NUR 283 ADULT HEALTH NURSING EXAM 3 (PDF) | 2026
QUESTIONS AND ANSWERS + RATIONALES | STUDY GUIDE |
100% CORRECT
1. The nurse is caring for four clients on a medical-surgical unit 24 hours postoperative. The
nurse performed a change-of-shift assessment 4 hours ago. Which change in client
condition should the nurse identify as the priority?
A) The client who reports an increased pain level of 8 on a scale of 0 to 10 after receiving
an opioid analgesic
B) The client who reports nausea after receiving prescribed antibiotics
C) The client whose dressing has a small amount of new serosanguineous drainage
D) The client who has voided 200 mL in the last 4 hours
Correct Answer: A) The client who reports an increased pain level of 8 on a scale of 0 to 10 after
receiving an opioid analgesic
Rationale: Unrelieved or increasing pain after opioid administration may signal serious
complications such as hemorrhage, compartment syndrome, or anastomotic leak. This change
from baseline is the most concerning and requires prompt evaluation .
2. The nurse preceptor is teaching a newly hired nurse about legal principles when
providing client care. Which situation should the nurse preceptor use as an example of
malpractice?
A) A nurse documents care at the end of the shift instead of in real time
B) A nurse delays administering a routine oral medication by 30 minutes
C) A client who is competent refuses an antidepressant medication. The nurse dissolves
the medication in food and administers it to the client without the client's knowledge
D) A nurse forgets to orient a new client to the call-bell system
Correct Answer: C) A client who is competent refuses an antidepressant medication. The nurse
dissolves the medication in food and administers it to the client without the client's knowledge
Rationale: Administering medication to a competent client who has refused it constitutes battery
and is a clear example of malpractice. The nurse violated the client's right to refuse treatment and
autonomy .
3. The nurse is reviewing the plan of care for a client diagnosed with pericarditis who has
been in the hospital for 24 hours. The nurse notes the client's current white blood cell
(WBC) count is 13,000/mm³ and they have a fever of 100.8°F orally. Which action is
most appropriate?
A) Discontinue current orders and request new cultures
B) Call the rapid response team immediately
C) Update the nursing interventions as needed
D) Prepare the client for emergency pericardiocentesis
Correct Answer: C) Update the nursing interventions as needed
,Rationale: Mild fever and mildly elevated WBC are expected inflammatory findings in acute
pericarditis. The nurse should continue monitoring and adjust interventions as needed, not
initiate emergency responses .
4. The charge nurse is reviewing clients' electronic medical records (EMRs). Which note by
a nurse indicates correct documentation?
A) "Client is uncooperative and rude."
B) "IV catheter site in left antecubital space is red and warm to touch. IV catheter
removed intact. 20-gauge catheter placed in right forearm."
C) "Client seems better today and is probably ready for discharge."
D) "Client is stable."
Correct Answer: B) "IV catheter site in left antecubital space is red and warm to touch. IV
catheter removed intact. 20-gauge catheter placed in right forearm."
Rationale: Documentation must be objective, specific, and complete. Option B describes
assessment, action, and outcome without subjective language, meeting legal and professional
documentation standards .
5. A client with cirrhosis reports several new areas of ecchymosis and has a partial
thromboplastin time (PTT) of 76 seconds. Which action should the nurse prioritize?
A) Apply ice to the areas of ecchymosis
B) Notify the provider immediately
C) Document the finding as expected
D) Prepare for a blood transfusion
Correct Answer: B) Notify the provider immediately
Rationale: Cirrhosis combined with an elevated PTT and new bruising indicates significant
coagulopathy and high bleeding risk. This finding requires immediate assessment and provider
notification .
6. A nurse is assessing a patient with left-sided heart failure. Which finding is most
expected?
A) Peripheral edema
B) Crackles in lungs
C) Ascites
D) Jugular vein distention
Correct Answer: B) Crackles in lungs
Rationale: Left-sided heart failure leads to pulmonary congestion and fluid accumulation in the
lungs, causing crackles on auscultation .
7. Which action is the priority when a patient develops acute chest pain?
A) Obtain a full set of vitals
B) Administer oxygen
, C) Notify family
D) Encourage deep breathing
Correct Answer: B) Administer oxygen
Rationale: Oxygen increases myocardial oxygen supply and is the immediate priority in
suspected cardiac ischemia .
8. Which lab value indicates kidney dysfunction?
A) BUN 8 mg/dL
B) Creatinine 0.8 mg/dL
C) Creatinine 3.2 mg/dL
D) Potassium 4.0 mEq/L
Correct Answer: C) Creatinine 3.2 mg/dL
Rationale: Elevated creatinine indicates impaired renal filtration. Normal creatinine is
approximately 0.6-1.2 mg/dL .
9. A patient with COPD should be given oxygen at which level?
A) 1–2 L/min
B) 3–4 L/min
C) 5–6 L/min
D) 8–10 L/min
Correct Answer: A) 1–2 L/min
Rationale: Low-flow oxygen (1-2 L/min) prevents suppression of the hypoxic respiratory drive
in COPD patients who may be chronic CO₂ retainers .
10. Which is the best indicator of fluid volume status?
A) Skin color
B) Daily weight
C) Temperature
D) Pain level
Correct Answer: B) Daily weight
Rationale: Daily weight accurately reflects fluid changes. A 1 kg weight gain is approximately
equivalent to 1 liter of fluid retention .
11. Which complication is most associated with immobility?
A) Hypoglycemia
B) Pressure ulcers
C) Hypertension
D) Hyperactivity
Correct Answer: B) Pressure ulcers
QUESTIONS AND ANSWERS + RATIONALES | STUDY GUIDE |
100% CORRECT
1. The nurse is caring for four clients on a medical-surgical unit 24 hours postoperative. The
nurse performed a change-of-shift assessment 4 hours ago. Which change in client
condition should the nurse identify as the priority?
A) The client who reports an increased pain level of 8 on a scale of 0 to 10 after receiving
an opioid analgesic
B) The client who reports nausea after receiving prescribed antibiotics
C) The client whose dressing has a small amount of new serosanguineous drainage
D) The client who has voided 200 mL in the last 4 hours
Correct Answer: A) The client who reports an increased pain level of 8 on a scale of 0 to 10 after
receiving an opioid analgesic
Rationale: Unrelieved or increasing pain after opioid administration may signal serious
complications such as hemorrhage, compartment syndrome, or anastomotic leak. This change
from baseline is the most concerning and requires prompt evaluation .
2. The nurse preceptor is teaching a newly hired nurse about legal principles when
providing client care. Which situation should the nurse preceptor use as an example of
malpractice?
A) A nurse documents care at the end of the shift instead of in real time
B) A nurse delays administering a routine oral medication by 30 minutes
C) A client who is competent refuses an antidepressant medication. The nurse dissolves
the medication in food and administers it to the client without the client's knowledge
D) A nurse forgets to orient a new client to the call-bell system
Correct Answer: C) A client who is competent refuses an antidepressant medication. The nurse
dissolves the medication in food and administers it to the client without the client's knowledge
Rationale: Administering medication to a competent client who has refused it constitutes battery
and is a clear example of malpractice. The nurse violated the client's right to refuse treatment and
autonomy .
3. The nurse is reviewing the plan of care for a client diagnosed with pericarditis who has
been in the hospital for 24 hours. The nurse notes the client's current white blood cell
(WBC) count is 13,000/mm³ and they have a fever of 100.8°F orally. Which action is
most appropriate?
A) Discontinue current orders and request new cultures
B) Call the rapid response team immediately
C) Update the nursing interventions as needed
D) Prepare the client for emergency pericardiocentesis
Correct Answer: C) Update the nursing interventions as needed
,Rationale: Mild fever and mildly elevated WBC are expected inflammatory findings in acute
pericarditis. The nurse should continue monitoring and adjust interventions as needed, not
initiate emergency responses .
4. The charge nurse is reviewing clients' electronic medical records (EMRs). Which note by
a nurse indicates correct documentation?
A) "Client is uncooperative and rude."
B) "IV catheter site in left antecubital space is red and warm to touch. IV catheter
removed intact. 20-gauge catheter placed in right forearm."
C) "Client seems better today and is probably ready for discharge."
D) "Client is stable."
Correct Answer: B) "IV catheter site in left antecubital space is red and warm to touch. IV
catheter removed intact. 20-gauge catheter placed in right forearm."
Rationale: Documentation must be objective, specific, and complete. Option B describes
assessment, action, and outcome without subjective language, meeting legal and professional
documentation standards .
5. A client with cirrhosis reports several new areas of ecchymosis and has a partial
thromboplastin time (PTT) of 76 seconds. Which action should the nurse prioritize?
A) Apply ice to the areas of ecchymosis
B) Notify the provider immediately
C) Document the finding as expected
D) Prepare for a blood transfusion
Correct Answer: B) Notify the provider immediately
Rationale: Cirrhosis combined with an elevated PTT and new bruising indicates significant
coagulopathy and high bleeding risk. This finding requires immediate assessment and provider
notification .
6. A nurse is assessing a patient with left-sided heart failure. Which finding is most
expected?
A) Peripheral edema
B) Crackles in lungs
C) Ascites
D) Jugular vein distention
Correct Answer: B) Crackles in lungs
Rationale: Left-sided heart failure leads to pulmonary congestion and fluid accumulation in the
lungs, causing crackles on auscultation .
7. Which action is the priority when a patient develops acute chest pain?
A) Obtain a full set of vitals
B) Administer oxygen
, C) Notify family
D) Encourage deep breathing
Correct Answer: B) Administer oxygen
Rationale: Oxygen increases myocardial oxygen supply and is the immediate priority in
suspected cardiac ischemia .
8. Which lab value indicates kidney dysfunction?
A) BUN 8 mg/dL
B) Creatinine 0.8 mg/dL
C) Creatinine 3.2 mg/dL
D) Potassium 4.0 mEq/L
Correct Answer: C) Creatinine 3.2 mg/dL
Rationale: Elevated creatinine indicates impaired renal filtration. Normal creatinine is
approximately 0.6-1.2 mg/dL .
9. A patient with COPD should be given oxygen at which level?
A) 1–2 L/min
B) 3–4 L/min
C) 5–6 L/min
D) 8–10 L/min
Correct Answer: A) 1–2 L/min
Rationale: Low-flow oxygen (1-2 L/min) prevents suppression of the hypoxic respiratory drive
in COPD patients who may be chronic CO₂ retainers .
10. Which is the best indicator of fluid volume status?
A) Skin color
B) Daily weight
C) Temperature
D) Pain level
Correct Answer: B) Daily weight
Rationale: Daily weight accurately reflects fluid changes. A 1 kg weight gain is approximately
equivalent to 1 liter of fluid retention .
11. Which complication is most associated with immobility?
A) Hypoglycemia
B) Pressure ulcers
C) Hypertension
D) Hyperactivity
Correct Answer: B) Pressure ulcers
