NR324 Adult Health I Exam Actual Exam
2026/2027 – Complete Exam-Style
Questions | Detailed Rationales – Pass
Guaranteed – A+ Graded
Question 1
A patient with heart failure has jugular venous distension, crackles
in both lung bases, and 3+ pitting edema in the lower extremities.
Which nursing diagnosis has the highest priority?
A. Impaired skin integrity
B. Excess fluid volume
C. Activity intolerance
D. Risk for infection
Correct ,,,,answer,,,: B
Rationale: Excess fluid volume is the priority because JVD, crackles,
and edema indicate fluid overload, which can lead to pulmonary
edema and respiratory compromise. Airway and breathing take
precedence.
Question 2
A patient with chronic kidney disease has a serum potassium of 6.8
mEq/L.
,What is the priority nursing intervention?
A. Encourage potassium-rich foods
B. Administer sodium polystyrene sulfonate (Kayexalate)
C. Restrict oral fluids
D. Prepare for hemodialysis
Correct ,,,,answer,,,: D
Rationale: Severe hyperkalemia (K+ >6.5) with ECG changes is a
medical emergency. Hemodialysis is the most definitive treatment.
Kayexalate is slower and used for moderate elevations.
Question 3
A postoperative patient reports sudden chest pain, dyspnea, and
hemoptysis. O2 saturation is 88%.
What should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Pneumothorax
D. Pneumonia
Correct ,,,,answer,,,: B
Rationale: Sudden chest pain, dyspnea, hemoptysis, and hypoxemia
in a postoperative patient suggest pulmonary embolism (PE) from
deep vein thrombosis.
Question 4
,A patient with COPD has an arterial blood gas (ABG): pH 7.32,
PaCO2 58, HCO3 28.
This indicates:
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Compensated metabolic alkalosis
D. Mixed disorder
Correct ,,,,answer,,,: B
Rationale: pH is low (acidosis), PaCO2 elevated (respiratory cause),
HCO3 slightly elevated (metabolic compensation). Compensation is
partial because pH is still abnormal.
Question 5
A patient with diabetes insipidus has a urine output of 400 mL/hr.
Which IV fluid should the nurse anticipate?
A. 0.9% normal saline
B. D5W
C. 0.45% normal saline
D. Lactated Ringer’s
Correct ,,,,answer,,,: A
Rationale: Diabetes insipidus causes massive water loss. Normal
saline (isotonic) replaces volume and prevents rapid osmolarity
shifts. Hypotonic fluids risk cerebral edema.
, Question 6
A patient with diabetic ketoacidosis (DKA) has a blood glucose of
650 mg/dL. IV insulin is started.
Which electrolyte requires close monitoring?
A. Sodium
B. Calcium
C. Potassium
D. Magnesium
Correct ,,,,answer,,,: C
Rationale: Insulin drives potassium into cells, causing hypokalemia.
Potassium must be monitored and replaced aggressively in DKA.
Question 7
A patient with cirrhosis has asterixis, confusion, and a serum
ammonia of 120 mcg/dL.
Which medication is expected?
A. Spironolactone
B. Lactulose
C. Furosemide
D. Octreotide
Correct ,,,,answer,,,: B
Rationale: Lactulose reduces serum ammonia by acidifying the colon
and promoting ammonia excretion in stool. Used for hepatic
encephalopathy.
2026/2027 – Complete Exam-Style
Questions | Detailed Rationales – Pass
Guaranteed – A+ Graded
Question 1
A patient with heart failure has jugular venous distension, crackles
in both lung bases, and 3+ pitting edema in the lower extremities.
Which nursing diagnosis has the highest priority?
A. Impaired skin integrity
B. Excess fluid volume
C. Activity intolerance
D. Risk for infection
Correct ,,,,answer,,,: B
Rationale: Excess fluid volume is the priority because JVD, crackles,
and edema indicate fluid overload, which can lead to pulmonary
edema and respiratory compromise. Airway and breathing take
precedence.
Question 2
A patient with chronic kidney disease has a serum potassium of 6.8
mEq/L.
,What is the priority nursing intervention?
A. Encourage potassium-rich foods
B. Administer sodium polystyrene sulfonate (Kayexalate)
C. Restrict oral fluids
D. Prepare for hemodialysis
Correct ,,,,answer,,,: D
Rationale: Severe hyperkalemia (K+ >6.5) with ECG changes is a
medical emergency. Hemodialysis is the most definitive treatment.
Kayexalate is slower and used for moderate elevations.
Question 3
A postoperative patient reports sudden chest pain, dyspnea, and
hemoptysis. O2 saturation is 88%.
What should the nurse suspect?
A. Atelectasis
B. Pulmonary embolism
C. Pneumothorax
D. Pneumonia
Correct ,,,,answer,,,: B
Rationale: Sudden chest pain, dyspnea, hemoptysis, and hypoxemia
in a postoperative patient suggest pulmonary embolism (PE) from
deep vein thrombosis.
Question 4
,A patient with COPD has an arterial blood gas (ABG): pH 7.32,
PaCO2 58, HCO3 28.
This indicates:
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Compensated metabolic alkalosis
D. Mixed disorder
Correct ,,,,answer,,,: B
Rationale: pH is low (acidosis), PaCO2 elevated (respiratory cause),
HCO3 slightly elevated (metabolic compensation). Compensation is
partial because pH is still abnormal.
Question 5
A patient with diabetes insipidus has a urine output of 400 mL/hr.
Which IV fluid should the nurse anticipate?
A. 0.9% normal saline
B. D5W
C. 0.45% normal saline
D. Lactated Ringer’s
Correct ,,,,answer,,,: A
Rationale: Diabetes insipidus causes massive water loss. Normal
saline (isotonic) replaces volume and prevents rapid osmolarity
shifts. Hypotonic fluids risk cerebral edema.
, Question 6
A patient with diabetic ketoacidosis (DKA) has a blood glucose of
650 mg/dL. IV insulin is started.
Which electrolyte requires close monitoring?
A. Sodium
B. Calcium
C. Potassium
D. Magnesium
Correct ,,,,answer,,,: C
Rationale: Insulin drives potassium into cells, causing hypokalemia.
Potassium must be monitored and replaced aggressively in DKA.
Question 7
A patient with cirrhosis has asterixis, confusion, and a serum
ammonia of 120 mcg/dL.
Which medication is expected?
A. Spironolactone
B. Lactulose
C. Furosemide
D. Octreotide
Correct ,,,,answer,,,: B
Rationale: Lactulose reduces serum ammonia by acidifying the colon
and promoting ammonia excretion in stool. Used for hepatic
encephalopathy.
