BSN Advanced Nursing Fundamentals Exam 7 Practice
UPDATED ACTUAL Questions and CORRECT Answers
1. A nurse is caring for a patient with a potassium level of 2.9 mEq/L. Which of
the following should be the priority nursing action?
A. Initiate continuous cardiac monitoring.
B. Monitor the patient for muscle weakness.
C. Encourage the intake of potassium-rich foods.
D. Assess for Chvostek’s sign.
Answer: A
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause life-threatening cardiac
dysrhythmias; therefore, cardiac monitoring is the highest priority.
2. Which arterial blood gas (ABG) result would a nurse expect for a patient with
severe chronic obstructive pulmonary disease (COPD)?
A. pH 7.32, PaCO2 52, HCO3 28
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.50, PaCO2 40, HCO3 30
Answer: A
Rationale: COPD patients typically experience respiratory acidosis (low pH, high PaCO2)
due to CO2 retention, often with renal compensation (elevated HCO3).
,3. A patient is receiving Total Parenteral Nutrition (TPN) via a central line. Which
intervention is most important for preventing infection?
A. Change the TPN bag every 48 hours.
B. Apply a clean technique during dressing changes.
C. Use a strict sterile technique when changing the central line dressing.
D. Administer IV antibiotics through the TPN port.
Answer: C
Rationale: TPN has a high glucose content and is administered via central venous access,
making it a high risk for infection. Sterile technique is mandatory for dressing changes.
4. The nurse notes a patient’s Trousseau’s sign is positive. This is an indication of
which electrolyte imbalance?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
Rationale: A positive Trousseau’s sign (carpal spasm induced by inflating a BP cuff) and
Chvostek’s sign are classic indicators of hypocalcemia.
5. What is the first action a nurse should take if a patient develops shivering and
low back pain during a blood transfusion?
A. Slow the infusion rate down.
B. Stop the transfusion immediately.
C. Administer an antipyretic.
D. Notify the healthcare provider.
Answer: B
Rationale: Shivering and low back pain suggest a hemolytic reaction. The nurse must stop
the infusion immediately to prevent further exposure to the incompatible blood.
, 6. A patient in the ICU has a pH of 7.25, PaCO2 of 40, and HCO3 of 18. This
indicates which acid-base imbalance?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Answer: D
Rationale: The low pH (<7.35) and low HCO3 (<22) with a normal PaCO2 indicate
metabolic acidosis.
7. Which patient is at the highest risk for developing hypermagnesemia?
A. A patient with chronic diarrhea.
B. A patient with chronic kidney disease using antacids.
C. A patient with alcoholism.
D. A patient on long-term nasogastric suctioning.
Answer: B
Rationale: The kidneys are responsible for magnesium excretion. Chronic kidney disease
combined with magnesium-containing antacids often leads to hypermagnesemia.
8. While suctioning a patient with an endotracheal tube, the nurse should limit
each suction pass to no more than:
A. 5 seconds
B. 10 to 15 seconds
C. 20 to 30 seconds
D. One minute
Answer: B
Rationale: Suctioning for more than 15 seconds can cause significant hypoxia and vagal
stimulation, potentially leading to bradycardia.
UPDATED ACTUAL Questions and CORRECT Answers
1. A nurse is caring for a patient with a potassium level of 2.9 mEq/L. Which of
the following should be the priority nursing action?
A. Initiate continuous cardiac monitoring.
B. Monitor the patient for muscle weakness.
C. Encourage the intake of potassium-rich foods.
D. Assess for Chvostek’s sign.
Answer: A
Rationale: Hypokalemia (potassium < 3.5 mEq/L) can cause life-threatening cardiac
dysrhythmias; therefore, cardiac monitoring is the highest priority.
2. Which arterial blood gas (ABG) result would a nurse expect for a patient with
severe chronic obstructive pulmonary disease (COPD)?
A. pH 7.32, PaCO2 52, HCO3 28
B. pH 7.48, PaCO2 30, HCO3 22
C. pH 7.30, PaCO2 35, HCO3 18
D. pH 7.50, PaCO2 40, HCO3 30
Answer: A
Rationale: COPD patients typically experience respiratory acidosis (low pH, high PaCO2)
due to CO2 retention, often with renal compensation (elevated HCO3).
,3. A patient is receiving Total Parenteral Nutrition (TPN) via a central line. Which
intervention is most important for preventing infection?
A. Change the TPN bag every 48 hours.
B. Apply a clean technique during dressing changes.
C. Use a strict sterile technique when changing the central line dressing.
D. Administer IV antibiotics through the TPN port.
Answer: C
Rationale: TPN has a high glucose content and is administered via central venous access,
making it a high risk for infection. Sterile technique is mandatory for dressing changes.
4. The nurse notes a patient’s Trousseau’s sign is positive. This is an indication of
which electrolyte imbalance?
A. Hyperkalemia
B. Hypocalcemia
C. Hyponatremia
D. Hypermagnesemia
Answer: B
Rationale: A positive Trousseau’s sign (carpal spasm induced by inflating a BP cuff) and
Chvostek’s sign are classic indicators of hypocalcemia.
5. What is the first action a nurse should take if a patient develops shivering and
low back pain during a blood transfusion?
A. Slow the infusion rate down.
B. Stop the transfusion immediately.
C. Administer an antipyretic.
D. Notify the healthcare provider.
Answer: B
Rationale: Shivering and low back pain suggest a hemolytic reaction. The nurse must stop
the infusion immediately to prevent further exposure to the incompatible blood.
, 6. A patient in the ICU has a pH of 7.25, PaCO2 of 40, and HCO3 of 18. This
indicates which acid-base imbalance?
A. Respiratory Alkalosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Metabolic Acidosis
Answer: D
Rationale: The low pH (<7.35) and low HCO3 (<22) with a normal PaCO2 indicate
metabolic acidosis.
7. Which patient is at the highest risk for developing hypermagnesemia?
A. A patient with chronic diarrhea.
B. A patient with chronic kidney disease using antacids.
C. A patient with alcoholism.
D. A patient on long-term nasogastric suctioning.
Answer: B
Rationale: The kidneys are responsible for magnesium excretion. Chronic kidney disease
combined with magnesium-containing antacids often leads to hypermagnesemia.
8. While suctioning a patient with an endotracheal tube, the nurse should limit
each suction pass to no more than:
A. 5 seconds
B. 10 to 15 seconds
C. 20 to 30 seconds
D. One minute
Answer: B
Rationale: Suctioning for more than 15 seconds can cause significant hypoxia and vagal
stimulation, potentially leading to bradycardia.
