NUR 257 ADVANCED NURSING
CONCEPTS COMPREHENSIVE EXAM
PREP QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE
1. A patient with chronic heart failure is prescribed Digoxin 0.125 mg daily. Which assessment
finding should the nurse prioritize as a potential indicator of toxicity?
A. Hypokalemia
B. Visual disturbances such as yellow-green halos
C. Heart rate of 88 beats per minute
D. Increased urinary output
Answer: B
Conceptual Explanation: Visual disturbances, including yellow-green halos and blurred
vision, are classic signs of Digoxin toxicity. While hypokalemia predisposes a patient to
toxicity, it is not a sign of toxicity itself.
2. A client is admitted with a potassium level of 6.8 mEq/L. Which provider order should the
nurse implement first?
A. Administer oral Sodium Polystyrene Sulfonate
,B. Begin a 24-hour urine collection
C. Obtain a 12-lead Electrocardiogram (ECG)
D. Administer a dose of Furosemide
Answer: C
Conceptual Explanation: Hyperkalemia can cause life-threatening cardiac dysrhythmias.
Assessing the cardiac rhythm via ECG is the priority to identify immediate risks before
administering medications.
3. An arterial blood gas (ABG) result shows: pH 7.28, PaCO2 52, HCO3 24. How should the
nurse interpret this result?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 indicates
a respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
4. A client in the ICU is experiencing Diabetic Ketoacidosis (DKA). Which IV fluid should the
nurse anticipate hanging when the blood glucose level reaches 250 mg/dL?
A. 0.45% Normal Saline
, B. Lactated Ringer’s
C. 3% Hypertonic Saline
D. 5% Dextrose in 0.45% Normal Saline
Answer: D
Conceptual Explanation: When glucose drops to 250 mg/dL in DKA, dextrose is added to
the IV fluids to prevent hypoglycemia and cerebral edema as insulin continues to be
administered.
5. A patient presents with sudden onset of chest pain, dyspnea, and hemoptysis. The nurse
suspects a pulmonary embolism. Which diagnostic test is considered the ‘gold standard’ for
confirmation?
A. Chest X-ray
B. D-dimer assay
C. CT Pulmonary Angiogram
D. Arterial Blood Gas
Answer: C
Conceptual Explanation: CT Pulmonary Angiography (CTPA) is the preferred gold
standard for diagnosing a pulmonary embolism due to its high sensitivity and specificity.
CONCEPTS COMPREHENSIVE EXAM
PREP QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE
1. A patient with chronic heart failure is prescribed Digoxin 0.125 mg daily. Which assessment
finding should the nurse prioritize as a potential indicator of toxicity?
A. Hypokalemia
B. Visual disturbances such as yellow-green halos
C. Heart rate of 88 beats per minute
D. Increased urinary output
Answer: B
Conceptual Explanation: Visual disturbances, including yellow-green halos and blurred
vision, are classic signs of Digoxin toxicity. While hypokalemia predisposes a patient to
toxicity, it is not a sign of toxicity itself.
2. A client is admitted with a potassium level of 6.8 mEq/L. Which provider order should the
nurse implement first?
A. Administer oral Sodium Polystyrene Sulfonate
,B. Begin a 24-hour urine collection
C. Obtain a 12-lead Electrocardiogram (ECG)
D. Administer a dose of Furosemide
Answer: C
Conceptual Explanation: Hyperkalemia can cause life-threatening cardiac dysrhythmias.
Assessing the cardiac rhythm via ECG is the priority to identify immediate risks before
administering medications.
3. An arterial blood gas (ABG) result shows: pH 7.28, PaCO2 52, HCO3 24. How should the
nurse interpret this result?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Answer: B
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 indicates
a respiratory cause. Since the HCO3 is normal, it is uncompensated respiratory acidosis.
4. A client in the ICU is experiencing Diabetic Ketoacidosis (DKA). Which IV fluid should the
nurse anticipate hanging when the blood glucose level reaches 250 mg/dL?
A. 0.45% Normal Saline
, B. Lactated Ringer’s
C. 3% Hypertonic Saline
D. 5% Dextrose in 0.45% Normal Saline
Answer: D
Conceptual Explanation: When glucose drops to 250 mg/dL in DKA, dextrose is added to
the IV fluids to prevent hypoglycemia and cerebral edema as insulin continues to be
administered.
5. A patient presents with sudden onset of chest pain, dyspnea, and hemoptysis. The nurse
suspects a pulmonary embolism. Which diagnostic test is considered the ‘gold standard’ for
confirmation?
A. Chest X-ray
B. D-dimer assay
C. CT Pulmonary Angiogram
D. Arterial Blood Gas
Answer: C
Conceptual Explanation: CT Pulmonary Angiography (CTPA) is the preferred gold
standard for diagnosing a pulmonary embolism due to its high sensitivity and specificity.
