Questions and Answers with Rationales Chamberlain
University
This comprehensive NSG 4800 Final Exam Study Guide contains 300
verified multiple-choice questions with correct answers in bold italic and
detailed rationales in bold italic, covering essential nursing topics
including heart failure management, diabetes care, critical care
interventions, medication calculations, and ethical/legal principles. Each
question is designed to mirror actual exam content with clinical
scenarios, prioritization questions, delegation principles, and evidence-
based practice guidelines that students commonly encounter on nursing
comprehensive exams. This resource is ideal for final exam preparation,
NCLEX review, and clinical simulation practice, offering immediate answer
verification with explanations that reinforce critical thinking and clinical
reasoning skills needed for nursing program success.
Question 1
A nurse is caring for a client with heart failure who suddenly develops
crackles, dyspnea, and pink frothy sputum. Which action should the nurse
perform first?
,A. Administer IV fluids
B. Place the client in high Fowler's position
C. Encourage oral fluids
D. Obtain a sputum sample
Correct Answer: B. Place the client in high Fowler's position
Explanation: The client is exhibiting signs of acute pulmonary edema,
a life-threatening complication of heart failure. Positioning the client
upright helps decrease venous return to the heart (preload) and
improves lung expansion, enhancing oxygenation. IV fluids would
worsen pulmonary congestion. Encouraging oral fluids is
contraindicated, and obtaining a sputum sample is not the priority
during respiratory distress .
Question 2
Which laboratory value should the nurse immediately report for a client
receiving warfarin therapy?
A. INR of 1.0
B. INR of 2.5
C. INR of 5.8
D. INR of 2.0
Correct Answer: C. INR of 5.8
,Explanation: A therapeutic INR for most conditions is usually
between 2.0 and 3.0. An INR of 5.8 places the client at high risk for
bleeding complications and requires immediate intervention. The
nurse should notify the provider promptly for possible dosage
adjustment or vitamin K administration .
Question 3
A nurse is assessing a client with hypoglycemia. Which symptom should
the nurse expect?
A. Bradycardia
B. Cool clammy skin
C. Fruity breath odor
D. Deep respirations
Correct Answer: B. Cool clammy skin
Explanation: Hypoglycemia activates the sympathetic nervous
system, causing diaphoresis, tremors, tachycardia, and cool clammy
skin. Fruity breath odor and deep respirations (Kussmaul's) are
associated with diabetic ketoacidosis (hyperglycemia) .
Question 4
, A postoperative client reports sudden calf pain and swelling. Which
complication should the nurse suspect first?
A. Cellulitis
B. Deep vein thrombosis
C. Myocardial infarction
D. Arterial insufficiency
Correct Answer: B. Deep vein thrombosis
Explanation: Calf pain, warmth, redness, and swelling are classic
signs of deep vein thrombosis (DVT). Postoperative immobility
increases the risk of clot formation. Immediate intervention is
necessary to prevent pulmonary embolism .
Question 5
A nurse is teaching a client with chronic kidney disease about diet
restrictions. Which food should the client avoid?
A. Apples
B. White rice
C. Bananas
D. Cabbage
Correct Answer: C. Bananas