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NRNP 6552 Final Exam 2025-2026 – 170+
Verified Questions with Detailed Rationales |
Guaranteed A+ Review
1. A 58-year-old patient with newly diagnosed hypertension is prescribed an
angiotensin-converting enzyme (ACE) inhibitor. Which of the following best
describes the primary mechanism by which ACE inhibitors help lower blood
pressure?
A. They cause vasodilation by preventing the conversion of angiotensin I to
angiotensin II, a powerful vasoconstrictor, thereby reducing peripheral vascular
resistance and lowering blood pressure.
B. They increase sodium retention in the kidneys, which increases blood volume
and pressure.
C. They block beta-adrenergic receptors in the heart to decrease heart rate and
contractility.
D. They inhibit calcium influx in vascular smooth muscle cells to relax vessels.
Correct Answer: A. They cause vasodilation by preventing the conversion of
angiotensin I to angiotensin II, a powerful vasoconstrictor, thereby reducing
, 2
peripheral vascular resistance and lowering blood pressure.
Rationale: ACE inhibitors reduce blood pressure primarily by inhibiting the
enzyme responsible for converting angiotensin I to angiotensin II. Since
angiotensin II is a potent vasoconstrictor, its reduction causes blood vessels to
dilate, lowering systemic vascular resistance and arterial pressure.
2. A 65-year-old patient on chronic warfarin therapy for atrial fibrillation is
scheduled for routine lab monitoring. Which laboratory test is most critical for
evaluating the effectiveness and safety of warfarin therapy?
A. International Normalized Ratio (INR), which standardizes prothrombin time to
monitor anticoagulation levels and prevent bleeding or clotting complications.
B. Activated partial thromboplastin time (aPTT), commonly used for monitoring
heparin therapy.
C. Serum potassium levels, which influence cardiac conduction but do not directly
measure anticoagulation.
D. Complete blood count (CBC) to monitor for anemia or infection but not
anticoagulation status.
Correct Answer: A. International Normalized Ratio (INR), which standardizes
prothrombin time to monitor anticoagulation levels and prevent bleeding or
clotting complications.
Rationale: The INR is the preferred and standardized test to monitor warfarin's
anticoagulant effect, ensuring therapeutic dosing that minimizes risks of bleeding
and thromboembolism.
, 3
3. A patient with type 2 diabetes is started on metformin. Which of the following
symptoms should prompt the nurse to advise the patient to seek immediate medical
attention due to a rare but serious adverse effect?
A. Shortness of breath, muscle pain, and unexplained fatigue indicating possible
lactic acidosis.
B. Mild muscle soreness and fatigue, common side effects during initial therapy.
C. Increased urination consistent with improved glycemic control.
D. Mild weakness related to blood sugar fluctuations.
Correct Answer: A. Shortness of breath, muscle pain, and unexplained fatigue
indicating possible lactic acidosis.
Rationale: Metformin rarely causes lactic acidosis, a life-threatening metabolic
condition characterized by respiratory distress, muscle pain, and fatigue, requiring
immediate intervention.
4. Before administering a beta-blocker such as metoprolol to a patient with
hypertension, which vital signs are essential for the nurse to assess to prevent
adverse cardiovascular effects?
A. Blood pressure and heart rate, to avoid causing symptomatic hypotension or
bradycardia.
B. Respiratory rate, as beta-blockers do not primarily affect respiration.
C. Oxygen saturation, which is not directly impacted by beta-blockers.
D. Temperature, unrelated to beta-blocker administration.
Correct Answer: A. Blood pressure and heart rate, to avoid causing symptomatic
hypotension or bradycardia.
Rationale: Beta-blockers reduce heart rate and myocardial contractility; assessing
, 4
these parameters before administration ensures the patient is not at risk for
dangerously low heart rate or blood pressure.
5. A 70-year-old patient is started on furosemide for congestive heart failure
management. Which electrolyte disturbance is the nurse most vigilant about
monitoring due to the action of loop diuretics?
A. Hypokalemia, because loop diuretics increase potassium excretion, risking
cardiac arrhythmias.
B. Hyperkalemia, which is less common with loop diuretics.
C. Hypercalcemia, which loop diuretics typically do not cause.
D. Hyponatremia, possible but less acutely dangerous compared to hypokalemia.
Correct Answer: A. Hypokalemia, because loop diuretics increase potassium
excretion, risking cardiac arrhythmias.
Rationale: Loop diuretics cause significant potassium loss, which can lead to
muscle weakness, cramps, and life-threatening arrhythmias, so potassium levels
must be monitored closely.
6. A patient is admitted with acute acetaminophen overdose. Which antidote should
the nurse anticipate administering to prevent hepatic damage?
A. N-acetylcysteine, which replenishes glutathione stores and detoxifies the toxic
metabolite of acetaminophen.
B. Activated charcoal, which is used primarily for recent ingestion but not as an
antidote.
C. Vitamin K, used for warfarin overdose.
D. Atropine, used in organophosphate poisoning.
NRNP 6552 Final Exam 2025-2026 – 170+
Verified Questions with Detailed Rationales |
Guaranteed A+ Review
1. A 58-year-old patient with newly diagnosed hypertension is prescribed an
angiotensin-converting enzyme (ACE) inhibitor. Which of the following best
describes the primary mechanism by which ACE inhibitors help lower blood
pressure?
A. They cause vasodilation by preventing the conversion of angiotensin I to
angiotensin II, a powerful vasoconstrictor, thereby reducing peripheral vascular
resistance and lowering blood pressure.
B. They increase sodium retention in the kidneys, which increases blood volume
and pressure.
C. They block beta-adrenergic receptors in the heart to decrease heart rate and
contractility.
D. They inhibit calcium influx in vascular smooth muscle cells to relax vessels.
Correct Answer: A. They cause vasodilation by preventing the conversion of
angiotensin I to angiotensin II, a powerful vasoconstrictor, thereby reducing
, 2
peripheral vascular resistance and lowering blood pressure.
Rationale: ACE inhibitors reduce blood pressure primarily by inhibiting the
enzyme responsible for converting angiotensin I to angiotensin II. Since
angiotensin II is a potent vasoconstrictor, its reduction causes blood vessels to
dilate, lowering systemic vascular resistance and arterial pressure.
2. A 65-year-old patient on chronic warfarin therapy for atrial fibrillation is
scheduled for routine lab monitoring. Which laboratory test is most critical for
evaluating the effectiveness and safety of warfarin therapy?
A. International Normalized Ratio (INR), which standardizes prothrombin time to
monitor anticoagulation levels and prevent bleeding or clotting complications.
B. Activated partial thromboplastin time (aPTT), commonly used for monitoring
heparin therapy.
C. Serum potassium levels, which influence cardiac conduction but do not directly
measure anticoagulation.
D. Complete blood count (CBC) to monitor for anemia or infection but not
anticoagulation status.
Correct Answer: A. International Normalized Ratio (INR), which standardizes
prothrombin time to monitor anticoagulation levels and prevent bleeding or
clotting complications.
Rationale: The INR is the preferred and standardized test to monitor warfarin's
anticoagulant effect, ensuring therapeutic dosing that minimizes risks of bleeding
and thromboembolism.
, 3
3. A patient with type 2 diabetes is started on metformin. Which of the following
symptoms should prompt the nurse to advise the patient to seek immediate medical
attention due to a rare but serious adverse effect?
A. Shortness of breath, muscle pain, and unexplained fatigue indicating possible
lactic acidosis.
B. Mild muscle soreness and fatigue, common side effects during initial therapy.
C. Increased urination consistent with improved glycemic control.
D. Mild weakness related to blood sugar fluctuations.
Correct Answer: A. Shortness of breath, muscle pain, and unexplained fatigue
indicating possible lactic acidosis.
Rationale: Metformin rarely causes lactic acidosis, a life-threatening metabolic
condition characterized by respiratory distress, muscle pain, and fatigue, requiring
immediate intervention.
4. Before administering a beta-blocker such as metoprolol to a patient with
hypertension, which vital signs are essential for the nurse to assess to prevent
adverse cardiovascular effects?
A. Blood pressure and heart rate, to avoid causing symptomatic hypotension or
bradycardia.
B. Respiratory rate, as beta-blockers do not primarily affect respiration.
C. Oxygen saturation, which is not directly impacted by beta-blockers.
D. Temperature, unrelated to beta-blocker administration.
Correct Answer: A. Blood pressure and heart rate, to avoid causing symptomatic
hypotension or bradycardia.
Rationale: Beta-blockers reduce heart rate and myocardial contractility; assessing
, 4
these parameters before administration ensures the patient is not at risk for
dangerously low heart rate or blood pressure.
5. A 70-year-old patient is started on furosemide for congestive heart failure
management. Which electrolyte disturbance is the nurse most vigilant about
monitoring due to the action of loop diuretics?
A. Hypokalemia, because loop diuretics increase potassium excretion, risking
cardiac arrhythmias.
B. Hyperkalemia, which is less common with loop diuretics.
C. Hypercalcemia, which loop diuretics typically do not cause.
D. Hyponatremia, possible but less acutely dangerous compared to hypokalemia.
Correct Answer: A. Hypokalemia, because loop diuretics increase potassium
excretion, risking cardiac arrhythmias.
Rationale: Loop diuretics cause significant potassium loss, which can lead to
muscle weakness, cramps, and life-threatening arrhythmias, so potassium levels
must be monitored closely.
6. A patient is admitted with acute acetaminophen overdose. Which antidote should
the nurse anticipate administering to prevent hepatic damage?
A. N-acetylcysteine, which replenishes glutathione stores and detoxifies the toxic
metabolite of acetaminophen.
B. Activated charcoal, which is used primarily for recent ingestion but not as an
antidote.
C. Vitamin K, used for warfarin overdose.
D. Atropine, used in organophosphate poisoning.
