NRSG 2350 NORTH EASTERN UNIVERSITY FINAL EXAM –
QUESTIONS AND ANSWERS | VERIFIED ANSWERS PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE |
EXAM PREP | STUDY GUIDE | PRACTICE TEST
1. A nurse is preparing to assess a newly admitted adult client diagnosed with acute
pyelonephritis. Which of the following clinical manifestations should the nurse expect to
find during the initial physical assessment?
A. Lower quadrant abdominal cramping with painless hematuria
B. Bilateral lower extremity edema and jugular venous distention
C. Costovertebral angle tenderness and high-grade fever
D. Suprapubic fullness and intermittent urinary hesitancy
Costovertebral angle tenderness and high-grade fever are hallmark physical assessment
findings associated with acute pyelonephritis due to bacterial infection and subsequent
inflammation of the renal parenchyma and pelvis.
2. A community health nurse is conducting an educational workshop for parents regarding
the transmission and prevention of pediculosis capitis in school-aged children. Which
statement made by a parent indicates a correct understanding of the teaching?
A. Head lice are primarily transmitted through sharing hats, combs, and upholstered
furniture.
B. Children with active infestations must be isolated from household members for fourteen days.
C. Chemical treatments completely eliminate all nits upon initial application without manual
removal.
D. Household pets frequently act as primary vectors for transferring head lice to children.
Head lice are transmitted primarily through direct head-to-head contact, as well as indirectly
through sharing personal items such as hats, hairbrushes, scarves, and resting on
contaminated upholstered surfaces.
3. An emergency department nurse is evaluating a client who presents with acute
respiratory distress, tracheal deviation to the left, absent breath sounds on the right side,
and hemodynamic instability. Which immediate intervention should the nurse anticipate?
A. Administering high-flow nebulized albuterol via a face mask
,B. Assisting the physician with emergent needle decompression of the right chest
C. Positioning the client flat in a supine posture to optimize cardiac preload
D. Preparing the client for immediate fiberoptic bronchoscopy
Tracheal deviation away from the affected side, absent breath sounds, and hemodynamic
instability indicate a tension pneumothorax, which is a life-threatening medical emergency
requiring immediate needle decompression to relieve intrapleural pressure.
4. A nurse is reviewing the laboratory results of a client receiving heparin therapy for deep
vein thrombosis. Which laboratory parameter must the nurse monitor to evaluate the
therapeutic efficacy of this medication?
A. International Normalized Ratio
B. Activated Partial Thromboplastin Time
C. Prothrombin Time
D. Bleeding Time
The Activated Partial Thromboplastin Time is the standard laboratory test utilized to monitor
the therapeutic effectiveness and adjust the dosage of unfractionated heparin therapy.
5. A nurse on a medical-surgical unit is caring for a client with chronic kidney disease who
exhibits a serum potassium level of 6.8 mEq/L. Which of the following electrocardiographic
changes should the nurse monitor for most closely?
A. Prominent U waves and depressed ST segments
B. Prolonged QT intervals and flattened T waves
C. Tall, peaked T waves and widened QRS complexes
D. Sinus bradycardia with premature atrial contractions
Severe hyperkalemia significantly alters cardiac conduction, classically manifesting on an
electrocardiogram as tall, peaked T waves, prolonged PR intervals, and widened QRS
complexes that can lead to ventricular fibrillation.
6. A nurse is providing discharge instructions to a client prescribed warfarin therapy
following a mechanical heart valve replacement. Which dietary instruction is essential for
the nurse to include?
,A. Eliminate all dietary sources of vitamin K to prevent unpredictable coagulation fluctuations.
B. Maintain a consistent daily intake of foods rich in vitamin K such as spinach and kale.
C. Increase consumption of grapefruit juice to enhance the hepatic metabolism of the
medication.
D. Restrict total fluid intake to less than 1,500 mL per day to prevent fluid overload.
Clients taking warfarin do not need to eliminate vitamin K completely; rather, they must
maintain a consistent daily intake because sudden fluctuations in vitamin K consumption
directly interfere with the anticoagulant efficacy.
7. A nurse is caring for a client with suspected appendicitis. Which of the following physical
assessment techniques should the nurse perform to elicit referred rebound tenderness in
the right lower quadrant?
A. Palpating deeply in the left lower quadrant and releasing pressure suddenly
B. Percussing the anterior abdominal wall while the client performs a deep inhalation
C. Asking the client to lift the right leg against manual downward resistance
D. Deeply palpating the right upper quadrant during inspiration to elicit a pain response
Rovsing's sign is elicited by deep palpation of the left lower quadrant followed by sudden
release, which pushes gas and fluid toward the right side, causing referred rebound tenderness
in the right lower quadrant indicative of peritoneal irritation.
8. A nurse is assessing a client who has sustained a traumatic brain injury and
demonstrates decorticate posturing upon painful stimulation. How should the nurse
document this neurological finding?
A. Extension of upper and lower extremities with internal rotation of the shoulders
B. Adduction of the arms, flexion of the elbows, wrists, and fingers, with extension of the
legs
C. Flaccid paralysis of all four extremities with absent deep tendon reflexes
D. Pronation of the forearms with bilateral hyperextension of the lower limbs
Decorticate posturing is characterized by upper extremity flexion, adduction, and internal
rotation with lower extremity extension, indicating damage to the cerebral hemispheres or
corticospinal tracts.
, 9. A nurse is caring for an older adult client admitted with dehydration and confusion.
Which physiological age-related renal change predisposes this population to rapid fluid
and electrolyte imbalances?
A. Increased glomerular filtration rate and hyperresponsiveness to antidiuretic hormone
B. Decreased number of functional nephrons and reduced urinary concentrating ability
C. Hypertrophy of the renal cortex and increased tubular secretion of hydrogen ions
D. Accelerated clearance of serum creatinine and heightened renal blood flow
Aging is associated with a progressive loss of functional nephrons, decreased renal blood flow,
and a reduced ability of the kidneys to concentrate urine, making older adults highly
vulnerable to dehydration and electrolyte shifts.
10. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following assessment findings should prompt the nurse to withhold the medication and
notify the healthcare provider?
A. Blood pressure of 128/82 mm Hg
B. Apical pulse rate of 54 beats per minute
C. Serum sodium level of 138 mEq/L
D. Respiratory rate of 16 breaths per minute
Digoxin has negative chronotropic effects on the heart; an apical pulse rate below 60 beats per
minute in an adult client indicates potential toxicity and requires withholding the dose and
notifying the provider.
11. A nurse in an emergency department receives a client who has experienced a severe
electrical burn from a high-voltage power line. Which of the following initial assessments is
the highest clinical priority?
A. Assessing the total body surface area affected by superficial burns
B. Evaluating the client for cardiac dysrhythmias and electrical conduction disruption
C. Measuring the extent of blistering and localized tissue edema
D. Documenting the entry and exit wounds on the extremities
QUESTIONS AND ANSWERS | VERIFIED ANSWERS PLUS
RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE |
EXAM PREP | STUDY GUIDE | PRACTICE TEST
1. A nurse is preparing to assess a newly admitted adult client diagnosed with acute
pyelonephritis. Which of the following clinical manifestations should the nurse expect to
find during the initial physical assessment?
A. Lower quadrant abdominal cramping with painless hematuria
B. Bilateral lower extremity edema and jugular venous distention
C. Costovertebral angle tenderness and high-grade fever
D. Suprapubic fullness and intermittent urinary hesitancy
Costovertebral angle tenderness and high-grade fever are hallmark physical assessment
findings associated with acute pyelonephritis due to bacterial infection and subsequent
inflammation of the renal parenchyma and pelvis.
2. A community health nurse is conducting an educational workshop for parents regarding
the transmission and prevention of pediculosis capitis in school-aged children. Which
statement made by a parent indicates a correct understanding of the teaching?
A. Head lice are primarily transmitted through sharing hats, combs, and upholstered
furniture.
B. Children with active infestations must be isolated from household members for fourteen days.
C. Chemical treatments completely eliminate all nits upon initial application without manual
removal.
D. Household pets frequently act as primary vectors for transferring head lice to children.
Head lice are transmitted primarily through direct head-to-head contact, as well as indirectly
through sharing personal items such as hats, hairbrushes, scarves, and resting on
contaminated upholstered surfaces.
3. An emergency department nurse is evaluating a client who presents with acute
respiratory distress, tracheal deviation to the left, absent breath sounds on the right side,
and hemodynamic instability. Which immediate intervention should the nurse anticipate?
A. Administering high-flow nebulized albuterol via a face mask
,B. Assisting the physician with emergent needle decompression of the right chest
C. Positioning the client flat in a supine posture to optimize cardiac preload
D. Preparing the client for immediate fiberoptic bronchoscopy
Tracheal deviation away from the affected side, absent breath sounds, and hemodynamic
instability indicate a tension pneumothorax, which is a life-threatening medical emergency
requiring immediate needle decompression to relieve intrapleural pressure.
4. A nurse is reviewing the laboratory results of a client receiving heparin therapy for deep
vein thrombosis. Which laboratory parameter must the nurse monitor to evaluate the
therapeutic efficacy of this medication?
A. International Normalized Ratio
B. Activated Partial Thromboplastin Time
C. Prothrombin Time
D. Bleeding Time
The Activated Partial Thromboplastin Time is the standard laboratory test utilized to monitor
the therapeutic effectiveness and adjust the dosage of unfractionated heparin therapy.
5. A nurse on a medical-surgical unit is caring for a client with chronic kidney disease who
exhibits a serum potassium level of 6.8 mEq/L. Which of the following electrocardiographic
changes should the nurse monitor for most closely?
A. Prominent U waves and depressed ST segments
B. Prolonged QT intervals and flattened T waves
C. Tall, peaked T waves and widened QRS complexes
D. Sinus bradycardia with premature atrial contractions
Severe hyperkalemia significantly alters cardiac conduction, classically manifesting on an
electrocardiogram as tall, peaked T waves, prolonged PR intervals, and widened QRS
complexes that can lead to ventricular fibrillation.
6. A nurse is providing discharge instructions to a client prescribed warfarin therapy
following a mechanical heart valve replacement. Which dietary instruction is essential for
the nurse to include?
,A. Eliminate all dietary sources of vitamin K to prevent unpredictable coagulation fluctuations.
B. Maintain a consistent daily intake of foods rich in vitamin K such as spinach and kale.
C. Increase consumption of grapefruit juice to enhance the hepatic metabolism of the
medication.
D. Restrict total fluid intake to less than 1,500 mL per day to prevent fluid overload.
Clients taking warfarin do not need to eliminate vitamin K completely; rather, they must
maintain a consistent daily intake because sudden fluctuations in vitamin K consumption
directly interfere with the anticoagulant efficacy.
7. A nurse is caring for a client with suspected appendicitis. Which of the following physical
assessment techniques should the nurse perform to elicit referred rebound tenderness in
the right lower quadrant?
A. Palpating deeply in the left lower quadrant and releasing pressure suddenly
B. Percussing the anterior abdominal wall while the client performs a deep inhalation
C. Asking the client to lift the right leg against manual downward resistance
D. Deeply palpating the right upper quadrant during inspiration to elicit a pain response
Rovsing's sign is elicited by deep palpation of the left lower quadrant followed by sudden
release, which pushes gas and fluid toward the right side, causing referred rebound tenderness
in the right lower quadrant indicative of peritoneal irritation.
8. A nurse is assessing a client who has sustained a traumatic brain injury and
demonstrates decorticate posturing upon painful stimulation. How should the nurse
document this neurological finding?
A. Extension of upper and lower extremities with internal rotation of the shoulders
B. Adduction of the arms, flexion of the elbows, wrists, and fingers, with extension of the
legs
C. Flaccid paralysis of all four extremities with absent deep tendon reflexes
D. Pronation of the forearms with bilateral hyperextension of the lower limbs
Decorticate posturing is characterized by upper extremity flexion, adduction, and internal
rotation with lower extremity extension, indicating damage to the cerebral hemispheres or
corticospinal tracts.
, 9. A nurse is caring for an older adult client admitted with dehydration and confusion.
Which physiological age-related renal change predisposes this population to rapid fluid
and electrolyte imbalances?
A. Increased glomerular filtration rate and hyperresponsiveness to antidiuretic hormone
B. Decreased number of functional nephrons and reduced urinary concentrating ability
C. Hypertrophy of the renal cortex and increased tubular secretion of hydrogen ions
D. Accelerated clearance of serum creatinine and heightened renal blood flow
Aging is associated with a progressive loss of functional nephrons, decreased renal blood flow,
and a reduced ability of the kidneys to concentrate urine, making older adults highly
vulnerable to dehydration and electrolyte shifts.
10. A nurse is preparing to administer digoxin to a client with heart failure. Which of the
following assessment findings should prompt the nurse to withhold the medication and
notify the healthcare provider?
A. Blood pressure of 128/82 mm Hg
B. Apical pulse rate of 54 beats per minute
C. Serum sodium level of 138 mEq/L
D. Respiratory rate of 16 breaths per minute
Digoxin has negative chronotropic effects on the heart; an apical pulse rate below 60 beats per
minute in an adult client indicates potential toxicity and requires withholding the dose and
notifying the provider.
11. A nurse in an emergency department receives a client who has experienced a severe
electrical burn from a high-voltage power line. Which of the following initial assessments is
the highest clinical priority?
A. Assessing the total body surface area affected by superficial burns
B. Evaluating the client for cardiac dysrhythmias and electrical conduction disruption
C. Measuring the extent of blistering and localized tissue edema
D. Documenting the entry and exit wounds on the extremities
