AS Associate Of Science In Nursing 5 — Questions and Answers
Question 1: A nurse is caring for a patient in alcohol withdrawal. Which medication class is most commonly used to manage withdrawal symptoms and prevent seizures?
- Opioid agonists
- Antipsychotics
- Benzodiazepines (Correct answer)
- Beta-blockers
Correct answer: Benzodiazepines
Benzodiazepines are the first-line pharmacologic treatment for alcohol withdrawal because they enhance GABA activity and reduce CNS excitability.
Question 2: Which assessment data best indicates that a patient with heart failure is responding positively to diuretic therapy?
- Increased blood urea nitrogen (BUN)
- Daily weight loss of 0.5–1 kg and decreased edema (Correct answer)
- Heart rate decrease from 100 to 72 bpm
- Serum potassium increase from 3.2 to 4.0 mEq/L
Correct answer: Daily weight loss of 0.5–1 kg and decreased edema
Gradual weight loss and reduced edema indicate effective fluid removal, the primary goal of diuretic therapy in heart failure.
Question 3: Which ethical principle is violated when a nurse shares a patient's diagnosis with the patient's employer without consent?
- Beneficence
- Justice
- Nonmaleficence
- Autonomy (Correct answer)
Correct answer: Autonomy
Disclosing private health information without consent violates the patient's autonomy and right to control personal information (also a HIPAA violation).
Question 4: A nurse delegates vital sign measurement to an unlicensed assistive personnel (UAP) for a stable postoperative patient. This delegation is:
- Inappropriate because postoperative assessment requires RN judgment
- Appropriate because it is a routine task within the UAP's scope (Correct answer)
- Inappropriate because UAPs cannot use electronic monitoring equipment
- Appropriate only if the charge nurse gives verbal permission
Correct answer: Appropriate because it is a routine task within the UAP's scope
Measuring vital signs on a stable patient is a routine task within the UAP's competency and appropriate for delegation under RN supervision.
Question 5: A patient receiving IV vancomycin develops flushing, erythema, and pruritus on the face, neck, and upper torso during infusion. This reaction is best described as:
- Anaphylaxis requiring immediate epinephrine
- Red man syndrome caused by too-rapid infusion (Correct answer)
- A type III immune complex hypersensitivity reaction
- Vancomycin-induced thrombocytopenia
Correct answer: Red man syndrome caused by too-rapid infusion
Red man syndrome is a non-immune infusion-related reaction to vancomycin that resolves by slowing or stopping the infusion.
Question 6: When performing oropharyngeal suctioning on an adult patient, the nurse should apply suction for no longer than:
- 5 seconds
- 10–15 seconds (Correct answer)
- 30 seconds
- 45 seconds
Correct answer: 10–15 seconds
Suctioning should be limited to 10–15 seconds per pass to prevent hypoxia and mucosal trauma.
Question 7: A nurse is reviewing a patient's ABG results: pH 7.30, PaCO2 52 mmHg, HCO3 24 mEq/L. How should the nurse interpret these values?
- Metabolic acidosis, uncompensated
- Respiratory alkalosis, compensated
- Respiratory acidosis, uncompensated (Correct answer)
- Metabolic alkalosis, uncompensated
Correct answer: Respiratory acidosis, uncompensated
Low pH with elevated PaCO2 and normal bicarbonate indicates uncompensated respiratory acidosis.
AS Associate Of Science In Nursing 5
A nurse is caring for a patient in alcohol withdrawal.
Which medication class is most commonly used to manage withdrawal symptoms and prevent seizures?