NUR 417 CARE OF ADULT
II COMPLETE EXAM BANK
BLOCK (EXAMS 1, 2, 3 &
FINAL EXAM) | LATEST
2026/2027 REAL STUDY
VERSION | 400 COMPLEX
MED-SURG & CRITICAL
CARE QUESTIONS WITH
EXHAUSTIVE CORRECT
VERIFIED ANSWERS &
DETAILED RATIONALES |
CONCORDIA UNIVERSITY
GRADED A+
Conquer your advanced medical-surgical and critical
care blocks with this comprehensive 400-question
practice exam bundle explicitly engineered for
,Concordia University's NUR 417 (Care of Adult II)
course curriculum. This premium study pack covers
every high-stakes topic spanning Exams 1, 2, 3, and
the cumulative Final Exam, including deep dives into
arterial blood gas (ABG) analysis, mechanical
ventilation alarms, hepatic encephalopathy tracking,
and acute cardiac dysrhythmias. Every single Next-
Generation NCLEX (NGN) style question features a
verified correct answer alongside a punchy, italicized
structural rationale, formatted with clean spacing
blocks for a flawless Stuvia deployment that
guarantees top student grades and skyrocketing
store sales.
Q1. A nurse is caring for a client who is 24 hours postoperative following an open
cholecystectomy. The nurse notes that the client’s T-tube has drained 150 mL of
greenish-brown fluid over the past 8 hours. Which of the following actions should
the nurse take?
a) Clamp the T-tube immediately and notify the surgeon.
b) Flush the T-tube with 30 mL of sterile normal saline.
,c) Document the finding as an expected postoperative manifestation.
d) Elevate the drainage bag above the level of the client's incision.
Answer: c
Rationale: Greenish-brown drainage is bile, and an output of 300 to 500 mL in the first
24 hours is entirely expected after an open cholecystectomy. The nurse should continue
to monitor the output. Clamping without an order can cause bile backup and peritonitis,
flushing requires a specific prescription, and the drainage bag must remain below the
level of the incision to allow gravity flow.
Q2. A nurse is reviewing the arterial blood gas (ABG) results for a client who has
a history of chronic obstructive pulmonary disease (COPD) and is experiencing
acute respiratory distress. The results are: pH 7.28, PaCO₂ 58 mm Hg, HCO₃⁻ 26
mEq/L, PaO₂ 62 mm Hg. How should the nurse interpret these findings?
a) Compensated metabolic acidosis
b) Uncompensated respiratory acidosis
c) Partially compensated respiratory alkalosis
d) Uncompensated metabolic alkalosis
Answer: b
Rationale: A pH below 7.35 indicates acidosis. A PaCO₂ greater than 45 mm Hg
indicates that the acidosis is respiratory in origin. Because the HCO₃⁻ is within the
normal reference range (22 to 26 mEq/L), the kidneys have not yet compensated for the
respiratory retention of carbon dioxide. This signifies uncompensated respiratory
acidosis.
Q3. A nurse is monitoring a client who has an acute myocardial infarction (MI)
and is receiving a continuous intravenous infusion of heparin. Which of the
following laboratory values should the nurse monitor to adjust the heparin
dosage?
a) Prothrombin time (PT)
b) International Normalized Ratio (INR)
c) Activated partial thromboplastin time (aPTT)
d) Platelet count
Answer: c
Rationale: The activated partial thromboplastin time (aPTT) is used to monitor the
therapeutic effectiveness of unfractionated heparin infusions. The dosage is adjusted
based on a titrated protocol to maintain the aPTT within a therapeutic range (typically
1.5 to 2.5 times the control value). PT and INR are used to monitor warfarin.
Q4. A nurse is reinforcing instructions with a client who has stable angina and a
new prescription for sublingual nitroglycerin tablets. Which instruction should
the nurse provide?
a) Swallow the tablet with a full glass of water.
b) Take up to 5 tablets spaced 10 minutes apart.
c) Place the tablet under the tongue when chest pain begins.
d) Storage of the medication should be in a clear plastic container.
, Answer: c
Rationale: Sublingual nitroglycerin must dissolve under the tongue for rapid absorption
during an anginal attack. The protocol is to take 1 tablet every 5 minutes for up to 3
doses. If pain is not relieved after the first dose, emergency services should be
activated immediately.
Q5. A nurse is checking the gastric residual volume of a client who is receiving
continuous enteral tube feedings. The residual volume is 300 mL. Which of the
following actions should the nurse take?
a) Flush the tube with 50 mL of ice water.
b) Hold the feeding and recheck the residual in 1 hour.
c) Discard the aspirated residual fluid.
d) Increase the infusion rate to catch up on the schedule.
Answer: b
Rationale: A gastric residual volume greater than 250 mL on two consecutive checks or
a single check over 500 mL indicates delayed gastric emptying and increases the risk of
aspiration. The feeding should be held, the client monitored, and the provider notified
according to facility protocol.
Q6. A nurse is collecting data from a client who has a skeletal traction pin for a
fractured femur. Which of the following findings indicates a localized infection at
the pin site?
a) Serosanguineous drainage on the dressing
b) Mild erythema extending 1 mm around the pin
c) Purulent drainage and localized warmth
d) Client report of a dull ache in the thigh
Answer: c
Rationale: Purulent (pus-like) drainage, foul odor, worsening localized warmth, and
severe tenderness are classic signs of a pin site infection. Small amounts of
serosanguineous drainage and minimal redness are normal healing responses during
the initial days.
Q7. A nurse is monitoring a client who has a chest tube connected to a water-seal
drainage system. The nurse notes continuous bubbling in the water-seal
chamber. How should the nurse interpret this finding?
a) The system is functioning normally.
b) There is an air leak in the system.
c) The client's lung has fully re-expanded.
d) The suction pressure needs to be increased.
Answer: b
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak
somewhere in the system or at the insertion site. Intermittent bubbling is normal during
coughing or exhalation. If the lung re-expands, bubbling stops completely.
Q8. A nurse is preparing a client for an upper gastrointestinal (GI) endoscopy.
Which of the following actions is the nurse's priority?
II COMPLETE EXAM BANK
BLOCK (EXAMS 1, 2, 3 &
FINAL EXAM) | LATEST
2026/2027 REAL STUDY
VERSION | 400 COMPLEX
MED-SURG & CRITICAL
CARE QUESTIONS WITH
EXHAUSTIVE CORRECT
VERIFIED ANSWERS &
DETAILED RATIONALES |
CONCORDIA UNIVERSITY
GRADED A+
Conquer your advanced medical-surgical and critical
care blocks with this comprehensive 400-question
practice exam bundle explicitly engineered for
,Concordia University's NUR 417 (Care of Adult II)
course curriculum. This premium study pack covers
every high-stakes topic spanning Exams 1, 2, 3, and
the cumulative Final Exam, including deep dives into
arterial blood gas (ABG) analysis, mechanical
ventilation alarms, hepatic encephalopathy tracking,
and acute cardiac dysrhythmias. Every single Next-
Generation NCLEX (NGN) style question features a
verified correct answer alongside a punchy, italicized
structural rationale, formatted with clean spacing
blocks for a flawless Stuvia deployment that
guarantees top student grades and skyrocketing
store sales.
Q1. A nurse is caring for a client who is 24 hours postoperative following an open
cholecystectomy. The nurse notes that the client’s T-tube has drained 150 mL of
greenish-brown fluid over the past 8 hours. Which of the following actions should
the nurse take?
a) Clamp the T-tube immediately and notify the surgeon.
b) Flush the T-tube with 30 mL of sterile normal saline.
,c) Document the finding as an expected postoperative manifestation.
d) Elevate the drainage bag above the level of the client's incision.
Answer: c
Rationale: Greenish-brown drainage is bile, and an output of 300 to 500 mL in the first
24 hours is entirely expected after an open cholecystectomy. The nurse should continue
to monitor the output. Clamping without an order can cause bile backup and peritonitis,
flushing requires a specific prescription, and the drainage bag must remain below the
level of the incision to allow gravity flow.
Q2. A nurse is reviewing the arterial blood gas (ABG) results for a client who has
a history of chronic obstructive pulmonary disease (COPD) and is experiencing
acute respiratory distress. The results are: pH 7.28, PaCO₂ 58 mm Hg, HCO₃⁻ 26
mEq/L, PaO₂ 62 mm Hg. How should the nurse interpret these findings?
a) Compensated metabolic acidosis
b) Uncompensated respiratory acidosis
c) Partially compensated respiratory alkalosis
d) Uncompensated metabolic alkalosis
Answer: b
Rationale: A pH below 7.35 indicates acidosis. A PaCO₂ greater than 45 mm Hg
indicates that the acidosis is respiratory in origin. Because the HCO₃⁻ is within the
normal reference range (22 to 26 mEq/L), the kidneys have not yet compensated for the
respiratory retention of carbon dioxide. This signifies uncompensated respiratory
acidosis.
Q3. A nurse is monitoring a client who has an acute myocardial infarction (MI)
and is receiving a continuous intravenous infusion of heparin. Which of the
following laboratory values should the nurse monitor to adjust the heparin
dosage?
a) Prothrombin time (PT)
b) International Normalized Ratio (INR)
c) Activated partial thromboplastin time (aPTT)
d) Platelet count
Answer: c
Rationale: The activated partial thromboplastin time (aPTT) is used to monitor the
therapeutic effectiveness of unfractionated heparin infusions. The dosage is adjusted
based on a titrated protocol to maintain the aPTT within a therapeutic range (typically
1.5 to 2.5 times the control value). PT and INR are used to monitor warfarin.
Q4. A nurse is reinforcing instructions with a client who has stable angina and a
new prescription for sublingual nitroglycerin tablets. Which instruction should
the nurse provide?
a) Swallow the tablet with a full glass of water.
b) Take up to 5 tablets spaced 10 minutes apart.
c) Place the tablet under the tongue when chest pain begins.
d) Storage of the medication should be in a clear plastic container.
, Answer: c
Rationale: Sublingual nitroglycerin must dissolve under the tongue for rapid absorption
during an anginal attack. The protocol is to take 1 tablet every 5 minutes for up to 3
doses. If pain is not relieved after the first dose, emergency services should be
activated immediately.
Q5. A nurse is checking the gastric residual volume of a client who is receiving
continuous enteral tube feedings. The residual volume is 300 mL. Which of the
following actions should the nurse take?
a) Flush the tube with 50 mL of ice water.
b) Hold the feeding and recheck the residual in 1 hour.
c) Discard the aspirated residual fluid.
d) Increase the infusion rate to catch up on the schedule.
Answer: b
Rationale: A gastric residual volume greater than 250 mL on two consecutive checks or
a single check over 500 mL indicates delayed gastric emptying and increases the risk of
aspiration. The feeding should be held, the client monitored, and the provider notified
according to facility protocol.
Q6. A nurse is collecting data from a client who has a skeletal traction pin for a
fractured femur. Which of the following findings indicates a localized infection at
the pin site?
a) Serosanguineous drainage on the dressing
b) Mild erythema extending 1 mm around the pin
c) Purulent drainage and localized warmth
d) Client report of a dull ache in the thigh
Answer: c
Rationale: Purulent (pus-like) drainage, foul odor, worsening localized warmth, and
severe tenderness are classic signs of a pin site infection. Small amounts of
serosanguineous drainage and minimal redness are normal healing responses during
the initial days.
Q7. A nurse is monitoring a client who has a chest tube connected to a water-seal
drainage system. The nurse notes continuous bubbling in the water-seal
chamber. How should the nurse interpret this finding?
a) The system is functioning normally.
b) There is an air leak in the system.
c) The client's lung has fully re-expanded.
d) The suction pressure needs to be increased.
Answer: b
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak
somewhere in the system or at the insertion site. Intermittent bubbling is normal during
coughing or exhalation. If the lung re-expands, bubbling stops completely.
Q8. A nurse is preparing a client for an upper gastrointestinal (GI) endoscopy.
Which of the following actions is the nurse's priority?
