NR 324 ADULT HEALTH 1 EXAM 2 ACTUAL 2026/2027
COMPREHENSIVE PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM REAL QUESTIONS WITH WELL
ELABORATED ANSWERS AND DETAILED RATIONALES
(RELIABLE ANSWERS) LATEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ |FULL REVISED EXAM |INSTANT
DOWNLOAD PDF |BRAND NEW!
1. A nurse is caring for a client with heart failure who is receiving
furosemide IV. Which finding indicates the medication is having a
therapeutic effect?
A) Weight gain of 2 lb in 24 hours
B) Increased jugular vein distention
C) Decreased pulmonary crackles (CORRECT ANSWER)
D) Increased blood pressure
Rationale: Furosemide is a diuretic that reduces fluid volume
overload. Decreased pulmonary crackles indicate reduced
pulmonary congestion, a therapeutic effect. Weight loss (not gain),
decreased JVD, and decreased blood pressure are expected
outcomes.
2. A client with a history of chronic obstructive pulmonary disease
(COPD) is admitted with pneumonia. The client's SpO₂ is 85% on
room air. The nurse should first:
,A) Administer the prescribed bronchodilator
B) Apply oxygen via nasal cannula as prescribed (CORRECT
ANSWER)
C) Obtain a sputum culture
D) Place the client in a supine position
Rationale: Hypoxemia requires immediate oxygen therapy to
improve oxygenation. Bronchodilators and sputum cultures are
important but do not address the immediate low oxygen saturation.
Supine positioning would worsen ventilation.
3. A client is admitted with a diagnosis of acute myocardial
infarction. Which laboratory finding is most specific to cardiac
muscle damage?
A) Elevated myoglobin
B) Elevated troponin I (CORRECT ANSWER)
C) Elevated C-reactive protein
D) Elevated white blood cell count
Rationale: Cardiac troponins (I and T) are the most sensitive and
specific markers for myocardial necrosis. Myoglobin is early but
nonspecific. CRP and WBC are markers of inflammation.
4. A nurse is teaching a client with a new prescription for lisinopril.
Which statement by the client indicates a need for further teaching?
,A) "I will change positions slowly to avoid dizziness."
B) "I will report any swelling of my lips or face."
C) "I can use salt substitutes freely because this drug causes
potassium loss." (CORRECT ANSWER)
D) "I will have my blood pressure monitored regularly."
Rationale: ACE inhibitors can cause hyperkalemia; salt substitutes
often contain potassium and should be avoided. Angioedema
(lip/face swelling) is a serious adverse effect requiring immediate
reporting. Orthostatic hypotension can occur.
5. A client with a chest tube to water seal drainage has continuous
bubbling in the water seal chamber. What is the nurse's priority
action?
A) Clamp the chest tube immediately
B) Assess the chest tube system for air leaks (CORRECT ANSWER)
C) Notify the healthcare provider
D) Increase the wall suction
Rationale: Continuous bubbling indicates an air leak. The nurse
should first check the system for loose connections or leaks at the
insertion site. Clamping can cause tension pneumothorax.
, 6. A client with a traumatic brain injury has a PaCO₂ of 50 mm Hg.
The nurse should anticipate that this will:
A) Decrease cerebral blood flow
B) Increase cerebral blood flow (CORRECT ANSWER)
C) Have no effect on cerebral blood flow
D) Decrease intracranial pressure
Rationale: Elevated PaCO₂ (hypercapnia) causes cerebral
vasodilation, which increases cerebral blood flow and can increase
intracranial pressure. Normal PaCO₂ is 35-45 mm Hg.
7. A client with cirrhosis and ascites has a serum albumin of 2.1
g/dL. Which intervention should the nurse anticipate?
A) Furosemide IV push
B) Albumin infusion and spironolactone (CORRECT ANSWER)
C) High-sodium IV fluids
D) Immediate large-volume paracentesis
Rationale: Low albumin decreases oncotic pressure, contributing to
ascites. Albumin infusion helps restore oncotic pressure, and
spironolactone is a potassium-sparing diuretic used to manage
ascites.
COMPREHENSIVE PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM REAL QUESTIONS WITH WELL
ELABORATED ANSWERS AND DETAILED RATIONALES
(RELIABLE ANSWERS) LATEST UPDATED VERSION 2026 EDITION
|GUARANTEED PASS A+ |FULL REVISED EXAM |INSTANT
DOWNLOAD PDF |BRAND NEW!
1. A nurse is caring for a client with heart failure who is receiving
furosemide IV. Which finding indicates the medication is having a
therapeutic effect?
A) Weight gain of 2 lb in 24 hours
B) Increased jugular vein distention
C) Decreased pulmonary crackles (CORRECT ANSWER)
D) Increased blood pressure
Rationale: Furosemide is a diuretic that reduces fluid volume
overload. Decreased pulmonary crackles indicate reduced
pulmonary congestion, a therapeutic effect. Weight loss (not gain),
decreased JVD, and decreased blood pressure are expected
outcomes.
2. A client with a history of chronic obstructive pulmonary disease
(COPD) is admitted with pneumonia. The client's SpO₂ is 85% on
room air. The nurse should first:
,A) Administer the prescribed bronchodilator
B) Apply oxygen via nasal cannula as prescribed (CORRECT
ANSWER)
C) Obtain a sputum culture
D) Place the client in a supine position
Rationale: Hypoxemia requires immediate oxygen therapy to
improve oxygenation. Bronchodilators and sputum cultures are
important but do not address the immediate low oxygen saturation.
Supine positioning would worsen ventilation.
3. A client is admitted with a diagnosis of acute myocardial
infarction. Which laboratory finding is most specific to cardiac
muscle damage?
A) Elevated myoglobin
B) Elevated troponin I (CORRECT ANSWER)
C) Elevated C-reactive protein
D) Elevated white blood cell count
Rationale: Cardiac troponins (I and T) are the most sensitive and
specific markers for myocardial necrosis. Myoglobin is early but
nonspecific. CRP and WBC are markers of inflammation.
4. A nurse is teaching a client with a new prescription for lisinopril.
Which statement by the client indicates a need for further teaching?
,A) "I will change positions slowly to avoid dizziness."
B) "I will report any swelling of my lips or face."
C) "I can use salt substitutes freely because this drug causes
potassium loss." (CORRECT ANSWER)
D) "I will have my blood pressure monitored regularly."
Rationale: ACE inhibitors can cause hyperkalemia; salt substitutes
often contain potassium and should be avoided. Angioedema
(lip/face swelling) is a serious adverse effect requiring immediate
reporting. Orthostatic hypotension can occur.
5. A client with a chest tube to water seal drainage has continuous
bubbling in the water seal chamber. What is the nurse's priority
action?
A) Clamp the chest tube immediately
B) Assess the chest tube system for air leaks (CORRECT ANSWER)
C) Notify the healthcare provider
D) Increase the wall suction
Rationale: Continuous bubbling indicates an air leak. The nurse
should first check the system for loose connections or leaks at the
insertion site. Clamping can cause tension pneumothorax.
, 6. A client with a traumatic brain injury has a PaCO₂ of 50 mm Hg.
The nurse should anticipate that this will:
A) Decrease cerebral blood flow
B) Increase cerebral blood flow (CORRECT ANSWER)
C) Have no effect on cerebral blood flow
D) Decrease intracranial pressure
Rationale: Elevated PaCO₂ (hypercapnia) causes cerebral
vasodilation, which increases cerebral blood flow and can increase
intracranial pressure. Normal PaCO₂ is 35-45 mm Hg.
7. A client with cirrhosis and ascites has a serum albumin of 2.1
g/dL. Which intervention should the nurse anticipate?
A) Furosemide IV push
B) Albumin infusion and spironolactone (CORRECT ANSWER)
C) High-sodium IV fluids
D) Immediate large-volume paracentesis
Rationale: Low albumin decreases oncotic pressure, contributing to
ascites. Albumin infusion helps restore oncotic pressure, and
spironolactone is a potassium-sparing diuretic used to manage
ascites.
