NUR-641E STUDY GUIDE 1 MIDTERM LATEST
UPDATED 2026-2027 ACTUAL FINAL EXAM PREP
WITH WELL ELLABORATED 100 PRACTICE
QUESTIONS AND 100% CORRECT VERIFIED
ANSWERS ALREADY A+ GRADED BRAND NEW!!!
1. A patient with heart failure is prescribed furosemide.
Which laboratory value requires
immediate intervention?
A) Serum potassium 3.8 mEq/L
B) Serum sodium 135 mEq/L
C) Serum potassium 2.9 mEq/L
D) Serum magnesium 2.0 mg/dL
Answer: C
Rationale: Hypokalemia (K <3.5) increases risk of
arrhythmias and digoxin toxicity.
2. A patient is receiving digoxin and develops nausea,
vomiting, and blurred yellow vision.
Which action is most appropriate?
,A) Increase the digoxin dose
B) Administer potassium chloride
C) Hold digoxin and check serum digoxin level
D) Continue digoxin and monitor symptoms
Answer: C
Rationale: Nausea and visual changes suggest digoxin
toxicity; hold dose and assess level.
3. Which medication is a loop diuretic commonly used for
acute pulmonary edema?
A) Hydrochlorothiazide
B) Spironolactone
C) Furosemide
D) Metolazone
Answer: C
Rationale: Furosemide (loop diuretic) acts rapidly for
acute volume overload.
4. A patient with hypertension is prescribed lisinopril.
Which adverse effect requires
patient education?
,A) Dry cough
B) Hyperkalemia
C) Angioedema
D) All of the above
Answer: D
Rationale: ACE inhibitors cause dry cough, hyperkalemia,
and angioedema (rare but serious).
5. A patient with asthma is prescribed propranolol for
migraines. The nurse should
question this order because propranolol can:
A) Cause hypertension
B) Cause bronchospasm in asthmatics
C) Increase heart rate
D) Increase blood glucose
Answer: B
Rationale: Non-selective beta-blockers (propranolol)
block beta-2 receptors, causing bronchospasm.
6. Which class of antihypertensive drugs is associated
with hyperkalemia and
, gynecomastia?
A) ACE inhibitors
B) Angiotensin II receptor blockers (ARBs)
C) Spironolactone (aldosterone antagonist)
D) Calcium channel blockers
Answer: C
Rationale: Spironolactone is potassium-sparing;
gynecomastia due to hormonal effects.
7. A patient with angina is prescribed nitroglycerin
sublingual. The nurse instructs the
patient to take:
A) One tablet every 5 minutes for up to 3 doses, then call
911 if no relief
B) One tablet every 15 minutes for 4 doses
C) Two tablets immediately, then one every hour
D) One tablet daily at bedtime
Answer: A
Rationale: Nitroglycerin protocol: one tablet; if no relief
in 5 minutes, call 911; may repeat twice.
UPDATED 2026-2027 ACTUAL FINAL EXAM PREP
WITH WELL ELLABORATED 100 PRACTICE
QUESTIONS AND 100% CORRECT VERIFIED
ANSWERS ALREADY A+ GRADED BRAND NEW!!!
1. A patient with heart failure is prescribed furosemide.
Which laboratory value requires
immediate intervention?
A) Serum potassium 3.8 mEq/L
B) Serum sodium 135 mEq/L
C) Serum potassium 2.9 mEq/L
D) Serum magnesium 2.0 mg/dL
Answer: C
Rationale: Hypokalemia (K <3.5) increases risk of
arrhythmias and digoxin toxicity.
2. A patient is receiving digoxin and develops nausea,
vomiting, and blurred yellow vision.
Which action is most appropriate?
,A) Increase the digoxin dose
B) Administer potassium chloride
C) Hold digoxin and check serum digoxin level
D) Continue digoxin and monitor symptoms
Answer: C
Rationale: Nausea and visual changes suggest digoxin
toxicity; hold dose and assess level.
3. Which medication is a loop diuretic commonly used for
acute pulmonary edema?
A) Hydrochlorothiazide
B) Spironolactone
C) Furosemide
D) Metolazone
Answer: C
Rationale: Furosemide (loop diuretic) acts rapidly for
acute volume overload.
4. A patient with hypertension is prescribed lisinopril.
Which adverse effect requires
patient education?
,A) Dry cough
B) Hyperkalemia
C) Angioedema
D) All of the above
Answer: D
Rationale: ACE inhibitors cause dry cough, hyperkalemia,
and angioedema (rare but serious).
5. A patient with asthma is prescribed propranolol for
migraines. The nurse should
question this order because propranolol can:
A) Cause hypertension
B) Cause bronchospasm in asthmatics
C) Increase heart rate
D) Increase blood glucose
Answer: B
Rationale: Non-selective beta-blockers (propranolol)
block beta-2 receptors, causing bronchospasm.
6. Which class of antihypertensive drugs is associated
with hyperkalemia and
, gynecomastia?
A) ACE inhibitors
B) Angiotensin II receptor blockers (ARBs)
C) Spironolactone (aldosterone antagonist)
D) Calcium channel blockers
Answer: C
Rationale: Spironolactone is potassium-sparing;
gynecomastia due to hormonal effects.
7. A patient with angina is prescribed nitroglycerin
sublingual. The nurse instructs the
patient to take:
A) One tablet every 5 minutes for up to 3 doses, then call
911 if no relief
B) One tablet every 15 minutes for 4 doses
C) Two tablets immediately, then one every hour
D) One tablet daily at bedtime
Answer: A
Rationale: Nitroglycerin protocol: one tablet; if no relief
in 5 minutes, call 911; may repeat twice.
