Adult Health Nursing III – Midterm Exam
Practice Questions & Answers
Question 1
A nurse is assessing a client with acute respiratory distress syndrome (ARDS).
Which clinical manifestation is most characteristic of this condition?
A) Increased lung compliance
B) Refractory hypoxemia
C) Bradypnea
D) Hypercapnia only
Correct Answer: B) Refractory hypoxemia
Rationale: ARDS is characterized by refractory hypoxemia that does not improve
with supplemental oxygen. This occurs due to alveolar damage, pulmonary edema,
and impaired gas exchange. Early recognition and mechanical ventilation with low
tidal volumes are essential.
Question 2
A client with heart failure is prescribed carvedilol. Which instruction should the
nurse include in the teaching plan?
A) "Take the medication only when you feel short of breath."
B) "Monitor your heart rate and report if it is below 50 beats per minute."
,C) "Stop the medication if you feel dizzy."
D) "Take the medication with a high-fat meal."
Correct Answer: B) "Monitor your heart rate and report if it is below 50 beats per
minute."
Rationale: Carvedilol is a beta-blocker that slows heart rate and reduces blood
pressure. Clients should monitor their pulse and report bradycardia (below 50 beats
per minute) to the healthcare provider. The medication should be taken
consistently, not as needed.
Question 3
A nurse is caring for a client with chronic obstructive pulmonary disease (COPD)
who has a respiratory rate of 28 breaths per minute and oxygen saturation of 88%
on room air. Which intervention should the nurse implement first?
A) Administer a PRN bronchodilator
B) Apply supplemental oxygen at 2 L/min via nasal cannula
C) Encourage pursed-lip breathing
D) Notify the healthcare provider
Correct Answer: B) Apply supplemental oxygen at 2 L/min via nasal cannula
Rationale: The client is hypoxemic (SpO₂ 88%), so oxygen therapy is the priority.
Low-flow oxygen (1-2 L/min) is administered to maintain SpO₂ between 88-92%
in COPD clients to prevent oxygen-induced hypercapnia.
,Question 4
A client with acute myocardial infarction is receiving morphine sulfate. Which
assessment finding indicates a therapeutic response?
A) Relief of chest pain
B) Increased heart rate
C) Increased blood pressure
D) Decreased urine output
Correct Answer: A) Relief of chest pain
Rationale: Morphine relieves pain, reduces anxiety, and decreases myocardial
oxygen demand through vasodilation. Relief of chest pain indicates a therapeutic
response and helps limit infarct size.
Question 5
A nurse is assessing a client with a chest tube following a thoracotomy. Which
finding requires immediate intervention?
A) Tidaling in the water seal chamber
B) Continuous bubbling in the water seal chamber
C) Drainage of 75 mL in the first hour
D) Mild pain at the insertion site
Correct Answer: B) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in
the system, which can lead to ineffective lung expansion and pneumothorax. This
requires immediate assessment to identify and correct the leak.
, Question 6
A client with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L.
Which intervention should the nurse implement first?
A) Administer sodium polystyrene sulfonate
B) Administer intravenous calcium gluconate
C) Prepare for hemodialysis
D) Restrict dietary potassium
Correct Answer: B) Administer intravenous calcium gluconate
Rationale: Calcium gluconate is administered first to stabilize cardiac membranes
and prevent life-threatening dysrhythmias from hyperkalemia. It does not lower
potassium but protects the heart while other measures are implemented.
Question 7
A nurse is teaching a client with newly diagnosed type 2 diabetes mellitus about
metformin. Which statement indicates the client needs further instruction?
A) "I will take the medication with meals."
B) "I will monitor my blood glucose levels regularly."
C) "I will stop the medication before having a CT scan with contrast."
D) "I will drink alcohol in moderation."
Correct Answer: D) "I will drink alcohol in moderation."
Practice Questions & Answers
Question 1
A nurse is assessing a client with acute respiratory distress syndrome (ARDS).
Which clinical manifestation is most characteristic of this condition?
A) Increased lung compliance
B) Refractory hypoxemia
C) Bradypnea
D) Hypercapnia only
Correct Answer: B) Refractory hypoxemia
Rationale: ARDS is characterized by refractory hypoxemia that does not improve
with supplemental oxygen. This occurs due to alveolar damage, pulmonary edema,
and impaired gas exchange. Early recognition and mechanical ventilation with low
tidal volumes are essential.
Question 2
A client with heart failure is prescribed carvedilol. Which instruction should the
nurse include in the teaching plan?
A) "Take the medication only when you feel short of breath."
B) "Monitor your heart rate and report if it is below 50 beats per minute."
,C) "Stop the medication if you feel dizzy."
D) "Take the medication with a high-fat meal."
Correct Answer: B) "Monitor your heart rate and report if it is below 50 beats per
minute."
Rationale: Carvedilol is a beta-blocker that slows heart rate and reduces blood
pressure. Clients should monitor their pulse and report bradycardia (below 50 beats
per minute) to the healthcare provider. The medication should be taken
consistently, not as needed.
Question 3
A nurse is caring for a client with chronic obstructive pulmonary disease (COPD)
who has a respiratory rate of 28 breaths per minute and oxygen saturation of 88%
on room air. Which intervention should the nurse implement first?
A) Administer a PRN bronchodilator
B) Apply supplemental oxygen at 2 L/min via nasal cannula
C) Encourage pursed-lip breathing
D) Notify the healthcare provider
Correct Answer: B) Apply supplemental oxygen at 2 L/min via nasal cannula
Rationale: The client is hypoxemic (SpO₂ 88%), so oxygen therapy is the priority.
Low-flow oxygen (1-2 L/min) is administered to maintain SpO₂ between 88-92%
in COPD clients to prevent oxygen-induced hypercapnia.
,Question 4
A client with acute myocardial infarction is receiving morphine sulfate. Which
assessment finding indicates a therapeutic response?
A) Relief of chest pain
B) Increased heart rate
C) Increased blood pressure
D) Decreased urine output
Correct Answer: A) Relief of chest pain
Rationale: Morphine relieves pain, reduces anxiety, and decreases myocardial
oxygen demand through vasodilation. Relief of chest pain indicates a therapeutic
response and helps limit infarct size.
Question 5
A nurse is assessing a client with a chest tube following a thoracotomy. Which
finding requires immediate intervention?
A) Tidaling in the water seal chamber
B) Continuous bubbling in the water seal chamber
C) Drainage of 75 mL in the first hour
D) Mild pain at the insertion site
Correct Answer: B) Continuous bubbling in the water seal chamber
Rationale: Continuous bubbling in the water seal chamber indicates an air leak in
the system, which can lead to ineffective lung expansion and pneumothorax. This
requires immediate assessment to identify and correct the leak.
, Question 6
A client with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L.
Which intervention should the nurse implement first?
A) Administer sodium polystyrene sulfonate
B) Administer intravenous calcium gluconate
C) Prepare for hemodialysis
D) Restrict dietary potassium
Correct Answer: B) Administer intravenous calcium gluconate
Rationale: Calcium gluconate is administered first to stabilize cardiac membranes
and prevent life-threatening dysrhythmias from hyperkalemia. It does not lower
potassium but protects the heart while other measures are implemented.
Question 7
A nurse is teaching a client with newly diagnosed type 2 diabetes mellitus about
metformin. Which statement indicates the client needs further instruction?
A) "I will take the medication with meals."
B) "I will monitor my blood glucose levels regularly."
C) "I will stop the medication before having a CT scan with contrast."
D) "I will drink alcohol in moderation."
Correct Answer: D) "I will drink alcohol in moderation."
