AS Associate Of Science In Nursing 3 — Questions and Answers
Question 1: A patient is ordered metformin. Which laboratory value must the nurse assess before administration?
- Serum potassium
- Serum creatinine (Correct answer)
- Complete blood count
- Liver enzymes (ALT/AST)
Correct answer: Serum creatinine
Metformin is contraindicated in significant renal impairment because reduced clearance raises the risk of lactic acidosis.
Question 2: Which of the following is a classic sign of increased intracranial pressure (ICP)?
- Tachycardia, hypotension, and bradypnea
- Bradycardia, widened pulse pressure, and irregular respirations (Correct answer)
- Hypertension, tachycardia, and diaphoresis
- Hypotension, tachypnea, and altered consciousness
Correct answer: Bradycardia, widened pulse pressure, and irregular respirations
Cushing's triad — bradycardia, widened pulse pressure, and irregular respirations — is a late sign of dangerously elevated ICP.
Question 3: A patient with a chest tube has continuous bubbling in the water-seal chamber. This finding most likely indicates:
- Normal functioning of the drainage system
- An air leak in the system or pleural space (Correct answer)
- Complete lung re-expansion
- Excessive fluid drainage
Correct answer: An air leak in the system or pleural space
Continuous bubbling in the water-seal chamber suggests an air leak from the pleural space or a break in the drainage system.
Question 4: Which nursing action best prevents catheter-associated urinary tract infections (CAUTIs)?
- Irrigating the catheter daily with sterile saline
- Maintaining a closed drainage system and keeping the bag below bladder level (Correct answer)
- Changing the catheter every 72 hours
- Applying antibiotic ointment at the catheter insertion site daily
Correct answer: Maintaining a closed drainage system and keeping the bag below bladder level
Maintaining a closed drainage system and dependent positioning prevents bacterial migration and is the primary CAUTI prevention strategy.
Question 5: A nurse is caring for a patient receiving a blood transfusion who develops fever, chills, and back pain 15 minutes after initiation. The priority action is:
- Slow the infusion rate and administer acetaminophen
- Stop the transfusion and maintain IV access with normal saline (Correct answer)
- Notify the blood bank and continue the transfusion at a slower rate
- Obtain a blood culture and administer diphenhydramine
Correct answer: Stop the transfusion and maintain IV access with normal saline
Signs of a hemolytic transfusion reaction require immediately stopping the transfusion while keeping the IV line patent with normal saline.
Question 6: Which position is most appropriate for a patient experiencing an acute asthma attack?
- Supine with legs elevated
- High Fowler's or sitting upright leaning forward (Correct answer)
- Left lateral Sims' position
- Prone with head of bed flat
Correct answer: High Fowler's or sitting upright leaning forward
High Fowler's position maximizes diaphragmatic excursion and reduces the work of breathing during bronchospasm.
Question 7: The five rights of medication administration include the right patient, right drug, right dose, right route, and:
- Right documentation
- Right time (Correct answer)
- Right nurse
- Right indication
Correct answer: Right time
The classic five rights are patient, drug, dose, route, and time — the foundational framework for safe medication administration.
AS Associate Of Science In Nursing 3
A patient is ordered metformin.
Which laboratory value must the nurse assess before administration?