NUR 176
Concepts of Adult Health Nursing for the
Practical Nurse I
Proctored Midterm Exam Review
(With Solutions)
2026
1
,1. A 68-year-old COPD patient is admitted with acute shortness of
breath and increased wheezing. Which intervention should the nurse
prioritize? a) Administer high-flow oxygen via non-rebreather mask b)
Encourage deep breathing and coughing exercises c) Administer
prescribed bronchodilators immediately d) Instruct strict bed rest
until symptoms improve
Answer: c) Administer prescribed bronchodilators immediately
Rationale: Bronchodilators are first-line therapy to relieve
bronchospasm in COPD exacerbation, improving airflow. High-flow
oxygen must be used cautiously to avoid CO2 retention.
2. A patient with congestive heart failure is prescribed furosemide.
What electrolyte imbalance should the nurse closely monitor? a)
Hyperkalemia b) Hypokalemia c) Hypernatremia d) Hyponatremia
Answer: b) Hypokalemia Rationale: Furosemide is a loop diuretic
causing potassium loss, which can lead to hypokalemia. Monitoring
potassium is essential to avoid arrhythmias.
3. Which lab test is most reliable for monitoring long-term glucose
control in diabetic adults? a) Fasting blood glucose b) Random blood
glucose c) HbA1c d) Oral glucose tolerance test
Answer: c) HbA1c Rationale: HbA1c reflects average blood glucose
levels over 2-3 months and is used to monitor diabetes control.
4. A patient post-thyroidectomy shows signs of tetany, including
muscle spasms and tingling. What electrolyte imbalance is likely
responsible? a) Hypercalcemia b) Hypocalcemia c)
Hypermagnesemia d) Hypomagnesemia
Answer: b) Hypocalcemia Rationale: Parathyroid damage during
thyroidectomy can cause hypocalcemia, leading to tetany.
5. During assessment of a patient with suspected deep vein
2
, thrombosis (DVT), which sign is most specific? a) Edema of the limb
b) Homan’s sign (calf pain on dorsiflexion) c) Warmth and redness
over the affected vein d) Unilateral leg swelling greater than 2 cm
compared to contralateral leg
Answer: d) Unilateral leg swelling greater than 2 cm compared to
contralateral leg Rationale: While all may occur, the significant
unilateral limb swelling is more specific for DVT.
6. What is the primary purpose of administering lisinopril to a patient
with hypertension? a) Increase heart rate b) Dilate blood vessels and
decrease blood pressure c) Retain sodium and water d) Increase
cardiac contractility
Answer: b) Dilate blood vessels and decrease blood pressure
Rationale: Lisinopril is an ACE inhibitor that reduces
vasoconstriction and lowers blood pressure.
TRUE / FALSE (T/F)
7. T/F: Patients with chronic kidney disease typically exhibit
hyperkalemia due to impaired potassium excretion. Answer: True
Rationale: Damaged kidneys cannot excrete potassium effectively,
leading to hyperkalemia.
8. T/F: Administering beta-blockers is contraindicated in patients with
asthma due to risk of bronchospasm. Answer: True Rationale: Non-
selective beta-blockers can cause bronchoconstriction and worsen
asthma symptoms.
9. T/F: In adults, the Glasgow Coma Scale (GCS) score includes
assessments of eye, verbal, and motor responses. Answer: True
Rationale: GCS evaluates these three parameters to assess
neurological status.
10. T/F: Patients with liver failure typically exhibit elevated INR
3
Concepts of Adult Health Nursing for the
Practical Nurse I
Proctored Midterm Exam Review
(With Solutions)
2026
1
,1. A 68-year-old COPD patient is admitted with acute shortness of
breath and increased wheezing. Which intervention should the nurse
prioritize? a) Administer high-flow oxygen via non-rebreather mask b)
Encourage deep breathing and coughing exercises c) Administer
prescribed bronchodilators immediately d) Instruct strict bed rest
until symptoms improve
Answer: c) Administer prescribed bronchodilators immediately
Rationale: Bronchodilators are first-line therapy to relieve
bronchospasm in COPD exacerbation, improving airflow. High-flow
oxygen must be used cautiously to avoid CO2 retention.
2. A patient with congestive heart failure is prescribed furosemide.
What electrolyte imbalance should the nurse closely monitor? a)
Hyperkalemia b) Hypokalemia c) Hypernatremia d) Hyponatremia
Answer: b) Hypokalemia Rationale: Furosemide is a loop diuretic
causing potassium loss, which can lead to hypokalemia. Monitoring
potassium is essential to avoid arrhythmias.
3. Which lab test is most reliable for monitoring long-term glucose
control in diabetic adults? a) Fasting blood glucose b) Random blood
glucose c) HbA1c d) Oral glucose tolerance test
Answer: c) HbA1c Rationale: HbA1c reflects average blood glucose
levels over 2-3 months and is used to monitor diabetes control.
4. A patient post-thyroidectomy shows signs of tetany, including
muscle spasms and tingling. What electrolyte imbalance is likely
responsible? a) Hypercalcemia b) Hypocalcemia c)
Hypermagnesemia d) Hypomagnesemia
Answer: b) Hypocalcemia Rationale: Parathyroid damage during
thyroidectomy can cause hypocalcemia, leading to tetany.
5. During assessment of a patient with suspected deep vein
2
, thrombosis (DVT), which sign is most specific? a) Edema of the limb
b) Homan’s sign (calf pain on dorsiflexion) c) Warmth and redness
over the affected vein d) Unilateral leg swelling greater than 2 cm
compared to contralateral leg
Answer: d) Unilateral leg swelling greater than 2 cm compared to
contralateral leg Rationale: While all may occur, the significant
unilateral limb swelling is more specific for DVT.
6. What is the primary purpose of administering lisinopril to a patient
with hypertension? a) Increase heart rate b) Dilate blood vessels and
decrease blood pressure c) Retain sodium and water d) Increase
cardiac contractility
Answer: b) Dilate blood vessels and decrease blood pressure
Rationale: Lisinopril is an ACE inhibitor that reduces
vasoconstriction and lowers blood pressure.
TRUE / FALSE (T/F)
7. T/F: Patients with chronic kidney disease typically exhibit
hyperkalemia due to impaired potassium excretion. Answer: True
Rationale: Damaged kidneys cannot excrete potassium effectively,
leading to hyperkalemia.
8. T/F: Administering beta-blockers is contraindicated in patients with
asthma due to risk of bronchospasm. Answer: True Rationale: Non-
selective beta-blockers can cause bronchoconstriction and worsen
asthma symptoms.
9. T/F: In adults, the Glasgow Coma Scale (GCS) score includes
assessments of eye, verbal, and motor responses. Answer: True
Rationale: GCS evaluates these three parameters to assess
neurological status.
10. T/F: Patients with liver failure typically exhibit elevated INR
3
