NSG 3500 - Exam 4 Questions With
Complete Solutions
Course
NSG 3500
1. A nurse is assessing a patient who has been prescribed digoxin. Which of the following
findings should prompt the nurse to withhold the medication and notify the healthcare
provider?
A) Heart rate of 62 bpm
B) Blood pressure of 130/80 mmHg
C) Potassium level of 3.0 mEq/L
D) Respiratory rate of 18 breaths per minute
Solution:
The correct answer is C) Potassium level of 3.0 mEq/L.
Digoxin toxicity is more likely when potassium levels are low. Normal potassium levels
range from 3.5 to 5.0 mEq/L.
The nurse should monitor the patient for signs of toxicity (nausea, vomiting, vision
changes) and report the low potassium level before administering digoxin.
2. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy at 4 L/min via nasal cannula. The nurse notices the patient is becoming drowsy and
has a decreased respiratory rate. What is the nurse's best action?
,A) Increase the oxygen flow rate to 6 L/min
B) Encourage the patient to take deep breaths
C) Reduce the oxygen flow rate and monitor closely
D) Stop oxygen therapy immediately
Solution:
The correct answer is C) Reduce the oxygen flow rate and monitor closely.
Patients with COPD have hypoxic drive as their main respiratory stimulus.
High oxygen levels can suppress their breathing. Reducing the oxygen flow rate can
help maintain adequate ventilation.
3. A nurse is caring for a patient with diabetes who is experiencing signs of hypoglycemia.
Which of the following interventions should the nurse perform first?
A) Administer glucagon intramuscularly
B) Give the patient 15 grams of a fast-acting carbohydrate
C) Check the patient’s blood glucose level
D) Notify the healthcare provider
Solution:
The correct answer is C) Check the patient’s blood glucose level.
Before any intervention, the nurse should confirm hypoglycemia (blood glucose <70
mg/dL).
, If hypoglycemia is confirmed, the nurse should follow the 15-15 rule (15g carbohydrate,
recheck in 15 minutes).
4. A nurse is educating a patient about warfarin therapy. Which of the following statements
by the patient indicates a need for further teaching?
A) "I will avoid leafy green vegetables."
B) "I will use an electric razor instead of a blade razor."
C) "I will take my medication at the same time every day."
D) "I will notify my doctor if I notice unusual bruising or bleeding."
Solution:
The correct answer is A) "I will avoid leafy green vegetables."
Patients on warfarin should NOT completely avoid vitamin K-rich foods but should
consume them consistently to maintain therapeutic INR levels.
5. A nurse is providing discharge instructions to a patient taking furosemide. Which
statement by the patient indicates understanding?
A) "I should take this medication in the evening before bed."
B) "I should eat foods rich in potassium."
C) "This medication will help lower my blood sugar."
D) "I don’t need to monitor my blood pressure while on this medication."
, Solution:
The correct answer is B) "I should eat foods rich in potassium."
Furosemide is a loop diuretic that can cause hypokalemia.
Patients should consume potassium-rich foods like bananas, oranges, and spinach.
6. A nurse is caring for a patient who has pneumonia. Which assessment finding requires
immediate intervention?
A) Crackles heard in the lung bases
B) Oxygen saturation of 89% on room air
C) Fever of 101.2°F (38.4°C)
D) A productive cough with yellow sputum
Solution:
The correct answer is B) Oxygen saturation of 89% on room air.
Oxygen saturation below 90% indicates hypoxia, which requires immediate intervention,
such as oxygen therapy.
7. A patient receiving heparin therapy develops bruising and petechiae. What is the nurse’s
priority action?
A) Administer vitamin K
B) Stop the heparin infusion and notify the provider
Complete Solutions
Course
NSG 3500
1. A nurse is assessing a patient who has been prescribed digoxin. Which of the following
findings should prompt the nurse to withhold the medication and notify the healthcare
provider?
A) Heart rate of 62 bpm
B) Blood pressure of 130/80 mmHg
C) Potassium level of 3.0 mEq/L
D) Respiratory rate of 18 breaths per minute
Solution:
The correct answer is C) Potassium level of 3.0 mEq/L.
Digoxin toxicity is more likely when potassium levels are low. Normal potassium levels
range from 3.5 to 5.0 mEq/L.
The nurse should monitor the patient for signs of toxicity (nausea, vomiting, vision
changes) and report the low potassium level before administering digoxin.
2. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy at 4 L/min via nasal cannula. The nurse notices the patient is becoming drowsy and
has a decreased respiratory rate. What is the nurse's best action?
,A) Increase the oxygen flow rate to 6 L/min
B) Encourage the patient to take deep breaths
C) Reduce the oxygen flow rate and monitor closely
D) Stop oxygen therapy immediately
Solution:
The correct answer is C) Reduce the oxygen flow rate and monitor closely.
Patients with COPD have hypoxic drive as their main respiratory stimulus.
High oxygen levels can suppress their breathing. Reducing the oxygen flow rate can
help maintain adequate ventilation.
3. A nurse is caring for a patient with diabetes who is experiencing signs of hypoglycemia.
Which of the following interventions should the nurse perform first?
A) Administer glucagon intramuscularly
B) Give the patient 15 grams of a fast-acting carbohydrate
C) Check the patient’s blood glucose level
D) Notify the healthcare provider
Solution:
The correct answer is C) Check the patient’s blood glucose level.
Before any intervention, the nurse should confirm hypoglycemia (blood glucose <70
mg/dL).
, If hypoglycemia is confirmed, the nurse should follow the 15-15 rule (15g carbohydrate,
recheck in 15 minutes).
4. A nurse is educating a patient about warfarin therapy. Which of the following statements
by the patient indicates a need for further teaching?
A) "I will avoid leafy green vegetables."
B) "I will use an electric razor instead of a blade razor."
C) "I will take my medication at the same time every day."
D) "I will notify my doctor if I notice unusual bruising or bleeding."
Solution:
The correct answer is A) "I will avoid leafy green vegetables."
Patients on warfarin should NOT completely avoid vitamin K-rich foods but should
consume them consistently to maintain therapeutic INR levels.
5. A nurse is providing discharge instructions to a patient taking furosemide. Which
statement by the patient indicates understanding?
A) "I should take this medication in the evening before bed."
B) "I should eat foods rich in potassium."
C) "This medication will help lower my blood sugar."
D) "I don’t need to monitor my blood pressure while on this medication."
, Solution:
The correct answer is B) "I should eat foods rich in potassium."
Furosemide is a loop diuretic that can cause hypokalemia.
Patients should consume potassium-rich foods like bananas, oranges, and spinach.
6. A nurse is caring for a patient who has pneumonia. Which assessment finding requires
immediate intervention?
A) Crackles heard in the lung bases
B) Oxygen saturation of 89% on room air
C) Fever of 101.2°F (38.4°C)
D) A productive cough with yellow sputum
Solution:
The correct answer is B) Oxygen saturation of 89% on room air.
Oxygen saturation below 90% indicates hypoxia, which requires immediate intervention,
such as oxygen therapy.
7. A patient receiving heparin therapy develops bruising and petechiae. What is the nurse’s
priority action?
A) Administer vitamin K
B) Stop the heparin infusion and notify the provider
