NURS 3305 - FINAL EXAM | QUESTIONS AND ANSWERS | 2026
UPDATE WITH COMPLETE SOLUTION
Fluid in the lungs sounds like - -crackles
--Ausculation of the heart placement - -APEToMan
aortic
pulmonic
erb's point
tricuspic
mitral
--Physiologic and system changes during the dying process - -all body systems
slow down
--Which patient is of highest priority
a. tracheal edema after extubation
b. emphysema, O2 88% and tachypneic
c. heart failure, +4 pitting edema and irregular HR
d. meningitis, temp 40 and pain 7/10 - -a. tracheal edema after extubation
--Indications of over-hydration - -crackles in the lungs
edema
bounding pulses
hypertension
intake > output
tachycardia
increased body weight
--How to prevent DVTs - -apply SCDs
encourage ambulation
elevate legs in bed
apply compression stockings
encourage the patient to change positions in bed
ensure the patient has a DVT prophylaxis med ordered
--Progression of pressure injuries - -stage 1: "non-blanching"
stage 2: surface
stage 3: penetrating surface
deep tissue injury
--How to prevent pneumonia - -incentive spirometry
make sure the pt is awake enough before giving anything PO
encouraging coughing and deep breathing (CDB)
encourage ambulation
keep pain under control
--Things to check when infusing blood - -verify IV is 20g or larger
transfuse with NS only
use blood tubing
verify blood with 2nd person
remain with the patient for the first 15 minutes
, describe s/s the patient should report
start the infusion within 30 minutes of receiving the blood
complete the infusion within 4 hours
--You are admitting a patient who flew in from Madagascar yesterday and is
complaining of leg pain and shortness of breath. What do you do first? - -assess
ABCs
--In order to maintain restraints - -active order: type, time applied, reason
assess at least q2h: circulation, ongoing need for restraint, patient's need for
food/hydration and toileting
--Ways to break sterile technique - -a sterile item goes over the 1 inch border
a non-sterile item touches inside the 1 inch border
you turn your back on the sterile field
those present don't wear masks
something wet goes through the sterile field
you touch a non-sterile item with sterile gloves
--Your patient voices discouragement regarding all the different kinds of pills
they are being discharged with. What would be the best response? - -"what are
you most concerned about with your medications?"
--Things to do/monitor with a pt receiving enteral feedings - -monitor:
electrolytes, I&Os, abdominal cramping, diarrhea
do: keep HOB elevated, flush with H2O prior to and after meds, oral care
--Your pt's O2 is 95% on RA, she has had a 5 lb weight gain over the last week,
hasn't urinated in 2 days, and has +4 pitting edema. which would be your
priority nursing diagnosis?
a. impaired gas exchange related to ineffective breathing
b. fluid volume, deficient related to excess fluid loss
c. electrolyte imbalance related to decreased oral intake
d. fluid volume, excess related to limited fluid output - -d. fluid volume, excess
related to limited fluid output
--When to clamp a chest tube - -checking for air leak
prior to removal
changing the chamber
when there's an order for it
--You are caring for a pt post-fem-pop bypass on their right leg. Name four ways
you will assess peripheral circulation. - -color
temperature
pulses
cap refill
edema
(compartment syndrome)
--Name three things you should know, specific to the route, for a medication
ordered IVP. - -compatibility with other medications
need to dilute
duration of infusion
UPDATE WITH COMPLETE SOLUTION
Fluid in the lungs sounds like - -crackles
--Ausculation of the heart placement - -APEToMan
aortic
pulmonic
erb's point
tricuspic
mitral
--Physiologic and system changes during the dying process - -all body systems
slow down
--Which patient is of highest priority
a. tracheal edema after extubation
b. emphysema, O2 88% and tachypneic
c. heart failure, +4 pitting edema and irregular HR
d. meningitis, temp 40 and pain 7/10 - -a. tracheal edema after extubation
--Indications of over-hydration - -crackles in the lungs
edema
bounding pulses
hypertension
intake > output
tachycardia
increased body weight
--How to prevent DVTs - -apply SCDs
encourage ambulation
elevate legs in bed
apply compression stockings
encourage the patient to change positions in bed
ensure the patient has a DVT prophylaxis med ordered
--Progression of pressure injuries - -stage 1: "non-blanching"
stage 2: surface
stage 3: penetrating surface
deep tissue injury
--How to prevent pneumonia - -incentive spirometry
make sure the pt is awake enough before giving anything PO
encouraging coughing and deep breathing (CDB)
encourage ambulation
keep pain under control
--Things to check when infusing blood - -verify IV is 20g or larger
transfuse with NS only
use blood tubing
verify blood with 2nd person
remain with the patient for the first 15 minutes
, describe s/s the patient should report
start the infusion within 30 minutes of receiving the blood
complete the infusion within 4 hours
--You are admitting a patient who flew in from Madagascar yesterday and is
complaining of leg pain and shortness of breath. What do you do first? - -assess
ABCs
--In order to maintain restraints - -active order: type, time applied, reason
assess at least q2h: circulation, ongoing need for restraint, patient's need for
food/hydration and toileting
--Ways to break sterile technique - -a sterile item goes over the 1 inch border
a non-sterile item touches inside the 1 inch border
you turn your back on the sterile field
those present don't wear masks
something wet goes through the sterile field
you touch a non-sterile item with sterile gloves
--Your patient voices discouragement regarding all the different kinds of pills
they are being discharged with. What would be the best response? - -"what are
you most concerned about with your medications?"
--Things to do/monitor with a pt receiving enteral feedings - -monitor:
electrolytes, I&Os, abdominal cramping, diarrhea
do: keep HOB elevated, flush with H2O prior to and after meds, oral care
--Your pt's O2 is 95% on RA, she has had a 5 lb weight gain over the last week,
hasn't urinated in 2 days, and has +4 pitting edema. which would be your
priority nursing diagnosis?
a. impaired gas exchange related to ineffective breathing
b. fluid volume, deficient related to excess fluid loss
c. electrolyte imbalance related to decreased oral intake
d. fluid volume, excess related to limited fluid output - -d. fluid volume, excess
related to limited fluid output
--When to clamp a chest tube - -checking for air leak
prior to removal
changing the chamber
when there's an order for it
--You are caring for a pt post-fem-pop bypass on their right leg. Name four ways
you will assess peripheral circulation. - -color
temperature
pulses
cap refill
edema
(compartment syndrome)
--Name three things you should know, specific to the route, for a medication
ordered IVP. - -compatibility with other medications
need to dilute
duration of infusion
