NUR 231 PRACTICE EXAM 2026/2027
QUESTIONS & VERIFIED ANSWERS |
ILLINOIS STATE UNIVERSITY (A+
GUARANTEE)
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical
ventilation with High-Level PEEP. Which hemodynamic change should the nurse monitor for
most closely?
A. Decreased venous return and hypotension
B. Increased cardiac output
C. Reduced intracranial pressure
D. Increased left ventricular end-diastolic volume
Answer: A
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which can
compress the vena cava, reducing venous return (preload) and leading to decreased
cardiac output and hypotension.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of a
massive pulmonary embolism?
A. pH 7.30, PaCO2 55 mmHg, HCO3 26 mEq/L
,B. pH 7.35, PaCO2 45 mmHg, HCO3 22 mEq/L
C. pH 7.48, PaCO2 30 mmHg, HCO3 23 mEq/L
D. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
Answer: C
Conceptual Explanation: Early PE typically causes tachypnea due to hypoxia and anxiety,
leading to respiratory alkalosis (high pH, low PaCO2).
3. A nurse is caring for a patient with a potassium level of 6.8 mEq/L. Which medication
should the nurse anticipate administering first to protect the myocardium?
A. Sodium polystyrene sulfonate
B. Insulin with Dextrose 50%
C. Furosemide
D. Calcium gluconate
Answer: D
Conceptual Explanation: Calcium gluconate does not lower potassium but stabilizes the
myocardial cell membrane to prevent lethal dysrhythmias while other treatments work to
lower the K+ level.
4. In a patient with Chronic Kidney Disease (CKD), the nurse notes a serum phosphorus level
of 6.2 mg/dL. Which medication is most appropriate?
A. Calcitriol
, B. Sevelamer
C. Aluminum hydroxide
D. Epoetin alfa
Answer: B
Conceptual Explanation: Sevelamer is a phosphate binder used to reduce serum
phosphorus levels in CKD patients by preventing absorption in the GI tract.
5. A patient presents with a ‘butterfly rash’ across the bridge of the nose and cheeks. Which
laboratory test is most specific for diagnosing Systemic Lupus Erythematosus (SLE)?
A. Positive Rheumatoid Factor (RF)
B. Anti-Double-Stranded DNA (anti-dsDNA)
C. Elevated Erythrocyte Sedimentation Rate (ESR)
D. Anti-Nuclear Antibody (ANA)
Answer: B
Conceptual Explanation: While ANA is a sensitive screening tool, anti-dsDNA is highly
specific for the diagnosis of SLE.
6. A nurse observes a patient’s rhythm on the monitor: no identifiable P waves and a rapid,
irregular QRS complex. The patient is symptomatic with a BP of 90/60. What is the priority
intervention?
A. Amiodarone 150 mg IV bolus
QUESTIONS & VERIFIED ANSWERS |
ILLINOIS STATE UNIVERSITY (A+
GUARANTEE)
1. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on mechanical
ventilation with High-Level PEEP. Which hemodynamic change should the nurse monitor for
most closely?
A. Decreased venous return and hypotension
B. Increased cardiac output
C. Reduced intracranial pressure
D. Increased left ventricular end-diastolic volume
Answer: A
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which can
compress the vena cava, reducing venous return (preload) and leading to decreased
cardiac output and hypotension.
2. Which arterial blood gas (ABG) result is most indicative of a patient in the early stages of a
massive pulmonary embolism?
A. pH 7.30, PaCO2 55 mmHg, HCO3 26 mEq/L
,B. pH 7.35, PaCO2 45 mmHg, HCO3 22 mEq/L
C. pH 7.48, PaCO2 30 mmHg, HCO3 23 mEq/L
D. pH 7.50, PaCO2 40 mmHg, HCO3 32 mEq/L
Answer: C
Conceptual Explanation: Early PE typically causes tachypnea due to hypoxia and anxiety,
leading to respiratory alkalosis (high pH, low PaCO2).
3. A nurse is caring for a patient with a potassium level of 6.8 mEq/L. Which medication
should the nurse anticipate administering first to protect the myocardium?
A. Sodium polystyrene sulfonate
B. Insulin with Dextrose 50%
C. Furosemide
D. Calcium gluconate
Answer: D
Conceptual Explanation: Calcium gluconate does not lower potassium but stabilizes the
myocardial cell membrane to prevent lethal dysrhythmias while other treatments work to
lower the K+ level.
4. In a patient with Chronic Kidney Disease (CKD), the nurse notes a serum phosphorus level
of 6.2 mg/dL. Which medication is most appropriate?
A. Calcitriol
, B. Sevelamer
C. Aluminum hydroxide
D. Epoetin alfa
Answer: B
Conceptual Explanation: Sevelamer is a phosphate binder used to reduce serum
phosphorus levels in CKD patients by preventing absorption in the GI tract.
5. A patient presents with a ‘butterfly rash’ across the bridge of the nose and cheeks. Which
laboratory test is most specific for diagnosing Systemic Lupus Erythematosus (SLE)?
A. Positive Rheumatoid Factor (RF)
B. Anti-Double-Stranded DNA (anti-dsDNA)
C. Elevated Erythrocyte Sedimentation Rate (ESR)
D. Anti-Nuclear Antibody (ANA)
Answer: B
Conceptual Explanation: While ANA is a sensitive screening tool, anti-dsDNA is highly
specific for the diagnosis of SLE.
6. A nurse observes a patient’s rhythm on the monitor: no identifiable P waves and a rapid,
irregular QRS complex. The patient is symptomatic with a BP of 90/60. What is the priority
intervention?
A. Amiodarone 150 mg IV bolus
