NUR 215 EXAM 3 EXAMINATION: COMPREHENSIVE 200-QUESTION
REVIEW COVERING IMMOBILITY EFFECTS, TARGET HEART RATE
CALCULATION, ANABOLIC STEROID ADVERSE EFFECTS, AND
RESPIRATORY/GASTROINTESTINAL NURSING INTERVENTIONS FOR
ARIZONA COLLEGE OF NURSING | UPDATED 2026-2027
1. A nurse is caring for an immobile client. Which assessment finding
indicates the client is developing atelectasis?
A. Increased bowel sounds
B. Diminished breath sounds in lung bases
C. Elevated blood pressure
D. Increased urine output
Answer: B. Diminished breath sounds in lung bases
Rationale: Atelectasis causes collapse of alveoli, leading to diminished
or absent breath sounds in affected areas. The lung bases are most
commonly affected due to gravity and pooling of secretions. Increased
bowel sounds, elevated blood pressure, and increased urine output are
not specific indicators of atelectasis.
2. Which intervention is most important for preventing pneumonia in
an immobile client?
A. Increasing caloric intake
B. Positioning client sitting up
,C. Administering stool softeners
D. Monitoring intake and output
Answer: B. Positioning client sitting up
Rationale: Sitting up allows for maximum lung expansion, which
prevents atelectasis and pneumonia. This position facilitates better
ventilation and helps mobilize secretions. Stool softeners address
gastrointestinal effects, not respiratory complications.
3. A client who is immobile reports constipation. The nurse
understands this is most likely due to which physiological change?
A. Increased peristalsis
B. Decreased peristalsis
C. Increased gastric acid secretion
D. Enhanced nutrient absorption
Answer: B. Decreased peristalsis
Rationale: Immobility decreases gastrointestinal motility, leading to
decreased peristalsis and constipation. This occurs because lack of
physical activity reduces the natural stimulation of bowel movements.
Paralytic ileus can occur in severe cases.
4. The nurse is teaching a client about using an incentive spirometer.
Which instruction should the nurse include?
A. Exhale forcefully into the device
B. Inhale slowly and deeply to raise the piston
,C. Use the device only once daily
D. Blow out quickly to achieve maximum effect
Answer: B. Inhale slowly and deeply to raise the piston
Rationale: Incentive spirometry (IS) requires the client to take a slow,
deep breath to raise the piston or ball, which promotes lung expansion
and prevents atelectasis. Forceful exhalation or rapid breathing does
not achieve the desired therapeutic effect.
5. Which adverse outcome is associated with androgenic anabolic
steroid use?
A. Hyperglycemia
B. Infertility
C. Hypotension
D. Bradycardia
Answer: B. Infertility
Rationale: Androgenic anabolic steroid use is associated with infertility
due to disruption of the hypothalamic-pituitary-gonadal axis. This leads
to decreased sperm production and testicular atrophy. Other adverse
effects include liver disease, cancer, and psychiatric disturbances.
6. A nurse is calculating target heart rate for a 48-year-old client. What
is the upper range target heart rate?
A. 132
B. 146
, C. 156
D. 172
Answer: B. 146
Rationale: Target heart rate is calculated as 220 - age for maximum
heart rate. For a 48-year-old, maximum is 172. Target range is 60-85% of
maximum: 172 × 0.85 = 146.2, rounded to 146 beats per minute for the
upper range.
7. The nurse notes that a client who is immobile has developed
shallow respirations. This finding indicates the client is at risk for
which complication?
A. Pulmonary embolism
B. Pneumothorax
C. Pneumonia
D. Pulmonary fibrosis
Answer: C. Pneumonia
Rationale: Shallow respirations allow secretions to pool in the lungs,
creating an environment for bacterial growth and increasing the risk of
pneumonia. The decreased chest wall expansion and ineffective
ventilation contribute to this risk.
8. Which statement by a client indicates understanding of target heart
rate exercise recommendations?
A. "I should exercise at maximum heart rate for best results"
B. "I should sustain the target range for at least 20 minutes"
REVIEW COVERING IMMOBILITY EFFECTS, TARGET HEART RATE
CALCULATION, ANABOLIC STEROID ADVERSE EFFECTS, AND
RESPIRATORY/GASTROINTESTINAL NURSING INTERVENTIONS FOR
ARIZONA COLLEGE OF NURSING | UPDATED 2026-2027
1. A nurse is caring for an immobile client. Which assessment finding
indicates the client is developing atelectasis?
A. Increased bowel sounds
B. Diminished breath sounds in lung bases
C. Elevated blood pressure
D. Increased urine output
Answer: B. Diminished breath sounds in lung bases
Rationale: Atelectasis causes collapse of alveoli, leading to diminished
or absent breath sounds in affected areas. The lung bases are most
commonly affected due to gravity and pooling of secretions. Increased
bowel sounds, elevated blood pressure, and increased urine output are
not specific indicators of atelectasis.
2. Which intervention is most important for preventing pneumonia in
an immobile client?
A. Increasing caloric intake
B. Positioning client sitting up
,C. Administering stool softeners
D. Monitoring intake and output
Answer: B. Positioning client sitting up
Rationale: Sitting up allows for maximum lung expansion, which
prevents atelectasis and pneumonia. This position facilitates better
ventilation and helps mobilize secretions. Stool softeners address
gastrointestinal effects, not respiratory complications.
3. A client who is immobile reports constipation. The nurse
understands this is most likely due to which physiological change?
A. Increased peristalsis
B. Decreased peristalsis
C. Increased gastric acid secretion
D. Enhanced nutrient absorption
Answer: B. Decreased peristalsis
Rationale: Immobility decreases gastrointestinal motility, leading to
decreased peristalsis and constipation. This occurs because lack of
physical activity reduces the natural stimulation of bowel movements.
Paralytic ileus can occur in severe cases.
4. The nurse is teaching a client about using an incentive spirometer.
Which instruction should the nurse include?
A. Exhale forcefully into the device
B. Inhale slowly and deeply to raise the piston
,C. Use the device only once daily
D. Blow out quickly to achieve maximum effect
Answer: B. Inhale slowly and deeply to raise the piston
Rationale: Incentive spirometry (IS) requires the client to take a slow,
deep breath to raise the piston or ball, which promotes lung expansion
and prevents atelectasis. Forceful exhalation or rapid breathing does
not achieve the desired therapeutic effect.
5. Which adverse outcome is associated with androgenic anabolic
steroid use?
A. Hyperglycemia
B. Infertility
C. Hypotension
D. Bradycardia
Answer: B. Infertility
Rationale: Androgenic anabolic steroid use is associated with infertility
due to disruption of the hypothalamic-pituitary-gonadal axis. This leads
to decreased sperm production and testicular atrophy. Other adverse
effects include liver disease, cancer, and psychiatric disturbances.
6. A nurse is calculating target heart rate for a 48-year-old client. What
is the upper range target heart rate?
A. 132
B. 146
, C. 156
D. 172
Answer: B. 146
Rationale: Target heart rate is calculated as 220 - age for maximum
heart rate. For a 48-year-old, maximum is 172. Target range is 60-85% of
maximum: 172 × 0.85 = 146.2, rounded to 146 beats per minute for the
upper range.
7. The nurse notes that a client who is immobile has developed
shallow respirations. This finding indicates the client is at risk for
which complication?
A. Pulmonary embolism
B. Pneumothorax
C. Pneumonia
D. Pulmonary fibrosis
Answer: C. Pneumonia
Rationale: Shallow respirations allow secretions to pool in the lungs,
creating an environment for bacterial growth and increasing the risk of
pneumonia. The decreased chest wall expansion and ineffective
ventilation contribute to this risk.
8. Which statement by a client indicates understanding of target heart
rate exercise recommendations?
A. "I should exercise at maximum heart rate for best results"
B. "I should sustain the target range for at least 20 minutes"
