NUR 3490 EXAM 1 – 2026 UPDATE Molloy College
Actual Exam 2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | 100% Verified | Pass
Guaranteed – A+ Graded
Section 1: Foundations & Core Concepts (Questions 1–15)
Q1: A patient receiving IV potassium chloride via peripheral line complains of burning at the insertion
site. Which action by the nurse is most appropriate?
A. Increase the infusion rate to finish the dose more quickly
B. Apply a warm compress and slow the infusion rate [CORRECT]
C. Switch to a larger gauge catheter without changing the rate
D. Stop the infusion immediately and notify the provider
Correct Answer: B
Rationale: The best answer is B. Potassium is irritating to peripheral veins, and a warm compress with a
reduced rate helps dilute the solution and improve comfort without stopping a necessary replacement.
This aligns with standard IV potassium administration guidelines.
Q2: Which of the following serum sodium levels is considered within normal range for an adult?
A. 118 mEq/L
B. 128 mEq/L
C. 138 mEq/L [CORRECT]
D. 158 mEq/L
Correct Answer: C
Rationale: The best answer is C. A normal serum sodium level for adults typically falls between 135 and
145 mEq/L, so 138 sits right in the middle of that expected range.
Q3: A patient is scheduled for elective surgery in the morning. The nurse reviews the preoperative
checklist and notes the patient ate a light snack two hours ago. What is the nurse's priority action?
A. Cancel the surgery immediately
B. Notify the surgeon and anesthesia provider [CORRECT]
C. Document the finding and proceed with pre-op teaching
D. Administer an antiemetic and continue with the schedule
Correct Answer: B
,Rationale: The best answer is B. The anesthesia team and surgeon need to know about any recent intake
so they can assess aspiration risk and decide whether to proceed or delay. This matches the principle
that NPO status is a shared decision, not a nursing judgment call alone.
Q4: During the immediate postoperative period, a patient develops stridor and difficulty breathing.
Which complication should the nurse suspect first?
A. Atelectasis
B. Laryngospasm or airway obstruction [CORRECT]
C. Pulmonary embolism
D. Pneumonia
Correct Answer: B
Rationale: The best answer is B. Stridor in the immediate post-op period usually points to upper airway
issues like laryngospasm, tongue obstruction, or swelling, which demand rapid airway intervention. This
aligns with the ABC priority in post-anesthesia recovery.
Q5: A patient reports pain rated 8/10 and describes it as "sharp and stabbing" in the right lower
quadrant. Which type of pain is the nurse most likely documenting?
A. Neuropathic pain
B. Visceral pain
C. Somatic pain [CORRECT]
D. Referred pain
Correct Answer: C
Rationale: The best answer is C. Sharp, well-localized pain in a specific area like the right lower quadrant
typically reflects somatic pain involving the parietal peritoneum or abdominal wall structures. This
matches the characteristic that somatic pain is usually easy for patients to point to.
Q6: When administering an opioid analgesic to a postoperative patient, which assessment is most
important for the nurse to complete first?
A. Check the patient's allergy history and current respiratory rate [CORRECT]
B. Assess the patient's bowel sounds in all four quadrants
C. Verify the patient's ability to ambulate independently
D. Review the patient's family history of substance use
Correct Answer: A
Rationale: The best answer is A. Before giving any opioid, you need to know about allergies and get a
baseline respiratory rate since opioids can depress breathing. This aligns with the safety-first approach
to pain management.
, Q7: A Stage 2 pressure injury is best described as which of the following?
A. Full-thickness tissue loss with visible subcutaneous fat
B. Nonblanchable erythema of intact skin
C. Partial-thickness loss of dermis presenting as a shallow open ulcer [CORRECT]
D. Deep tissue injury with a purple or maroon localized area
Correct Answer: C
Rationale: The best answer is C. Stage 2 pressure injuries involve partial-thickness skin loss where you
might see a shiny or dry shallow ulcer, or a ruptured blister, but no deeper tissue is exposed. This
matches the standard NPIAP staging definitions.
Q8: Which Braden Scale score indicates a patient is at high risk for developing a pressure injury?
A. 20–23
B. 15–18
C. 13–14
D. 10–12 or lower [CORRECT]
Correct Answer: D
Rationale: The best answer is D. On the Braden Scale, scores of 10–12 or below fall into the high-risk
category, while 15–18 is mild risk and 13–14 is moderate risk. This aligns with standard pressure injury
prevention protocols.
Q9: When caring for a patient on Contact Precautions for a known MRSA wound infection, which PPE
item is absolutely required before entering the room?
A. N95 respirator mask
B. Gown and gloves [CORRECT]
C. Face shield and goggles
D. Powered air-purifying respirator
Correct Answer: B
Rationale: The best answer is B. Contact Precautions for MRSA require a gown and gloves to prevent
direct contact with the patient or contaminated surfaces. This matches CDC standard precaution
guidelines for contact-transmitted organisms.
Q10: A postoperative patient has an order for morphine 4 mg IV every 4 hours as needed for pain. The
nurse checks the medication administration record and sees the last dose was given 2 hours ago. The
patient now reports pain of 9/10. What is the nurse's best action?
A. Administer the next dose immediately since the patient is in severe pain
Actual Exam 2026/2027 with Detailed Rationales |
Complete Exam-Style Questions | 100% Verified | Pass
Guaranteed – A+ Graded
Section 1: Foundations & Core Concepts (Questions 1–15)
Q1: A patient receiving IV potassium chloride via peripheral line complains of burning at the insertion
site. Which action by the nurse is most appropriate?
A. Increase the infusion rate to finish the dose more quickly
B. Apply a warm compress and slow the infusion rate [CORRECT]
C. Switch to a larger gauge catheter without changing the rate
D. Stop the infusion immediately and notify the provider
Correct Answer: B
Rationale: The best answer is B. Potassium is irritating to peripheral veins, and a warm compress with a
reduced rate helps dilute the solution and improve comfort without stopping a necessary replacement.
This aligns with standard IV potassium administration guidelines.
Q2: Which of the following serum sodium levels is considered within normal range for an adult?
A. 118 mEq/L
B. 128 mEq/L
C. 138 mEq/L [CORRECT]
D. 158 mEq/L
Correct Answer: C
Rationale: The best answer is C. A normal serum sodium level for adults typically falls between 135 and
145 mEq/L, so 138 sits right in the middle of that expected range.
Q3: A patient is scheduled for elective surgery in the morning. The nurse reviews the preoperative
checklist and notes the patient ate a light snack two hours ago. What is the nurse's priority action?
A. Cancel the surgery immediately
B. Notify the surgeon and anesthesia provider [CORRECT]
C. Document the finding and proceed with pre-op teaching
D. Administer an antiemetic and continue with the schedule
Correct Answer: B
,Rationale: The best answer is B. The anesthesia team and surgeon need to know about any recent intake
so they can assess aspiration risk and decide whether to proceed or delay. This matches the principle
that NPO status is a shared decision, not a nursing judgment call alone.
Q4: During the immediate postoperative period, a patient develops stridor and difficulty breathing.
Which complication should the nurse suspect first?
A. Atelectasis
B. Laryngospasm or airway obstruction [CORRECT]
C. Pulmonary embolism
D. Pneumonia
Correct Answer: B
Rationale: The best answer is B. Stridor in the immediate post-op period usually points to upper airway
issues like laryngospasm, tongue obstruction, or swelling, which demand rapid airway intervention. This
aligns with the ABC priority in post-anesthesia recovery.
Q5: A patient reports pain rated 8/10 and describes it as "sharp and stabbing" in the right lower
quadrant. Which type of pain is the nurse most likely documenting?
A. Neuropathic pain
B. Visceral pain
C. Somatic pain [CORRECT]
D. Referred pain
Correct Answer: C
Rationale: The best answer is C. Sharp, well-localized pain in a specific area like the right lower quadrant
typically reflects somatic pain involving the parietal peritoneum or abdominal wall structures. This
matches the characteristic that somatic pain is usually easy for patients to point to.
Q6: When administering an opioid analgesic to a postoperative patient, which assessment is most
important for the nurse to complete first?
A. Check the patient's allergy history and current respiratory rate [CORRECT]
B. Assess the patient's bowel sounds in all four quadrants
C. Verify the patient's ability to ambulate independently
D. Review the patient's family history of substance use
Correct Answer: A
Rationale: The best answer is A. Before giving any opioid, you need to know about allergies and get a
baseline respiratory rate since opioids can depress breathing. This aligns with the safety-first approach
to pain management.
, Q7: A Stage 2 pressure injury is best described as which of the following?
A. Full-thickness tissue loss with visible subcutaneous fat
B. Nonblanchable erythema of intact skin
C. Partial-thickness loss of dermis presenting as a shallow open ulcer [CORRECT]
D. Deep tissue injury with a purple or maroon localized area
Correct Answer: C
Rationale: The best answer is C. Stage 2 pressure injuries involve partial-thickness skin loss where you
might see a shiny or dry shallow ulcer, or a ruptured blister, but no deeper tissue is exposed. This
matches the standard NPIAP staging definitions.
Q8: Which Braden Scale score indicates a patient is at high risk for developing a pressure injury?
A. 20–23
B. 15–18
C. 13–14
D. 10–12 or lower [CORRECT]
Correct Answer: D
Rationale: The best answer is D. On the Braden Scale, scores of 10–12 or below fall into the high-risk
category, while 15–18 is mild risk and 13–14 is moderate risk. This aligns with standard pressure injury
prevention protocols.
Q9: When caring for a patient on Contact Precautions for a known MRSA wound infection, which PPE
item is absolutely required before entering the room?
A. N95 respirator mask
B. Gown and gloves [CORRECT]
C. Face shield and goggles
D. Powered air-purifying respirator
Correct Answer: B
Rationale: The best answer is B. Contact Precautions for MRSA require a gown and gloves to prevent
direct contact with the patient or contaminated surfaces. This matches CDC standard precaution
guidelines for contact-transmitted organisms.
Q10: A postoperative patient has an order for morphine 4 mg IV every 4 hours as needed for pain. The
nurse checks the medication administration record and sees the last dose was given 2 hours ago. The
patient now reports pain of 9/10. What is the nurse's best action?
A. Administer the next dose immediately since the patient is in severe pain
