NURS 341 FINAL EXAM ACTUAL QUESTIONS AND
SOLUTIONS GRADED A+
✔✔A nurse assesses a patient diagnosed with hypertension. Which target organ
damage could result from poorly controlled hypertension? Select all that apply.
A) Retinopathy
B) Hepatomegaly
C) Nephrosclerosis
D) Left ventricular hypertrophy - ✔✔A. retinopathy
C. nephrosclerosis
D. left ventricular hypertrophy
Target organs affected by hypertension include the eyes (retinopathy), kidneys
(nephrosclerosis), and heart (left ventricular hypertrophy). Hepatomegaly (enlarged
liver) is unrelated to hypertension.
✔✔The nurse knows that secondary hypertension is characterized by:
A) A gradual increase in blood pressure.
B) A specific identifiable cause.
C) Occurrence primarily in older adults.
D) Higher response to lifestyle modifications. - ✔✔B. A specific identifiable cause.
Secondary hypertension has a specific underlying cause, such as kidney disease or
hormonal disorders, unlike primary hypertension, which has no single identifiable cause.
✔✔A patient with newly diagnosed hypertension asks why lifestyle changes are
recommended before medication. Which response by the nurse is most appropriate?
A) "Medications are only effective for advanced hypertension."
B) "Lifestyle changes can sometimes control BP without the need for medication."
C) "Medications are ineffective without lifestyle changes."
D) "Medications will only be needed if you have other health issues." - ✔✔B. "Lifestyle
changes can sometimes control BP without the need for medication."
Lifestyle changes, such as diet and exercise, may effectively control blood pressure,
potentially reducing or delaying the need for medication.
✔✔During patient teaching, which instruction is most important for a patient starting
antihypertensive medications?
A) "Stop taking the medication if your BP returns to normal."
B) "Continue taking the medication even if you feel better."
C) "Take the medication only when your BP feels high."
D) "Double your dose if you miss a pill." - ✔✔B. "Continue taking the medication even if
you feel better."
,Hypertension often has no symptoms, so patients may feel fine. Continuous medication
is crucial to keep blood pressure in a safe range and prevent complications.
✔✔The nurse is reviewing a patient's lab results. Which of the following labs may
indicate target organ damage from hypertension? Select all that apply.
A) Elevated serum creatinine
B) High-density lipoprotein (HDL) level of 70 mg/dL
C) Low hemoglobin level
D) Elevated blood urea nitrogen (BUN) - ✔✔A. elevated serum creatine
D. elevated blood urea nitrogen (BUN)
Elevated creatinine and BUN levels indicate kidney damage, a common consequence
of unmanaged hypertension. HDL levels and hemoglobin are not direct indicators of
hypertension-related organ damage.
✔✔A nurse is educating a patient about factors that may elevate BP. Which of the
following statements indicates the patient understood the teaching?
A) "Using a lot of salt doesn't affect my blood pressure."
B) "Smoking and stress can both increase my BP."
C) "I don't need to worry about my BP since I am not overweight."
D) "Only caffeine and alcohol affect my BP, not diet." - ✔✔B. "Smoking and stress can
both increase my BP."
Smoking and stress are known to raise blood pressure. High salt intake, diet, and
weight are also factors, but the patient's response correctly identifies smoking and
stress.
✔✔The nurse is educating a patient on the DASH diet for hypertension management.
Which of the following foods should the patient choose? Select all that apply.
A) Fresh fruits
B) Whole grains
C) Processed meats
D) High-fat dairy products - ✔✔A. fresh fruits
B. whole grains
The DASH diet emphasizes fruits, vegetables, and whole grains while avoiding high-
sodium and high-fat foods, such as processed meats and high-fat dairy.
✔✔Which lifestyle modifications should a nurse suggest to a patient with hypertension
to reduce cardiovascular risk? Select all that apply.
A) Reduce sodium intake.
B) Begin aerobic exercise.
C) Avoid smoking.
D) Limit water intake. - ✔✔A. reduce sodium intake
B. begin aerobic exercise
, C. avoid smoking
Lifestyle modifications for hypertension include reducing sodium, regular exercise, and
avoiding smoking. Limiting water intake is not a recommended measure.
✔✔A patient scheduled for elective surgery asks what to expect postoperatively. The
nurse should include:
A. Sensory expectations (e.g., sounds in the OR).
B. The process (e.g., movement through rooms).
C. Procedural steps (e.g., equipment used).
D. Medication side effects. - ✔✔A. sensory expectations
B. the process
C. procedural steps
Preoperative education should include sensory expectations, procedural processes, and
equipment used to help reduce anxiety and prepare the patient. Medication side effects
are more specific to postoperative education.
✔✔A nurse is preparing to perform preoperative teaching for an elderly patient. Which
of the following should the nurse prioritize? (Select all that apply)
A. Discussing postoperative exercises.
B. Assessing sensory deficits.
C. Verifying cultural preferences.
D. Explaining the purpose of fasting. - ✔✔B. assessing sensory deficits
C. verifying cultural preferences
For elderly patients, it's essential to assess sensory deficits and respect cultural
preferences to ensure understanding and comfort during preoperative teaching.
Exercises and fasting can be addressed once these foundational needs are met.
✔✔During the postoperative period, a patient develops hypotension with cold, clammy
skin. The nurse's priority intervention should be:
A. Check recent labs for electrolyte imbalance.
B. Increase IV fluid rate per protocol.
C. Position patient flat with legs elevated.
D. Administer oxygen at 2 L/min via nasal cannula. - ✔✔C. position patient flat with legs
elevated
Hypotension with cold, clammy skin may indicate shock. Elevating the legs helps
increase blood flow to vital organs and improve blood pressure. Other interventions can
follow based on the patient's response.
✔✔A patient in the PACU is showing signs of respiratory distress. Which actions should
the nurse take first? (Select all that apply)
A. Reposition the patient to a lateral position.
SOLUTIONS GRADED A+
✔✔A nurse assesses a patient diagnosed with hypertension. Which target organ
damage could result from poorly controlled hypertension? Select all that apply.
A) Retinopathy
B) Hepatomegaly
C) Nephrosclerosis
D) Left ventricular hypertrophy - ✔✔A. retinopathy
C. nephrosclerosis
D. left ventricular hypertrophy
Target organs affected by hypertension include the eyes (retinopathy), kidneys
(nephrosclerosis), and heart (left ventricular hypertrophy). Hepatomegaly (enlarged
liver) is unrelated to hypertension.
✔✔The nurse knows that secondary hypertension is characterized by:
A) A gradual increase in blood pressure.
B) A specific identifiable cause.
C) Occurrence primarily in older adults.
D) Higher response to lifestyle modifications. - ✔✔B. A specific identifiable cause.
Secondary hypertension has a specific underlying cause, such as kidney disease or
hormonal disorders, unlike primary hypertension, which has no single identifiable cause.
✔✔A patient with newly diagnosed hypertension asks why lifestyle changes are
recommended before medication. Which response by the nurse is most appropriate?
A) "Medications are only effective for advanced hypertension."
B) "Lifestyle changes can sometimes control BP without the need for medication."
C) "Medications are ineffective without lifestyle changes."
D) "Medications will only be needed if you have other health issues." - ✔✔B. "Lifestyle
changes can sometimes control BP without the need for medication."
Lifestyle changes, such as diet and exercise, may effectively control blood pressure,
potentially reducing or delaying the need for medication.
✔✔During patient teaching, which instruction is most important for a patient starting
antihypertensive medications?
A) "Stop taking the medication if your BP returns to normal."
B) "Continue taking the medication even if you feel better."
C) "Take the medication only when your BP feels high."
D) "Double your dose if you miss a pill." - ✔✔B. "Continue taking the medication even if
you feel better."
,Hypertension often has no symptoms, so patients may feel fine. Continuous medication
is crucial to keep blood pressure in a safe range and prevent complications.
✔✔The nurse is reviewing a patient's lab results. Which of the following labs may
indicate target organ damage from hypertension? Select all that apply.
A) Elevated serum creatinine
B) High-density lipoprotein (HDL) level of 70 mg/dL
C) Low hemoglobin level
D) Elevated blood urea nitrogen (BUN) - ✔✔A. elevated serum creatine
D. elevated blood urea nitrogen (BUN)
Elevated creatinine and BUN levels indicate kidney damage, a common consequence
of unmanaged hypertension. HDL levels and hemoglobin are not direct indicators of
hypertension-related organ damage.
✔✔A nurse is educating a patient about factors that may elevate BP. Which of the
following statements indicates the patient understood the teaching?
A) "Using a lot of salt doesn't affect my blood pressure."
B) "Smoking and stress can both increase my BP."
C) "I don't need to worry about my BP since I am not overweight."
D) "Only caffeine and alcohol affect my BP, not diet." - ✔✔B. "Smoking and stress can
both increase my BP."
Smoking and stress are known to raise blood pressure. High salt intake, diet, and
weight are also factors, but the patient's response correctly identifies smoking and
stress.
✔✔The nurse is educating a patient on the DASH diet for hypertension management.
Which of the following foods should the patient choose? Select all that apply.
A) Fresh fruits
B) Whole grains
C) Processed meats
D) High-fat dairy products - ✔✔A. fresh fruits
B. whole grains
The DASH diet emphasizes fruits, vegetables, and whole grains while avoiding high-
sodium and high-fat foods, such as processed meats and high-fat dairy.
✔✔Which lifestyle modifications should a nurse suggest to a patient with hypertension
to reduce cardiovascular risk? Select all that apply.
A) Reduce sodium intake.
B) Begin aerobic exercise.
C) Avoid smoking.
D) Limit water intake. - ✔✔A. reduce sodium intake
B. begin aerobic exercise
, C. avoid smoking
Lifestyle modifications for hypertension include reducing sodium, regular exercise, and
avoiding smoking. Limiting water intake is not a recommended measure.
✔✔A patient scheduled for elective surgery asks what to expect postoperatively. The
nurse should include:
A. Sensory expectations (e.g., sounds in the OR).
B. The process (e.g., movement through rooms).
C. Procedural steps (e.g., equipment used).
D. Medication side effects. - ✔✔A. sensory expectations
B. the process
C. procedural steps
Preoperative education should include sensory expectations, procedural processes, and
equipment used to help reduce anxiety and prepare the patient. Medication side effects
are more specific to postoperative education.
✔✔A nurse is preparing to perform preoperative teaching for an elderly patient. Which
of the following should the nurse prioritize? (Select all that apply)
A. Discussing postoperative exercises.
B. Assessing sensory deficits.
C. Verifying cultural preferences.
D. Explaining the purpose of fasting. - ✔✔B. assessing sensory deficits
C. verifying cultural preferences
For elderly patients, it's essential to assess sensory deficits and respect cultural
preferences to ensure understanding and comfort during preoperative teaching.
Exercises and fasting can be addressed once these foundational needs are met.
✔✔During the postoperative period, a patient develops hypotension with cold, clammy
skin. The nurse's priority intervention should be:
A. Check recent labs for electrolyte imbalance.
B. Increase IV fluid rate per protocol.
C. Position patient flat with legs elevated.
D. Administer oxygen at 2 L/min via nasal cannula. - ✔✔C. position patient flat with legs
elevated
Hypotension with cold, clammy skin may indicate shock. Elevating the legs helps
increase blood flow to vital organs and improve blood pressure. Other interventions can
follow based on the patient's response.
✔✔A patient in the PACU is showing signs of respiratory distress. Which actions should
the nurse take first? (Select all that apply)
A. Reposition the patient to a lateral position.
