NU 170 EXAM 4 EXAM PRACTICE | STUDY GUIDE | TESTBANK | PRACTICE
QUESTIONS & ANSWERS | EXAM PREPARATION | ADVANCED REVIEW | LATEST
UPDATE 2026/2027
Examiner:
Nursing faculty/instructor for the NU 170 course (institution-specific).
## TABLE OF CONTENTS
1. Adult Medical-Surgical Nursing
2. Cardiovascular Disorders
3. Respiratory Disorders
4. Renal and Urinary Disorders
5. Fluid, Electrolyte, and Acid-Base Balance
6. Endocrine Disorders
7. Medication Administration and Safety
8. Nursing Assessment and Clinical Judgment
9. Prioritization and Delegation
10. Patient Education and Evidence-Based Nursing Care
## DESCRIPTION
This comprehensive practice exam is designed to help students prepare for NU 170
Exam 4 by reinforcing major concepts commonly emphasized in nursing coursework,
instructor review materials, standard nursing textbooks, and clinical study guides. The
questions focus on advanced application of nursing knowledge through realistic
patient scenarios requiring critical thinking, prioritization, clinical judgment, and safe
decision-making. Topics include cardiovascular, respiratory, endocrine, renal, and fluid
and electrolyte disorders, along with medication safety, patient education, and
evidence-based interventions. These practice questions are intended solely as an
educational study resource and are not actual examination questions. They are
designed to strengthen understanding of key concepts, identify knowledge gaps, and
build confidence before taking the course examination.
QUESTION 1.
,A nurse is caring for a patient admitted with acute decompensated heart failure.
Which assessment finding requires the nurse's immediate intervention?
A. Bilateral ankle edema rated 2+
B. Jugular venous distention when sitting upright
C. Oxygen saturation of 84% despite receiving 4 L/min via nasal cannula
D. Weight gain of 2 kg over the previous week
🔴 Correct Answer: C. Oxygen saturation of 84% despite receiving 4 L/min via
nasal cannula
🔵 Explanation: Persistent hypoxemia despite supplemental oxygen indicates
impaired gas exchange and poses an immediate threat to life. Although edema,
jugular venous distention, and recent weight gain are expected findings in worsening
heart failure, they are less urgent than inadequate oxygenation, which requires
prompt intervention.
QUESTION 2.
A patient with diabetic ketoacidosis is receiving intravenous insulin therapy. Which
laboratory value best indicates that treatment is effective?
A. Closure of the anion gap
B. Serum glucose decreases to 250 mg/dL
C. Potassium level rises to 5.4 mEq/L
D. Urine glucose becomes negative
🔴 Correct Answer: A. Closure of the anion gap
🔵 Explanation: Resolution of diabetic ketoacidosis is determined primarily by
correction of metabolic acidosis, reflected by closure of the anion gap. Although blood
glucose decreases during treatment, ketosis and acidosis may persist. Urine glucose
and potassium changes alone do not confirm complete resolution.
QUESTION 3.
,A nurse assesses a patient with chronic kidney disease. Which finding most strongly
suggests fluid volume excess?
A. Serum potassium of 5.8 mEq/L
B. Bounding peripheral pulses with bibasilar crackles
C. Hemoglobin of 9.5 g/dL
D. Serum phosphorus of 5.5 mg/dL
🔴 Correct Answer: B. Bounding peripheral pulses with bibasilar crackles
🔵 Explanation: Bounding pulses and pulmonary crackles indicate excess
intravascular volume and pulmonary congestion. Elevated potassium, anemia, and
hyperphosphatemia are common manifestations of chronic kidney disease but do not
specifically indicate fluid overload requiring immediate intervention.
QUESTION 4.
Which action should the nurse prioritize when a patient receiving intravenous
potassium chloride reports burning at the infusion site?
A. Slow the infusion and assess the IV site
B. Discontinue potassium permanently
C. Flush the line rapidly with saline
D. Increase the infusion rate to complete therapy sooner
🔴 Correct Answer: A. Slow the infusion and assess the IV site
🔵 Explanation: Potassium chloride is irritating to veins and may cause discomfort if
infused too quickly or if infiltration occurs. The nurse should assess the site and reduce
the infusion rate if appropriate. Rapid flushing or increasing the rate increases the risk
of injury, while permanent discontinuation may not be clinically indicated.
QUESTION 5.
A patient with chronic obstructive pulmonary disease suddenly becomes restless
and confused. Which nursing action is most appropriate first?
, A. Administer prescribed sedative medication
B. Increase oxygen to 15 L/min via nonrebreather mask
C. Assess oxygen saturation and respiratory status
D. Encourage the patient to ambulate
🔴 Correct Answer: C. Assess oxygen saturation and respiratory status
🔵 Explanation: Restlessness and confusion may indicate worsening hypoxemia or
hypercapnia. The nurse should first assess the patient's respiratory status before
implementing additional interventions. Sedation or indiscriminate oxygen
administration may worsen respiratory compromise in susceptible patients.
QUESTION 6.
Which patient should the charge nurse assess first?
A. A patient with pneumonia whose temperature increased from 38.1°C to 38.4°C
B. A patient with heart failure who reports increasing orthopnea and pink frothy
sputum
C. A patient with diabetes requesting dietary counseling
D. A postoperative patient requesting pain medication rated 6/10
🔴 Correct Answer: B. A patient with heart failure who reports increasing
orthopnea and pink frothy sputum
🔵 Explanation: Pink frothy sputum and worsening orthopnea strongly suggest acute
pulmonary edema, which is a life-threatening emergency requiring immediate
assessment. The remaining situations are important but are less urgent than
impending respiratory failure.
QUESTION 7.
A patient's arterial blood gas results are pH 7.29, PaCO₂ 52 mmHg, and HCO₃⁻ 25
mEq/L. Which interpretation is correct?
QUESTIONS & ANSWERS | EXAM PREPARATION | ADVANCED REVIEW | LATEST
UPDATE 2026/2027
Examiner:
Nursing faculty/instructor for the NU 170 course (institution-specific).
## TABLE OF CONTENTS
1. Adult Medical-Surgical Nursing
2. Cardiovascular Disorders
3. Respiratory Disorders
4. Renal and Urinary Disorders
5. Fluid, Electrolyte, and Acid-Base Balance
6. Endocrine Disorders
7. Medication Administration and Safety
8. Nursing Assessment and Clinical Judgment
9. Prioritization and Delegation
10. Patient Education and Evidence-Based Nursing Care
## DESCRIPTION
This comprehensive practice exam is designed to help students prepare for NU 170
Exam 4 by reinforcing major concepts commonly emphasized in nursing coursework,
instructor review materials, standard nursing textbooks, and clinical study guides. The
questions focus on advanced application of nursing knowledge through realistic
patient scenarios requiring critical thinking, prioritization, clinical judgment, and safe
decision-making. Topics include cardiovascular, respiratory, endocrine, renal, and fluid
and electrolyte disorders, along with medication safety, patient education, and
evidence-based interventions. These practice questions are intended solely as an
educational study resource and are not actual examination questions. They are
designed to strengthen understanding of key concepts, identify knowledge gaps, and
build confidence before taking the course examination.
QUESTION 1.
,A nurse is caring for a patient admitted with acute decompensated heart failure.
Which assessment finding requires the nurse's immediate intervention?
A. Bilateral ankle edema rated 2+
B. Jugular venous distention when sitting upright
C. Oxygen saturation of 84% despite receiving 4 L/min via nasal cannula
D. Weight gain of 2 kg over the previous week
🔴 Correct Answer: C. Oxygen saturation of 84% despite receiving 4 L/min via
nasal cannula
🔵 Explanation: Persistent hypoxemia despite supplemental oxygen indicates
impaired gas exchange and poses an immediate threat to life. Although edema,
jugular venous distention, and recent weight gain are expected findings in worsening
heart failure, they are less urgent than inadequate oxygenation, which requires
prompt intervention.
QUESTION 2.
A patient with diabetic ketoacidosis is receiving intravenous insulin therapy. Which
laboratory value best indicates that treatment is effective?
A. Closure of the anion gap
B. Serum glucose decreases to 250 mg/dL
C. Potassium level rises to 5.4 mEq/L
D. Urine glucose becomes negative
🔴 Correct Answer: A. Closure of the anion gap
🔵 Explanation: Resolution of diabetic ketoacidosis is determined primarily by
correction of metabolic acidosis, reflected by closure of the anion gap. Although blood
glucose decreases during treatment, ketosis and acidosis may persist. Urine glucose
and potassium changes alone do not confirm complete resolution.
QUESTION 3.
,A nurse assesses a patient with chronic kidney disease. Which finding most strongly
suggests fluid volume excess?
A. Serum potassium of 5.8 mEq/L
B. Bounding peripheral pulses with bibasilar crackles
C. Hemoglobin of 9.5 g/dL
D. Serum phosphorus of 5.5 mg/dL
🔴 Correct Answer: B. Bounding peripheral pulses with bibasilar crackles
🔵 Explanation: Bounding pulses and pulmonary crackles indicate excess
intravascular volume and pulmonary congestion. Elevated potassium, anemia, and
hyperphosphatemia are common manifestations of chronic kidney disease but do not
specifically indicate fluid overload requiring immediate intervention.
QUESTION 4.
Which action should the nurse prioritize when a patient receiving intravenous
potassium chloride reports burning at the infusion site?
A. Slow the infusion and assess the IV site
B. Discontinue potassium permanently
C. Flush the line rapidly with saline
D. Increase the infusion rate to complete therapy sooner
🔴 Correct Answer: A. Slow the infusion and assess the IV site
🔵 Explanation: Potassium chloride is irritating to veins and may cause discomfort if
infused too quickly or if infiltration occurs. The nurse should assess the site and reduce
the infusion rate if appropriate. Rapid flushing or increasing the rate increases the risk
of injury, while permanent discontinuation may not be clinically indicated.
QUESTION 5.
A patient with chronic obstructive pulmonary disease suddenly becomes restless
and confused. Which nursing action is most appropriate first?
, A. Administer prescribed sedative medication
B. Increase oxygen to 15 L/min via nonrebreather mask
C. Assess oxygen saturation and respiratory status
D. Encourage the patient to ambulate
🔴 Correct Answer: C. Assess oxygen saturation and respiratory status
🔵 Explanation: Restlessness and confusion may indicate worsening hypoxemia or
hypercapnia. The nurse should first assess the patient's respiratory status before
implementing additional interventions. Sedation or indiscriminate oxygen
administration may worsen respiratory compromise in susceptible patients.
QUESTION 6.
Which patient should the charge nurse assess first?
A. A patient with pneumonia whose temperature increased from 38.1°C to 38.4°C
B. A patient with heart failure who reports increasing orthopnea and pink frothy
sputum
C. A patient with diabetes requesting dietary counseling
D. A postoperative patient requesting pain medication rated 6/10
🔴 Correct Answer: B. A patient with heart failure who reports increasing
orthopnea and pink frothy sputum
🔵 Explanation: Pink frothy sputum and worsening orthopnea strongly suggest acute
pulmonary edema, which is a life-threatening emergency requiring immediate
assessment. The remaining situations are important but are less urgent than
impending respiratory failure.
QUESTION 7.
A patient's arterial blood gas results are pH 7.29, PaCO₂ 52 mmHg, and HCO₃⁻ 25
mEq/L. Which interpretation is correct?
