NUR 290 FINAL EXAM –LATEST EXAM QUESTIONS AND
ANSWERS | VERIFIED ANSWERS PLUS RATIONALES |
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PREP | STUDY GUIDE | PRACTICE TEST
1. A nurse is assessing a client admitted with acute chest pain. Which of the following
findings is the most reliable indicator of acute myocardial infarction requiring immediate
escalation?
A. Sharp, localized pain that worsens with deep inspiration
B. Crushing substernal chest pressure radiating to the left arm
C. Intermittent burning sensation relieved by antacids
D. Dull ache in the calf muscle during ambulation
Crushing substernal chest pressure radiating to the left arm is the classic presentation of
myocardial ischemia and infarction, signaling a high-priority cardiac event that requires
immediate emergency intervention and electrocardiogram evaluation.
2. A nurse prepares to administer a prescribed dose of intravenous digoxin to a client with
heart failure. Prior to administration, the nurse reviews the client's laboratory results.
Which finding requires withholding the medication and notifying the provider?
A. Serum potassium level of 3.0 mEq/L
B. Serum sodium level of 138 mEq/L
C. Serum creatinine level of 0.9 mg/dL
D. Serum magnesium level of 2.0 mEq/L
Hypokalemia significantly increases the binding affinity of digoxin to the Na+/K+-ATPase
pump, heightening the risk of severe digitalis toxicity and life-threatening dysrhythmias.
Potassium must be repleted before administration.
3. An adult client with type 1 diabetes mellitus is found unresponsive, diaphoretic, and
tachycardic. A capillary blood glucose reading is 42 mg/dL. Which of the following is the
most appropriate immediate nursing intervention?
A. Administer regular insulin subcutaneously according to the sliding scale
B. Provide 15 grams of simple carbohydrates via oral route if the swallow reflex is intact
,C. Administer 1 mg of intramuscular glucagon or IV dextrose as prescribed due to
unresponsiveness
D. Encourage the client to drink a large glass of orange juice immediately while lying flat
An unresponsive client lacks a safe swallow reflex, making oral administration a severe
aspiration risk. Parenteral interventions such as IV dextrose or IM glucagon are mandatory
for immediate glycemic recovery.
4. A nurse is caring for a client post-thyroidectomy. Which assessment finding indicates a
potential life-threatening complication in the immediate postoperative period?
A. Mild discomfort at the surgical incision site during swallowing
B. Soft, blowing sounds heard over the trachea intermittently
C. Development of laryngeal stridor and severe respiratory distress
D. Mild hypocalcemic paresthesia around the mouth controlled by diet
Laryngeal stridor indicates acute airway obstruction resulting from edema, hematoma
formation, or accidental parathyroid damage. This is a surgical emergency requiring
immediate notification of the rapid response team and availability of a tracheostomy tray.
5. A client with chronic kidney disease (CKD) reports severe fatigue and generalized
weakness. Laboratory results reveal a hemoglobin level of 8.2 g/dL. The nurse recognizes
this anemia is primarily caused by which factor?
A. Increased hemolysis of red blood cells in the spleen
B. Deficient dietary intake of iron and folic acid
C. Decreased production of erythropoietin by the damaged kidneys
D. Chronic blood loss through the gastrointestinal tract
The failing kidneys experience a loss of functioning nephrons, resulting in inadequate
synthesis and secretion of erythropoietin, the hormone responsible for stimulating bone
marrow red blood cell production.
6. A client is receiving a continuous infusion of heparin for the treatment of deep vein
thrombosis. Which laboratory value should the nurse monitor to evaluate the therapeutic
efficacy of this medication?
A. Prothrombin Time (PT)
, B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Bleeding Time
Unfractionated heparin acts on the intrinsic coagulation pathway. The activated partial
thromboplastin time is the standard laboratory assay utilized to monitor and titrate heparin
infusions safely.
7. A nurse is developing a care plan for a client newly diagnosed with hypertension. Which
lifestyle modification should be prioritized as the most effective initial intervention to lower
blood pressure?
A. Elimination of all dairy products from the daily diet
B. Sodium restriction combined with regular aerobic exercise and weight management
C. Complete cessation of all high-intensity physical activity
D. Doubling daily fluid intake to enhance renal filtration
Dietary sodium reduction, regular physical activity, and maintaining a healthy body weight
are cornerstone lifestyle interventions clinically proven to significantly reduce blood pressure
in hypertensive clients.
8. A client admitted with severe dehydration secondary to gastroenteritis has a serum
sodium level of 152 mEq/L. Which intravenous fluid order should the nurse anticipate
implementing first?
A. 0.9% Sodium Chloride (Normal Saline)
B. 3% Sodium Chloride
C. 0.45% Sodium Chloride (Hypotonic Saline)
D. 5% Dextrose in 0.9% Sodium Chloride
Hypernatremia associated with extracellular fluid volume deficit is initially managed with
isotonic fluids like 0.9% Sodium Chloride to restore intravascular volume and normalize
hemodynamics before addressing intracellular shifts.
9. A nurse is assessing a client with left-sided heart failure. Which of the following
respiratory symptoms is the nurse most likely to observe?
ANSWERS | VERIFIED ANSWERS PLUS RATIONALES |
GUARANTEED PASS | LATEST EXAM UPDATE | EXAM
PREP | STUDY GUIDE | PRACTICE TEST
1. A nurse is assessing a client admitted with acute chest pain. Which of the following
findings is the most reliable indicator of acute myocardial infarction requiring immediate
escalation?
A. Sharp, localized pain that worsens with deep inspiration
B. Crushing substernal chest pressure radiating to the left arm
C. Intermittent burning sensation relieved by antacids
D. Dull ache in the calf muscle during ambulation
Crushing substernal chest pressure radiating to the left arm is the classic presentation of
myocardial ischemia and infarction, signaling a high-priority cardiac event that requires
immediate emergency intervention and electrocardiogram evaluation.
2. A nurse prepares to administer a prescribed dose of intravenous digoxin to a client with
heart failure. Prior to administration, the nurse reviews the client's laboratory results.
Which finding requires withholding the medication and notifying the provider?
A. Serum potassium level of 3.0 mEq/L
B. Serum sodium level of 138 mEq/L
C. Serum creatinine level of 0.9 mg/dL
D. Serum magnesium level of 2.0 mEq/L
Hypokalemia significantly increases the binding affinity of digoxin to the Na+/K+-ATPase
pump, heightening the risk of severe digitalis toxicity and life-threatening dysrhythmias.
Potassium must be repleted before administration.
3. An adult client with type 1 diabetes mellitus is found unresponsive, diaphoretic, and
tachycardic. A capillary blood glucose reading is 42 mg/dL. Which of the following is the
most appropriate immediate nursing intervention?
A. Administer regular insulin subcutaneously according to the sliding scale
B. Provide 15 grams of simple carbohydrates via oral route if the swallow reflex is intact
,C. Administer 1 mg of intramuscular glucagon or IV dextrose as prescribed due to
unresponsiveness
D. Encourage the client to drink a large glass of orange juice immediately while lying flat
An unresponsive client lacks a safe swallow reflex, making oral administration a severe
aspiration risk. Parenteral interventions such as IV dextrose or IM glucagon are mandatory
for immediate glycemic recovery.
4. A nurse is caring for a client post-thyroidectomy. Which assessment finding indicates a
potential life-threatening complication in the immediate postoperative period?
A. Mild discomfort at the surgical incision site during swallowing
B. Soft, blowing sounds heard over the trachea intermittently
C. Development of laryngeal stridor and severe respiratory distress
D. Mild hypocalcemic paresthesia around the mouth controlled by diet
Laryngeal stridor indicates acute airway obstruction resulting from edema, hematoma
formation, or accidental parathyroid damage. This is a surgical emergency requiring
immediate notification of the rapid response team and availability of a tracheostomy tray.
5. A client with chronic kidney disease (CKD) reports severe fatigue and generalized
weakness. Laboratory results reveal a hemoglobin level of 8.2 g/dL. The nurse recognizes
this anemia is primarily caused by which factor?
A. Increased hemolysis of red blood cells in the spleen
B. Deficient dietary intake of iron and folic acid
C. Decreased production of erythropoietin by the damaged kidneys
D. Chronic blood loss through the gastrointestinal tract
The failing kidneys experience a loss of functioning nephrons, resulting in inadequate
synthesis and secretion of erythropoietin, the hormone responsible for stimulating bone
marrow red blood cell production.
6. A client is receiving a continuous infusion of heparin for the treatment of deep vein
thrombosis. Which laboratory value should the nurse monitor to evaluate the therapeutic
efficacy of this medication?
A. Prothrombin Time (PT)
, B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Bleeding Time
Unfractionated heparin acts on the intrinsic coagulation pathway. The activated partial
thromboplastin time is the standard laboratory assay utilized to monitor and titrate heparin
infusions safely.
7. A nurse is developing a care plan for a client newly diagnosed with hypertension. Which
lifestyle modification should be prioritized as the most effective initial intervention to lower
blood pressure?
A. Elimination of all dairy products from the daily diet
B. Sodium restriction combined with regular aerobic exercise and weight management
C. Complete cessation of all high-intensity physical activity
D. Doubling daily fluid intake to enhance renal filtration
Dietary sodium reduction, regular physical activity, and maintaining a healthy body weight
are cornerstone lifestyle interventions clinically proven to significantly reduce blood pressure
in hypertensive clients.
8. A client admitted with severe dehydration secondary to gastroenteritis has a serum
sodium level of 152 mEq/L. Which intravenous fluid order should the nurse anticipate
implementing first?
A. 0.9% Sodium Chloride (Normal Saline)
B. 3% Sodium Chloride
C. 0.45% Sodium Chloride (Hypotonic Saline)
D. 5% Dextrose in 0.9% Sodium Chloride
Hypernatremia associated with extracellular fluid volume deficit is initially managed with
isotonic fluids like 0.9% Sodium Chloride to restore intravascular volume and normalize
hemodynamics before addressing intracellular shifts.
9. A nurse is assessing a client with left-sided heart failure. Which of the following
respiratory symptoms is the nurse most likely to observe?
