NURSING EXAMS
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NURSE WISEMAN 2026/2027 MEDICINE
,NURS 480 exam 1 Nurse Practitioners
Review Exam (Latest 2026/ 2027
Update) 100% Verified Questions &
Answers | Grade A+
Which action should the nurse take first when a patient
complains of acute chest pain and dyspnea soon after
insertion of a centrally inserted IV catheter?
a. Notify the health care provider.
b. Offer reassurance to the patient.
c. Auscultate the patients breath sounds.
d. Give the prescribed PRN morphine sulfate IV.
ANS: C
The initial action should be to assess the patient further
because the history and symptoms are consistent with
several possible complications of central line insertion,
including embolism and pneumothorax. The other actions
may be appropriate, but further assessment of the
patient is needed before notifying the health care
provider, offering reassurance, or administration of
morphine
,The nurse palpates the posterior chest while the patient
says 99 and notes absent fremitus. Which action should
the nurse take next?
a. Palpate the anterior chest and observe for barrel chest.
b. Encourage the patient to turn, cough, and deep
breathe.
c. Review the chest x-ray report for evidence of
pneumonia.
d. Auscultate anterior and posterior breath sounds
bilaterally.
ANS: D
To assess for tactile fremitus, the nurse should use the
palms of the hands to assess for vibration when the
patient repeats a word or phrase such as 99. After noting
absent fremitus, the nurse should then auscultate the
lungs to assess for the presence or absence of breath
sounds. Absent fremitus may be noted with
pneumothorax or atelectasis. The vibration is increased in
conditions such as pneumonia, lung tumors, thick
bronchial secretions, and pleural effusion. Turning,
coughing, and deep breathing is an appropriate
intervention for atelectasis, but the nurse needs to first
assess breath sounds. Fremitus is decreased if the hand is
, farther from the lung or the lung is hyperinflated (barrel
chest).The anterior of the chest is more difficult to
palpate for fremitus because of the presence of large
muscles and breast tissue.
The nurse monitors a patient after chest tube placement
for a hemopneumothorax. The nurse is most concerned if
which assessment finding is observed?
a. A large air leak in the water-seal chamber
b. 400 mL of blood in the collection chamber
c. Complaint of pain with each deep inspiration
d. Subcutaneous emphysema at the insertion site
ANS: B
The large amount of blood may indicate that the patient
is in danger of developing hypovolemic shock. An air leak
would be expected immediately after chest tube
placement for a pneumothorax. Initially, brisk bubbling of
air occurs in this chamber when a pneumothorax is
evacuated. The pain should be treated but is not as
urgent a concern as the possibility of continued
hemorrhage. Subcutaneous emphysema should be
monitored but is not unusual in a patient with
pneumothorax. A small amount of subcutaneous air is
harmless and will be reabsorbed.
• Nursing Exam Prep Made Easy — Get
Your Documents Today!
NURSE WISEMAN 2026/2027 MEDICINE
,NURS 480 exam 1 Nurse Practitioners
Review Exam (Latest 2026/ 2027
Update) 100% Verified Questions &
Answers | Grade A+
Which action should the nurse take first when a patient
complains of acute chest pain and dyspnea soon after
insertion of a centrally inserted IV catheter?
a. Notify the health care provider.
b. Offer reassurance to the patient.
c. Auscultate the patients breath sounds.
d. Give the prescribed PRN morphine sulfate IV.
ANS: C
The initial action should be to assess the patient further
because the history and symptoms are consistent with
several possible complications of central line insertion,
including embolism and pneumothorax. The other actions
may be appropriate, but further assessment of the
patient is needed before notifying the health care
provider, offering reassurance, or administration of
morphine
,The nurse palpates the posterior chest while the patient
says 99 and notes absent fremitus. Which action should
the nurse take next?
a. Palpate the anterior chest and observe for barrel chest.
b. Encourage the patient to turn, cough, and deep
breathe.
c. Review the chest x-ray report for evidence of
pneumonia.
d. Auscultate anterior and posterior breath sounds
bilaterally.
ANS: D
To assess for tactile fremitus, the nurse should use the
palms of the hands to assess for vibration when the
patient repeats a word or phrase such as 99. After noting
absent fremitus, the nurse should then auscultate the
lungs to assess for the presence or absence of breath
sounds. Absent fremitus may be noted with
pneumothorax or atelectasis. The vibration is increased in
conditions such as pneumonia, lung tumors, thick
bronchial secretions, and pleural effusion. Turning,
coughing, and deep breathing is an appropriate
intervention for atelectasis, but the nurse needs to first
assess breath sounds. Fremitus is decreased if the hand is
, farther from the lung or the lung is hyperinflated (barrel
chest).The anterior of the chest is more difficult to
palpate for fremitus because of the presence of large
muscles and breast tissue.
The nurse monitors a patient after chest tube placement
for a hemopneumothorax. The nurse is most concerned if
which assessment finding is observed?
a. A large air leak in the water-seal chamber
b. 400 mL of blood in the collection chamber
c. Complaint of pain with each deep inspiration
d. Subcutaneous emphysema at the insertion site
ANS: B
The large amount of blood may indicate that the patient
is in danger of developing hypovolemic shock. An air leak
would be expected immediately after chest tube
placement for a pneumothorax. Initially, brisk bubbling of
air occurs in this chamber when a pneumothorax is
evacuated. The pain should be treated but is not as
urgent a concern as the possibility of continued
hemorrhage. Subcutaneous emphysema should be
monitored but is not unusual in a patient with
pneumothorax. A small amount of subcutaneous air is
harmless and will be reabsorbed.
