NURS 640 EXAM SCRIPT 2026 FULL
QUESTIONS AND CORRECT ANSWERS
ALREADY PASSED
◉ 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
◉ A client tells the nurse that she had rheumatic heart disease as a child.
For which of the following valvular disorders should this client be
assessed? Answer: Mitral stenosis
◉ A client, recovering from surgery to replace a calcified aortic valve
with a mechanical valve, should be instructed that which of the
following medications will be needed long term? Answer: Anticoagulant
QUESTIONS AND CORRECT ANSWERS
ALREADY PASSED
◉ 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
◉ A client tells the nurse that she had rheumatic heart disease as a child.
For which of the following valvular disorders should this client be
assessed? Answer: Mitral stenosis
◉ A client, recovering from surgery to replace a calcified aortic valve
with a mechanical valve, should be instructed that which of the
following medications will be needed long term? Answer: Anticoagulant
