NUR283 COMPREHENSIVE 3 -
ADVANCED NURSING PRACTICE
QUESTIONS AND ANSWERS
1. A patient with a history of heart failure is admitted with a potassium level of 6.8 mEq/L.
The nurse notes peaked T waves on the ECG. Which medication should the nurse expect to
administer first to protect the myocardium?
A. Sodium Polystyrene Sulfonate
B. Calcium Gluconate
C. Insulin and Dextrose
D. Furosemide
Answer: B
Conceptual Explanation: Calcium gluconate is administered in hyperkalemia to stabilize
the myocardial cell membrane and prevent life-threatening arrhythmias, although it does
not lower potassium levels itself.
,2. A client is admitted with a suspected tension pneumothorax. Which clinical finding should
the nurse prioritize?
A. Tracheal deviation to the unaffected side
B. Muffled heart sounds
C. Bilateral wheezing
D. Increased tactile fremitus
Answer: A
Conceptual Explanation: Tracheal deviation to the unaffected side is a late and critical
sign of tension pneumothorax, indicating significant mediastinal shift that can lead to
obstructive shock.
3. A nurse is caring for a patient following a thyroidectomy. The patient reports tingling in the
fingers and toes. Which action should the nurse take first?
A. Assess for Chvostek’s sign
B. Administer a dose of levothyroxine
C. Check the patient’s temperature
D. Notify the provider of potential hemorrhage
Answer: A
, Conceptual Explanation: Tingling in the extremities (paresthesia) after thyroidectomy
suggests hypocalcemia due to accidental parathyroid damage. Assessing for Chvostek’s sign
confirms neuromuscular irritability.
4. Which assessment finding in a patient with acute pancreatitis requires immediate
notification of the healthcare provider?
A. Nausea and vomiting
B. Epigastric pain radiating to the back
C. Serum amylase level three times normal
D. Ecchymosis around the umbilicus
Answer: D
Conceptual Explanation: Cullen’s sign (ecchymosis around the umbilicus) indicates
retroperitoneal hemorrhage and is a sign of severe, potentially necrotizing pancreatitis.
5. A patient in the ICU has a pulmonary artery wedge pressure (PAWP) of 22 mmHg. Which
intervention is most appropriate?
A. Infusion of normal saline at 150 mL/hr
B. Administration of a loop diuretic
C. Trendelenburg positioning
D. Administration of norepinephrine
Answer: B
ADVANCED NURSING PRACTICE
QUESTIONS AND ANSWERS
1. A patient with a history of heart failure is admitted with a potassium level of 6.8 mEq/L.
The nurse notes peaked T waves on the ECG. Which medication should the nurse expect to
administer first to protect the myocardium?
A. Sodium Polystyrene Sulfonate
B. Calcium Gluconate
C. Insulin and Dextrose
D. Furosemide
Answer: B
Conceptual Explanation: Calcium gluconate is administered in hyperkalemia to stabilize
the myocardial cell membrane and prevent life-threatening arrhythmias, although it does
not lower potassium levels itself.
,2. A client is admitted with a suspected tension pneumothorax. Which clinical finding should
the nurse prioritize?
A. Tracheal deviation to the unaffected side
B. Muffled heart sounds
C. Bilateral wheezing
D. Increased tactile fremitus
Answer: A
Conceptual Explanation: Tracheal deviation to the unaffected side is a late and critical
sign of tension pneumothorax, indicating significant mediastinal shift that can lead to
obstructive shock.
3. A nurse is caring for a patient following a thyroidectomy. The patient reports tingling in the
fingers and toes. Which action should the nurse take first?
A. Assess for Chvostek’s sign
B. Administer a dose of levothyroxine
C. Check the patient’s temperature
D. Notify the provider of potential hemorrhage
Answer: A
, Conceptual Explanation: Tingling in the extremities (paresthesia) after thyroidectomy
suggests hypocalcemia due to accidental parathyroid damage. Assessing for Chvostek’s sign
confirms neuromuscular irritability.
4. Which assessment finding in a patient with acute pancreatitis requires immediate
notification of the healthcare provider?
A. Nausea and vomiting
B. Epigastric pain radiating to the back
C. Serum amylase level three times normal
D. Ecchymosis around the umbilicus
Answer: D
Conceptual Explanation: Cullen’s sign (ecchymosis around the umbilicus) indicates
retroperitoneal hemorrhage and is a sign of severe, potentially necrotizing pancreatitis.
5. A patient in the ICU has a pulmonary artery wedge pressure (PAWP) of 22 mmHg. Which
intervention is most appropriate?
A. Infusion of normal saline at 150 mL/hr
B. Administration of a loop diuretic
C. Trendelenburg positioning
D. Administration of norepinephrine
Answer: B
