NUR 390 Exam 4 V1 | NUR 390 Nursing Care of the
Adult I | Actual Q&A with Rationale (NUR390 Exam
4) | Concordia
1. A patient with Type 1 Diabetes Mellitus is found unresponsive and clammy. What is the
priority nursing action?
A. Administer 15g of oral glucose gel
B. Check the patient’s blood glucose level
C. Administer Glucagon IM or SQ
D. Call the healthcare provider immediately
Correct Answer: C
Explanation: In an unresponsive patient with suspected hypoglycemia, the priority is to
restore glucose levels safely without risking aspiration. Administering Glucagon IM or SQ is
the standard emergency intervention for an unconscious patient who cannot swallow.
Checking the blood glucose level is important, but in an emergency with clear symptoms of
severe hypoglycemia (unresponsive and clammy), immediate intervention takes
precedence over diagnostic confirmation.
2. A nurse is teaching a patient with COPD about the use of a pursed-lip breathing technique.
Which statement by the patient indicates understanding?
A. I should inhale twice as long as I exhale
B. This will help me get rid of excess carbon dioxide
,C. I will use this technique only when I am exercising
D. I should hold my breath for 5 seconds before exhaling
Correct Answer: B
Explanation: Pursed-lip breathing prolongs exhalation and prevents air trapping in the
alveoli, which facilitates the removal of carbon dioxide. The technique involves exhaling for
twice the duration of inhalation to ensure complete emptying of the lungs. It should be
used during periods of dyspnea and as part of general management, not exclusively during
exercise.
3. Which clinical manifestations should the nurse expect in a patient diagnosed with
Cushing’s Syndrome? (Select All That Apply)
A. Truncal obesity
B. Hypotension
C. Hyperpigmentation
D. Moon face
E. Purple striae on the abdomen
F. Thin, fragile skin
Correct Answer: A, D, E, F
Explanation: Cushing’s Syndrome results from an excess of corticosteroids, leading to
truncal obesity, a moon-shaped face, and purple striae. Patients also typically present with
,thin, fragile skin that bruises easily due to protein wasting. Hypotension is not a feature;
instead, hypertension is common due to fluid retention and mineralocorticoid effects.
4. A patient’s ABG results are: pH 7.31, PaCO2 50 mmHg, and HCO3 24 mEq/L. The nurse
interprets these results as:
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause for the acidosis. The bicarbonate (HCO3) level is within the normal range
(22-26 mEq/L), suggesting the condition is uncompensated. This pattern is consistent with
Respiratory Acidosis, often seen in conditions like COPD or respiratory depression.
5. A patient with Diabetes Insipidus (DI) is receiving Desmopressin. Which finding indicates
the medication is effective?
A. Decrease in serum sodium levels
B. Increase in urine output
C. Increase in urine specific gravity
D. Decrease in blood pressure
, Correct Answer: C
Explanation: Diabetes Insipidus is characterized by a deficiency of ADH, leading to large
amounts of dilute urine and low specific gravity. Desmopressin acts as an ADH
replacement, helping the kidneys reabsorb water and concentrate the urine. An increase in
urine specific gravity (moving toward the normal range of 1.005–1.030) indicates the
treatment is working.
6. A patient is admitted with a diagnosis of Diabetic Ketoacidosis (DKA). Which IV fluid should
the nurse anticipate administering first?
A. 5% Dextrose in 0.45% Saline
B. 0.45% Normal Saline
C. 0.9% Normal Saline
D. 5% Dextrose in Water
Correct Answer: C
Explanation: Initial management of DKA requires aggressive fluid resuscitation to restore
circulatory volume and perfusion to the kidneys. Isotonic saline (0.9% NaCl) is the fluid of
choice for initial volume expansion. Dextrose-containing fluids are only added later when
blood glucose levels reach approximately 250 mg/dL to prevent cerebral edema.
7. A patient with hyperthyroidism is scheduled for a thyroidectomy. Which medication does
the nurse expect to administer preoperatively to reduce the vascularity of the thyroid gland?
A. Levothyroxine
Adult I | Actual Q&A with Rationale (NUR390 Exam
4) | Concordia
1. A patient with Type 1 Diabetes Mellitus is found unresponsive and clammy. What is the
priority nursing action?
A. Administer 15g of oral glucose gel
B. Check the patient’s blood glucose level
C. Administer Glucagon IM or SQ
D. Call the healthcare provider immediately
Correct Answer: C
Explanation: In an unresponsive patient with suspected hypoglycemia, the priority is to
restore glucose levels safely without risking aspiration. Administering Glucagon IM or SQ is
the standard emergency intervention for an unconscious patient who cannot swallow.
Checking the blood glucose level is important, but in an emergency with clear symptoms of
severe hypoglycemia (unresponsive and clammy), immediate intervention takes
precedence over diagnostic confirmation.
2. A nurse is teaching a patient with COPD about the use of a pursed-lip breathing technique.
Which statement by the patient indicates understanding?
A. I should inhale twice as long as I exhale
B. This will help me get rid of excess carbon dioxide
,C. I will use this technique only when I am exercising
D. I should hold my breath for 5 seconds before exhaling
Correct Answer: B
Explanation: Pursed-lip breathing prolongs exhalation and prevents air trapping in the
alveoli, which facilitates the removal of carbon dioxide. The technique involves exhaling for
twice the duration of inhalation to ensure complete emptying of the lungs. It should be
used during periods of dyspnea and as part of general management, not exclusively during
exercise.
3. Which clinical manifestations should the nurse expect in a patient diagnosed with
Cushing’s Syndrome? (Select All That Apply)
A. Truncal obesity
B. Hypotension
C. Hyperpigmentation
D. Moon face
E. Purple striae on the abdomen
F. Thin, fragile skin
Correct Answer: A, D, E, F
Explanation: Cushing’s Syndrome results from an excess of corticosteroids, leading to
truncal obesity, a moon-shaped face, and purple striae. Patients also typically present with
,thin, fragile skin that bruises easily due to protein wasting. Hypotension is not a feature;
instead, hypertension is common due to fluid retention and mineralocorticoid effects.
4. A patient’s ABG results are: pH 7.31, PaCO2 50 mmHg, and HCO3 24 mEq/L. The nurse
interprets these results as:
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: A
Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause for the acidosis. The bicarbonate (HCO3) level is within the normal range
(22-26 mEq/L), suggesting the condition is uncompensated. This pattern is consistent with
Respiratory Acidosis, often seen in conditions like COPD or respiratory depression.
5. A patient with Diabetes Insipidus (DI) is receiving Desmopressin. Which finding indicates
the medication is effective?
A. Decrease in serum sodium levels
B. Increase in urine output
C. Increase in urine specific gravity
D. Decrease in blood pressure
, Correct Answer: C
Explanation: Diabetes Insipidus is characterized by a deficiency of ADH, leading to large
amounts of dilute urine and low specific gravity. Desmopressin acts as an ADH
replacement, helping the kidneys reabsorb water and concentrate the urine. An increase in
urine specific gravity (moving toward the normal range of 1.005–1.030) indicates the
treatment is working.
6. A patient is admitted with a diagnosis of Diabetic Ketoacidosis (DKA). Which IV fluid should
the nurse anticipate administering first?
A. 5% Dextrose in 0.45% Saline
B. 0.45% Normal Saline
C. 0.9% Normal Saline
D. 5% Dextrose in Water
Correct Answer: C
Explanation: Initial management of DKA requires aggressive fluid resuscitation to restore
circulatory volume and perfusion to the kidneys. Isotonic saline (0.9% NaCl) is the fluid of
choice for initial volume expansion. Dextrose-containing fluids are only added later when
blood glucose levels reach approximately 250 mg/dL to prevent cerebral edema.
7. A patient with hyperthyroidism is scheduled for a thyroidectomy. Which medication does
the nurse expect to administer preoperatively to reduce the vascularity of the thyroid gland?
A. Levothyroxine
