CNR N4000: DR. CHELLY
COMPREHENSIVE NURSING REVIEW
QUESTIONS AND ANSWERS | 2026/2027
UPDATED | 100% CORRECT
1. A client is admitted with a lithium level of 2.1 mEq/L. Which clinical manifestation should
the nurse expect to observe?
A. Mild thirst and polyuria
B. Fine hand tremors and nausea
C. Giddiness, blurred vision, and ataxia
D. Hyperactivity and increased pressured speech
Answer: C
Conceptual Explanation: Lithium levels above 1.5 mEq/L indicate toxicity. Levels
between 2.0 and 2.5 mEq/L typically present with neurological signs like giddiness, blurred
vision, ataxia, and severe hypotension.
2. A client with a pH of 7.31, PaCO2 of 52 mmHg, and HCO3 of 28 mEq/L is experiencing which
acid-base imbalance?
A. Uncompensated Respiratory Acidosis
B. Partially Compensated Respiratory Acidosis
,C. Fully Compensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), PaCO2 is high (respiratory), and the
HCO3 is elevated (compensation). Because the pH is not within normal range, it is partially
compensated.
3. The nurse is caring for a client with a history of heart failure taking Digoxin. The client’s
potassium level is 3.1 mEq/L. What is the priority nursing action?
A. Administer the scheduled dose of Digoxin
B. Assess the client for yellow-green vision changes
C. Increase the client’s dietary intake of sodium
D. Encourage the client to exercise to increase circulation
Answer: B
Conceptual Explanation: Hypokalemia (potassium < 3.5) significantly increases the risk of
Digoxin toxicity. The nurse must assess for signs of toxicity, such as visual changes (halos)
and arrhythmias.
4. A client with a T6 spinal cord injury reports a sudden, severe headache and nasal
congestion. The nurse notes a BP of 190/100 mmHg. What is the immediate priority?
A. Administer prescribed antihypertensive medication
, B. Place the client in a flat, supine position
C. Check the client for bladder distention or fecal impaction
D. Request a STAT CT scan of the head
Answer: C
Conceptual Explanation: These are classic signs of Autonomic Dysreflexia, often triggered
by a full bladder or bowel. Finding and removing the stimulus is the priority treatment.
5. A nurse is calculating the IV fluid resuscitation for a 70 kg client with 40% total body
surface area (TBSA) burns using the Parkland formula. How much fluid should be given in the
first 8 hours?
A. 2,800 mL
B. 11,200 mL
C. 5,600 mL
D. 7,000 mL
Answer: C
Conceptual Explanation: Parkland formula = 4mL x kg x %BSA. (4 x 70 x 40 = 11,200 mL
total for 24 hours). Half of the total (5,600 mL) is given in the first 8 hours.
6. A child with Tetralogy of Fallot becomes cyanotic and dyspneic during a crying spell. Which
action should the nurse take first?
A. Administer high-flow oxygen via mask
COMPREHENSIVE NURSING REVIEW
QUESTIONS AND ANSWERS | 2026/2027
UPDATED | 100% CORRECT
1. A client is admitted with a lithium level of 2.1 mEq/L. Which clinical manifestation should
the nurse expect to observe?
A. Mild thirst and polyuria
B. Fine hand tremors and nausea
C. Giddiness, blurred vision, and ataxia
D. Hyperactivity and increased pressured speech
Answer: C
Conceptual Explanation: Lithium levels above 1.5 mEq/L indicate toxicity. Levels
between 2.0 and 2.5 mEq/L typically present with neurological signs like giddiness, blurred
vision, ataxia, and severe hypotension.
2. A client with a pH of 7.31, PaCO2 of 52 mmHg, and HCO3 of 28 mEq/L is experiencing which
acid-base imbalance?
A. Uncompensated Respiratory Acidosis
B. Partially Compensated Respiratory Acidosis
,C. Fully Compensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: B
Conceptual Explanation: The pH is low (acidosis), PaCO2 is high (respiratory), and the
HCO3 is elevated (compensation). Because the pH is not within normal range, it is partially
compensated.
3. The nurse is caring for a client with a history of heart failure taking Digoxin. The client’s
potassium level is 3.1 mEq/L. What is the priority nursing action?
A. Administer the scheduled dose of Digoxin
B. Assess the client for yellow-green vision changes
C. Increase the client’s dietary intake of sodium
D. Encourage the client to exercise to increase circulation
Answer: B
Conceptual Explanation: Hypokalemia (potassium < 3.5) significantly increases the risk of
Digoxin toxicity. The nurse must assess for signs of toxicity, such as visual changes (halos)
and arrhythmias.
4. A client with a T6 spinal cord injury reports a sudden, severe headache and nasal
congestion. The nurse notes a BP of 190/100 mmHg. What is the immediate priority?
A. Administer prescribed antihypertensive medication
, B. Place the client in a flat, supine position
C. Check the client for bladder distention or fecal impaction
D. Request a STAT CT scan of the head
Answer: C
Conceptual Explanation: These are classic signs of Autonomic Dysreflexia, often triggered
by a full bladder or bowel. Finding and removing the stimulus is the priority treatment.
5. A nurse is calculating the IV fluid resuscitation for a 70 kg client with 40% total body
surface area (TBSA) burns using the Parkland formula. How much fluid should be given in the
first 8 hours?
A. 2,800 mL
B. 11,200 mL
C. 5,600 mL
D. 7,000 mL
Answer: C
Conceptual Explanation: Parkland formula = 4mL x kg x %BSA. (4 x 70 x 40 = 11,200 mL
total for 24 hours). Half of the total (5,600 mL) is given in the first 8 hours.
6. A child with Tetralogy of Fallot becomes cyanotic and dyspneic during a crying spell. Which
action should the nurse take first?
A. Administer high-flow oxygen via mask
