NURS 321 COMPLETE EXAM TEST BANK 350
MULTIPLE-CHOICE QUESTIONS WITH ANSWERS
AND RATIONALES
EXAM 1 – Foundations of Professional Nursing
1. A nurse is caring for a client who is receiving total parenteral nutrition
(TPN) and develops refeeding syndrome. Which of the following laboratory
findings should the nurse expect?
A. Hyperkalemia
B. Hyperphosphatemia
C. Hypophosphatemia
D. Hyperglycemia
Correct Answer: C. Hypophosphatemia
Rationale: Refeeding syndrome is characterized by severe fluid and
electrolyte shifts, particularly hypophosphatemia, as glucose metabolism
increases cellular uptake of phosphate. Other findings include hypokalemia
and hypomagnesemia.
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,2. A nurse is assessing a client who is receiving TPN therapy via an infusion
pump. Which of the following actions should the nurse take?
A. Infuse the solution over 2 hours
B. Change the tubing every 24 hours
C. Monitor blood glucose levels
D. Administer through a peripheral IV
Correct Answer: C. Monitor blood glucose levels
Rationale: TPN contains high concentrations of dextrose, requiring close
monitoring of blood glucose to detect hyperglycemia. Tubing should be
changed every 24 hours, and TPN requires central line access due to high
osmolarity.
---
3. Which statement by Mr. Jhanes regarding an endoscopic procedure
indicates that further teaching is required?
A. "I can eat solid foods 12 hours prior to the procedure."
B. "I cannot eat or drink 1 hour prior to the procedure."
C. "I can eat solid foods 3 hours prior to the procedure."
D. "I can return to my normal diet after the procedure."
Correct Answer: C. "I can eat solid foods 3 hours prior to the procedure."
,Rationale: Patients undergoing endoscopy typically require NPO status for 6-8
hours before the procedure. Eating solid foods 3 hours prior indicates a
misunderstanding that requires further teaching.
---
4. After an endoscopic gastroduodenoscopy procedure, in which order should
the nurse prioritize interventions?
A. Vital signs, focused physical assessment, start diet, discontinue IV fluids
B. Focused physical assessment, vital signs, discontinue IV fluids, start diet
C. Discontinue IV fluids, vital signs, focused physical assessment, start diet
D. Start diet, discontinue IV fluids, focused physical assessment, vital signs
Correct Answer: A. Vital signs, focused physical assessment, start diet,
discontinue IV fluids
Rationale: After an invasive procedure, the priority is to assess the patient's
stability through vital signs and focused physical assessment before advancing
diet or discontinuing IV access.
---
5. A nurse is using Swanson's theory of caring in practice. Which of the
following actions best demonstrates the "knowing" subdimension?
A. Holding the patient's hand during a painful procedure
, B. Explaining the procedure to the patient before performing it
C. Assessing the patient's understanding of their diagnosis
D. Calling the patient by their preferred name
Correct Answer: C. Assessing the patient's understanding of their diagnosis
Rationale: Swanson's theory includes five caring processes: knowing, being
with, doing for, enabling, and maintaining belief. "Knowing" involves striving
to understand an event as it has meaning in the life of the other.
---
6. A nurse is providing care to a patient from a different cultural background.
Which action demonstrates cultural competence?
A. Assuming the patient shares the same beliefs as the nurse
B. Asking the patient about their health beliefs and practices
C. Telling the patient how things are done in this country
D. Avoiding discussion of cultural differences
Correct Answer: B. Asking the patient about their health beliefs and practices
Rationale: Cultural competence requires active inquiry into the patient's
beliefs, values, and practices to provide individualized, respectful care.
Assumptions and avoidance are barriers to culturally competent care.
---
MULTIPLE-CHOICE QUESTIONS WITH ANSWERS
AND RATIONALES
EXAM 1 – Foundations of Professional Nursing
1. A nurse is caring for a client who is receiving total parenteral nutrition
(TPN) and develops refeeding syndrome. Which of the following laboratory
findings should the nurse expect?
A. Hyperkalemia
B. Hyperphosphatemia
C. Hypophosphatemia
D. Hyperglycemia
Correct Answer: C. Hypophosphatemia
Rationale: Refeeding syndrome is characterized by severe fluid and
electrolyte shifts, particularly hypophosphatemia, as glucose metabolism
increases cellular uptake of phosphate. Other findings include hypokalemia
and hypomagnesemia.
---
,2. A nurse is assessing a client who is receiving TPN therapy via an infusion
pump. Which of the following actions should the nurse take?
A. Infuse the solution over 2 hours
B. Change the tubing every 24 hours
C. Monitor blood glucose levels
D. Administer through a peripheral IV
Correct Answer: C. Monitor blood glucose levels
Rationale: TPN contains high concentrations of dextrose, requiring close
monitoring of blood glucose to detect hyperglycemia. Tubing should be
changed every 24 hours, and TPN requires central line access due to high
osmolarity.
---
3. Which statement by Mr. Jhanes regarding an endoscopic procedure
indicates that further teaching is required?
A. "I can eat solid foods 12 hours prior to the procedure."
B. "I cannot eat or drink 1 hour prior to the procedure."
C. "I can eat solid foods 3 hours prior to the procedure."
D. "I can return to my normal diet after the procedure."
Correct Answer: C. "I can eat solid foods 3 hours prior to the procedure."
,Rationale: Patients undergoing endoscopy typically require NPO status for 6-8
hours before the procedure. Eating solid foods 3 hours prior indicates a
misunderstanding that requires further teaching.
---
4. After an endoscopic gastroduodenoscopy procedure, in which order should
the nurse prioritize interventions?
A. Vital signs, focused physical assessment, start diet, discontinue IV fluids
B. Focused physical assessment, vital signs, discontinue IV fluids, start diet
C. Discontinue IV fluids, vital signs, focused physical assessment, start diet
D. Start diet, discontinue IV fluids, focused physical assessment, vital signs
Correct Answer: A. Vital signs, focused physical assessment, start diet,
discontinue IV fluids
Rationale: After an invasive procedure, the priority is to assess the patient's
stability through vital signs and focused physical assessment before advancing
diet or discontinuing IV access.
---
5. A nurse is using Swanson's theory of caring in practice. Which of the
following actions best demonstrates the "knowing" subdimension?
A. Holding the patient's hand during a painful procedure
, B. Explaining the procedure to the patient before performing it
C. Assessing the patient's understanding of their diagnosis
D. Calling the patient by their preferred name
Correct Answer: C. Assessing the patient's understanding of their diagnosis
Rationale: Swanson's theory includes five caring processes: knowing, being
with, doing for, enabling, and maintaining belief. "Knowing" involves striving
to understand an event as it has meaning in the life of the other.
---
6. A nurse is providing care to a patient from a different cultural background.
Which action demonstrates cultural competence?
A. Assuming the patient shares the same beliefs as the nurse
B. Asking the patient about their health beliefs and practices
C. Telling the patient how things are done in this country
D. Avoiding discussion of cultural differences
Correct Answer: B. Asking the patient about their health beliefs and practices
Rationale: Cultural competence requires active inquiry into the patient's
beliefs, values, and practices to provide individualized, respectful care.
Assumptions and avoidance are barriers to culturally competent care.
---
