Download NSG6020 / NSG 6020 Midterm 2 Exam 2025 Questions and Answers Updated (2025 / 2026) (Veri and more Exams Nursing in PDF only on Docsity!
NSG6020 / NSG 6020 Midterm 2 Exam 2025
Questions and Answers Updated (2025 / 2026)
(Verified Answers)
- Which of the following drug classes is most effective in treating hypertension in African American patients? A. ACE inhibitors B. Beta-blockers C. Calcium channel blockers D. Alpha-1 antagonists Calcium channel blockers are more effective in African American patients due to lower renin levels, which makes them less responsive to ACE inhibitors and beta- blockers.
- Which antibiotic is contraindicated in pregnancy due to its effect on fetal bone growth? A. Amoxicillin B. Doxycycline C. Erythromycin D. Cephalexin
Doxycycline, a tetracycline, can impair fetal bone growth and discolor teeth, making it unsafe during pregnancy.
- Which of the following insulins has the shortest onset of action? A. Regular insulin B. NPH insulin C. Lispro (Humalog) D. Detemir (Levemir) Lispro is a rapid-acting insulin with onset in about 15 minutes, ideal for controlling postprandial glucose spikes.
- A patient taking warfarin has an INR of 5.2 without bleeding. What is the appropriate action? A. Continue warfarin at the same dose B. Increase warfarin dose C. Hold 1–2 doses of warfarin D. Administer vitamin K immediately An INR of 5.2 without bleeding is treated by holding warfarin until INR decreases. Vitamin K is reserved for higher INR or active bleeding.
- Which drug is used as first-line therapy in a newly diagnosed type 2 diabetic with normal renal function?
Diphenhydramine has strong anticholinergic properties, increasing risk of confusion, falls, and urinary retention in older adults.
- What lab value must be monitored with statin therapy? A. BUN B. Hemoglobin C. INR D. Liver enzymes Statins can cause hepatotoxicity; liver enzymes (ALT, AST) should be monitored at baseline and if symptoms arise.
- Which of the following is a potential side effect of spironolactone? A. Hypokalemia B. Hypernatremia C. Gynecomastia D. Tachycardia Spironolactone is a potassium-sparing diuretic and an aldosterone antagonist, which can cause gynecomastia due to hormonal effects. 10.A 30-year-old female on isotretinoin must be monitored for: A. Renal failure B. Pregnancy
C. Cardiac arrhythmias D. Hyperthyroidism Isotretinoin is teratogenic and contraindicated in pregnancy; patients must follow iPLEDGE requirements including pregnancy tests. 11.What is the antidote for benzodiazepine overdose? A. Naloxone B. Protamine sulfate C. Flumazenil D. Atropine Flumazenil is a benzodiazepine antagonist used in acute overdose, but it must be used cautiously due to risk of seizures. 12.What is the preferred antibiotic for treating group A streptococcal pharyngitis? A. Penicillin V B. Erythromycin C. Amoxicillin-clavulanate D. Azithromycin Penicillin V is the drug of choice for strep pharyngitis; resistance remains low. 13.A known side effect of amiodarone includes:
16.What is a key teaching point for levothyroxine? A. Take with food B. Take on an empty stomach C. Take at bedtime D. Take with calcium Levothyroxine absorption is best on an empty stomach, ideally 30–60 minutes before breakfast. 17.Which diabetes medication promotes weight loss? A. Sulfonylureas B. GLP-1 receptor agonists C. DPP-4 inhibitors D. Insulin GLP-1 receptor agonists (e.g., liraglutide) slow gastric emptying and suppress appetite, contributing to weight loss. 18.A common adverse effect of niacin is: A. Flushing B. Constipation C. Hypertension D. Hyperkalemia Niacin often causes prostaglandin-mediated flushing; this may be mitigated by taking aspirin beforehand.
19.What class is alendronate, used for osteoporosis? A. SERMs B. Bisphosphonates C. Calcitonin analogs D. Estrogen Alendronate is a bisphosphonate that inhibits osteoclast-mediated bone resorption. 20.Which of the following drugs can cause tendon rupture? A. Amoxicillin B. Ciprofloxacin C. Azithromycin D. Nitrofurantoin Fluoroquinolones like ciprofloxacin can cause tendonitis and tendon rupture, particularly in older adults. 21.What is a major side effect of long-term proton pump inhibitor (PPI) use? A. Hyperkalemia B. Constipation C. Vitamin B12 deficiency D. Weight gain
C. Hypokalemia D. Hypernatremia Hypokalemia increases the risk of digoxin toxicity due to increased myocardial sensitivity. 25.What is the black box warning for black cohosh? A. Kidney damage B. Hepatotoxicity C. Arrhythmias D. GI bleeding Black cohosh has been associated with rare cases of liver failure and hepatitis. 26.Which opioid is considered a partial agonist and may precipitate withdrawal? A. Morphine B. Buprenorphine C. Fentanyl D. Hydrocodone Buprenorphine is a partial mu-opioid receptor agonist and can displace full agonists, triggering withdrawal. 27.A common side effect of SSRIs is:
A. Sexual dysfunction B. Constipation C. Weight loss D. Hypertension Sexual dysfunction is a frequent adverse effect of SSRIs and may lead to nonadherence. 28.What electrolyte imbalance is associated with ACE inhibitors? A. Hypocalcemia B. Hypernatremia C. Hyperkalemia D. Hypomagnesemia ACE inhibitors can cause potassium retention, leading to hyperkalemia. 29.Which drug should be avoided in children due to the risk of Reye's syndrome? A. Acetaminophen B. Ibuprofen C. Aspirin D. Naproxen Aspirin is linked to Reye's syndrome when given to children with viral illnesses.
Non-dihydropyridine CCBs can decrease cardiac output and worsen heart failure symptoms. 33.What is a major concern when combining SSRIs and MAOIs? A. Heart block B. Renal failure C. Serotonin syndrome D. Hypokalemia Combining serotonergic agents can lead to serotonin syndrome, a potentially fatal condition. 34.Which diabetes drug class increases risk of genitourinary infections? A. DPP-4 inhibitors B. SGLT2 inhibitors C. Sulfonylureas D. Thiazolidinediones SGLT2 inhibitors promote glycosuria, which fosters an environment for fungal and bacterial infections. 35.The maximum daily dose of acetaminophen for adults is: A. 1000 mg B. 2000 mg
C. 3000 mg D. 4000 mg The FDA-recommended maximum dose is 4000 mg/day to avoid liver toxicity. 36.Which of the following is true regarding naloxone? A. Has a long duration of action B. May require repeated dosing C. Prevents alcohol toxicity D. Is used for benzodiazepine overdose Naloxone’s short half-life may require repeat doses as opioid effects outlast it. 37.What is the mechanism of action of levothyroxine? A. Inhibits TSH B. Stimulates thyroid gland C. Replaces T4 hormone D. Blocks T3 to T4 conversion Levothyroxine is synthetic T4 that replaces low thyroid hormone levels. 38.What is a common side effect of corticosteroids? A. Hypoglycemia B. Weight loss
A. ALT
B. WBC
C. Serum sodium D. Hemoglobin Hyponatremia increases lithium reabsorption in the kidneys, raising the risk of toxicity. 42.What is a key teaching point for bisphosphonates like alendronate? A. Remain upright for 30 minutes after taking B. Take with calcium C. Take before bedtime D. Take with orange juice To avoid esophagitis, patients should remain upright and take it on an empty stomach with water. 43.Which lab abnormality can occur with thiazide diuretics? A. Hyperkalemia B. Hyperuricemia C. Hypocalcemia D. Hypermagnesemia Thiazides can increase uric acid levels, increasing the risk for gout. 44.A patient is prescribed phenytoin. Which side effect is most likely?
A. Alopecia B. Gingival hyperplasia C. Dry eyes D. Photosensitivity Phenytoin can cause overgrowth of gum tissue, especially with poor dental hygiene. 45.A patient is using an inhaled corticosteroid. What should you educate them to do after use? A. Drink milk B. Take a deep breath C. Rinse mouth D. Drink coffee Rinsing the mouth reduces the risk of oropharyngeal candidiasis (thrush). 46.What is the primary use of tamsulosin? A. Erectile dysfunction B. Benign prostatic hyperplasia C. Urinary incontinence D. Hypogonadism Tamsulosin relaxes smooth muscle in the prostate and bladder neck to relieve BPH symptoms.
50.Which of the following is a long-acting insulin? A. Regular B. Lispro C. Glargine D. NPH Glargine is a long-acting insulin with a 24-hour duration and no pronounced peak. 51.Which antibiotic has a risk of QT prolongation? A. Amoxicillin B. Cephalexin C. Doxycycline D. Azithromycin Azithromycin can prolong the QT interval, increasing the risk of torsades de pointes, especially in patients with electrolyte imbalances. 52.Which of the following medications should not be taken with grapefruit juice? A. Amoxicillin B. Atorvastatin C. Furosemide D. Metformin
Grapefruit juice inhibits CYP3A4, increasing serum levels of drugs like atorvastatin, risking toxicity. 53.What is a major side effect of vancomycin when administered too quickly? A. Red man syndrome B. Hyperkalemia C. Stevens-Johnson syndrome D. Bronchospasm Rapid infusion of vancomycin can cause histamine release, resulting in flushing, rash, and hypotension—called red man syndrome. 54.Which drug requires regular INR monitoring? A. Heparin B. Apixaban C. Warfarin D. Dabigatran Warfarin affects vitamin K–dependent clotting factors and requires INR monitoring to avoid bleeding or clotting. 55.Which of the following medications can cause peripheral edema? A. Lisinopril B. Amlodipine
