NR 447 EXAM 2 BRAND NEW VERSION 2027-2028 Q&A EXAM
| ALL QUESTIONS AND ANSWERS PLUS DETAILED RATIONALES
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INSTANT PDF 2027-2028
1. A nurse is caring for a client who has just returned from abdominal surgery. Which
assessment finding requires the nurse's priority intervention?
A. Incisional pain rated 5/10
B. Temperature of 37.6°C (99.7°F)
C. Oxygen saturation of 88% on room air
D. Urine output of 35 mL/hr
An oxygen saturation of 88% indicates impaired oxygenation and requires immediate
assessment and intervention. Airway and breathing take priority over pain, temperature, and
borderline urine output.
2. A client with heart failure reports increasing shortness of breath when lying flat. Which
finding most strongly supports worsening pulmonary congestion?
A. Bilateral crackles at the lung bases
B. Warm, dry skin
C. Increased appetite
D. Bounding peripheral pulses
Bilateral crackles indicate fluid accumulation in the lungs and are a common manifestation of
worsening left-sided heart failure.
3. A nurse is teaching a client prescribed furosemide. Which statement by the client
indicates an understanding of the medication?
A. “I should increase my sodium intake while taking this medication.”
B. “I should report muscle weakness or unusual fatigue.”
C. “I should take this medication only when my ankles swell.”
D. “I should expect my urine output to decrease.”
Furosemide can cause electrolyte losses, particularly hypokalemia. Muscle weakness and
fatigue can indicate a significant potassium imbalance and should be reported.
4. A client with chronic obstructive pulmonary disease is receiving oxygen therapy. Which
nursing action is most appropriate?
,A. Administer oxygen at the highest possible flow rate.
B. Maintain oxygen according to the prescribed target range.
C. Discontinue oxygen whenever the client becomes dyspneic.
D. Encourage prolonged breath-holding exercises.
Clients with COPD require carefully titrated oxygen therapy based on the prescribed target
saturation and clinical condition rather than automatically receiving high-flow oxygen.
5. A client with diabetes mellitus is confused, diaphoretic, and trembling. Which action
should the nurse take first if the client is conscious and able to swallow?
A. Administer a rapid source of glucose.
B. Administer scheduled long-acting insulin.
C. Restrict oral fluids.
D. Place the client on a high-protein diet immediately.
The findings are consistent with hypoglycemia. A conscious client who can swallow should
receive a rapid-acting carbohydrate to raise blood glucose promptly.
6. A nurse is assessing a client with suspected hypovolemia. Which finding is most
concerning?
A. Heart rate of 104/min
B. Blood pressure of 88/54 mm Hg
C. Capillary refill of 2 seconds
D. Moist oral mucosa
Hypotension indicates significant reduction in circulating volume and may signal progression
toward hypovolemic shock.
7. A client is prescribed potassium chloride intravenously. Which nursing action is
essential?
A. Administer the medication by IV push.
B. Dilute the medication and administer it using an infusion pump.
C. Mix the medication with an antacid.
D. Give the medication undiluted through a peripheral IV.
IV potassium must be diluted and administered at a controlled rate. IV push potassium can
cause fatal cardiac dysrhythmias.
8. A client with pneumonia has a respiratory rate of 30/min, oxygen saturation of 91%, and
increasing fatigue. Which intervention is the priority?
A. Encourage the client to eat a high-calorie meal.
B. Assess respiratory status and support oxygenation.
, C. Delay assessment until the next scheduled vital signs.
D. Encourage the client to ambulate independently.
Tachypnea, reduced oxygen saturation, and fatigue suggest impaired respiratory function.
Oxygenation and respiratory assessment take priority.
9. A client receiving an opioid analgesic becomes difficult to arouse and has respirations of
7/min. Which medication should the nurse anticipate administering?
A. Naloxone
B. Protamine sulfate
C. Vitamin K
D. Acetylcysteine
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression.
10. A nurse is caring for a client after a myocardial infarction. Which assessment finding
requires immediate attention?
A. Mild anxiety
B. Heart rate of 78/min
C. New onset of ventricular dysrhythmia
D. Mild fatigue
A new ventricular dysrhythmia following myocardial infarction can rapidly compromise
cardiac output and become life-threatening.
11. A client with hypertension asks why lifestyle modification is recommended even when
medication controls the blood pressure. Which response is best?
A. “Lifestyle changes are unnecessary if your medication works.”
B. “Lifestyle changes can improve blood pressure control and reduce cardiovascular risk.”
C. “Lifestyle changes are needed only for clients who do not take medication.”
D. “Medication should eventually be discontinued when lifestyle changes begin.”
Dietary modification, physical activity, weight management, and other lifestyle measures can
improve blood pressure control and decrease cardiovascular complications.
12. A nurse is assessing a client with peripheral arterial disease. Which finding would the
nurse expect?
A. Warm, edematous legs
B. Brown pigmentation around the ankles
C. Diminished peripheral pulses and cool extremities
D. Pain relieved by dangling the legs
| ALL QUESTIONS AND ANSWERS PLUS DETAILED RATIONALES
| COMPLETE STUDYGUIDE| GUARANTEED PASS | DOWNLOAD
INSTANT PDF 2027-2028
1. A nurse is caring for a client who has just returned from abdominal surgery. Which
assessment finding requires the nurse's priority intervention?
A. Incisional pain rated 5/10
B. Temperature of 37.6°C (99.7°F)
C. Oxygen saturation of 88% on room air
D. Urine output of 35 mL/hr
An oxygen saturation of 88% indicates impaired oxygenation and requires immediate
assessment and intervention. Airway and breathing take priority over pain, temperature, and
borderline urine output.
2. A client with heart failure reports increasing shortness of breath when lying flat. Which
finding most strongly supports worsening pulmonary congestion?
A. Bilateral crackles at the lung bases
B. Warm, dry skin
C. Increased appetite
D. Bounding peripheral pulses
Bilateral crackles indicate fluid accumulation in the lungs and are a common manifestation of
worsening left-sided heart failure.
3. A nurse is teaching a client prescribed furosemide. Which statement by the client
indicates an understanding of the medication?
A. “I should increase my sodium intake while taking this medication.”
B. “I should report muscle weakness or unusual fatigue.”
C. “I should take this medication only when my ankles swell.”
D. “I should expect my urine output to decrease.”
Furosemide can cause electrolyte losses, particularly hypokalemia. Muscle weakness and
fatigue can indicate a significant potassium imbalance and should be reported.
4. A client with chronic obstructive pulmonary disease is receiving oxygen therapy. Which
nursing action is most appropriate?
,A. Administer oxygen at the highest possible flow rate.
B. Maintain oxygen according to the prescribed target range.
C. Discontinue oxygen whenever the client becomes dyspneic.
D. Encourage prolonged breath-holding exercises.
Clients with COPD require carefully titrated oxygen therapy based on the prescribed target
saturation and clinical condition rather than automatically receiving high-flow oxygen.
5. A client with diabetes mellitus is confused, diaphoretic, and trembling. Which action
should the nurse take first if the client is conscious and able to swallow?
A. Administer a rapid source of glucose.
B. Administer scheduled long-acting insulin.
C. Restrict oral fluids.
D. Place the client on a high-protein diet immediately.
The findings are consistent with hypoglycemia. A conscious client who can swallow should
receive a rapid-acting carbohydrate to raise blood glucose promptly.
6. A nurse is assessing a client with suspected hypovolemia. Which finding is most
concerning?
A. Heart rate of 104/min
B. Blood pressure of 88/54 mm Hg
C. Capillary refill of 2 seconds
D. Moist oral mucosa
Hypotension indicates significant reduction in circulating volume and may signal progression
toward hypovolemic shock.
7. A client is prescribed potassium chloride intravenously. Which nursing action is
essential?
A. Administer the medication by IV push.
B. Dilute the medication and administer it using an infusion pump.
C. Mix the medication with an antacid.
D. Give the medication undiluted through a peripheral IV.
IV potassium must be diluted and administered at a controlled rate. IV push potassium can
cause fatal cardiac dysrhythmias.
8. A client with pneumonia has a respiratory rate of 30/min, oxygen saturation of 91%, and
increasing fatigue. Which intervention is the priority?
A. Encourage the client to eat a high-calorie meal.
B. Assess respiratory status and support oxygenation.
, C. Delay assessment until the next scheduled vital signs.
D. Encourage the client to ambulate independently.
Tachypnea, reduced oxygen saturation, and fatigue suggest impaired respiratory function.
Oxygenation and respiratory assessment take priority.
9. A client receiving an opioid analgesic becomes difficult to arouse and has respirations of
7/min. Which medication should the nurse anticipate administering?
A. Naloxone
B. Protamine sulfate
C. Vitamin K
D. Acetylcysteine
Naloxone is an opioid antagonist used to reverse opioid-induced respiratory depression.
10. A nurse is caring for a client after a myocardial infarction. Which assessment finding
requires immediate attention?
A. Mild anxiety
B. Heart rate of 78/min
C. New onset of ventricular dysrhythmia
D. Mild fatigue
A new ventricular dysrhythmia following myocardial infarction can rapidly compromise
cardiac output and become life-threatening.
11. A client with hypertension asks why lifestyle modification is recommended even when
medication controls the blood pressure. Which response is best?
A. “Lifestyle changes are unnecessary if your medication works.”
B. “Lifestyle changes can improve blood pressure control and reduce cardiovascular risk.”
C. “Lifestyle changes are needed only for clients who do not take medication.”
D. “Medication should eventually be discontinued when lifestyle changes begin.”
Dietary modification, physical activity, weight management, and other lifestyle measures can
improve blood pressure control and decrease cardiovascular complications.
12. A nurse is assessing a client with peripheral arterial disease. Which finding would the
nurse expect?
A. Warm, edematous legs
B. Brown pigmentation around the ankles
C. Diminished peripheral pulses and cool extremities
D. Pain relieved by dangling the legs
