate dependence.
C) Nitrate tolerance.
D) Toxic effects.
11. A nurse who provides care on a busy medical unit of a large hospital is constantly faced
with new drugs on patients' medication administration records. What strategy should the
[Date]
3
, 8
nurse employ to foster up-to-date information about the nursing management of new or
uncommon drugs?
A) Focus on learning about a prototype drug that is characteristic of a larger drug class
B) Identify similarities between new drugs and older drugs that are commonly used on the
unit
C) Commit time and energy during each shift to learning about new drugs
D) Liaise with pharmacists and pharmacy technicians who work at the hospital
12. A 58-year-old man is admitted to the emergency department. A diagnosis of severe
digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG)
confirms toxicity. The nurse will administer which of the following drugs?
A) Furosemide
B) Digoxin immune fab
C) Captopril
D) Dopamine
13. A hospital patient's physician has prescribed quetiapine (Seroquel) to be administered
at bedtime. Being unfamiliar with the medication, the nurse has looked it up in a nursing
drug manual and noted that the drug is an antipsychotic that is indicated for the
treatment of schizophrenia and bipolar disorder. The patient has no psychiatric history,
and upon questioning, the physician states that it is being prescribed to help the patient
fall asleep at night. How should the nurse best understand this practice?
A) This off-label use of the drug is prohibited by federal laws and professional
practice standards.
B) This is an appropriate use of the drug, provided it is supported by the literature.
C) This is acceptable if the patient has failed to respond adequately to conventional sleep
aids. D) This is a practice that may negate the physician's and nurse's liability insurance.
14. A patient has been prescribed lithium therapy. Which of the following signs and
[Date]
4
NURS6521N Midterm Exam
Questions and Answers
1. A nurse is caring for a postsurgical patient who has small tortuous veins and had a
difficult IV insertion. The patient is now receiving IV medications on a regular basis.
What is the best nursing intervention to minimize the adverse effects of this drug therapy?
A) Monitor the patient's bleeding time
B) Check the patient's blood glucose levels
C) Record baseline vital signs
D) Monitor the IV site for redness, swelling, or pain
2. A patient is in the clinic after 6 weeks of taking riluzole (Rilutek) for a recent
diagnosis of amyotrophic lateral sclerosis. The nurse will prioritize assessment for
which of the following?
A) Weight gain
B) Constipation
C) Increased energy
D) Dizziness
3. Which of the following patients demonstrates the clearest indication for
treatment with prednisone?
A) A 66-year-old woman whose history of smoking has culminated in a diagnosis of
emphysema
B) A 70-year-old man whose rheumatoid arthritis has not responded to OTC pain relievers
C) A 12-year-old boy whose long-standing fatigue and malaise have been attributed to
leukemia
D) A 50-year-old woman who is being treated for hypertension with a diuretic and an
ACE inhibitor
[Date]
1
, 8
4. A nurse has been administering a drug to a patient intramuscularly (IM). The
physician discontinued the IM dose and wrote an order for the drug to be given orally.
The nurse notices
that the oral dosage is considerably higher than the parenteral dose and understands
that this is due to
A) passive diffusion.
B) active transport.
C) glomerular filtration.
D) first-pass effect.
5. A cardiac care nurse is monitoring a patient who is receiving lidocaine (Xylocaine)
per IV infusion pump for an acute ventricular arrhythmia associated with an acute
MI. Which of the following patient manifestations would cause the nurse to notify the
physician immediately?
A) Confusion
B) Headache
C) Nausea
D) Leg cramps
6. A nurse is caring for a patient who is admitted into the cardiac care unit with
acute, decompensated heart failure. Nesiritide (Natrecor) has been ordered. When
preparing for administration of the drug, the nurse will
A) add the reconstituted vial of medication to a 1,000 mL IV bag.
B) shake the vial vigorously to mix the medication for reconstitution.
C) administer the initial IV bolus over approximately 60 seconds.
D) use the reconstituted solution within a 36-hour period.
7. A nurse is discussing with a patient the efficacy of a drug that his physician has
suggested he begin taking. Efficacy of a drug means which of the following?
A) The amount of the drug that must be given to produce a particular response
[Date]
2
, 8
B) How well a drug produces its desired effect
C) A drug's strength of attraction for a receptor site
D) A drug's ability to stimulate its receptor
8. A nurse is conducting a medication resolution of a new resident of a care facility and
notes that the woman has been taking neostigmine. The nurse should recognize that the
woman may have a history of what problem?
A) Alzheimer disease
B) Parkinson disease
C) Myasthenia gravis
D) Multiple sclerosis
9. A 77-year-old man's chronic heart failure is being treated with a regimen of quinapril
(Accupril) and furosemide (Lasix). Which of the following assessment findings would
suggest that the loop diuretic is contributing to a therapeutic effect?
A) The man's glomerular filtration rate and creatinine levels are within reference ranges.
B) The man's heart rate is between 60 and 70 beats per minute with a regular rhythm.
C) The man's potassium and sodium levels remain with reference ranges.
D) The man's chest sounds are clear and his ankle edema is lessened.
10. A nurse explains to a patient that nitroglycerin patches should be applied in the
morning and removed in the evening. This medication schedule reduces the potential for
A) Adverse effects.
B) Nitrate dependence.
C) Nitrate tolerance.
D) Toxic effects.
11. A nurse who provides care on a busy medical unit of a large hospital is constantly faced
with new drugs on patients' medication administration records. What strategy should the
[Date]
3
, 8
nurse employ to foster up-to-date information about the nursing management of new or
uncommon drugs?
A) Focus on learning about a prototype drug that is characteristic of a larger drug class
B) Identify similarities between new drugs and older drugs that are commonly used on the
unit
C) Commit time and energy during each shift to learning about new drugs
D) Liaise with pharmacists and pharmacy technicians who work at the hospital
12. A 58-year-old man is admitted to the emergency department. A diagnosis of severe
digoxin toxicity is made. Bradycardia is present, and an electrocardiogram (ECG)
confirms toxicity. The nurse will administer which of the following drugs?
A) Furosemide
B) Digoxin immune fab
C) Captopril
D) Dopamine
13. A hospital patient's physician has prescribed quetiapine (Seroquel) to be administered
at bedtime. Being unfamiliar with the medication, the nurse has looked it up in a nursing
drug manual and noted that the drug is an antipsychotic that is indicated for the
treatment of schizophrenia and bipolar disorder. The patient has no psychiatric history,
and upon questioning, the physician states that it is being prescribed to help the patient
fall asleep at night. How should the nurse best understand this practice?
A) This off-label use of the drug is prohibited by federal laws and professional
practice standards.
B) This is an appropriate use of the drug, provided it is supported by the literature.
C) This is acceptable if the patient has failed to respond adequately to conventional sleep
aids. D) This is a practice that may negate the physician's and nurse's liability insurance.
14. A patient has been prescribed lithium therapy. Which of the following signs and
[Date]
4
