NR 283: Final Exam Questions and Answers
Latest 2025/2026 – Chamberlain College of
Nursing
1. During the evaluation phase of the nursing process, the nurse notes that the patient’s pain
remains 7/10 after 30 minutes of the prescribed analgesic. Which action best demonstrates
clinical judgment?
A. Repeat the dose immediately
B. Reassess the patient in another 30 minutes
C. Notify the provider and discuss alternative therapy
D. Document the pain score and take no further action
Correct Answer: C
Rationale: Evaluation determines intervention effectiveness; persistent severe pain warrants
provider collaboration for plan adjustment.
2. A 4-year-old is admitted with suspected sepsis. Which vital-sign change is the earliest
indicator of impending septic shock?
A. Narrowed pulse pressure
B. Tachypnea
C. Bradycardia
D. Hypertension
Correct Answer: B
Rationale: Tachypnea is an early compensatory response to metabolic acidosis and hypoxemia in
sepsis before hypotension occurs.
3. When preparing to administer a new prescription for lisinopril 5 mg PO, which laboratory
result requires immediate follow-up?
A. Serum sodium 138 mEq/L
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B. Serum potassium 5.8 mEq/L
C. Serum chloride 100 mEq/L
D. Serum glucose 95 mg/dL
Correct Answer: B
Rationale: Lisinopril can increase potassium; a level of 5.8 mEq/L places the patient at risk for
life-threatening dysrhythmias.
4. The nurse is caring for an immunocompromised adult. Which infection-control action has the
highest priority?
A. Wearing an N95 respirator during all contact
B. Placing the patient in a private negative-pressure room
C. Performing hand hygiene before and after every patient contact
D. Limiting visitors to 30 minutes per day
Correct Answer: C
Rationale: Hand hygiene is the single most effective measure to prevent transmission of
pathogens in all settings.
5. A 15-month-old weighs 10 kg. The safe dose range of acetaminophen is 10–15 mg/kg/dose
q6h. Which ordered dose is safe?
A. 80 mg q6h
B. 100 mg q6h
C. 160 mg q6h
D. 200 mg q6h
Correct Answer: C
Rationale: 10 kg × 15 mg/kg = 150 mg; 160 mg is the nearest standard liquid concentration
within safe range.
6. The nurse witnesses a colleague documenting vital signs she did not measure. Which ethical
principle is being violated?
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A. Beneficence
B. Nonmaleficence
C. Veracity
D. Fidelity
Correct Answer: C
Rationale: Veracity requires truthfulness; charting data not obtained is deceptive and
compromises patient safety.
7. During morning assessment, the nurse notes a 78-year-old patient’s systolic blood pressure
dropped from 140 mmHg to 98 mmHg after receiving an antihypertensive. The patient denies
dizziness. What is the priority nursing action?
A. Hold the next dose and document
B. Obtain orthostatic vital signs
C. Increase oral fluid intake
D. Discontinue all antihypertensives
Correct Answer: B
Rationale: Orthostatic measurements clarify whether the drop is positional and guide subsequent
intervention.
8. A school-age child with asthma is taught to use a peak-flow meter. Which value indicates the
child’s personal best should be reassessed?
A. 50% of personal best
B. 60% of personal best
C. 80% of personal best
D. 100% of personal best
Correct Answer: A
Rationale: Readings ≤50% signal severe airway obstruction and require immediate
bronchodilator therapy and provider contact.
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9. The nurse is preparing insulin lispro for a patient with type 1 diabetes. Which injection
technique is correct?
A. Inject into the deltoid and massage vigorously
B. Administer at a 90-degree angle with the patient lying supine
C. Give 15 minutes before the meal into subcutaneous tissue
D. Roll the vial between palms to warm before drawing up
Correct Answer: C
Rationale: Lispro is rapid-acting; administering 15 min before eating ensures onset coincides
with carbohydrate absorption.
10. A 6-year-old is post-tonsillectomy. Which finding requires immediate intervention?
A. Complaint of a sore throat
B. Frequent swallowing
C. Pain rating 4/10
D. Temperature 37.2 °C
Correct Answer: B
Rationale: Frequent swallowing may indicate posterior bleeding trickling down the throat, a life-
threatening complication.
11. The nurse is educating an older adult on warfarin therapy. Which statement demonstrates
understanding?
A. “I will eat spinach daily for iron.”
B. “I will have my INR checked every month.”
C. “I will take ibuprofen for arthritis pain.”
D. “I will double my dose if I forget yesterday’s pill.”
Correct Answer: B
Rationale: Monthly INR monitoring ensures the warfarin dose maintains therapeutic
anticoagulation and minimizes bleeding risk.