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398 Midterm

Total questions: 133

Worksheet time: 2hrs 2mins

Name
Class
Date
1.

A patient with pre-eclampsia is being monitored on the labor and delivery unit. Which of the following findings would require immediate nursing intervention?

a)

Blood pressure of 148/94

b)

Deep tendon reflexes 3+

c)

Proteinuria +1

d)

Epigastric pain

2.

Which of the following medications is used to reverse opioid overdose?

a)

Oxycodone

b)

Morphine

c)

Naloxone

d)

Methadone

3.

Which of the following best describes the mechanism of action of aspirin?

a)

Blocks serotonin receptors

b)

Inhibits cyclooxygenase (COX) enzymes

c)

Enhances GABA receptors

d)

Increases dopamine availability

4.

A nurse is providing education on montelukast. Which statement by the patient indicates a need for further teaching?

a)

I will use this medication daily, even when I'm not having symptoms.

b)

This medication can be used during an asthma attack.

c)

This medication helps control my asthma long-term.

d)

I should notify my provider if I experience mood changes.

5.

A child is brought in with febrile seizures. Which is the priority nursing intervention?

a)

Start IV fluids

b)

Administer antipyretics

c)

Protect the child from injury

d)

Reassure the parents

6.

Which of the following is a nursing priority for a patient receiving phenytoin?

a)

Monitoring for respiratory depression

b)

Checking for gingival hyperplasia

c)

Assessing for serotonin syndrome

d)

Watching for orthostatic hypotension

7.

A patient with asthma has been prescribed albuterol. Which of the following side effects should the nurse educate the patient about?

a)

Bradycardia

b)

Tremors

c)

Diarrhea

d)

Sedation

8.

Which of the following microbes is considered highly resistant and forms biofilms?

a)

Streptococcus pyogenes

b)

Pseudomonas aeruginosa

c)

Mycobacterium tuberculosis

d)

Escherichia coli

9.

The nurse is caring for a patient with increased intracranial pressure (ICP). Which medication would be expected?

a)

Lisinopril

b)

Morphine

c)

Mannitol

d)

Albuterol

10.

Which of the following is a key teaching point for a patient starting carbamazepine?

a)

Increase potassium-rich foods

b)

Use additional contraception methods

c)

Expect short-term drowsiness only

d)

Monitor for weight gain

11.

A patient has cystic fibrosis. Which electrolyte imbalance is most likely?

a)

Hypokalemia

b)

Hypernatremia

c)

Hyponatremia

d)

Hyperkalemia

12.

A patient is receiving ceftriaxone. Which nursing action is most important?

a)

Administer with meals

b)

Encourage fluid restriction

c)

Assess for allergic reaction

d)

Monitor for hyperkalemia

13.

Which of the following patterns of inheritance is most commonly associated with Duchenne muscular dystrophy?

a)

Autosomal dominant

b)

Autosomal recessive

c)

X-linked recessive

d)

Mitochondrial

14.

Which of the following would be most concerning in a patient with sickle cell disease?

a)

Hemoglobin of 9 g/dL

b)

Reports of joint pain

c)

Fever of 101.5°F

d)

Mild fatigue

15.

Which prototype drug requires blood pressure monitoring prior to administration?

a)

Levetiracetam

b)

Lisinopril

c)

Montelukast

d)

Nitrofurantoin

16.

A patient is receiving ciprofloxacin for a UTI. Which patient teaching is correct?

a)

I can stop the medication once symptoms improve.

b)

I should avoid dairy products with this medication.

c)

It’s safe to take with antacids.

d)

Sun exposure isn’t a concern with this drug.

17.

Which of the following is true about pathogenicity?

a)

It refers to the ability of a microbe to resist antibiotics.

b)

It refers to a microbe's ability to cause disease.

c)

It refers to how microbes evade phagocytosis.

d)

It refers to the genetic mutation rate of a microbe.

18.

Which of the following conditions is characterized by a loss of brain tissue, headache, vomiting, and a bulging fontanelle in infants?

a)

Seizure disorder

b)

Increased ICP

c)

Asthma

d)

Sickle cell crisis

19.

What is the therapeutic action of hydralazine?

a)

Beta-blocker that reduces heart rate

b)

Calcium channel blocker

c)

Direct arterial vasodilator

d)

ACE inhibitor

20.

Which prototype drug works by relaxing smooth muscle in the bronchi?

a)

Albuterol

b)

Beclomethasone

c)

Ipratropium

d)

Montelukast

21.

Which of the following genetic concepts best explains why some individuals with the same gene mutation have different disease severity?

a)

Penetrance

b)

Dominance

c)

Recessiveness

d)

Expressivity

22.

Which of the following medications requires assessment for respiratory depression?

a)

Oxycodone

b)

Divalproex

c)

Albuterol

d)

Lisinopril

23.

Which is a risk factor for pelvic inflammatory disease (PID)?

a)

Oral contraceptive use

b)

Nulliparity

c)

Multiple sexual partners

d)

Breastfeeding

24.

The nurse is educating a patient prescribed doxycycline. Which statement requires correction?

a)

I will use sunscreen and avoid tanning beds.

b)

I can take this with milk to reduce stomach upset.

c)

I should complete the full course even if I feel better.

d)

I should not lie down immediately after taking this medication.

25.

A patient develops shortness of breath, chest pain, and hemoptysis post-op. Which condition is suspected?

a)

Pneumonia

b)

Pulmonary embolism

c)

Bronchiolitis

d)

Asthma

26.

The nurse is preparing to administer beclomethasone inhaler. What should the patient do after using it?

a)

Drink milk

b)

Take a deep breath

c)

Rinse the mouth

d)

Lie flat

27.

Which type of injury is associated with free radical formation and worsens after oxygenation?

a)

Mechanical injury

b)

Reperfusion injury

c)

Hypoxic injury

d)

Radiation injury

28.

Which of the following is a side effect of levetiracetam?

a)

Hepatotoxicity

b)

Aggression and mood changes

c)

Gingival hyperplasia

d)

Stevens-Johnson syndrome

29.

Which electrolyte should be monitored closely with divalproex?

a)

Sodium

b)

Potassium

c)

Ammonia

d)

Calcium

30.

A patient with asthma is prescribed ipratropium. What is its primary action?

a)

Anti-inflammatory corticosteroid

b)

Leukotriene modifier

c)

Anticholinergic bronchodilator

d)

Mast cell stabilizer

31.

A genetic disease that results from a mutation in both alleles of a gene would be classified as:

a)

Autosomal dominant

b)

Autosomal recessive

c)

X-linked recessive

d)

Chromosomal deletion

32.

Which of the following findings would a nurse expect in a child with bronchiolitis?

a)

Barrel chest and clubbing

b)

Wheezing and nasal flaring

c)

Productive cough with green sputum

d)

Inspiratory stridor

33.

Which of the following is a priority teaching point for a patient on metoprolol?

a)

May cause urinary retention

b)

Take with antacids

c)

Monitor heart rate and blood pressure

d)

Avoid salt substitutes

34.

The mechanism of action for lisinopril is:

a)

Blocking calcium channels

b)

Inhibiting ACE enzyme

c)

Stimulating beta-2 receptors

d)

Blocking dopamine reuptake

35.

A nurse is reviewing the chart of a patient with meningitis. Which clinical finding is most expected?

a)

Clear lung sounds

b)

Hyperreflexia

c)

Nuchal rigidity

d)

Jaundice

36.

Which of the following patient reports suggests an adverse effect of nitrofurantoin?

a)

Numbness in fingers

b)

Metallic taste

c)

Dry mouth

d)

Tinnitus

37.

Which of the following best describes ischemic cell injury?

a)

Increased ATP production

b)

Excess oxygen delivery

c)

Impaired blood flow leading to hypoxia

d)

Cellular adaptation and regeneration

38.

Which of the following findings in a child with seizures is most concerning?

a)

Drowsiness after the episode

b)

Postictal confusion

c)

Seizure lasting over 5 minutes

d)

Mild headache

39.

Which is the most important consideration when giving morphine IV?

a)

Hyperkalemia

b)

Respiratory rate

c)

Urine output

d)

Bowel sounds

40.

Which is the most important consideration when giving morphine IV?

a)

Hyperkalemia

b)

Respiratory rate

c)

Urine output

d)

Bowel sounds

41.

Which of the following is a common adverse effect of amlodipine?

a)

Bradycardia

b)

Peripheral edema

c)

Dry cough

d)

Hypoglycemia

42.

Which nursing consideration is appropriate for a patient on cephalexin?

a)

Administer with dairy

b)

Encourage high-fiber foods

c)

Assess for penicillin allergy

d)

Withhold if blood pressure is elevated

43.

A patient with sickle cell disease asks about prevention of crises. Which is the most appropriate teaching?

a)

Drink at least 3 liters of fluid daily.

b)

Take iron supplements daily.

c)

Avoid protein-rich meals.

d)

Rest frequently during the day.

44.

Which of the following describes apoptosis?

a)

Cell death caused by infection

b)

Uncontrolled cell rupture

c)

Programmed cell death

d)

Cell hypertrophy

45.

Which term refers to a microbe's ability to adhere to host tissues?

a)

Virulence

b)

Pathogenicity

c)

Mobility

d)

Adherence

46.

What is a key nursing teaching for a patient prescribed naloxone at home?

a)

It can be reused without issue.

b)

It must be stored in the refrigerator.

c)

You should call 911 even if the person wakes up.

d)

It will provide long-lasting reversal.

47.

A patient receiving oxygen therapy develops reperfusion injury. This is primarily due to:

a)

Mitochondrial swelling

b)

Release of free radicals

c)

Decreased oxygen tension

d)

Increased anaerobic metabolism

48.

Which is a clinical manifestation of a urinary tract infection?

a)

Watery diarrhea

b)

Suprapubic pain

c)

Petechiae

d)

Polycythemia

49.

Which of the following medications acts as a leukotriene receptor antagonist?

a)

Albuterol

b)

Ipratropium

c)

Montelukast

d)

Beclomethasone

50.

Which of the following drugs is contraindicated during pregnancy?

a)

Metoprolol

b)

Doxycycline

c)

Ceftriaxone

d)

Albuterol

51.

Which host characteristic increases susceptibility to infection?

a)

Young adult age

b)

Intact skin

c)

Malnutrition

d)

Adequate hydration

52.

The nurse is teaching a patient with asthma how to use an albuterol inhaler. Which of the following statements are correct teaching points?

a)

Shake the inhaler before use

b)

Use albuterol daily even when asymptomatic

c)

Wait at least 1 minute between puffs

d)

Rinse mouth after each use

e)

It may cause tremors and increased heart rate

53.

Which of the following are expected manifestations of meningitis in a pediatric patient?

a)

Nuchal rigidity

b)

Photophobia

c)

Polyuria

d)

High-pitched cry in infants

e)

Positive Brudzinski sign

54.

Which of the following conditions increase the risk of developing a urinary tract infection (UTI)?

a)

Urinary stasis

b)

Dehydration

c)

Short urethra (in females)

d)

High fluid intake

e)

Diabetes mellitus

55.

The nurse is reviewing labs for a patient taking phenytoin. Which findings are concerning and require further action?

a)

Gingival hyperplasia

b)

Serum level of 25 mcg/mL

c)

Diplopia and ataxia

d)

Reports of sedation

e)

Heart rate of 110 bpm

56.

Which are nursing considerations for a patient taking doxycycline?

a)

Take with a glass of milk

b)

Avoid sun exposure or wear sunscreen

c)

Take on an empty stomach

d)

Use backup birth control

e)

Avoid lying down immediately after taking

57.

Which are signs of increased intracranial pressure (ICP) in a child?

a)

Headache

b)

Decreased level of consciousness

c)

Hypotension

d)

Bulging fontanelle

e)

Projectile vomiting

58.

The nurse is preparing to administer metoprolol. Which of the following must be assessed first?

a)

Heart rate

b)

Respiratory rate

c)

Blood pressure

d)

Potassium level

e)

Temperature

59.

Which are common side effects of opioid medications like morphine and oxycodone?

a)

Constipation

b)

Diarrhea

c)

Respiratory depression

d)

Miosis (pupil constriction)

e)

Sedation

60.

The nurse is educating a patient starting carbamazepine. Which points should be included?

a)

May decrease effectiveness of oral contraceptives

b)

Monitor for rash or skin changes

c)

May cause hyponatremia

d)

Safe to take with grapefruit juice

e)

Periodic CBC monitoring may be required

61.

Which of the following are considered mechanisms of cellular injury?

a)

Ischemia

b)

Oxidative stress

c)

Hyperplasia

d)

Toxin exposure

e)

Mechanical trauma

62.

Which of the following are expected signs and symptoms of pelvic inflammatory disease (PID)?

a)

Lower abdominal pain

b)

Vaginal discharge

c)

Costovertebral angle tenderness

d)

Fever and chills

e)

Dyspareunia (pain with intercourse)

63.

The nurse is teaching about naloxone to a patient's family. Which points are important to include?

a)

It should be given if breathing slows or stops

b)

Effects may wear off before opioid does

c)

Always call 911 after administering

d)

It can be safely stored at room temperature

e)

Repeated doses may be needed

64.

Which of the following statements about antibiotic resistance are true?

a)

It can result from overuse of antibiotics

b)

Resistant microbes can spread between people

c)

It’s a natural process that can’t be influenced

d)

Incomplete antibiotic courses can contribute

e)

It only affects hospital-acquired infections

65.

Which are adverse effects or considerations of ACE inhibitors like lisinopril?

a)

Dry cough

b)

Hyperkalemia

c)

Angioedema

d)

Hypoglycemia

e)

Teratogenicity

66.

Which of the following are expected symptoms of asthma exacerbation?

a)

Wheezing

b)

Retractions

c)

Stridor

d)

Coughing

e)

Chest tightness

67.

The nurse is caring for a child with bronchiolitis. Which interventions are appropriate?

a)

Suction nasal secretions

b)

Administer albuterol routinely

c)

Encourage oral fluid intake

d)

Administer antibiotics as ordered

e)

Monitor oxygen saturation

68.

Which of the following are true about sickle cell disease?

a)

It is autosomal dominant

b)

Painful crises are common

c)

Hydration helps prevent crises

d)

It affects hemoglobin structure

e)

Infection can trigger sickling

69.

Which prototype medications are used to treat hypertension?

a)

Lisinopril

b)

Amlodipine

c)

Hydralazine

d)

Metoprolol

e)

Divalproex

70.

Which of the following describe features of a microbe's virulence?

a)

Ability to adhere to host cells

b)

Ability to form biofilms

c)

Ability to replicate inside host DNA

d)

Resistance to phagocytosis

e)

Production of toxins

71.

Which of the following are expected nursing considerations when administering ceftriaxone?

a)

Monitor for allergic reaction

b)

Check renal function

c)

Assess for diarrhea

d)

Monitor ECG for QT prolongation

e)

Watch for signs of superinfection

72.

Cystic fibrosis causes loss of sodium and chloride in sweat — leading to hyponatremia.

a)

A

b)

B

c)

C

d)

D

73.

Ceftriaxone can cause allergic reactions, especially in those with penicillin allergies.

a)

A

b)

B

c)

C

d)

D

74.

Duchenne muscular dystrophy is X-linked recessive, affecting mostly males.

a)

A

b)

B

c)

C

d)

D

75.

Fever in sickle cell disease may signal infection and can precipitate crisis — urgent!

a)

A

b)

B

c)

C

d)

D

76.

Lisinopril, an ACE inhibitor, may cause hypotension — check BP first.

a)

A

b)

B

c)

C

d)

D

77.

Dairy reduces absorption of ciprofloxacin; take it 2 hours before or 6 hours after.

a)

A

b)

B

c)

C

d)

D

78.

Pathogenicity refers to the ability of a microbe to cause disease.

a)

A

b)

B

c)

C

d)

D

79.

Increased ICP in infants may show vomiting, bulging fontanelle, and lethargy.

a)

A

b)

B

c)

C

d)

D

80.

Hydralazine is a direct arterial vasodilator — reduces BP by relaxing vessels.

a)

A

b)

B

c)

C

d)

D

81.

Albuterol is a β2-agonist that relaxes smooth muscle in the airways.

a)

A

b)

B

c)

C

d)

D

82.

Expressivity describes variations in symptom severity among individuals with the same genotype.

a)

A

b)

B

c)

C

d)

D

83.

Oxycodone is an opioid — monitor for respiratory depression.

a)

A

b)

B

c)

C

d)

D

84.

Multiple partners increase risk for STIs, leading to pelvic inflammatory disease.

a)

A

b)

B

c)

C

d)

D

85.

Doxycycline should not be taken with dairy — it reduces drug absorption.

a)

A

b)

B

c)

C

d)

D

86.

Pulmonary embolism signs include dyspnea, chest pain, hemoptysis, post-op risk.

a)

A

b)

B

c)

C

d)

D

87.

Rinse mouth after inhaled steroids (beclomethasone) to prevent oral thrush.

a)

A

b)

B

c)

C

d)

D

88.

Reperfusion injury involves free radical damage after restoring blood flow.

a)

A

b)

B

c)

C

d)

D

89.

Levetiracetam is known to cause behavioral changes, such as aggression.

a)

A

b)

B

c)

C

d)

D

90.

Divalproex may increase ammonia levels — monitor for hepatotoxicity/encephalopathy.

a)

A

b)

B

c)

C

d)

D

91.

Ipratropium is an anticholinergic bronchodilator — prevents bronchoconstriction.

a)

A

b)

B

c)

C

d)

D

92.

Autosomal recessive disorders require two mutated alleles for disease to appear.

a)

A

b)

B

c)

C

d)

D

93.

Bronchiolitis in children causes wheezing, nasal flaring, retractions, and tachypnea.

a)

A

b)

B

c)

C

d)

D

94.

Metoprolol lowers HR and BP — monitor both before administration.

a)

A

b)

B

c)

C

d)

D

95.

Lisinopril is an ACE inhibitor — it prevents angiotensin I to II conversion, lowering BP.

a)

A

b)

B

c)

C

d)

D

96.

Nuchal rigidity is a classic sign of meningitis due to meningeal inflammation.

a)

A

b)

B

c)

C

d)

D

97.

Nitrofurantoin may cause peripheral neuropathy — report numbness/tingling.

a)

A

b)

B

c)

C

d)

D

98.

Ischemic injury results from inadequate blood flow → hypoxia → cellular dysfunction.

a)

A

b)

B

c)

C

d)

D

99.

Seizure >5 minutes is status epilepticus, a medical emergency.

a)

A

b)

B

c)

C

d)

D

100.

Morphine depresses respiratory rate — monitor closely before and after admin.

a)

A

b)

B

c)

C

d)

D

101.

Amlodipine, a calcium channel blocker, commonly causes peripheral edema.

a)

A

b)

B

c)

C

d)

D

102.

Cephalexin can cause cross-reactivity in those with penicillin allergies.

a)

A

b)

B

c)

C

d)

D

103.

Hydration prevents sickling of RBCs in sickle cell disease — 3+ liters/day.

a)

A

b)

B

c)

C

d)

D

104.

Apoptosis is programmed, regulated cell death — distinct from necrosis.

a)

A

b)

B

c)

C

d)

D

105.

Adherence refers to a microbe’s ability to stick to host tissues.

a)

A

b)

B

c)

C

d)

D

106.

After naloxone use, always call 911 — effects are short-lived and recurrence possible.

a)

A

b)

B

c)

C

d)

D

107.

Free radicals are released during reperfusion and damage cellular structures.

a)

A

b)

B

c)

C

d)

D

108.

Suprapubic pain, frequency, and dysuria are signs of a UTI.

a)

A

b)

B

c)

C

d)

D

109.

Montelukast blocks leukotriene receptors — reduces inflammation in asthma.

a)

A

b)

B

c)

C

d)

D

110.

Doxycycline is teratogenic and contraindicated in pregnancy.

a)

A

b)

B

c)

C

d)

D

111.

Malnutrition impairs immune function and increases risk of infection.

a)

A

b)

B

c)

C

d)

D

112.

Shake the inhaler before use.

4 lines
113.

Wait 1 minute between puffs.

4 lines
114.

May cause tremors, ↑HR.

4 lines
115.

Nuchal rigidity, Photophobia, High-pitched cry, Brudzinski sign.

4 lines
116.

Urinary stasis, dehydration, short urethra, diabetes.

4 lines
117.

Gingival hyperplasia, toxic level (>20), ataxia.

4 lines
118.

Sun sensitivity, empty stomach, backup birth control, upright after taking.

4 lines
119.

Headache, ↓ LOC, bulging fontanelle, projectile vomiting.

4 lines
120.

HR & BP must be checked for beta-blockers.

4 lines
121.

Constipation, respiratory depression, miosis, sedation.

4 lines
122.

↓ birth control, rash risk, hyponatremia, CBC needed.

4 lines
123.

Ischemia, oxidative stress, toxins, mechanical trauma.

4 lines
124.

Pain, discharge, fever, dyspareunia.

4 lines
125.

Naloxone must be used at signs of opioid toxicity, wears off fast, may need repeats, room temp storage is okay, and 911 should always be called.

4 lines
126.

Overuse, transmission, incomplete courses.

4 lines
127.

Dry cough, ↑K+, angioedema, teratogenic.

4 lines
128.

Wheezing, retractions, coughing, chest tightness.

4 lines
129.

Suction, fluids, O2 monitoring.

4 lines
130.

Pain, hydration, hemoglobin defect, infection risk.

4 lines
131.

Lisinopril, amlodipine, hydralazine, metoprolol.

4 lines
132.

Adherence, biofilms, antiphagocytic, toxins.

4 lines
133.

Allergic reactions, renal fxn, diarrhea, superinfection.

4 lines

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