NURS 3366: Exam 1 Review
Questions with Correct Answers
Course
NURS 3366
1. A nurse is caring for a patient with heart failure who suddenly reports severe shortness
of breath and has oxygen saturation of 84%. Which nursing action should be performed
first?
A. Notify the healthcare provider.
B. Raise the head of the bed and administer oxygen as prescribed.
C. Obtain a complete health history.
D. Administer scheduled oral medications.
Answer: B. Raise the head of the bed and administer oxygen as prescribed.
Explanation:
Using the ABC (Airway, Breathing, Circulation) priority framework, impaired oxygenation
requires immediate intervention. Positioning the patient upright and providing supplemental
oxygen can rapidly improve ventilation while further assessment and provider notification
follow.
2. Which assessment finding is most consistent with left-sided heart failure?
A. Jugular vein distention
B. Pulmonary crackles and dyspnea
C. Peripheral edema only
D. Enlarged liver
Answer: B. Pulmonary crackles and dyspnea
Explanation:
Left-sided heart failure causes blood to back up into the lungs, leading to pulmonary congestion,
crackles, orthopnea, dyspnea, and decreased oxygenation.
,3. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy. Which oxygen saturation goal is generally appropriate unless otherwise
prescribed?
A. 100%
B. 98–100%
C. 88–92%
D. Above 99%
Answer: C. 88–92%
Explanation:
Many patients with advanced COPD are managed with a target oxygen saturation of
approximately 88–92% to provide adequate oxygenation while minimizing the risk of worsening
carbon dioxide retention. Individual provider orders should always be followed.
4. Which laboratory value should the nurse monitor most closely in a patient receiving
warfarin (Coumadin)?
A. Hemoglobin A1C
B. INR (International Normalized Ratio)
C. Serum potassium
D. Troponin
Answer: B. INR (International Normalized Ratio)
Explanation:
The INR measures the effectiveness of warfarin therapy and helps guide dosage adjustments
while reducing the risk of bleeding or clot formation.
5. Which electrolyte imbalance places a patient at greatest risk for developing life-
threatening cardiac dysrhythmias?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Calcium 9.2 mg/dL
, D. Chloride 102 mEq/L
Answer: B. Potassium 2.8 mEq/L
Explanation:
Hypokalemia significantly increases the risk of ventricular dysrhythmias, muscle weakness, and
ECG abnormalities such as flattened T waves and U waves.
6. A nurse is teaching a patient about preventing healthcare-associated infections (HAIs).
Which patient statement indicates correct understanding?
A. "Hand hygiene is one of the best ways to prevent infection."
B. "Antibiotics should be taken for every illness."
C. "Gloves replace handwashing."
D. "I should stop antibiotics once I feel better."
Answer: A. "Hand hygiene is one of the best ways to prevent infection."
Explanation:
Proper hand hygiene remains the single most effective method of preventing the spread of
infection in healthcare settings.
7. Which assessment finding requires immediate nursing intervention?
A. Temperature of 99.1°F (37.3°C)
B. Blood pressure of 118/72 mmHg
C. New onset confusion with oxygen saturation of 85%
D. Heart rate of 78 beats/minute
Answer: C. New onset confusion with oxygen saturation of 85%
Explanation:
Hypoxemia accompanied by altered mental status is a medical emergency requiring immediate
intervention to restore oxygenation.
8. Which nursing intervention helps reduce the risk of deep vein thrombosis (DVT) in
hospitalized patients?
Questions with Correct Answers
Course
NURS 3366
1. A nurse is caring for a patient with heart failure who suddenly reports severe shortness
of breath and has oxygen saturation of 84%. Which nursing action should be performed
first?
A. Notify the healthcare provider.
B. Raise the head of the bed and administer oxygen as prescribed.
C. Obtain a complete health history.
D. Administer scheduled oral medications.
Answer: B. Raise the head of the bed and administer oxygen as prescribed.
Explanation:
Using the ABC (Airway, Breathing, Circulation) priority framework, impaired oxygenation
requires immediate intervention. Positioning the patient upright and providing supplemental
oxygen can rapidly improve ventilation while further assessment and provider notification
follow.
2. Which assessment finding is most consistent with left-sided heart failure?
A. Jugular vein distention
B. Pulmonary crackles and dyspnea
C. Peripheral edema only
D. Enlarged liver
Answer: B. Pulmonary crackles and dyspnea
Explanation:
Left-sided heart failure causes blood to back up into the lungs, leading to pulmonary congestion,
crackles, orthopnea, dyspnea, and decreased oxygenation.
,3. A patient with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy. Which oxygen saturation goal is generally appropriate unless otherwise
prescribed?
A. 100%
B. 98–100%
C. 88–92%
D. Above 99%
Answer: C. 88–92%
Explanation:
Many patients with advanced COPD are managed with a target oxygen saturation of
approximately 88–92% to provide adequate oxygenation while minimizing the risk of worsening
carbon dioxide retention. Individual provider orders should always be followed.
4. Which laboratory value should the nurse monitor most closely in a patient receiving
warfarin (Coumadin)?
A. Hemoglobin A1C
B. INR (International Normalized Ratio)
C. Serum potassium
D. Troponin
Answer: B. INR (International Normalized Ratio)
Explanation:
The INR measures the effectiveness of warfarin therapy and helps guide dosage adjustments
while reducing the risk of bleeding or clot formation.
5. Which electrolyte imbalance places a patient at greatest risk for developing life-
threatening cardiac dysrhythmias?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Calcium 9.2 mg/dL
, D. Chloride 102 mEq/L
Answer: B. Potassium 2.8 mEq/L
Explanation:
Hypokalemia significantly increases the risk of ventricular dysrhythmias, muscle weakness, and
ECG abnormalities such as flattened T waves and U waves.
6. A nurse is teaching a patient about preventing healthcare-associated infections (HAIs).
Which patient statement indicates correct understanding?
A. "Hand hygiene is one of the best ways to prevent infection."
B. "Antibiotics should be taken for every illness."
C. "Gloves replace handwashing."
D. "I should stop antibiotics once I feel better."
Answer: A. "Hand hygiene is one of the best ways to prevent infection."
Explanation:
Proper hand hygiene remains the single most effective method of preventing the spread of
infection in healthcare settings.
7. Which assessment finding requires immediate nursing intervention?
A. Temperature of 99.1°F (37.3°C)
B. Blood pressure of 118/72 mmHg
C. New onset confusion with oxygen saturation of 85%
D. Heart rate of 78 beats/minute
Answer: C. New onset confusion with oxygen saturation of 85%
Explanation:
Hypoxemia accompanied by altered mental status is a medical emergency requiring immediate
intervention to restore oxygenation.
8. Which nursing intervention helps reduce the risk of deep vein thrombosis (DVT) in
hospitalized patients?
