1|Page
CNUR 204 Practice Exam — 2 VERSIONS Questions with
Answers & Rationales
1. A 68-year-old patient with heart failure reports rapid weight gain and shortness of breath.
What should the nurse assess first?
A. Urine output
B. Lung sounds
C. Potassium level
D. Bowel sounds
Answer: B
Rationale: Rapid weight gain and dyspnea suggest fluid retention in the lungs. Assessing lung
sounds checks for pulmonary edema, which impacts oxygenation and is an urgent concern.
2. A patient with COPD asks how to reduce dyspnea at home. Which technique should the nurse
recommend?
A. Hold breath frequently
B. Pursed-lip breathing
C. Rapid shallow breathing
D. Breath-holding exercises
Answer: B
Rationale: Pursed-lip breathing helps slow expiration and maintain airway patency, improving
oxygenation in COPD.
3. A patient with type 1 diabetes has a glucose of 45 mg/dL and is alert but shaky. What is the
best initial action?
A. Give insulin
B. Administer 15 g fast-acting carbohydrate
C. Provide high-protein snack
D. Encourage exercise
Answer: B
Rationale: Hypoglycemia requires rapid glucose correction; fast-acting carbohydrate is the first
intervention.
2026 2027 GRADED A+
,2|Page
4. Which electrolyte imbalance is most likely with furosemide use?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
Rationale: Loop diuretics cause potassium loss, risking hypokalemia.
5. A patient with pneumonia has an O₂ saturation of 85% on room air. The nurse should:
A. Ensure hydration
B. Begin oxygen therapy
C. Encourage ambulation
D. Give antipyretic
Answer: B
Rationale: Hypoxia is an immediate threat; supplemental oxygen is priority.
6. A patient with CKD and hyperkalemia has ECG changes with tall, peaked T waves. What is the
priority concern?
A. Dehydration
B. Arrhythmia
C. Hypotension
D. Hypoglycemia
Answer: B
Rationale: Tall, peaked T waves indicate hyperkalemia affecting cardiac conduction — this is
life-threatening.
7. The nurse should administer naloxone for which sign after surgery?
A. Respiratory rate 8 breaths/min
B. Pulse 80 bpm
C. Moderate pain
D. Temperature 37°C
2026 2027 GRADED A+
,3|Page
Answer: A
Rationale: A low respiratory rate after opioid analgesics suggests overdose; naloxone reverses
respiratory depression.
8. A patient with MI reports chest pain not relieved by nitroglycerin. What’s the next action?
A. Provide antacids
B. Notify provider immediately
C. Encourage deep breathing
D. Document findings
Answer: B
Rationale: Persistent ischemic pain needs prompt evaluation for recurrent MI or complications.
9. A postoperative patient on heparin has an aPTT significantly above normal. What should the
nurse do?
A. Increase heparin
B. Hold heparin and notify provider
C. Encourage ambulation
D. Administer vitamin K
Answer: B
Rationale: Elevated aPTT increases bleeding risk. Hold heparin and notify provider for
adjustment.
10. A patient with GI bleeding becomes hypotensive and tachycardic. The nurse’s priority is to:
A. Administer IV fluids
B. Give antacids
C. Apply cold compress
D. Encourage ambulation
Answer: A
Rationale: Hypotension and tachycardia indicate hypovolemia; fluid resuscitation is urgent.
2026 2027 GRADED A+
, 4|Page
11. Which lab result indicates improving infection in pneumonia?
A. WBC 18,000 → 9,000
B. WBC 9,000 → 18,000
C. Platelets increasing
D. Hemoglobin decreasing
Answer: A
Rationale: WBC normalizing reflects resolution of infection.
12. A patient with Parkinson’s disease has trouble initiating movement. Which intervention is
best?
A. Encourage heavy lifting
B. Provide ROM exercises
C. Restrict fluids
D. Avoid activity
Answer: B
Rationale: ROM helps maintain mobility and reduces stiffness.
13. A patient on warfarin reports black, tarry stools. What is priority?
A. Continue medication
B. Hold warfarin and notify provider
C. Encourage fiber
D. Document and move on
Answer: B
Rationale: Tarry stools suggest GI bleeding — urgent anticoagulation review is required.
14. Patient is prescribed insulin lispro. When should the nurse administer it?
A. 30 minutes before meals
B. With meals
C. Before bedtime
D. Only when hyperglycemic
Answer: B
Rationale: Rapid-acting lispro should be given with meals to control post-prandial glucose.
2026 2027 GRADED A+
CNUR 204 Practice Exam — 2 VERSIONS Questions with
Answers & Rationales
1. A 68-year-old patient with heart failure reports rapid weight gain and shortness of breath.
What should the nurse assess first?
A. Urine output
B. Lung sounds
C. Potassium level
D. Bowel sounds
Answer: B
Rationale: Rapid weight gain and dyspnea suggest fluid retention in the lungs. Assessing lung
sounds checks for pulmonary edema, which impacts oxygenation and is an urgent concern.
2. A patient with COPD asks how to reduce dyspnea at home. Which technique should the nurse
recommend?
A. Hold breath frequently
B. Pursed-lip breathing
C. Rapid shallow breathing
D. Breath-holding exercises
Answer: B
Rationale: Pursed-lip breathing helps slow expiration and maintain airway patency, improving
oxygenation in COPD.
3. A patient with type 1 diabetes has a glucose of 45 mg/dL and is alert but shaky. What is the
best initial action?
A. Give insulin
B. Administer 15 g fast-acting carbohydrate
C. Provide high-protein snack
D. Encourage exercise
Answer: B
Rationale: Hypoglycemia requires rapid glucose correction; fast-acting carbohydrate is the first
intervention.
2026 2027 GRADED A+
,2|Page
4. Which electrolyte imbalance is most likely with furosemide use?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hypomagnesemia
Answer: B
Rationale: Loop diuretics cause potassium loss, risking hypokalemia.
5. A patient with pneumonia has an O₂ saturation of 85% on room air. The nurse should:
A. Ensure hydration
B. Begin oxygen therapy
C. Encourage ambulation
D. Give antipyretic
Answer: B
Rationale: Hypoxia is an immediate threat; supplemental oxygen is priority.
6. A patient with CKD and hyperkalemia has ECG changes with tall, peaked T waves. What is the
priority concern?
A. Dehydration
B. Arrhythmia
C. Hypotension
D. Hypoglycemia
Answer: B
Rationale: Tall, peaked T waves indicate hyperkalemia affecting cardiac conduction — this is
life-threatening.
7. The nurse should administer naloxone for which sign after surgery?
A. Respiratory rate 8 breaths/min
B. Pulse 80 bpm
C. Moderate pain
D. Temperature 37°C
2026 2027 GRADED A+
,3|Page
Answer: A
Rationale: A low respiratory rate after opioid analgesics suggests overdose; naloxone reverses
respiratory depression.
8. A patient with MI reports chest pain not relieved by nitroglycerin. What’s the next action?
A. Provide antacids
B. Notify provider immediately
C. Encourage deep breathing
D. Document findings
Answer: B
Rationale: Persistent ischemic pain needs prompt evaluation for recurrent MI or complications.
9. A postoperative patient on heparin has an aPTT significantly above normal. What should the
nurse do?
A. Increase heparin
B. Hold heparin and notify provider
C. Encourage ambulation
D. Administer vitamin K
Answer: B
Rationale: Elevated aPTT increases bleeding risk. Hold heparin and notify provider for
adjustment.
10. A patient with GI bleeding becomes hypotensive and tachycardic. The nurse’s priority is to:
A. Administer IV fluids
B. Give antacids
C. Apply cold compress
D. Encourage ambulation
Answer: A
Rationale: Hypotension and tachycardia indicate hypovolemia; fluid resuscitation is urgent.
2026 2027 GRADED A+
, 4|Page
11. Which lab result indicates improving infection in pneumonia?
A. WBC 18,000 → 9,000
B. WBC 9,000 → 18,000
C. Platelets increasing
D. Hemoglobin decreasing
Answer: A
Rationale: WBC normalizing reflects resolution of infection.
12. A patient with Parkinson’s disease has trouble initiating movement. Which intervention is
best?
A. Encourage heavy lifting
B. Provide ROM exercises
C. Restrict fluids
D. Avoid activity
Answer: B
Rationale: ROM helps maintain mobility and reduces stiffness.
13. A patient on warfarin reports black, tarry stools. What is priority?
A. Continue medication
B. Hold warfarin and notify provider
C. Encourage fiber
D. Document and move on
Answer: B
Rationale: Tarry stools suggest GI bleeding — urgent anticoagulation review is required.
14. Patient is prescribed insulin lispro. When should the nurse administer it?
A. 30 minutes before meals
B. With meals
C. Before bedtime
D. Only when hyperglycemic
Answer: B
Rationale: Rapid-acting lispro should be given with meals to control post-prandial glucose.
2026 2027 GRADED A+
