• NUR 417 09/16/2026
NUR 417 Nursing Care of the Adult 2 Exam
2026–2027 | Review & Next Gen Practice
Questions with Answers, Detailed Rationales
The nurse is providing care to a patient with a third-degree burn on his left thigh and left forearm. During wound
care, the nurse applies Elase to the burned areas. Which of the following types ofwound debridement is this
nurse using?
1. enzymatic
2. mechanical
3. surgical
4. topical
- Correct Answer :Correct Answer: 1
P 1
, • NUR 417 09/16/2026
Rationale: Enzymatic debridement involves the use of a topical agent to dissolve and remove necrotic tissue. An
enzyme such as Elase is applied in a thin layer directly to the wound and covered with one layer of fine mesh
gauze. A topical antimicrobial agent is then applied and covered with a bulky wet dressing. Mechanical
debridement may be performed by applying and removing gauze dressings, hydrotherapy, irrigation, or using
scissors and tweezers. Surgical debridement is the process of excising the wound to the fascia or removing thin
slices of the burn to the level of viable tissue. Topical treatments are key in the care of a burn but do not involve
debridement.
A patient with third-degree burns is being treated with high-volume intravenous fluids and has a urine output of
40 cc per hour. The nurse realizes that this urine output
1. is normal for this patient.
2. provides evidence that the patient is dehydrated.
3. provides evidence that the patient is over-hydrated.
4. is indicative of pending renal failure. –
Correct Answer :Correct Answer: 1
Rationale: Intake and output measurements indicate the adequacy of fluid resuscitation, and should range from
30 to 50 mL per hour in an adult.
A patient with third-degree burns to his right arm is scheduled for passive range of motion to the extremity every
two hours. Which of the following should the nurse do prior to this exercise session?
1. Medicate for pain.
2. Empty the patient's in-dwelling catheter collection bag.
3. Change the patient's bed linens.
4. Change the dressing on the burn. –
Correct Answer :Correct Answer: 1
Rationale: The nurse should anticipate this patient's needs for analgesia and administer pain medication to
promote the patient's comfort during the exercise session. Arm exercise is not related to the amount of urine in
the catheter bag. Linen changes do not impact range of motion activities. The burn's dressing is changed
according to the physician's orders or as needed.
A patient with third-degree burns to her face just learned that she will have extensive scarring once the burn
heals. Which of the following nursing diagnoses would be applicable to this patient at this time?
P 2
, • NUR 417 09/16/2026
1. Powerlessness
2. Potential for Infection
3. Fluid Volume Deficit
4. Risk for Ineffective Airway Clearance –
Correct Answer :Correct Answer: 1
Rationale: This patient can begin to experience powerlessness in that she has no control over the outcome of
healing on scar formation to her face. The nurse should allow the patient to express feelings in efforts to help
the patient cope with the news of potential scarring. The patient with a third-degree burn is at risk for infection,
however, this question is focused on the impact of her facial scarring. There is inadequate information to
determine the patient's risk for fluid volume deficit or ineffective airway clearance. Further, this is not the focus
of the question.
A client who used to work as a nurse asks, "Why is the hospital using a 'fancy new IV' without a needle? That
seems expensive." How does the nurse respond?
"OSHA, a government agency, requires us to use this new type of IV."
"These systems are designed to save time, not money."
"They minimize health care workers' exposure to contaminated needles." –
Correct Answer :C.
Needleless IVs were designed to protect health care personnel from exposure to contaminated needles. The
Occupational Safety and Health Administration (OSHA) requires the use of devices with engineered safety
mechanisms only. It does not mandate that they be needleless. Saving time and money is not the purpose of the
needleless IV, and it was not designed to protect clients from exposure to contaminated needles.
The nurse is teaching a hospitalized client who is being discharged about how to care for a peripherally inserted
central catheter (PICC) line. Which client statement indicates a need for further education?
"I can continue my 20-mile running schedule as I have for the past 10 years." Correct
P 3
, • NUR 417 09/16/2026
"I can still go about my normal activities of daily living."
"I have less chance of getting an infection because the line is not in my hand."
- Correct Answer :A.
Excessive physical activity can dislodge the PICC and should be avoided. Clients with PICCs should be able to
perform normal activities of daily living. PICCs have low complication rates because the insertion site is in the
upper extremity. The dry skin of the arm has fewer types and numbers of microorganisms, leading to lower rates
of infection. PICC lines can be used long term (months).
The nurse is admitting clients to the same-day surgery unit. Which insertion site for routine peripheral venous
catheters does the nurse choose most often?
Back of the hand for an older adult
Cephalic vein of the forearm Correct
Lower arm on the side of a radical mastectomy
Subclavian vein
- Correct Answer :B.
For same-day surgery, the cephalic or basilic vein allows insertion of a larger IV catheter while allowing
movement of the arm without impairing intravenous flow. Peripheral venous catheters should never be inserted
into the back of the hand in an older adult because the veins are brittle. Peripheral venous catheters should
never be inserted into the lower arm on the same side as a radical mastectomy because they interfere with
limited circulation. Catheters are typically inserted into the subclavian vein by the health care provider, not by the
nurse
A client admitted to the intensive care unit is expected to remain for 3 weeks. The nurse has orders to start an
IV. Which vascular access device is best for this client?
Midline catheter Correct
Peripherally inserted central catheter (PICC) Incorrect
Short peripheral catheter
P 4
NUR 417 Nursing Care of the Adult 2 Exam
2026–2027 | Review & Next Gen Practice
Questions with Answers, Detailed Rationales
The nurse is providing care to a patient with a third-degree burn on his left thigh and left forearm. During wound
care, the nurse applies Elase to the burned areas. Which of the following types ofwound debridement is this
nurse using?
1. enzymatic
2. mechanical
3. surgical
4. topical
- Correct Answer :Correct Answer: 1
P 1
, • NUR 417 09/16/2026
Rationale: Enzymatic debridement involves the use of a topical agent to dissolve and remove necrotic tissue. An
enzyme such as Elase is applied in a thin layer directly to the wound and covered with one layer of fine mesh
gauze. A topical antimicrobial agent is then applied and covered with a bulky wet dressing. Mechanical
debridement may be performed by applying and removing gauze dressings, hydrotherapy, irrigation, or using
scissors and tweezers. Surgical debridement is the process of excising the wound to the fascia or removing thin
slices of the burn to the level of viable tissue. Topical treatments are key in the care of a burn but do not involve
debridement.
A patient with third-degree burns is being treated with high-volume intravenous fluids and has a urine output of
40 cc per hour. The nurse realizes that this urine output
1. is normal for this patient.
2. provides evidence that the patient is dehydrated.
3. provides evidence that the patient is over-hydrated.
4. is indicative of pending renal failure. –
Correct Answer :Correct Answer: 1
Rationale: Intake and output measurements indicate the adequacy of fluid resuscitation, and should range from
30 to 50 mL per hour in an adult.
A patient with third-degree burns to his right arm is scheduled for passive range of motion to the extremity every
two hours. Which of the following should the nurse do prior to this exercise session?
1. Medicate for pain.
2. Empty the patient's in-dwelling catheter collection bag.
3. Change the patient's bed linens.
4. Change the dressing on the burn. –
Correct Answer :Correct Answer: 1
Rationale: The nurse should anticipate this patient's needs for analgesia and administer pain medication to
promote the patient's comfort during the exercise session. Arm exercise is not related to the amount of urine in
the catheter bag. Linen changes do not impact range of motion activities. The burn's dressing is changed
according to the physician's orders or as needed.
A patient with third-degree burns to her face just learned that she will have extensive scarring once the burn
heals. Which of the following nursing diagnoses would be applicable to this patient at this time?
P 2
, • NUR 417 09/16/2026
1. Powerlessness
2. Potential for Infection
3. Fluid Volume Deficit
4. Risk for Ineffective Airway Clearance –
Correct Answer :Correct Answer: 1
Rationale: This patient can begin to experience powerlessness in that she has no control over the outcome of
healing on scar formation to her face. The nurse should allow the patient to express feelings in efforts to help
the patient cope with the news of potential scarring. The patient with a third-degree burn is at risk for infection,
however, this question is focused on the impact of her facial scarring. There is inadequate information to
determine the patient's risk for fluid volume deficit or ineffective airway clearance. Further, this is not the focus
of the question.
A client who used to work as a nurse asks, "Why is the hospital using a 'fancy new IV' without a needle? That
seems expensive." How does the nurse respond?
"OSHA, a government agency, requires us to use this new type of IV."
"These systems are designed to save time, not money."
"They minimize health care workers' exposure to contaminated needles." –
Correct Answer :C.
Needleless IVs were designed to protect health care personnel from exposure to contaminated needles. The
Occupational Safety and Health Administration (OSHA) requires the use of devices with engineered safety
mechanisms only. It does not mandate that they be needleless. Saving time and money is not the purpose of the
needleless IV, and it was not designed to protect clients from exposure to contaminated needles.
The nurse is teaching a hospitalized client who is being discharged about how to care for a peripherally inserted
central catheter (PICC) line. Which client statement indicates a need for further education?
"I can continue my 20-mile running schedule as I have for the past 10 years." Correct
P 3
, • NUR 417 09/16/2026
"I can still go about my normal activities of daily living."
"I have less chance of getting an infection because the line is not in my hand."
- Correct Answer :A.
Excessive physical activity can dislodge the PICC and should be avoided. Clients with PICCs should be able to
perform normal activities of daily living. PICCs have low complication rates because the insertion site is in the
upper extremity. The dry skin of the arm has fewer types and numbers of microorganisms, leading to lower rates
of infection. PICC lines can be used long term (months).
The nurse is admitting clients to the same-day surgery unit. Which insertion site for routine peripheral venous
catheters does the nurse choose most often?
Back of the hand for an older adult
Cephalic vein of the forearm Correct
Lower arm on the side of a radical mastectomy
Subclavian vein
- Correct Answer :B.
For same-day surgery, the cephalic or basilic vein allows insertion of a larger IV catheter while allowing
movement of the arm without impairing intravenous flow. Peripheral venous catheters should never be inserted
into the back of the hand in an older adult because the veins are brittle. Peripheral venous catheters should
never be inserted into the lower arm on the same side as a radical mastectomy because they interfere with
limited circulation. Catheters are typically inserted into the subclavian vein by the health care provider, not by the
nurse
A client admitted to the intensive care unit is expected to remain for 3 weeks. The nurse has orders to start an
IV. Which vascular access device is best for this client?
Midline catheter Correct
Peripherally inserted central catheter (PICC) Incorrect
Short peripheral catheter
P 4
