NUR 283 COMPREHENSIVE NURSING
EXAM III QUESTIONS AND ANSWERS
1. A client with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. The nurse notes a sudden drop in SpO2 and increased peak airway pressures.
Which action should the nurse take first?
A. Auscultate bilateral lung sounds
B. Suction the client’s endotracheal tube
C. Increase the FiO2 to 100%
D. Call for a portable chest X-ray
Answer: A
Conceptual Explanation: Assessment is the priority. The nurse must first auscultate to
determine if the cause is a displaced tube, pneumothorax, or secretions before intervening.
2. A nurse is caring for a client with a Pheochromocytoma. Which clinical finding is the most
critical for the nurse to monitor?
A. Serum glucose levels
B. Abdominal pain
,C. Severe headache and hypertension
D. Weight loss
Answer: C
Conceptual Explanation: Pheochromocytoma causes excessive catecholamine release,
leading to hypertensive crisis, which can cause stroke or organ damage.
3. The nurse is preparing to administer Alteplase (tPA) to a client with an acute ischemic
stroke. Which finding would be a contraindication for this therapy?
A. Symptom onset occurred 2 hours ago
B. Blood pressure is 160/90 mmHg
C. Client is 75 years old
D. Major surgery within the last 14 days
Answer: D
Conceptual Explanation: Major surgery within the past 14 days is a contraindication for
tPA due to the high risk of internal hemorrhage at the surgical site.
4. Which of the following clients should the nurse assess first after receiving the change-of-
shift report?
A. A client with heart failure who has 2+ pitting edema
B. A client with chronic kidney disease and a potassium level of 5.8 mEq/L
C. A client with a chest tube showing 50 mL of drainage in 2 hours
, D. A client with pancreatitis reporting 8/10 abdominal pain
Answer: B
Conceptual Explanation: Hyperkalemia (5.8 mEq/L) poses an immediate risk for cardiac
dysrhythmias and arrest, requiring urgent intervention.
5. A client with a head injury develops DI (Diabetes Insipidus). Which of the following should
the nurse expect to observe?
A. Serum sodium of 125 mEq/L
B. High urine osmolarity
C. Urine specific gravity of 1.002
D. Weight gain and peripheral edema
Answer: C
Conceptual Explanation: Diabetes Insipidus is characterized by low ADH, leading to
massive dilute urine output and low urine specific gravity.
6. A client is admitted with Thyroid Storm. Which medication should the nurse expect to
administer to block the peripheral conversion of T4 to T3?
A. Propylthiouracil (PTU)
B. Levothyroxine
C. Iodine solution
D. Furosemide
EXAM III QUESTIONS AND ANSWERS
1. A client with acute respiratory distress syndrome (ARDS) is receiving mechanical
ventilation. The nurse notes a sudden drop in SpO2 and increased peak airway pressures.
Which action should the nurse take first?
A. Auscultate bilateral lung sounds
B. Suction the client’s endotracheal tube
C. Increase the FiO2 to 100%
D. Call for a portable chest X-ray
Answer: A
Conceptual Explanation: Assessment is the priority. The nurse must first auscultate to
determine if the cause is a displaced tube, pneumothorax, or secretions before intervening.
2. A nurse is caring for a client with a Pheochromocytoma. Which clinical finding is the most
critical for the nurse to monitor?
A. Serum glucose levels
B. Abdominal pain
,C. Severe headache and hypertension
D. Weight loss
Answer: C
Conceptual Explanation: Pheochromocytoma causes excessive catecholamine release,
leading to hypertensive crisis, which can cause stroke or organ damage.
3. The nurse is preparing to administer Alteplase (tPA) to a client with an acute ischemic
stroke. Which finding would be a contraindication for this therapy?
A. Symptom onset occurred 2 hours ago
B. Blood pressure is 160/90 mmHg
C. Client is 75 years old
D. Major surgery within the last 14 days
Answer: D
Conceptual Explanation: Major surgery within the past 14 days is a contraindication for
tPA due to the high risk of internal hemorrhage at the surgical site.
4. Which of the following clients should the nurse assess first after receiving the change-of-
shift report?
A. A client with heart failure who has 2+ pitting edema
B. A client with chronic kidney disease and a potassium level of 5.8 mEq/L
C. A client with a chest tube showing 50 mL of drainage in 2 hours
, D. A client with pancreatitis reporting 8/10 abdominal pain
Answer: B
Conceptual Explanation: Hyperkalemia (5.8 mEq/L) poses an immediate risk for cardiac
dysrhythmias and arrest, requiring urgent intervention.
5. A client with a head injury develops DI (Diabetes Insipidus). Which of the following should
the nurse expect to observe?
A. Serum sodium of 125 mEq/L
B. High urine osmolarity
C. Urine specific gravity of 1.002
D. Weight gain and peripheral edema
Answer: C
Conceptual Explanation: Diabetes Insipidus is characterized by low ADH, leading to
massive dilute urine output and low urine specific gravity.
6. A client is admitted with Thyroid Storm. Which medication should the nurse expect to
administer to block the peripheral conversion of T4 to T3?
A. Propylthiouracil (PTU)
B. Levothyroxine
C. Iodine solution
D. Furosemide
