Saudi Prometric Nursing Medical-Surgical Nursing

Question 1

A patient with type 2 diabetes is prescribed metformin. Which condition is a contraindication to metformin therapy?

Accepted Answer

Chronic kidney disease (eGFR <30 mL/min)

Answer

Metformin is contraindicated in patients with significant renal impairment (eGFR <30 mL/min) because it is renally excreted and accumulation increases the risk of lactic acidosis, a rare but potentially fatal complication.

Question 2

A nurse is caring for a patient following a myocardial infarction. The patient develops new ST elevation in leads II, III, and aVF. Which area of the heart is most likely affected?

Accepted Answer

Inferior wall

Answer

Leads II, III, and aVF view the inferior wall of the heart, which is supplied by the right coronary artery (RCA). ST elevation in these leads indicates an inferior MI, most commonly due to RCA occlusion.

Question 3

A patient with chronic obstructive pulmonary disease (COPD) is admitted with acute exacerbation. Which oxygen delivery method and target saturation is most appropriate?

Accepted Answer

Controlled oxygen via Venturi mask, target SpO2 88–92%

Answer

COPD patients with hypercapnia rely on hypoxic drive for breathing. Controlled oxygen via Venturi mask targeting SpO2 88–92% avoids both hypoxia and excessive oxygen that could suppress respiratory drive and worsen hypercapnia.

Question 4

The nurse is caring for a patient post-thyroidectomy. Which finding should the nurse assess for as the most serious immediate complication?

Accepted Answer

Stridor and respiratory distress

Answer

Post-thyroidectomy, the most immediate life-threatening complication is hematoma formation causing airway compression, presenting as stridor and respiratory distress. Hypocalcemia (from parathyroid removal) and hoarseness are also concerns but are less immediately fatal.

Question 5

A patient is prescribed digoxin. Which assessment finding requires the nurse to withhold the medication and notify the physician?

Accepted Answer

Apical pulse of 52 beats per minute

Answer

Digoxin should be withheld if the apical pulse is below 60 beats per minute. Bradycardia is a sign of digoxin toxicity. Hypokalemia also increases digoxin toxicity risk, but the potassium level here is normal.

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Practice Test

Saudi Prometric Nursing Medical-Surgical Nursing