NSG 5140 – ADVANCED NURSING PRACTICE
FINAL EXAM ACTUAL PREP QUESTIONS AND
WELL REVISED ANSWERS - LATEST AND
COMPLETE UPDATE WITH VERIFIED
SOLUTIONS – ASSURED PASS
1. A 55-year-old patient with Type 2 diabetes presents with neuropathic pain in
both feet. Which intervention reflects the best evidence-based nursing
management for neuropathy?
A. Encourage daily hot foot baths
B. Prescribe high-dose NSAIDs for pain control
C. Initiate gabapentin therapy and educate on foot care
D. Limit patient activity to prevent further nerve injury
Rationale: Gabapentin is first-line pharmacologic therapy for diabetic
neuropathy. Daily hot baths may cause burns due to reduced sensation, NSAIDs
are generally ineffective for neuropathic pain, and activity should be
encouraged, not restricted.
2. A patient in the ICU develops sudden hypotension, tachycardia, and muffled
heart sounds following cardiac surgery. What is the priority nursing action?
A. Obtain a 12-lead ECG
B. Notify the rapid response team and prepare for pericardiocentesis
C. Administer IV fluids rapidly
D. Increase oxygen via nasal cannula
,Rationale: These signs indicate cardiac tamponade, a medical emergency
requiring immediate intervention. Rapid fluid resuscitation may worsen
tamponade.
3. Which ethical principle is primarily involved when a nurse respects a
patient’s decision to refuse a blood transfusion?
A. Beneficence
B. Justice
C. Nonmaleficence
D. Autonomy
Rationale: Autonomy refers to respecting a patient’s right to make decisions
about their own care.
4. A patient is receiving chemotherapy and develops febrile neutropenia.
Which nursing intervention is highest priority?
A. Administer scheduled antiemetics
B. Obtain blood cultures and start broad-spectrum IV antibiotics
C. Provide education about hand hygiene
D. Monitor fluid intake and output
Rationale: Febrile neutropenia is a medical emergency. Immediate cultures and
IV antibiotics are crucial to prevent sepsis.
5. During an admission assessment, a patient reports chronic fatigue, pallor,
and shortness of breath. Lab results reveal hemoglobin of 7 g/dL. Which
clinical diagnosis is most consistent?
A. Iron-deficiency anemia
B. Thrombocytopenia
, C. Polycythemia vera
D. Leukemia
Rationale: Fatigue, pallor, and low hemoglobin suggest iron-deficiency anemia;
other options present differently.
6. Which nursing intervention best demonstrates secondary prevention in
cardiovascular disease?
A. Teaching patients to avoid smoking
B. Screening for hypertension and hyperlipidemia
C. Providing nutritional counseling for a healthy diet
D. Administering prescribed antihypertensive medications
Rationale: Secondary prevention focuses on early detection through screening.
7. A patient with chronic kidney disease develops hyperkalemia with ECG
showing peaked T waves. Which is the priority nursing action?
A. Administer sodium bicarbonate orally
B. Prepare the patient for dialysis
C. Administer IV calcium gluconate and notify provider
D. Encourage potassium-rich foods
Rationale: IV calcium stabilizes cardiac membranes in severe hyperkalemia;
dialysis may be required afterward.
8. Which communication technique is most appropriate when providing
culturally sensitive care to a patient who speaks limited English?
A. Speak loudly to ensure understanding
B. Use a certified medical interpreter
, C. Rely on family members for translation
D. Provide written instructions only
Rationale: Certified interpreters ensure accurate communication and respect
patient autonomy.
9. A nurse is preparing to administer a new medication. Which action best
reflects the principle of patient safety?
A. Administer immediately to save time
B. Check the patient’s allergy history and current medications
C. Verify the “five rights” of medication administration
D. Rely on verbal orders without documentation
Rationale: The five rights (right patient, drug, dose, route, time) prevent
medication errors.
10.A patient with COPD presents with increased dyspnea, wheezing, and use of
accessory muscles. Which intervention is priority?
A. Encourage deep-breathing exercises
B. Administer prescribed bronchodilator via nebulizer
C. Initiate oxygen at 6 L/min regardless of SpO₂
D. Place the patient supine for comfort
Rationale: Immediate bronchodilation is critical in acute COPD exacerbation;
oxygen must be titrated.
11.A patient refuses a recommended lumbar puncture. The nurse explains risks
and benefits and documents the refusal. Which ethical principle is being
upheld?
FINAL EXAM ACTUAL PREP QUESTIONS AND
WELL REVISED ANSWERS - LATEST AND
COMPLETE UPDATE WITH VERIFIED
SOLUTIONS – ASSURED PASS
1. A 55-year-old patient with Type 2 diabetes presents with neuropathic pain in
both feet. Which intervention reflects the best evidence-based nursing
management for neuropathy?
A. Encourage daily hot foot baths
B. Prescribe high-dose NSAIDs for pain control
C. Initiate gabapentin therapy and educate on foot care
D. Limit patient activity to prevent further nerve injury
Rationale: Gabapentin is first-line pharmacologic therapy for diabetic
neuropathy. Daily hot baths may cause burns due to reduced sensation, NSAIDs
are generally ineffective for neuropathic pain, and activity should be
encouraged, not restricted.
2. A patient in the ICU develops sudden hypotension, tachycardia, and muffled
heart sounds following cardiac surgery. What is the priority nursing action?
A. Obtain a 12-lead ECG
B. Notify the rapid response team and prepare for pericardiocentesis
C. Administer IV fluids rapidly
D. Increase oxygen via nasal cannula
,Rationale: These signs indicate cardiac tamponade, a medical emergency
requiring immediate intervention. Rapid fluid resuscitation may worsen
tamponade.
3. Which ethical principle is primarily involved when a nurse respects a
patient’s decision to refuse a blood transfusion?
A. Beneficence
B. Justice
C. Nonmaleficence
D. Autonomy
Rationale: Autonomy refers to respecting a patient’s right to make decisions
about their own care.
4. A patient is receiving chemotherapy and develops febrile neutropenia.
Which nursing intervention is highest priority?
A. Administer scheduled antiemetics
B. Obtain blood cultures and start broad-spectrum IV antibiotics
C. Provide education about hand hygiene
D. Monitor fluid intake and output
Rationale: Febrile neutropenia is a medical emergency. Immediate cultures and
IV antibiotics are crucial to prevent sepsis.
5. During an admission assessment, a patient reports chronic fatigue, pallor,
and shortness of breath. Lab results reveal hemoglobin of 7 g/dL. Which
clinical diagnosis is most consistent?
A. Iron-deficiency anemia
B. Thrombocytopenia
, C. Polycythemia vera
D. Leukemia
Rationale: Fatigue, pallor, and low hemoglobin suggest iron-deficiency anemia;
other options present differently.
6. Which nursing intervention best demonstrates secondary prevention in
cardiovascular disease?
A. Teaching patients to avoid smoking
B. Screening for hypertension and hyperlipidemia
C. Providing nutritional counseling for a healthy diet
D. Administering prescribed antihypertensive medications
Rationale: Secondary prevention focuses on early detection through screening.
7. A patient with chronic kidney disease develops hyperkalemia with ECG
showing peaked T waves. Which is the priority nursing action?
A. Administer sodium bicarbonate orally
B. Prepare the patient for dialysis
C. Administer IV calcium gluconate and notify provider
D. Encourage potassium-rich foods
Rationale: IV calcium stabilizes cardiac membranes in severe hyperkalemia;
dialysis may be required afterward.
8. Which communication technique is most appropriate when providing
culturally sensitive care to a patient who speaks limited English?
A. Speak loudly to ensure understanding
B. Use a certified medical interpreter
, C. Rely on family members for translation
D. Provide written instructions only
Rationale: Certified interpreters ensure accurate communication and respect
patient autonomy.
9. A nurse is preparing to administer a new medication. Which action best
reflects the principle of patient safety?
A. Administer immediately to save time
B. Check the patient’s allergy history and current medications
C. Verify the “five rights” of medication administration
D. Rely on verbal orders without documentation
Rationale: The five rights (right patient, drug, dose, route, time) prevent
medication errors.
10.A patient with COPD presents with increased dyspnea, wheezing, and use of
accessory muscles. Which intervention is priority?
A. Encourage deep-breathing exercises
B. Administer prescribed bronchodilator via nebulizer
C. Initiate oxygen at 6 L/min regardless of SpO₂
D. Place the patient supine for comfort
Rationale: Immediate bronchodilation is critical in acute COPD exacerbation;
oxygen must be titrated.
11.A patient refuses a recommended lumbar puncture. The nurse explains risks
and benefits and documents the refusal. Which ethical principle is being
upheld?
