PNR 201/PNR201 Final Exam V1 | Medical-Surgical
Nursing Q&A with Rationale | Fortis College
1. A nurse is caring for a client with Chronic Obstructive Pulmonary Disease (COPD) who is
experiencing dyspnea. Which breathing technique should the nurse instruct the client to use
to promote carbon dioxide elimination?
A. Pursed-lip breathing
B. Deep chest breathing
C. Diaphragmatic breathing
D. Rapid, shallow breathing
Correct Answer: A
Explanation: Pursed-lip breathing helps to maintain positive airway pressure in the
bronchioles, which prevents airway collapse during exhalation. This technique allows for
more effective expiration and the removal of trapped carbon dioxide. It is a key
intervention taught in PNR 201 to help COPD patients manage shortness of breath and
improve gas exchange.
2. Which laboratory value is the most reliable indicator of a client’s glycemic control over the
past 3 months?
A. Fasting blood glucose
B. Postprandial glucose
,C. Glycosylated hemoglobin (HbA1c)
D. Oral glucose tolerance test
Correct Answer: C
Explanation: The HbA1c test measures the percentage of hemoglobin that has glucose
attached to it, reflecting average blood sugar levels over the lifespan of a red blood cell.
Unlike daily finger-stick tests, it provides a stable long-term picture of how well the client’s
diabetes is being managed. For the PNR 201 medical-surgical curriculum, understanding
the significance of a target HbA1c below 7% is vital for evaluating treatment efficacy.
3. A client is diagnosed with right-sided heart failure. Which clinical manifestation should the
nurse expect to find during the assessment?
A. Peripheral edema
B. Pulmonary crackles
C. Dyspnea on exertion
D. Orthopnea
Correct Answer: A
Explanation: Right-sided heart failure results in the inability of the right ventricle to pump
blood effectively into the pulmonary circulation, leading to systemic venous congestion.
This congestion manifests as peripheral edema, jugular venous distention, and
hepatomegaly. Left-sided heart failure, by contrast, involves pulmonary symptoms like
crackles and orthopnea due to backflow into the lungs.
,4. A nurse is preparing to administer Lisinopril to a client with hypertension. What is a
common side effect of ACE inhibitors that the nurse should monitor for?
A. Persistent dry cough
B. Tachycardia
C. Hypokalemia
D. Increased urinary output
Correct Answer: A
Explanation: A persistent dry cough is a well-documented side effect of Angiotensin-
Converting Enzyme (ACE) inhibitors caused by the accumulation of bradykinin in the
respiratory tract. If the cough becomes intolerable, the healthcare provider may switch the
client to an Angiotensin II Receptor Blocker (ARB). Monitoring for this symptom is a
standard nursing responsibility in cardiovascular care modules.
5. In the immediate postoperative period after a total hip arthroplasty, which position is most
appropriate for the client’s affected leg?
A. Abduction with a wedge pillow
B. Adduction with internal rotation
C. Flexion at 120 degrees
D. External rotation with knee flexion
Correct Answer: A
, Explanation: Maintaining the leg in an abducted position using an abduction pillow or
wedge is essential to prevent dislocation of the new hip prosthesis. The nurse must ensure
the client avoids crossing their legs or bending at the hip more than 90 degrees. This
specific positioning protocol is a critical safety standard taught in PNR 201 orthopedic
nursing.
6. A client presents with signs of a stroke. The nurse knows that the ‘gold standard’ for
determining if the stroke is ischemic or hemorrhagic is which diagnostic test?
A. Lumbar puncture
B. Non-contrast Computed Tomography (CT) scan
C. Electroencephalogram (EEG)
D. Magnetic Resonance Imaging (MRI)
Correct Answer: B
Explanation: A non-contrast CT scan of the head is the priority diagnostic tool to quickly
differentiate between a thrombus and a bleed. This distinction is vital because
thrombolytic therapy (tPA) is contraindicated in hemorrhagic strokes and can be fatal.
Rapid assessment within the ‘golden hour’ is a primary focus of medical-surgical
emergency protocols.
7. A nurse is teaching a client about iron-deficiency anemia and the administration of oral
iron supplements. Which instruction should be included?
A. Take the supplement with orange juice
Nursing Q&A with Rationale | Fortis College
1. A nurse is caring for a client with Chronic Obstructive Pulmonary Disease (COPD) who is
experiencing dyspnea. Which breathing technique should the nurse instruct the client to use
to promote carbon dioxide elimination?
A. Pursed-lip breathing
B. Deep chest breathing
C. Diaphragmatic breathing
D. Rapid, shallow breathing
Correct Answer: A
Explanation: Pursed-lip breathing helps to maintain positive airway pressure in the
bronchioles, which prevents airway collapse during exhalation. This technique allows for
more effective expiration and the removal of trapped carbon dioxide. It is a key
intervention taught in PNR 201 to help COPD patients manage shortness of breath and
improve gas exchange.
2. Which laboratory value is the most reliable indicator of a client’s glycemic control over the
past 3 months?
A. Fasting blood glucose
B. Postprandial glucose
,C. Glycosylated hemoglobin (HbA1c)
D. Oral glucose tolerance test
Correct Answer: C
Explanation: The HbA1c test measures the percentage of hemoglobin that has glucose
attached to it, reflecting average blood sugar levels over the lifespan of a red blood cell.
Unlike daily finger-stick tests, it provides a stable long-term picture of how well the client’s
diabetes is being managed. For the PNR 201 medical-surgical curriculum, understanding
the significance of a target HbA1c below 7% is vital for evaluating treatment efficacy.
3. A client is diagnosed with right-sided heart failure. Which clinical manifestation should the
nurse expect to find during the assessment?
A. Peripheral edema
B. Pulmonary crackles
C. Dyspnea on exertion
D. Orthopnea
Correct Answer: A
Explanation: Right-sided heart failure results in the inability of the right ventricle to pump
blood effectively into the pulmonary circulation, leading to systemic venous congestion.
This congestion manifests as peripheral edema, jugular venous distention, and
hepatomegaly. Left-sided heart failure, by contrast, involves pulmonary symptoms like
crackles and orthopnea due to backflow into the lungs.
,4. A nurse is preparing to administer Lisinopril to a client with hypertension. What is a
common side effect of ACE inhibitors that the nurse should monitor for?
A. Persistent dry cough
B. Tachycardia
C. Hypokalemia
D. Increased urinary output
Correct Answer: A
Explanation: A persistent dry cough is a well-documented side effect of Angiotensin-
Converting Enzyme (ACE) inhibitors caused by the accumulation of bradykinin in the
respiratory tract. If the cough becomes intolerable, the healthcare provider may switch the
client to an Angiotensin II Receptor Blocker (ARB). Monitoring for this symptom is a
standard nursing responsibility in cardiovascular care modules.
5. In the immediate postoperative period after a total hip arthroplasty, which position is most
appropriate for the client’s affected leg?
A. Abduction with a wedge pillow
B. Adduction with internal rotation
C. Flexion at 120 degrees
D. External rotation with knee flexion
Correct Answer: A
, Explanation: Maintaining the leg in an abducted position using an abduction pillow or
wedge is essential to prevent dislocation of the new hip prosthesis. The nurse must ensure
the client avoids crossing their legs or bending at the hip more than 90 degrees. This
specific positioning protocol is a critical safety standard taught in PNR 201 orthopedic
nursing.
6. A client presents with signs of a stroke. The nurse knows that the ‘gold standard’ for
determining if the stroke is ischemic or hemorrhagic is which diagnostic test?
A. Lumbar puncture
B. Non-contrast Computed Tomography (CT) scan
C. Electroencephalogram (EEG)
D. Magnetic Resonance Imaging (MRI)
Correct Answer: B
Explanation: A non-contrast CT scan of the head is the priority diagnostic tool to quickly
differentiate between a thrombus and a bleed. This distinction is vital because
thrombolytic therapy (tPA) is contraindicated in hemorrhagic strokes and can be fatal.
Rapid assessment within the ‘golden hour’ is a primary focus of medical-surgical
emergency protocols.
7. A nurse is teaching a client about iron-deficiency anemia and the administration of oral
iron supplements. Which instruction should be included?
A. Take the supplement with orange juice
