,NR 324 Adult Health I Final Exam | Chamberlain
College of Nursing | Latest 2026/2027 Update
1. A nurse is caring for four clients. Which client should the nurse assess first?
A) A client with pneumonia who has a temperature of 101.2°F and is diaphoretic
B) A client who is 1 day post-operative abdominal surgery with a heart rate of 110 bpm
C) A client with a history of heart failure who has new-onset confusion and crackles in the lungs
D) A client with a fractured femur who is requesting pain medication
Correct Answer: A client with a history of heart failure who has new-onset confusion and crackles in
the lungs
Rationale: New-onset confusion and crackles in a client with heart failure are signs of acute
decompensated heart failure and pulmonary edema, which is a life-threatening emergency. This client
should be assessed first using the ABCs and Maslow's hierarchy. The other clients have stable
conditions that can be addressed after the unstable client.
2. A client is on fall precautions. Which of the following interventions is most appropriate?
A) Keep the bed in the highest position
B) Apply a bed alarm and keep the call light within reach
C) Restrain the client to prevent falls
D) Keep the side rails down for easy access
Correct Answer: Apply a bed alarm and keep the call light within reach
Rationale: Fall precautions include keeping the bed in the lowest position, applying a bed alarm,
ensuring the call light is within reach, and keeping side rails up. Restraints are a last resort and are not
the first-line intervention for fall prevention. Keeping the bed in the highest position and side rails
down increase the risk of falls.
3. A client with tuberculosis is prescribed rifampin. Which instruction should the nurse include in the
teaching?
,A) "This medication may turn your urine orange."
B) "Take this medication on an empty stomach."
C) "You can stop taking this medication when you feel better."
D) "This medication will cure your TB in 2 weeks."
Correct Answer: "This medication may turn your urine orange."
Rationale: Rifampin commonly causes orange discoloration of urine, sweat, and tears. This is a
harmless side effect but should be communicated to the client to prevent alarm. Rifampin should be
taken with food if GI upset occurs, and treatment lasts for months. Clients must complete the full
course of therapy.
4. A nurse is caring for a client with a chest tube. Which finding requires immediate intervention?
A) Tidaling in the water seal chamber
B) 50 mL of serosanguineous drainage in the first hour
C) Continuous bubbling in the water seal chamber
D) The chest tube is secured to the client's chest
Correct Answer: Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system, which
requires immediate assessment and intervention. Tidaling (intermittent bubbling with respiration) is
an expected finding. Drainage of 50 mL in the first hour is not immediately concerning, and a secured
chest tube is a safety measure.
5. A patient is admitted with severe dehydration. Which assessment finding would the nurse expect?
A) Bounding pulse
B) Jugular vein distention
C) Orthostatic hypotension
D) Crackles in lung bases
, Correct Answer: Orthostatic hypotension
Rationale: Dehydration causes hypovolemia, leading to orthostatic hypotension. Bounding pulse,
jugular vein distention, and crackles in lung bases indicate fluid overload, not dehydration. Other signs
of dehydration include tachycardia, dry mucous membranes, and decreased urine output.
6. A patient has a serum sodium level of 125 mEq/L. Which assessment finding is most concerning?
A) Dry mucous membranes
B) Thirst
C) Altered mental status
D) Fever
Correct Answer: Altered mental status
Rationale: Severe hyponatremia causes cerebral edema, leading to confusion and seizures. Dry
mucous membranes, thirst, and fever are signs of hypernatremia (dehydration), not hyponatremia.
Altered mental status indicates neurological involvement and requires immediate intervention.
7. A patient has a serum potassium level of 6.8 mEq/L. Which ECG change would the nurse expect?
A) Flattened T waves
B) U waves
C) Peaked T waves
D) Prolonged QT interval
Correct Answer: Peaked T waves
Rationale: Hyperkalemia causes peaked (tented) T waves. Flattened T waves and U waves are
associated with hypokalemia. Prolonged QT interval is associated with hypocalcemia. Hyperkalemia
can progress to widened QRS complexes and ventricular fibrillation if untreated.
College of Nursing | Latest 2026/2027 Update
1. A nurse is caring for four clients. Which client should the nurse assess first?
A) A client with pneumonia who has a temperature of 101.2°F and is diaphoretic
B) A client who is 1 day post-operative abdominal surgery with a heart rate of 110 bpm
C) A client with a history of heart failure who has new-onset confusion and crackles in the lungs
D) A client with a fractured femur who is requesting pain medication
Correct Answer: A client with a history of heart failure who has new-onset confusion and crackles in
the lungs
Rationale: New-onset confusion and crackles in a client with heart failure are signs of acute
decompensated heart failure and pulmonary edema, which is a life-threatening emergency. This client
should be assessed first using the ABCs and Maslow's hierarchy. The other clients have stable
conditions that can be addressed after the unstable client.
2. A client is on fall precautions. Which of the following interventions is most appropriate?
A) Keep the bed in the highest position
B) Apply a bed alarm and keep the call light within reach
C) Restrain the client to prevent falls
D) Keep the side rails down for easy access
Correct Answer: Apply a bed alarm and keep the call light within reach
Rationale: Fall precautions include keeping the bed in the lowest position, applying a bed alarm,
ensuring the call light is within reach, and keeping side rails up. Restraints are a last resort and are not
the first-line intervention for fall prevention. Keeping the bed in the highest position and side rails
down increase the risk of falls.
3. A client with tuberculosis is prescribed rifampin. Which instruction should the nurse include in the
teaching?
,A) "This medication may turn your urine orange."
B) "Take this medication on an empty stomach."
C) "You can stop taking this medication when you feel better."
D) "This medication will cure your TB in 2 weeks."
Correct Answer: "This medication may turn your urine orange."
Rationale: Rifampin commonly causes orange discoloration of urine, sweat, and tears. This is a
harmless side effect but should be communicated to the client to prevent alarm. Rifampin should be
taken with food if GI upset occurs, and treatment lasts for months. Clients must complete the full
course of therapy.
4. A nurse is caring for a client with a chest tube. Which finding requires immediate intervention?
A) Tidaling in the water seal chamber
B) 50 mL of serosanguineous drainage in the first hour
C) Continuous bubbling in the water seal chamber
D) The chest tube is secured to the client's chest
Correct Answer: Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in the system, which
requires immediate assessment and intervention. Tidaling (intermittent bubbling with respiration) is
an expected finding. Drainage of 50 mL in the first hour is not immediately concerning, and a secured
chest tube is a safety measure.
5. A patient is admitted with severe dehydration. Which assessment finding would the nurse expect?
A) Bounding pulse
B) Jugular vein distention
C) Orthostatic hypotension
D) Crackles in lung bases
, Correct Answer: Orthostatic hypotension
Rationale: Dehydration causes hypovolemia, leading to orthostatic hypotension. Bounding pulse,
jugular vein distention, and crackles in lung bases indicate fluid overload, not dehydration. Other signs
of dehydration include tachycardia, dry mucous membranes, and decreased urine output.
6. A patient has a serum sodium level of 125 mEq/L. Which assessment finding is most concerning?
A) Dry mucous membranes
B) Thirst
C) Altered mental status
D) Fever
Correct Answer: Altered mental status
Rationale: Severe hyponatremia causes cerebral edema, leading to confusion and seizures. Dry
mucous membranes, thirst, and fever are signs of hypernatremia (dehydration), not hyponatremia.
Altered mental status indicates neurological involvement and requires immediate intervention.
7. A patient has a serum potassium level of 6.8 mEq/L. Which ECG change would the nurse expect?
A) Flattened T waves
B) U waves
C) Peaked T waves
D) Prolonged QT interval
Correct Answer: Peaked T waves
Rationale: Hyperkalemia causes peaked (tented) T waves. Flattened T waves and U waves are
associated with hypokalemia. Prolonged QT interval is associated with hypocalcemia. Hyperkalemia
can progress to widened QRS complexes and ventricular fibrillation if untreated.
