NUR210 ADVANCED CLINICAL
NURSING EXAM QUESTIONS AND
ANSWERS
1. A nurse is caring for a patient with a serum potassium level of 2.8 mEq/L. Which
assessment finding is the most critical for the nurse to monitor?
A. Hyperactive bowel sounds
B. Prominent U waves on the ECG
C. Hyperreflexia of the deep tendons
D. Tall, peaked T waves on the ECG
Answer: B
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) is characterized by ECG
changes such as U waves and ST-segment depression. Tall peaked T waves are a sign of
hyperkalemia.
2. When assessing a patient for suspected fluid volume deficit, which laboratory value would
the nurse expect to find increased?
A. Serum Creatinine
,B. Glomerular Filtration Rate (GFR)
C. Blood Urea Nitrogen (BUN)
D. Hemoglobin levels
Answer: C
Conceptual Explanation: In fluid volume deficit (dehydration), the BUN is typically
elevated out of proportion to creatinine due to hemoconcentration and decreased renal
perfusion.
3. A patient has been diagnosed with respiratory acidosis. Which of the following arterial
blood gas (ABG) results is consistent with this diagnosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L
B. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
C. pH 7.30, PaCO2 38 mmHg, HCO3 18 mEq/L
D. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L
Answer: D
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (< 7.35) and a
high PaCO2 (> 45 mmHg).
4. The nurse is preparing to administer a units-based dose of Heparin. Which laboratory test
is used to monitor the effectiveness of this medication?
A. Prothrombin Time (PT)
, B. International Normalized Ratio (INR)
C. Platelet count
D. Activated Partial Thromboplastin Time (aPTT)
Answer: D
Conceptual Explanation: Heparin therapy is monitored using the aPTT. PT/INR is used to
monitor Warfarin therapy.
5. A nurse is caring for a patient with a stage 3 pressure injury. How should the nurse
document the characteristics of this wound?
A. Non-blanchable erythema of intact skin
B. Full-thickness tissue loss with visible subcutaneous fat
C. Partial-thickness loss of dermis with a shallow open ulcer
D. Full-thickness tissue loss with exposed bone, tendon, or muscle
Answer: B
Conceptual Explanation: Stage 3 pressure injuries involve full-thickness skin loss
involving damage or necrosis of subcutaneous tissue that may extend down to, but not
through, underlying fascia.
6. A nurse is evaluating the Glasgow Coma Scale (GCS) of a patient. The patient opens eyes to
speech, uses inappropriate words, and withdraws from pain. What is the total score?
A. 8
NURSING EXAM QUESTIONS AND
ANSWERS
1. A nurse is caring for a patient with a serum potassium level of 2.8 mEq/L. Which
assessment finding is the most critical for the nurse to monitor?
A. Hyperactive bowel sounds
B. Prominent U waves on the ECG
C. Hyperreflexia of the deep tendons
D. Tall, peaked T waves on the ECG
Answer: B
Conceptual Explanation: Hypokalemia (potassium < 3.5 mEq/L) is characterized by ECG
changes such as U waves and ST-segment depression. Tall peaked T waves are a sign of
hyperkalemia.
2. When assessing a patient for suspected fluid volume deficit, which laboratory value would
the nurse expect to find increased?
A. Serum Creatinine
,B. Glomerular Filtration Rate (GFR)
C. Blood Urea Nitrogen (BUN)
D. Hemoglobin levels
Answer: C
Conceptual Explanation: In fluid volume deficit (dehydration), the BUN is typically
elevated out of proportion to creatinine due to hemoconcentration and decreased renal
perfusion.
3. A patient has been diagnosed with respiratory acidosis. Which of the following arterial
blood gas (ABG) results is consistent with this diagnosis?
A. pH 7.48, PaCO2 30 mmHg, HCO3 24 mEq/L
B. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
C. pH 7.30, PaCO2 38 mmHg, HCO3 18 mEq/L
D. pH 7.32, PaCO2 50 mmHg, HCO3 26 mEq/L
Answer: D
Conceptual Explanation: Respiratory acidosis is characterized by a low pH (< 7.35) and a
high PaCO2 (> 45 mmHg).
4. The nurse is preparing to administer a units-based dose of Heparin. Which laboratory test
is used to monitor the effectiveness of this medication?
A. Prothrombin Time (PT)
, B. International Normalized Ratio (INR)
C. Platelet count
D. Activated Partial Thromboplastin Time (aPTT)
Answer: D
Conceptual Explanation: Heparin therapy is monitored using the aPTT. PT/INR is used to
monitor Warfarin therapy.
5. A nurse is caring for a patient with a stage 3 pressure injury. How should the nurse
document the characteristics of this wound?
A. Non-blanchable erythema of intact skin
B. Full-thickness tissue loss with visible subcutaneous fat
C. Partial-thickness loss of dermis with a shallow open ulcer
D. Full-thickness tissue loss with exposed bone, tendon, or muscle
Answer: B
Conceptual Explanation: Stage 3 pressure injuries involve full-thickness skin loss
involving damage or necrosis of subcutaneous tissue that may extend down to, but not
through, underlying fascia.
6. A nurse is evaluating the Glasgow Coma Scale (GCS) of a patient. The patient opens eyes to
speech, uses inappropriate words, and withdraws from pain. What is the total score?
A. 8
