Adult Health Nursing I 2026/2027– 150 Practice
Questions with Answers & Rationales
Question 1:
A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 86% while receiving oxygen at 2 L/min through a nasal cannula.
Which action should the nurse take first?
A. Increase oxygen to 6 L/min
B. Assess the client's respiratory effort and mental status
C. Place the client flat in bed
D. Administer a prescribed sedative
Correct Answer: B. Assess the client's respiratory effort and mental status
Rationale:
A COPD client with hypoxemia requires immediate assessment of respiratory
effort, airway status, and mental status. Oxygen should be carefully titrated
according to prescribed targets, but rapidly increasing flow without assessment
may worsen carbon dioxide retention in susceptible clients.
Question 2:
A client with heart failure reports gaining 2.5 kg (5.5 lb) over the past three days.
Which finding is most concerning?
A. Increased appetite
B. Mild ankle discomfort
,C. Bilateral crackles and dyspnea at rest
D. Increased urinary frequency
Correct Answer: C. Bilateral crackles and dyspnea at rest
Rationale:
Rapid weight gain indicates fluid retention, while crackles and dyspnea at rest
suggest pulmonary congestion. This combination may indicate worsening heart
failure and impaired oxygenation. The client requires prompt assessment and
intervention to prevent progression to acute pulmonary edema and respiratory
failure.
Question 3:
A client taking warfarin for atrial fibrillation has an international normalized ratio
(INR) of 5.8. Which finding requires immediate attention?
A. Occasional bruising on the arms
B. Black, tarry stool
C. Mild fatigue
D. Decreased appetite
Correct Answer: B. Black, tarry stool
Rationale:
An INR of 5.8 significantly increases bleeding risk. Black, tarry stool may indicate
gastrointestinal bleeding and requires immediate evaluation. The nurse should
notify the provider and anticipate interventions to reduce anticoagulation and
control bleeding based on the client's clinical condition.
,Question 4:
A conscious client with diabetes mellitus becomes pale, shaky, diaphoretic, and
confused. The blood glucose level is 48 mg/dL. Which intervention is most
appropriate?
A. Administer 15 g of rapid-acting carbohydrate
B. Administer regular insulin
C. Restrict oral fluids
D. Encourage the client to ambulate
Correct Answer: A. Administer 15 g of rapid-acting carbohydrate
Rationale:
The client's symptoms and glucose level indicate hypoglycemia. Because the client
is conscious and able to swallow, approximately 15 g of rapid-acting carbohydrate
should be administered, followed by reassessment in about 15 minutes. Additional
treatment is provided if glucose remains low.
Question 5:
A client with left-sided heart failure develops increasing dyspnea, orthopnea, and
bilateral crackles. Which pathophysiologic process best explains these findings?
A. Decreased systemic vascular resistance
B. Pulmonary fluid accumulation
C. Increased renal filtration
D. Reduced pulmonary blood flow
Correct Answer: B. Pulmonary fluid accumulation
, Rationale:
Left-sided heart failure causes blood to back up into the pulmonary circulation.
Increased hydrostatic pressure forces fluid into the pulmonary interstitial and
alveolar spaces, producing crackles, dyspnea, and orthopnea. Severe pulmonary
congestion can progress to acute pulmonary edema.
Question 6:
A client hospitalized with pneumonia has a respiratory rate of 32/min, oxygen
saturation of 84%, and increasing confusion. Which action has the highest priority?
A. Encourage oral fluids
B. Obtain a sputum specimen
C. Apply supplemental oxygen
D. Administer an antipyretic
Correct Answer: C. Apply supplemental oxygen
Rationale:
The client has significant hypoxemia accompanied by tachypnea and altered
mental status. Airway and breathing take priority under the ABC framework.
Supplemental oxygen should be initiated according to the prescribed protocol
while further assessment and treatment of the pneumonia continue.
Question 7:
A client newly diagnosed with hypertension asks which lifestyle change can help
reduce blood pressure. Which response is most appropriate?
A. Increase sodium intake during exercise
B. Reduce dietary sodium and increase physical activity
Questions with Answers & Rationales
Question 1:
A client with chronic obstructive pulmonary disease (COPD) has an oxygen
saturation of 86% while receiving oxygen at 2 L/min through a nasal cannula.
Which action should the nurse take first?
A. Increase oxygen to 6 L/min
B. Assess the client's respiratory effort and mental status
C. Place the client flat in bed
D. Administer a prescribed sedative
Correct Answer: B. Assess the client's respiratory effort and mental status
Rationale:
A COPD client with hypoxemia requires immediate assessment of respiratory
effort, airway status, and mental status. Oxygen should be carefully titrated
according to prescribed targets, but rapidly increasing flow without assessment
may worsen carbon dioxide retention in susceptible clients.
Question 2:
A client with heart failure reports gaining 2.5 kg (5.5 lb) over the past three days.
Which finding is most concerning?
A. Increased appetite
B. Mild ankle discomfort
,C. Bilateral crackles and dyspnea at rest
D. Increased urinary frequency
Correct Answer: C. Bilateral crackles and dyspnea at rest
Rationale:
Rapid weight gain indicates fluid retention, while crackles and dyspnea at rest
suggest pulmonary congestion. This combination may indicate worsening heart
failure and impaired oxygenation. The client requires prompt assessment and
intervention to prevent progression to acute pulmonary edema and respiratory
failure.
Question 3:
A client taking warfarin for atrial fibrillation has an international normalized ratio
(INR) of 5.8. Which finding requires immediate attention?
A. Occasional bruising on the arms
B. Black, tarry stool
C. Mild fatigue
D. Decreased appetite
Correct Answer: B. Black, tarry stool
Rationale:
An INR of 5.8 significantly increases bleeding risk. Black, tarry stool may indicate
gastrointestinal bleeding and requires immediate evaluation. The nurse should
notify the provider and anticipate interventions to reduce anticoagulation and
control bleeding based on the client's clinical condition.
,Question 4:
A conscious client with diabetes mellitus becomes pale, shaky, diaphoretic, and
confused. The blood glucose level is 48 mg/dL. Which intervention is most
appropriate?
A. Administer 15 g of rapid-acting carbohydrate
B. Administer regular insulin
C. Restrict oral fluids
D. Encourage the client to ambulate
Correct Answer: A. Administer 15 g of rapid-acting carbohydrate
Rationale:
The client's symptoms and glucose level indicate hypoglycemia. Because the client
is conscious and able to swallow, approximately 15 g of rapid-acting carbohydrate
should be administered, followed by reassessment in about 15 minutes. Additional
treatment is provided if glucose remains low.
Question 5:
A client with left-sided heart failure develops increasing dyspnea, orthopnea, and
bilateral crackles. Which pathophysiologic process best explains these findings?
A. Decreased systemic vascular resistance
B. Pulmonary fluid accumulation
C. Increased renal filtration
D. Reduced pulmonary blood flow
Correct Answer: B. Pulmonary fluid accumulation
, Rationale:
Left-sided heart failure causes blood to back up into the pulmonary circulation.
Increased hydrostatic pressure forces fluid into the pulmonary interstitial and
alveolar spaces, producing crackles, dyspnea, and orthopnea. Severe pulmonary
congestion can progress to acute pulmonary edema.
Question 6:
A client hospitalized with pneumonia has a respiratory rate of 32/min, oxygen
saturation of 84%, and increasing confusion. Which action has the highest priority?
A. Encourage oral fluids
B. Obtain a sputum specimen
C. Apply supplemental oxygen
D. Administer an antipyretic
Correct Answer: C. Apply supplemental oxygen
Rationale:
The client has significant hypoxemia accompanied by tachypnea and altered
mental status. Airway and breathing take priority under the ABC framework.
Supplemental oxygen should be initiated according to the prescribed protocol
while further assessment and treatment of the pneumonia continue.
Question 7:
A client newly diagnosed with hypertension asks which lifestyle change can help
reduce blood pressure. Which response is most appropriate?
A. Increase sodium intake during exercise
B. Reduce dietary sodium and increase physical activity
