NUR 257 ADULT NURSING II - EXAM
REVIEW COMPREHENSIVE QUESTIONS
AND ANSWERS | 2026/2027 UPDATE |
100% CORRECT-GALEN.
1. A patient with atrial fibrillation is receiving warfarin. Which laboratory value should the
nurse monitor to determine the effectiveness of the therapy?
A. Partial Thromboplastin Time (PTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Conceptual Explanation: INR is the standard monitoring parameter for warfarin
(Coumadin) therapy, typically targeted between 2.0 and 3.0 for atrial fibrillation.
2. A client is admitted with suspected Acute Respiratory Distress Syndrome (ARDS). Which
clinical finding is most characteristic of the early stage of ARDS?
A. Hypoxemia that does not respond to increased oxygen
B. Intercostal retractions and frothy sputum
C. Hypercapnia and respiratory acidosis
,D. Decreased lung compliance on the ventilator
Answer: A
Conceptual Explanation: Refractory hypoxemia, which is hypoxemia that does not
improve despite increasing concentrations of delivered oxygen, is a hallmark of ARDS.
3. The nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
electrolyte imbalance is the nurse most likely to observe?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypophosphatemia
Answer: C
Conceptual Explanation: During the oliguric phase, the kidneys’ inability to excrete
potassium leads to hyperkalemia, which is a life-threatening complication.
4. A patient presents to the ED with a blood glucose of 750 mg/dL, no ketones in the urine,
and profound dehydration. Which condition does the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Metabolic Acidosis
C. Hypoglycemic unawareness
D. Hyperglycemic Hyperosmolar State (HHS)
, Answer: D
Conceptual Explanation: HHS is characterized by extreme hyperglycemia and
dehydration without the significant ketosis found in DKA.
5. Which assessment finding in a patient with a chest tube requires immediate intervention?
A. Fluctuation of water in the suction control chamber
B. Serosanguinous drainage in the collection chamber
C. Intermittent bubbling in the water-seal chamber during coughing
D. Continuous bubbling in the water-seal chamber
Answer: D
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates a
persistent air leak in the system or from the patient, requiring immediate troubleshooting.
6. A patient with a T4 spinal cord injury reports a sudden, severe headache and is found to
have a BP of 190/110 mmHg. What is the priority nursing action?
A. Administer an antihypertensive medication
B. Place the patient in a supine position
C. Check the patient’s bladder for distension
D. Call the physician for a neurological consult
Answer: C
REVIEW COMPREHENSIVE QUESTIONS
AND ANSWERS | 2026/2027 UPDATE |
100% CORRECT-GALEN.
1. A patient with atrial fibrillation is receiving warfarin. Which laboratory value should the
nurse monitor to determine the effectiveness of the therapy?
A. Partial Thromboplastin Time (PTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Bleeding time
Answer: C
Conceptual Explanation: INR is the standard monitoring parameter for warfarin
(Coumadin) therapy, typically targeted between 2.0 and 3.0 for atrial fibrillation.
2. A client is admitted with suspected Acute Respiratory Distress Syndrome (ARDS). Which
clinical finding is most characteristic of the early stage of ARDS?
A. Hypoxemia that does not respond to increased oxygen
B. Intercostal retractions and frothy sputum
C. Hypercapnia and respiratory acidosis
,D. Decreased lung compliance on the ventilator
Answer: A
Conceptual Explanation: Refractory hypoxemia, which is hypoxemia that does not
improve despite increasing concentrations of delivered oxygen, is a hallmark of ARDS.
3. The nurse is caring for a patient in the oliguric phase of Acute Kidney Injury (AKI). Which
electrolyte imbalance is the nurse most likely to observe?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypophosphatemia
Answer: C
Conceptual Explanation: During the oliguric phase, the kidneys’ inability to excrete
potassium leads to hyperkalemia, which is a life-threatening complication.
4. A patient presents to the ED with a blood glucose of 750 mg/dL, no ketones in the urine,
and profound dehydration. Which condition does the nurse suspect?
A. Diabetic Ketoacidosis (DKA)
B. Metabolic Acidosis
C. Hypoglycemic unawareness
D. Hyperglycemic Hyperosmolar State (HHS)
, Answer: D
Conceptual Explanation: HHS is characterized by extreme hyperglycemia and
dehydration without the significant ketosis found in DKA.
5. Which assessment finding in a patient with a chest tube requires immediate intervention?
A. Fluctuation of water in the suction control chamber
B. Serosanguinous drainage in the collection chamber
C. Intermittent bubbling in the water-seal chamber during coughing
D. Continuous bubbling in the water-seal chamber
Answer: D
Conceptual Explanation: Continuous bubbling in the water-seal chamber indicates a
persistent air leak in the system or from the patient, requiring immediate troubleshooting.
6. A patient with a T4 spinal cord injury reports a sudden, severe headache and is found to
have a BP of 190/110 mmHg. What is the priority nursing action?
A. Administer an antihypertensive medication
B. Place the patient in a supine position
C. Check the patient’s bladder for distension
D. Call the physician for a neurological consult
Answer: C
