NSG 527 MIDTERM EXAM QUESTIONS AND ANSWERS WITH VERIFIED RATIONALES (2026/2027) – 100% PASS GUARANTEE ALREADY GRADED A+

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NSG 527 MIDTERM EXAM QUESTIONS AND ANSWERS WITH
VERIFIED RATIONALES (2026/2027) – 100% PASS GUARANTEE
ALREADY GRADED A+



1.
A patient with uncontrolled hypertension is prescribed an ACE inhibitor. The nurse
is preparing discharge teaching. Which instruction is most important to emphasize?
A. Avoid grapefruit juice
B. Report persistent cough
C. Take medication with milk
D. Expect ankle swelling
Correct Answer: B
Rationale: ACE inhibitors such as lisinopril commonly cause a persistent dry
cough due to increased bradykinin levels in the lungs. While other side effects like
hyperkalemia and dizziness are possible, the cough is distinctive and can be severe
enough to require a change of therapy. Patients should be taught to report this
immediately, as it often leads to discontinuation of the drug.



2.
A nurse is caring for a patient with heart failure who has been prescribed
furosemide. Which laboratory result requires the most immediate intervention?
A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Creatinine 0.9 mg/dL
D. BUN 16 mg/dL
Correct Answer: B
Rationale: Loop diuretics such as furosemide cause significant potassium loss,
which can quickly lead to hypokalemia. A potassium level of 2.9 mEq/L is
dangerously low and can precipitate life-threatening arrhythmias. Nurses must
recognize this value as critical, notify the provider promptly, and anticipate
interventions such as potassium replacement and ECG monitoring.

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3.
Which assessment finding indicates digoxin toxicity in a patient receiving the drug
for heart failure?
A. Blurred vision and halos
B. Constipation
C. Increased appetite
D. Dry cough
Correct Answer: A
Rationale: Digoxin toxicity most often presents with visual disturbances such as
blurred vision, yellow-green halos around lights, as well as nausea, vomiting, and
cardiac arrhythmias. Because the therapeutic window of digoxin is narrow,
monitoring for these early warning signs is critical to prevent severe complications
such as ventricular arrhythmias.



4.
A diabetic patient is prescribed metformin for type 2 diabetes management. Which
teaching point is most important for the nurse to include?
A. Stop medication if urine output increases
B. Hold dose before IV contrast studies
C. Take at bedtime on empty stomach
D. Expect weight gain
Correct Answer: B
Rationale: Metformin is contraindicated when contrast dye is administered
because it increases the risk of lactic acidosis, a rare but potentially fatal condition.
Patients must be instructed to withhold metformin 24–48 hours prior to contrast
exposure and restart only when renal function is confirmed as stable. This teaching
prevents serious metabolic complications.



5.
Which finding in a pediatric patient most strongly suggests respiratory distress and
requires urgent assessment?

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A. Normal respiratory rate
B. Retractions and nasal flaring
C. Pink skin tone
D. Occasional dry cough
Correct Answer: B
Rationale: Retractions and nasal flaring are hallmark signs of increased work of
breathing in children, reflecting that accessory muscles are being recruited to
maintain oxygenation. This is an early indicator of impending respiratory failure
and requires immediate intervention, such as supplemental oxygen and possible
escalation of care. Prompt recognition by the nurse can prevent deterioration.



6.
A nurse is reviewing labs for a patient on warfarin. Which result requires the most
immediate attention?
A. INR 1.0
B. INR 2.5
C. INR 3.0
D. INR 6.0
Correct Answer: D
Rationale: An INR of 6.0 is dangerously high and indicates a significant risk of
bleeding. Warfarin requires close monitoring, with therapeutic INR typically
between 2–3 for most conditions. At this level, the nurse should anticipate holding
the dose and preparing for possible vitamin K administration.



7.
A patient on insulin reports feeling shaky, sweaty, and confused. Which
intervention should the nurse take first?
A. Administer glucagon injection
B. Give 15 g of simple carbohydrates
C. Notify the healthcare provider
D. Recheck blood glucose in one hour
Correct Answer: B

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Rationale: These symptoms indicate hypoglycemia, which is an immediate
emergency. The first step is to administer a rapid source of glucose such as juice,
candy, or glucose tablets. Glucagon is reserved for severe cases when the patient
cannot swallow safely.


8.
A patient prescribed spironolactone is being counseled. Which statement indicates
the need for further teaching?
A. “I will avoid using salt substitutes.”
B. “I may have increased urination.”
C. “I should monitor for signs of breast tenderness.”
D. “I will eat more bananas for potassium.”
Correct Answer: D
Rationale: Spironolactone is a potassium-sparing diuretic, so extra dietary
potassium can cause hyperkalemia. Salt substitutes also often contain potassium,
which is why they must be avoided. Nurses should emphasize this to prevent
cardiac complications.


9.
A patient with COPD is prescribed albuterol inhaler. What is the primary nursing
teaching?
A. Use the inhaler only at bedtime
B. Rinse mouth after each use
C. Carry the inhaler for acute shortness of breath
D. Take with food to reduce GI upset
Correct Answer: C
Rationale: Albuterol is a short-acting beta agonist (SABA) used as a rescue
inhaler during acute bronchospasm. Patients should carry it at all times. Rinsing
the mouth is more critical for corticosteroid inhalers, not albuterol.



10.
Which patient should not receive a beta blocker?