1
NR324 CJE HIGH-YIELD PRACTICE DRILL EXAM QUESTIONS
AND ANSWERS PRACTICE QUESTIONS WITH SOLUTIONS
NEWEST | ALREADY GRADED A
1.
A nurse is caring for a hospitalized adult client who has been admitted with severe
hyponatremia. The client has become increasingly confused and is demonstrating
muscle twitching while attempting to get out of bed without assistance. The most
recent serum sodium concentration is 118 mEq/L. Based on the client's
neurological changes and laboratory findings, which nursing intervention should
the nurse implement as the immediate priority?
A. Encourage the client to drink additional free water to improve hydration
B. Initiate seizure precautions and perform frequent neurological assessments
C. Administer a potassium-containing intravenous solution as prescribed
D. Place the client in a high-Fowler position and encourage ambulation
Answer: B
2.
A client with chronic heart failure is admitted to the medical-surgical unit with
increasing bilateral lower-extremity edema, a 3-kg weight gain over several days,
and increasing shortness of breath when lying flat. The nurse reviews the
medication prescription and identifies a loop diuretic. Which assessment finding
would provide the strongest indication that the prescribed therapy is producing the
intended effect?
A. The client reports increased thirst and dry oral mucous membranes
B. The client's urine becomes darker and more concentrated
C. The client's daily weight decreases and peripheral edema improves
D. The client's respiratory rate increases after medication administration
Answer: C
3.
A nurse is caring for an adult client whose serum potassium concentration is 6.8
mEq/L and whose electrocardiogram demonstrates tall, peaked T waves. The client
is otherwise awake and able to communicate appropriately. The healthcare
,2
provider prescribes several interventions to reduce the immediate cardiac risk
associated with the electrolyte abnormality. Which prescribed medication should
the nurse anticipate administering first to stabilize the cardiac membrane?
A. Calcium gluconate
B. Sodium-restricted diet
C. Oral potassium supplement
D. Ferrous sulfate
Answer: A
4.
A postoperative client who underwent abdominal surgery several hours earlier
suddenly develops increasing abdominal pain, a rigid abdomen, tachycardia,
hypotension, and a rapidly increasing respiratory rate. The nurse recognizes that
these findings represent a significant deterioration rather than expected
postoperative discomfort. Which action should the nurse take first?
A. Administer the next scheduled oral analgesic
B. Encourage the client to ambulate in the hallway
C. Perform an immediate focused assessment and notify the healthcare provider of
the acute deterioration
D. Place a warm compress over the operative incision
Answer: C
5.
A nurse is assessing an adult client who has been receiving intravenous fluids for
several hours. The client develops new crackles throughout both lung fields,
increasing shortness of breath, peripheral edema, and an elevated blood pressure
compared with the admission measurement. Which complication should the nurse
suspect based on the combination of respiratory and cardiovascular findings?
A. Fluid volume excess
B. Fluid volume deficit
C. Hypocalcemia
D. Metabolic alkalosis
Answer: A
,3
6.
A client with chronic obstructive pulmonary disease is receiving supplemental
oxygen and is being monitored for respiratory status. The nurse notes increasing
drowsiness, shallow respirations, and a decreasing level of responsiveness
compared with the client's earlier assessment. Which action is most appropriate for
the nurse to take?
A. Ignore the change because drowsiness is expected in chronic respiratory disease
B. Perform an immediate respiratory assessment and notify the healthcare provider
of the deterioration
C. Encourage the client to drink several glasses of water
D. Place the client flat and leave the room to obtain routine supplies
Answer: B
7.
A client with diabetes mellitus is admitted with nausea, vomiting, abdominal
discomfort, dehydration, and an elevated blood glucose concentration. The client
has deep, rapid respirations and appears increasingly fatigued. Which acid-base
disturbance should the nurse recognize as most consistent with this clinical
presentation?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: D
8.
A nurse is caring for a client who has been prescribed an anticoagulant following
hospitalization for a thromboembolic disorder. The client asks why laboratory
monitoring is necessary when taking the medication. Which response best reflects
the primary nursing concern associated with anticoagulant therapy?
A. Monitoring is necessary because anticoagulants can increase the risk of
bleeding
B. Monitoring is necessary because anticoagulants routinely cause severe
, 4
hypoglycemia
C. Monitoring is necessary because anticoagulants always produce hypertension
D. Monitoring is necessary because anticoagulants permanently increase platelet
production
Answer: A
9.
A client with a newly diagnosed deep-vein thrombosis reports sudden chest pain,
severe shortness of breath, anxiety, and a rapid heart rate. The nurse recognizes
that the client may have developed a potentially life-threatening complication.
Which condition should the nurse suspect?
A. Pulmonary embolism
B. Chronic bronchitis
C. Gastroesophageal reflux disease
D. Stable angina
Answer: A
10.
A nurse is preparing to administer a medication to an adult client who has multiple
prescribed medications and several documented allergies. Before administration,
the nurse notices that the medication label appears different from the medication
listed in the electronic medication record. Which action should the nurse take?
A. Administer the medication because the prescription is already documented
B. Ask another client whether the medication appears correct
C. Hold the medication until the discrepancy is verified through the appropriate
medication-safety process
D. Document administration before determining whether the medication is correct
Answer: C
11.
A client with chronic kidney disease is admitted with fatigue, peripheral edema,
decreased urine output, and elevated serum creatinine. The nurse is reviewing the
client's dietary plan and laboratory results. Which electrolyte abnormality is
NR324 CJE HIGH-YIELD PRACTICE DRILL EXAM QUESTIONS
AND ANSWERS PRACTICE QUESTIONS WITH SOLUTIONS
NEWEST | ALREADY GRADED A
1.
A nurse is caring for a hospitalized adult client who has been admitted with severe
hyponatremia. The client has become increasingly confused and is demonstrating
muscle twitching while attempting to get out of bed without assistance. The most
recent serum sodium concentration is 118 mEq/L. Based on the client's
neurological changes and laboratory findings, which nursing intervention should
the nurse implement as the immediate priority?
A. Encourage the client to drink additional free water to improve hydration
B. Initiate seizure precautions and perform frequent neurological assessments
C. Administer a potassium-containing intravenous solution as prescribed
D. Place the client in a high-Fowler position and encourage ambulation
Answer: B
2.
A client with chronic heart failure is admitted to the medical-surgical unit with
increasing bilateral lower-extremity edema, a 3-kg weight gain over several days,
and increasing shortness of breath when lying flat. The nurse reviews the
medication prescription and identifies a loop diuretic. Which assessment finding
would provide the strongest indication that the prescribed therapy is producing the
intended effect?
A. The client reports increased thirst and dry oral mucous membranes
B. The client's urine becomes darker and more concentrated
C. The client's daily weight decreases and peripheral edema improves
D. The client's respiratory rate increases after medication administration
Answer: C
3.
A nurse is caring for an adult client whose serum potassium concentration is 6.8
mEq/L and whose electrocardiogram demonstrates tall, peaked T waves. The client
is otherwise awake and able to communicate appropriately. The healthcare
,2
provider prescribes several interventions to reduce the immediate cardiac risk
associated with the electrolyte abnormality. Which prescribed medication should
the nurse anticipate administering first to stabilize the cardiac membrane?
A. Calcium gluconate
B. Sodium-restricted diet
C. Oral potassium supplement
D. Ferrous sulfate
Answer: A
4.
A postoperative client who underwent abdominal surgery several hours earlier
suddenly develops increasing abdominal pain, a rigid abdomen, tachycardia,
hypotension, and a rapidly increasing respiratory rate. The nurse recognizes that
these findings represent a significant deterioration rather than expected
postoperative discomfort. Which action should the nurse take first?
A. Administer the next scheduled oral analgesic
B. Encourage the client to ambulate in the hallway
C. Perform an immediate focused assessment and notify the healthcare provider of
the acute deterioration
D. Place a warm compress over the operative incision
Answer: C
5.
A nurse is assessing an adult client who has been receiving intravenous fluids for
several hours. The client develops new crackles throughout both lung fields,
increasing shortness of breath, peripheral edema, and an elevated blood pressure
compared with the admission measurement. Which complication should the nurse
suspect based on the combination of respiratory and cardiovascular findings?
A. Fluid volume excess
B. Fluid volume deficit
C. Hypocalcemia
D. Metabolic alkalosis
Answer: A
,3
6.
A client with chronic obstructive pulmonary disease is receiving supplemental
oxygen and is being monitored for respiratory status. The nurse notes increasing
drowsiness, shallow respirations, and a decreasing level of responsiveness
compared with the client's earlier assessment. Which action is most appropriate for
the nurse to take?
A. Ignore the change because drowsiness is expected in chronic respiratory disease
B. Perform an immediate respiratory assessment and notify the healthcare provider
of the deterioration
C. Encourage the client to drink several glasses of water
D. Place the client flat and leave the room to obtain routine supplies
Answer: B
7.
A client with diabetes mellitus is admitted with nausea, vomiting, abdominal
discomfort, dehydration, and an elevated blood glucose concentration. The client
has deep, rapid respirations and appears increasingly fatigued. Which acid-base
disturbance should the nurse recognize as most consistent with this clinical
presentation?
A. Respiratory alkalosis
B. Respiratory acidosis
C. Metabolic alkalosis
D. Metabolic acidosis
Answer: D
8.
A nurse is caring for a client who has been prescribed an anticoagulant following
hospitalization for a thromboembolic disorder. The client asks why laboratory
monitoring is necessary when taking the medication. Which response best reflects
the primary nursing concern associated with anticoagulant therapy?
A. Monitoring is necessary because anticoagulants can increase the risk of
bleeding
B. Monitoring is necessary because anticoagulants routinely cause severe
, 4
hypoglycemia
C. Monitoring is necessary because anticoagulants always produce hypertension
D. Monitoring is necessary because anticoagulants permanently increase platelet
production
Answer: A
9.
A client with a newly diagnosed deep-vein thrombosis reports sudden chest pain,
severe shortness of breath, anxiety, and a rapid heart rate. The nurse recognizes
that the client may have developed a potentially life-threatening complication.
Which condition should the nurse suspect?
A. Pulmonary embolism
B. Chronic bronchitis
C. Gastroesophageal reflux disease
D. Stable angina
Answer: A
10.
A nurse is preparing to administer a medication to an adult client who has multiple
prescribed medications and several documented allergies. Before administration,
the nurse notices that the medication label appears different from the medication
listed in the electronic medication record. Which action should the nurse take?
A. Administer the medication because the prescription is already documented
B. Ask another client whether the medication appears correct
C. Hold the medication until the discrepancy is verified through the appropriate
medication-safety process
D. Document administration before determining whether the medication is correct
Answer: C
11.
A client with chronic kidney disease is admitted with fatigue, peripheral edema,
decreased urine output, and elevated serum creatinine. The nurse is reviewing the
client's dietary plan and laboratory results. Which electrolyte abnormality is
