NURS 4581 Nursing of Adults with
Complex Needs Final Exam Questions
And Correct Answers (Verified Answers)
Plus Rationale 2027 Q&A| Instant
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1. A nurse is caring for a client admitted with septic shock. Which
assessment finding indicates that fluid resuscitation has been
effective?
A. Heart rate of 128 beats/minute
B. Urine output of 40 mL/hour
C. Blood pressure of 82/48 mm Hg
D. Serum lactate of 5.2 mmol/L
Answer: B. Urine output of 40 mL/hour
Rationale: Adequate urine output (at least 0.5 mL/kg/hour in adults) is
one of the best indicators of improved tissue perfusion following fluid
,resuscitation. Persistent hypotension, tachycardia, and elevated lactate
levels indicate ongoing inadequate perfusion.
2. Which laboratory value requires immediate intervention in a client
receiving intravenous heparin?
A. Platelet count of 42,000/mm³
B. Hemoglobin of 13.8 g/dL
C. Sodium of 138 mEq/L
D. White blood cell count of 9,200/mm³
Answer: A. Platelet count of 42,000/mm³
Rationale: A significant drop in platelet count suggests heparin-induced
thrombocytopenia (HIT), a life-threatening complication requiring
immediate discontinuation of heparin and notification of the healthcare
provider.
3. A client with acute respiratory distress syndrome (ARDS) is
mechanically ventilated. Which intervention best reduces
ventilator-induced lung injury?
A. High tidal volume ventilation
B. Low tidal volume ventilation
,C. Increased oxygen concentration to 100% continuously
D. High respiratory rate without PEEP
Answer: B. Low tidal volume ventilation
Rationale: Low tidal volume ventilation (approximately 6 mL/kg of ideal
body weight) minimizes alveolar overdistention and reduces ventilator-
associated lung injury, improving survival in ARDS.
4. A nurse is assessing a client with increased intracranial pressure.
Which finding is most concerning?
A. Headache relieved by analgesics
B. Glasgow Coma Scale score decreasing from 14 to 11
C. Pupils equal and reactive to light
D. Heart rate of 88 beats/minute
Answer: B. Glasgow Coma Scale score decreasing from 14 to 11
Rationale: A declining level of consciousness is often the earliest and
most significant indicator of worsening intracranial pressure and
requires immediate evaluation.
, 5. Which electrolyte imbalance is most likely to cause peaked T
waves on an electrocardiogram?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Answer: B. Hyperkalemia
Rationale: Hyperkalemia characteristically causes peaked T waves,
widened QRS complexes, and can progress to fatal cardiac dysrhythmias
if untreated.
6. A client with diabetic ketoacidosis (DKA) is receiving treatment.
Which finding indicates improvement?
A. Blood glucose remains above 350 mg/dL.
B. Serum bicarbonate increases to 22 mEq/L.
C. Urine ketones increase.
D. Respiratory rate remains 34 breaths/minute.
Answer: B. Serum bicarbonate increases to 22 mEq/L
Complex Needs Final Exam Questions
And Correct Answers (Verified Answers)
Plus Rationale 2027 Q&A| Instant
Download Pdf
1. A nurse is caring for a client admitted with septic shock. Which
assessment finding indicates that fluid resuscitation has been
effective?
A. Heart rate of 128 beats/minute
B. Urine output of 40 mL/hour
C. Blood pressure of 82/48 mm Hg
D. Serum lactate of 5.2 mmol/L
Answer: B. Urine output of 40 mL/hour
Rationale: Adequate urine output (at least 0.5 mL/kg/hour in adults) is
one of the best indicators of improved tissue perfusion following fluid
,resuscitation. Persistent hypotension, tachycardia, and elevated lactate
levels indicate ongoing inadequate perfusion.
2. Which laboratory value requires immediate intervention in a client
receiving intravenous heparin?
A. Platelet count of 42,000/mm³
B. Hemoglobin of 13.8 g/dL
C. Sodium of 138 mEq/L
D. White blood cell count of 9,200/mm³
Answer: A. Platelet count of 42,000/mm³
Rationale: A significant drop in platelet count suggests heparin-induced
thrombocytopenia (HIT), a life-threatening complication requiring
immediate discontinuation of heparin and notification of the healthcare
provider.
3. A client with acute respiratory distress syndrome (ARDS) is
mechanically ventilated. Which intervention best reduces
ventilator-induced lung injury?
A. High tidal volume ventilation
B. Low tidal volume ventilation
,C. Increased oxygen concentration to 100% continuously
D. High respiratory rate without PEEP
Answer: B. Low tidal volume ventilation
Rationale: Low tidal volume ventilation (approximately 6 mL/kg of ideal
body weight) minimizes alveolar overdistention and reduces ventilator-
associated lung injury, improving survival in ARDS.
4. A nurse is assessing a client with increased intracranial pressure.
Which finding is most concerning?
A. Headache relieved by analgesics
B. Glasgow Coma Scale score decreasing from 14 to 11
C. Pupils equal and reactive to light
D. Heart rate of 88 beats/minute
Answer: B. Glasgow Coma Scale score decreasing from 14 to 11
Rationale: A declining level of consciousness is often the earliest and
most significant indicator of worsening intracranial pressure and
requires immediate evaluation.
, 5. Which electrolyte imbalance is most likely to cause peaked T
waves on an electrocardiogram?
A. Hypokalemia
B. Hyperkalemia
C. Hyponatremia
D. Hypercalcemia
Answer: B. Hyperkalemia
Rationale: Hyperkalemia characteristically causes peaked T waves,
widened QRS complexes, and can progress to fatal cardiac dysrhythmias
if untreated.
6. A client with diabetic ketoacidosis (DKA) is receiving treatment.
Which finding indicates improvement?
A. Blood glucose remains above 350 mg/dL.
B. Serum bicarbonate increases to 22 mEq/L.
C. Urine ketones increase.
D. Respiratory rate remains 34 breaths/minute.
Answer: B. Serum bicarbonate increases to 22 mEq/L
