NUR 123 Exam #2 Fall 2025

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Free NUR 123 Exam #2 Fall 2025 Questions

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

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.

The nurse recognizes that the antimetabolite drug, methotrexate, is contraindicated in which patient condition?

Pregnancy
Mucositis
Cardiac dysrhythmias
Brain cancer

Explanation

Correct Answer:
A. Pregnancy

Explanation:
Methotrexate is a potent antimetabolite used in cancer treatment and autoimmune conditions. However, it is contraindicated during pregnancy because it is classified as a teratogen. Methotrexate can cause severe birth defects and fetal harm by interfering with the development of the fetus. Therefore, it should not be used by pregnant women, and adequate contraception should be used during treatment. If pregnancy occurs, methotrexate should be discontinued immediately due to its potential risks to fetal development.

Which adverse effects should a patient taking ondansetron for chemotherapy-induced nausea be instructed to watch for?

Liver and renal damage
Headache and diarrhea
Dry mouth and blurred vision
Glucose intolerance and hypokalemia

Explanation

Correct Answer:
B. Headache and diarrhea

Explanation:
Ondansetron is a 5-HT3 receptor antagonist used to prevent nausea and vomiting associated with chemotherapy. Common side effects include headache and diarrhea. Headache occurs due to the drug's effect on serotonin receptors in the brain, and diarrhea can result from its gastrointestinal side effects. These are usually mild and manageable but should be monitored by the patient during treatment.

The nurse who is caring for a patient with diabetes receives the following order for insulin: NPH 10 units Intravenous (IV). The nurse will perform which action?

Administer the dose as ordered
Give the drug subcutaneously
Question the insulin dose
Clarify the insulin type and route

Explanation

Correct Answer:
D. Clarify the insulin type and route

Explanation

D. Clarify the insulin type and route
NPH insulin (Neutral Protamine Hagedorn) is an intermediate-acting insulin typically given subcutaneously rather than intravenously. NPH insulin is not suitable for IV administration because it is designed to be absorbed slowly, and its pharmacokinetics make it inappropriate for rapid changes in blood glucose levels, which is necessary for intravenous administration. The nurse should clarify this order with the healthcare provider to ensure that the correct insulin type and administration route are used.

Which information should the nurse know is a common effect of ketamine?

This medication will take approximately 30 minutes to begin working
Your child does not need to be on a cardiac monitor for the procedure
Be certain to turn up the lights and stimulate him to wake up as soon as possible in recovery
Nystagmus and hallucinations are common effects of this medication

Explanation

Correct Answer:
D. Nystagmus and hallucinations are common effects of this medication

Explanation

D. Nystagmus and hallucinations are common effects of this medication
Ketamine is a dissociative anesthetic that is often used for sedation and analgesia. Common side effects include nystagmus (involuntary eye movements) and hallucinations. These effects are due to the drug's impact on the central nervous system and its action as an NMDA receptor antagonist. Nystagmus and hallucinations can occur during and after recovery, so nurses should be prepared to manage these symptoms.

A nurse is caring for a patient who is taking raltegravir. What should the nurse do daily?

Monitor stool color
Monitor the sclera of the eyes
Monitor intake and output
Monitor the blood urea nitrogen (BUN) level

Explanation

Correct Answer:
B. Monitor the sclera of the eyes

Explanation

B. Monitor the sclera of the eyes
Raltegravir is an integrase inhibitor used for the treatment of HIV. One of the known side effects of raltegravir is hepatotoxicity, which can lead to liver damage. A common sign of liver dysfunction is jaundice, which causes the sclera (the whites of the eyes) to turn yellow. Therefore, it is important for the nurse to monitor the sclera for any signs of yellowing, which could indicate liver problems or bilirubin buildup.

A patient is ordered to receive insulin lispro at mealtimes. The nurse will instruct this patient to administer the medication at which time?

5 minutes before eating
30 minutes before eating
10 minutes after eating
15 minutes after eating

Explanation

Correct Answer:
A. 5 minutes before eating

Explanation:
Insulin lispro is a rapid-acting insulin that begins to work within 15 minutes of administration, peaks in about 1 to 2 hours, and lasts for 3 to 4 hours. It is most effective when given just before meals, typically 5 to 15 minutes before eating, so that it can match the rise in blood glucose from the meal. Administering it 5 minutes before eating allows for optimal timing and better blood glucose control after the meal.

The nurse understands that a patient being treated with vincristine may experience which side effect?

Weight gain
Peripheral neuropathy
Cardiac arrhythmias
Blurry vision

Explanation

Correct Answer:
B. Peripheral neuropathy

Explanation

B. Peripheral neuropathy
Vincristine is a chemotherapy agent from the vinca alkaloid class. One of the most common and significant side effects of vincristine is peripheral neuropathy, which results from damage to the nerves outside the brain and spinal cord. Symptoms of peripheral neuropathy include tingling, numbness, weakness, and pain in the hands and feet. This side effect is dose-dependent and can be severe, leading to functional impairment in some patients. Nurses should closely monitor patients for signs of neuropathy and adjust the treatment plan if necessary.

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

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.

10.

Which instructions would the nurse provide for the patient receiving the anti-tumor antibiotic doxorubicin?

To drink beverages containing alcohol in moderate amount.
To take acetylsalicylic acid as needed for headache.
To consult with health care providers before receiving immunizations.
To avoid hot foods and high fiber-rich foods.

Explanation

Correct Answer:
C. To consult with health care providers before receiving immunizations.

Explanation:

Doxorubicin is a chemotherapy drug that can suppress the immune system, increasing the risk of infections. Because of this immunosuppressive effect, it is essential for patients receiving doxorubicin to consult with their healthcare provider before receiving any vaccinations, especially live vaccines. The immune system may not respond properly, or the vaccine may pose an increased risk of infection during chemotherapy. It’s important to discuss any vaccinations to ensure they are safe to administer.

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