,NR-325 Verified Adult Health II Final Exam |
Chamberlain College of Nursing | Q & A |
2026/2027 Edition
1. A client with acute decompensated heart failure presents with severe dyspnea, orthopnea,
and pink frothy sputum. Which medication does the nurse anticipate administering to reduce
preload and afterload simultaneously?
A) Nitroglycerin
B) Sodium nitroprusside
C) Furosemide
D) Dobutamine
Correct Answer: Sodium nitroprusside
Rationale: Sodium nitroprusside is a potent vasodilator that reduces both preload and afterload,
making it effective in acute heart failure with pulmonary edema. Nitroglycerin primarily reduces
preload, furosemide reduces volume, and dobutamine increases contractility without significant
afterload reduction.
2. A client with chronic obstructive pulmonary disease has an arterial blood gas showing pH
7.32, PaCO2 55 mm Hg, HCO3- 32 mEq/L, and PaO2 60 mm Hg. Which interpretation is correct?
A) Acute respiratory acidosis
B) Chronic respiratory acidosis with metabolic compensation
C) Mixed metabolic alkalosis and respiratory acidosis
,D) Respiratory alkalosis with metabolic compensation
Correct Answer: Chronic respiratory acidosis with metabolic compensation
Rationale: The elevated PaCO2 indicates respiratory acidosis, and the elevated HCO3- indicates
renal compensation. The pH is only mildly decreased despite significant hypercapnia, suggesting
chronic compensation rather than an acute, uncompensated state.
3. A client with cirrhosis develops ascites and peripheral edema. Which pathophysiological
mechanism contributes most significantly to fluid accumulation?
A) Increased aldosterone secretion and sodium retention
B) Decreased portal venous pressure
C) Increased serum albumin
D) Decreased antidiuretic hormone
Correct Answer: Increased aldosterone secretion and sodium retention
Rationale: In cirrhosis, impaired hepatic metabolism of aldosterone leads to increased levels,
causing sodium and water retention. Portal hypertension (not decreased) and decreased
albumin (not increased) also contribute, but aldosterone excess is a primary mechanism.
4. A client with chronic kidney disease has a serum potassium of 6.7 mEq/L and peaked T waves
on ECG. Which immediate intervention should the nurse implement first?
A) Administer intravenous calcium gluconate
B) Prepare the client for emergent hemodialysis
C) Administer oral sodium polystyrene sulfonate
, D) Initiate a potassium-restricted diet
Correct Answer: Administer intravenous calcium gluconate
Rationale: Calcium gluconate is administered first to stabilize cardiac membranes and prevent
life-threatening dysrhythmias in severe hyperkalemia. Sodium polystyrene sulfonate and dietary
restriction are slower interventions, and hemodialysis requires preparation time.
5. A client with type 1 diabetes mellitus is found unresponsive with a blood glucose of 32
mg/dL. After administering 50% dextrose IV, the client regains consciousness. Which nursing
action is most important to prevent recurrence of hypoglycemia?
A) Administer a continuous insulin infusion
B) Provide a meal or snack containing complex carbohydrates and protein
C) Increase the client's long-acting insulin dose
D) Restrict all carbohydrate intake for 24 hours
Correct Answer: Provide a meal or snack containing complex carbohydrates and protein
Rationale: After acute hypoglycemia is corrected, a meal or snack with complex carbohydrates
and protein sustains blood glucose and prevents recurrence. Insulin administration would
worsen hypoglycemia, increasing insulin is contraindicated, and restricting carbohydrates is
dangerous.
6. A client with increased intracranial pressure has a Glasgow Coma Scale score of 8. Which
nursing intervention is most appropriate for this client?
A) Encourage oral fluid intake
B) Position the client in a flat, supine position
Chamberlain College of Nursing | Q & A |
2026/2027 Edition
1. A client with acute decompensated heart failure presents with severe dyspnea, orthopnea,
and pink frothy sputum. Which medication does the nurse anticipate administering to reduce
preload and afterload simultaneously?
A) Nitroglycerin
B) Sodium nitroprusside
C) Furosemide
D) Dobutamine
Correct Answer: Sodium nitroprusside
Rationale: Sodium nitroprusside is a potent vasodilator that reduces both preload and afterload,
making it effective in acute heart failure with pulmonary edema. Nitroglycerin primarily reduces
preload, furosemide reduces volume, and dobutamine increases contractility without significant
afterload reduction.
2. A client with chronic obstructive pulmonary disease has an arterial blood gas showing pH
7.32, PaCO2 55 mm Hg, HCO3- 32 mEq/L, and PaO2 60 mm Hg. Which interpretation is correct?
A) Acute respiratory acidosis
B) Chronic respiratory acidosis with metabolic compensation
C) Mixed metabolic alkalosis and respiratory acidosis
,D) Respiratory alkalosis with metabolic compensation
Correct Answer: Chronic respiratory acidosis with metabolic compensation
Rationale: The elevated PaCO2 indicates respiratory acidosis, and the elevated HCO3- indicates
renal compensation. The pH is only mildly decreased despite significant hypercapnia, suggesting
chronic compensation rather than an acute, uncompensated state.
3. A client with cirrhosis develops ascites and peripheral edema. Which pathophysiological
mechanism contributes most significantly to fluid accumulation?
A) Increased aldosterone secretion and sodium retention
B) Decreased portal venous pressure
C) Increased serum albumin
D) Decreased antidiuretic hormone
Correct Answer: Increased aldosterone secretion and sodium retention
Rationale: In cirrhosis, impaired hepatic metabolism of aldosterone leads to increased levels,
causing sodium and water retention. Portal hypertension (not decreased) and decreased
albumin (not increased) also contribute, but aldosterone excess is a primary mechanism.
4. A client with chronic kidney disease has a serum potassium of 6.7 mEq/L and peaked T waves
on ECG. Which immediate intervention should the nurse implement first?
A) Administer intravenous calcium gluconate
B) Prepare the client for emergent hemodialysis
C) Administer oral sodium polystyrene sulfonate
, D) Initiate a potassium-restricted diet
Correct Answer: Administer intravenous calcium gluconate
Rationale: Calcium gluconate is administered first to stabilize cardiac membranes and prevent
life-threatening dysrhythmias in severe hyperkalemia. Sodium polystyrene sulfonate and dietary
restriction are slower interventions, and hemodialysis requires preparation time.
5. A client with type 1 diabetes mellitus is found unresponsive with a blood glucose of 32
mg/dL. After administering 50% dextrose IV, the client regains consciousness. Which nursing
action is most important to prevent recurrence of hypoglycemia?
A) Administer a continuous insulin infusion
B) Provide a meal or snack containing complex carbohydrates and protein
C) Increase the client's long-acting insulin dose
D) Restrict all carbohydrate intake for 24 hours
Correct Answer: Provide a meal or snack containing complex carbohydrates and protein
Rationale: After acute hypoglycemia is corrected, a meal or snack with complex carbohydrates
and protein sustains blood glucose and prevents recurrence. Insulin administration would
worsen hypoglycemia, increasing insulin is contraindicated, and restricting carbohydrates is
dangerous.
6. A client with increased intracranial pressure has a Glasgow Coma Scale score of 8. Which
nursing intervention is most appropriate for this client?
A) Encourage oral fluid intake
B) Position the client in a flat, supine position
