LATEST NUR 445 FINAL EXAM QUESTIONS AND CORRECT
ANSWERS WITH RATIONALES
Core Domains:
- Critical Care and Hemodynamics
- Neurological and Sensory Disorders
- Renal and Gastrointestinal Disorders
- Endocrine Emergencies
- Leadership, Ethics, and Professional Practice
- Emergency and Disaster Nursing
Introduction
This comprehensive examination assesses the candidate's mastery of
advanced medical-surgical and critical care nursing concepts. It
evaluates clinical judgment, prioritization, leadership, and evidence-
based decision-making in high-acuity settings. Questions emphasize
real-world application, interdisciplinary collaboration, and adherence
to professional standards.
SECTION ONE: QUESTIONS 1–50
Question 1
What medication is used to decrease increased intracranial pressure
(ICP)?
A. Furosemide
B. Mannitol
C. Dexamethasone
D. Acetazolamide
B. Mannitol
, RATIONALE: Mannitol is an osmotic diuretic that reduces ICP by
creating an osmotic gradient across the blood-brain barrier, pulling fluid
out of brain cells and into the intravascular compartment.
Question 2
A nurse is caring for a patient who suddenly develops shortness of
breath, tachycardia, and chest pain 12 hours post-operation.
Oxygen saturation drops to 86%. What is the priority action?
A. Encourage ambulation
B. Suspect pulmonary embolism and activate rapid response
C. Give oral fluids
D. Reassess in 30 minutes
B. Suspect pulmonary embolism and activate rapid response
RATIONALE: Sudden hypoxia and chest pain post-operation
strongly suggest pulmonary embolism, requiring immediate emergency
response.
Question 3
For a rhythm to be considered sinus tachycardia, what will the
ventricular rate be?
A. 40-60 bpm
B. 60-100 bpm
C. 100-149 bpm
D. 150-250 bpm
C. 100-149 bpm
RATIONALE: Sinus tachycardia is defined by a ventricular rate of
100-149 beats per minute with normal P waves and a regular rhythm.
Question 4
A patient with DKA is receiving insulin therapy. Which electrolyte
must be closely monitored?
, A. Calcium
B. Potassium
C. Sodium
D. Magnesium
B. Potassium
RATIONALE: Insulin shifts potassium into cells, causing dangerous
hypokalemia. Potassium levels must be monitored closely during DKA
treatment.
Question 5
What is the normal range for central venous pressure (CVP)?
A. 2-6 mmHg
B. 4-12 mmHg
C. 8-15 mmHg
D. 10-20 mmHg
A. 2-6 mmHg
RATIONALE: Normal CVP is 2-6 mmHg. Low CVP indicates
hypovolemia; elevated CVP suggests fluid overload or right heart
failure.
Question 6
A patient with a spinal cord injury at T6 suddenly develops severe
headache, hypertension, and bradycardia. What is the priority
action?
A. Administer antihypertensive medications immediately
B. Check for bladder distention or fecal impaction
C. Elevate the head of the bed
D. Notify the provider
B. Check for bladder distention or fecal impaction
ANSWERS WITH RATIONALES
Core Domains:
- Critical Care and Hemodynamics
- Neurological and Sensory Disorders
- Renal and Gastrointestinal Disorders
- Endocrine Emergencies
- Leadership, Ethics, and Professional Practice
- Emergency and Disaster Nursing
Introduction
This comprehensive examination assesses the candidate's mastery of
advanced medical-surgical and critical care nursing concepts. It
evaluates clinical judgment, prioritization, leadership, and evidence-
based decision-making in high-acuity settings. Questions emphasize
real-world application, interdisciplinary collaboration, and adherence
to professional standards.
SECTION ONE: QUESTIONS 1–50
Question 1
What medication is used to decrease increased intracranial pressure
(ICP)?
A. Furosemide
B. Mannitol
C. Dexamethasone
D. Acetazolamide
B. Mannitol
, RATIONALE: Mannitol is an osmotic diuretic that reduces ICP by
creating an osmotic gradient across the blood-brain barrier, pulling fluid
out of brain cells and into the intravascular compartment.
Question 2
A nurse is caring for a patient who suddenly develops shortness of
breath, tachycardia, and chest pain 12 hours post-operation.
Oxygen saturation drops to 86%. What is the priority action?
A. Encourage ambulation
B. Suspect pulmonary embolism and activate rapid response
C. Give oral fluids
D. Reassess in 30 minutes
B. Suspect pulmonary embolism and activate rapid response
RATIONALE: Sudden hypoxia and chest pain post-operation
strongly suggest pulmonary embolism, requiring immediate emergency
response.
Question 3
For a rhythm to be considered sinus tachycardia, what will the
ventricular rate be?
A. 40-60 bpm
B. 60-100 bpm
C. 100-149 bpm
D. 150-250 bpm
C. 100-149 bpm
RATIONALE: Sinus tachycardia is defined by a ventricular rate of
100-149 beats per minute with normal P waves and a regular rhythm.
Question 4
A patient with DKA is receiving insulin therapy. Which electrolyte
must be closely monitored?
, A. Calcium
B. Potassium
C. Sodium
D. Magnesium
B. Potassium
RATIONALE: Insulin shifts potassium into cells, causing dangerous
hypokalemia. Potassium levels must be monitored closely during DKA
treatment.
Question 5
What is the normal range for central venous pressure (CVP)?
A. 2-6 mmHg
B. 4-12 mmHg
C. 8-15 mmHg
D. 10-20 mmHg
A. 2-6 mmHg
RATIONALE: Normal CVP is 2-6 mmHg. Low CVP indicates
hypovolemia; elevated CVP suggests fluid overload or right heart
failure.
Question 6
A patient with a spinal cord injury at T6 suddenly develops severe
headache, hypertension, and bradycardia. What is the priority
action?
A. Administer antihypertensive medications immediately
B. Check for bladder distention or fecal impaction
C. Elevate the head of the bed
D. Notify the provider
B. Check for bladder distention or fecal impaction
