NUR 215 EXAM 3 STUDY GUIDE | TESTBANK | PRACTICE QUESTIONS & ANSWERS |
EXAM PREPARATION | ADVANCED REVIEW | COMPREHENSIVE PRACTICE EXAM |
LATEST UPDATE 2026/2027
Examiner:
Arizona College of Nursing
TABLE OF CONTENTS
1. Cardiovascular Disorders and Nursing Management
2. Respiratory Disorders and Clinical Decision-Making
3. Hematologic and Immune System Disorders
4. Endocrine Disorders
5. Renal and Urinary Disorders
6. Gastrointestinal Disorders
7. Fluid, Electrolyte, and Acid-Base Balance
8. Pharmacologic Management
9. Nursing Assessment and Prioritization
10. Patient Safety, Clinical Judgment, and Professional Practice
CARDIOVASCULAR || RESPIRATORY || HEMATOLOGY || ENDOCRINE || RENAL ||
GASTROINTESTINAL || FLUID BALANCE || ELECTROLYTES || ACID-BASE ||
PHARMACOLOGY || NURSING PROCESS || PRIORITIZATION || CLINICAL JUDGMENT
|| PATIENT SAFETY || EVIDENCE-BASED PRACTICE || COMPREHENSIVE REVIEW ||
ADVANCED EXAM PREPARATION
QUESTION 1.
A nurse is caring for a patient admitted with acute decompensated heart failure. Four
hours after receiving intravenous furosemide, the patient becomes increasingly
lethargic. Laboratory results reveal potassium 2.8 mEq/L. Which nursing action has
the highest priority?
A. Encourage foods rich in potassium.
B. Administer prescribed potassium replacement immediately.
,C. Restrict oral fluids to reduce cardiac workload.
D. Continue monitoring because mild hypokalemia is expected.
Correct Answer: B. Administer prescribed potassium replacement immediately.
Explanation: Severe hypokalemia significantly increases the risk for life-threatening
cardiac dysrhythmias and requires prompt correction. Dietary intake is inadequate
for acute replacement, fluid restriction does not address the immediate problem,
and hypokalemia should never be considered an expected finding requiring only
observation.
────────────────────────────────────────
QUESTION 2.
A patient with chronic obstructive pulmonary disease suddenly becomes confused
while receiving oxygen at 6 L/min via nasal cannula. Which interpretation by the
nurse is most appropriate?
A. The patient is likely experiencing oxygen-induced hypoventilation.
B. The patient is developing hypoglycemia.
C. The confusion indicates improving oxygenation.
D. The patient requires immediate fluid resuscitation.
Correct Answer: A. The patient is likely experiencing oxygen-induced
hypoventilation.
Explanation: Excessive oxygen administration in some patients with chronic COPD
may reduce respiratory drive and worsen carbon dioxide retention, leading to
altered mental status. Hypoglycemia should be confirmed before assuming its
presence, improved oxygenation does not cause confusion, and fluid resuscitation is
not supported by the scenario.
────────────────────────────────────────
QUESTION 3.
,A nurse reviews arterial blood gas results: pH 7.30, PaCO₂ 52 mmHg, HCO₃⁻ 25
mEq/L. Which interpretation is most accurate?
A. Metabolic acidosis without compensation
B. Respiratory alkalosis with full compensation
C. Respiratory acidosis without metabolic compensation
D. Fully compensated metabolic alkalosis
Correct Answer: C. Respiratory acidosis without metabolic compensation.
Explanation: The low pH indicates acidosis, while the elevated PaCO₂ identifies a
respiratory cause. Because bicarbonate remains within the normal range, renal
compensation has not yet occurred. The remaining options are inconsistent with
the laboratory findings.
────────────────────────────────────────
QUESTION 4.
A patient with diabetic ketoacidosis begins insulin therapy. Which assessment finding
requires the nurse's most immediate intervention?
A. Blood glucose decreases from 480 mg/dL to 260 mg/dL.
B. Serum potassium decreases from 5.8 mEq/L to 3.2 mEq/L.
C. Respiratory rate decreases from 30 to 22 breaths/min.
D. Urine output increases to 60 mL/hr.
Correct Answer: B. Serum potassium decreases from 5.8 mEq/L to 3.2 mEq/L.
Explanation: Insulin drives potassium into cells, placing the patient at significant
risk for hypokalemia and potentially fatal cardiac dysrhythmias. The remaining
findings are expected indicators of therapeutic improvement during treatment.
────────────────────────────────────────
QUESTION 5.
, A nurse is assessing a patient with suspected upper gastrointestinal bleeding. Which
finding most strongly suggests significant blood loss requiring rapid intervention?
A. Mild epigastric discomfort
B. Black tarry stool without symptoms
C. Heart rate of 128 beats/min with hypotension
D. Nausea after meals
Correct Answer: C. Heart rate of 128 beats/min with hypotension
Explanation: Tachycardia accompanied by hypotension suggests hemodynamic
instability from significant blood loss requiring immediate intervention. Melena
alone may indicate bleeding but does not necessarily reflect current instability.
Epigastric discomfort and nausea are less urgent findings.
────────────────────────────────────────
QUESTION 6.
A patient receiving heparin develops sudden flank pain and hematuria. Which
nursing action is most appropriate?
A. Continue the infusion and reassess in one hour.
B. Administer aspirin for pain relief.
C. Stop the heparin infusion and notify the provider immediately.
D. Increase intravenous fluids only.
Correct Answer: C. Stop the heparin infusion and notify the provider
immediately.
Explanation: Flank pain and hematuria may indicate serious bleeding related to
anticoagulation. The medication should be stopped promptly while the provider is
notified. Continuing therapy or administering aspirin could worsen bleeding, and
fluids alone are insufficient management.
────────────────────────────────────────
QUESTION 7.
EXAM PREPARATION | ADVANCED REVIEW | COMPREHENSIVE PRACTICE EXAM |
LATEST UPDATE 2026/2027
Examiner:
Arizona College of Nursing
TABLE OF CONTENTS
1. Cardiovascular Disorders and Nursing Management
2. Respiratory Disorders and Clinical Decision-Making
3. Hematologic and Immune System Disorders
4. Endocrine Disorders
5. Renal and Urinary Disorders
6. Gastrointestinal Disorders
7. Fluid, Electrolyte, and Acid-Base Balance
8. Pharmacologic Management
9. Nursing Assessment and Prioritization
10. Patient Safety, Clinical Judgment, and Professional Practice
CARDIOVASCULAR || RESPIRATORY || HEMATOLOGY || ENDOCRINE || RENAL ||
GASTROINTESTINAL || FLUID BALANCE || ELECTROLYTES || ACID-BASE ||
PHARMACOLOGY || NURSING PROCESS || PRIORITIZATION || CLINICAL JUDGMENT
|| PATIENT SAFETY || EVIDENCE-BASED PRACTICE || COMPREHENSIVE REVIEW ||
ADVANCED EXAM PREPARATION
QUESTION 1.
A nurse is caring for a patient admitted with acute decompensated heart failure. Four
hours after receiving intravenous furosemide, the patient becomes increasingly
lethargic. Laboratory results reveal potassium 2.8 mEq/L. Which nursing action has
the highest priority?
A. Encourage foods rich in potassium.
B. Administer prescribed potassium replacement immediately.
,C. Restrict oral fluids to reduce cardiac workload.
D. Continue monitoring because mild hypokalemia is expected.
Correct Answer: B. Administer prescribed potassium replacement immediately.
Explanation: Severe hypokalemia significantly increases the risk for life-threatening
cardiac dysrhythmias and requires prompt correction. Dietary intake is inadequate
for acute replacement, fluid restriction does not address the immediate problem,
and hypokalemia should never be considered an expected finding requiring only
observation.
────────────────────────────────────────
QUESTION 2.
A patient with chronic obstructive pulmonary disease suddenly becomes confused
while receiving oxygen at 6 L/min via nasal cannula. Which interpretation by the
nurse is most appropriate?
A. The patient is likely experiencing oxygen-induced hypoventilation.
B. The patient is developing hypoglycemia.
C. The confusion indicates improving oxygenation.
D. The patient requires immediate fluid resuscitation.
Correct Answer: A. The patient is likely experiencing oxygen-induced
hypoventilation.
Explanation: Excessive oxygen administration in some patients with chronic COPD
may reduce respiratory drive and worsen carbon dioxide retention, leading to
altered mental status. Hypoglycemia should be confirmed before assuming its
presence, improved oxygenation does not cause confusion, and fluid resuscitation is
not supported by the scenario.
────────────────────────────────────────
QUESTION 3.
,A nurse reviews arterial blood gas results: pH 7.30, PaCO₂ 52 mmHg, HCO₃⁻ 25
mEq/L. Which interpretation is most accurate?
A. Metabolic acidosis without compensation
B. Respiratory alkalosis with full compensation
C. Respiratory acidosis without metabolic compensation
D. Fully compensated metabolic alkalosis
Correct Answer: C. Respiratory acidosis without metabolic compensation.
Explanation: The low pH indicates acidosis, while the elevated PaCO₂ identifies a
respiratory cause. Because bicarbonate remains within the normal range, renal
compensation has not yet occurred. The remaining options are inconsistent with
the laboratory findings.
────────────────────────────────────────
QUESTION 4.
A patient with diabetic ketoacidosis begins insulin therapy. Which assessment finding
requires the nurse's most immediate intervention?
A. Blood glucose decreases from 480 mg/dL to 260 mg/dL.
B. Serum potassium decreases from 5.8 mEq/L to 3.2 mEq/L.
C. Respiratory rate decreases from 30 to 22 breaths/min.
D. Urine output increases to 60 mL/hr.
Correct Answer: B. Serum potassium decreases from 5.8 mEq/L to 3.2 mEq/L.
Explanation: Insulin drives potassium into cells, placing the patient at significant
risk for hypokalemia and potentially fatal cardiac dysrhythmias. The remaining
findings are expected indicators of therapeutic improvement during treatment.
────────────────────────────────────────
QUESTION 5.
, A nurse is assessing a patient with suspected upper gastrointestinal bleeding. Which
finding most strongly suggests significant blood loss requiring rapid intervention?
A. Mild epigastric discomfort
B. Black tarry stool without symptoms
C. Heart rate of 128 beats/min with hypotension
D. Nausea after meals
Correct Answer: C. Heart rate of 128 beats/min with hypotension
Explanation: Tachycardia accompanied by hypotension suggests hemodynamic
instability from significant blood loss requiring immediate intervention. Melena
alone may indicate bleeding but does not necessarily reflect current instability.
Epigastric discomfort and nausea are less urgent findings.
────────────────────────────────────────
QUESTION 6.
A patient receiving heparin develops sudden flank pain and hematuria. Which
nursing action is most appropriate?
A. Continue the infusion and reassess in one hour.
B. Administer aspirin for pain relief.
C. Stop the heparin infusion and notify the provider immediately.
D. Increase intravenous fluids only.
Correct Answer: C. Stop the heparin infusion and notify the provider
immediately.
Explanation: Flank pain and hematuria may indicate serious bleeding related to
anticoagulation. The medication should be stopped promptly while the provider is
notified. Continuing therapy or administering aspirin could worsen bleeding, and
fluids alone are insufficient management.
────────────────────────────────────────
QUESTION 7.
