NURS 280 - 239 Questions and Answers Already Graded A+
Premium Exam Tested And Verified
Subject Area Nursing
Description This examination assesses advanced nursing concepts including pathophysiology,
pharmacology, evidence-based practice, health assessment, and nursing
leadership. Questions require synthesis of knowledge across multiple domains,
clinical reasoning, and application of current standards of care.
Expected Grade A+
Total Questions 239
Duration 3 hours
Learning Outcomes 1. Apply complex pathophysiological concepts to nursing assessment and
intervention.
2. Critically evaluate pharmacological treatments and their implications for patient
safety.
3. Integrate evidence-based practice into clinical decision-making.
4. Demonstrate advanced health assessment skills across diverse populations.
5. Analyze ethical and leadership issues in nursing practice.
Accreditation This exam aligns with AACN Baccalaureate Essentials and NCLEX-RN test plan
standards.
Page 1
,1. A patient with chronic kidney disease stage 4 is prescribed lisinopril. Which
laboratory value requires immediate holding of the medication and notification of
the provider?
A. Serum potassium 5.2 mEq/L
B. Serum creatinine 2.8 mg/dL
C. Blood urea nitrogen 45 mg/dL
D. Serum sodium 135 mEq/L
Answer: A. Serum potassium 5.2 mEq/L
Lisinopril, an ACE inhibitor, can cause hyperkalemia due to reduced aldosterone
secretion. A potassium of 5.2 mEq/L is elevated and may worsen with continued use,
especially in CKD. While creatinine and BUN are elevated in CKD, they do not require
immediate holding of lisinopril unless there is a significant acute rise. Sodium is
normal.
2. A community health nurse is evaluating a program aimed at reducing childhood
obesity. Which outcome measure best reflects the program's effectiveness at the
population level?
A. Decrease in body mass index percentile among participants over one year
B. Increase in knowledge about nutrition among parents
C. Number of participants who report increased physical activity
D. Reduction in incidence of type 2 diabetes among children in the community
Answer: D. Reduction in incidence of type 2 diabetes among children in the
community
Population-level effectiveness is best measured by a reduction in disease incidence (type
2 diabetes) attributable to the program. While individual BMI decrease and increased
knowledge are positive, they are intermediate outcomes. The ultimate goal is preventing
disease at the community level.
Page 2
,3. A nurse is caring for a patient receiving a continuous infusion of norepinephrine.
The patient's blood pressure is 90/50 mm Hg, heart rate 120 bpm. Which assessment
finding indicates a potential adverse effect requiring immediate action?
A. Urine output 30 mL over the last hour
B. Oxygen saturation 94% on room air
C. Cool, mottled extremities with weak peripheral pulses
D. Central venous pressure 4 mm Hg
Answer: C. Cool, mottled extremities with weak peripheral pulses
Norepinephrine causes vasoconstriction, which can lead to reduced perfusion to
extremities, causing cool, mottled skin and weak pulses, indicating possible ischemia.
This requires dose reduction or discontinuation. Low urine output and CVP are
expected in hypoperfusion; oxygen saturation is acceptable.
4. In a study comparing two wound care protocols, the nurse researcher uses a
randomized controlled trial design. Which potential threat to internal validity is
minimized by randomization?
A. History
B. Selection bias
C. Maturation
D. Hawthorne effect
Answer: B. Selection bias
Randomization minimizes selection bias by ensuring that known and unknown
confounding variables are equally distributed between groups. History and maturation
affect both groups equally; Hawthorne effect is minimized by blinding, not
randomization.
Page 3
, 5. A patient with a history of chronic obstructive pulmonary disease (COPD)
presents with acute onset of pleuritic chest pain and dyspnea. Arterial blood gas
shows pH 7.48, PaCO2 30 mm Hg, PaO2 60 mm Hg, HCO3- 24 mEq/L. Which
acid-base disorder is present?
A. Uncompensated respiratory alkalosis
B. Partially compensated respiratory alkalosis
C. Uncompensated metabolic alkalosis
D. Partially compensated metabolic alkalosis
Answer: A. Uncompensated respiratory alkalosis
The pH is elevated (alkalemia), PaCO2 is decreased (respiratory alkalosis), and HCO3-
is normal (24 mEq/L). Since the HCO3- is within normal range, there is no
compensation, indicating an uncompensated respiratory alkalosis. This is consistent
with hyperventilation from acute pulmonary embolism or pain.
6. A nurse is developing a plan of care for a patient with a new diagnosis of type 2
diabetes. Which intervention should be prioritized to address the patient's
knowledge deficit regarding insulin administration?
A. Provide written instructions on insulin storage
B. Demonstrate the use of an insulin pen and have the patient return demonstrate
C. Refer to a diabetes educator for a class on carbohydrate counting
D. Discuss the importance of rotating injection sites
Answer: B. Demonstrate the use of an insulin pen and have the patient return
demonstrate
The priority is to ensure the patient can safely administer insulin. Return
demonstration is the most effective method to assess and teach psychomotor skills.
Written instructions and site rotation are important but secondary to correct
administration technique. Carbohydrate counting is relevant but not immediate.
Page 4
Premium Exam Tested And Verified
Subject Area Nursing
Description This examination assesses advanced nursing concepts including pathophysiology,
pharmacology, evidence-based practice, health assessment, and nursing
leadership. Questions require synthesis of knowledge across multiple domains,
clinical reasoning, and application of current standards of care.
Expected Grade A+
Total Questions 239
Duration 3 hours
Learning Outcomes 1. Apply complex pathophysiological concepts to nursing assessment and
intervention.
2. Critically evaluate pharmacological treatments and their implications for patient
safety.
3. Integrate evidence-based practice into clinical decision-making.
4. Demonstrate advanced health assessment skills across diverse populations.
5. Analyze ethical and leadership issues in nursing practice.
Accreditation This exam aligns with AACN Baccalaureate Essentials and NCLEX-RN test plan
standards.
Page 1
,1. A patient with chronic kidney disease stage 4 is prescribed lisinopril. Which
laboratory value requires immediate holding of the medication and notification of
the provider?
A. Serum potassium 5.2 mEq/L
B. Serum creatinine 2.8 mg/dL
C. Blood urea nitrogen 45 mg/dL
D. Serum sodium 135 mEq/L
Answer: A. Serum potassium 5.2 mEq/L
Lisinopril, an ACE inhibitor, can cause hyperkalemia due to reduced aldosterone
secretion. A potassium of 5.2 mEq/L is elevated and may worsen with continued use,
especially in CKD. While creatinine and BUN are elevated in CKD, they do not require
immediate holding of lisinopril unless there is a significant acute rise. Sodium is
normal.
2. A community health nurse is evaluating a program aimed at reducing childhood
obesity. Which outcome measure best reflects the program's effectiveness at the
population level?
A. Decrease in body mass index percentile among participants over one year
B. Increase in knowledge about nutrition among parents
C. Number of participants who report increased physical activity
D. Reduction in incidence of type 2 diabetes among children in the community
Answer: D. Reduction in incidence of type 2 diabetes among children in the
community
Population-level effectiveness is best measured by a reduction in disease incidence (type
2 diabetes) attributable to the program. While individual BMI decrease and increased
knowledge are positive, they are intermediate outcomes. The ultimate goal is preventing
disease at the community level.
Page 2
,3. A nurse is caring for a patient receiving a continuous infusion of norepinephrine.
The patient's blood pressure is 90/50 mm Hg, heart rate 120 bpm. Which assessment
finding indicates a potential adverse effect requiring immediate action?
A. Urine output 30 mL over the last hour
B. Oxygen saturation 94% on room air
C. Cool, mottled extremities with weak peripheral pulses
D. Central venous pressure 4 mm Hg
Answer: C. Cool, mottled extremities with weak peripheral pulses
Norepinephrine causes vasoconstriction, which can lead to reduced perfusion to
extremities, causing cool, mottled skin and weak pulses, indicating possible ischemia.
This requires dose reduction or discontinuation. Low urine output and CVP are
expected in hypoperfusion; oxygen saturation is acceptable.
4. In a study comparing two wound care protocols, the nurse researcher uses a
randomized controlled trial design. Which potential threat to internal validity is
minimized by randomization?
A. History
B. Selection bias
C. Maturation
D. Hawthorne effect
Answer: B. Selection bias
Randomization minimizes selection bias by ensuring that known and unknown
confounding variables are equally distributed between groups. History and maturation
affect both groups equally; Hawthorne effect is minimized by blinding, not
randomization.
Page 3
, 5. A patient with a history of chronic obstructive pulmonary disease (COPD)
presents with acute onset of pleuritic chest pain and dyspnea. Arterial blood gas
shows pH 7.48, PaCO2 30 mm Hg, PaO2 60 mm Hg, HCO3- 24 mEq/L. Which
acid-base disorder is present?
A. Uncompensated respiratory alkalosis
B. Partially compensated respiratory alkalosis
C. Uncompensated metabolic alkalosis
D. Partially compensated metabolic alkalosis
Answer: A. Uncompensated respiratory alkalosis
The pH is elevated (alkalemia), PaCO2 is decreased (respiratory alkalosis), and HCO3-
is normal (24 mEq/L). Since the HCO3- is within normal range, there is no
compensation, indicating an uncompensated respiratory alkalosis. This is consistent
with hyperventilation from acute pulmonary embolism or pain.
6. A nurse is developing a plan of care for a patient with a new diagnosis of type 2
diabetes. Which intervention should be prioritized to address the patient's
knowledge deficit regarding insulin administration?
A. Provide written instructions on insulin storage
B. Demonstrate the use of an insulin pen and have the patient return demonstrate
C. Refer to a diabetes educator for a class on carbohydrate counting
D. Discuss the importance of rotating injection sites
Answer: B. Demonstrate the use of an insulin pen and have the patient return
demonstrate
The priority is to ensure the patient can safely administer insulin. Return
demonstration is the most effective method to assess and teach psychomotor skills.
Written instructions and site rotation are important but secondary to correct
administration technique. Carbohydrate counting is relevant but not immediate.
Page 4
