NUR 6130 – Exam 3 Questions and Answers | Newest 2026 |
100% Correct - William Paterson University.
1. A 68-year-old woman with type 2 diabetes and chronic kidney disease (eGFR 35 mL/min) is
admitted with sepsis. Her family requests that she be kept comfortable and not receive
aggressive resuscitation. She has no advance directives. The healthcare team is considering a
palliative care consult. Which action by the nurse best demonstrates patient-centered care and
ethical practice?
A. Initiate a palliative care consult and facilitate a family meeting to clarify goals of care and document her
wishes.
B. Defer all goals-of-care discussions until the patient can participate, as she is the only valid decision maker.
C. Encourage the family to make decisions based on what they think she would want, without involving the
healthcare team.
D. Continue aggressive treatment as the standard of care, since her wishes are unknown and she is not
actively dying.
Answer: A. Initiate a palliative care consult and facilitate a family meeting to clarify goals of
care and document her wishes.
2. A nurse is preparing a diabetic patient for discharge and providing education on foot care.
Which teaching point is most critical for preventing complications in a patient with peripheral
neuropathy?
A. Inspect feet daily using a mirror, and report any new cuts, blisters, or color changes.
B. Soak feet daily in warm water for 20 minutes to improve circulation.
C. Walk barefoot indoors to strengthen the muscles in the feet.
D. Apply a heating pad to the feet to relieve numbness.
Answer: A. Inspect feet daily using a mirror, and report any new cuts, blisters, or color
changes.
3. A nursing student is studying the impact of nurse staffing ratios on patient outcomes. Which
statement best reflects the current evidence on this topic?
A. Higher nurse-to-patient ratios are associated with lower rates of adverse events, such as medication errors
and falls.
B. Nurse staffing ratios have no significant effect on patient outcomes when technology is used.
C. Lower nurse-to-patient ratios increase patient satisfaction but do not affect clinical outcomes.
D. Adequate staffing is only important in intensive care settings, not on general medical-surgical units.
Answer: A. Higher nurse-to-patient ratios are associated with lower rates of adverse events,
such as medication errors and falls.
4. A nurse is implementing a new evidence-based practice (EBP) protocol for central line
insertion to reduce catheter-related bloodstream infections. According to the Iowa Model, what
is the first step in this process?
A. Identify a clinical trigger or problem that prompts a need for change.
B. Conduct a systematic review of the literature on central line infections.
C. Pilot the new protocol on a single unit to test feasibility.
D. Evaluate the outcomes of the practice change through data collection.
Answer: A. Identify a clinical trigger or problem that prompts a need for change.
,5. A nurse is appraising a research article to determine if the findings can be applied to her
clinical practice. Which question is most important to ask during critical appraisal?
A. Were the study participants similar to the patient population in my practice setting?
B. Did the research team include a nurse scientist?
C. Was the study funded by a reputable organization?
D. How many times has the article been cited?
Answer: A. Were the study participants similar to the patient population in my practice setting?
6. A nurse is conducting a literature search to answer a clinical question about the use of
chlorhexidine bathing to prevent hospital-acquired infections. Which database is most
appropriate for nursing research?
A. CINAHL (Cumulative Index of Nursing and Allied Health Literature)
B. MEDLINE (Medical Literature Analysis and Retrieval System Online)
C. PubMed Central
D. Cochrane Database of Systematic Reviews
Answer: A. CINAHL (Cumulative Index of Nursing and Allied Health Literature)
7. A nurse is preparing to administer a high-alert medication such as heparin. What is the most
important safety check to prevent a medication error?
A. Verify the patient's identity using two identifiers, such as name and date of birth.
B. Confirm the order with another nurse before administering.
C. Check the medication label three times before administration.
D. Calculate the dose based on the patient's weight each time.
Answer: A. Verify the patient's identity using two identifiers, such as name and date of birth.
8. A nurse receives a critical lab value for a patient with heart failure: potassium level of 6.5
mEq/L. The patient is on spironolactone and has an irregular heart rhythm. What is the nurse's
priority action?
A. Hold the next dose of spironolactone and notify the healthcare provider immediately.
B. Administer the next dose of spironolactone and reassess the rhythm in 30 minutes.
C. Document the lab value and continue monitoring the patient.
D. Encourage the patient to eat potassium-rich foods to balance electrolytes.
Answer: A. Hold the next dose of spironolactone and notify the healthcare provider
immediately.
9. A nurse is performing an abdominal assessment on a patient with suspected bowel
obstruction. She asks the patient to lie supine and examines each quadrant. Which assessment
technique should the nurse use first?
A. Inspection
B. Auscultation
C. Percussion
D. Palpation
Answer: A. Inspection
10. A 45-year-old patient presents with chest pain that is described as 'tearing' and radiates to
the back. Blood pressure is 150/90 mmHg in the right arm and 120/80 mmHg in the left arm.
Which assessment finding is most critical?
, A. The difference in blood pressure between arms.
B. The chest pain radiating to the back.
C. The patient's age and gender.
D. The pain being described as 'tearing'.
Answer: A. The difference in blood pressure between arms.
11. A nurse is assessing a patient's cranial nerve function after a head injury. Which technique
is correct for assessing the hypoglossal nerve (CN XII)?
A. Ask the patient to protrude the tongue and move it side to side.
B. Assess the patient's ability to shrug the shoulders against resistance.
C. Test the patient's ability to identify odors with eyes closed.
D. Check the patient's gag reflex by stimulating the back of the throat.
Answer: A. Ask the patient to protrude the tongue and move it side to side.
12. A patient is about to receive vancomycin 1 g IV for methicillin-resistant Staphylococcus
aureus (MRSA) infection. The nurse reviews the patient's serum creatinine level, which is 1.8
mg/dL. What is the most appropriate nursing action?
A. Hold the dose and contact the prescriber to adjust the dose based on renal function.
B. Administer the dose intravenously over 1 hour as ordered.
C. Administer the dose and monitor the patient for adverse reactions.
D. Give the dose orally instead of intravenously because of renal impairment.
Answer: A. Hold the dose and contact the prescriber to adjust the dose based on renal
function.
13. A nurse is administering a loading dose of phenytoin to a patient with status epilepticus.
What is the maximum rate of IV administration to prevent cardiac arrhythmias?
A. 50 mg/min
B. 25 mg/min
C. 10 mg/min
D. 100 mg/min
Answer: A. 50 mg/min
14. A patient on a medical-surgical unit suddenly develops a temperature of 102.5°F, heart rate
120 bpm, and blood pressure 80/60 mmHg. The patient appears confused. The nurse suspects
sepsis. What is the nurse's priority action?
A. Administer a normal saline bolus of 30 mL/kg over 1 hour.
B. Obtain blood cultures before administering antibiotics.
C. Notify the healthcare provider of the patient's condition.
D. Initiate oxygen at 2 L/min via nasal cannula.
Answer: A. Administer a normal saline bolus of 30 mL/kg over 1 hour.
15. A patient is receiving a continuous infusion of IV insulin for diabetic ketoacidosis (DKA).
The nurse notices the potassium level is 3.0 mEq/L, and the ECG shows U waves. What is the
correct nursing action?
A. Stop the insulin infusion and notify the provider to begin potassium replacement.
B. Continue the insulin infusion and monitor the potassium closely.
C. Increase the insulin infusion rate to lower glucose faster.
100% Correct - William Paterson University.
1. A 68-year-old woman with type 2 diabetes and chronic kidney disease (eGFR 35 mL/min) is
admitted with sepsis. Her family requests that she be kept comfortable and not receive
aggressive resuscitation. She has no advance directives. The healthcare team is considering a
palliative care consult. Which action by the nurse best demonstrates patient-centered care and
ethical practice?
A. Initiate a palliative care consult and facilitate a family meeting to clarify goals of care and document her
wishes.
B. Defer all goals-of-care discussions until the patient can participate, as she is the only valid decision maker.
C. Encourage the family to make decisions based on what they think she would want, without involving the
healthcare team.
D. Continue aggressive treatment as the standard of care, since her wishes are unknown and she is not
actively dying.
Answer: A. Initiate a palliative care consult and facilitate a family meeting to clarify goals of
care and document her wishes.
2. A nurse is preparing a diabetic patient for discharge and providing education on foot care.
Which teaching point is most critical for preventing complications in a patient with peripheral
neuropathy?
A. Inspect feet daily using a mirror, and report any new cuts, blisters, or color changes.
B. Soak feet daily in warm water for 20 minutes to improve circulation.
C. Walk barefoot indoors to strengthen the muscles in the feet.
D. Apply a heating pad to the feet to relieve numbness.
Answer: A. Inspect feet daily using a mirror, and report any new cuts, blisters, or color
changes.
3. A nursing student is studying the impact of nurse staffing ratios on patient outcomes. Which
statement best reflects the current evidence on this topic?
A. Higher nurse-to-patient ratios are associated with lower rates of adverse events, such as medication errors
and falls.
B. Nurse staffing ratios have no significant effect on patient outcomes when technology is used.
C. Lower nurse-to-patient ratios increase patient satisfaction but do not affect clinical outcomes.
D. Adequate staffing is only important in intensive care settings, not on general medical-surgical units.
Answer: A. Higher nurse-to-patient ratios are associated with lower rates of adverse events,
such as medication errors and falls.
4. A nurse is implementing a new evidence-based practice (EBP) protocol for central line
insertion to reduce catheter-related bloodstream infections. According to the Iowa Model, what
is the first step in this process?
A. Identify a clinical trigger or problem that prompts a need for change.
B. Conduct a systematic review of the literature on central line infections.
C. Pilot the new protocol on a single unit to test feasibility.
D. Evaluate the outcomes of the practice change through data collection.
Answer: A. Identify a clinical trigger or problem that prompts a need for change.
,5. A nurse is appraising a research article to determine if the findings can be applied to her
clinical practice. Which question is most important to ask during critical appraisal?
A. Were the study participants similar to the patient population in my practice setting?
B. Did the research team include a nurse scientist?
C. Was the study funded by a reputable organization?
D. How many times has the article been cited?
Answer: A. Were the study participants similar to the patient population in my practice setting?
6. A nurse is conducting a literature search to answer a clinical question about the use of
chlorhexidine bathing to prevent hospital-acquired infections. Which database is most
appropriate for nursing research?
A. CINAHL (Cumulative Index of Nursing and Allied Health Literature)
B. MEDLINE (Medical Literature Analysis and Retrieval System Online)
C. PubMed Central
D. Cochrane Database of Systematic Reviews
Answer: A. CINAHL (Cumulative Index of Nursing and Allied Health Literature)
7. A nurse is preparing to administer a high-alert medication such as heparin. What is the most
important safety check to prevent a medication error?
A. Verify the patient's identity using two identifiers, such as name and date of birth.
B. Confirm the order with another nurse before administering.
C. Check the medication label three times before administration.
D. Calculate the dose based on the patient's weight each time.
Answer: A. Verify the patient's identity using two identifiers, such as name and date of birth.
8. A nurse receives a critical lab value for a patient with heart failure: potassium level of 6.5
mEq/L. The patient is on spironolactone and has an irregular heart rhythm. What is the nurse's
priority action?
A. Hold the next dose of spironolactone and notify the healthcare provider immediately.
B. Administer the next dose of spironolactone and reassess the rhythm in 30 minutes.
C. Document the lab value and continue monitoring the patient.
D. Encourage the patient to eat potassium-rich foods to balance electrolytes.
Answer: A. Hold the next dose of spironolactone and notify the healthcare provider
immediately.
9. A nurse is performing an abdominal assessment on a patient with suspected bowel
obstruction. She asks the patient to lie supine and examines each quadrant. Which assessment
technique should the nurse use first?
A. Inspection
B. Auscultation
C. Percussion
D. Palpation
Answer: A. Inspection
10. A 45-year-old patient presents with chest pain that is described as 'tearing' and radiates to
the back. Blood pressure is 150/90 mmHg in the right arm and 120/80 mmHg in the left arm.
Which assessment finding is most critical?
, A. The difference in blood pressure between arms.
B. The chest pain radiating to the back.
C. The patient's age and gender.
D. The pain being described as 'tearing'.
Answer: A. The difference in blood pressure between arms.
11. A nurse is assessing a patient's cranial nerve function after a head injury. Which technique
is correct for assessing the hypoglossal nerve (CN XII)?
A. Ask the patient to protrude the tongue and move it side to side.
B. Assess the patient's ability to shrug the shoulders against resistance.
C. Test the patient's ability to identify odors with eyes closed.
D. Check the patient's gag reflex by stimulating the back of the throat.
Answer: A. Ask the patient to protrude the tongue and move it side to side.
12. A patient is about to receive vancomycin 1 g IV for methicillin-resistant Staphylococcus
aureus (MRSA) infection. The nurse reviews the patient's serum creatinine level, which is 1.8
mg/dL. What is the most appropriate nursing action?
A. Hold the dose and contact the prescriber to adjust the dose based on renal function.
B. Administer the dose intravenously over 1 hour as ordered.
C. Administer the dose and monitor the patient for adverse reactions.
D. Give the dose orally instead of intravenously because of renal impairment.
Answer: A. Hold the dose and contact the prescriber to adjust the dose based on renal
function.
13. A nurse is administering a loading dose of phenytoin to a patient with status epilepticus.
What is the maximum rate of IV administration to prevent cardiac arrhythmias?
A. 50 mg/min
B. 25 mg/min
C. 10 mg/min
D. 100 mg/min
Answer: A. 50 mg/min
14. A patient on a medical-surgical unit suddenly develops a temperature of 102.5°F, heart rate
120 bpm, and blood pressure 80/60 mmHg. The patient appears confused. The nurse suspects
sepsis. What is the nurse's priority action?
A. Administer a normal saline bolus of 30 mL/kg over 1 hour.
B. Obtain blood cultures before administering antibiotics.
C. Notify the healthcare provider of the patient's condition.
D. Initiate oxygen at 2 L/min via nasal cannula.
Answer: A. Administer a normal saline bolus of 30 mL/kg over 1 hour.
15. A patient is receiving a continuous infusion of IV insulin for diabetic ketoacidosis (DKA).
The nurse notices the potassium level is 3.0 mEq/L, and the ECG shows U waves. What is the
correct nursing action?
A. Stop the insulin infusion and notify the provider to begin potassium replacement.
B. Continue the insulin infusion and monitor the potassium closely.
C. Increase the insulin infusion rate to lower glucose faster.
