NURS 328 COMPREHENSIVE NURSING
EXAMINATION QUESTIONS WITH
VERIFIED ANSWERS
1. A patient with heart failure is prescribed Digoxin. Which laboratory result would the nurse
identify as increasing the risk for Digoxin toxicity?
A. Serum Magnesium 2.0 mEq/L
B. Serum Calcium 9.5 mg/dL
C. Serum Potassium 3.2 mEq/L
D. Serum Sodium 138 mEq/L
Answer: C
Conceptual Explanation: Hypokalemia (low potassium) sensitizes the myocardium to
Digoxin, significantly increasing the risk of toxicity even if the drug level is within the
therapeutic range.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of
Acute Respiratory Distress Syndrome (ARDS)?
A. pH 7.30, PaCO2 55, HCO3 26
B. pH 7.35, PaCO2 40, HCO3 24
,C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.25, PaCO2 60, HCO3 28
Answer: C
Conceptual Explanation: Early ARDS typically presents with respiratory alkalosis due to
tachypnea and hyperventilation as the body attempts to compensate for hypoxia.
3. A patient with a head injury has a Glasglow Coma Scale (GCS) score of 7. What is the
priority nursing intervention?
A. Prepare for endotracheal intubation
B. Monitor intracranial pressure (ICP)
C. Assess pupillary response every hour
D. Administer intravenous Mannitol
Answer: A
Conceptual Explanation: A GCS score of 8 or less typically indicates a need for airway
protection; ‘less than 8, intubate’ is the standard clinical guideline.
4. Which assessment finding in a patient with a T6 spinal cord injury would lead the nurse to
suspect Autonomic Dysreflexia?
A. Extreme hypertension and bradycardia
B. Flaccid paralysis and loss of reflexes
C. Tachycardia and hypotension
, D. Hypothermia and diaphoresis below the level of injury
Answer: A
Conceptual Explanation: Autonomic Dysreflexia is characterized by a massive
sympathetic discharge causing severe hypertension, coupled with a compensatory
parasympathetic bradycardia.
5. A patient is receiving a continuous intravenous infusion of Heparin. The nurse notes the
aPTT is 110 seconds (Control 25-35). Which action should the nurse take first?
A. Stop the Heparin infusion
B. Notify the healthcare provider
C. Administer Protamine Sulfate
D. Draw a repeat aPTT sample
Answer: A
Conceptual Explanation: The aPTT is significantly above the therapeutic range (usually
1.5-2.5 times the control). The priority is to stop the infusion to prevent hemorrhage.
6. In a patient with Acute Kidney Injury (AKI), which phase is characterized by a sudden
increase in urine output to 3-5 Liters per day?
A. Oliguric phase
B. Diuretic phase
C. Recovery phase
EXAMINATION QUESTIONS WITH
VERIFIED ANSWERS
1. A patient with heart failure is prescribed Digoxin. Which laboratory result would the nurse
identify as increasing the risk for Digoxin toxicity?
A. Serum Magnesium 2.0 mEq/L
B. Serum Calcium 9.5 mg/dL
C. Serum Potassium 3.2 mEq/L
D. Serum Sodium 138 mEq/L
Answer: C
Conceptual Explanation: Hypokalemia (low potassium) sensitizes the myocardium to
Digoxin, significantly increasing the risk of toxicity even if the drug level is within the
therapeutic range.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of
Acute Respiratory Distress Syndrome (ARDS)?
A. pH 7.30, PaCO2 55, HCO3 26
B. pH 7.35, PaCO2 40, HCO3 24
,C. pH 7.48, PaCO2 30, HCO3 22
D. pH 7.25, PaCO2 60, HCO3 28
Answer: C
Conceptual Explanation: Early ARDS typically presents with respiratory alkalosis due to
tachypnea and hyperventilation as the body attempts to compensate for hypoxia.
3. A patient with a head injury has a Glasglow Coma Scale (GCS) score of 7. What is the
priority nursing intervention?
A. Prepare for endotracheal intubation
B. Monitor intracranial pressure (ICP)
C. Assess pupillary response every hour
D. Administer intravenous Mannitol
Answer: A
Conceptual Explanation: A GCS score of 8 or less typically indicates a need for airway
protection; ‘less than 8, intubate’ is the standard clinical guideline.
4. Which assessment finding in a patient with a T6 spinal cord injury would lead the nurse to
suspect Autonomic Dysreflexia?
A. Extreme hypertension and bradycardia
B. Flaccid paralysis and loss of reflexes
C. Tachycardia and hypotension
, D. Hypothermia and diaphoresis below the level of injury
Answer: A
Conceptual Explanation: Autonomic Dysreflexia is characterized by a massive
sympathetic discharge causing severe hypertension, coupled with a compensatory
parasympathetic bradycardia.
5. A patient is receiving a continuous intravenous infusion of Heparin. The nurse notes the
aPTT is 110 seconds (Control 25-35). Which action should the nurse take first?
A. Stop the Heparin infusion
B. Notify the healthcare provider
C. Administer Protamine Sulfate
D. Draw a repeat aPTT sample
Answer: A
Conceptual Explanation: The aPTT is significantly above the therapeutic range (usually
1.5-2.5 times the control). The priority is to stop the infusion to prevent hemorrhage.
6. In a patient with Acute Kidney Injury (AKI), which phase is characterized by a sudden
increase in urine output to 3-5 Liters per day?
A. Oliguric phase
B. Diuretic phase
C. Recovery phase
