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NSG2311 Exam 3 Crash Review

Total questions: 60

Worksheet time: 30mins

Name
Class
Date
1.

A patient with type 1 diabetes is prescribed insulin lispro. Which instruction should the nurse include?

a)

Take this insulin at bedtime.

b)

Take this insulin 30 minutes before meals.

c)

Take this insulin with the first bite of your meal.

d)

Do not mix this insulin with any other insulin.

2.

The nurse administers regular insulin at 0730. When is the patient MOST at risk for hypoglycemia?

a)

0800

b)

0900

c)

1100

d)

1500

3.

A patient receiving NPH insulin reports feeling shaky and sweaty at 1200. The nurse suspects:

a)

Expected adverse reaction

b)

Mid-morning hypoglycemia

c)

Dawn phenomenon

d)

Somogyi effect

4.

A nurse prepares to mix regular insulin and NPH. Which action indicates correct technique?

a)

Draw up NPH first

b)

Do not mix insulins

c)

Inject air into NPH first

d)

Shake NPH vigorously

5.

Which patient statement indicates correct teaching regarding insulin glargine?

a)

“I can mix this with lispro.”

b)

“I should take it at the same time each day.”

c)

“This insulin peaks two hours after I inject it.”

d)

“I should take it three times per day.”

6.

A type 2 diabetic patient started metformin 2 days ago and reports diarrhea. The nurse should:

a)

Tell the patient to stop the medication

b)

Inform the patient this effect often improves

c)

Give an antidiarrheal medication

d)

Reduce the dose immediately

7.

Before a CT scan with contrast, which action is priority for a patient taking metformin?

a)

Check potassium

b)

Hold metformin for 48 hrs

c)

Increase the dose

d)

Give with extra fluids

8.

A nurse is teaching about glipizide. Which finding indicates effectiveness?

a)

Decreased urine output

b)

Lower fasting blood glucose

c)

Weight loss

d)

Increased appetite

9.

Which finding requires immediate intervention in a patient taking glipizide?

a)

Photosensitivity

b)

Nausea

c)

Rash and fever

d)

Mild GI upset

10.

A patient taking glipizide reports drinking alcohol. The nurse should warn about:

a)

Extreme hyperglycemia

b)

Hypertensive crisis

11.

A patient taking prednisone long-term is at risk for:

a)

Hypoglycemia

b)

Immunosuppression

c)

Weight loss

d)

Hyponatremia

12.

Which finding indicates prednisone needs urgent evaluation?

a)

Increased appetite

b)

Weight gain

c)

Fever

d)

Mild irritability

13.

A patient taking prednisone says, “I stopped taking it yesterday because I felt better.” The nurse should respond:

a)

“That is fine.”

b)

“This medication must be tapered.”

c)

“You can restart anytime.”

d)

“Take it only when ill.”

14.

A patient taking fludrocortisone for Addison’s disease should report:

a)

Mild fatigue

b)

Increased urination

c)

Swelling in legs

d)

Mild headache

15.

Which lab value MOST important for a patient on fludrocortisone?

a)

Hemoglobin

b)

Potassium

c)

Platelets

d)

BUN

16.

Which statement indicates correct teaching about levothyroxine?

a)

“I will take it with breakfast.”

b)

“I should take it at night.”

c)

“I will take it on an empty stomach.”

d)

“I can take it with antacids.”

17.

A patient taking levothyroxine reports palpitations, heat intolerance, and insomnia. The nurse suspects:

a)

Dose too low

b)

Allergic reaction

c)

Overreplacement

d)

Normal side effects

18.

A patient taking methimazole should report immediately:

a)

Mild headache

b)

Insomnia

c)

Fever and sore throat

d)

Constipation

19.

After radioactive iodine therapy, which statement indicates correct teaching?

a)

“I should share utensils with my family.”

b)

“I’ll avoid pregnant women for a few days.”

c)

“I should save my urine for testing.”

d)

“This medication cures hypothyroidism permanently.”

20.

A patient receiving RAI-131 reports dry mouth and sore throat. The nurse should recommend:

a)

High-fat meals

b)

More fluids

21.

Which level requires immediate action for a patient on lithium?

a)

0.8 mEq/L

b)

1.1 mEq/L

c)

1.6 mEq/L

d)

0.6 mEq/L

22.

A patient taking lithium has nausea, vomiting, coarse tremors, and confusion. Priority action:

a)

Give another dose

b)

Restrict fluids

c)

Notify provider

d)

Give potassium

23.

Teaching for a patient on lithium should include:

a)

“Decrease sodium intake.”

b)

“Avoid dehydration.”

c)

“Take NSAIDs for headaches.”

d)

“Stop medication if thirsty.”

24.

Which patient is NOT a good candidate for lithium therapy?

a)

Hypertension

b)

Renal impairment

c)

Anxiety

d)

Tachycardia

25.

A patient taking lamotrigine reports a new rash. The nurse should:

a)

Reassure patient

b)

Continue medication

c)

Report immediately

d)

Apply lotion

26.

A patient taking haloperidol develops neck stiffness and oculogyric crisis. Which is priority?

a)

Reassurance

b)

Apply heat

c)

Administer benztropine

d)

Hold fluids

27.

A patient taking haloperidol presents with high fever, severe rigidity, and altered mental status. This is:

a)

Serotonin syndrome

b)

NMS

c)

EPS

d)

Dystonia

28.

Which finding is a tardive dyskinesia symptom?

a)

Drooling

b)

Tongue protrusion

c)

Arm rigidity

d)

Muscle spasms

29.

A teaching point for a patient taking chlorpromazine is to:

a)

Avoid sunlight

b)

Eat high-fat foods

c)

Expect diarrhea

d)

Stop medication if constipated

30.

Which lab test is essential for a patient taking clozapine?

a)

Hemoglobin

b)

WBC/ANC

31.

Which food should a patient taking phenelzine avoid?

a)

Apple

b)

Cheddar cheese

c)

Chicken breast

d)

Yogurt

32.

A patient taking phenelzine reports a severe headache and stiff neck. The nurse suspects:

a)

Stroke

b)

Hypertensive crisis

c)

Withdrawal

d)

Serotonin syndrome

33.

A patient on fluoxetine reports agitation, sweating, fever, and tremors. The nurse suspects:

a)

Withdrawal

b)

Hypertensive crisis

c)

Serotonin syndrome

d)

Lithium toxicity

34.

What teaching is appropriate for fluoxetine?

a)

Expect immediate effect

b)

Avoid stopping abruptly

c)

Take with MAOIs

d)

Avoid exercise

35.

Which patient should NOT receive bupropion?

a)

Migraine history

b)

Hypertension

c)

Seizure disorder

d)

Hyperlipidemia

36.

Which statement indicates correct bupropion teaching?

a)

“I’ll take it before bed.”

b)

“This medication may help me quit smoking.”

c)

“This will cause weight gain.”

d)

“This medication is very sedating.”

37.

A patient receives diazepam IV. Which assessment is priority?

a)

Heart sounds

b)

Respiratory rate

c)

Urine output

d)

Temperature

38.

Teaching for a patient taking alprazolam includes:

a)

Take PRN for acute anxiety

b)

Do not take with grapefruit juice

c)

Expect no risk of dependence

d)

Stop abruptly if drowsy

39.

Which patient statement indicates correct teaching about buspirone?

a)

“I can take it only when anxious.”

b)

“It may take weeks to work.”

c)

“It causes major sedation.”

d)

“I should avoid taking it long-term.”

40.

Which interaction is concerning for a patient taking buspirone?

a)

Milk

b)

Grapefruit juice

c)

Apples

d)

Lettuce

41.

A diabetic patient on prednisone may need:

a)

Lower insulin dose

b)

Higher insulin dose

c)

Less glucose monitoring

d)

More NPH mixing

42.

A patient taking methimazole with dark urine likely has:

a)

Renal failure

b)

Liver toxicity

c)

Dehydration

d)

Infection

43.

A patient starting levothyroxine should be monitored for:

a)

Bradycardia

b)

Cold intolerance

c)

Tachycardia

d)

Weight gain

44.

Lithium levels increase with:

a)

Hydration

b)

High sodium

c)

NSAIDs

d)

Diuretics stopped

45.

A patient taking chlorpromazine should report:

a)

Sunburn

b)

Constipation

c)

Yellowing of skin

d)

Mild drowsiness

46.

Which intervention is appropriate for NMS?

a)

Increase antipsychotic dose

b)

Stop the antipsychotic

c)

Administer tyramine

d)

Give insulin

47.

A patient taking glipizide who skips meals risks:

a)

Hyperglycemia

b)

Hypoglycemia

c)

Hypertension

d)

Tachycardia

48.

A patient taking prednisone with gastric irritation should:

a)

Take on empty stomach

b)

Take with food

c)

Stop medication

d)

Add caffeine

49.

A patient after RAI develops hypothyroidism. Expected medication?

a)

Methimazole

b)

Prednisone

c)

Levothyroxine

d)

Lithium

50.

A patient taking fluoxetine says, “I feel more energy but still depressed.” Priority?

a)

Medication is ineffective

b)

Risk for suicide

c)

Too much serotonin

d)

Dose too low

51.

A patient taking NPH asks why insulin is cloudy. The nurse states:

a)

“It has added preservatives.”

b)

“This is normal—roll before use.”

c)

“It means it has expired.”

d)

“It contains regular insulin.”

52.

Sign of hypoglycemia:

a)

Excessive thirst

b)

Sweating and shakiness

c)

Increased urination

d)

Dry skin

53.

Which instruction is correct for lithium?

a)

Maintain high fluid intake

b)

Restrict fluids

c)

Avoid salt

d)

Skip doses when feeling well

54.

Buspirone is preferred for patients with:

a)

Seizure disorders

b)

Chronic pain

c)

Substance use disorder

d)

Tachycardia

55.

Which teaching is correct for MAOIs?

a)

Avoid chocolate

b)

Take PRN

c)

Take with SSRIs

d)

Limit sodium

56.

A patient taking lamotrigine with dizziness should:

a)

Stop abruptly

b)

Report only if rash

c)

Take at bedtime

d)

Increase dose

57.

A patient taking chlorpromazine with low BP on standing is experiencing:

a)

QT prolongation

b)

EPS

c)

Orthostatic hypotension

d)

NMS

58.

A patient taking prednisone is at highest risk for which infection sign?

a)

Tachycardia

b)

Fever

c)

Constipation

d)

Bradycardia

59.

A patient on fluoxetine taking St. John’s Wort risks:

a)

Hypertension

b)

Serotonin syndrome

c)

Increased appetite

d)

Dehydration

60.

Which is an adverse effect of amitriptyline?

a)

Diarrhea

b)

Blurred vision and urinary retention

c)

Hypotension

d)

Increased libido