, Question 1
A client with heart failure is prescribed furosemide 40 mg IV. Which
assessment finding best indicates a therapeutic response to this medication?
A. Urine output of 30 mL/hr with stable weight
B. Decreased serum potassium from 4.0 to 3.2 mEq/L
C. Reduction in jugular venous distention and crackles
D. Blood pressure decrease from 140/90 to 110/70 mm Hg
Correct Answer: C - Reduction in jugular venous distention and
crackles
RATIONALE
Therapeutic response to a loop diuretic in heart failure is reduction of
fluid overload, evidenced by decreased JVD and crackles. Option A
indicates adequate but not necessarily improved output; B is an
adverse effect (hypokalemia); D may be a side effect but not the
primary therapeutic goal.
Question 2
A client with type 1 diabetes has a blood glucose of 320 mg/dL, pH 7.25, and
positive serum ketones. Which provider prescription is the priority?
A. Administer regular insulin IV bolus per protocol
B. Give sodium bicarbonate 50 mEq IV push
C. Start 0.9% sodium chloride infusion at 500 mL/hr
D. Obtain a stat chest x-ray
Correct Answer: C - Start 0.9% sodium chloride infusion at 500
mL/hr
RATIONALE
For diabetic ketoacidosis, initial priority is aggressive IV fluid
resuscitation with isotonic saline to restore volume. Insulin is given
after fluids are started; bicarbonate is not routine and may be harmful;
chest x-ray is not the immediate priority.
Page 2
, Question 3
A client is admitted with an acute exacerbation of COPD. Which oxygen
delivery method is most appropriate to maintain SpO2 between 88% and 92%?
A. Non-rebreather mask at 10 L/min
B. Venturi mask at 24% to 28%
C. Simple face mask at 6 L/min
D. Nasal cannula at 6 L/min
Correct Answer: B - Venturi mask at 24% to 28%
RATIONALE
COPD clients require controlled oxygen therapy to avoid hypercarbia;
a Venturi mask delivers precise low FiO2 (24-28%). High-flow
devices (A, C, D) risk oxygen-induced hypercapnia.
Question 4
A client with acute kidney injury has a serum potassium of 6.8 mEq/L. Which
intervention should the nurse anticipate first?
A. Administer sodium polystyrene sulfonate orally
B. Prepare for emergency hemodialysis
C. Give calcium gluconate IV
D. Restrict dietary potassium
Correct Answer: C - Give calcium gluconate IV
RATIONALE
Calcium gluconate is the first-line emergency treatment for
hyperkalemia to stabilize cardiac membranes. Polystyrene and dietary
restriction are slower; dialysis is definitive but not immediate.
Question 5
A client is receiving heparin IV for pulmonary embolism. Which laboratory
value should the nurse monitor to evaluate therapeutic effect?
Page 3
A client with heart failure is prescribed furosemide 40 mg IV. Which
assessment finding best indicates a therapeutic response to this medication?
A. Urine output of 30 mL/hr with stable weight
B. Decreased serum potassium from 4.0 to 3.2 mEq/L
C. Reduction in jugular venous distention and crackles
D. Blood pressure decrease from 140/90 to 110/70 mm Hg
Correct Answer: C - Reduction in jugular venous distention and
crackles
RATIONALE
Therapeutic response to a loop diuretic in heart failure is reduction of
fluid overload, evidenced by decreased JVD and crackles. Option A
indicates adequate but not necessarily improved output; B is an
adverse effect (hypokalemia); D may be a side effect but not the
primary therapeutic goal.
Question 2
A client with type 1 diabetes has a blood glucose of 320 mg/dL, pH 7.25, and
positive serum ketones. Which provider prescription is the priority?
A. Administer regular insulin IV bolus per protocol
B. Give sodium bicarbonate 50 mEq IV push
C. Start 0.9% sodium chloride infusion at 500 mL/hr
D. Obtain a stat chest x-ray
Correct Answer: C - Start 0.9% sodium chloride infusion at 500
mL/hr
RATIONALE
For diabetic ketoacidosis, initial priority is aggressive IV fluid
resuscitation with isotonic saline to restore volume. Insulin is given
after fluids are started; bicarbonate is not routine and may be harmful;
chest x-ray is not the immediate priority.
Page 2
, Question 3
A client is admitted with an acute exacerbation of COPD. Which oxygen
delivery method is most appropriate to maintain SpO2 between 88% and 92%?
A. Non-rebreather mask at 10 L/min
B. Venturi mask at 24% to 28%
C. Simple face mask at 6 L/min
D. Nasal cannula at 6 L/min
Correct Answer: B - Venturi mask at 24% to 28%
RATIONALE
COPD clients require controlled oxygen therapy to avoid hypercarbia;
a Venturi mask delivers precise low FiO2 (24-28%). High-flow
devices (A, C, D) risk oxygen-induced hypercapnia.
Question 4
A client with acute kidney injury has a serum potassium of 6.8 mEq/L. Which
intervention should the nurse anticipate first?
A. Administer sodium polystyrene sulfonate orally
B. Prepare for emergency hemodialysis
C. Give calcium gluconate IV
D. Restrict dietary potassium
Correct Answer: C - Give calcium gluconate IV
RATIONALE
Calcium gluconate is the first-line emergency treatment for
hyperkalemia to stabilize cardiac membranes. Polystyrene and dietary
restriction are slower; dialysis is definitive but not immediate.
Question 5
A client is receiving heparin IV for pulmonary embolism. Which laboratory
value should the nurse monitor to evaluate therapeutic effect?
Page 3
