NUR 283 COMPREHENSIVE NURSING
EXAMINATION QUESTIONS AND
ANSWERS
1. A nurse is caring for a client with a history of cirrhosis who is now presenting with altered
mental status and asterixis. Which laboratory result should the nurse prioritize?
A. Serum Creatinine 1.2 mg/dL
B. Serum Potassium 3.8 mEq/L
C. Serum Ammonia 110 µmol/L
D. Hemoglobin 12 g/dL
Answer: C
Conceptual Explanation: Asterixis and altered mental status in cirrhosis suggest hepatic
encephalopathy, which is caused by elevated serum ammonia levels.
2. A client is admitted with Diabetic Ketoacidosis (DKA). The nurse notes Kussmaul
respirations. What is the physiological purpose of this breathing pattern?
A. To increase oxygen saturation
B. To increase the partial pressure of carbon dioxide
,C. To reduce the work of breathing
D. To decrease carbon dioxide levels to compensate for metabolic acidosis
Answer: D
Conceptual Explanation: Kussmaul respirations are deep, rapid breaths that represent
the body’s attempt to blow off CO2 to compensate for metabolic acidosis.
3. A nurse is assessing a client 2 hours post-thyroidectomy. The client reports tingling in the
fingertips and around the mouth. Which action should the nurse take first?
A. Encourage the client to cough and deep breathe
B. Check the surgical dressing for bleeding
C. Administer an analgesic for discomfort
D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling indicates hypocalcemia, a potential complication if the
parathyroid glands were accidentally removed or damaged. Chvostek’s sign is an
assessment for neuromuscular irritability caused by low calcium.
4. A client with a C6 spinal cord injury reports a sudden, severe headache and has a blood
pressure of 190/100 mmHg. Which action is the priority?
A. Check the client for bladder distension
B. Administer PRN antihypertensive medication
, C. Place the client in a supine position
D. Lower the head of the bed
Answer: A
Conceptual Explanation: These are symptoms of autonomic dysreflexia. The priority is to
identify and remove the triggering stimulus, most commonly a distended bladder or fecal
impaction, while sitting the client upright.
5. A nurse is monitoring a client receiving a continuous IV infusion of heparin. Which
laboratory value requires immediate notification of the healthcare provider?
A. aPTT of 70 seconds
B. Platelet count of 90,000/mm³
C. INR of 1.2
D. Hemoglobin of 14 g/dL
Answer: B
Conceptual Explanation: A significant drop in platelets (below 150,000 or 50% from
baseline) suggests Heparin-Induced Thrombocytopenia (HIT), a life-threatening
complication.
EXAMINATION QUESTIONS AND
ANSWERS
1. A nurse is caring for a client with a history of cirrhosis who is now presenting with altered
mental status and asterixis. Which laboratory result should the nurse prioritize?
A. Serum Creatinine 1.2 mg/dL
B. Serum Potassium 3.8 mEq/L
C. Serum Ammonia 110 µmol/L
D. Hemoglobin 12 g/dL
Answer: C
Conceptual Explanation: Asterixis and altered mental status in cirrhosis suggest hepatic
encephalopathy, which is caused by elevated serum ammonia levels.
2. A client is admitted with Diabetic Ketoacidosis (DKA). The nurse notes Kussmaul
respirations. What is the physiological purpose of this breathing pattern?
A. To increase oxygen saturation
B. To increase the partial pressure of carbon dioxide
,C. To reduce the work of breathing
D. To decrease carbon dioxide levels to compensate for metabolic acidosis
Answer: D
Conceptual Explanation: Kussmaul respirations are deep, rapid breaths that represent
the body’s attempt to blow off CO2 to compensate for metabolic acidosis.
3. A nurse is assessing a client 2 hours post-thyroidectomy. The client reports tingling in the
fingertips and around the mouth. Which action should the nurse take first?
A. Encourage the client to cough and deep breathe
B. Check the surgical dressing for bleeding
C. Administer an analgesic for discomfort
D. Assess for Chvostek’s sign
Answer: D
Conceptual Explanation: Tingling indicates hypocalcemia, a potential complication if the
parathyroid glands were accidentally removed or damaged. Chvostek’s sign is an
assessment for neuromuscular irritability caused by low calcium.
4. A client with a C6 spinal cord injury reports a sudden, severe headache and has a blood
pressure of 190/100 mmHg. Which action is the priority?
A. Check the client for bladder distension
B. Administer PRN antihypertensive medication
, C. Place the client in a supine position
D. Lower the head of the bed
Answer: A
Conceptual Explanation: These are symptoms of autonomic dysreflexia. The priority is to
identify and remove the triggering stimulus, most commonly a distended bladder or fecal
impaction, while sitting the client upright.
5. A nurse is monitoring a client receiving a continuous IV infusion of heparin. Which
laboratory value requires immediate notification of the healthcare provider?
A. aPTT of 70 seconds
B. Platelet count of 90,000/mm³
C. INR of 1.2
D. Hemoglobin of 14 g/dL
Answer: B
Conceptual Explanation: A significant drop in platelets (below 150,000 or 50% from
baseline) suggests Heparin-Induced Thrombocytopenia (HIT), a life-threatening
complication.
