NURS 404 Exam 1 – Latest Update 2026 | Complete
Actual Exam with Verified Q&A – Graded A+
1. A patient is admitted to the ED with hypovolemia. Which IV solution should the RN
anticipate administering?
Answer: 0.9% Normal Saline (isotonic crystalloid) or Lactated Ringer's. ✔✔
2. Why use a 10mL syringe to flush a PICC line?
Answer: 1, 3, and 5mL syringes will exert too much pressure. ✔✔
3. The RN notes a grating heart sound when auscultating the apical pulse of a patient with
pericarditis. What should the RN do with this assessment data?
Answer: Note the findings in the patient's medical record (normal for pericarditis). ✔✔
4. A client with an increasing number of PVCs is scheduled for 24 hr Holter monitoring.
The nurse instructs the client to:
Answer: Keep an accurate record of activity during the day. ✔✔
5. The RN receives in report that the patient with a pacemaker has experienced loss of
capture. Which situation is consistent with this?
Answer: Pacemaker spikes are noted, but no P waves or QRS complex follows. ✔✔
6. A nurse on a cardiac unit is caring for a patient who is on telemetry. The nurse
recognizes the patient's HR is 44/min and notifies the healthcare provider. The nurse
should anticipate which management strategy will be used by this patient?
Answer: Pacemaker insertion. ✔✔
7. Influenza vaccination needle size?
Answer: 22–25 gauge IM injection. ✔✔
pg. 1
,8. D5W classification?
Answer: Isotonic in the bag, hypotonic when infused. ✔✔
9. TACO (Transfusion-Associated Circulatory Overload) characteristics?
Answer: More serious, elevated BNP, can be seen during or directly after transfusion. ✔✔
10. TRALI (Transfusion-Related Acute Lung Injury) characteristics?
Answer: NO DIURETICS; occurs within 6 hours of transfusion. ✔✔
11. Rate to give platelets?
Answer: 15–30 minutes. ✔✔
12. BNP (B-type Natriuretic Peptide) information?
Answer: Made in the ventricles; normal <100 pg/mL; used for diagnosing heart failure. ✔✔
13. Blood Transfusion rate guidelines?
Answer: 120 mL/hr for the first 15 minutes, can increase to 15–250 mL/hr after; must be
completed within 4 hours. ✔✔
14. A new RN is caring for a client receiving drug therapy via a smart pump. What
statement by the new nurse demonstrates the need for more instruction on this technology?
Answer: "I don't need to manually calculate IV infusion rates with smart pumps." ✔✔
15. PICC Lines – key facts?
Answer: 3–8 inches long, placed in the upper arm, used for hydration and drug therapy for 6–14
days; DO NOT USE for vesicant drugs or to draw blood. ✔✔
16. (No question number 16 provided in the document.)
pg. 2
, 17. Which condition or manifestation in the client with a serum sodium level of 149
indicates to the nurse that this electrolyte imbalance may be caused by excessive fluid loss?
Answer: Hematocrit is 52%. ✔✔
18. A client is receiving an intravenous infusion of 100 mEq KCl in 1000 mL of normal
saline. How many mEq of potassium per hour does the nurse calculate the client will
receive if the IV is infused at 150 mL/hour?
Answer: 15 mEq/hr (100 mEq ÷ 1000 mL = 0.1 mEq/mL; 0.1 × 150 mL/hr = 15 mEq/hr). ✔✔
19. Which assessment data is the most relevant for the nurse to obtain from a client who
has a serum potassium level of 2.9?
Answer: Monitor ECG for U waves, flattened T waves, and ST depression; assess for muscle
weakness and respiratory status. ✔✔
20. A client is receiving gentamycin intravenously reports that the peripheral IV insertion
site has become painful and reddened. What is the priority nursing action?
Answer: Stop the infusion and discontinue the IV site. ✔✔
21. An older adult client receiving an infusion of 5% dextrose in 0.9% normal saline at 150
mL/hour has developed shortness of breath with a decrease in O2 saturation to 86%. What
is the priority nursing intervention?
Answer: Stop the infusion, place the patient in high-Fowler's position, and administer oxygen;
notify the healthcare provider. ✔✔
22. The nurse is teaching a class regarding reduction of risk factors for cardiovascular
disease. Which teaching statements will the nurse include?
Answer: – If you tend to get angry easily, then your risk for heart disease is higher.
– Do not eat more calories on a daily basis than you are able to burn.
– Secondhand smoke creates a significant risk to others.
– Exercise moderately at least 2 days per week for a total of 150 minutes. ✔✔
pg. 3
Actual Exam with Verified Q&A – Graded A+
1. A patient is admitted to the ED with hypovolemia. Which IV solution should the RN
anticipate administering?
Answer: 0.9% Normal Saline (isotonic crystalloid) or Lactated Ringer's. ✔✔
2. Why use a 10mL syringe to flush a PICC line?
Answer: 1, 3, and 5mL syringes will exert too much pressure. ✔✔
3. The RN notes a grating heart sound when auscultating the apical pulse of a patient with
pericarditis. What should the RN do with this assessment data?
Answer: Note the findings in the patient's medical record (normal for pericarditis). ✔✔
4. A client with an increasing number of PVCs is scheduled for 24 hr Holter monitoring.
The nurse instructs the client to:
Answer: Keep an accurate record of activity during the day. ✔✔
5. The RN receives in report that the patient with a pacemaker has experienced loss of
capture. Which situation is consistent with this?
Answer: Pacemaker spikes are noted, but no P waves or QRS complex follows. ✔✔
6. A nurse on a cardiac unit is caring for a patient who is on telemetry. The nurse
recognizes the patient's HR is 44/min and notifies the healthcare provider. The nurse
should anticipate which management strategy will be used by this patient?
Answer: Pacemaker insertion. ✔✔
7. Influenza vaccination needle size?
Answer: 22–25 gauge IM injection. ✔✔
pg. 1
,8. D5W classification?
Answer: Isotonic in the bag, hypotonic when infused. ✔✔
9. TACO (Transfusion-Associated Circulatory Overload) characteristics?
Answer: More serious, elevated BNP, can be seen during or directly after transfusion. ✔✔
10. TRALI (Transfusion-Related Acute Lung Injury) characteristics?
Answer: NO DIURETICS; occurs within 6 hours of transfusion. ✔✔
11. Rate to give platelets?
Answer: 15–30 minutes. ✔✔
12. BNP (B-type Natriuretic Peptide) information?
Answer: Made in the ventricles; normal <100 pg/mL; used for diagnosing heart failure. ✔✔
13. Blood Transfusion rate guidelines?
Answer: 120 mL/hr for the first 15 minutes, can increase to 15–250 mL/hr after; must be
completed within 4 hours. ✔✔
14. A new RN is caring for a client receiving drug therapy via a smart pump. What
statement by the new nurse demonstrates the need for more instruction on this technology?
Answer: "I don't need to manually calculate IV infusion rates with smart pumps." ✔✔
15. PICC Lines – key facts?
Answer: 3–8 inches long, placed in the upper arm, used for hydration and drug therapy for 6–14
days; DO NOT USE for vesicant drugs or to draw blood. ✔✔
16. (No question number 16 provided in the document.)
pg. 2
, 17. Which condition or manifestation in the client with a serum sodium level of 149
indicates to the nurse that this electrolyte imbalance may be caused by excessive fluid loss?
Answer: Hematocrit is 52%. ✔✔
18. A client is receiving an intravenous infusion of 100 mEq KCl in 1000 mL of normal
saline. How many mEq of potassium per hour does the nurse calculate the client will
receive if the IV is infused at 150 mL/hour?
Answer: 15 mEq/hr (100 mEq ÷ 1000 mL = 0.1 mEq/mL; 0.1 × 150 mL/hr = 15 mEq/hr). ✔✔
19. Which assessment data is the most relevant for the nurse to obtain from a client who
has a serum potassium level of 2.9?
Answer: Monitor ECG for U waves, flattened T waves, and ST depression; assess for muscle
weakness and respiratory status. ✔✔
20. A client is receiving gentamycin intravenously reports that the peripheral IV insertion
site has become painful and reddened. What is the priority nursing action?
Answer: Stop the infusion and discontinue the IV site. ✔✔
21. An older adult client receiving an infusion of 5% dextrose in 0.9% normal saline at 150
mL/hour has developed shortness of breath with a decrease in O2 saturation to 86%. What
is the priority nursing intervention?
Answer: Stop the infusion, place the patient in high-Fowler's position, and administer oxygen;
notify the healthcare provider. ✔✔
22. The nurse is teaching a class regarding reduction of risk factors for cardiovascular
disease. Which teaching statements will the nurse include?
Answer: – If you tend to get angry easily, then your risk for heart disease is higher.
– Do not eat more calories on a daily basis than you are able to burn.
– Secondhand smoke creates a significant risk to others.
– Exercise moderately at least 2 days per week for a total of 150 minutes. ✔✔
pg. 3
