NR 341 EXAM 2 -COMPLEX ADULT HEALTH
|ACTUAL QUESTIONS AND VERIFIED
ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
. A nurse is assessing a client who has suffered a nasal fracture. Which assessment would
the nurse perform first?
a. Facial pain
b. Vital signs
c. Bone displacement
d. Airway patentcy
CORRECT ANSWER
ANS: D Airway patentcy
A patent airway is the priority. The nurse first would make sure that the airway is patent
and then would determine whether the client is in pain and whether bone displacement
or blood loss has occurred.
Question 2
A nurse assesses a client who has a nasal fracture. The client reports constant nasal
drainage, a headache, and difficulty with vision. What action would the nurse take next?
a. Collect the nasal drainage on a piece of filter paper.
b. Encourage the client to blow his or her nose.
c. Perform a test focused on a neurologic examination.
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@THE STUDY VAULT
,d. Palpate the nose, face, and neck.
CORRECT ANSWER
ANS: A Collect the nasal drainage on a piece of filter paper
The client with nasal drainage after facial trauma could have a skull fracture resulting in
leakage of cerebrospinal fluid (CSF). CSF can be differentiated from regular drainage by
the fact that it forms a halo when dripped on filter paper and tests positive for glucose.
The other actions would be appropriate but are not as high a priority as assessing for CSF.
A CSF leak would increase the patient's risk for infection.
Question 3
A nurse teaches a client who had a supraglottic laryngectomy. Which technique would the
nurse teach the client to prevent aspiration?
a. Tilt the head back as far as possible when swallowing.
b. Swallow twice while bearing down.
c. Breathe slowly and deeply while swallowing.
d. Keep the head very still and straight while swallowing.
CORRECT ANSWER
ANS: B Swallow twice while bearing down.
The client post supraglottic laryngectomy has a high risk for aspiration. The nurse or
speech language pathologist teaches the client the supraglottic method of swallowing.
This includes placing a small amount of food in the mouth, performing the Valsalva
maneuver, then swallowing twice. The client sits upright. The client holds the breath
while swallowing twice. Keeping the head still and straight will not decrease the risk of
aspiration.
Question 4
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@THE STUDY VAULT
,A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for
development of obstructive sleep apnea?
a. A 26-year-old woman who is 8 months pregnant.
b. A 42-year-old man with gastroesophageal reflux disease.
c. A 55-year-old woman who is 50 lb (23 kg) overweight.
d. A 73-year-old man with type 2 diabetes mellitus.
CORRECT ANSWER
ANS: C 55-year-old woman who is 50 lb (23 kg) overweight.
The client at highest risk would be the one who is extremely overweight. None of the
other clients have risk factors for sleep apnea. Clients with sleep apnea may develop
gastroesophageal reflux.
Question 5
A nurse cares for a client who has hypertension that has not responded well to several
medications. The client states compliance is not an issue. What action would the nurse
take next?
a. Assess the client for obstructive sleep apnea.
b. Arrange a home sleep apnea test.
c. Encourage the client to begin exercising.
d. Schedule a polysomnography
CORRECT ANSWER
ANS: A Assess the client for obstructive sleep apnea.
Hypertension not responding to medications can be a sign of obstructive sleep apnea
(OSA). The nurse would assess the client using an evidence-based tool, such as the STOP-
Bang Sleep Apnea Questionnaire, the Epworth Sleepiness Scale, the Pittsburgh Sleep
3
@THE STUDY VAULT
, Quality Index, and the Multiple Sleep Latency Test. If the results of the assessment
indicate OSA may be a problem, the nurse would consult the primary health care
provider for further testing. An at-home sleep-study is often done prior to a
polysomnography. Excessive weight can contribute to OSA so exercising is always
encouraged, but this is not specific to assessing for OSA.
Question 6
A nurse cares for a client after radiation therapy for neck cancer. The client reports
extreme dry mouth. What action by the nurse is most appropriate?
a. Ask the client to gargle with mouthwash containing lidocaine.
b. Administer IV fluid boluses every 2 hours.
c. Explain that xerostomia may be a permanent side effect.
d. Assess the client's neck for redness and swelling.
CORRECT ANSWER
ANS: C Explain that xerostomia may be a permanent side effect.
Xerostomia, or dry mouth, is a potential side effect of radiation, particularly if the
salivary glands were in the radiation zone. Unfortunately, this may be long term or even
permanent. Gargling with lidocaine would not help. Increasing fluids is somewhat
helpful, but the client would be encouraged to drink. The client's neck may have redness
and swelling, but this finding is not related to the reported dry mouth.
Question 7
A nurse cares for a client who had a partial laryngectomy 10 days ago. The client states
that all food tastes bland. How would the nurse respond?
a. "I will consult the speech therapist to ensure you are swallowing properly." b. "This is
normal after surgery. What types of food do you like to eat?"
4
@THE STUDY VAULT
|ACTUAL QUESTIONS AND VERIFIED
ANSWERS|BRAND NEW 2026-2027
UPDATE|GRADED A+
Question 1
. A nurse is assessing a client who has suffered a nasal fracture. Which assessment would
the nurse perform first?
a. Facial pain
b. Vital signs
c. Bone displacement
d. Airway patentcy
CORRECT ANSWER
ANS: D Airway patentcy
A patent airway is the priority. The nurse first would make sure that the airway is patent
and then would determine whether the client is in pain and whether bone displacement
or blood loss has occurred.
Question 2
A nurse assesses a client who has a nasal fracture. The client reports constant nasal
drainage, a headache, and difficulty with vision. What action would the nurse take next?
a. Collect the nasal drainage on a piece of filter paper.
b. Encourage the client to blow his or her nose.
c. Perform a test focused on a neurologic examination.
1
@THE STUDY VAULT
,d. Palpate the nose, face, and neck.
CORRECT ANSWER
ANS: A Collect the nasal drainage on a piece of filter paper
The client with nasal drainage after facial trauma could have a skull fracture resulting in
leakage of cerebrospinal fluid (CSF). CSF can be differentiated from regular drainage by
the fact that it forms a halo when dripped on filter paper and tests positive for glucose.
The other actions would be appropriate but are not as high a priority as assessing for CSF.
A CSF leak would increase the patient's risk for infection.
Question 3
A nurse teaches a client who had a supraglottic laryngectomy. Which technique would the
nurse teach the client to prevent aspiration?
a. Tilt the head back as far as possible when swallowing.
b. Swallow twice while bearing down.
c. Breathe slowly and deeply while swallowing.
d. Keep the head very still and straight while swallowing.
CORRECT ANSWER
ANS: B Swallow twice while bearing down.
The client post supraglottic laryngectomy has a high risk for aspiration. The nurse or
speech language pathologist teaches the client the supraglottic method of swallowing.
This includes placing a small amount of food in the mouth, performing the Valsalva
maneuver, then swallowing twice. The client sits upright. The client holds the breath
while swallowing twice. Keeping the head still and straight will not decrease the risk of
aspiration.
Question 4
2
@THE STUDY VAULT
,A nurse assesses clients on the medical-surgical unit. Which client is at greatest risk for
development of obstructive sleep apnea?
a. A 26-year-old woman who is 8 months pregnant.
b. A 42-year-old man with gastroesophageal reflux disease.
c. A 55-year-old woman who is 50 lb (23 kg) overweight.
d. A 73-year-old man with type 2 diabetes mellitus.
CORRECT ANSWER
ANS: C 55-year-old woman who is 50 lb (23 kg) overweight.
The client at highest risk would be the one who is extremely overweight. None of the
other clients have risk factors for sleep apnea. Clients with sleep apnea may develop
gastroesophageal reflux.
Question 5
A nurse cares for a client who has hypertension that has not responded well to several
medications. The client states compliance is not an issue. What action would the nurse
take next?
a. Assess the client for obstructive sleep apnea.
b. Arrange a home sleep apnea test.
c. Encourage the client to begin exercising.
d. Schedule a polysomnography
CORRECT ANSWER
ANS: A Assess the client for obstructive sleep apnea.
Hypertension not responding to medications can be a sign of obstructive sleep apnea
(OSA). The nurse would assess the client using an evidence-based tool, such as the STOP-
Bang Sleep Apnea Questionnaire, the Epworth Sleepiness Scale, the Pittsburgh Sleep
3
@THE STUDY VAULT
, Quality Index, and the Multiple Sleep Latency Test. If the results of the assessment
indicate OSA may be a problem, the nurse would consult the primary health care
provider for further testing. An at-home sleep-study is often done prior to a
polysomnography. Excessive weight can contribute to OSA so exercising is always
encouraged, but this is not specific to assessing for OSA.
Question 6
A nurse cares for a client after radiation therapy for neck cancer. The client reports
extreme dry mouth. What action by the nurse is most appropriate?
a. Ask the client to gargle with mouthwash containing lidocaine.
b. Administer IV fluid boluses every 2 hours.
c. Explain that xerostomia may be a permanent side effect.
d. Assess the client's neck for redness and swelling.
CORRECT ANSWER
ANS: C Explain that xerostomia may be a permanent side effect.
Xerostomia, or dry mouth, is a potential side effect of radiation, particularly if the
salivary glands were in the radiation zone. Unfortunately, this may be long term or even
permanent. Gargling with lidocaine would not help. Increasing fluids is somewhat
helpful, but the client would be encouraged to drink. The client's neck may have redness
and swelling, but this finding is not related to the reported dry mouth.
Question 7
A nurse cares for a client who had a partial laryngectomy 10 days ago. The client states
that all food tastes bland. How would the nurse respond?
a. "I will consult the speech therapist to ensure you are swallowing properly." b. "This is
normal after surgery. What types of food do you like to eat?"
4
@THE STUDY VAULT
