GALEN NUR 283 COMP 1–3
COMPREHENSIVE EXAM REVIEW
1. A nurse is caring for a client with a history of congestive heart failure who is currently
taking Digoxin. Which of the following laboratory results should be reported to the provider
immediately?
A. Potassium level of 3.2 mEq/L
B. Sodium level of 138 mEq/L
C. Digoxin level of 0.8 ng/mL
D. Creatinine level of 1.0 mg/dL
Answer: A
Conceptual Explanation: Hypokalemia (potassium less than 3.5 mEq/L) significantly
increases the risk of Digoxin toxicity, even if the Digoxin level itself is within the
therapeutic range (0.5–2.0 ng/mL).
,2. A client is admitted to the ICU with a diagnosis of Acute Respiratory Distress Syndrome
(ARDS). Which mechanical ventilator setting change would the nurse anticipate to improve
oxygenation?
A. Increase the Positive End-Expiratory Pressure (PEEP)
B. Increase the tidal volume to 12 mL/kg
C. Decrease the respiratory rate
D. Decrease the Fraction of Inspired Oxygen (FiO2)
Answer: A
Conceptual Explanation: PEEP helps keep alveoli open at the end of expiration, improving
gas exchange and oxygenation in ARDS clients. High tidal volumes are avoided to prevent
barotrauma (lung-protective ventilation).
3. A nurse is assessing a client in the early stages of shock. Which of the following clinical
manifestations is most indicative of the compensatory stage of shock?
A. Increased heart rate and narrowed pulse pressure
B. Confusion and lethargy
C. Anuria and metabolic acidosis
D. Hypotension and bradycardia
Answer: A
, Conceptual Explanation: In the compensatory stage of shock, the body uses the
sympathetic nervous system to maintain cardiac output, resulting in tachycardia and
vasoconstriction (narrowed pulse pressure). Hypotension usually marks the progressive
stage.
4. Which of the following interventions is the priority for a nurse managing a client with
Autonomic Dysreflexia?
A. Elevating the head of the bed to 90 degrees
B. Checking the client for fecal impaction
C. Administering a bolus of intravenous fluids
D. Palpating the bladder for distention
Answer: A
Conceptual Explanation: The immediate priority in autonomic dysreflexia is to sit the
client upright (high-Fowler’s) to help lower blood pressure through postural hypotension
before identifying and removing the stimulus (like bladder distention or impaction).
5. A client presents to the emergency department with a suspected myocardial infarction.
Which cardiac biomarker is most specific for myocardial injury and remains elevated for up to
two weeks?
A. Troponin T
B. CK-MB
C. Myoglobin
COMPREHENSIVE EXAM REVIEW
1. A nurse is caring for a client with a history of congestive heart failure who is currently
taking Digoxin. Which of the following laboratory results should be reported to the provider
immediately?
A. Potassium level of 3.2 mEq/L
B. Sodium level of 138 mEq/L
C. Digoxin level of 0.8 ng/mL
D. Creatinine level of 1.0 mg/dL
Answer: A
Conceptual Explanation: Hypokalemia (potassium less than 3.5 mEq/L) significantly
increases the risk of Digoxin toxicity, even if the Digoxin level itself is within the
therapeutic range (0.5–2.0 ng/mL).
,2. A client is admitted to the ICU with a diagnosis of Acute Respiratory Distress Syndrome
(ARDS). Which mechanical ventilator setting change would the nurse anticipate to improve
oxygenation?
A. Increase the Positive End-Expiratory Pressure (PEEP)
B. Increase the tidal volume to 12 mL/kg
C. Decrease the respiratory rate
D. Decrease the Fraction of Inspired Oxygen (FiO2)
Answer: A
Conceptual Explanation: PEEP helps keep alveoli open at the end of expiration, improving
gas exchange and oxygenation in ARDS clients. High tidal volumes are avoided to prevent
barotrauma (lung-protective ventilation).
3. A nurse is assessing a client in the early stages of shock. Which of the following clinical
manifestations is most indicative of the compensatory stage of shock?
A. Increased heart rate and narrowed pulse pressure
B. Confusion and lethargy
C. Anuria and metabolic acidosis
D. Hypotension and bradycardia
Answer: A
, Conceptual Explanation: In the compensatory stage of shock, the body uses the
sympathetic nervous system to maintain cardiac output, resulting in tachycardia and
vasoconstriction (narrowed pulse pressure). Hypotension usually marks the progressive
stage.
4. Which of the following interventions is the priority for a nurse managing a client with
Autonomic Dysreflexia?
A. Elevating the head of the bed to 90 degrees
B. Checking the client for fecal impaction
C. Administering a bolus of intravenous fluids
D. Palpating the bladder for distention
Answer: A
Conceptual Explanation: The immediate priority in autonomic dysreflexia is to sit the
client upright (high-Fowler’s) to help lower blood pressure through postural hypotension
before identifying and removing the stimulus (like bladder distention or impaction).
5. A client presents to the emergency department with a suspected myocardial infarction.
Which cardiac biomarker is most specific for myocardial injury and remains elevated for up to
two weeks?
A. Troponin T
B. CK-MB
C. Myoglobin
