NURS 640 EXAM 1 EXAM STUDY GUIDE 2026
PRACTICE QUESTIONS WITH FULL SOLUTION
GRADED A+
◉ A client is diagnosed with emphysema. For which of the following
hematologic disorders should the nurse include in the assessment of
this client? Answer: polycythemia caused by an increase in the
number of red blood cells in response to a reduced amount of
oxygen in the body
◉ Inpatient insulin dosing Answer: TDD
50% basal
50% prandial
may need to add rapid acting for meal
titrate 10-20% until goal met
◉ . The nurse is listening to the breath sounds of a patient with
severe asthma. Air passing through narrowed bronchioles would
produce which of these adventitious sounds? Answer: Wheezes
,◉ Caused by air squeezed or compressed through passageways
narrowed almost to closure by collapsing, swelling, secretions, or
tumors, such as with acute asthma or chronic emphysema Answer:
Wheezes
◉ The nurse has just recorded a positive iliopsoas test on a patient
who has abdominal pain. This test is used to confirm a(n): Answer:
An inflamed or perforated appendix irritates the iliopsoas muscle,
producing pain in the RLQ.
◉ S3 heart sound Answer: An auscultated S3 is a sign that increased
blood volume remains in the ventricle with each beat and that the
heart is beginning to fail
◉ S4 heart sound Answer: An S4 sound may indicate increased
resistance to ventricular filling
◉ A client is diagnosed with heart failure. Which of the following
diagnostic tests is useful to determine the degree of the failure?
Answer: Brain natriuretic peptide is a hormone found in the left
ventricle; it is used to help diagnose and grade the severity of heart
failure
◉ Blood cultures Answer: used to diagnose carditis
,◉ Sed Rate Answer: used to diagnose pericarditis
◉ A nurse is instructing a client regarding medications and
substances contraindicated for the client with heart failure. Which of
the following would not be contraindicated? Answer: Loop diuretics
(e.g., furosemide) are part of the recommended medications for
heart failure.
◉ Contraindications in HF Answer: Alcohol, metformin, and
pioglitazone (a thiazolidinedione) are contraindicated.
◉ The nurse is determining nursing diagnoses appropriate for a
client demonstrating productive cough with pink frothy sputum,
shortness of breath, and crackles. Which of the following nursing
diagnoses is of the most importance? Answer: Impaired gas
exchange
◉ In planning the care for a client diagnosed with heart failure,
which of the following would be an appropriate goal? Answer:
Increased Activity levels
◉ 6.The nurse is instructing a client diagnosed with mild heart
failure on dietary modifications. Which of the following client
statements indicates that the instruction has been effective? Answer:
Low Salt Diet
, ◉ A client is undergoing diagnostic testing for infective endocarditis.
Which of the following laboratory tests would be most useful in
diagnosis? Answer: Blood cultures identify the causative organisms.
◉ Which of the following would the nurse most likely assess in a
client diagnosed with rightsided heart failure? Answer: An
assessment finding in a client diagnosed with right-sided heart
failure is distended neck veins
◉ Left Sided HF Findings Answer: Oliguria, cough with frothy blood-
tinged sputum, and syncope are all clinical manifestations of left-
sided heart failure.
◉ .Which of the following diagnostic tests is useful to diagnose
mitral valve prolapse? Answer: Transesophageal echocardiography
is useful in the assessment of cardiac murmurs, stenosis, and
regurgitation of all four cardiac valves
◉ A client diagnosed with mitral valve prolapse is experiencing
palpitations. Which of the following should the nurse instruct this
client? Answer: avoid caffeine, alcohol, and tobacco
PRACTICE QUESTIONS WITH FULL SOLUTION
GRADED A+
◉ A client is diagnosed with emphysema. For which of the following
hematologic disorders should the nurse include in the assessment of
this client? Answer: polycythemia caused by an increase in the
number of red blood cells in response to a reduced amount of
oxygen in the body
◉ Inpatient insulin dosing Answer: TDD
50% basal
50% prandial
may need to add rapid acting for meal
titrate 10-20% until goal met
◉ . The nurse is listening to the breath sounds of a patient with
severe asthma. Air passing through narrowed bronchioles would
produce which of these adventitious sounds? Answer: Wheezes
,◉ Caused by air squeezed or compressed through passageways
narrowed almost to closure by collapsing, swelling, secretions, or
tumors, such as with acute asthma or chronic emphysema Answer:
Wheezes
◉ The nurse has just recorded a positive iliopsoas test on a patient
who has abdominal pain. This test is used to confirm a(n): Answer:
An inflamed or perforated appendix irritates the iliopsoas muscle,
producing pain in the RLQ.
◉ S3 heart sound Answer: An auscultated S3 is a sign that increased
blood volume remains in the ventricle with each beat and that the
heart is beginning to fail
◉ S4 heart sound Answer: An S4 sound may indicate increased
resistance to ventricular filling
◉ A client is diagnosed with heart failure. Which of the following
diagnostic tests is useful to determine the degree of the failure?
Answer: Brain natriuretic peptide is a hormone found in the left
ventricle; it is used to help diagnose and grade the severity of heart
failure
◉ Blood cultures Answer: used to diagnose carditis
,◉ Sed Rate Answer: used to diagnose pericarditis
◉ A nurse is instructing a client regarding medications and
substances contraindicated for the client with heart failure. Which of
the following would not be contraindicated? Answer: Loop diuretics
(e.g., furosemide) are part of the recommended medications for
heart failure.
◉ Contraindications in HF Answer: Alcohol, metformin, and
pioglitazone (a thiazolidinedione) are contraindicated.
◉ The nurse is determining nursing diagnoses appropriate for a
client demonstrating productive cough with pink frothy sputum,
shortness of breath, and crackles. Which of the following nursing
diagnoses is of the most importance? Answer: Impaired gas
exchange
◉ In planning the care for a client diagnosed with heart failure,
which of the following would be an appropriate goal? Answer:
Increased Activity levels
◉ 6.The nurse is instructing a client diagnosed with mild heart
failure on dietary modifications. Which of the following client
statements indicates that the instruction has been effective? Answer:
Low Salt Diet
, ◉ A client is undergoing diagnostic testing for infective endocarditis.
Which of the following laboratory tests would be most useful in
diagnosis? Answer: Blood cultures identify the causative organisms.
◉ Which of the following would the nurse most likely assess in a
client diagnosed with rightsided heart failure? Answer: An
assessment finding in a client diagnosed with right-sided heart
failure is distended neck veins
◉ Left Sided HF Findings Answer: Oliguria, cough with frothy blood-
tinged sputum, and syncope are all clinical manifestations of left-
sided heart failure.
◉ .Which of the following diagnostic tests is useful to diagnose
mitral valve prolapse? Answer: Transesophageal echocardiography
is useful in the assessment of cardiac murmurs, stenosis, and
regurgitation of all four cardiac valves
◉ A client diagnosed with mitral valve prolapse is experiencing
palpitations. Which of the following should the nurse instruct this
client? Answer: avoid caffeine, alcohol, and tobacco
