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NSG 527 MIDTERM EXAM 2026/2027 – LATEST 260 QUESTIONS &
VERIFIED ANSWERS WITH RATIONALES,100% CORRECT ALREADY
GRADED A+
1. A 62-year-old patient with hypertension is prescribed lisinopril. What is the
primary mechanism of action of this medication?
A. Blocks angiotensin II receptors
B. Inhibits the conversion of angiotensin I to angiotensin II
C. Increases aldosterone secretion
D. Stimulates renin release
Correct Answer: B. Inhibits the conversion of angiotensin I to angiotensin II
Rationale: Lisinopril is an ACE inhibitor that prevents the formation of
angiotensin II, resulting in vasodilation and reduced blood pressure.
2. A patient receiving digoxin complains of nausea and visual disturbances.
Which laboratory test should be assessed immediately?
A. Potassium level
B. Sodium level
C. Calcium level
D. Blood urea nitrogen
Correct Answer: A. Potassium level
Rationale: Hypokalemia increases the risk of digoxin toxicity; checking potassium
levels helps identify contributing electrolyte imbalances.
3. When educating a patient about warfarin therapy, which statement
demonstrates correct understanding?
A. “I should eat more green leafy vegetables.”
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B. “I need regular INR monitoring.”
C. “I can take ibuprofen for headaches.”
D. “My diet does not affect my medication.”
Correct Answer: B. “I need regular INR monitoring.”
Rationale: Warfarin requires INR monitoring to maintain therapeutic
anticoagulation and reduce bleeding risk.
4. Which adverse effect is most concerning when initiating a beta-blocker in a
patient with diabetes?
A. Hypoglycemia unawareness
B. Weight loss
C. Polyuria
D. Muscle cramps
Correct Answer: A. Hypoglycemia unawareness
Rationale: Beta-blockers can mask tachycardia and other adrenergic signs of
hypoglycemia, posing a risk for diabetic patients.
5. A patient taking atorvastatin develops muscle pain and weakness. Which
action should the provider take first?
A. Continue therapy with lower dose
B. Check creatine kinase (CK) level
C. Switch to a fibrate
D. Add ezetimibe
Correct Answer: B. Check creatine kinase (CK) level
Rationale: Elevated CK suggests statin-induced myopathy or rhabdomyolysis,
requiring prompt evaluation and discontinuation if confirmed.
6. A 45-year-old asthmatic patient is prescribed propranolol. What should
concern the nurse about this prescription?
A. It can cause bronchoconstriction
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B. It increases heart rate
C. It enhances bronchodilation
D. It reduces anxiety symptoms only
Correct Answer: A. It can cause bronchoconstriction
Rationale: Non-selective beta-blockers like propranolol can block beta-2 receptors
in the lungs, leading to bronchospasm.
7. Which antibiotic requires monitoring for red man syndrome when infused
too rapidly?
A. Vancomycin
B. Ceftriaxone
C. Azithromycin
D. Gentamicin
Correct Answer: A. Vancomycin
Rationale: Rapid infusion of vancomycin can cause histamine-mediated flushing,
hypotension, and rash—known as red man syndrome.
8. What is a key nursing consideration when administering furosemide IV?
A. Administer slowly to prevent ototoxicity
B. Give on an empty stomach
C. Restrict fluid intake before dosing
D. Administer with potassium supplements only
Correct Answer: A. Administer slowly to prevent ototoxicity
Rationale: Rapid IV administration of loop diuretics increases risk of hearing loss;
slow infusion prevents ototoxicity.
9. A patient on lithium therapy presents with tremors and confusion. What
should the nurse assess first?
A. Serum lithium level
B. Thyroid function
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C. Blood glucose
D. Electrocardiogram
Correct Answer: A. Serum lithium level
Rationale: These are early signs of lithium toxicity; serum levels confirm whether
levels exceed the therapeutic range.
10. When administering insulin glargine, which statement is correct?
A. It should be mixed with regular insulin
B. It provides long-acting basal control
C. It peaks within one hour
D. It is used for immediate glucose correction
Correct Answer: B. It provides long-acting basal control
Rationale: Glargine is a long-acting insulin providing steady basal levels with no
pronounced peak.
11. Which adverse effect is most commonly associated with calcium channel
blockers like amlodipine?
A. Peripheral edema
B. Cough
C. Bradycardia
D. Hyperkalemia
Correct Answer: A. Peripheral edema
Rationale: Vasodilation of arterioles can cause fluid accumulation in peripheral
tissues, resulting in edema.
12. A patient is prescribed metformin. What condition is a contraindication
for this drug?
A. Chronic kidney disease
B. Type 2 diabetes
NSG 527 MIDTERM EXAM 2026/2027 – LATEST 260 QUESTIONS &
VERIFIED ANSWERS WITH RATIONALES,100% CORRECT ALREADY
GRADED A+
1. A 62-year-old patient with hypertension is prescribed lisinopril. What is the
primary mechanism of action of this medication?
A. Blocks angiotensin II receptors
B. Inhibits the conversion of angiotensin I to angiotensin II
C. Increases aldosterone secretion
D. Stimulates renin release
Correct Answer: B. Inhibits the conversion of angiotensin I to angiotensin II
Rationale: Lisinopril is an ACE inhibitor that prevents the formation of
angiotensin II, resulting in vasodilation and reduced blood pressure.
2. A patient receiving digoxin complains of nausea and visual disturbances.
Which laboratory test should be assessed immediately?
A. Potassium level
B. Sodium level
C. Calcium level
D. Blood urea nitrogen
Correct Answer: A. Potassium level
Rationale: Hypokalemia increases the risk of digoxin toxicity; checking potassium
levels helps identify contributing electrolyte imbalances.
3. When educating a patient about warfarin therapy, which statement
demonstrates correct understanding?
A. “I should eat more green leafy vegetables.”
,2 | Page
B. “I need regular INR monitoring.”
C. “I can take ibuprofen for headaches.”
D. “My diet does not affect my medication.”
Correct Answer: B. “I need regular INR monitoring.”
Rationale: Warfarin requires INR monitoring to maintain therapeutic
anticoagulation and reduce bleeding risk.
4. Which adverse effect is most concerning when initiating a beta-blocker in a
patient with diabetes?
A. Hypoglycemia unawareness
B. Weight loss
C. Polyuria
D. Muscle cramps
Correct Answer: A. Hypoglycemia unawareness
Rationale: Beta-blockers can mask tachycardia and other adrenergic signs of
hypoglycemia, posing a risk for diabetic patients.
5. A patient taking atorvastatin develops muscle pain and weakness. Which
action should the provider take first?
A. Continue therapy with lower dose
B. Check creatine kinase (CK) level
C. Switch to a fibrate
D. Add ezetimibe
Correct Answer: B. Check creatine kinase (CK) level
Rationale: Elevated CK suggests statin-induced myopathy or rhabdomyolysis,
requiring prompt evaluation and discontinuation if confirmed.
6. A 45-year-old asthmatic patient is prescribed propranolol. What should
concern the nurse about this prescription?
A. It can cause bronchoconstriction
,3 | Page
B. It increases heart rate
C. It enhances bronchodilation
D. It reduces anxiety symptoms only
Correct Answer: A. It can cause bronchoconstriction
Rationale: Non-selective beta-blockers like propranolol can block beta-2 receptors
in the lungs, leading to bronchospasm.
7. Which antibiotic requires monitoring for red man syndrome when infused
too rapidly?
A. Vancomycin
B. Ceftriaxone
C. Azithromycin
D. Gentamicin
Correct Answer: A. Vancomycin
Rationale: Rapid infusion of vancomycin can cause histamine-mediated flushing,
hypotension, and rash—known as red man syndrome.
8. What is a key nursing consideration when administering furosemide IV?
A. Administer slowly to prevent ototoxicity
B. Give on an empty stomach
C. Restrict fluid intake before dosing
D. Administer with potassium supplements only
Correct Answer: A. Administer slowly to prevent ototoxicity
Rationale: Rapid IV administration of loop diuretics increases risk of hearing loss;
slow infusion prevents ototoxicity.
9. A patient on lithium therapy presents with tremors and confusion. What
should the nurse assess first?
A. Serum lithium level
B. Thyroid function
, 4 | Page
C. Blood glucose
D. Electrocardiogram
Correct Answer: A. Serum lithium level
Rationale: These are early signs of lithium toxicity; serum levels confirm whether
levels exceed the therapeutic range.
10. When administering insulin glargine, which statement is correct?
A. It should be mixed with regular insulin
B. It provides long-acting basal control
C. It peaks within one hour
D. It is used for immediate glucose correction
Correct Answer: B. It provides long-acting basal control
Rationale: Glargine is a long-acting insulin providing steady basal levels with no
pronounced peak.
11. Which adverse effect is most commonly associated with calcium channel
blockers like amlodipine?
A. Peripheral edema
B. Cough
C. Bradycardia
D. Hyperkalemia
Correct Answer: A. Peripheral edema
Rationale: Vasodilation of arterioles can cause fluid accumulation in peripheral
tissues, resulting in edema.
12. A patient is prescribed metformin. What condition is a contraindication
for this drug?
A. Chronic kidney disease
B. Type 2 diabetes
