ECPI VB Nur 168 Concepts 3 Final
Review exam newest update 2025 with
all complete questions and correct
answer
A nurse is monitoring a patient who is receiving an IV infusion of normal saline. The
patient is apprehensive and presents with a pounding headache, rapid pulse rate, chills,
and dyspnea. What would be the nurse's priority intervention related to these
symptoms?
A. Discontinue the infusion immediately, monitor vital signs, and report findings to
primary care provider immediately.
B. Slow the rate of infusion, notify the primary care provider immediately and monitor
vital signs.
C. Pinch off the catheter or secure the system to prevent entry of air, place the patient in
the Trendelenburg position, and call for assistance.
D. Discontinue the infusion immediately, apply warm compresses to the site, and restart
the IV at another site. - CORRECT ANSWER A
A nurse carefully assesses the acid-base balance of a patient whose carbonic acid
(H2CO3) level is decreased. This is most likely a patient with damage to the:
A. Kidneys
B. Lungs
C. Adrenal glands
D. Blood vessels - CORRECT ANSWER B
A nurse is monitoring a patient who is diagnosed with hypokalemia. Which nursing
intervention would be appropriate for this patient?
A. Encourage foods and fluids with high sodium content.
B. Administer oral K supplements as ordered.
C. Caution the patient about eating foods high in potassium content.
D. Discuss calcium-losing aspects of nicotine and alcohol use. - CORRECT ANSWER B
A nurse is initiating a peripheral venous access IV infusion for a patient. Following the
procedure, the nurse observes that the fluid does not flow easily into the vein and the
skin around the insertion site is edematous and cool to the touch. What would be the
nurse's next action related to these findings?
A. Reposition the extremity and raise the height of the IV pole.
B. Apply pressure to the dressing on the IV.
C. Pull the catheter out slightly and reinsert it.
D. Put on gloves; remove the catheter - CORRECT ANSWER D
,When monitoring an IV site and infusion, a nurse notes pain at the access site with
erythema and edema. What grade of phlebitis would the nurse document?
A. 1
B. 2
C. 3
D. 4 - CORRECT ANSWER B
A nurse is administering a blood transfusion for a patient following surgery. During the
transfusion, the patient displays signs of dyspnea, dry cough, and pulmonary edema.
What would be the nurse's priority actions related to these symptoms?
A. Slow or stop the infusion; monitor vital signs, notify the health care provider, place
the patient in upright position with feet dependent.
B. Stop the transfusion immediately and keep the vein open with normal saline, notify
the health care provider stat, administer antihistamine parenterally as needed.
C. Stop the transfusion immediately and keep the vein open with normal saline, notify
the health care provider, and treat symptoms.
D. Stop the infusion immediately, obtain a culture of the patient's blood, monitor vital
signs, notify the health care provider, administer antibiotics stat. - CORRECT ANSWER
A
A nurse is performing physical assessments for patients with fluid imbalance. Which
finding indicates a fluid volume excess?
A. A pinched and drawn facial expression
B. Deep, rapid respirations.
C. Moist crackles heard upon auscultation
D. Tachycardia - CORRECT ANSWER C
During rounds, a charge nurse hears the patient care technician yelling loudly to a
patient regarding a transfer from the bed to chair. Upon entering the room, what is the
nurse's BEST response?
A."You need to speak to the patient quietly so you don't disturb the other patients."
B. "Let me help you with your transfer technique."
C."When you are finished, be sure to apologize for your rough demeanor."
D. "When your patient is safe and comfortable, meet me at the desk." - CORRECT
ANSWER D
A public health nurse is leaving the home of a young mother who has a special needs
baby. The neighbor states, "How is she doing, since the baby's father is no help?" What
is the nurse's BEST response to the neighbor?
A. "New mothers need support."
B. "The lack of a father is difficult."
C. "How are you today?"
D. "It is a very sad situation." - CORRECT ANSWER A
A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and
dehydration. During the admission interview, the nurse should implement which
communication techniques to elicit the most information from the parents?
,A. The use of reflective questions
B. The use of closed questions
C. The use of assertive questions
D. The use of clarifying questions - CORRECT ANSWER D
A nurse enters a patient's room and examines the patient's IV fluids and cardiac
monitor. The patient states, "Well, I haven't seen you before. Who are you?" What is the
nurse's BEST response?
A. "I'm just the IV therapist checking your IV."
B. "I've been transferred to this division and will be caring for you."
C. "I'm sorry, my name is John Smith and I am your nurse."
D. "My name is John Smith, I am your nurse and I'll be caring for you until 11 PM." -
CORRECT ANSWER D
A nurse enters the room of a patient with cancer. The patient is crying and states, "I feel
so alone." Which response by the nurse is the most therapeutic action?
A. The nurse stands at the patient's bedside and states, "I understand how you feel. My
mother said the same thing when she was ill."
B. The nurse places a hand on the patient's arm and states, "You feel so alone."
C. The nurse stands in the patient's room and asks, "Why do you feel so alone? Your
wife has been here every day."
D. The nurse holds the patient's hand and asks, "What makes you feel so alone?" -
CORRECT ANSWER D
A nurse caring for a patient who is hospitalized following a double mastectomy is
preparing a discharge plan for the patient. Which action should be the focus of this
termination phase of the helping relationship?
A. Determining the progress made in achieving established goals
B. Clarifying when the patient should take medications
C. Reporting the progress made in teaching to the staff
D. Including all family members in the teaching session - CORRECT ANSWER A
A nursing student is nervous and concerned about working at a clinical facility. Which
action would BEST decrease anxiety and ensure success in the student's provision of
patient care?
A. Determining the established goals of the institution
B. Ensuring that verbal and nonverbal communication is congruent
C. Engaging in self-talk to plan the day and decrease fear
D. Speaking with fellow colleagues about how they feel - CORRECT ANSWER C
A nurse in the rehabilitation division states to the head nurse: "I need the day off and
you didn't give it to me!" The head nurse replies, "Well, I wasn't aware you needed the
day off, and it isn't possible since staffing is so inadequate." Instead of this exchange,
what communication by the nurse would have been more effective?
A. "I placed a request to have 8th of August off, but I'm working and I have a doctor's
appointment."
, B. "I would like to discuss my schedule with you. I requested the 8th of August off for a
doctor's appointment. Could I make an appointment?"
C. "I will need to call in on the 8th of August because I have a doctor's appointment."
D. "Since you didn't give me the 8th of August off, will I need to find someone to work
for me?" - CORRECT ANSWER B
During a nursing staff meeting, the nurses resolve a problem of delayed documentation
by agreeing unanimously that they will make sure all vital signs are reported and
charted within 15 minutes following assessment. This is an example of which
characteristics of effective communication? Select all that apply.
A. Group decision making
B. Group leadership
C. Group power
D. Group identity
E. Group patterns of interaction
F. Group cohesiveness - CORRECT ANSWER A, D, E, F
A nurse notices a patient is walking to the bathroom with a stooped gait, facial
grimacing, and gasping sounds. Based on these nonverbal clues, for which condition
would the nurse assess?
A. Pain
B. Anxiety
C. Depression
D. Fluid volume deficit - CORRECT ANSWER A
A nursing student is preparing to administer morning care to a patient. What is the
MOST important question that the nursing student should ask the patient about
personal hygiene?
A. "Would you prefer a bath or a shower?"
B. "May I help you with a bed bath now or later this morning?"
C. "I will be giving you your bath. Do you use soap or shower gel?"
D. "I prefer a shower in the evening. When would you like your bath?" - CORRECT
ANSWER B
A nurse is providing instruction to a patient regarding the procedure to change a
colostomy bag. During the teaching session, the patient asks, "What type of foods
should I avoid to prevent gas?" The patient's question allows for what type of
communication on the nurse's part?
A. A closed-ended answer
B. Information clarification
C. The nurse to give advice
D. Assertive behavior - CORRECT ANSWER B
When interacting with a patient, the nurse answers, "I am sure everything will be fine.
You have nothing to worry about." This is an example of what type of inappropriate
communication technique?
Review exam newest update 2025 with
all complete questions and correct
answer
A nurse is monitoring a patient who is receiving an IV infusion of normal saline. The
patient is apprehensive and presents with a pounding headache, rapid pulse rate, chills,
and dyspnea. What would be the nurse's priority intervention related to these
symptoms?
A. Discontinue the infusion immediately, monitor vital signs, and report findings to
primary care provider immediately.
B. Slow the rate of infusion, notify the primary care provider immediately and monitor
vital signs.
C. Pinch off the catheter or secure the system to prevent entry of air, place the patient in
the Trendelenburg position, and call for assistance.
D. Discontinue the infusion immediately, apply warm compresses to the site, and restart
the IV at another site. - CORRECT ANSWER A
A nurse carefully assesses the acid-base balance of a patient whose carbonic acid
(H2CO3) level is decreased. This is most likely a patient with damage to the:
A. Kidneys
B. Lungs
C. Adrenal glands
D. Blood vessels - CORRECT ANSWER B
A nurse is monitoring a patient who is diagnosed with hypokalemia. Which nursing
intervention would be appropriate for this patient?
A. Encourage foods and fluids with high sodium content.
B. Administer oral K supplements as ordered.
C. Caution the patient about eating foods high in potassium content.
D. Discuss calcium-losing aspects of nicotine and alcohol use. - CORRECT ANSWER B
A nurse is initiating a peripheral venous access IV infusion for a patient. Following the
procedure, the nurse observes that the fluid does not flow easily into the vein and the
skin around the insertion site is edematous and cool to the touch. What would be the
nurse's next action related to these findings?
A. Reposition the extremity and raise the height of the IV pole.
B. Apply pressure to the dressing on the IV.
C. Pull the catheter out slightly and reinsert it.
D. Put on gloves; remove the catheter - CORRECT ANSWER D
,When monitoring an IV site and infusion, a nurse notes pain at the access site with
erythema and edema. What grade of phlebitis would the nurse document?
A. 1
B. 2
C. 3
D. 4 - CORRECT ANSWER B
A nurse is administering a blood transfusion for a patient following surgery. During the
transfusion, the patient displays signs of dyspnea, dry cough, and pulmonary edema.
What would be the nurse's priority actions related to these symptoms?
A. Slow or stop the infusion; monitor vital signs, notify the health care provider, place
the patient in upright position with feet dependent.
B. Stop the transfusion immediately and keep the vein open with normal saline, notify
the health care provider stat, administer antihistamine parenterally as needed.
C. Stop the transfusion immediately and keep the vein open with normal saline, notify
the health care provider, and treat symptoms.
D. Stop the infusion immediately, obtain a culture of the patient's blood, monitor vital
signs, notify the health care provider, administer antibiotics stat. - CORRECT ANSWER
A
A nurse is performing physical assessments for patients with fluid imbalance. Which
finding indicates a fluid volume excess?
A. A pinched and drawn facial expression
B. Deep, rapid respirations.
C. Moist crackles heard upon auscultation
D. Tachycardia - CORRECT ANSWER C
During rounds, a charge nurse hears the patient care technician yelling loudly to a
patient regarding a transfer from the bed to chair. Upon entering the room, what is the
nurse's BEST response?
A."You need to speak to the patient quietly so you don't disturb the other patients."
B. "Let me help you with your transfer technique."
C."When you are finished, be sure to apologize for your rough demeanor."
D. "When your patient is safe and comfortable, meet me at the desk." - CORRECT
ANSWER D
A public health nurse is leaving the home of a young mother who has a special needs
baby. The neighbor states, "How is she doing, since the baby's father is no help?" What
is the nurse's BEST response to the neighbor?
A. "New mothers need support."
B. "The lack of a father is difficult."
C. "How are you today?"
D. "It is a very sad situation." - CORRECT ANSWER A
A 3-year-old child is being admitted to a medical division for vomiting, diarrhea, and
dehydration. During the admission interview, the nurse should implement which
communication techniques to elicit the most information from the parents?
,A. The use of reflective questions
B. The use of closed questions
C. The use of assertive questions
D. The use of clarifying questions - CORRECT ANSWER D
A nurse enters a patient's room and examines the patient's IV fluids and cardiac
monitor. The patient states, "Well, I haven't seen you before. Who are you?" What is the
nurse's BEST response?
A. "I'm just the IV therapist checking your IV."
B. "I've been transferred to this division and will be caring for you."
C. "I'm sorry, my name is John Smith and I am your nurse."
D. "My name is John Smith, I am your nurse and I'll be caring for you until 11 PM." -
CORRECT ANSWER D
A nurse enters the room of a patient with cancer. The patient is crying and states, "I feel
so alone." Which response by the nurse is the most therapeutic action?
A. The nurse stands at the patient's bedside and states, "I understand how you feel. My
mother said the same thing when she was ill."
B. The nurse places a hand on the patient's arm and states, "You feel so alone."
C. The nurse stands in the patient's room and asks, "Why do you feel so alone? Your
wife has been here every day."
D. The nurse holds the patient's hand and asks, "What makes you feel so alone?" -
CORRECT ANSWER D
A nurse caring for a patient who is hospitalized following a double mastectomy is
preparing a discharge plan for the patient. Which action should be the focus of this
termination phase of the helping relationship?
A. Determining the progress made in achieving established goals
B. Clarifying when the patient should take medications
C. Reporting the progress made in teaching to the staff
D. Including all family members in the teaching session - CORRECT ANSWER A
A nursing student is nervous and concerned about working at a clinical facility. Which
action would BEST decrease anxiety and ensure success in the student's provision of
patient care?
A. Determining the established goals of the institution
B. Ensuring that verbal and nonverbal communication is congruent
C. Engaging in self-talk to plan the day and decrease fear
D. Speaking with fellow colleagues about how they feel - CORRECT ANSWER C
A nurse in the rehabilitation division states to the head nurse: "I need the day off and
you didn't give it to me!" The head nurse replies, "Well, I wasn't aware you needed the
day off, and it isn't possible since staffing is so inadequate." Instead of this exchange,
what communication by the nurse would have been more effective?
A. "I placed a request to have 8th of August off, but I'm working and I have a doctor's
appointment."
, B. "I would like to discuss my schedule with you. I requested the 8th of August off for a
doctor's appointment. Could I make an appointment?"
C. "I will need to call in on the 8th of August because I have a doctor's appointment."
D. "Since you didn't give me the 8th of August off, will I need to find someone to work
for me?" - CORRECT ANSWER B
During a nursing staff meeting, the nurses resolve a problem of delayed documentation
by agreeing unanimously that they will make sure all vital signs are reported and
charted within 15 minutes following assessment. This is an example of which
characteristics of effective communication? Select all that apply.
A. Group decision making
B. Group leadership
C. Group power
D. Group identity
E. Group patterns of interaction
F. Group cohesiveness - CORRECT ANSWER A, D, E, F
A nurse notices a patient is walking to the bathroom with a stooped gait, facial
grimacing, and gasping sounds. Based on these nonverbal clues, for which condition
would the nurse assess?
A. Pain
B. Anxiety
C. Depression
D. Fluid volume deficit - CORRECT ANSWER A
A nursing student is preparing to administer morning care to a patient. What is the
MOST important question that the nursing student should ask the patient about
personal hygiene?
A. "Would you prefer a bath or a shower?"
B. "May I help you with a bed bath now or later this morning?"
C. "I will be giving you your bath. Do you use soap or shower gel?"
D. "I prefer a shower in the evening. When would you like your bath?" - CORRECT
ANSWER B
A nurse is providing instruction to a patient regarding the procedure to change a
colostomy bag. During the teaching session, the patient asks, "What type of foods
should I avoid to prevent gas?" The patient's question allows for what type of
communication on the nurse's part?
A. A closed-ended answer
B. Information clarification
C. The nurse to give advice
D. Assertive behavior - CORRECT ANSWER B
When interacting with a patient, the nurse answers, "I am sure everything will be fine.
You have nothing to worry about." This is an example of what type of inappropriate
communication technique?
