NUR 332 FINAL EXAM PRACTICE QUESTIONS | PRACTICE QUESTIONS & ANSWERS |
COMPREHENSIVE NCLEX NURSING STUDY GUIDE 2026/2027
The client is being admitted to r/o a brain tumor. What classic triad of symptoms supports a
diagnosis of a brain tumor?
A) nervousness, metastasis to the lungs, seizures.
B) headache, vomiting, and papilledema.
C) hypotension, tachycardia, and tachypnea.
D) abrupt loss of motor function, diarrhea, change in taste. - ANS ✔✔Answer = B
Rationale:
-the classic triad of symptoms suggesting a brain tumor includes a dull headache, vomiting
(w/out nausea and unrelated to food) and papilledema, which is optic nerve edema.
-Nervousness is not a symptom of a brain tumor, and brain tumors rarely metastasize outside
the cranium.
-HTN and bradycardia (not tachycardia) can occur in ICP, which may stump you to choose C
-Abrupt loss of motor function is suggestive of a stroke.
Which cardiac enzyme would the nurse expect to elevate first in a client diagnosed with a
myocardial infarction (MI)?
A) Creatine Kinase (CK-MB)
B) Lactate Dehydrogenase (LDH)
C) Troponin
D) WBCs - ANS ✔✔Answer = C
Rationale:
-Troponin is the enzyme that elevates quickly- within 1 to 2 hours.
,-CK-MB elevates in 12 to 24 hours.
-LDH elevates in 24-36 hours
-WBCs are not a cardiac enzyme! They elevate as a result of necrotic tissue.
The client is admitted to the telemetry unit diagnosed with acute exacerbation of congestive
heart failure (CHF). Which signs/symptoms would the nurse expect to find when assessing this
client?
A) Apical pulse rate of 110 and 4+ pitting edema of the feet
B) Thick white sputum and crackles that clear with cough
C) The client is sleeping with no pillow and eupnea
D) Radial pulse rate of 90 and CRT less than 3 seconds. - ANS ✔✔Answer = A
Rationale:
-the client with CHF would present with tachycardia (an apical rate of 110), dependent edema,
fatigue, third heart sounds, lung congestion, and change in mental status.
-In CHF, sputum is usually pink and frothy. Crackles do not clear after coughing. A CHF pt will
have labored breathing - not normal breathing (eupnea means normal breathing). Lastly, apical
pulse is preferred over radial in assessment of cardiac status in CHF.
The nurse is developing a discharge teaching plan for the client diagnosed with congestive heart
failure. Which interventions should be included in plan? Select all that apply:
A) Notify the provider if there is a weight gain of more than one pound in a week.
B) Teach the client how to count the radial pulse when taking digoxin, a cardiac glycoside.
C) Instruct the client to remove the saltshaker from the dinner table.
D) Encourage the client to monitor urine output for change in color to become dark.
E) Discuss the importance of taking the loop diuretic furosemide at bedtime. - ANS ✔✔Answer
= B), C)
,Rationale:
-the client needs to know that digoxin cannot be taken if radial pulse is less than 60.
-Weight gain of 1 pound in 1 week is irrelevant. Client should call weight gain of more than 2 or
3 pounds in 1 day.
-Urine should not be darker in this situation. If anything it may appear lighter and may increase
due to diuretics.
-The client should take diuretic in the morning - not at night! (to avoid nocturia)
The client diagnosed with rule-out myocardial infarction is experiencing chest pain while
walking to the bathroom. Which action should the nurse implement first?
A) Administer sublingual nitroglycerin.
B) Obtain a STAT electrocardiogram (ECG).
C) Have the client sit down immediately.
D) Assess the client's vital signs. - ANS ✔✔Answer = C
Rationale:
-stopping all activity will decrease the need of the myocardium for oxygen (may decrease chest
pain)
-An ECG should be ordered, but not before having the client sit down.
-taking vital signs will not help the client relieve chest pain.
Which diagnostic test is used to confirm the diagnosis of Amyotropic Lateral Sclerosis (ALS)?
A) Electromyogram (EMG).
, B) Muscle biopsy.
C) Serum creatine kinase (CK).
D) Pulmonary function test. - ANS ✔✔Answer = B
Rationale:
-a biopsy can confirm presence of muscle atrophy and loss of muscle fiber.
-an EMG does not confirm ALS; it is done to differentiate a neuropathy from a myopathy.
-CK may or may not be elevated in ALS, however it does not diagnose ALS.
The client had a right-sided chest tube inserted 2 hours ago for a pneumothorax. Which action
should the nurse implement if there is no fluctuation in the water-seal compartment?
A) Obtain an order for a STAT chest x-ray.
B) Increase the amount of wall suction.
C) Check the tubing for kinks or clots.
D) Monitor the client's pulse oximeter reading. - ANS ✔✔Answer = C
Rationale:
-The air from the pleural space is not getting to the water seal compartment. Checking the
tubing is appropriate in finding out why this is, and usually it's because the client is lying on the
tubing, it is kinked, or there is a dependent loop. (Note: the key here is '2 hours ago')
-increasing the amount of wall suction will not address WHY there is no fluctuation in the water-
seal compartment. Need to find out what is causing this before taking action.
The nurse writes a problem of "impaired gas exchange" for a client diagnosed with cancer of the
lung. Which interventions should be included in the plan of care? Select all that apply.
A) Apply O2 via nasal cannula.
B) Have the dietitian plan for 6 small meals per day.
COMPREHENSIVE NCLEX NURSING STUDY GUIDE 2026/2027
The client is being admitted to r/o a brain tumor. What classic triad of symptoms supports a
diagnosis of a brain tumor?
A) nervousness, metastasis to the lungs, seizures.
B) headache, vomiting, and papilledema.
C) hypotension, tachycardia, and tachypnea.
D) abrupt loss of motor function, diarrhea, change in taste. - ANS ✔✔Answer = B
Rationale:
-the classic triad of symptoms suggesting a brain tumor includes a dull headache, vomiting
(w/out nausea and unrelated to food) and papilledema, which is optic nerve edema.
-Nervousness is not a symptom of a brain tumor, and brain tumors rarely metastasize outside
the cranium.
-HTN and bradycardia (not tachycardia) can occur in ICP, which may stump you to choose C
-Abrupt loss of motor function is suggestive of a stroke.
Which cardiac enzyme would the nurse expect to elevate first in a client diagnosed with a
myocardial infarction (MI)?
A) Creatine Kinase (CK-MB)
B) Lactate Dehydrogenase (LDH)
C) Troponin
D) WBCs - ANS ✔✔Answer = C
Rationale:
-Troponin is the enzyme that elevates quickly- within 1 to 2 hours.
,-CK-MB elevates in 12 to 24 hours.
-LDH elevates in 24-36 hours
-WBCs are not a cardiac enzyme! They elevate as a result of necrotic tissue.
The client is admitted to the telemetry unit diagnosed with acute exacerbation of congestive
heart failure (CHF). Which signs/symptoms would the nurse expect to find when assessing this
client?
A) Apical pulse rate of 110 and 4+ pitting edema of the feet
B) Thick white sputum and crackles that clear with cough
C) The client is sleeping with no pillow and eupnea
D) Radial pulse rate of 90 and CRT less than 3 seconds. - ANS ✔✔Answer = A
Rationale:
-the client with CHF would present with tachycardia (an apical rate of 110), dependent edema,
fatigue, third heart sounds, lung congestion, and change in mental status.
-In CHF, sputum is usually pink and frothy. Crackles do not clear after coughing. A CHF pt will
have labored breathing - not normal breathing (eupnea means normal breathing). Lastly, apical
pulse is preferred over radial in assessment of cardiac status in CHF.
The nurse is developing a discharge teaching plan for the client diagnosed with congestive heart
failure. Which interventions should be included in plan? Select all that apply:
A) Notify the provider if there is a weight gain of more than one pound in a week.
B) Teach the client how to count the radial pulse when taking digoxin, a cardiac glycoside.
C) Instruct the client to remove the saltshaker from the dinner table.
D) Encourage the client to monitor urine output for change in color to become dark.
E) Discuss the importance of taking the loop diuretic furosemide at bedtime. - ANS ✔✔Answer
= B), C)
,Rationale:
-the client needs to know that digoxin cannot be taken if radial pulse is less than 60.
-Weight gain of 1 pound in 1 week is irrelevant. Client should call weight gain of more than 2 or
3 pounds in 1 day.
-Urine should not be darker in this situation. If anything it may appear lighter and may increase
due to diuretics.
-The client should take diuretic in the morning - not at night! (to avoid nocturia)
The client diagnosed with rule-out myocardial infarction is experiencing chest pain while
walking to the bathroom. Which action should the nurse implement first?
A) Administer sublingual nitroglycerin.
B) Obtain a STAT electrocardiogram (ECG).
C) Have the client sit down immediately.
D) Assess the client's vital signs. - ANS ✔✔Answer = C
Rationale:
-stopping all activity will decrease the need of the myocardium for oxygen (may decrease chest
pain)
-An ECG should be ordered, but not before having the client sit down.
-taking vital signs will not help the client relieve chest pain.
Which diagnostic test is used to confirm the diagnosis of Amyotropic Lateral Sclerosis (ALS)?
A) Electromyogram (EMG).
, B) Muscle biopsy.
C) Serum creatine kinase (CK).
D) Pulmonary function test. - ANS ✔✔Answer = B
Rationale:
-a biopsy can confirm presence of muscle atrophy and loss of muscle fiber.
-an EMG does not confirm ALS; it is done to differentiate a neuropathy from a myopathy.
-CK may or may not be elevated in ALS, however it does not diagnose ALS.
The client had a right-sided chest tube inserted 2 hours ago for a pneumothorax. Which action
should the nurse implement if there is no fluctuation in the water-seal compartment?
A) Obtain an order for a STAT chest x-ray.
B) Increase the amount of wall suction.
C) Check the tubing for kinks or clots.
D) Monitor the client's pulse oximeter reading. - ANS ✔✔Answer = C
Rationale:
-The air from the pleural space is not getting to the water seal compartment. Checking the
tubing is appropriate in finding out why this is, and usually it's because the client is lying on the
tubing, it is kinked, or there is a dependent loop. (Note: the key here is '2 hours ago')
-increasing the amount of wall suction will not address WHY there is no fluctuation in the water-
seal compartment. Need to find out what is causing this before taking action.
The nurse writes a problem of "impaired gas exchange" for a client diagnosed with cancer of the
lung. Which interventions should be included in the plan of care? Select all that apply.
A) Apply O2 via nasal cannula.
B) Have the dietitian plan for 6 small meals per day.
