Exam 2 Review Bank 2026/2027 –
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Question 1
A client with heart failure is receiving IV furosemide. Which assessment finding
requires the nurse's priority attention?
A. Urine output of 1,500 mL over 24 hours
B. Potassium level of 2.8 mEq/L
C. Blood pressure of 108/68 mm Hg
D. Weight loss of 1 kg over 24 hours
Answer: _B. Potassium level of 2.8 mEq/L_
Rationale: Furosemide is a loop diuretic that can cause significant potassium loss.
Severe hypokalemia increases the risk of potentially life-threatening cardiac
dysrhythmias and requires prompt intervention.
Question 2
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy. Which oxygen-delivery approach is generally most appropriate when
precise, controlled oxygen concentrations are needed?
A. Nonrebreather mask
B. Venturi mask
C. Simple face mask
D. Partial-rebreather mask
Answer: _B. Venturi mask_
,Rationale: A Venturi mask delivers a controlled and relatively precise fraction of
inspired oxygen, making it useful when careful oxygen titration is needed in clients
with COPD.
Question 3
A client with diabetic ketoacidosis (DKA) has a blood glucose level of 520 mg/dL.
Which prescription should the nurse anticipate as an initial component of
treatment?
A. IV isotonic fluid replacement
B. Oral hypoglycemic medication
C. Fluid restriction
D. IV potassium immediately before laboratory evaluation
Answer: _A. IV isotonic fluid replacement_
Rationale: Severe dehydration is a major consequence of DKA. Initial
management generally includes rapid IV isotonic fluid replacement, followed by
insulin therapy and careful electrolyte management.
Question 4
A client with acute kidney injury has a potassium level of 6.7 mEq/L. Which ECG
finding should the nurse anticipate?
A. Prolonged QT interval
B. Peaked T waves
C. Prominent U waves
D. ST-segment elevation caused by hypokalemia
Answer: _B. Peaked T waves_
Rationale: Hyperkalemia can produce tall, peaked T waves and may progress to
conduction abnormalities, widening of the QRS complex, and potentially fatal
dysrhythmias.
Question 5
A client is admitted with suspected bacterial pneumonia. Which assessment finding
is most concerning?
,A. Productive cough with yellow sputum
B. Temperature of 38.2°C (100.8°F)
C. Respiratory rate of 32/min with increasing confusion
D. Pleuritic chest discomfort when coughing
Answer: _C. Respiratory rate of 32/min with increasing confusion_
Rationale: Tachypnea accompanied by acute confusion can indicate worsening
hypoxemia or respiratory failure. Airway and breathing problems take priority
over other manifestations of pneumonia.
Question 6
A client with cirrhosis develops ascites. Which intervention should the nurse
anticipate?
A. Encourage a high-sodium diet
B. Monitor daily weight and abdominal girth
C. Encourage unrestricted fluid intake
D. Place the client in a completely flat position
Answer: _B. Monitor daily weight and abdominal girth_
Rationale: Daily weight and abdominal-girth measurements help evaluate changes
in fluid accumulation. Sodium restriction and prescribed diuretics may also be
used to manage ascites.
Question 7
A client receiving digoxin reports nausea and seeing yellow-green halos around
lights. Which action should the nurse take?
A. Administer the next dose with food
B. Hold the medication and notify the provider
C. Encourage increased sodium intake
D. Administer an additional dose
Answer: _B. Hold the medication and notify the provider_
, Rationale: Nausea and visual disturbances such as yellow-green halos are classic
manifestations associated with digoxin toxicity. The medication should be withheld
and the client evaluated promptly.
Question 8
Which finding is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Dependent peripheral edema
C. Pulmonary crackles and dyspnea
D. Enlarged liver
Answer: _C. Pulmonary crackles and dyspnea_
Rationale: Left-sided heart failure causes blood to back up into the pulmonary
circulation, producing pulmonary congestion, crackles, orthopnea, and dyspnea.
Question 9
A client with a suspected pulmonary embolism suddenly develops dyspnea and
chest pain. What is the nurse's priority action?
A. Encourage ambulation
B. Apply oxygen and assess respiratory status
C. Place the client in Trendelenburg position
D. Offer oral fluids
Answer: _B. Apply oxygen and assess respiratory status_
Rationale: A pulmonary embolism can rapidly compromise oxygenation. The nurse
should support oxygenation and immediately assess airway, breathing, circulation,
and hemodynamic status while activating appropriate emergency management.
Question 10
A client with a history of myocardial infarction asks why cardiac rehabilitation is
recommended. Which response is most appropriate?
A. "It eliminates the need for prescribed medications."
B. "It helps improve cardiovascular function and supports risk-factor