NUR 123 Exam #2 Fall 2025

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Free NUR 123 Exam #2 Fall 2025 Questions

1.

The nurse recognizes that endometrial cancer is a common complication in patients receiving which hormonal therapy?

  • Tamoxifen

  • Leuprolide

  • Cetuximab

  • Anastrozole

Explanation

Explanation
Correct Answer:
 A. Tamoxifen

Explanation

A. Tamoxifen
 Tamoxifen is a selective estrogen receptor modulator (SERM) commonly used in the treatment and prevention of breast cancer, particularly in estrogen receptor-positive (ER+) cases. One of the known side effects of tamoxifen is an increased risk of endometrial cancer, as it has estrogen-like effects on the endometrium (lining of the uterus). These estrogenic effects can stimulate the growth of endometrial tissue, which can lead to hyperplasia or cancer over time, especially in postmenopausal women. Patients on tamoxifen should be monitored regularly for signs of uterine cancer, including abnormal bleeding.

2.

Which statement shows a patient's understanding of the administration schedule of antiretroviral drugs?

  • "If I miss a dose, I don't worry about it."

  • "I have a printed schedule and I follow it closely every day."

  • "When I miss a dose, I just double the amount next time."

  • "I take the pills whenever I wake up in the morning."

Explanation

Explanation
Correct Answer:
 B. "I have a printed schedule and I follow it closely every day."

Explanation

B. "I have a printed schedule and I follow it closely every day."
 Following a strict and consistent administration schedule is crucial for the effectiveness of antiretroviral therapy (ART) in managing HIV. Adherence to the prescribed schedule helps maintain the appropriate drug levels in the body and prevents the development of drug resistance. Having a printed schedule and following it carefully ensures the patient takes their medication at the correct times each day, improving the chances of successful treatment outcomes.

3.

The nurse is teaching a patient who is newly diagnosed with type I diabetes mellitus about insulin administration. Which statement by the patient indicates a need for further teaching?

  • "I should give each injection approximately two finger widths away from a previous injection."

  • "I will not be concerned about a raised lump under my skin from injecting insulin."

  • "Insulin is absorbed better from subcutaneous sites on my abdomen."

  • "I will rotate the site of each injection."

Explanation

Explanation
Correct Answer:
 B. "I will not be concerned about a raised lump under my skin from injecting insulin."

Explanation:
 A raised lump or hardened area under the skin, known as lipohypertrophy, can occur from repeated insulin injections in the same area. Over time, this can interfere with insulin absorption and lead to erratic blood sugar control. Patients should be instructed to avoid injecting into these areas and should rotate injection sites to prevent this complication. If the patient is not concerned about the lumps, further teaching is needed to emphasize the importance of site rotation and monitoring for lipohypertrophy.

4.

A nurse is preparing to administer metformin 500 mg PO BID to a patient. Which factor would contraindicate the administration of metformin to this patient?

  • A history of hypertension

  • Allergy to sulfonamides

  • A history of renal disease

  • The ingestion of carbohydrates

Explanation

Explanation
Correct Answer:
 C. A history of renal disease

Explanation:
 Metformin is contraindicated in patients with a history of renal disease, particularly those with impaired kidney function, as it is primarily excreted through the kidneys. Renal dysfunction can lead to the accumulation of metformin in the body, increasing the risk of lactic acidosis, a rare but serious side effect. Kidney function should be assessed before initiating metformin, and it should be avoided in patients with a glomerular filtration rate (GFR) below 30 mL/min.

5.

A patient has been prescribed enfuvirtide, a Fusion Inhibitor, to treat Human Immunodeficiency Virus (HIV). What adverse reaction will the nurse monitor the patient for?

  • Hypertension

  • Bleeding

  • Localized erythema

  • Dizziness

Explanation

Explanation
Correct Answer:
 C. Localized erythema

Explanation

C. Localized erythema
 Enfuvirtide is a fusion inhibitor used in the treatment of HIV. One of the most common side effects of enfuvirtide is localized erythema (redness) at the injection site. This reaction occurs due to the subcutaneous injection of the drug and is often associated with mild irritation or inflammation. Nurses should monitor the injection site for signs of erythema, swelling, or pain, as well as any signs of infection.

6.

Which anesthetic drug is used during surgery because it helps open the airways (bronchodilation) in patients with asthma?

  • Midazolam

  • Propofol

  • Pentobarbital

  • Ketamine

Explanation

Explanation
Correct Answer:
 D. Ketamine

Explanation

D. Ketamine
 Ketamine is a dissociative anesthetic that has bronchodilatory properties, making it particularly useful in patients with asthma or other respiratory conditions. It works by inhibiting the NMDA (N-methyl-D-aspartate) receptors, leading to sedation and analgesia, while also causing relaxation of the bronchial muscles, which helps in opening the airways. This makes ketamine a preferred choice for asthmatic patients undergoing surgery, as it reduces the risk of bronchospasm and helps maintain airway patency.

7.

Match each type of oral antidiabetic drug with its correct drug class.

A. Metformin
 B. Glipizide
 C. Repaglinide
 D. Pioglitazone

Possible Answers:

  1. Sulfonylurea
  2. Meglitinide
  3. Biguanide
  4. Thiazolidinedione

  • Metformin

  • Glipizide

  • Repaglinide

  • Pioglitazone

Explanation

Explanation
Correct Answer:
  • A. Metformin → 3. Biguanide
  • B. Glipizide → 1. Sulfonylurea
  • C. Repaglinide → 2. Meglitinide
  • D. Pioglitazone → 4. Thiazolidinedione

Explanation
A. Metformin → 3. Biguanide
 Metformin is a biguanide class drug used primarily in the treatment of type 2 diabetes. It works by decreasing glucose production in the liver and improving insulin sensitivity.

B. Glipizide → 1. Sulfonylurea
 Glipizide is a sulfonylurea that works by stimulating the pancreas to release more insulin. It is commonly used in type 2 diabetes management.

C. Repaglinide → 2. Meglitinide
 Repaglinide is a meglitinide, which works similarly to sulfonylureas but with a faster onset and shorter duration of action. It stimulates insulin secretion from the pancreas but is typically taken with meals.

D. Pioglitazone → 4. Thiazolidinedione
 Pioglitazone is a thiazolidinedione, which works by improving insulin sensitivity in muscle and adipose tissue and reducing glucose production in the liver. It is used to treat type 2 diabetes.

8.

Which complication should a patient immediately report to their provider when taking metoclopramide, a Dopamine antagonist?

  • Involuntary movements of the face and neck

  • Elevated blood pressure

  • Dizziness when standing

  • Diarrhea

Explanation

Explanation
Correct Answer:
 A. Involuntary movements of the face and neck

Explanation

A. Involuntary movements of the face and neck
 Metoclopramide, a dopamine antagonist, can cause extrapyramidal side effects, including tardive dyskinesia, which presents as involuntary movements, especially of the face and neck. These movements may include grimacing, lip smacking, and tongue protrusion. Tardive dyskinesia is a serious, potentially irreversible condition, and patients taking metoclopramide should immediately report any signs of these involuntary movements to their provider for prompt evaluation and possible adjustment of therapy.

9.

Which signs and symptoms should a nurse recognize as indicators of lidocaine toxicity? (Select all that apply.)

  • Slurred speech

  • Seizure activity

  • Loss of sensation to the lower extremities

  • Fever

  • Muscle twitching

Explanation

Explanation
Correct Answer:
 A. Slurred speech
B. Seizure activity
E. Muscle twitching

Explanation
A. Slurred speech
 Slurred speech is a common early sign of lidocaine toxicity, indicating central nervous system (CNS) depression. When lidocaine accumulates in the bloodstream, it can cause neurological disturbances, including difficulty articulating words. This happens because lidocaine interferes with normal nerve function, impairing communication between the brain and muscles involved in speech. This is one of the initial symptoms that can signal the need for intervention.

B. Seizure activity
 Seizure activity is a more severe manifestation of lidocaine toxicity. As lidocaine affects the CNS, it can cause excitation or overactivity of the neurons, leading to seizures. This is a critical sign, as it suggests the drug concentration has reached levels that significantly impact brain function. Immediate medical attention is required to prevent further complications, including status epilepticus or permanent brain damage.

E. Muscle twitching
 Muscle twitching is another indicator of lidocaine toxicity, reflecting hyperexcitability in the neuromuscular system. This can occur due to the drug’s effects on sodium channels in nerves, which may cause abnormal firing of neurons. Muscle twitching is an early symptom, often noticed in the limbs, and is part of the spectrum of CNS-related side effects of lidocaine toxicity. Monitoring and prompt intervention are essential to prevent escalation to more severe symptoms like seizures.

10.

A nurse is caring for a patient taking maraviroc. Which statement describes how this CCR5 antagonist fights Human Immunodeficiency Virus (HIV)?

  • Maraviroc prevents the reproduction of viral DNA and therefore interrupts the cell replication

  • Maraviroc prevents HIV from entering your cells by binding to a cysteine chemokine receptor on the cell membrane

  • Maraviroc inhibits enzymes and prevents the reproduction of viral DNA preventing cell entry and reproduction of the cell.

  • Maraviroc inhibits enzymes needed for HIV replication

Explanation

Explanation
Correct Answer:
 B. Maraviroc prevents HIV from entering your cells by binding to a cysteine chemokine receptor on the cell membrane

Explanation:
 Maraviroc is a CCR5 antagonist that works by blocking the CCR5 receptor on the surface of T-cells. The CCR5 receptor is one of the co-receptors that HIV uses to enter the host cell. By binding to this receptor, maraviroc prevents HIV from entering the cells and infecting them, thereby reducing the viral load. It does not affect viral DNA replication directly, unlike other antiretroviral agents that target viral enzymes.

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