NR 341
FINAL EXAM
Verified Questions & Answers With Rationales
(Complex Adult Health)
Chamberlain
IT COVERS CONTENT
from Weeks 1 through 8
,Table of Contents
NR 341 FINAL EXAM SET 1.......................................................... 2
NR 341 FINAL EXAM SET 2....................................................... 31
NR 341 FINAL EXAM SET 1
1. The nurse in a healthcare clinic is assessing a client three months after a new
diagnosis of type 1 diabetes. What client statement(s) should concern the nurse and
require follow up? Select all that apply.
A. "When I exercise, I make sure to increase my insulin."
B. "I have been tired lately and lost about 5 pounds last week."
C. "I'm drinking so much water that I've been urinating a lot."
D. "I check my blood sugar before every meal."
Correct Answer: A, B, C
Expert Rationale:
• A is correct: Increasing insulin without medical guidance during exercise is
dangerous; exercise typically lowers blood glucose, and insulin adjustment should
be provider-directed to prevent hypoglycemia.
• B is correct: Unexplained weight loss and fatigue are classic signs of hyperglycemia
and possible diabetic ketoacidosis (DKA), indicating inadequate glycemic control.
• C is correct: Polydipsia and polyuria are hallmark symptoms of hyperglycemia and
osmotic diuresis, requiring immediate follow-up.
• D is incorrect: Checking blood glucose before meals is appropriate self-
management and not concerning.
,2. The nurse is monitoring a client admitted with a severe burn injury who is
receiving intravenous fluid resuscitation. What finding should indicate to the nurse
that the client is improving?
A. Decreased blood pressure
B. Increased blood pressure
C. Decreased urine output
D. Increased heart rate
Correct Answer: B
Expert Rationale:
During burn shock (first 24–48 hours), capillary leak causes massive fluid shifts and
hypovolemia. Increased blood pressure indicates successful fluid resuscitation and
hemodynamic stabilization. Decreased blood pressure (A), decreased urine output (C), and
increased heart rate (D) are all signs of ongoing hypovolemic shock and inadequate
resuscitation. Urine output of 0.5–1 mL/kg/hr is the primary resuscitation goal, but among
the options provided, increased blood pressure is the best indicator of improvement.
3. The nurse cares for a client with acute thyrotoxicosis. What action(s) should the
nurse plan to include in the client's care? Select all that apply.
A. Cover the client with cooling blankets
B. Administer prescribed intravenous fluids
C. Monitor the client's cardiac rhythm
D. Provide ordered acetaminophen
E. Administer levothyroxine
Correct Answer: A, B, C, D
Expert Rationale:
Acute thyrotoxicosis (thyroid storm) is a life-threatening hypermetabolic state.
• A is correct: Cooling blankets treat hyperthermia (fever >104°F/40°C) by reducing
metabolic demand.
• B is correct: IV fluids prevent dehydration from diaphoresis, vomiting, and diarrhea.
• C is correct: Cardiac monitoring is essential due to risk of tachycardia, atrial
fibrillation, and heart failure.
• D is correct: Acetaminophen treats fever; aspirin is contraindicated as it displaces
T3/T4 from protein-binding sites.
, • E is incorrect: Levothyroxine is contraindicated—it is thyroid replacement therapy
for hypothyroidism and would worsen thyrotoxicosis.
4. A client presents to the emergency department with partial-thickness burns to the
left arm and abdomen sustained at work. What action should the nurse plan to
include in the client's care?
A. Apply ice directly to the burn wounds
B. Administer prescribed opioid analgesia for pain management
C. Debride the wound at the bedside immediately
D. Apply topical silver sulfadiazine before assessment
Correct Answer: B
Expert Rationale:
Partial-thickness burns are extremely painful due to exposed nerve endings. Opioid
analgesia is the priority for pain management. Ice (A) causes vasoconstriction and further
tissue damage. Debridement (C) is not performed at the bedside without analgesia and is
typically delayed until fluid resuscitation is underway. Silver sulfadiazine (D) is applied
after thorough wound assessment and cleansing, not before.
5. The nurse is caring for a client with end-stage liver disease and has provided the
prescribed treatment regimen. What finding indicates the client's condition is
improving?
A. Increased bilirubin
B. Decreased bilirubin
C. Increased ammonia
D. Decreased albumin
Correct Answer: B
Expert Rationale:
In end-stage liver disease, the liver cannot conjugate and excrete bilirubin effectively,
leading to jaundice and elevated bilirubin levels. Decreased bilirubin indicates improved
hepatocellular function and successful treatment. Increased bilirubin (A) and increased
ammonia (C) indicate worsening hepatic function. Decreased albumin (D) reflects impaired
synthetic function and is a negative finding.
FINAL EXAM
Verified Questions & Answers With Rationales
(Complex Adult Health)
Chamberlain
IT COVERS CONTENT
from Weeks 1 through 8
,Table of Contents
NR 341 FINAL EXAM SET 1.......................................................... 2
NR 341 FINAL EXAM SET 2....................................................... 31
NR 341 FINAL EXAM SET 1
1. The nurse in a healthcare clinic is assessing a client three months after a new
diagnosis of type 1 diabetes. What client statement(s) should concern the nurse and
require follow up? Select all that apply.
A. "When I exercise, I make sure to increase my insulin."
B. "I have been tired lately and lost about 5 pounds last week."
C. "I'm drinking so much water that I've been urinating a lot."
D. "I check my blood sugar before every meal."
Correct Answer: A, B, C
Expert Rationale:
• A is correct: Increasing insulin without medical guidance during exercise is
dangerous; exercise typically lowers blood glucose, and insulin adjustment should
be provider-directed to prevent hypoglycemia.
• B is correct: Unexplained weight loss and fatigue are classic signs of hyperglycemia
and possible diabetic ketoacidosis (DKA), indicating inadequate glycemic control.
• C is correct: Polydipsia and polyuria are hallmark symptoms of hyperglycemia and
osmotic diuresis, requiring immediate follow-up.
• D is incorrect: Checking blood glucose before meals is appropriate self-
management and not concerning.
,2. The nurse is monitoring a client admitted with a severe burn injury who is
receiving intravenous fluid resuscitation. What finding should indicate to the nurse
that the client is improving?
A. Decreased blood pressure
B. Increased blood pressure
C. Decreased urine output
D. Increased heart rate
Correct Answer: B
Expert Rationale:
During burn shock (first 24–48 hours), capillary leak causes massive fluid shifts and
hypovolemia. Increased blood pressure indicates successful fluid resuscitation and
hemodynamic stabilization. Decreased blood pressure (A), decreased urine output (C), and
increased heart rate (D) are all signs of ongoing hypovolemic shock and inadequate
resuscitation. Urine output of 0.5–1 mL/kg/hr is the primary resuscitation goal, but among
the options provided, increased blood pressure is the best indicator of improvement.
3. The nurse cares for a client with acute thyrotoxicosis. What action(s) should the
nurse plan to include in the client's care? Select all that apply.
A. Cover the client with cooling blankets
B. Administer prescribed intravenous fluids
C. Monitor the client's cardiac rhythm
D. Provide ordered acetaminophen
E. Administer levothyroxine
Correct Answer: A, B, C, D
Expert Rationale:
Acute thyrotoxicosis (thyroid storm) is a life-threatening hypermetabolic state.
• A is correct: Cooling blankets treat hyperthermia (fever >104°F/40°C) by reducing
metabolic demand.
• B is correct: IV fluids prevent dehydration from diaphoresis, vomiting, and diarrhea.
• C is correct: Cardiac monitoring is essential due to risk of tachycardia, atrial
fibrillation, and heart failure.
• D is correct: Acetaminophen treats fever; aspirin is contraindicated as it displaces
T3/T4 from protein-binding sites.
, • E is incorrect: Levothyroxine is contraindicated—it is thyroid replacement therapy
for hypothyroidism and would worsen thyrotoxicosis.
4. A client presents to the emergency department with partial-thickness burns to the
left arm and abdomen sustained at work. What action should the nurse plan to
include in the client's care?
A. Apply ice directly to the burn wounds
B. Administer prescribed opioid analgesia for pain management
C. Debride the wound at the bedside immediately
D. Apply topical silver sulfadiazine before assessment
Correct Answer: B
Expert Rationale:
Partial-thickness burns are extremely painful due to exposed nerve endings. Opioid
analgesia is the priority for pain management. Ice (A) causes vasoconstriction and further
tissue damage. Debridement (C) is not performed at the bedside without analgesia and is
typically delayed until fluid resuscitation is underway. Silver sulfadiazine (D) is applied
after thorough wound assessment and cleansing, not before.
5. The nurse is caring for a client with end-stage liver disease and has provided the
prescribed treatment regimen. What finding indicates the client's condition is
improving?
A. Increased bilirubin
B. Decreased bilirubin
C. Increased ammonia
D. Decreased albumin
Correct Answer: B
Expert Rationale:
In end-stage liver disease, the liver cannot conjugate and excrete bilirubin effectively,
leading to jaundice and elevated bilirubin levels. Decreased bilirubin indicates improved
hepatocellular function and successful treatment. Increased bilirubin (A) and increased
ammonia (C) indicate worsening hepatic function. Decreased albumin (D) reflects impaired
synthetic function and is a negative finding.
