NURS 280 Final Exam | Premium Study
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1. A client is prescribed Kayexalate. Which lab value would be a priority for the
nurse to follow up with the physician?
A) Potassium level of 3.0 mEq/L
B) Potassium level of 5.5 mEq/L
C) Sodium level of 140 mEq/L
D) Calcium level of 9.0 mg/dL
Correct Answer: A
Rationale: Kayexalate is a cation-exchange resin used to treat hyperkalemia by
exchanging sodium for potassium in the gastrointestinal tract. If a client's
potassium is already low (hypokalemia), administering Kayexalate could cause a
life-threatening drop in potassium. A level of 3.0 mEq/L is below the normal range
(3.5-5.0 mEq/L) and indicates hypokalemia, making it the priority concern .
2. A client has a serum potassium level of 6.8 mEq/L. Which ECG change would
the nurse expect to see?
A) Flattened T waves
B) Peaked (tented) T waves
C) Prolonged PR interval
D) ST segment depression
Correct Answer: B
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) is characterized by peaked, tall,
tented T waves on the ECG . Flattened T waves are seen in hypokalemia, and other
changes like a widened QRS complex can occur as potassium levels continue to
rise .
,3. The nurse is assessing a client with fluid volume excess. Which finding would
the nurse expect?
A) Decreased blood pressure
B) Dry mucous membranes
C) Crackles in the lungs
D) Decreased urine output
Correct Answer: C
Rationale: Fluid volume excess (hypervolemia) leads to pulmonary congestion,
which is heard as crackles on auscultation. Other signs include edema,
hypertension, and distended neck veins. Dry mucous membranes and decreased
urine output are signs of fluid volume deficit (hypovolemia) .
4. Which acid-base imbalance is characterized by a pH < 7.35 and a PaCO₂ > 45
mmHg?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: C
Rationale: Respiratory acidosis is caused by hypoventilation, which leads to an
accumulation of carbon dioxide (PaCO₂). This results in a low pH (<7.35) and an
elevated PaCO₂ (>45 mmHg). Metabolic acidosis would have a low pH but a low
bicarbonate level .
5. Which of the following foods should a client with hypokalemia be encouraged
to eat?
A) Apples
B) Bananas
,C) Rice
D) Bread
Correct Answer: B
Rationale: Bananas are a well-known, potassium-rich food . Other high-potassium
foods include oranges, potatoes, avocados, and tomatoes. Apples, rice, and bread
are not significant sources of potassium.
6. The nurse is precepting a new hire who is caring for a client receiving a
continuous NG feeding. The nurse should intervene if the new hire is observed
doing what?
A) Checking tube placement by aspirating gastric contents.
B) Elevating the head of the bed to 30 degrees.
C) Flushing the tube with 30 mL of water.
D) Instilling 30 mL of air into the feeding tube while auscultating the stomach for
bowel sounds.
Correct Answer: D
Rationale: The "whoosh test" (instilling air and auscultating) is no longer
considered a reliable method for verifying NG tube placement. The gold standard
is to check the pH of aspirated gastric contents or confirm placement with an x-
ray. Therefore, the nurse should intervene if this outdated practice is observed .
7. The nurse is caring for a client with left ventricular failure. Which finding is
consistent with this diagnosis?
A) Peripheral edema
B) Wheezing during expiration
C) Jugular venous distention
D) Hepatomegaly
Correct Answer: B
Rationale: Left-sided heart failure leads to pulmonary congestion. Wheezing
, (cardiac asthma) and crackles are common findings . Peripheral edema, jugular
venous distention, and hepatomegaly are signs of right-sided heart failure .
8. A patient with a history of smoking and hypertension is at risk for a
myocardial infarction. What is a classic sign of an acute STEMI on an ECG?
A) PR prolongation
B) ST-segment elevation
C) Flattened T-waves
D) Prolonged QT interval
Correct Answer: B
Rationale: ST-segment elevation on an ECG is a hallmark sign of an ST-elevation
myocardial infarction (STEMI), indicating acute, full-thickness ischemia of the
heart muscle . Other findings like PR prolongation, flattened T-waves, or a
prolonged QT interval are associated with other cardiac conditions or electrolyte
imbalances .
9. A patient with atrial fibrillation is at risk for which complication?
A) Pulmonary embolism
B) Stroke
C) Deep vein thrombosis
D) Cardiac tamponade
Correct Answer: B
Rationale: Atrial fibrillation causes blood to pool in the atria, which can lead to
the formation of clots. If a clot dislodges, it can travel to the brain, causing a stroke
(embolic stroke). Anticoagulation therapy is typically prescribed for stroke
prevention in these patients .
10. A patient is prescribed warfarin. Which lab value is most important to
monitor?
Bundle with Verified Questions and
Answers
1. A client is prescribed Kayexalate. Which lab value would be a priority for the
nurse to follow up with the physician?
A) Potassium level of 3.0 mEq/L
B) Potassium level of 5.5 mEq/L
C) Sodium level of 140 mEq/L
D) Calcium level of 9.0 mg/dL
Correct Answer: A
Rationale: Kayexalate is a cation-exchange resin used to treat hyperkalemia by
exchanging sodium for potassium in the gastrointestinal tract. If a client's
potassium is already low (hypokalemia), administering Kayexalate could cause a
life-threatening drop in potassium. A level of 3.0 mEq/L is below the normal range
(3.5-5.0 mEq/L) and indicates hypokalemia, making it the priority concern .
2. A client has a serum potassium level of 6.8 mEq/L. Which ECG change would
the nurse expect to see?
A) Flattened T waves
B) Peaked (tented) T waves
C) Prolonged PR interval
D) ST segment depression
Correct Answer: B
Rationale: Hyperkalemia (potassium > 5.0 mEq/L) is characterized by peaked, tall,
tented T waves on the ECG . Flattened T waves are seen in hypokalemia, and other
changes like a widened QRS complex can occur as potassium levels continue to
rise .
,3. The nurse is assessing a client with fluid volume excess. Which finding would
the nurse expect?
A) Decreased blood pressure
B) Dry mucous membranes
C) Crackles in the lungs
D) Decreased urine output
Correct Answer: C
Rationale: Fluid volume excess (hypervolemia) leads to pulmonary congestion,
which is heard as crackles on auscultation. Other signs include edema,
hypertension, and distended neck veins. Dry mucous membranes and decreased
urine output are signs of fluid volume deficit (hypovolemia) .
4. Which acid-base imbalance is characterized by a pH < 7.35 and a PaCO₂ > 45
mmHg?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: C
Rationale: Respiratory acidosis is caused by hypoventilation, which leads to an
accumulation of carbon dioxide (PaCO₂). This results in a low pH (<7.35) and an
elevated PaCO₂ (>45 mmHg). Metabolic acidosis would have a low pH but a low
bicarbonate level .
5. Which of the following foods should a client with hypokalemia be encouraged
to eat?
A) Apples
B) Bananas
,C) Rice
D) Bread
Correct Answer: B
Rationale: Bananas are a well-known, potassium-rich food . Other high-potassium
foods include oranges, potatoes, avocados, and tomatoes. Apples, rice, and bread
are not significant sources of potassium.
6. The nurse is precepting a new hire who is caring for a client receiving a
continuous NG feeding. The nurse should intervene if the new hire is observed
doing what?
A) Checking tube placement by aspirating gastric contents.
B) Elevating the head of the bed to 30 degrees.
C) Flushing the tube with 30 mL of water.
D) Instilling 30 mL of air into the feeding tube while auscultating the stomach for
bowel sounds.
Correct Answer: D
Rationale: The "whoosh test" (instilling air and auscultating) is no longer
considered a reliable method for verifying NG tube placement. The gold standard
is to check the pH of aspirated gastric contents or confirm placement with an x-
ray. Therefore, the nurse should intervene if this outdated practice is observed .
7. The nurse is caring for a client with left ventricular failure. Which finding is
consistent with this diagnosis?
A) Peripheral edema
B) Wheezing during expiration
C) Jugular venous distention
D) Hepatomegaly
Correct Answer: B
Rationale: Left-sided heart failure leads to pulmonary congestion. Wheezing
, (cardiac asthma) and crackles are common findings . Peripheral edema, jugular
venous distention, and hepatomegaly are signs of right-sided heart failure .
8. A patient with a history of smoking and hypertension is at risk for a
myocardial infarction. What is a classic sign of an acute STEMI on an ECG?
A) PR prolongation
B) ST-segment elevation
C) Flattened T-waves
D) Prolonged QT interval
Correct Answer: B
Rationale: ST-segment elevation on an ECG is a hallmark sign of an ST-elevation
myocardial infarction (STEMI), indicating acute, full-thickness ischemia of the
heart muscle . Other findings like PR prolongation, flattened T-waves, or a
prolonged QT interval are associated with other cardiac conditions or electrolyte
imbalances .
9. A patient with atrial fibrillation is at risk for which complication?
A) Pulmonary embolism
B) Stroke
C) Deep vein thrombosis
D) Cardiac tamponade
Correct Answer: B
Rationale: Atrial fibrillation causes blood to pool in the atria, which can lead to
the formation of clots. If a clot dislodges, it can travel to the brain, causing a stroke
(embolic stroke). Anticoagulation therapy is typically prescribed for stroke
prevention in these patients .
10. A patient is prescribed warfarin. Which lab value is most important to
monitor?
