NUR 1115 FINAL EXAM-OXYGENATION ,FLUID &
ELECTROLYTES,ABGs, PERIOPERATIVE
NURSING,PHARMACOLOGY & WOUND CARE LATEST EXAM |
ALL PRACTICE Q&A 2026/2027 | A+ GRADED |
COMPREHENSIVE EXAM GUIDE 2026&2027
1. A postoperative client has an oxygen saturation of 88% on room air and is increasingly
restless. Which action should the nurse take first?
A. Encourage oral fluids
B. Apply supplemental oxygen
C. Administer a prescribed sedative
D. Place the client flat in bed
Supplemental oxygen addresses the immediate evidence of hypoxemia. Restlessness can be
an early manifestation of inadequate oxygenation.
2. Which assessment finding most strongly suggests inadequate oxygenation in an adult
client?
A. Warm extremities
B. Respiratory rate of 16/min
C. New-onset confusion
D. Blood pressure of 118/72 mmHg
Acute confusion may occur when the brain receives insufficient oxygen and requires prompt
assessment of respiratory status.
3. A client with chronic obstructive pulmonary disease is receiving oxygen therapy. Which
nursing action is most appropriate?
A. Administer oxygen at the lowest prescribed concentration that maintains the target
saturation
B. Discontinue oxygen whenever the client becomes drowsy
C. Maintain oxygen at maximum flow continuously
D. Restrict all activity while oxygen is being administered
Clients with COPD require carefully titrated oxygen according to the prescribed target range
and clinical response rather than automatically receiving high concentrations.
4. Which finding indicates increased work of breathing?
A. Symmetrical chest expansion without accessory muscle use
B. Respiratory rate of 14/min
C. Regular depth of respirations
D. Intercostal retractions and nasal flaring
,Accessory muscle use, retractions, and nasal flaring indicate increased respiratory effort and
possible respiratory compromise.
5. A client receiving oxygen through a nasal cannula reports dryness of the nasal passages.
Which intervention is appropriate?
A. Apply petroleum jelly inside the nares
B. Increase oxygen flow independently
C. Use prescribed humidification when appropriate
D. Remove oxygen permanently
Humidification can reduce mucosal dryness when clinically appropriate. Petroleum-based
products should be avoided around oxygen equipment because of fire risk.
6. Which arterial blood gas result is within expected adult ranges?
A. pH 7.40, PaCO₂ 40 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.25, PaCO₂ 30 mmHg, HCO₃⁻ 18 mEq/L
C. pH 7.55, PaCO₂ 50 mmHg, HCO₃⁻ 30 mEq/L
D. pH 7.30, PaCO₂ 60 mmHg, HCO₃⁻ 28 mEq/L
A pH of 7.35–7.45, PaCO₂ of approximately 35–45 mmHg, and bicarbonate of approximately
22–26 mEq/L are expected adult ABG values.
7. A client's ABGs are pH 7.30, PaCO₂ 52 mmHg, and HCO₃⁻ 24 mEq/L. How should the
nurse interpret these findings?
A. Uncompensated metabolic alkalosis
B. Uncompensated respiratory acidosis
C. Compensated respiratory alkalosis
D. Uncompensated metabolic acidosis
The low pH indicates acidosis, while the elevated PaCO₂ identifies a respiratory cause. Normal
bicarbonate indicates little or no metabolic compensation.
8. Which ABG pattern is most consistent with metabolic acidosis?
A. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.48, PaCO₂ 48 mmHg, HCO₃⁻ 34 mEq/L
C. pH 7.28, PaCO₂ 38 mmHg, HCO₃⁻ 18 mEq/L
D. pH 7.36, PaCO₂ 52 mmHg, HCO₃⁻ 30 mEq/L
The low pH establishes acidemia and the decreased bicarbonate identifies a metabolic cause.
9. A client hyperventilates during an acute anxiety episode. Which ABG change would the
nurse anticipate?
A. Decreased PaCO₂
B. Increased PaCO₂
,C. Increased bicarbonate immediately
D. Decreased blood pH caused directly by retained carbon dioxide
Hyperventilation removes carbon dioxide faster than it is produced, causing PaCO₂ to fall and
potentially producing respiratory alkalosis.
10. Which client should the nurse assess first?
A. Client with chronic dyspnea whose oxygen saturation is at the prescribed baseline
B. Client requesting assistance with repositioning
C. Client with a respiratory rate of 18/min and clear breath sounds
D. Client with sudden dyspnea, cyanosis, and oxygen saturation of 82%
Sudden severe hypoxemia and cyanosis represent an immediate threat to life and require
priority intervention.
11. A client with pneumonia has thick respiratory secretions. Which intervention best
promotes secretion clearance?
A. Restrict fluids
B. Encourage appropriate hydration and coughing
C. Maintain strict bed rest
D. Avoid repositioning
Adequate hydration can help thin secretions, while effective coughing facilitates airway
clearance.
12. Which position generally promotes lung expansion in a client experiencing dyspnea?
A. High-Fowler's position
B. Supine position
C. Trendelenburg position
D. Prone position with the head flat
Elevating the upper body reduces abdominal pressure against the diaphragm and facilitates
lung expansion.
13. A pulse oximeter displays an unexpectedly low reading on a client whose clinical
condition appears unchanged. What should the nurse do first?
A. Immediately administer a sedative
B. Remove the oxygen source
C. Assess the probe placement and client circulation
D. Document respiratory failure
Probe displacement, poor peripheral perfusion, movement, and other technical factors can
produce inaccurate readings. The nurse should verify the measurement before interpreting it.
, 14. Which finding is most concerning in a client receiving opioid analgesia after surgery?
A. Pain rated 4/10
B. Respiratory rate of 7/min with increasing drowsiness
C. Mild nausea
D. Blood pressure of 124/76 mmHg
Opioids can depress the respiratory system. Marked respiratory depression with increasing
sedation requires immediate assessment and intervention.
15. Which oxygen-delivery device can provide a precise concentration of oxygen for a
spontaneously breathing client?
A. Simple face mask
B. Nasal cannula
C. Nonrebreather mask
D. Venturi mask
A Venturi mask delivers a controlled oxygen concentration and is particularly useful when
precise oxygen therapy is required.
16. A client has a PaO₂ of 58 mmHg. What does this finding indicate?
A. Hypoxemia
B. Hyperkalemia
C. Metabolic alkalosis
D. Hypernatremia
A PaO₂ below the expected arterial range indicates reduced oxygenation of arterial blood.
17. Which assessment is most important before administering a prescribed opioid to a
postoperative client?
A. Hair color
B. Bowel sound location only
C. Respiratory rate and level of consciousness
D. Dietary preference
Opioids can cause respiratory depression and sedation, making respiratory status and
consciousness essential safety assessments.
18. A client develops sudden unilateral absent breath sounds and severe dyspnea after a
central line procedure. Which complication should the nurse suspect?
A. Hypoglycemia
B. Pneumothorax
C. Constipation
D. Urinary retention
Answer: B
ELECTROLYTES,ABGs, PERIOPERATIVE
NURSING,PHARMACOLOGY & WOUND CARE LATEST EXAM |
ALL PRACTICE Q&A 2026/2027 | A+ GRADED |
COMPREHENSIVE EXAM GUIDE 2026&2027
1. A postoperative client has an oxygen saturation of 88% on room air and is increasingly
restless. Which action should the nurse take first?
A. Encourage oral fluids
B. Apply supplemental oxygen
C. Administer a prescribed sedative
D. Place the client flat in bed
Supplemental oxygen addresses the immediate evidence of hypoxemia. Restlessness can be
an early manifestation of inadequate oxygenation.
2. Which assessment finding most strongly suggests inadequate oxygenation in an adult
client?
A. Warm extremities
B. Respiratory rate of 16/min
C. New-onset confusion
D. Blood pressure of 118/72 mmHg
Acute confusion may occur when the brain receives insufficient oxygen and requires prompt
assessment of respiratory status.
3. A client with chronic obstructive pulmonary disease is receiving oxygen therapy. Which
nursing action is most appropriate?
A. Administer oxygen at the lowest prescribed concentration that maintains the target
saturation
B. Discontinue oxygen whenever the client becomes drowsy
C. Maintain oxygen at maximum flow continuously
D. Restrict all activity while oxygen is being administered
Clients with COPD require carefully titrated oxygen according to the prescribed target range
and clinical response rather than automatically receiving high concentrations.
4. Which finding indicates increased work of breathing?
A. Symmetrical chest expansion without accessory muscle use
B. Respiratory rate of 14/min
C. Regular depth of respirations
D. Intercostal retractions and nasal flaring
,Accessory muscle use, retractions, and nasal flaring indicate increased respiratory effort and
possible respiratory compromise.
5. A client receiving oxygen through a nasal cannula reports dryness of the nasal passages.
Which intervention is appropriate?
A. Apply petroleum jelly inside the nares
B. Increase oxygen flow independently
C. Use prescribed humidification when appropriate
D. Remove oxygen permanently
Humidification can reduce mucosal dryness when clinically appropriate. Petroleum-based
products should be avoided around oxygen equipment because of fire risk.
6. Which arterial blood gas result is within expected adult ranges?
A. pH 7.40, PaCO₂ 40 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.25, PaCO₂ 30 mmHg, HCO₃⁻ 18 mEq/L
C. pH 7.55, PaCO₂ 50 mmHg, HCO₃⁻ 30 mEq/L
D. pH 7.30, PaCO₂ 60 mmHg, HCO₃⁻ 28 mEq/L
A pH of 7.35–7.45, PaCO₂ of approximately 35–45 mmHg, and bicarbonate of approximately
22–26 mEq/L are expected adult ABG values.
7. A client's ABGs are pH 7.30, PaCO₂ 52 mmHg, and HCO₃⁻ 24 mEq/L. How should the
nurse interpret these findings?
A. Uncompensated metabolic alkalosis
B. Uncompensated respiratory acidosis
C. Compensated respiratory alkalosis
D. Uncompensated metabolic acidosis
The low pH indicates acidosis, while the elevated PaCO₂ identifies a respiratory cause. Normal
bicarbonate indicates little or no metabolic compensation.
8. Which ABG pattern is most consistent with metabolic acidosis?
A. pH 7.50, PaCO₂ 30 mmHg, HCO₃⁻ 24 mEq/L
B. pH 7.48, PaCO₂ 48 mmHg, HCO₃⁻ 34 mEq/L
C. pH 7.28, PaCO₂ 38 mmHg, HCO₃⁻ 18 mEq/L
D. pH 7.36, PaCO₂ 52 mmHg, HCO₃⁻ 30 mEq/L
The low pH establishes acidemia and the decreased bicarbonate identifies a metabolic cause.
9. A client hyperventilates during an acute anxiety episode. Which ABG change would the
nurse anticipate?
A. Decreased PaCO₂
B. Increased PaCO₂
,C. Increased bicarbonate immediately
D. Decreased blood pH caused directly by retained carbon dioxide
Hyperventilation removes carbon dioxide faster than it is produced, causing PaCO₂ to fall and
potentially producing respiratory alkalosis.
10. Which client should the nurse assess first?
A. Client with chronic dyspnea whose oxygen saturation is at the prescribed baseline
B. Client requesting assistance with repositioning
C. Client with a respiratory rate of 18/min and clear breath sounds
D. Client with sudden dyspnea, cyanosis, and oxygen saturation of 82%
Sudden severe hypoxemia and cyanosis represent an immediate threat to life and require
priority intervention.
11. A client with pneumonia has thick respiratory secretions. Which intervention best
promotes secretion clearance?
A. Restrict fluids
B. Encourage appropriate hydration and coughing
C. Maintain strict bed rest
D. Avoid repositioning
Adequate hydration can help thin secretions, while effective coughing facilitates airway
clearance.
12. Which position generally promotes lung expansion in a client experiencing dyspnea?
A. High-Fowler's position
B. Supine position
C. Trendelenburg position
D. Prone position with the head flat
Elevating the upper body reduces abdominal pressure against the diaphragm and facilitates
lung expansion.
13. A pulse oximeter displays an unexpectedly low reading on a client whose clinical
condition appears unchanged. What should the nurse do first?
A. Immediately administer a sedative
B. Remove the oxygen source
C. Assess the probe placement and client circulation
D. Document respiratory failure
Probe displacement, poor peripheral perfusion, movement, and other technical factors can
produce inaccurate readings. The nurse should verify the measurement before interpreting it.
, 14. Which finding is most concerning in a client receiving opioid analgesia after surgery?
A. Pain rated 4/10
B. Respiratory rate of 7/min with increasing drowsiness
C. Mild nausea
D. Blood pressure of 124/76 mmHg
Opioids can depress the respiratory system. Marked respiratory depression with increasing
sedation requires immediate assessment and intervention.
15. Which oxygen-delivery device can provide a precise concentration of oxygen for a
spontaneously breathing client?
A. Simple face mask
B. Nasal cannula
C. Nonrebreather mask
D. Venturi mask
A Venturi mask delivers a controlled oxygen concentration and is particularly useful when
precise oxygen therapy is required.
16. A client has a PaO₂ of 58 mmHg. What does this finding indicate?
A. Hypoxemia
B. Hyperkalemia
C. Metabolic alkalosis
D. Hypernatremia
A PaO₂ below the expected arterial range indicates reduced oxygenation of arterial blood.
17. Which assessment is most important before administering a prescribed opioid to a
postoperative client?
A. Hair color
B. Bowel sound location only
C. Respiratory rate and level of consciousness
D. Dietary preference
Opioids can cause respiratory depression and sedation, making respiratory status and
consciousness essential safety assessments.
18. A client develops sudden unilateral absent breath sounds and severe dyspnea after a
central line procedure. Which complication should the nurse suspect?
A. Hypoglycemia
B. Pneumothorax
C. Constipation
D. Urinary retention
Answer: B
