BSN Advanced Nursing Fundamentals Exam 9 Practice
UPDATED ACTUAL Questions and CORRECT Answers
1. A patient with chronic obstructive pulmonary disease (COPD) has the
following arterial blood gas (ABG) results: pH 7.31, PaCO2 52 mmHg, and HCO3
26 mEq/L. How should the nurse interpret these results?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
Answer: D
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory component),
indicating respiratory acidosis. The HCO3 is within normal range, suggesting no
compensation yet.
2. When assessing a patient’s neurological status using the Glasgow Coma Scale
(GCS), which score would indicate the patient is in a comatose state?
A. 15
B. 12
C. 10
D. 7
Answer: D
Rationale: A GCS score of 8 or less is generally accepted as indicating a comatose state or
severe brain injury.
,3. The nurse is preparing to suction a patient with a tracheostomy. What is the
maximum amount of time the nurse should apply suction during a single pass?
A. 5 seconds
B. 30 seconds
C. 20 to 25 seconds
D. 10 to 15 seconds
Answer: D
Rationale: Suctioning should be limited to 10-15 seconds to prevent hypoxia and mucosal
damage.
4. A patient is receiving Total Parenteral Nutrition (TPN) via a central venous
access device. Which laboratory value is most important for the nurse to
monitor frequently?
A. Serum sodium
B. Serum glucose
C. Hemoglobin
D. Creatinine
Answer: B
Rationale: TPN has a high glucose concentration, putting the patient at risk for
hyperglycemia; blood glucose monitoring is essential.
5. The nurse observes continuous bubbling in the water-seal chamber of a chest
tube drainage system. What does this finding likely indicate?
A. The system is functioning normally.
B. The patient has a pneumothorax.
C. The suction is set too high.
D. There is an air leak in the system.
Answer: D
, Rationale: Continuous bubbling in the water-seal chamber indicates an air leak between
the patient and the water seal.
6. Before administering a bolus enteral feeding through a nasogastric tube,
which action should the nurse take to verify tube placement?
A. Auscultate for a ‘whoosh’ of air over the epigastrium.
B. Test the pH of the aspirated gastric contents.
C. Observe the color of the aspirate.
D. Perform a chest X-ray every time.
Answer: B
Rationale: While X-ray is the gold standard for initial placement, pH testing of aspirate is
the preferred bedside method for ongoing verification.
7. During a blood transfusion, a patient develops chills, lower back pain, and
tachycardia. What is the nurse’s priority action?
A. Slow the infusion rate and notify the provider.
B. Administer an antihistamine.
C. Stop the transfusion immediately and disconnect the tubing.
D. Check the patient’s temperature.
Answer: C
Rationale: Chills and back pain are signs of an acute hemolytic reaction. The transfusion
must be stopped immediately to prevent further reaction.
8. A surgical wound that is left open to heal by the formation of granulation
tissue is healing by which process?
A. Secondary intention
B. Primary intention
C. Tertiary intention
D. Delayed closure
Answer: A
UPDATED ACTUAL Questions and CORRECT Answers
1. A patient with chronic obstructive pulmonary disease (COPD) has the
following arterial blood gas (ABG) results: pH 7.31, PaCO2 52 mmHg, and HCO3
26 mEq/L. How should the nurse interpret these results?
A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
Answer: D
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory component),
indicating respiratory acidosis. The HCO3 is within normal range, suggesting no
compensation yet.
2. When assessing a patient’s neurological status using the Glasgow Coma Scale
(GCS), which score would indicate the patient is in a comatose state?
A. 15
B. 12
C. 10
D. 7
Answer: D
Rationale: A GCS score of 8 or less is generally accepted as indicating a comatose state or
severe brain injury.
,3. The nurse is preparing to suction a patient with a tracheostomy. What is the
maximum amount of time the nurse should apply suction during a single pass?
A. 5 seconds
B. 30 seconds
C. 20 to 25 seconds
D. 10 to 15 seconds
Answer: D
Rationale: Suctioning should be limited to 10-15 seconds to prevent hypoxia and mucosal
damage.
4. A patient is receiving Total Parenteral Nutrition (TPN) via a central venous
access device. Which laboratory value is most important for the nurse to
monitor frequently?
A. Serum sodium
B. Serum glucose
C. Hemoglobin
D. Creatinine
Answer: B
Rationale: TPN has a high glucose concentration, putting the patient at risk for
hyperglycemia; blood glucose monitoring is essential.
5. The nurse observes continuous bubbling in the water-seal chamber of a chest
tube drainage system. What does this finding likely indicate?
A. The system is functioning normally.
B. The patient has a pneumothorax.
C. The suction is set too high.
D. There is an air leak in the system.
Answer: D
, Rationale: Continuous bubbling in the water-seal chamber indicates an air leak between
the patient and the water seal.
6. Before administering a bolus enteral feeding through a nasogastric tube,
which action should the nurse take to verify tube placement?
A. Auscultate for a ‘whoosh’ of air over the epigastrium.
B. Test the pH of the aspirated gastric contents.
C. Observe the color of the aspirate.
D. Perform a chest X-ray every time.
Answer: B
Rationale: While X-ray is the gold standard for initial placement, pH testing of aspirate is
the preferred bedside method for ongoing verification.
7. During a blood transfusion, a patient develops chills, lower back pain, and
tachycardia. What is the nurse’s priority action?
A. Slow the infusion rate and notify the provider.
B. Administer an antihistamine.
C. Stop the transfusion immediately and disconnect the tubing.
D. Check the patient’s temperature.
Answer: C
Rationale: Chills and back pain are signs of an acute hemolytic reaction. The transfusion
must be stopped immediately to prevent further reaction.
8. A surgical wound that is left open to heal by the formation of granulation
tissue is healing by which process?
A. Secondary intention
B. Primary intention
C. Tertiary intention
D. Delayed closure
Answer: A
