MARYVILLE NURS 612 EXAM 1
QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES
GRADED A+ LATEST
Question 1
A 62-year-old patient with chronic heart failure presents with increasing shortness
of breath, orthopnea, and lower extremity edema. Which intervention should be
prioritized first?
A. Administer a high-dose loop diuretic
B. Obtain a chest X-ray
C. Encourage the patient to ambulate
D. Teach a low-sodium diet
Answer: A. Administer a high-dose loop diuretic
Rationale: The patient is exhibiting signs of fluid overload and pulmonary
congestion. Loop diuretics rapidly reduce fluid volume, alleviating symptoms.
Chest X-ray is useful but not the immediate intervention. Diet teaching and
ambulation are supportive measures.
Question 2
Which lab result is most indicative of early acute kidney injury in a hospitalized
patient?
A. Creatinine 1.4 mg/dL (baseline 0.8 mg/dL)
B. BUN 12 mg/dL
C. Sodium 140 mEq/L
D. Potassium 4.2 mEq/L
Answer: A. Creatinine 1.4 mg/dL (baseline 0.8 mg/dL)
,Rationale: An increase in creatinine from baseline is a sensitive indicator of early
kidney injury. BUN alone may be affected by hydration or protein intake, while
sodium and potassium may remain normal initially.
Question 3
A patient with COPD reports increased sputum production and low-grade fever.
Which treatment should the nurse anticipate?
A. High-dose corticosteroids only
B. Antibiotic therapy targeting bacterial infection
C. Immediate intubation
D. Oxygen therapy above 4 L/min
Answer: B. Antibiotic therapy targeting bacterial infection
Rationale: Increased sputum and fever suggest an infectious exacerbation.
Antibiotics are indicated. Oxygen therapy must be carefully titrated in COPD to
avoid hypercapnia, corticosteroids may be adjunctive, and intubation is not first-
line.
Question 4
A nurse is educating a patient with type 1 diabetes about hypoglycemia
management. Which statement by the patient indicates understanding?
A. “I will take my insulin if I feel shaky.”
B. “I will drink 4 ounces of juice if my blood sugar is 60 mg/dL.”
C. “I will ignore sweating and check my blood pressure instead.”
D. “I will exercise to raise my blood sugar.”
Answer: B. “I will drink 4 ounces of juice if my blood sugar is 60 mg/dL.”
Rationale: Hypoglycemia is treated with 15–20 grams of fast-acting carbohydrate.
Blood sugar of 60 mg/dL is appropriate to treat. Insulin lowers glucose, ignoring
symptoms is unsafe, and exercise lowers glucose.
,Question 5
Which cardiovascular change is expected in normal aging?
A. Decreased systolic blood pressure
B. Thickened ventricular walls with decreased compliance
C. Increased maximal heart rate
D. Hyperdynamic cardiac output
Answer: B. Thickened ventricular walls with decreased compliance
Rationale: Age-related changes include ventricular stiffening and reduced
compliance, which may affect diastolic filling. Systolic BP may rise, maximal
heart rate declines, and cardiac output may decrease under stress.
Question 6
A patient presents with sudden-onset severe right upper quadrant pain, nausea, and
vomiting. Lab results show elevated ALT, AST, and bilirubin. What is the most
likely diagnosis?
A. Acute pancreatitis
B. Acute cholecystitis
C. Peptic ulcer disease
D. Gastroenteritis
Answer: B. Acute cholecystitis
Rationale: Right upper quadrant pain with elevated liver enzymes and bilirubin
indicates biliary obstruction or inflammation, consistent with acute cholecystitis.
Pancreatitis typically has epigastric pain radiating to the back and elevated
amylase/lipase.
, Question 7
A patient with a history of hypertension is prescribed a thiazide diuretic. Which
electrolyte imbalance should the nurse monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Answer: B. Hypokalemia
Rationale: Thiazide diuretics can cause potassium loss, leading to hypokalemia.
They may mildly increase calcium, but potassium depletion is the primary concern.
Sodium may decrease, not increase.
Question 8
Which action by a nurse demonstrates appropriate delegation?
A. Assigning medication administration to a nursing assistant
B. Requesting a nursing student to perform a sterile dressing change independently
C. Asking an LPN to reinforce patient education on diet
D. Allowing a CNA to perform an initial patient assessment
Answer: C. Asking an LPN to reinforce patient education on diet
Rationale: Delegation must match the scope of practice. LPNs can reinforce
education. Medication administration and initial assessments require RN oversight,
and sterile procedures need RN supervision.
QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES
GRADED A+ LATEST
Question 1
A 62-year-old patient with chronic heart failure presents with increasing shortness
of breath, orthopnea, and lower extremity edema. Which intervention should be
prioritized first?
A. Administer a high-dose loop diuretic
B. Obtain a chest X-ray
C. Encourage the patient to ambulate
D. Teach a low-sodium diet
Answer: A. Administer a high-dose loop diuretic
Rationale: The patient is exhibiting signs of fluid overload and pulmonary
congestion. Loop diuretics rapidly reduce fluid volume, alleviating symptoms.
Chest X-ray is useful but not the immediate intervention. Diet teaching and
ambulation are supportive measures.
Question 2
Which lab result is most indicative of early acute kidney injury in a hospitalized
patient?
A. Creatinine 1.4 mg/dL (baseline 0.8 mg/dL)
B. BUN 12 mg/dL
C. Sodium 140 mEq/L
D. Potassium 4.2 mEq/L
Answer: A. Creatinine 1.4 mg/dL (baseline 0.8 mg/dL)
,Rationale: An increase in creatinine from baseline is a sensitive indicator of early
kidney injury. BUN alone may be affected by hydration or protein intake, while
sodium and potassium may remain normal initially.
Question 3
A patient with COPD reports increased sputum production and low-grade fever.
Which treatment should the nurse anticipate?
A. High-dose corticosteroids only
B. Antibiotic therapy targeting bacterial infection
C. Immediate intubation
D. Oxygen therapy above 4 L/min
Answer: B. Antibiotic therapy targeting bacterial infection
Rationale: Increased sputum and fever suggest an infectious exacerbation.
Antibiotics are indicated. Oxygen therapy must be carefully titrated in COPD to
avoid hypercapnia, corticosteroids may be adjunctive, and intubation is not first-
line.
Question 4
A nurse is educating a patient with type 1 diabetes about hypoglycemia
management. Which statement by the patient indicates understanding?
A. “I will take my insulin if I feel shaky.”
B. “I will drink 4 ounces of juice if my blood sugar is 60 mg/dL.”
C. “I will ignore sweating and check my blood pressure instead.”
D. “I will exercise to raise my blood sugar.”
Answer: B. “I will drink 4 ounces of juice if my blood sugar is 60 mg/dL.”
Rationale: Hypoglycemia is treated with 15–20 grams of fast-acting carbohydrate.
Blood sugar of 60 mg/dL is appropriate to treat. Insulin lowers glucose, ignoring
symptoms is unsafe, and exercise lowers glucose.
,Question 5
Which cardiovascular change is expected in normal aging?
A. Decreased systolic blood pressure
B. Thickened ventricular walls with decreased compliance
C. Increased maximal heart rate
D. Hyperdynamic cardiac output
Answer: B. Thickened ventricular walls with decreased compliance
Rationale: Age-related changes include ventricular stiffening and reduced
compliance, which may affect diastolic filling. Systolic BP may rise, maximal
heart rate declines, and cardiac output may decrease under stress.
Question 6
A patient presents with sudden-onset severe right upper quadrant pain, nausea, and
vomiting. Lab results show elevated ALT, AST, and bilirubin. What is the most
likely diagnosis?
A. Acute pancreatitis
B. Acute cholecystitis
C. Peptic ulcer disease
D. Gastroenteritis
Answer: B. Acute cholecystitis
Rationale: Right upper quadrant pain with elevated liver enzymes and bilirubin
indicates biliary obstruction or inflammation, consistent with acute cholecystitis.
Pancreatitis typically has epigastric pain radiating to the back and elevated
amylase/lipase.
, Question 7
A patient with a history of hypertension is prescribed a thiazide diuretic. Which
electrolyte imbalance should the nurse monitor for?
A. Hyperkalemia
B. Hypokalemia
C. Hypercalcemia
D. Hypernatremia
Answer: B. Hypokalemia
Rationale: Thiazide diuretics can cause potassium loss, leading to hypokalemia.
They may mildly increase calcium, but potassium depletion is the primary concern.
Sodium may decrease, not increase.
Question 8
Which action by a nurse demonstrates appropriate delegation?
A. Assigning medication administration to a nursing assistant
B. Requesting a nursing student to perform a sterile dressing change independently
C. Asking an LPN to reinforce patient education on diet
D. Allowing a CNA to perform an initial patient assessment
Answer: C. Asking an LPN to reinforce patient education on diet
Rationale: Delegation must match the scope of practice. LPNs can reinforce
education. Medication administration and initial assessments require RN oversight,
and sterile procedures need RN supervision.
