NUR 390 Exam 2 V1 | NUR 390 Nursing Care of the
Adult I | Actual Q&A with Rationale (NUR390 Exam
2) | Concordia
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD) who is
experiencing dyspnea. Which breathing technique should the nurse teach the patient to
promote carbon dioxide elimination?
A. Diaphragmatic breathing
B. Pursed-lip breathing
C. Deep chest breathing
D. Rapid, shallow breathing
Correct Answer: B
Explanation: Pursed-lip breathing helps to maintain positive pressure in the airways,
preventing alveolar collapse during expiration. This technique prolongs exhalation and
allows for more effective removal of trapped carbon dioxide. The nurse should instruct the
patient to breathe in through the nose and exhale slowly through puckered lips.
2. A patient with heart failure is being discharged. Which of the following instructions is most
critical for the nurse to include in the teaching plan to monitor for worsening fluid retention?
A. Check for swelling in the hands every morning.
B. Monitor for shortness of breath when exercising.
,C. Limit fluid intake to 3 liters per day.
D. Weigh yourself daily at the same time with the same amount of clothing.
Correct Answer: D
Explanation: Daily weights are the most sensitive and reliable indicator of fluid volume
changes in a patient with heart failure. A weight gain of 3 pounds in 2 days or 5 pounds in a
week typically indicates a significant fluid shift that requires medical intervention. Patients
should be taught to report these specific changes to their healthcare provider immediately.
3. The nurse is reviewing the Arterial Blood Gas (ABG) results for a patient: pH 7.31, PaCO2 55
mmHg, and HCO3 26 mEq/L. Which acid-base imbalance does the nurse identify?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Correct Answer: A
Explanation: The pH of 7.31 is below the normal range (7.35-7.45), indicating acidosis.
The PaCO2 of 55 is elevated (normal 35-45), suggesting that the respiratory system is the
cause of the acidosis. The HCO3 is within normal limits, indicating that compensation has
not yet occurred significantly.
, 4. A post-operative patient reports sudden sharp chest pain and shortness of breath. The
nurse notes the patient is tachycardic and tachypneic. Which complication should the nurse
suspect first?
A. Myocardial Infarction
B. Pneumonia
C. Atelectasis
D. Pulmonary Embolism
Correct Answer: D
Explanation: Sudden onset of pleuritic chest pain and dyspnea in a post-operative patient
are hallmark signs of a pulmonary embolism. Patients who have undergone surgery are at
high risk for Deep Vein Thrombosis (DVT), which can lead to PE. Immediate assessment of
oxygen saturation and notification of the rapid response team are required.
5. A nurse is assessing a patient for symptoms of left-sided heart failure. Which clinical
manifestations should the nurse expect? (Select All That Apply)
A. Crackles in the lungs
B. Jugular Venous Distension (JVD)
C. Dyspnea on exertion
D. Orthopnea
E. Peripheral edema
Adult I | Actual Q&A with Rationale (NUR390 Exam
2) | Concordia
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD) who is
experiencing dyspnea. Which breathing technique should the nurse teach the patient to
promote carbon dioxide elimination?
A. Diaphragmatic breathing
B. Pursed-lip breathing
C. Deep chest breathing
D. Rapid, shallow breathing
Correct Answer: B
Explanation: Pursed-lip breathing helps to maintain positive pressure in the airways,
preventing alveolar collapse during expiration. This technique prolongs exhalation and
allows for more effective removal of trapped carbon dioxide. The nurse should instruct the
patient to breathe in through the nose and exhale slowly through puckered lips.
2. A patient with heart failure is being discharged. Which of the following instructions is most
critical for the nurse to include in the teaching plan to monitor for worsening fluid retention?
A. Check for swelling in the hands every morning.
B. Monitor for shortness of breath when exercising.
,C. Limit fluid intake to 3 liters per day.
D. Weigh yourself daily at the same time with the same amount of clothing.
Correct Answer: D
Explanation: Daily weights are the most sensitive and reliable indicator of fluid volume
changes in a patient with heart failure. A weight gain of 3 pounds in 2 days or 5 pounds in a
week typically indicates a significant fluid shift that requires medical intervention. Patients
should be taught to report these specific changes to their healthcare provider immediately.
3. The nurse is reviewing the Arterial Blood Gas (ABG) results for a patient: pH 7.31, PaCO2 55
mmHg, and HCO3 26 mEq/L. Which acid-base imbalance does the nurse identify?
A. Respiratory Acidosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Metabolic Alkalosis
Correct Answer: A
Explanation: The pH of 7.31 is below the normal range (7.35-7.45), indicating acidosis.
The PaCO2 of 55 is elevated (normal 35-45), suggesting that the respiratory system is the
cause of the acidosis. The HCO3 is within normal limits, indicating that compensation has
not yet occurred significantly.
, 4. A post-operative patient reports sudden sharp chest pain and shortness of breath. The
nurse notes the patient is tachycardic and tachypneic. Which complication should the nurse
suspect first?
A. Myocardial Infarction
B. Pneumonia
C. Atelectasis
D. Pulmonary Embolism
Correct Answer: D
Explanation: Sudden onset of pleuritic chest pain and dyspnea in a post-operative patient
are hallmark signs of a pulmonary embolism. Patients who have undergone surgery are at
high risk for Deep Vein Thrombosis (DVT), which can lead to PE. Immediate assessment of
oxygen saturation and notification of the rapid response team are required.
5. A nurse is assessing a patient for symptoms of left-sided heart failure. Which clinical
manifestations should the nurse expect? (Select All That Apply)
A. Crackles in the lungs
B. Jugular Venous Distension (JVD)
C. Dyspnea on exertion
D. Orthopnea
E. Peripheral edema
