NUR 2811 Capstone Module 10 Exam |
Questions and Answers with Rationales |
2026/2027 Updated | 100% Correct -
International College of Health Sciences
NUR 2811 Capstone Module 10 Exam | Questions and Answers with Rationales |
2026/2027 Updated | 100% Correct - International College of Health Sciences
1. A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus.
The client asks the nurse to explain the rotation of insulin injection sites. Which
statement by the nurse is most accurate?
A) "You should use the same site every day to ensure consistent absorption."
B) "You must rotate sites to prevent lipodystrophy, which can cause unpredictable
insulin absorption."
C) "Rotating sites is only necessary if you experience pain at the injection site."
D) "You should only rotate between the left and right arms."
Correct Answer: B
Rationale: Rotating insulin injection sites is crucial to prevent lipodystrophy
(hypertrophy or atrophy of subcutaneous fat). Lipodystrophy can lead to erratic
and unpredictable insulin absorption, compromising glycemic control. Option A is
incorrect as it promotes lipodystrophy. Option C is incorrect as prevention is key.
Option D is too limited; rotation should include all appropriate sites (abdomen,
thighs, buttocks, arms).
,2. A client with chronic kidney disease is prescribed epoetin alfa. The nurse
understands that the rotation of the drug's binding site is not a concern, but
what is the primary reason for monitoring hemoglobin levels?
A) To ensure the drug is not causing aplastic anemia.
B) To evaluate the effectiveness of the drug in stimulating red blood cell
production.
C) To determine if the client is developing iron overload.
D) To assess for the development of hypertension.
Correct Answer: B
Rationale: Epoetin alfa stimulates erythropoiesis. Monitoring hemoglobin levels
evaluates the drug's effectiveness. If hemoglobin rises too quickly or too high, the
dose may need adjustment. While aplastic anemia is a rare complication, the
primary reason for monitoring is effectiveness. Iron overload is a risk but is
monitored with ferritin and transferrin saturation. Hypertension is a side effect,
not the primary reason for hemoglobin monitoring.
3. A nurse is teaching a client about the rotation of the head of the femur in the
acetabulum. This concept is most relevant when assessing a client for which
condition?
A) Osteoporosis
B) Hip fracture
C) Osteoarthritis
D) Developmental dysplasia of the hip (DDH)
Correct Answer: D
Rationale: The rotation of the head of the femur within the acetabulum is a key
component of hip stability. In developmental dysplasia of the hip (DDH), the
femoral head is improperly seated in the acetabulum, leading to abnormal
rotation and potential dislocation. This is a congenital condition often screened for
in newborns (e.g., Ortolani and Barlow tests). Osteoporosis, hip fracture, and
osteoarthritis are acquired conditions, though they can affect hip mechanics.
,4. A client is prescribed warfarin. The nurse understands that the rotation of the
drug's molecular structure (isomerism) is significant because:
A) Only one isomer is pharmacologically active.
B) The drug is a racemic mixture, and both isomers are equally active.
C) The isomers have identical half-lives.
D) The drug's rotation does not affect its clinical efficacy.
Correct Answer: A
Rationale: Warfarin is a racemic mixture of two enantiomers (R- and S-warfarin).
The S-enantiomer is approximately 3-5 times more potent as a vitamin K
antagonist than the R-enantiomer. This is a classic example of how the rotation of
a drug's molecular structure (stereochemistry) significantly impacts its
pharmacological activity.
5. A nurse is caring for a post-operative client who has an order for morphine via
patient-controlled analgesia (PCA). The nurse should monitor for which of the
following as a sign of respiratory depression?
A) Respiratory rate of 18 breaths/min
B) Respiratory rate of 10 breaths/min
C) Oxygen saturation of 95%
D) Client reports of incisional pain
Correct Answer: B
Rationale: A respiratory rate of less than 12 breaths/min is a classic sign of opioid-
induced respiratory depression. The nurse must monitor the client's respiratory
status closely and have naloxone available. Option A is a normal respiratory rate.
Option C is a normal oxygen saturation. Option D indicates the PCA is effective for
pain.
6. A client with a diagnosis of bipolar disorder is prescribed lithium. The nurse
should instruct the client to maintain a consistent intake of which of the
following?
A) Potassium
B) Sodium
, C) Calcium
D) Magnesium
Correct Answer: B
Rationale: Lithium is a salt, and its levels are affected by sodium and fluid balance.
A low-sodium diet or dehydration can lead to lithium retention and toxicity.
Therefore, clients should maintain a consistent, normal sodium and fluid intake.
7. A nurse is assessing a client with a suspected pulmonary embolism. Which of
the following findings is most consistent with this diagnosis?
A) Bradycardia and hypertension
B) Sudden onset of pleuritic chest pain and dyspnea
C) Productive cough with green sputum
D) Peripheral edema and jugular venous distention
Correct Answer: B
Rationale: A pulmonary embolism (PE) often presents with sudden onset of
dyspnea, pleuritic chest pain (worse on inspiration), tachycardia, and tachypnea.
Option A is incorrect; tachycardia and hypotension are more common. Option C
suggests pneumonia. Option D suggests heart failure.
8. A nurse is preparing to administer digoxin to a client. The nurse should
withhold the dose and notify the provider if the client's apical pulse is below
which of the following?
A) 100 beats/min
B) 90 beats/min
C) 60 beats/min
D) 50 beats/min
Correct Answer: C
Rationale: Digoxin slows the heart rate. The nurse must assess the apical pulse for
a full minute before administration. If the apical pulse is below 60 beats/min in an
adult, the dose should be withheld, and the provider notified. Options A and B are
elevated. Option D is dangerously low, but 60 is the standard threshold for
withholding.
Questions and Answers with Rationales |
2026/2027 Updated | 100% Correct -
International College of Health Sciences
NUR 2811 Capstone Module 10 Exam | Questions and Answers with Rationales |
2026/2027 Updated | 100% Correct - International College of Health Sciences
1. A nurse is caring for a client with a new diagnosis of type 1 diabetes mellitus.
The client asks the nurse to explain the rotation of insulin injection sites. Which
statement by the nurse is most accurate?
A) "You should use the same site every day to ensure consistent absorption."
B) "You must rotate sites to prevent lipodystrophy, which can cause unpredictable
insulin absorption."
C) "Rotating sites is only necessary if you experience pain at the injection site."
D) "You should only rotate between the left and right arms."
Correct Answer: B
Rationale: Rotating insulin injection sites is crucial to prevent lipodystrophy
(hypertrophy or atrophy of subcutaneous fat). Lipodystrophy can lead to erratic
and unpredictable insulin absorption, compromising glycemic control. Option A is
incorrect as it promotes lipodystrophy. Option C is incorrect as prevention is key.
Option D is too limited; rotation should include all appropriate sites (abdomen,
thighs, buttocks, arms).
,2. A client with chronic kidney disease is prescribed epoetin alfa. The nurse
understands that the rotation of the drug's binding site is not a concern, but
what is the primary reason for monitoring hemoglobin levels?
A) To ensure the drug is not causing aplastic anemia.
B) To evaluate the effectiveness of the drug in stimulating red blood cell
production.
C) To determine if the client is developing iron overload.
D) To assess for the development of hypertension.
Correct Answer: B
Rationale: Epoetin alfa stimulates erythropoiesis. Monitoring hemoglobin levels
evaluates the drug's effectiveness. If hemoglobin rises too quickly or too high, the
dose may need adjustment. While aplastic anemia is a rare complication, the
primary reason for monitoring is effectiveness. Iron overload is a risk but is
monitored with ferritin and transferrin saturation. Hypertension is a side effect,
not the primary reason for hemoglobin monitoring.
3. A nurse is teaching a client about the rotation of the head of the femur in the
acetabulum. This concept is most relevant when assessing a client for which
condition?
A) Osteoporosis
B) Hip fracture
C) Osteoarthritis
D) Developmental dysplasia of the hip (DDH)
Correct Answer: D
Rationale: The rotation of the head of the femur within the acetabulum is a key
component of hip stability. In developmental dysplasia of the hip (DDH), the
femoral head is improperly seated in the acetabulum, leading to abnormal
rotation and potential dislocation. This is a congenital condition often screened for
in newborns (e.g., Ortolani and Barlow tests). Osteoporosis, hip fracture, and
osteoarthritis are acquired conditions, though they can affect hip mechanics.
,4. A client is prescribed warfarin. The nurse understands that the rotation of the
drug's molecular structure (isomerism) is significant because:
A) Only one isomer is pharmacologically active.
B) The drug is a racemic mixture, and both isomers are equally active.
C) The isomers have identical half-lives.
D) The drug's rotation does not affect its clinical efficacy.
Correct Answer: A
Rationale: Warfarin is a racemic mixture of two enantiomers (R- and S-warfarin).
The S-enantiomer is approximately 3-5 times more potent as a vitamin K
antagonist than the R-enantiomer. This is a classic example of how the rotation of
a drug's molecular structure (stereochemistry) significantly impacts its
pharmacological activity.
5. A nurse is caring for a post-operative client who has an order for morphine via
patient-controlled analgesia (PCA). The nurse should monitor for which of the
following as a sign of respiratory depression?
A) Respiratory rate of 18 breaths/min
B) Respiratory rate of 10 breaths/min
C) Oxygen saturation of 95%
D) Client reports of incisional pain
Correct Answer: B
Rationale: A respiratory rate of less than 12 breaths/min is a classic sign of opioid-
induced respiratory depression. The nurse must monitor the client's respiratory
status closely and have naloxone available. Option A is a normal respiratory rate.
Option C is a normal oxygen saturation. Option D indicates the PCA is effective for
pain.
6. A client with a diagnosis of bipolar disorder is prescribed lithium. The nurse
should instruct the client to maintain a consistent intake of which of the
following?
A) Potassium
B) Sodium
, C) Calcium
D) Magnesium
Correct Answer: B
Rationale: Lithium is a salt, and its levels are affected by sodium and fluid balance.
A low-sodium diet or dehydration can lead to lithium retention and toxicity.
Therefore, clients should maintain a consistent, normal sodium and fluid intake.
7. A nurse is assessing a client with a suspected pulmonary embolism. Which of
the following findings is most consistent with this diagnosis?
A) Bradycardia and hypertension
B) Sudden onset of pleuritic chest pain and dyspnea
C) Productive cough with green sputum
D) Peripheral edema and jugular venous distention
Correct Answer: B
Rationale: A pulmonary embolism (PE) often presents with sudden onset of
dyspnea, pleuritic chest pain (worse on inspiration), tachycardia, and tachypnea.
Option A is incorrect; tachycardia and hypotension are more common. Option C
suggests pneumonia. Option D suggests heart failure.
8. A nurse is preparing to administer digoxin to a client. The nurse should
withhold the dose and notify the provider if the client's apical pulse is below
which of the following?
A) 100 beats/min
B) 90 beats/min
C) 60 beats/min
D) 50 beats/min
Correct Answer: C
Rationale: Digoxin slows the heart rate. The nurse must assess the apical pulse for
a full minute before administration. If the apical pulse is below 60 beats/min in an
adult, the dose should be withheld, and the provider notified. Options A and B are
elevated. Option D is dangerously low, but 60 is the standard threshold for
withholding.
