3276 Adult Nursing II
Final Exam Review
(Questions & Solutions)
2025
1
, 1. Multiple Choice
Question:
A 82‑year‑old male with a history of congestive heart failure, chronic
kidney disease, and diabetes presents to the ED with acute dyspnea and
confusion. Which initial assessment parameter is most critical to
determine his imminent risk?
- A. Temperature
- B. Oxygen saturation
- C. Blood glucose
- D. Jugular venous distension
Correct ANS:
B. Oxygen saturation
Rationale:
Oxygen saturation provides a rapid measure of tissue oxygenation. In
patients with multiple chronic comorbidities, hypoxemia may signal
imminent decompensation and necessitates urgent intervention.
---
2. Fill-in-the-Blank
Question:
The systematic framework consisting of assessment, diagnosis, planning,
implementation, and evaluation is known as the __________.
Correct ANS:
nursing process
Rationale:
The nursing process is the foundational structure for delivering
individualized, evidence‑based care. It is essential in both acute and
2
,chronic management, ensuring that interventions are continuously
reassessed and modified based on patient response.
---
3. True/False
Question:
True or False: Older adults with critical illness often present with atypical
symptoms such as confusion, falls, or generalized weakness rather than
classic signs of conditions like myocardial infarction or sepsis.
Correct ANS:
True
Rationale:
Due to age‑related physiologic changes and multiple comorbidities, older
adults frequently present atypically. Recognizing these subtler indicators
is vital to avoid delays in diagnosis and treatment.
---
4. Multiple Response
Question:
When conducting a comprehensive assessment for an acutely ill adult
with chronic health alterations, which components are essential? (Select
all that apply)
- A. Vital sign measurements and hemodynamic status
- B. Mental status and cognitive function
- C. Nutritional assessment and recent weight history
- D. Social, cultural, and psychosocial factors
- E. Patient’s astrological sign
Correct ANSs:
A, B, C, D
3
, Rationale:
A complete assessment integrates objective physiologic data, mental
status, nutritional history, and the patient's social context. An astrological
sign (E) is not relevant to clinical decision-making.
---
5. Multiple Choice
Question:
A 70‑year‑old female with COPD and heart failure presents with severe
pneumonia and respiratory distress. To optimize oxygenation while
minimizing the risk of ventilator‑induced lung injury, which ventilation
strategy is most appropriate?
- A. High tidal volume ventilation
- B. Lung‑protective ventilation with low tidal volumes and optimal PEEP
- C. Pressure‑controlled ventilation with minimal PEEP
- D. Immediate conversion to non‑invasive ventilation
Correct ANS:
B. Lung‑protective ventilation with low tidal volumes and optimal PEEP
Rationale:
Lung‑protective ventilation (using low tidal volumes around 6 mL/kg of
predicted body weight along with appropriate PEEP) minimizes alveolar
overdistension and injury. This strategy is key for patients with
compromised pulmonary reserves.
---
6. Fill-in-the-Blank
Question:
When adjusting medication dosages in patients with renal impairment,
nurses estimate drug clearance using calculations of __________
clearance.
4
Final Exam Review
(Questions & Solutions)
2025
1
, 1. Multiple Choice
Question:
A 82‑year‑old male with a history of congestive heart failure, chronic
kidney disease, and diabetes presents to the ED with acute dyspnea and
confusion. Which initial assessment parameter is most critical to
determine his imminent risk?
- A. Temperature
- B. Oxygen saturation
- C. Blood glucose
- D. Jugular venous distension
Correct ANS:
B. Oxygen saturation
Rationale:
Oxygen saturation provides a rapid measure of tissue oxygenation. In
patients with multiple chronic comorbidities, hypoxemia may signal
imminent decompensation and necessitates urgent intervention.
---
2. Fill-in-the-Blank
Question:
The systematic framework consisting of assessment, diagnosis, planning,
implementation, and evaluation is known as the __________.
Correct ANS:
nursing process
Rationale:
The nursing process is the foundational structure for delivering
individualized, evidence‑based care. It is essential in both acute and
2
,chronic management, ensuring that interventions are continuously
reassessed and modified based on patient response.
---
3. True/False
Question:
True or False: Older adults with critical illness often present with atypical
symptoms such as confusion, falls, or generalized weakness rather than
classic signs of conditions like myocardial infarction or sepsis.
Correct ANS:
True
Rationale:
Due to age‑related physiologic changes and multiple comorbidities, older
adults frequently present atypically. Recognizing these subtler indicators
is vital to avoid delays in diagnosis and treatment.
---
4. Multiple Response
Question:
When conducting a comprehensive assessment for an acutely ill adult
with chronic health alterations, which components are essential? (Select
all that apply)
- A. Vital sign measurements and hemodynamic status
- B. Mental status and cognitive function
- C. Nutritional assessment and recent weight history
- D. Social, cultural, and psychosocial factors
- E. Patient’s astrological sign
Correct ANSs:
A, B, C, D
3
, Rationale:
A complete assessment integrates objective physiologic data, mental
status, nutritional history, and the patient's social context. An astrological
sign (E) is not relevant to clinical decision-making.
---
5. Multiple Choice
Question:
A 70‑year‑old female with COPD and heart failure presents with severe
pneumonia and respiratory distress. To optimize oxygenation while
minimizing the risk of ventilator‑induced lung injury, which ventilation
strategy is most appropriate?
- A. High tidal volume ventilation
- B. Lung‑protective ventilation with low tidal volumes and optimal PEEP
- C. Pressure‑controlled ventilation with minimal PEEP
- D. Immediate conversion to non‑invasive ventilation
Correct ANS:
B. Lung‑protective ventilation with low tidal volumes and optimal PEEP
Rationale:
Lung‑protective ventilation (using low tidal volumes around 6 mL/kg of
predicted body weight along with appropriate PEEP) minimizes alveolar
overdistension and injury. This strategy is key for patients with
compromised pulmonary reserves.
---
6. Fill-in-the-Blank
Question:
When adjusting medication dosages in patients with renal impairment,
nurses estimate drug clearance using calculations of __________
clearance.
4
