NUR 213 -Complex Health Concepts Comprehensive Final
EXAM 2026-2027 LATEST UPDATED VERSION QUESTIONS AND
ANSWERS
When caring for a client with an abdominal aortic aneurysm (AAA), the nurse suspects dissection of the
aneurysm when the client makes which statement?
A. "I feel my heart beating in my abdominal area."
B. "I just started to feel a tearing pain in my belly."
C. "I have a headache. May I have some acetaminophen?"
D. "I have had hoarseness for a few weeks." - answer>>B
Rationale: Severe pain of sudden onset in the back or lower abdomen, which may radiate to the groin,
buttocks, or legs, is indicative of impending rupture of AAA.
To evaluate both oxygenation and ventilation in a patient with acute respiratory failure, the nurse uses
the findings revealed with
a. arterial blood gas (ABG) analysis.
b. hemodynamic monitoring.
c. chest x-rays.
d. pulse oximetry. - answer>>A
Rationale: ABG analysis is useful because it provides information about both oxygenation and
ventilation and assists with determining possible etiologies and appropriate treatment. The other tests
may also provide useful information about patient status but will not indicate whether the patient has
hypoxemia, hypercapnia, or both.
. A finding indicating to the nurse that a 22-year-old patient with respiratory distress is in acute
respiratory failure includes a
,a. shallow breathing pattern.
b. partial pressure of arterial oxygen (PaO2) of 45 mm Hg.
c. partial pressure of carbon dioxide in arterial gas (PaCO2) of 34 mm Hg.
d. respiratory rate of 32/min. - answer>>B
Rationale: The PaO2 indicates severe hypoxemia and that the nurse should take immediate action to
correct this problem. Shallow breathing, rapid respiratory rate, and low PaCO2 can be caused by other
factors, such as anxiety or pain.
Which information obtained by the nurse when assessing a patient with acute respiratory distress
syndrome (ARDS) who is being treated with mechanical ventilation and high levels of positive end-
expiratory pressure (PEEP) indicates a complication of ventilator therapy is occurring?
a. The patient has subcutaneous emphysema
b. The patient has a sinus bradycardia, rate 52.
c. The patient's PaO2 is 50 mm Hg and the SaO2 is 88%.
d. The patient has bronchial breath sounds in both the lung fields. - answer>>A
Rationale: Complications of positive-pressure ventilation (PPV) and PEEP include subcutaneous
emphysema. Bradycardia, hypoxemia, and bronchial breath sounds are all concerns, but they are not
caused by PPV and PEEP.Cognitive Level: Application Text Reference: p. 1816Nursing Process:
Assessment NCLEX: Physiological Integrity
Which of these nursing actions included in the care of a mechanically ventilated patient with acute
respiratory distress syndrome (ARDS) is most appropriate for the RN to delegate to an experienced
LPN/LVN working in the intensive care unit?
a. Placing the patient in the prone position
b. Assessment of patient breath sounds
c. Administration of enteral tube feedings
,d. Obtaining the pulmonary artery pressures - answer>>C
Rationale: Administration of tube feedings is included in LPN/LVN education and scope of practice and
can be safely delegated to an LPN/LVN who is experienced in caring for critically ill patients. Placing a
patient who is on a ventilator in the prone position requires multiple staff and should be supervised by
an RN. Assessment of breath sounds and obtaining pulmonary artery pressures require advanced
assessment skills and should be done by the RN caring for a critically ill patient.
The nurse is developing a teaching plan for a pt with hep A. What should the nurse tell the client to do?
A. limit caloric intake and reduce wt
B. increase carbs and protein in diet
C. avoid contact with others and sleep in a separate room
D. intensify routine exercise and increase strength - answer>>B. increase carbs and protein in diet
Rationale: A low fat, high protein, high carb diet is encouraged to promote liver rejuvenation
The nurse is caring for a patient who just arrived to the emergency department from a house fire.
Which of the following are signs that the patient may be suffering from injuries related to smoke
inhalation? Select all that apply:
A) stridor
B) soot around the patients mouth and nares
C) urine output 20 mL/hr
D) singed eyebrows
E) respiratory rate is 18 breaths per minute - answer>>A,B,D
A patient comes in who has suffered an electrical burn. What is the nurses priority intervention?
A) auscultate lung sounds
, B) elevate the head of the bed
C) monitor cardiac rhythm
D) assess pedal pulses
E) locate site of entry and exit - answer>>C) monitor cardiac rhythm
The nurse is caring for a patient who is recovering from a burn injury. What is the nurses priority during
the Rehab Phase?
A) providing a high calorie diet
B) providing resources for vocational training
C) performing ROM exercises
D) performing dressing changes
E) auscultating lung sounds - answer>>B) providing resources for vocational training
On admission to the burn unit, a patient with an approximate 25% total body surface area (TBSA) burn
has the following initial laboratory results: Hct 56%, Hb 17.2 mg/dL (172 g/L), serum K+ 4.8 mEq/L (4.8
mmol/L), and serum Na+ 135 mEq/L (135 mmol/L). Which action will the nurse anticipate taking?
A) Prepare for intubation
B) Administer morphine sulfate IV
C) Assess level of consciousness
D) Increase the rate of the ordered IV solution
E) Call the HCP - answer>>D) Increase the rate of the ordered IV solution.
rationale:The patient's lab data show hemoconcentration, which may lead to a decrease in blood flow
to the microcirculation unless fluid intake is increased. Documentation and continuing to monitor are
inadequate responses to the data. Since the hematocrit and hemoglobin are elevated, a transfusion is
inappropriate, although transfusions may be needed after the emergent phase.
EXAM 2026-2027 LATEST UPDATED VERSION QUESTIONS AND
ANSWERS
When caring for a client with an abdominal aortic aneurysm (AAA), the nurse suspects dissection of the
aneurysm when the client makes which statement?
A. "I feel my heart beating in my abdominal area."
B. "I just started to feel a tearing pain in my belly."
C. "I have a headache. May I have some acetaminophen?"
D. "I have had hoarseness for a few weeks." - answer>>B
Rationale: Severe pain of sudden onset in the back or lower abdomen, which may radiate to the groin,
buttocks, or legs, is indicative of impending rupture of AAA.
To evaluate both oxygenation and ventilation in a patient with acute respiratory failure, the nurse uses
the findings revealed with
a. arterial blood gas (ABG) analysis.
b. hemodynamic monitoring.
c. chest x-rays.
d. pulse oximetry. - answer>>A
Rationale: ABG analysis is useful because it provides information about both oxygenation and
ventilation and assists with determining possible etiologies and appropriate treatment. The other tests
may also provide useful information about patient status but will not indicate whether the patient has
hypoxemia, hypercapnia, or both.
. A finding indicating to the nurse that a 22-year-old patient with respiratory distress is in acute
respiratory failure includes a
,a. shallow breathing pattern.
b. partial pressure of arterial oxygen (PaO2) of 45 mm Hg.
c. partial pressure of carbon dioxide in arterial gas (PaCO2) of 34 mm Hg.
d. respiratory rate of 32/min. - answer>>B
Rationale: The PaO2 indicates severe hypoxemia and that the nurse should take immediate action to
correct this problem. Shallow breathing, rapid respiratory rate, and low PaCO2 can be caused by other
factors, such as anxiety or pain.
Which information obtained by the nurse when assessing a patient with acute respiratory distress
syndrome (ARDS) who is being treated with mechanical ventilation and high levels of positive end-
expiratory pressure (PEEP) indicates a complication of ventilator therapy is occurring?
a. The patient has subcutaneous emphysema
b. The patient has a sinus bradycardia, rate 52.
c. The patient's PaO2 is 50 mm Hg and the SaO2 is 88%.
d. The patient has bronchial breath sounds in both the lung fields. - answer>>A
Rationale: Complications of positive-pressure ventilation (PPV) and PEEP include subcutaneous
emphysema. Bradycardia, hypoxemia, and bronchial breath sounds are all concerns, but they are not
caused by PPV and PEEP.Cognitive Level: Application Text Reference: p. 1816Nursing Process:
Assessment NCLEX: Physiological Integrity
Which of these nursing actions included in the care of a mechanically ventilated patient with acute
respiratory distress syndrome (ARDS) is most appropriate for the RN to delegate to an experienced
LPN/LVN working in the intensive care unit?
a. Placing the patient in the prone position
b. Assessment of patient breath sounds
c. Administration of enteral tube feedings
,d. Obtaining the pulmonary artery pressures - answer>>C
Rationale: Administration of tube feedings is included in LPN/LVN education and scope of practice and
can be safely delegated to an LPN/LVN who is experienced in caring for critically ill patients. Placing a
patient who is on a ventilator in the prone position requires multiple staff and should be supervised by
an RN. Assessment of breath sounds and obtaining pulmonary artery pressures require advanced
assessment skills and should be done by the RN caring for a critically ill patient.
The nurse is developing a teaching plan for a pt with hep A. What should the nurse tell the client to do?
A. limit caloric intake and reduce wt
B. increase carbs and protein in diet
C. avoid contact with others and sleep in a separate room
D. intensify routine exercise and increase strength - answer>>B. increase carbs and protein in diet
Rationale: A low fat, high protein, high carb diet is encouraged to promote liver rejuvenation
The nurse is caring for a patient who just arrived to the emergency department from a house fire.
Which of the following are signs that the patient may be suffering from injuries related to smoke
inhalation? Select all that apply:
A) stridor
B) soot around the patients mouth and nares
C) urine output 20 mL/hr
D) singed eyebrows
E) respiratory rate is 18 breaths per minute - answer>>A,B,D
A patient comes in who has suffered an electrical burn. What is the nurses priority intervention?
A) auscultate lung sounds
, B) elevate the head of the bed
C) monitor cardiac rhythm
D) assess pedal pulses
E) locate site of entry and exit - answer>>C) monitor cardiac rhythm
The nurse is caring for a patient who is recovering from a burn injury. What is the nurses priority during
the Rehab Phase?
A) providing a high calorie diet
B) providing resources for vocational training
C) performing ROM exercises
D) performing dressing changes
E) auscultating lung sounds - answer>>B) providing resources for vocational training
On admission to the burn unit, a patient with an approximate 25% total body surface area (TBSA) burn
has the following initial laboratory results: Hct 56%, Hb 17.2 mg/dL (172 g/L), serum K+ 4.8 mEq/L (4.8
mmol/L), and serum Na+ 135 mEq/L (135 mmol/L). Which action will the nurse anticipate taking?
A) Prepare for intubation
B) Administer morphine sulfate IV
C) Assess level of consciousness
D) Increase the rate of the ordered IV solution
E) Call the HCP - answer>>D) Increase the rate of the ordered IV solution.
rationale:The patient's lab data show hemoconcentration, which may lead to a decrease in blood flow
to the microcirculation unless fluid intake is increased. Documentation and continuing to monitor are
inadequate responses to the data. Since the hematocrit and hemoglobin are elevated, a transfusion is
inappropriate, although transfusions may be needed after the emergent phase.
