NUR 114 Exam 5: Advanced Nursing Fundamentals & N… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 114 Exam 5: Advanced Nursing Fundamentals & NCLEX
Preparation 2026/2027 UPDATE
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 114 Exam 5: Advanced Nursing Fundamentals & N… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient’s arterial blood gas (ABG) results show: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is below 7.35 (acidosis) and the PaCO2 is elevated above 45 mmHg (respiratory
origin), while the HCO3 is within normal limits, indicating an uncompensated respiratory acidosis.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level. Knowing the reason behind
the correct answer makes it easier to rule out the wrong options quickly. Look for the choice that
protects the client and matches the priority need.
2. An elderly patient presents with tenting of the skin, dry mucous membranes, and a serum
sodium level of 152 mEq/L. Which intervention is the priority?
A. Administer a bolus of 3% Normal Saline
B. Administer intravenous D5W slowly
C. Restrict fluid intake to 1000 mL per day
D. Encourage oral intake of plain water
Answer: B
Rationale: The patient is experiencing hypernatremic dehydration. Hypotonic solutions like D5W are
used to lower sodium levels, but must be infused slowly to prevent cerebral edema. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety. Knowing the reason behind the correct answer makes it
easier to rule out the wrong options quickly. Look for the choice that protects the client and matches
the priority need.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 114 Exam 5: Advanced Nursing Fundamentals & N… 2026/2027 • Verified • Assured Grade A+
3. During the preoperative assessment, a patient mentions a family history of high fever
during surgery. The nurse should immediately prepare for the potential of:
A. Septic Shock
B. Hypovolemic Shock
C. Anaphylactic Reaction
D. Malignant Hyperthermia
Answer: D
Rationale: Malignant hyperthermia is a life-threatening, autosomal dominant disorder triggered by
volatile anesthetics and succinylcholine, characterized by rapid onset of fever and muscle rigidity.
Clear understanding of this concept improves both test performance and everyday clinical judgment.
Practice applying it to short case scenarios to lock the idea in place. Clear understanding of this
concept improves both test performance and everyday clinical judgment. Practice applying it to short
case scenarios to lock the idea in place.
4. A nurse finds a post-operative patient’s abdominal wound has opened, and internal
organs are protruding. What is the immediate nursing action?
A. Gently push the organs back into the abdominal cavity
B. Leave the wound open to air and call the surgeon
C. Apply a tight abdominal binder to hold the organs in place
D. Cover the site with sterile gauze soaked in sterile normal saline
Answer: D
Rationale: This is evisceration. The priority is to protect the organs from drying and infection by
covering them with sterile, saline-soaked dressings while awaiting emergency surgery. Understanding
this helps the nurse notice early warning signs and act before the problem gets worse. Early action
often prevents bigger complications for the client. Understanding this helps the nurse notice early
warning signs and act before the problem gets worse. Early action often prevents bigger complications
for the client.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 114 Exam 5: Advanced Nursing Fundamentals & NCLEX
Preparation 2026/2027 UPDATE
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 114 Exam 5: Advanced Nursing Fundamentals & N… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient’s arterial blood gas (ABG) results show: pH 7.30, PaCO2 52 mmHg, and HCO3 26
mEq/L. Which acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: B
Rationale: The pH is below 7.35 (acidosis) and the PaCO2 is elevated above 45 mmHg (respiratory
origin), while the HCO3 is within normal limits, indicating an uncompensated respiratory acidosis.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level. Knowing the reason behind
the correct answer makes it easier to rule out the wrong options quickly. Look for the choice that
protects the client and matches the priority need.
2. An elderly patient presents with tenting of the skin, dry mucous membranes, and a serum
sodium level of 152 mEq/L. Which intervention is the priority?
A. Administer a bolus of 3% Normal Saline
B. Administer intravenous D5W slowly
C. Restrict fluid intake to 1000 mL per day
D. Encourage oral intake of plain water
Answer: B
Rationale: The patient is experiencing hypernatremic dehydration. Hypotonic solutions like D5W are
used to lower sodium levels, but must be infused slowly to prevent cerebral edema. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety. Knowing the reason behind the correct answer makes it
easier to rule out the wrong options quickly. Look for the choice that protects the client and matches
the priority need.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 114 Exam 5: Advanced Nursing Fundamentals & N… 2026/2027 • Verified • Assured Grade A+
3. During the preoperative assessment, a patient mentions a family history of high fever
during surgery. The nurse should immediately prepare for the potential of:
A. Septic Shock
B. Hypovolemic Shock
C. Anaphylactic Reaction
D. Malignant Hyperthermia
Answer: D
Rationale: Malignant hyperthermia is a life-threatening, autosomal dominant disorder triggered by
volatile anesthetics and succinylcholine, characterized by rapid onset of fever and muscle rigidity.
Clear understanding of this concept improves both test performance and everyday clinical judgment.
Practice applying it to short case scenarios to lock the idea in place. Clear understanding of this
concept improves both test performance and everyday clinical judgment. Practice applying it to short
case scenarios to lock the idea in place.
4. A nurse finds a post-operative patient’s abdominal wound has opened, and internal
organs are protruding. What is the immediate nursing action?
A. Gently push the organs back into the abdominal cavity
B. Leave the wound open to air and call the surgeon
C. Apply a tight abdominal binder to hold the organs in place
D. Cover the site with sterile gauze soaked in sterile normal saline
Answer: D
Rationale: This is evisceration. The priority is to protect the organs from drying and infection by
covering them with sterile, saline-soaked dressings while awaiting emergency surgery. Understanding
this helps the nurse notice early warning signs and act before the problem gets worse. Early action
often prevents bigger complications for the client. Understanding this helps the nurse notice early
warning signs and act before the problem gets worse. Early action often prevents bigger complications
for the client.
Exam (Elaborations) • Detailed Rationales Page 3
