NUR 114 Exam 4: Advanced Nursing Concepts and NCL… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 114 Exam 4: Advanced Nursing Concepts and NCLEX
Practice 2026/2027 UPDATE
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 114 Exam 4: Advanced Nursing Concepts and NCL… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mm Hg, and HCO3 26
mEq/L. Which interpretation and nursing intervention are most appropriate?
A. Metabolic acidosis; provide sodium bicarbonate intravenously.
B. Metabolic alkalosis; monitor for hypokalemia and administer saline.
C. Respiratory alkalosis; administer oxygen via a non-rebreather mask.
D. Respiratory acidosis; encourage deep breathing and coughing.
Answer: D
Rationale: The pH is low (<7.35) indicating acidosis, and the PaCO2 is high (>45) indicating a
respiratory cause. This is uncompensated respiratory acidosis. Interventions should focus on
improving ventilation. In practice, this guides the nurse to set priorities and protect the client from harm.
Safety, nutrition, and clear communication are frequent priorities. Exam questions often test whether
you can pick the most practical and safe choice for the client in real situations. Focus on what the
nurse can actually do right now.
2. A nurse is caring for a patient who is 6 hours postoperative following abdominal surgery.
The patient reports sudden shortness of breath and chest pain. The nurse notes an oxygen
saturation of 88%. What is the priority action?
A. Obtain an electrocardiogram (ECG).
B. Administer the prescribed PRN morphine.
C. Initiate oxygen therapy and notify the Rapid Response Team.
D. Encourage the use of the incentive spirometer.
Answer: C
Rationale: Sudden onset of dyspnea and hypoxia in a postoperative patient suggests a pulmonary
embolism. Immediate oxygenation and escalation of care are required. Understanding this helps the
nurse notice early warning signs and act before the problem gets worse. Early action often prevents
bigger complications for the client. This is important because the nurse must choose the action that
keeps the client safest while still meeting their basic needs. Always think about safety first when
answering these questions.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 114 Exam 4: Advanced Nursing Concepts and NCL… 2026/2027 • Verified • Assured Grade A+
3. A patient with Type 1 Diabetes Mellitus is found unconscious and diaphoretic. The
fingerstick blood glucose is 42 mg/dL. Which medication should the nurse prepare to
administer if no IV access is available?
A. Regular insulin subcutaneously.
B. Glucagon intramuscularly.
C. 100 mL of 5% Dextrose in Water (D5W).
D. Acarbose orally.
Answer: B
Rationale: For severe hypoglycemia in an unconscious patient without IV access, IM glucagon is the
standard treatment to mobilize glucose stores. Understanding this helps the nurse notice early warning
signs and act before the problem gets worse. Early action often prevents bigger complications for the
client. In practice, this guides the nurse to set priorities and protect the client from harm. Safety,
nutrition, and clear communication are frequent priorities.
4. Which assessment finding in a patient with a chest tube requires immediate intervention
by the nurse?
A. 100 mL of serosanguinous drainage in the first hour post-insertion.
B. Fluctuation of the water level in the water seal chamber during respiration.
C. Constant bubbling in the water seal chamber.
D. Presence of subcutaneous emphysema around the insertion site.
Answer: C
Rationale: Constant bubbling in the water seal chamber indicates an air leak in the system. Tidaling
(fluctuation) is normal, and serosanguinous drainage is expected initially. This knowledge supports
safe care and helps the nurse teach the client and family clearly and simply. Clear teaching improves
cooperation and reduces anxiety. This knowledge supports safe care and helps the nurse teach the
client and family clearly and simply. Clear teaching improves cooperation and reduces anxiety.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 114 Exam 4: Advanced Nursing Concepts and NCLEX
Practice 2026/2027 UPDATE
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 114 Exam 4: Advanced Nursing Concepts and NCL… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 55 mm Hg, and HCO3 26
mEq/L. Which interpretation and nursing intervention are most appropriate?
A. Metabolic acidosis; provide sodium bicarbonate intravenously.
B. Metabolic alkalosis; monitor for hypokalemia and administer saline.
C. Respiratory alkalosis; administer oxygen via a non-rebreather mask.
D. Respiratory acidosis; encourage deep breathing and coughing.
Answer: D
Rationale: The pH is low (<7.35) indicating acidosis, and the PaCO2 is high (>45) indicating a
respiratory cause. This is uncompensated respiratory acidosis. Interventions should focus on
improving ventilation. In practice, this guides the nurse to set priorities and protect the client from harm.
Safety, nutrition, and clear communication are frequent priorities. Exam questions often test whether
you can pick the most practical and safe choice for the client in real situations. Focus on what the
nurse can actually do right now.
2. A nurse is caring for a patient who is 6 hours postoperative following abdominal surgery.
The patient reports sudden shortness of breath and chest pain. The nurse notes an oxygen
saturation of 88%. What is the priority action?
A. Obtain an electrocardiogram (ECG).
B. Administer the prescribed PRN morphine.
C. Initiate oxygen therapy and notify the Rapid Response Team.
D. Encourage the use of the incentive spirometer.
Answer: C
Rationale: Sudden onset of dyspnea and hypoxia in a postoperative patient suggests a pulmonary
embolism. Immediate oxygenation and escalation of care are required. Understanding this helps the
nurse notice early warning signs and act before the problem gets worse. Early action often prevents
bigger complications for the client. This is important because the nurse must choose the action that
keeps the client safest while still meeting their basic needs. Always think about safety first when
answering these questions.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 114 Exam 4: Advanced Nursing Concepts and NCL… 2026/2027 • Verified • Assured Grade A+
3. A patient with Type 1 Diabetes Mellitus is found unconscious and diaphoretic. The
fingerstick blood glucose is 42 mg/dL. Which medication should the nurse prepare to
administer if no IV access is available?
A. Regular insulin subcutaneously.
B. Glucagon intramuscularly.
C. 100 mL of 5% Dextrose in Water (D5W).
D. Acarbose orally.
Answer: B
Rationale: For severe hypoglycemia in an unconscious patient without IV access, IM glucagon is the
standard treatment to mobilize glucose stores. Understanding this helps the nurse notice early warning
signs and act before the problem gets worse. Early action often prevents bigger complications for the
client. In practice, this guides the nurse to set priorities and protect the client from harm. Safety,
nutrition, and clear communication are frequent priorities.
4. Which assessment finding in a patient with a chest tube requires immediate intervention
by the nurse?
A. 100 mL of serosanguinous drainage in the first hour post-insertion.
B. Fluctuation of the water level in the water seal chamber during respiration.
C. Constant bubbling in the water seal chamber.
D. Presence of subcutaneous emphysema around the insertion site.
Answer: C
Rationale: Constant bubbling in the water seal chamber indicates an air leak in the system. Tidaling
(fluctuation) is normal, and serosanguinous drainage is expected initially. This knowledge supports
safe care and helps the nurse teach the client and family clearly and simply. Clear teaching improves
cooperation and reduces anxiety. This knowledge supports safe care and helps the nurse teach the
client and family clearly and simply. Clear teaching improves cooperation and reduces anxiety.
Exam (Elaborations) • Detailed Rationales Page 3
