NURS 660 SUM 2023 ALL SETS EXAM 1 QUESTIONS WITH COMPLETE SOLUTIONS

NURS 660 SUM 2023 ALL SETS EXAM 1 QUESTIONS WITH COMPLETE SOLUTIONS

 Course

 NURS 660

1. Question: A 55-year-old patient is diagnosed with Type 2 Diabetes Mellitus (T2DM). The
provider prescribes metformin. What is the primary mechanism of action for metformin in
managing T2DM?

 A) Increases insulin sensitivity

 B) Stimulates insulin secretion

 C) Inhibits glucagon secretion

 D) Decreases glucose absorption in the intestines

 Answer: A) Increases insulin sensitivity

 Rationale: Metformin works by increasing insulin sensitivity in peripheral tissues, particularly
muscle, and reducing hepatic glucose production. It does not stimulate insulin secretion,
which helps reduce the risk of hypoglycemia.



2. Question: A patient with congestive heart failure (CHF) is prescribed an ACE inhibitor. Which of
the following is an important adverse effect to monitor for?

 A) Hyperkalemia

 B) Hypoglycemia

 C) Tachycardia

 D) Constipation

 Answer: A) Hyperkalemia

 Rationale: ACE inhibitors, such as enalapril, can lead to hyperkalemia by reducing
aldosterone levels, which decreases potassium excretion. Monitoring potassium levels is
critical during treatment.



3. Question: A 68-year-old patient with chronic obstructive pulmonary disease (COPD) is
prescribed a combination inhaler containing a corticosteroid and a long-acting beta-agonist (LABA).
What is the primary benefit of using this combination therapy?

 A) Reduced frequency of exacerbations

 B) Increased blood pressure control

 C) Prevention of corticosteroid-related osteoporosis

 D) Decreased risk of respiratory infections

 Answer: A) Reduced frequency of exacerbations

,  Rationale: Combination therapy with a corticosteroid and a LABA helps reduce inflammation
and relax the smooth muscles of the airway, thereby decreasing the frequency of COPD
exacerbations.



4. Question: A 72-year-old patient with hypertension is prescribed amlodipine. What is the primary
effect of this medication?

 A) Increases heart rate

 B) Reduces blood pressure by dilating blood vessels

 C) Inhibits sodium retention in the kidneys

 D) Increases renal blood flow

 Answer: B) Reduces blood pressure by dilating blood vessels

 Rationale: Amlodipine is a calcium channel blocker that works by relaxing and dilating blood
vessels, which helps reduce blood pressure. It does not directly affect heart rate or renal
sodium retention.



5. Question: A patient with acute pancreatitis is being managed in the hospital. Which of the
following is a primary nursing intervention during the acute phase of pancreatitis?

 A) Encourage high-fat meals

 B) Administer fluids and electrolytes intravenously

 C) Provide oral nutrition immediately to enhance healing

 D) Monitor for signs of hypoglycemia

 Answer: B) Administer fluids and electrolytes intravenously

 Rationale: During the acute phase of pancreatitis, fluid resuscitation is a priority to prevent
hypovolemia and manage electrolyte imbalances. Oral nutrition is typically withheld initially
to rest the pancreas.



6. Question: A 50-year-old patient is diagnosed with depression and prescribed fluoxetine. Which
of the following is a potential side effect of SSRIs like fluoxetine?

 A) Tachycardia

 B) Weight loss

 C) Sexual dysfunction

 D) Increased appetite

 Answer: C) Sexual dysfunction

,  Rationale: Sexual dysfunction, including decreased libido and difficulty achieving orgasm, is a
well-known side effect of SSRIs like fluoxetine. Patients should be informed of this possibility.



7. Question: A 45-year-old patient is diagnosed with a deep vein thrombosis (DVT). The provider
prescribes rivaroxaban. What is the mechanism of action for rivaroxaban?

 A) Inhibits thrombin

 B) Inhibits factor Xa

 C) Increases platelet aggregation

 D) Enhances fibrinolysis

 Answer: B) Inhibits factor Xa

 Rationale: Rivaroxaban is an oral anticoagulant that works by inhibiting factor Xa, a key
enzyme in the coagulation cascade, thereby reducing thrombin generation and preventing
clot formation.



8. Question: A patient with chronic kidney disease (CKD) is prescribed epoetin alfa. What is the
intended effect of this medication?

 A) Increase red blood cell production

 B) Reduce blood pressure

 C) Improve renal filtration

 D) Decrease blood urea nitrogen (BUN) levels

 Answer: A) Increase red blood cell production

 Rationale: Epoetin alfa is a synthetic form of erythropoietin used to stimulate red blood cell
production in patients with CKD, where the kidneys are unable to produce sufficient
erythropoietin naturally.



9. Question: A patient presents with acute asthma exacerbation. The provider prescribes albuterol.
What is the primary mechanism of action for albuterol in the treatment of asthma?

 A) It reduces inflammation in the airways

 B) It inhibits the release of histamine

 C) It dilates bronchial smooth muscle

 D) It decreases mucus production

 Answer: C) It dilates bronchial smooth muscle

 Rationale: Albuterol is a short-acting beta-agonist that works by relaxing bronchial smooth
muscle, which leads to bronchodilation and relief of acute asthma symptoms.

, 10. Question: A patient with Parkinson's disease is prescribed carbidopa-levodopa. What is the
purpose of combining carbidopa with levodopa?

 A) To reduce the risk of gastrointestinal side effects

 B) To increase the effectiveness of levodopa in the brain

 C) To prevent dyskinesia

 D) To decrease the risk of serotonin syndrome

 Answer: B) To increase the effectiveness of levodopa in the brain

 Rationale: Carbidopa prevents the peripheral breakdown of levodopa, ensuring that more
levodopa reaches the brain, where it can be converted into dopamine to help manage
Parkinson's disease symptoms.

11. Question: A patient with chronic atrial fibrillation is prescribed warfarin. What is the most
important test to monitor while the patient is on warfarin therapy?

 A) Complete blood count (CBC)

 B) Liver function tests

 C) Prothrombin time (PT) and International Normalized Ratio (INR)

 D) Serum creatinine levels

 Answer: C) Prothrombin time (PT) and International Normalized Ratio (INR)

 Rationale: Warfarin is monitored through PT/INR to ensure therapeutic anticoagulation and
avoid bleeding complications. The INR should typically be between 2.0 and 3.0 for most
indications.



12. Question: A patient with hypertension is prescribed hydrochlorothiazide. What is the primary
side effect of thiazide diuretics to monitor for?

 A) Hyperkalemia

 B) Hypoglycemia

 C) Hypokalemia

 D) Hyponatremia

 Answer: C) Hypokalemia

 Rationale: Thiazide diuretics like hydrochlorothiazide can cause potassium loss, leading to
hypokalemia. Potassium levels should be regularly monitored to prevent complications like
arrhythmias.