NUR 390 Exam 1 V1 | NUR 390 Nursing Care of the
Adult I | Actual Q&A with Rationale (NUR390 Exam
1) | Concordia
1. A nurse is assessing a patient with a potassium level of 3.2 mEq/L. Which clinical
manifestation should the nurse expect to find?
A. Hyperactive bowel sounds and diarrhea
B. Prominent U-waves on the EKG
C. Peaked T-waves and widened QRS complexes
D. Muscle tetany and positive Chvostek’s sign
Correct Answer: B
Explanation: Hypokalemia, defined as a serum potassium level below 3.5 mEq/L, affects
myocardial repolarization and results in characteristic EKG changes such as prominent U-
waves. The nurse should also monitor for muscle weakness, lethargy, and decreased bowel
sounds due to reduced smooth muscle contraction. Peaked T-waves are associated with
hyperkalemia, while Chvostek’s sign is specific to hypocalcemia.
2. A patient is admitted with a diagnosis of dehydration. Which assessment findings should
the nurse identify as consistent with fluid volume deficit? (Select all that Apply)
A. Orthostatic hypotension
B. Neck vein distention
,C. Decreased skin turgor
D. Concentrated urine with high specific gravity
E. Bounding peripheral pulses
F. Tachycardia
Correct Answer: ACDF
Explanation: Fluid volume deficit (dehydration) leads to decreased circulating volume,
which manifests as tachycardia and orthostatic hypotension as the body attempts to
maintain cardiac output. Decreased skin turgor and concentrated urine (high specific
gravity) indicate a lack of interstitial and intracellular fluid. Bounding pulses and neck vein
distention are clinical signs of fluid volume excess, not deficit.
3. The nurse is caring for a patient who has just returned from surgery. Which action is the
priority for the nurse to perform first?
A. Check the surgical dressing for drainage
B. Assess the patient’s airway patency and respiratory status
C. Monitor the patient’s urinary output
D. Administer prescribed pain medication
Correct Answer: B
Explanation: According to the ABC (Airway, Breathing, Circulation) priority framework,
ensuring a patent airway and adequate ventilation is the most critical intervention in the
,immediate postoperative period. Anesthesia and opioids can depress the respiratory
system, placing the patient at high risk for hypoxia. While checking dressings and managing
pain are important, they follow the stabilization of respiratory and circulatory status.
4. A patient’s arterial blood gas (ABG) results are as follows: pH 7.30, PaCO2 52 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these results?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Correct Answer: C
Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause for the acid-base imbalance. The bicarbonate (HCO3) level is within the
normal range (22-26 mEq/L), suggesting there has been no compensation yet. Therefore,
the nurse correctly identifies this as uncompensated respiratory acidosis, often caused by
hypoventilation.
5. A nurse is preparing to administer intravenous potassium chloride (KCl) to a patient with
hypokalemia. Which action is essential for the nurse to take?
A. Check that the patient’s urinary output is at least 30 mL/hr
B. Ensure the potassium concentration does not exceed 10 mEq/hr via a peripheral line
C. Restrict fluid intake while the infusion is running
, D. Administer the KCl via IV push over 1-2 minutes
Correct Answer: A
Explanation: Potassium is excreted primarily by the kidneys; if renal function is impaired
(low urine output), the patient is at high risk for lethal hyperkalemia. IV potassium must
never be given as a bolus or IV push, as this can cause immediate cardiac arrest. The nurse
must verify adequate renal perfusion (at least 30 mL/hr) and use an infusion pump for
safety.
6. The nurse is providing preoperative teaching to a patient scheduled for surgery. Which
statement by the patient indicates a need for further teaching?
A. ‘I will need to sign the consent form before I receive my sedative.’
B. ‘The surgeon will explain the risks and benefits of the procedure to me.’
C. ‘The nurse will be the one to explain the surgical procedure to me in detail.’
D. ‘I should stop taking my aspirin one week before the surgery.’
Correct Answer: C
Explanation: It is the legal responsibility of the surgeon, not the nurse, to explain the
surgical procedure, risks, benefits, and alternatives to the patient. The nurse’s role in the
consent process is to witness the patient’s signature and verify that the patient
understands the information provided by the surgeon. If the patient has questions about
the procedure itself, the nurse must notify the surgeon to return and provide clarification.
Adult I | Actual Q&A with Rationale (NUR390 Exam
1) | Concordia
1. A nurse is assessing a patient with a potassium level of 3.2 mEq/L. Which clinical
manifestation should the nurse expect to find?
A. Hyperactive bowel sounds and diarrhea
B. Prominent U-waves on the EKG
C. Peaked T-waves and widened QRS complexes
D. Muscle tetany and positive Chvostek’s sign
Correct Answer: B
Explanation: Hypokalemia, defined as a serum potassium level below 3.5 mEq/L, affects
myocardial repolarization and results in characteristic EKG changes such as prominent U-
waves. The nurse should also monitor for muscle weakness, lethargy, and decreased bowel
sounds due to reduced smooth muscle contraction. Peaked T-waves are associated with
hyperkalemia, while Chvostek’s sign is specific to hypocalcemia.
2. A patient is admitted with a diagnosis of dehydration. Which assessment findings should
the nurse identify as consistent with fluid volume deficit? (Select all that Apply)
A. Orthostatic hypotension
B. Neck vein distention
,C. Decreased skin turgor
D. Concentrated urine with high specific gravity
E. Bounding peripheral pulses
F. Tachycardia
Correct Answer: ACDF
Explanation: Fluid volume deficit (dehydration) leads to decreased circulating volume,
which manifests as tachycardia and orthostatic hypotension as the body attempts to
maintain cardiac output. Decreased skin turgor and concentrated urine (high specific
gravity) indicate a lack of interstitial and intracellular fluid. Bounding pulses and neck vein
distention are clinical signs of fluid volume excess, not deficit.
3. The nurse is caring for a patient who has just returned from surgery. Which action is the
priority for the nurse to perform first?
A. Check the surgical dressing for drainage
B. Assess the patient’s airway patency and respiratory status
C. Monitor the patient’s urinary output
D. Administer prescribed pain medication
Correct Answer: B
Explanation: According to the ABC (Airway, Breathing, Circulation) priority framework,
ensuring a patent airway and adequate ventilation is the most critical intervention in the
,immediate postoperative period. Anesthesia and opioids can depress the respiratory
system, placing the patient at high risk for hypoxia. While checking dressings and managing
pain are important, they follow the stabilization of respiratory and circulatory status.
4. A patient’s arterial blood gas (ABG) results are as follows: pH 7.30, PaCO2 52 mmHg, and
HCO3 26 mEq/L. How should the nurse interpret these results?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Correct Answer: C
Explanation: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg indicates a
respiratory cause for the acid-base imbalance. The bicarbonate (HCO3) level is within the
normal range (22-26 mEq/L), suggesting there has been no compensation yet. Therefore,
the nurse correctly identifies this as uncompensated respiratory acidosis, often caused by
hypoventilation.
5. A nurse is preparing to administer intravenous potassium chloride (KCl) to a patient with
hypokalemia. Which action is essential for the nurse to take?
A. Check that the patient’s urinary output is at least 30 mL/hr
B. Ensure the potassium concentration does not exceed 10 mEq/hr via a peripheral line
C. Restrict fluid intake while the infusion is running
, D. Administer the KCl via IV push over 1-2 minutes
Correct Answer: A
Explanation: Potassium is excreted primarily by the kidneys; if renal function is impaired
(low urine output), the patient is at high risk for lethal hyperkalemia. IV potassium must
never be given as a bolus or IV push, as this can cause immediate cardiac arrest. The nurse
must verify adequate renal perfusion (at least 30 mL/hr) and use an infusion pump for
safety.
6. The nurse is providing preoperative teaching to a patient scheduled for surgery. Which
statement by the patient indicates a need for further teaching?
A. ‘I will need to sign the consent form before I receive my sedative.’
B. ‘The surgeon will explain the risks and benefits of the procedure to me.’
C. ‘The nurse will be the one to explain the surgical procedure to me in detail.’
D. ‘I should stop taking my aspirin one week before the surgery.’
Correct Answer: C
Explanation: It is the legal responsibility of the surgeon, not the nurse, to explain the
surgical procedure, risks, benefits, and alternatives to the patient. The nurse’s role in the
consent process is to witness the patient’s signature and verify that the patient
understands the information provided by the surgeon. If the patient has questions about
the procedure itself, the nurse must notify the surgeon to return and provide clarification.
