NUR 231 FINAL EXAM -
COMPREHENSIVE NURSING PRACTICE
QUESTIONS & VERIFIED ANSWERS |
ILLINOIS STATE UNIVERSITY (A+
GUARANTEE)
1. A patient with chronic renal failure presents with a potassium level of 6.8 mEq/L. Which of
the following is the most immediate priority for the nurse?
A. Administering sodium polystyrene sulfonate (Kayexalate) orally.
B. Educating the patient on a low-potassium diet.
C. Obtaining a 12-lead electrocardiogram (ECG).
D. Checking the patient’s urine output for the last 8 hours.
Answer: C
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) can cause life-threatening
cardiac arrhythmias. The immediate priority is to assess for cardiac changes using an ECG
before proceeding with treatments like Kayexalate.
2. A nurse is caring for a patient who has just undergone a thyroidectomy. Which assessment
finding requires immediate intervention?
A. A hoarse voice when the patient speaks.
,B. Laryngeal stridor or harsh, high-pitched respiratory sounds.
C. Pain at the surgical site rated 4/10.
D. Small amounts of serosanguinous drainage on the dressing.
Answer: B
Conceptual Explanation: Stridor indicates an upper airway obstruction, which is an
emergency. It could be caused by edema, hemorrhage, or nerve damage after thyroid
surgery.
3. A patient with a history of heart failure is prescribed Digoxin. Which laboratory result
would most likely increase the risk of Digoxin toxicity?
A. Potassium 3.2 mEq/L
B. Sodium 138 mEq/L
C. Calcium 9.5 mg/dL
D. Magnesium 2.0 mEq/L
Answer: A
Conceptual Explanation: Hypokalemia (low potassium) sensitizes the myocardium to
digoxin, significantly increasing the risk of toxicity even if the digoxin level is within the
therapeutic range.
, 4. In the management of a patient with Diabetic Ketoacidosis (DKA), which IV fluid should the
nurse expect to administer once the blood glucose level reaches 250 mg/dL?
A. 0.45% Normal Saline
B. Lactated Ringer’s solution
C. 5% Dextrose in 0.45% Normal Saline
D. 0.9% Normal Saline only
Answer: C
Conceptual Explanation: When glucose levels drop to 250 mg/dL, dextrose is added to
the IV fluids to prevent hypoglycemia and cerebral edema as the insulin infusion continues
to resolve ketosis.
5. A patient is admitted with suspected Meningitis. Which nursing action is the highest
priority upon admission?
A. Administering the first dose of broad-spectrum antibiotics.
B. Placing the patient on Droplet Precautions.
C. Assisting with a lumbar puncture.
D. Performing a baseline neurological assessment.
Answer: B
COMPREHENSIVE NURSING PRACTICE
QUESTIONS & VERIFIED ANSWERS |
ILLINOIS STATE UNIVERSITY (A+
GUARANTEE)
1. A patient with chronic renal failure presents with a potassium level of 6.8 mEq/L. Which of
the following is the most immediate priority for the nurse?
A. Administering sodium polystyrene sulfonate (Kayexalate) orally.
B. Educating the patient on a low-potassium diet.
C. Obtaining a 12-lead electrocardiogram (ECG).
D. Checking the patient’s urine output for the last 8 hours.
Answer: C
Conceptual Explanation: Hyperkalemia (K+ > 5.0 mEq/L) can cause life-threatening
cardiac arrhythmias. The immediate priority is to assess for cardiac changes using an ECG
before proceeding with treatments like Kayexalate.
2. A nurse is caring for a patient who has just undergone a thyroidectomy. Which assessment
finding requires immediate intervention?
A. A hoarse voice when the patient speaks.
,B. Laryngeal stridor or harsh, high-pitched respiratory sounds.
C. Pain at the surgical site rated 4/10.
D. Small amounts of serosanguinous drainage on the dressing.
Answer: B
Conceptual Explanation: Stridor indicates an upper airway obstruction, which is an
emergency. It could be caused by edema, hemorrhage, or nerve damage after thyroid
surgery.
3. A patient with a history of heart failure is prescribed Digoxin. Which laboratory result
would most likely increase the risk of Digoxin toxicity?
A. Potassium 3.2 mEq/L
B. Sodium 138 mEq/L
C. Calcium 9.5 mg/dL
D. Magnesium 2.0 mEq/L
Answer: A
Conceptual Explanation: Hypokalemia (low potassium) sensitizes the myocardium to
digoxin, significantly increasing the risk of toxicity even if the digoxin level is within the
therapeutic range.
, 4. In the management of a patient with Diabetic Ketoacidosis (DKA), which IV fluid should the
nurse expect to administer once the blood glucose level reaches 250 mg/dL?
A. 0.45% Normal Saline
B. Lactated Ringer’s solution
C. 5% Dextrose in 0.45% Normal Saline
D. 0.9% Normal Saline only
Answer: C
Conceptual Explanation: When glucose levels drop to 250 mg/dL, dextrose is added to
the IV fluids to prevent hypoglycemia and cerebral edema as the insulin infusion continues
to resolve ketosis.
5. A patient is admitted with suspected Meningitis. Which nursing action is the highest
priority upon admission?
A. Administering the first dose of broad-spectrum antibiotics.
B. Placing the patient on Droplet Precautions.
C. Assisting with a lumbar puncture.
D. Performing a baseline neurological assessment.
Answer: B
