NYC EDUCATION OFFICER
EXAMINATION COMPLETE QUESTIONS,
ANSWERS WITH RATIONALES
Questions 1-50: Fundamentals of Nursing & Medical-Surgical I
1. A patient with heart failure is prescribed furosemide. Which assessment
finding indicates that the medication is having the desired therapeutic effect?
A) Decreased heart rate
B) Increased blood pressure
C) Decreased peripheral edema
D) Increased jugular venous distention
Correct Answer: C
Rationale: Furosemide is a loop diuretic used to reduce fluid volume overload
in heart failure. A decrease in peripheral edema is a direct indicator of
reduced fluid volume. Increased JVD (D) indicates fluid overload, which the
drug aims to reduce. The medication can cause hypotension, not hypertension
(B). A decreased heart rate is not a direct therapeutic effect of furosemide (A).
2. A nurse is providing teaching to a patient with a new colostomy. Which
statement by the patient indicates a need for further teaching?
A) "I will need to irrigate my colostomy daily to have a bowel movement."
B) "I should avoid eating foods like popcorn and nuts to prevent blockage."
,C) "The color of my stoma should remain pink and moist."
D) "I can change my pouch system in the morning before I eat."
Correct Answer: A
Rationale: Only a descending or sigmoid colostomy is typically irrigated to
promote scheduled bowel movements; an ascending or transverse colostomy
is not. The stoma should be pink and moist (C). Patients are advised to avoid
foods that can cause blockages (B). Changing the pouch in the morning before
eating is a good practice as the bowel is less active (D).
3. A patient is experiencing acute alcohol withdrawal. Which assessment
finding would the nurse expect to see first?
A) Seizures
B) Delirium tremens
C) Tremors
D) Hypotension
Correct Answer: C
Rationale: Tremors ("the shakes") are one of the earliest signs of alcohol
withdrawal, often occurring within 6-12 hours of the last drink. Seizures (A)
can occur, but usually later. Delirium tremens (B) is a severe, late
complication. Hypertension, not hypotension (D), is a common manifestation.
4. A patient is NPO (nothing by mouth) prior to surgery. The nurse notes that
the patient's serum potassium level is 3.2 mEq/L. Which of the following is the
priority nursing action?
A) Notify the healthcare provider.
B) Encourage the patient to drink orange juice.
,C) Document the finding in the chart.
D) Place the patient on a cardiac monitor.
Correct Answer: A
Rationale: A potassium level of 3.2 is hypokalemia. Since the patient is NPO,
oral replacement is not an option. The priority is to notify the provider to
order IV replacement. While cardiac monitoring (D) may be necessary, it is
not the first step. The provider must be informed to initiate treatment.
5. A nurse is preparing to administer a blood transfusion. Which of the
following IV solutions is compatible for infusion with packed red blood cells
(PRBCs)?
A) 5% Dextrose in Water (D5W)
B) 0.9% Normal Saline
C) Lactated Ringer's
D) 0.45% Normal Saline
Correct Answer: B
Rationale: 0.9% Normal Saline is the only solution recommended for use with
blood products. Dextrose solutions (A) can cause hemolysis. Lactated Ringer's
(C) contains calcium, which can cause clotting in the IV tubing. Hypotonic
solutions (D) can cause red blood cells to swell and lyse.
6. A patient with diabetes mellitus type 1 is experiencing hypoglycemia. Which
of the following is the priority nursing intervention?
A) Administer 15g of rapid-acting carbohydrate.
B) Administer 1 mg of glucagon intramuscularly.
C) Recheck the blood glucose in 15 minutes.
, D) Assess the patient's level of consciousness.
Correct Answer: D
Rationale: Assessment is always the first step. The nurse must first assess the
patient's ability to swallow safely. If the patient is unconscious or unable to
swallow, glucagon (B) or IV dextrose must be given, not oral carbohydrates
(A). Rechecking glucose (C) is done after treatment.
7. A patient is diagnosed with deep vein thrombosis (DVT) in the left leg.
Which nursing intervention is a priority?
A) Apply heat to the affected leg.
B) Massage the affected leg gently.
C) Encourage ambulation to promote circulation.
D) Measure the circumference of the calf daily.
Correct Answer: D
Rationale: Monitoring for changes in leg swelling by daily measurement is a
key intervention to assess the effectiveness of treatment and monitor for
progression. Heat (A) and massage (B) are contraindicated as they can
dislodge the clot. Strict bed rest is often prescribed initially to prevent
embolization (C).
8. A nurse is caring for a patient with a chest tube after a pneumothorax. What
is the purpose of the water seal chamber?
A) To regulate the amount of suction applied.
B) To collect drainage from the pleural space.
C) To allow air to escape but prevent it from re-entering the chest.
D) To monitor the patient's respiratory rate.
EXAMINATION COMPLETE QUESTIONS,
ANSWERS WITH RATIONALES
Questions 1-50: Fundamentals of Nursing & Medical-Surgical I
1. A patient with heart failure is prescribed furosemide. Which assessment
finding indicates that the medication is having the desired therapeutic effect?
A) Decreased heart rate
B) Increased blood pressure
C) Decreased peripheral edema
D) Increased jugular venous distention
Correct Answer: C
Rationale: Furosemide is a loop diuretic used to reduce fluid volume overload
in heart failure. A decrease in peripheral edema is a direct indicator of
reduced fluid volume. Increased JVD (D) indicates fluid overload, which the
drug aims to reduce. The medication can cause hypotension, not hypertension
(B). A decreased heart rate is not a direct therapeutic effect of furosemide (A).
2. A nurse is providing teaching to a patient with a new colostomy. Which
statement by the patient indicates a need for further teaching?
A) "I will need to irrigate my colostomy daily to have a bowel movement."
B) "I should avoid eating foods like popcorn and nuts to prevent blockage."
,C) "The color of my stoma should remain pink and moist."
D) "I can change my pouch system in the morning before I eat."
Correct Answer: A
Rationale: Only a descending or sigmoid colostomy is typically irrigated to
promote scheduled bowel movements; an ascending or transverse colostomy
is not. The stoma should be pink and moist (C). Patients are advised to avoid
foods that can cause blockages (B). Changing the pouch in the morning before
eating is a good practice as the bowel is less active (D).
3. A patient is experiencing acute alcohol withdrawal. Which assessment
finding would the nurse expect to see first?
A) Seizures
B) Delirium tremens
C) Tremors
D) Hypotension
Correct Answer: C
Rationale: Tremors ("the shakes") are one of the earliest signs of alcohol
withdrawal, often occurring within 6-12 hours of the last drink. Seizures (A)
can occur, but usually later. Delirium tremens (B) is a severe, late
complication. Hypertension, not hypotension (D), is a common manifestation.
4. A patient is NPO (nothing by mouth) prior to surgery. The nurse notes that
the patient's serum potassium level is 3.2 mEq/L. Which of the following is the
priority nursing action?
A) Notify the healthcare provider.
B) Encourage the patient to drink orange juice.
,C) Document the finding in the chart.
D) Place the patient on a cardiac monitor.
Correct Answer: A
Rationale: A potassium level of 3.2 is hypokalemia. Since the patient is NPO,
oral replacement is not an option. The priority is to notify the provider to
order IV replacement. While cardiac monitoring (D) may be necessary, it is
not the first step. The provider must be informed to initiate treatment.
5. A nurse is preparing to administer a blood transfusion. Which of the
following IV solutions is compatible for infusion with packed red blood cells
(PRBCs)?
A) 5% Dextrose in Water (D5W)
B) 0.9% Normal Saline
C) Lactated Ringer's
D) 0.45% Normal Saline
Correct Answer: B
Rationale: 0.9% Normal Saline is the only solution recommended for use with
blood products. Dextrose solutions (A) can cause hemolysis. Lactated Ringer's
(C) contains calcium, which can cause clotting in the IV tubing. Hypotonic
solutions (D) can cause red blood cells to swell and lyse.
6. A patient with diabetes mellitus type 1 is experiencing hypoglycemia. Which
of the following is the priority nursing intervention?
A) Administer 15g of rapid-acting carbohydrate.
B) Administer 1 mg of glucagon intramuscularly.
C) Recheck the blood glucose in 15 minutes.
, D) Assess the patient's level of consciousness.
Correct Answer: D
Rationale: Assessment is always the first step. The nurse must first assess the
patient's ability to swallow safely. If the patient is unconscious or unable to
swallow, glucagon (B) or IV dextrose must be given, not oral carbohydrates
(A). Rechecking glucose (C) is done after treatment.
7. A patient is diagnosed with deep vein thrombosis (DVT) in the left leg.
Which nursing intervention is a priority?
A) Apply heat to the affected leg.
B) Massage the affected leg gently.
C) Encourage ambulation to promote circulation.
D) Measure the circumference of the calf daily.
Correct Answer: D
Rationale: Monitoring for changes in leg swelling by daily measurement is a
key intervention to assess the effectiveness of treatment and monitor for
progression. Heat (A) and massage (B) are contraindicated as they can
dislodge the clot. Strict bed rest is often prescribed initially to prevent
embolization (C).
8. A nurse is caring for a patient with a chest tube after a pneumothorax. What
is the purpose of the water seal chamber?
A) To regulate the amount of suction applied.
B) To collect drainage from the pleural space.
C) To allow air to escape but prevent it from re-entering the chest.
D) To monitor the patient's respiratory rate.
