NURS 534 Final Questions with Complete Solutions.

NURS 534 Final Questions with
Complete Solutions.
Course
NURS 534
1. A 68-year-old patient with heart failure presents with increasing dyspnea, bilateral
crackles, and 3+ pitting edema. Which intervention should the nurse prioritize?
A. Encourage increased oral fluid intake
B. Place the patient in a supine position
C. Assess oxygenation and administer prescribed diuretics
D. Restrict all physical activity permanently
Complete Solution
Correct Answer: C. Assess oxygenation and administer prescribed diuretics
The patient's findings indicate acute fluid overload associated with heart failure. Priority nursing
actions include:
 Assess airway, breathing, and oxygen saturation.
 Administer supplemental oxygen if prescribed.
 Administer prescribed loop diuretics (e.g., furosemide).
 Monitor urine output and daily weight.
 Assess lung sounds and vital signs frequently.
 Position the patient in high Fowler's position to reduce the work of breathing.
Early intervention helps improve oxygenation and decrease pulmonary congestion.


2. Which laboratory value is the most sensitive indicator of long-term glycemic control in
patients with diabetes mellitus?
A. Random blood glucose
B. Hemoglobin A1c (HbA1c)
C. Serum insulin level
D. Urine glucose
Complete Solution
Correct Answer: B. Hemoglobin A1c (HbA1c)

,HbA1c reflects the average blood glucose concentration over approximately the previous 2–3
months by measuring the percentage of glycated hemoglobin. It is widely used to evaluate the
effectiveness of diabetes management and guide treatment adjustments.


3. Which assessment finding requires immediate intervention in a patient receiving
intravenous potassium chloride?
A. Mild discomfort at the IV site
B. Peaked T waves on the ECG
C. Heart rate of 72 beats/minute
D. Blood pressure of 126/78 mmHg
Complete Solution
Correct Answer: B. Peaked T waves on the ECG
Peaked T waves are an early sign of hyperkalemia, which can progress to life-threatening cardiac
arrhythmias. The nurse should:
 Stop potassium administration if indicated.
 Notify the healthcare provider immediately.
 Obtain additional laboratory values.
 Continuously monitor the ECG.
 Prepare for emergency treatment if severe hyperkalemia is confirmed.


4. A nurse is caring for a patient with sepsis. Which assessment finding best indicates
improving tissue perfusion?
A. Urine output of 40 mL/hour
B. Increasing serum lactate level
C. Cool, mottled extremities
D. Altered mental status
Complete Solution
Correct Answer: A. Urine output of 40 mL/hour
Adequate urine output (generally ≥0.5 mL/kg/hour in adults) is an important indicator of
improving renal perfusion. Additional signs of improvement include:
 Decreasing serum lactate

,  Improved mental status
 Warm extremities
 Stable blood pressure
 Improving capillary refill


5. Which medication is considered first-line therapy for anaphylaxis?
A. Diphenhydramine
B. Epinephrine
C. Prednisone
D. Albuterol
Complete Solution
Correct Answer: B. Epinephrine
Intramuscular epinephrine is the first-line treatment for anaphylaxis because it:
 Reverses airway edema
 Causes bronchodilation
 Improves blood pressure
 Reduces mucosal swelling
 Counteracts systemic vasodilation
Adjunctive therapies such as antihistamines, corticosteroids, and bronchodilators may be
administered after epinephrine but should not delay its use.


6. Which assessment finding is most consistent with left-sided heart failure?
A. Hepatomegaly
B. Jugular venous distention
C. Pulmonary crackles and orthopnea
D. Ascites
Complete Solution
Correct Answer: C. Pulmonary crackles and orthopnea
Left-sided heart failure leads to pulmonary congestion, producing:

,  Dyspnea
 Orthopnea
 Paroxysmal nocturnal dyspnea
 Crackles
 Pulmonary edema
 Fatigue
Right-sided heart failure more commonly causes peripheral edema, hepatomegaly, ascites, and
jugular venous distention.


7. Which action best demonstrates evidence-based nursing practice?
A. Performing interventions solely based on routine
B. Combining current research evidence, clinical expertise, and patient preferences
C. Following outdated policies without review
D. Using personal experience as the only guide
Complete Solution
Correct Answer: B. Combining current research evidence, clinical expertise, and patient
preferences
Evidence-based practice integrates:
 Best available research evidence
 Clinical expertise
 Patient values and preferences
This approach improves patient safety, quality of care, and clinical outcomes.


8. A patient receiving warfarin develops spontaneous bleeding. Which laboratory result is
most concerning?
A. INR of 1.0
B. INR of 2.3
C. INR of 6.5
D. Platelet count of 250,000/mm³
Complete Solution