Barry University NUR 432: Final Exam NUR432| 100 Q&A | Latest 2025/26.

NUR 432 Final Exam 100 Q&A Latest 2026. Cardiac (Questions 1-25) 1. For a patient in sinus bradycardia with a systolic BP 90 mmHg, what is the first-line pharmacological treatment? o A) Amiodarone o B) Epinephrine o C) Dopamine o D) Transcutaneous Pacemaker 2. A patient is in Ventricular Tachycardia (VT) with a pulse but is hypotensive. What is the immediate treatment? o A) CPR and defibrillation o B) Administration of Lidocaine o C) Synchronized cardioversion o D) Transcutaneous pacing 3. What is the initial treatment for a patient in Ventricular Fibrillation (V-Fib) with no pulse? o A) Administer Amiodarone IV push o B) Initiate CPR and defibrillate o C) Start a Lidocaine drip o D) Prepare for synchronized cardioversion 4. A patient with newly diagnosed Atrial Fibrillation (A-fib) presents to the ER within 2 hours of symptom onset. What intervention might be indicated? o A) Rate control with Metoprolol o B) Anticoagulation with Warfarin o C) Electrical cardioversion o D) Catheter ablation 5. What is the correct treatment for a patient in asystole? o A) Immediate defibrillation o B) Administration of Epinephrine; DO NOT DEFIBRILLATE o C) Synchronized cardioversion o D) Administration of Adenosine 6. A patient is receiving Procainamide for a ventricular arrhythmia. What is its primary mechanism of action? o A) Increases myocardial contractility o B) Decreases myocardial excitability and slows conduction o C) Causes peripheral vasodilation o D) Blocks adrenergic stimulation 7. Amiodarone has which of the following significant properties? o A) It works immediately and its effects wear off quickly. o B) It may take weeks to be effective, and adverse effects can last for months. o C) It primarily increases heart rate. o D) It is contraindicated in all atrial arrhythmias. 8. During a cardiac arrest, Epinephrine is administered primarily for what effect? o A) Bronchodilation o B) To increase arterial BP and coronary perfusion o C) To slow the heart rate o D) As a potent diuretic 9. What is the therapeutic INR range for a patient on Warfarin therapy? o A) 1.0 - 1.5 o B) 2.0 - 3.0 o C) 3.5 - 4.5 o D) 0.5 - 1.0 10. Patient education for Warfarin includes advising them to: o A) Increase intake of green leafy vegetables. o B) Use a soft toothbrush and an electric razor. o C) Take the medication with milk. o D) Expect orange discoloration of urine. 11. A patient with Ventricular Hypertrophy should typically avoid which medication? o A) Beta-blockers (e.g., Metoprolol) o B) Calcium Channel Blockers o C) Digoxin o D) ACE Inhibitors 12. What is the key difference between stable and unstable angina? o A) Stable angina is unpredictable; unstable is predictable. o B) Stable angina is relieved by rest or nitroglycerin; unstable angina is not. o C) Unstable angina is less severe. o D) Only unstable angina requires medical attention. 13. After a cardiac catheterization via the femoral artery, what is a critical nursing intervention? o A) Encourage ambulation within 2 hours. o B) Keep the leg straight and immobilize it for 6-8 hours. o C) Apply a heating pad to the site for comfort. o D) Restrict fluids to prevent overload. 14. A patient experiencing chest pain takes one nitroglycerin tablet sublingually. The pain is not relieved after 5 minutes. What should the nurse instruct the patient to do? o A) Take two more tablets immediately. o B) Take a second tablet, and if no relief in 5 more minutes, take a third. o C) Lie down and wait 15 minutes before taking another. o D) Call 911 immediately after the first tablet fails. 15. What lab value is the "gold standard" blood test for diagnosing heart failure? o A) Troponin I o B) CK-MB o C) B-type Natriuretic Peptide (BNP) o D) D-dimer 16. A patient presents with fatigue, distended jugular veins, hepatomegaly, and dependent edema. This is most indicative of: o A) Left-sided heart failure o B) Right-sided heart failure o C) Cardiogenic shock o D) Pericarditis 17. Management of right-sided heart failure primarily focuses on reducing: o A) Afterload o B) Contractility o C) Heart rate o D) Preload (with diuretics and fluid restriction) 18. The P wave on an ECG represents: o A) Ventricular depolarization o B) Atrial depolarization o C) Ventricular repolarization o D) Atrial repolarization 19. A normal PR interval is: o A) 0.06 - 0.10 seconds o B) 0.12 - 0.20 seconds o C) Less than 0.12 seconds o D) 0.20 - 0.30 seconds 20. The acronym "MONA" for acute MI treatment stands for: o A) Morphine, Oxygen, Nitrates, Aspirin o B) Metoprolol, Oxygen, Nitroglycerin, Aspirin o C) Morphine, Oxygen, Norepinephrine, Atenolol o D) Metoprolol, Oxygen, Nitrates, Anticoagulant 21. Which lab value is most specific to myocardial injury? o A) CK-MB o B) Troponin I o C) Myoglobin o D) BNP 22. A complication of MI that presents with sharp chest pain relieved by sitting up and leaning forward is: o A) Ventricular aneurysm o B) Cardiogenic shock o C) Pericarditis o D) Papillary muscle dysfunction 23. Which valve disorder is most commonly caused by Rheumatic Heart Disease? o A) Aortic stenosis o B) Mitral valve prolapse o C) Mitral valve stenosis o D) Tricuspid regurgitation 24. A patient with a mechanical heart valve requires lifelong: o A) Antibiotic therapy o B) Anticoagulant therapy o C) Steroid therapy o D) Diuretic therapy 25. Tender, painful nodules on the pads of fingers and toes (Osler's nodes) are a late sign of: o A) Pericarditis o B) Endocarditis o C) Myocarditis o D) Cardiomyopathy Respiratory (Questions 26-45) 26. A patient's ABG results are: pH 7.50, PaCO2 30, HCO3 24. This indicates: o A) Metabolic acidosis o B) Metabolic alkalosis o C) Respiratory acidosis o D) Respiratory alkalosis 27. The primary diagnostic test for a Pulmonary Embolism (PE) is: o A) Chest X-ray o B) D-dimer o C) CT Pulmonary Angiogram (CTPA) o D) Ventilation-Perfusion (V/Q) scan 28. Initial treatment for a hemodynamically stable patient with a PE involves: o A) IV Heparin or LMWH overlap with Warfarin o B) Immediate thrombolytic therapy o C) Surgical embolectomy o D) Aspirin therapy only o 29. A patient in status asthmaticus is not responding to initial bronchodilators. The nurse should prepare for: o A) Discharge with oral steroids o B) Back-to-back nebulizer treatments and IV corticosteroids o C) Administration of an ACE inhibitor o D) Immediate chest tube insertion 30. A high-pressure alarm sounds on a ventilator. The nurse's first action should be to: o A) Increase the tidal volume setting. o B) Check the patient for biting the ETT or assess for secretions. o C) Administer a paralytic agent. o D) Silence the alarm and call respiratory therapy. 31. The priority intervention for a patient with a suspected upper airway obstruction is: o A) Administer oxygen. o B) Perform abdominal thrusts (Heimlich maneuver). o C) Administer steroids. o D) Prepare for intubation. 32. When verifying placement of a newly inserted endotracheal tube (ETT), the nurse should: o A) Listen for breath sounds over the stomach first. o B) Listen for bilateral breath sounds and check for condensation in the tube. o C) Secure the tube immediately before checking. o D) Inflate the cuff to 50 cm H2O. 33. A patient with a tracheostomy has thick secretions. To safely suction, the nurse should: o A) Suction for 30-45 seconds. o B) Use sterile saline lavage routinely. o C) Pre-oxygenate and limit suctioning to 15 seconds. o D) Apply suction while inserting the catheter. 34. Which oxygen delivery device can deliver the highest FiO2 (80-95%)? o A) Nasal cannula o B) Simple face mask o C) Venturi mask o D) Non-rebreather mask 35. The hallmark sign of Acute Respiratory Distress Syndrome (ARDS) is: o A) Hypertension o B) Refractory hypoxemia o C) Productive cough o D) Bradycardia 36. A key strategy in mechanical ventilation for ARDS is using: o A) High tidal volumes o B) Low tidal volumes and PEEP o C) No PEEP o D) Inverse ratio ventilation only 37. In which ventilator mode does the patient trigger every breath, but the ventilator delivers a preset volume? o A) Controlled Mandatory Ventilation (CMV) o B) Assist-Control (A/C) o C) Synchronized Intermittent Mandatory Ventilation (SIMV) o D) Continuous Positive Airway Pressure (CPAP) 38. A trauma patient has absent breath sounds on the right, hyperresonance to percussion, and tracheal deviation to the left. This indicates: o A) Tension pneumothorax o B) Hemothorax o C) Simple pneumothorax o D) Pulmonary contusion 39. When a chest tube is accidentally pulled out of a patient's chest, the nurse's immediate action is to: o A) Try to reinsert it. o B) Cover the site with a sterile occlusive dressing taped on three sides. o C) Apply direct pressure with a gauze pad. o D) Place the patient in Trendelenburg position. 40. Continuous bubbling in the water-seal chamber of a chest drainage system indicates: o A) Normal evaporation o B) An air leak in the system o C) Proper suction control o D) That the lung has fully re-expanded 41. To confirm proper placement of a chest tube for a pneumothorax, the nurse would expect it to be inserted in the: o A) 2nd-3rd intercostal space, midclavicular line o B) 4th-5th intercostal space, midaxillary line o C) 8th-9th intercostal space, posteriorly o D) Subcostal area 42. BiPAP differs from CPAP because it provides: o A) No pressure support o B) Two different pressures: higher on inhalation, lower on exhalation o C) Pressure only during exhalation o D) Intermittent mandatory breaths 43. A normal PaO2 level in an ABG is: o A) 35-45 mmHg o B) 80-100 mmHg o C) 22-26 mEq/L o D) 60 mmHg 44. A patient with COPD is most likely to have what type of acid-base imbalance? o A) Respiratory acidosis o B) Respiratory alkalosis o C) Metabolic acidosis o D) Metabolic alkalosis 45. Which condition results from failure to clear fetal lung fluid and is common in cesarean section babies? o A) Respiratory Distress Syndrome (RDS) o B) Transient Tachypnea of the Newborn (TTN) o C) Meconium Aspiration Syndrome (MAS) o D) Bronchopulmonary Dysplasia (BPD) Shock & Renal (Questions 46-60) 46. Signs of hypovolemic shock include all EXCEPT: o A) Tachycardia o B) Hypotension o C) Warm, flushed skin o D) Decreased urinary output 47. The patient population at greatest risk for Cardiogenic Shock is those with: o A) A recent Myocardial Infarction (MI) o B) Chronic kidney disease o C) Peptic ulcer disease o D) Asthma 48. The priority intervention for anaphylactic shock is: o A) Administer IV fluids o B) Administer Epinephrine o C) Position the patient supine o D) Start Dopamine drip 49. A key diagnostic indicator for severe sepsis progressing to septic shock is: o A) Hypertension o B) Lactic acid level 4 mmol/L o C) Bradycardia o D) Hypoglycemia 50. When administering a blood transfusion, the nurse must check vital signs: o A) Only at the end of the infusion o B) At baseline, 15 minutes after starting, and at completion o C) Every hour o D) Only if the patient complains of symptoms 51. A normal Mean Arterial Pressure (MAP) is: o A) 50-60 mmHg o B) 70-100 mmHg o C) 110-120 mmHg o D) 120 mmHg 52. A key difference between Acute and Chronic Renal Failure is: o A) Acute is reversible; chronic is progressive and irreversible. o B) Chronic always has a sudden onset. o C) Acute is characterized by polyuria. o D) Chronic is never caused by hypertension. 53. Prerenal acute renal failure is most commonly caused by: o A) Direct kidney infection o B) Glomerulonephritis o C) Hypovolemia/ decreased perfusion (e.g., shock, dehydration) o D) Urinary tract obstruction 54. A patient with Chronic Kidney Disease (CKD) is started on Epoetin alfa. The goal of this medication is to: o A) Lower potassium levels o B) Stimulate red blood cell production (treat anemia) o C) Increase urine output o D) Bind phosphorus 55. For a patient with a new arteriovenous (AV) fistula for hemodialysis, which nursing action is contraindicated? o A) Auscultating for a bruit o B) Palpating for a thrill o C) Taking a blood pressure on the same arm o D) Assessing capillary refill in the fingers 56. The primary indication for initiating hemodialysis is: o A) Mild anemia o B) Fluid overload and electrolyte imbalances (e.g., hyperkalemia) unresponsive to medical management o C) Hypertension o D) Low creatinine levels 57. Peritoneal Dialysis (PD) carries a high risk for: o A) Hyperglycemia o B) Peritonitis o C) Air embolism o D) Vascular steal syndrome 58. A normal Glomerular Filtration Rate (GFR) is approximately: o A) 30-59 mL/min o B) 60-89 mL/min o C) 90-125 mL/min o D) 125 mL/min 59. Elevated WBCs in a urinalysis most likely indicate: o A) Kidney stones o B) Urinary Tract Infection (UTI) o C) Diabetes insipidus o D) Normal finding 60. A patient with CKD should generally avoid which class of medications due to their effect on the GFR? o A) Antibiotics o B) NSAIDs o C) Antihistamines o D) Bronchodilators Neurological (Questions 61-75) 61. A key diagnostic test to differentiate between an ischemic and hemorrhagic stroke is: o A) Lumbar Puncture o B) EEG o C) Non-contrast Head CT o D) MRI with contrast 62. The time window for administering IV t-PA for an ischemic stroke is: o A) 30 minutes from symptom onset o B) 3 hours (or up to 4.5 hours in some criteria) o C) 6 hours o D) 24 hours 63. Cushing's Triad, indicative of increased Intracranial Pressure (ICP), includes: o A) Hypertension, bradycardia, irregular respirations o B) Hypotension, tachycardia, tachypnea o C) Fever, headache, photophobia o D) Decorticate posturing, fixed pupils, hyperthermia 64. Which IV solution is used to treat cerebral edema and lower ICP? o A) 0.45% Normal Saline o B) D5W o C) Lactated Ringer's o D) Mannitol or 3% Hypertonic Saline 65. A patient with a cervical spinal cord injury at C3-C4 is at greatest risk for: o A) Paraplegia o B) Autonomic dysreflexia o C) Respiratory failure o D) Neurogenic shock with hypotension and bradycardia 66. Syndrome of Inappropriate Antidiuretic Hormone (SIADH) is characterized by: o A) High serum sodium, low urine output o B) Low serum sodium, high urine osmolality, fluid retention o C) Hyperglycemia, polyuria o D) Hypercalcemia, confusion 67. Diabetes Insipidus (DI) results from a lack of ADH and presents with: o A) Concentrated urine and hypernatremia o B) Dilute urine in large volumes and hypernatremia o C) Low urine output and hyponatremia o D) Glycosuria and polydipsia 68. Which cranial nerve is responsible for pupillary constriction and eye movement? o A) Cranial Nerve II (Optic) o B) Cranial Nerve III (Oculomotor) o C) Cranial Nerve V (Trigeminal) o D) Cranial Nerve VII (Facial) 69. After a lumbar puncture, the nurse should instruct the patient to: o A) Ambulate immediately to prevent headache. o B) Lie flat for a period of time to prevent a spinal headache. o C) Limit fluid intake for 8 hours. o D) Sit upright to reduce CSF pressure. 70. A patient with Atrial Fibrillation is at increased risk for which type of stroke? o A) Hemorrhagic stroke o B) Ischemic stroke (from cardioembolism) o C) Subarachnoid hemorrhage o D) Lacunar stroke 71. A major risk of t-PA therapy for stroke is: o A) Hypertension o B) Infection o C) Bleeding/hemorrhage o D) Seizure 72. A patient with a brain tumor displays signs of increased ICP. Which order should the nurse question? o A) Elevate head of bed 30 degrees. o B) Administer Mannitol 50g IV. o C) Perform a lumbar puncture for CSF analysis. o D) Maintain PaO2 80 and PaCO2 35-40. 73. Which medication is used to prevent cerebral vasospasm after a subarachnoid hemorrhage? o A) Heparin o B) Nimodipine o C) Phenytoin o D) Dexamethasone 74. Normal ICP is: o A) 0-15 mmHg o B) 20-30 mmHg o C) 40-60 mmHg o D) 5 mmHg 75. The Babinski reflex (toes fan upward) in an adult is a sign of: o A) Normal neurological function o B) Upper motor neuron lesion o C) Lower motor neuron lesion o D) Cerebellar dysfunction Gastrointestinal (Questions 76-90) 76. Hepatitis B is primarily transmitted through: o A) Fecal-oral route o B) Blood and body fluids (sexual contact, needle sticks) o C) Contaminated water o D) Airborne droplets 77. There is currently no vaccine available for which type of hepatitis? o A) Hepatitis A o B) Hepatitis B o C) Hepatitis C o D) Hepatitis D 78. The most common cause of acute pancreatitis is: o A) Viral infection o B) Gallstones and alcohol abuse o C) Autoimmune disease o D) Scorpion sting 79. After a liver biopsy, the nurse should position the patient on their: o A) Left side o B) Right side (to tamponade the site) o C) Back, with HOB elevated o D) Abdomen 80. A major complication of end-stage liver cirrhosis is: o A) Hypoglycemia o B) Bleeding esophageal varices o C) Constipation o D) Hypertension 81. Lactulose is administered to patients with cirrhosis to: o A) Reduce abdominal ascites o B) Lower serum ammonia levels and treat encephalopathy o C) Promote bile flow o D) Treat portal hypertension 82. Which medication class is used to reduce gastric acid production and promote ulcer healing? o A) Antacids (e.g., Mylanta) o B) H2 Receptor Antagonists (e.g., Famotidine) o C) Cytoprotective Agents (e.g., Sucralfate) o D) Proton Pump Inhibitors (e.g., Pantoprazole) 83. Total Parenteral Nutrition (TPN) must be administered through: o A) A peripheral IV o B) A central venous catheter o C) A nasogastric tube o D) A subcutaneous site 84. A patient undergoing a paracentesis should: o A) Have a full bladder o B) Be NPO for 12 hours prior o C) Lie flat on their back o D) Receive prophylactic antibiotics 85. The most common cause of peptic ulcers is: o A) Spicy food o B) Stress o C) Infection with H. pylori or use of NSAIDs o D) Alcohol consumption 86. Cullen's sign (periumbilical bruising) and Grey-Turner's sign (flank bruising) are associated with: o A) Hepatitis o B) Severe acute pancreatitis o C) Cholecystitis o D) Diverticulitis 87. A patient with end-stage liver disease and GI bleeding becomes combative and confused. The nurse suspects elevated ammonia levels and should prepare to administer: o A) Pantoprazole o B) Octreotide o C) Lactulose o D) Vitamin K 88. The purpose of Sucralfate (Carafate) in treating gastric ulcers is to: o A) Neutralize gastric acid o B) Reduce acid production o C) Form a protective barrier over the ulcer o D) Eradicate H. pylori 89. In assessing abdominal pain, the appendix is located in the: o A) Right Upper Quadrant (RUQ) o B) Left Upper Quadrant (LUQ) o C) Right Lower Quadrant (RLQ) o D) Left Lower Quadrant (LLQ) 90. Which diagnostic test is used to detect H. pylori infection? o A) Liver function tests o B) Urea breath test o C) Serum amylase o D) Abdominal ultrasound Burns, Skin, & Disaster (Questions 91-100) 91. Using the Rule of Nines, an adult's entire anterior trunk accounts for what percentage of Total Body Surface Area (TBSA)? o A) 9% o B) 18% o C) 36% o D) 1% 92. A burn that appears red, moist, and has blisters is classified as: o A) Superficial (1st degree) o B) Partial-thickness (2nd degree) o C) Full-thickness (3rd degree) o D) Fourth degree 93. The topical antimicrobial agent of choice for a patient with a facial burn is: o A) Silver sulfadiazine (Silvadene) o B) Mafenide acetate (Sulfamylon) o C) Bacitracin o D) Silver nitrate 94. A patient with major burns in the emergent phase will have fluid resuscitation calculated based on: o A) The Parkland formula (4 mL LR x kg x % TBSA) o B) Their oral intake o C) A standard bolus of 1 liter o D) Their urine output only 95. The primary nursing concern for a patient with an inhalation injury is: o A) Infection o B) Airway obstruction o C) Pain o D) Hypothermia 96. In disaster triage, a patient who is breathing but has a capillary refill 2 seconds is tagged with which color? o A) Green (Minor/Walking Wounded) o B) Yellow (Delayed) o C) Red (Immediate) o D) Black (Expectant) 97. Level A PPE (Personal Protective Equipment) includes: o A) Gloves and gown only o B) A full encapsulated suit with Self-Contained Breathing Apparatus (SCBA) o C) A simple mask and eye protection o D) An N95 respirator and face shield 98. Pulmonary Anthrax is treated with: o A) Penicillin G only o B) Ciprofloxacin or Doxycycline o C) Antifungal agents o D) Supportive care only; no antimicrobials are effective 99. A Stage 3 pressure ulcer involves: o A) Non-blanchable erythema of intact skin o B) Partial-thickness skin loss o C) Full-thickness skin loss with damage to subcutaneous tissue o D) Full-thickness tissue loss with exposed bone/tendon 100. A patient presents hot, dry, ashen skin, altered mental status, and a temperature of 105°F (40.6°C). The nurse suspects: * A) Hypothermia * B) Heat exhaustion * C) Heat stroke * D) Sepsis