NR 325 Med-Surg Exam Questions with
Detailed Answers & Rationales |
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A client with chronic obstructive pulmonary disease (COPD) is admitted with
an acute exacerbation. The nurse notes a rising PaCO₂ and deteriorating
mental status. What does this indicate?
,a. Improving ventilation
b. Onset of respiratory failure
c. Metabolic alkalosis
d. Adequate compensation
✔️ Correct Answer: B
Rationale: Rising CO₂ and worsening mental status in a COPD exacerbation
suggest ventilatory failure and CO₂ retention. This indicates respiratory
failure requiring immediate intervention. DIF: Application | OBJ: Recognize
respiratory failure | TOP: Respiratory / COPD
A postoperative client complains of sudden shortness of breath, chest pain,
and tachycardia. What is the nurse's first action?
a. Administer pain medication
b. Encourage deep breathing and coughing
c. Assess oxygen saturation and apply supplemental oxygen
d. Ambulate the client
✔️ Correct Answer: C
Rationale: These signs suggest pulmonary embolism; ensuring oxygenation
is a priority. Assessment of oxygen saturation guides further intervention.
DIF: Application | OBJ: Prioritize emergency care | TOP: Respiratory /
Pulmonary embolism
,A client with heart failure is started on spironolactone. Which lab value
requires close monitoring?
a. Serum sodium
b. Serum potassium
c. Blood glucose
d. Serum calcium
✔️ Correct Answer: B
Rationale: Spironolactone is potassium-sparing, so it can cause
hyperkalemia. Regular monitoring of potassium levels is essential to prevent
life-threatening cardiac arrhythmias. DIF: Knowledge | OBJ: Monitor diuretic
therapy | TOP: Cardiovascular / Heart failure
A client with pancreatitis is NPO and receiving IV fluids. Which lab result
would be especially concerning?
a. Rising BUN and creatinine
b. Decreasing amylase
c. Stable sodium
d. Slight leukocytosis
✔️ Correct Answer: A
Rationale: Rising BUN/creatinine suggests worsening renal perfusion or
possible acute kidney injury, a serious complication of pancreatitis. DIF:
Application | OBJ: Monitor for complications | TOP: Gastrointestinal /
Pancreatitis
, A nurse is caring for a client with a tracheostomy. Which intervention helps
maintain airway patency?
a. Suction only when audible secretions are present
b. Perform closed inline suctioning as needed
c. Limit humidification to reduce moisture
d. Never change ties
✔️ Correct Answer: B
Rationale: Closed inline suctioning maintains airway patency without
disconnecting the client from the ventilator (if applicable). It reduces the risk
of hypoxia and infection. DIF: Application | OBJ: Provide airway care | TOP:
Respiratory / Tracheostomy
A client with deep vein thrombosis (DVT) is placed on heparin infusion.
Which parameter should the nurse monitor to guide therapy?
a. Platelet count
b. aPTT (activated partial thromboplastin time)
c. Hemoglobin
d. Sodium level
✔️ Correct Answer: B
Rationale: aPTT guides heparin dosing to maintain therapeutic
anticoagulation. The therapeutic range is typically 1.5–2.5 times the normal
control value. DIF: Knowledge | OBJ: Monitor anticoagulant therapy | TOP:
Cardiovascular / DVT
Detailed Answers & Rationales |
Verified & Graded A+ | Latest Edition
2026/2027 Frequently Most Tested Questions
and 100% Accurate From Past papers | Graded
A+ , Reviewed and Updated | 100% Guarantee
Pass | Latest Exam and Newest Version!!!
A client with chronic obstructive pulmonary disease (COPD) is admitted with
an acute exacerbation. The nurse notes a rising PaCO₂ and deteriorating
mental status. What does this indicate?
,a. Improving ventilation
b. Onset of respiratory failure
c. Metabolic alkalosis
d. Adequate compensation
✔️ Correct Answer: B
Rationale: Rising CO₂ and worsening mental status in a COPD exacerbation
suggest ventilatory failure and CO₂ retention. This indicates respiratory
failure requiring immediate intervention. DIF: Application | OBJ: Recognize
respiratory failure | TOP: Respiratory / COPD
A postoperative client complains of sudden shortness of breath, chest pain,
and tachycardia. What is the nurse's first action?
a. Administer pain medication
b. Encourage deep breathing and coughing
c. Assess oxygen saturation and apply supplemental oxygen
d. Ambulate the client
✔️ Correct Answer: C
Rationale: These signs suggest pulmonary embolism; ensuring oxygenation
is a priority. Assessment of oxygen saturation guides further intervention.
DIF: Application | OBJ: Prioritize emergency care | TOP: Respiratory /
Pulmonary embolism
,A client with heart failure is started on spironolactone. Which lab value
requires close monitoring?
a. Serum sodium
b. Serum potassium
c. Blood glucose
d. Serum calcium
✔️ Correct Answer: B
Rationale: Spironolactone is potassium-sparing, so it can cause
hyperkalemia. Regular monitoring of potassium levels is essential to prevent
life-threatening cardiac arrhythmias. DIF: Knowledge | OBJ: Monitor diuretic
therapy | TOP: Cardiovascular / Heart failure
A client with pancreatitis is NPO and receiving IV fluids. Which lab result
would be especially concerning?
a. Rising BUN and creatinine
b. Decreasing amylase
c. Stable sodium
d. Slight leukocytosis
✔️ Correct Answer: A
Rationale: Rising BUN/creatinine suggests worsening renal perfusion or
possible acute kidney injury, a serious complication of pancreatitis. DIF:
Application | OBJ: Monitor for complications | TOP: Gastrointestinal /
Pancreatitis
, A nurse is caring for a client with a tracheostomy. Which intervention helps
maintain airway patency?
a. Suction only when audible secretions are present
b. Perform closed inline suctioning as needed
c. Limit humidification to reduce moisture
d. Never change ties
✔️ Correct Answer: B
Rationale: Closed inline suctioning maintains airway patency without
disconnecting the client from the ventilator (if applicable). It reduces the risk
of hypoxia and infection. DIF: Application | OBJ: Provide airway care | TOP:
Respiratory / Tracheostomy
A client with deep vein thrombosis (DVT) is placed on heparin infusion.
Which parameter should the nurse monitor to guide therapy?
a. Platelet count
b. aPTT (activated partial thromboplastin time)
c. Hemoglobin
d. Sodium level
✔️ Correct Answer: B
Rationale: aPTT guides heparin dosing to maintain therapeutic
anticoagulation. The therapeutic range is typically 1.5–2.5 times the normal
control value. DIF: Knowledge | OBJ: Monitor anticoagulant therapy | TOP:
Cardiovascular / DVT
