NUR301 FINAL EXAM PRACTICE QUESTIONS
WITH CORRECT ANSWERS
The |nurse |understands |which |is |the |cause |of |respiratory |alkalosis?
A. |hyperglycemia
b. |hyperventilation
c. |fluid |loss
d. |airway |compromise |- |CORRECT |ANSWER✔✔-b. |hyperventilation
the |nurse |instructs |a |pt |how |to |use |an |incentive |spirometer. |which |statement |by |the |pt |shows |
that |teaching |is |effective?
a. |i |should |take |a |deep |breathe |and |blow |into |the |mouthpiece
b. |im |glad |i |only |have |to |do |this |twice |a |day
c. |i |can |ask |for |pain |medication |prior |to |using |the |spirometer
d. |i |should |lie |down |to |use |the |spirometer |- |CORRECT |ANSWER✔✔-c. |i |can |ask |for |pain |
medication |prior |to |using |the |spirometer
rationale: |the |pt |will |put |the |mouthpiece |in |the |mouth |and |close |the |lips |tightly |around |it. |the
|pt |will |slowly |exhale |completely. |the |pt |will |then |inhale |slowly |and |deeply |to |make |the |piston |
rise
the |nurse |identifies |which |client |is |most |at |risk |for |developing |pneumonia?
a. |a |client |with |a |urinary |catheter
b. |a |client |with |an |ng |tube
c. |a |client |with |psoriasis
,d. |a |client |with |paget |disease |- |CORRECT |ANSWER✔✔-b. |a |client |with |an |ng |tube
when |assessing |a |client |for |tactile |remitUs, |which |part |of |the |hand |does |the |nurse |use?
a. |fingertips |and |finger |pads
b. |dorsal |surface |of |the |hand
c. |ulnar |and |palmar |surface |of |the |hand
d. |dorsiflexed |surface |of |the |wrist |- |CORRECT |ANSWER✔✔-c. |ulnar |and |palmar |surface |of |the |
hand
rationale: |the |nurse |asks |the |pt |to |say |the |number |"99". |tactile |remits |is |palpable |vibrations |
that |will |increase |when |lung |consolidation |exists |such |as |with |pneumonia, |and |decreased |with
|pleural |effusion, |pneumothorax, |bronchial |obstruction |or |air |trapping |occurs
a |pt |is |admitted |into |the |hospital |with |a |diagnosis |of |acute |right |upper |lobe |pneumonia. |the |
pt |has |a |history |of |chronic |bronchitis. |which |symptom |does |the |nurse |expect |to |see?
a. |moist, |cool |skin
b. |rust-colored |sputum
c. |bradycardia
d. |decreased |respiratory |rate |- |CORRECT |ANSWER✔✔-b. |rust-colored |sputum
rationale: |rust |colored |sputum, |or |blood-tinged |due |to |inflammation |is |a |typical |finding |for |
pneumonia. |the |pt |may |also |have |increased |respirations, |dyspnea, |coughing, |and |pleuritic |
pain. |treatment |includes |antibiotics, |supplemental |oxygen, |and |chest |pt. |the |nurse |should |
assess |breath |sounds, |VS |including |pulse |oximetry. |the |nurse |should |encourage |coughing |and |
deep |breathing |every |2 |hours |and |increased |fluids
the |nurse |places |a |pulse |oximetry |probe |on |a |pt. |the |pt |asks |"why |do |i |have |this |thing |on |
me?" |which |response |by |the |nurse |is |the |best?
a. |it |enables |your |IV |fluids |to |run
b. |it |monitors |your |pulse |rate
,c |it |tells |us |if |your |BP |is |within |normal |limits
d |it |measures |the |amount |of |oxygen |circulating |in |your |blood |- |CORRECT |ANSWER✔✔-d |it |
measures |the |amount |of |oxygen |circulating |in |your |blood
on |the |first |post |day, |a |pt |developed |a |fever. |the |nurse |auscultates |crackles |bilaterally |in |the |
lower |lobes. |the |nurse |understands |which |complication |of |surgery |is |probably |developing?
a. |HF
b. |thromophlebitis
c. |PE
d. |atelectasis |- |CORRECT |ANSWER✔✔-d. |atelectasis |
rationale: |general |anesthesia |is |a |common |cause |of |atelectasis. |atelectasis |occurs |when |
secretions |block |the |bronchioles |and |the |alveoli |collapse, |causing |hypoventilation. |deep |
breathing |excercies |and |coughing |after |surgery |can |reduce |the |pt's |risk |of |developing |this
the |nurse |monitors |a |client |receiving |oxygen |per |face |mask. |the |nurse |is |most |concerned |with |
which |observation
a. |there |is |condensation |in |the |tubing
b. |the |pulse |oximetry |reading |is |92%
c. |the |client |has |a |nonproductive |cough
d. |the |skin |under |the |elastic |band |is |reddened |- |CORRECT |ANSWER✔✔-c. |the |client |has |a |
nonproductive |cough
rationale: |this |is |a |sign |of |lung |oxygen |toxicity
which |objective |data |is |most |important |when |determining |if |a |pt |is |hypoxic?
a. |cool, |bluish |skin
b. |abnormal |blood |gases
, c. |elevated |temperature
d. |increased |sputum |production |- |CORRECT |ANSWER✔✔-b. |abnormal |blood |gases
rationale: |arterial |blood |gases |(ABG) |measures |tissue |oxygenation, |co2 |removal, |and |acid-base
|balance. |if |the |pt |has |inadequate |exchange |of |oxygen |and |co2, |respiratory |acidosis |occurs
the |nurse |identifies |which |type |of |food |is |most |likely |to |present |problems |for |a |pt |with |
respiratory |issues?
a |fruits
b |grains
c |dairy
d |fish |- |CORRECT |ANSWER✔✔-c |dairy
rationale: |dairy |products |are |mucus |producing |which |can |cause |thick |secretions
after |receiving |hand |off |shift |report, |the |nurse |assesses |a |pt |who |is |having |cheyne-stokes |
respirations. |which |is |the |best |description |of |this |breathing |pattern?
a. |regular |but |increased |in |rate |and |abnormally |deep |respirations
b. |irregular |patterns |of |shallow |breathing |alternating |with |periods |of |apnea
c. |regular |rapid |and |shallow |breathing
d. |gradual |increase |in |depth |of |respirations, |followed |by |a |gradual |decrease |in |depth, |then |a |
period |of |apnea |- |CORRECT |ANSWER✔✔-d. |gradual |increase |in |depth |of |respirations, |followed
|by |a |gradual |decrease |in |depth, |then |a |period |of |apnea
after |oxygen |had |been |administered, |the |next |priority |intervention |the |nurse |would |initiate |for
|a |pt |with |a |pulmonary |embolism |is |the |administration |of |which |of |the |following |therapies?
a. |normal |saline |IV |fluid
b. |IV |heparin
WITH CORRECT ANSWERS
The |nurse |understands |which |is |the |cause |of |respiratory |alkalosis?
A. |hyperglycemia
b. |hyperventilation
c. |fluid |loss
d. |airway |compromise |- |CORRECT |ANSWER✔✔-b. |hyperventilation
the |nurse |instructs |a |pt |how |to |use |an |incentive |spirometer. |which |statement |by |the |pt |shows |
that |teaching |is |effective?
a. |i |should |take |a |deep |breathe |and |blow |into |the |mouthpiece
b. |im |glad |i |only |have |to |do |this |twice |a |day
c. |i |can |ask |for |pain |medication |prior |to |using |the |spirometer
d. |i |should |lie |down |to |use |the |spirometer |- |CORRECT |ANSWER✔✔-c. |i |can |ask |for |pain |
medication |prior |to |using |the |spirometer
rationale: |the |pt |will |put |the |mouthpiece |in |the |mouth |and |close |the |lips |tightly |around |it. |the
|pt |will |slowly |exhale |completely. |the |pt |will |then |inhale |slowly |and |deeply |to |make |the |piston |
rise
the |nurse |identifies |which |client |is |most |at |risk |for |developing |pneumonia?
a. |a |client |with |a |urinary |catheter
b. |a |client |with |an |ng |tube
c. |a |client |with |psoriasis
,d. |a |client |with |paget |disease |- |CORRECT |ANSWER✔✔-b. |a |client |with |an |ng |tube
when |assessing |a |client |for |tactile |remitUs, |which |part |of |the |hand |does |the |nurse |use?
a. |fingertips |and |finger |pads
b. |dorsal |surface |of |the |hand
c. |ulnar |and |palmar |surface |of |the |hand
d. |dorsiflexed |surface |of |the |wrist |- |CORRECT |ANSWER✔✔-c. |ulnar |and |palmar |surface |of |the |
hand
rationale: |the |nurse |asks |the |pt |to |say |the |number |"99". |tactile |remits |is |palpable |vibrations |
that |will |increase |when |lung |consolidation |exists |such |as |with |pneumonia, |and |decreased |with
|pleural |effusion, |pneumothorax, |bronchial |obstruction |or |air |trapping |occurs
a |pt |is |admitted |into |the |hospital |with |a |diagnosis |of |acute |right |upper |lobe |pneumonia. |the |
pt |has |a |history |of |chronic |bronchitis. |which |symptom |does |the |nurse |expect |to |see?
a. |moist, |cool |skin
b. |rust-colored |sputum
c. |bradycardia
d. |decreased |respiratory |rate |- |CORRECT |ANSWER✔✔-b. |rust-colored |sputum
rationale: |rust |colored |sputum, |or |blood-tinged |due |to |inflammation |is |a |typical |finding |for |
pneumonia. |the |pt |may |also |have |increased |respirations, |dyspnea, |coughing, |and |pleuritic |
pain. |treatment |includes |antibiotics, |supplemental |oxygen, |and |chest |pt. |the |nurse |should |
assess |breath |sounds, |VS |including |pulse |oximetry. |the |nurse |should |encourage |coughing |and |
deep |breathing |every |2 |hours |and |increased |fluids
the |nurse |places |a |pulse |oximetry |probe |on |a |pt. |the |pt |asks |"why |do |i |have |this |thing |on |
me?" |which |response |by |the |nurse |is |the |best?
a. |it |enables |your |IV |fluids |to |run
b. |it |monitors |your |pulse |rate
,c |it |tells |us |if |your |BP |is |within |normal |limits
d |it |measures |the |amount |of |oxygen |circulating |in |your |blood |- |CORRECT |ANSWER✔✔-d |it |
measures |the |amount |of |oxygen |circulating |in |your |blood
on |the |first |post |day, |a |pt |developed |a |fever. |the |nurse |auscultates |crackles |bilaterally |in |the |
lower |lobes. |the |nurse |understands |which |complication |of |surgery |is |probably |developing?
a. |HF
b. |thromophlebitis
c. |PE
d. |atelectasis |- |CORRECT |ANSWER✔✔-d. |atelectasis |
rationale: |general |anesthesia |is |a |common |cause |of |atelectasis. |atelectasis |occurs |when |
secretions |block |the |bronchioles |and |the |alveoli |collapse, |causing |hypoventilation. |deep |
breathing |excercies |and |coughing |after |surgery |can |reduce |the |pt's |risk |of |developing |this
the |nurse |monitors |a |client |receiving |oxygen |per |face |mask. |the |nurse |is |most |concerned |with |
which |observation
a. |there |is |condensation |in |the |tubing
b. |the |pulse |oximetry |reading |is |92%
c. |the |client |has |a |nonproductive |cough
d. |the |skin |under |the |elastic |band |is |reddened |- |CORRECT |ANSWER✔✔-c. |the |client |has |a |
nonproductive |cough
rationale: |this |is |a |sign |of |lung |oxygen |toxicity
which |objective |data |is |most |important |when |determining |if |a |pt |is |hypoxic?
a. |cool, |bluish |skin
b. |abnormal |blood |gases
, c. |elevated |temperature
d. |increased |sputum |production |- |CORRECT |ANSWER✔✔-b. |abnormal |blood |gases
rationale: |arterial |blood |gases |(ABG) |measures |tissue |oxygenation, |co2 |removal, |and |acid-base
|balance. |if |the |pt |has |inadequate |exchange |of |oxygen |and |co2, |respiratory |acidosis |occurs
the |nurse |identifies |which |type |of |food |is |most |likely |to |present |problems |for |a |pt |with |
respiratory |issues?
a |fruits
b |grains
c |dairy
d |fish |- |CORRECT |ANSWER✔✔-c |dairy
rationale: |dairy |products |are |mucus |producing |which |can |cause |thick |secretions
after |receiving |hand |off |shift |report, |the |nurse |assesses |a |pt |who |is |having |cheyne-stokes |
respirations. |which |is |the |best |description |of |this |breathing |pattern?
a. |regular |but |increased |in |rate |and |abnormally |deep |respirations
b. |irregular |patterns |of |shallow |breathing |alternating |with |periods |of |apnea
c. |regular |rapid |and |shallow |breathing
d. |gradual |increase |in |depth |of |respirations, |followed |by |a |gradual |decrease |in |depth, |then |a |
period |of |apnea |- |CORRECT |ANSWER✔✔-d. |gradual |increase |in |depth |of |respirations, |followed
|by |a |gradual |decrease |in |depth, |then |a |period |of |apnea
after |oxygen |had |been |administered, |the |next |priority |intervention |the |nurse |would |initiate |for
|a |pt |with |a |pulmonary |embolism |is |the |administration |of |which |of |the |following |therapies?
a. |normal |saline |IV |fluid
b. |IV |heparin
