NGN Matrix Quiz: Can You Fill Every Row Right?

1. A patient with acute kidney injury has a creatinine of 4.2 mg/dL. What is the priority intervention?

Restrict fluids and monitor electrolytes; consider dialysis

Increase IV fluids and sodium intake

Administer diuretics to increase urine output

Order a high-protein diet immediately

2. Which nursing action is correct when administering IV potassium?

Dilute in IV fluid; infuse slowly; monitor EKG and serum level

Push IV bolus rapidly through peripheral line

Mix with sodium bicarbonate in same line

Administer without cardiac monitoring

3. A patient with cirrhosis has ascites and jaundice. What is the expected finding on liver function tests?

Elevated bilirubin, ALT, AST, and prolonged PT/INR

Decreased creatinine and normal albumin

High hemoglobin and normal glucose

Low potassium and elevated sodium

4. Which symptom suggests hypoglycemia rather than hyperglycemia?

Tremor, palpitations, diaphoresis, confusion

Polyuria, polydipsia, slow onset

Fruity breath odor and Kussmaul respirations

Weight loss over weeks and fatigue

5. A post-operative patient develops sudden shortness of breath and chest pain. What is the priority assessment?

Assess for signs of pulmonary embolism; obtain EKG and chest X-ray

Administer oxygen and assume it is anxiety

Check vital signs only; continue monitoring

Place patient flat and elevate legs

6. Which medication interaction requires immediate intervention?

Warfarin and NSAIDs together

Acetaminophen and ibuprofen together

Metformin and contrast dye

Penicillin and amoxicillin together

7. A patient with pneumonia has a PaO2 of 55 mmHg on room air. What oxygen therapy is indicated?

Nasal cannula at 2-3 L/min initially; adjust to maintain PaO2 >60

High-flow oxygen mask without monitoring

Mechanical ventilation immediately

Room air; oxygen not needed

8. Which assessment indicates pulmonary edema in a heart failure patient?

Crackles, orthopnea, pink frothy sputum, tachycardia

Clear lung sounds, normal respiratory rate, dry cough

Wheezing only, normal oxygen saturation

Decreased breath sounds, barrel chest

9. A patient on ACE inhibitor therapy develops a dry cough. What is the appropriate action?

Discontinue immediately; notify provider; consider ARB

Increase dose to mask cough symptoms

Add antihistamine and continue medication

Switch to beta-blocker without consulting provider

10. Which sign indicates adequate cerebral perfusion in a head-injured patient?

Alert, oriented, normal pupil response, appropriate commands

Drowsy, pinpoint pupils, decorticate posturing

Unresponsive, dilated pupils, abnormal respirations

Agitated, constricted pupils, rapid breathing

11. A 68-year-old patient presents with chest pain, dyspnea, and diaphoresis. Which findings would indicate acute myocardial infarction?

Elevated troponin and ST-segment elevation

Decreased hemoglobin and low blood pressure

Normal EKG and negative troponin

Elevated glucose and tachycardia only

12. Which electrolyte abnormality causes peaked T waves and widened QRS on EKG?

Hyperkalemia

Hypokalemia

Hypercalcemia

Hypocalcemia

13. A patient with COPD has a pCO2 of 65 mmHg and pH 7.30. What acid-base disorder is present?

Respiratory acidosis

Respiratory alkalosis

Metabolic acidosis

Metabolic alkalosis

14. Which finding indicates successful fluid resuscitation in shock?

Urine output >0.5 mL/kg/hr, improved mental status, adequate perfusion

Increased heart rate and decreased blood pressure

High central venous pressure with pulmonary edema

Decreased respiratory rate and cool extremities

15. A patient receiving heparin develops thrombocytopenia. What is the concern?

Heparin-induced thrombocytopenia (HIT)

Vitamin K deficiency

Disseminated intravascular coagulation

Allergic reaction to the medication

16. Which assessment finding suggests septic shock in a post-operative patient?

Fever, tachycardia, hypotension, altered mental status

Hypothermia, bradycardia, hypertension, alertness

Normal temperature with decreased urine output

Elevated BP and clear lung sounds

17. A diabetic patient's fasting glucose is 320 mg/dL. Which complication is most likely?

Hypoglycemia and seizures

Hyperglycemic crisis with acidosis

Hyperosmolar hyperglycemic state

Brittle diabetes response

18. Which sign indicates increased intracranial pressure?

Bradycardia, hypertension, irregular respirations

Tachycardia, hypotension, rapid breathing

Normal vitals with clear mental status

Hypothermia and decreased pupil response

19. A patient on warfarin has an INR of 8.5. What is the priority nursing action?

Continue current dose; recheck in 1 week

Notify provider; assess for bleeding

Increase dose to achieve therapeutic level

Administer vitamin K without provider order

20. Which medication requires monitoring for QT prolongation?

Metformin

Ciprofloxacin

Lisinopril

Ibuprofen