NR 341 Complex Adult Health Final Exam 3
Questions and Answers with Rationales
2024/2025
1. A patient with COPD is receiving oxygen via nasal cannula at 4 L/min. Which
assessment requires immediate action?
A. Respiratory rate of 10 breaths/min
B. Oxygen saturation of 90%
C. Barrel-shaped chest
D. Use of accessory muscles
Correct Answer: A. Respiratory rate of 10 breaths/min
Rationale: A low respiratory rate in a COPD patient receiving oxygen indicates
possible CO₂ retention and respiratory depression due to hypoxic drive
suppression.
2. Which of the following lab results is most concerning in a patient with
congestive heart failure (CHF)?
,A. B-type natriuretic peptide (BNP) 950 pg/mL
B. Potassium 3.2 mEq/L
C. Hemoglobin 11.5 g/dL
D. Sodium 137 mEq/L
Correct Answer: B. Potassium 3.2 mEq/L
Rationale: Hypokalemia increases the risk of digoxin toxicity and dysrhythmias in
CHF patients, especially if taking loop diuretics.
3. A nurse is caring for a patient who has had a thoracentesis. Which finding
requires immediate action?
A. Blood pressure of 92/60 mmHg
B. Pain at the puncture site
C. Asymmetrical chest movement
D. Slight blood on the dressing
Correct Answer: C. Asymmetrical chest movement
Rationale: This could indicate a pneumothorax, a serious complication of
thoracentesis requiring urgent attention.
4. A nurse assesses a client with pneumonia. Which finding indicates the need
for immediate intervention?
A. Crackles in the lung bases
B. Fever of 101.2°F
, C. Restlessness and confusion
D. Productive cough with green sputum
Correct Answer: C. Restlessness and confusion
Rationale: These may indicate hypoxia or sepsis, both of which require immediate
medical intervention.
5. Which ECG change is most concerning in a patient receiving furosemide?
A. Peaked T waves
B. Flattened T waves and U waves
C. Shortened QT interval
D. Tall P waves
Correct Answer: B. Flattened T waves and U waves
Rationale: These changes suggest hypokalemia, a common side effect of
furosemide (a loop diuretic).
6. A client is 24 hours post-lobectomy. Which intervention should the nurse
prioritize?
A. Monitor pain levels
B. Encourage fluid intake
C. Assist with incentive spirometry
D. Monitor bowel sounds
Questions and Answers with Rationales
2024/2025
1. A patient with COPD is receiving oxygen via nasal cannula at 4 L/min. Which
assessment requires immediate action?
A. Respiratory rate of 10 breaths/min
B. Oxygen saturation of 90%
C. Barrel-shaped chest
D. Use of accessory muscles
Correct Answer: A. Respiratory rate of 10 breaths/min
Rationale: A low respiratory rate in a COPD patient receiving oxygen indicates
possible CO₂ retention and respiratory depression due to hypoxic drive
suppression.
2. Which of the following lab results is most concerning in a patient with
congestive heart failure (CHF)?
,A. B-type natriuretic peptide (BNP) 950 pg/mL
B. Potassium 3.2 mEq/L
C. Hemoglobin 11.5 g/dL
D. Sodium 137 mEq/L
Correct Answer: B. Potassium 3.2 mEq/L
Rationale: Hypokalemia increases the risk of digoxin toxicity and dysrhythmias in
CHF patients, especially if taking loop diuretics.
3. A nurse is caring for a patient who has had a thoracentesis. Which finding
requires immediate action?
A. Blood pressure of 92/60 mmHg
B. Pain at the puncture site
C. Asymmetrical chest movement
D. Slight blood on the dressing
Correct Answer: C. Asymmetrical chest movement
Rationale: This could indicate a pneumothorax, a serious complication of
thoracentesis requiring urgent attention.
4. A nurse assesses a client with pneumonia. Which finding indicates the need
for immediate intervention?
A. Crackles in the lung bases
B. Fever of 101.2°F
, C. Restlessness and confusion
D. Productive cough with green sputum
Correct Answer: C. Restlessness and confusion
Rationale: These may indicate hypoxia or sepsis, both of which require immediate
medical intervention.
5. Which ECG change is most concerning in a patient receiving furosemide?
A. Peaked T waves
B. Flattened T waves and U waves
C. Shortened QT interval
D. Tall P waves
Correct Answer: B. Flattened T waves and U waves
Rationale: These changes suggest hypokalemia, a common side effect of
furosemide (a loop diuretic).
6. A client is 24 hours post-lobectomy. Which intervention should the nurse
prioritize?
A. Monitor pain levels
B. Encourage fluid intake
C. Assist with incentive spirometry
D. Monitor bowel sounds
