NURS 280 FINAL EXAM STUDY GUIDE | TESTBANK | PRACTICE QUESTIONS &
ANSWERS | EXAM PREPARATION | COMPREHENSIVE PRACTICE EXAM | LATEST
UPDATE 2026/2027 | ADVANCED REVIEW
Examiner:
School/College of Nursing (Course-Based Final Examination – NURS 280)
TABLE OF CONTENTS
1. Comprehensive Patient Assessment
2. Clinical Judgment and Nursing Process
3. Adult Medical-Surgical Nursing
4. Pharmacology and Medication Safety
5. Fluid, Electrolyte, and Acid-Base Balance
6. Cardiovascular Disorders
7. Respiratory Disorders
8. Endocrine Disorders
9. Neurological Disorders
10. Renal and Gastrointestinal Disorders
11. Infection Prevention and Control
12. Perioperative Nursing
13. Professional Practice, Ethics, and Patient Safety
PATIENT ASSESSMENT || CLINICAL JUDGMENT || NURSING PROCESS ||
PHARMACOLOGY || MEDICATION SAFETY || FLUID BALANCE || ELECTROLYTES ||
ACID-BASE BALANCE || CARDIOVASCULAR CARE || RESPIRATORY MANAGEMENT ||
ENDOCRINE DISORDERS || NEUROLOGICAL ASSESSMENT || RENAL NURSING ||
GASTROINTESTINAL CARE || INFECTION PREVENTION || PERIOPERATIVE NURSING
|| EVIDENCE-BASED PRACTICE || ETHICS || PATIENT SAFETY || INTERPROFESSIONAL
COLLABORATION
QUESTION 1.
,A patient admitted with septic shock remains hypotensive despite receiving the
prescribed crystalloid bolus. Which nursing action best demonstrates appropriate
clinical judgment before initiating vasopressor therapy?
A. Verify vascular access, reassess perfusion indicators, and communicate persistent
hypotension to the provider.
B. Delay reassessment until laboratory results become available.
C. Administer a maintenance IV infusion instead of vasopressors.
D. Encourage oral fluid intake.
🔴 Correct Answer: A. Verify vascular access, reassess perfusion indicators, and
communicate persistent hypotension to the provider.
🔵 Explanation: Persistent hypotension after adequate fluid resuscitation warrants
reassessment and prompt communication because vasopressor therapy may be
indicated. Confirming IV access and evaluating tissue perfusion support safe decision-
making. The other options either delay treatment or are inappropriate for a patient in
shock.
QUESTION 2.
A nurse reviews laboratory findings for a patient receiving loop diuretics. Which
result requires the highest priority intervention?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Chloride 102 mEq/L
D. Magnesium 2.0 mg/dL
🔴 Correct Answer: B. Potassium 2.8 mEq/L
🔵 Explanation: Severe hypokalemia significantly increases the risk of cardiac
dysrhythmias and requires prompt intervention. Patients taking loop diuretics
commonly lose potassium. The remaining laboratory values are within or close to
expected ranges and are less immediately concerning.
,QUESTION 3.
A patient with chronic obstructive pulmonary disease suddenly develops increased
work of breathing and decreasing oxygen saturation despite low-flow oxygen. Which
nursing action is most appropriate?
A. Remove supplemental oxygen.
B. Encourage the patient to ambulate.
C. Perform a focused respiratory assessment and notify the rapid response team if
deterioration continues.
D. Administer a sedative.
🔴 Correct Answer: C. Perform a focused respiratory assessment and notify the
rapid response team if deterioration continues.
🔵 Explanation: Rapid recognition of respiratory deterioration allows timely escalation
of care. A focused assessment identifies changes in airway, breathing, and circulation
before further interventions. The remaining options either worsen respiratory
compromise or delay appropriate treatment.
QUESTION 4.
A postoperative patient reports calf pain, unilateral swelling, and warmth. Which
nursing action reflects the highest priority?
A. Massage the affected extremity.
B. Encourage vigorous leg exercises.
C. Apply a heating pad continuously.
D. Limit manipulation of the extremity and immediately notify the provider.
🔴 Correct Answer: D. Limit manipulation of the extremity and immediately notify
the provider.
🔵 Explanation: These findings are highly suggestive of deep vein thrombosis.
Manipulating the extremity could increase the risk of embolization. Prompt reporting
facilitates diagnostic evaluation and treatment while reducing the risk of pulmonary
embolism.
, QUESTION 5.
A patient with diabetic ketoacidosis begins insulin therapy. Which assessment finding
most strongly suggests treatment is effective?
A. Progressive decrease in serum glucose with improving mental status.
B. Increasing urine ketones despite stable glucose.
C. Persistent tachypnea with worsening acidosis.
D. Increasing serum potassium above baseline.
🔴 Correct Answer: A. Progressive decrease in serum glucose with improving
mental status.
🔵 Explanation: Successful treatment of diabetic ketoacidosis is reflected by improving
neurological status and controlled reduction in blood glucose while correcting
metabolic abnormalities. Persistent acidosis or worsening electrolyte disturbances
indicate incomplete treatment rather than improvement.
QUESTION 6.
While preparing to administer a high-alert medication, the nurse notices the
prescribed dose exceeds the usual recommended range. What is the most
appropriate action?
A. Administer the medication because it was prescribed.
B. Ask another nurse to administer it instead.
C. Verify the prescription with the prescriber before administration.
D. Reduce the dose independently.
🔴 Correct Answer: C. Verify the prescription with the prescriber before
administration.
🔵 Explanation: Medication safety requires clarification whenever a prescribed dose
appears unusually high. Nurses should not independently alter prescribed doses or
administer medications that may place the patient at unnecessary risk. Verification
promotes safe practice.
ANSWERS | EXAM PREPARATION | COMPREHENSIVE PRACTICE EXAM | LATEST
UPDATE 2026/2027 | ADVANCED REVIEW
Examiner:
School/College of Nursing (Course-Based Final Examination – NURS 280)
TABLE OF CONTENTS
1. Comprehensive Patient Assessment
2. Clinical Judgment and Nursing Process
3. Adult Medical-Surgical Nursing
4. Pharmacology and Medication Safety
5. Fluid, Electrolyte, and Acid-Base Balance
6. Cardiovascular Disorders
7. Respiratory Disorders
8. Endocrine Disorders
9. Neurological Disorders
10. Renal and Gastrointestinal Disorders
11. Infection Prevention and Control
12. Perioperative Nursing
13. Professional Practice, Ethics, and Patient Safety
PATIENT ASSESSMENT || CLINICAL JUDGMENT || NURSING PROCESS ||
PHARMACOLOGY || MEDICATION SAFETY || FLUID BALANCE || ELECTROLYTES ||
ACID-BASE BALANCE || CARDIOVASCULAR CARE || RESPIRATORY MANAGEMENT ||
ENDOCRINE DISORDERS || NEUROLOGICAL ASSESSMENT || RENAL NURSING ||
GASTROINTESTINAL CARE || INFECTION PREVENTION || PERIOPERATIVE NURSING
|| EVIDENCE-BASED PRACTICE || ETHICS || PATIENT SAFETY || INTERPROFESSIONAL
COLLABORATION
QUESTION 1.
,A patient admitted with septic shock remains hypotensive despite receiving the
prescribed crystalloid bolus. Which nursing action best demonstrates appropriate
clinical judgment before initiating vasopressor therapy?
A. Verify vascular access, reassess perfusion indicators, and communicate persistent
hypotension to the provider.
B. Delay reassessment until laboratory results become available.
C. Administer a maintenance IV infusion instead of vasopressors.
D. Encourage oral fluid intake.
🔴 Correct Answer: A. Verify vascular access, reassess perfusion indicators, and
communicate persistent hypotension to the provider.
🔵 Explanation: Persistent hypotension after adequate fluid resuscitation warrants
reassessment and prompt communication because vasopressor therapy may be
indicated. Confirming IV access and evaluating tissue perfusion support safe decision-
making. The other options either delay treatment or are inappropriate for a patient in
shock.
QUESTION 2.
A nurse reviews laboratory findings for a patient receiving loop diuretics. Which
result requires the highest priority intervention?
A. Sodium 138 mEq/L
B. Potassium 2.8 mEq/L
C. Chloride 102 mEq/L
D. Magnesium 2.0 mg/dL
🔴 Correct Answer: B. Potassium 2.8 mEq/L
🔵 Explanation: Severe hypokalemia significantly increases the risk of cardiac
dysrhythmias and requires prompt intervention. Patients taking loop diuretics
commonly lose potassium. The remaining laboratory values are within or close to
expected ranges and are less immediately concerning.
,QUESTION 3.
A patient with chronic obstructive pulmonary disease suddenly develops increased
work of breathing and decreasing oxygen saturation despite low-flow oxygen. Which
nursing action is most appropriate?
A. Remove supplemental oxygen.
B. Encourage the patient to ambulate.
C. Perform a focused respiratory assessment and notify the rapid response team if
deterioration continues.
D. Administer a sedative.
🔴 Correct Answer: C. Perform a focused respiratory assessment and notify the
rapid response team if deterioration continues.
🔵 Explanation: Rapid recognition of respiratory deterioration allows timely escalation
of care. A focused assessment identifies changes in airway, breathing, and circulation
before further interventions. The remaining options either worsen respiratory
compromise or delay appropriate treatment.
QUESTION 4.
A postoperative patient reports calf pain, unilateral swelling, and warmth. Which
nursing action reflects the highest priority?
A. Massage the affected extremity.
B. Encourage vigorous leg exercises.
C. Apply a heating pad continuously.
D. Limit manipulation of the extremity and immediately notify the provider.
🔴 Correct Answer: D. Limit manipulation of the extremity and immediately notify
the provider.
🔵 Explanation: These findings are highly suggestive of deep vein thrombosis.
Manipulating the extremity could increase the risk of embolization. Prompt reporting
facilitates diagnostic evaluation and treatment while reducing the risk of pulmonary
embolism.
, QUESTION 5.
A patient with diabetic ketoacidosis begins insulin therapy. Which assessment finding
most strongly suggests treatment is effective?
A. Progressive decrease in serum glucose with improving mental status.
B. Increasing urine ketones despite stable glucose.
C. Persistent tachypnea with worsening acidosis.
D. Increasing serum potassium above baseline.
🔴 Correct Answer: A. Progressive decrease in serum glucose with improving
mental status.
🔵 Explanation: Successful treatment of diabetic ketoacidosis is reflected by improving
neurological status and controlled reduction in blood glucose while correcting
metabolic abnormalities. Persistent acidosis or worsening electrolyte disturbances
indicate incomplete treatment rather than improvement.
QUESTION 6.
While preparing to administer a high-alert medication, the nurse notices the
prescribed dose exceeds the usual recommended range. What is the most
appropriate action?
A. Administer the medication because it was prescribed.
B. Ask another nurse to administer it instead.
C. Verify the prescription with the prescriber before administration.
D. Reduce the dose independently.
🔴 Correct Answer: C. Verify the prescription with the prescriber before
administration.
🔵 Explanation: Medication safety requires clarification whenever a prescribed dose
appears unusually high. Nurses should not independently alter prescribed doses or
administer medications that may place the patient at unnecessary risk. Verification
promotes safe practice.
