NR 325 EXAM – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES |DOWNLOAD AND PASS | LATEST EXAM UPDATE
2026/2027
Core Domains
Cardiovascular Disorders
Respiratory Disorders
Neurological Disorders
Endocrine Disorders
Renal and Urinary Disorders
Gastrointestinal and Hepatobiliary Disorders
Shock, Sepsis, and Critical Care
Fluid, Electrolyte, and Acid-Base Balance
Perioperative and Pain Management
Ethics, Safety, and Professional Standards
Introduction
This comprehensive examination assesses the clinical knowledge and decision-
making skills essential for professional nursing practice in adult health. The
assessment evaluates foundational theory, applied professional knowledge,
regulatory compliance, ethical standards, and real-world clinical judgment across
medical-surgical populations. Multiple-choice and scenario-based questions
emphasize safe prioritization, evidence-based interventions, and patient-centered
care. Candidates must demonstrate the ability to synthesize assessment data, identify
complications, and implement appropriate nursing actions within the scope of
practice.
SECTION ONE: QUESTIONS 1–50
,Question 1
A nurse is assessing a client with suspected systemic inflammatory response
syndrome (SIRS). Which finding meets the criteria for this condition?
A. Temperature of 100.0°F (37.8°C)
B. Heart rate of 78 beats per minute
C. Respiratory rate of 24 breaths per minute
D. White blood cell count of 9,000/mm³
🟢 Correct Answer: C. Respiratory rate of 24 breaths per minute
🔴 Explanation: SIRS criteria include a respiratory rate greater than 20 breaths per
minute, temperature greater than 100.4°F or less than 96.8°F, heart rate greater
than 90 beats per minute, and WBC count greater than 12,000/mm³ or less than
4,000/mm³. Only the respiratory rate meets the threshold.
Question 2
A client with acute decompensated heart failure has gained 2.5 kg since yesterday.
Which nursing action is most appropriate?
A. Restrict all oral fluids immediately
B. Administer the prescribed diuretic and notify the provider
C. Reassess the weight in 4 hours
D. Document the finding as expected
🟢 Correct Answer: B. Administer the prescribed diuretic and notify the provider
🔴 Explanation: A weight gain of 2.5 kg in 24 hours indicates significant fluid
retention requiring prompt intervention. The nurse should administer prescribed
diuretics and notify the provider, as medication adjustments may be needed.
Question 3
,A nurse is caring for a patient with a T6 spinal cord injury who develops a severe
pounding headache, nasal congestion, and blood pressure of 190/110 mm Hg.
What is the priority nursing action?
A. Administer PRN antihypertensive medication
B. Place the patient in a supine position
C. Sit the patient upright and check for bladder distention
D. Obtain a STAT head CT scan
🟢 Correct Answer: C. Sit the patient upright and check for bladder distention
🔴 Explanation: These findings indicate autonomic dysreflexia, a life-threatening
emergency. The priority is to sit the patient upright to reduce blood pressure and
identify the noxious stimulus, most commonly a full bladder.
Question 4
A patient with acute respiratory distress syndrome (ARDS) has an oxygen saturation
of 85% despite receiving 100% oxygen via non-rebreather mask. Which
pathophysiological mechanism explains this finding?
A. Decreased alveolar surface tension
B. Damage to the alveolar-capillary membrane
C. Increased surfactant production
D. Localized bronchial constriction
🟢 Correct Answer: B. Damage to the alveolar-capillary membrane
🔴 Explanation: ARDS is characterized by non-cardiogenic pulmonary edema
resulting from damage to the alveolar-capillary membrane. This leads to severe
hypoxemia that is often refractory to oxygen therapy due to intrapulmonary
shunting.
Question 5
, A nurse is preparing to administer intravenous potassium chloride to a patient with
hypokalemia. Which safety measure is critical?
A. Administer the potassium by rapid IV push
B. Infuse the potassium via a peripheral line at a maximum rate of 10 mEq/hour
C. Mix the potassium in 50 mL of sterile water
D. Verify the patient has adequate urine output prior to administration
🟢 Correct Answer: D. Verify the patient has adequate urine output prior to
administration
🔴 Explanation: Potassium should never be given by IV push. Adequate renal
function must be confirmed before administration to prevent hyperkalemia. The
maximum recommended infusion rate is typically 10 mEq/hour through a
peripheral line, but confirming urine output is the essential safety assessment.
Question 6
A client with cirrhosis and ascites is receiving spironolactone. Which laboratory
finding indicates a need to discontinue the medication?
A. Serum sodium of 132 mEq/L
B. Serum potassium of 5.8 mEq/L
C. Blood urea nitrogen of 20 mg/dL
D. Serum creatinine of 1.2 mg/dL
🟢 Correct Answer: B. Serum potassium of 5.8 mEq/L
🔴 Explanation: Spironolactone is a potassium-sparing diuretic. Hyperkalemia is a
significant adverse effect, and a potassium level of 5.8 mEq/L is dangerously
elevated, requiring discontinuation of the medication.
Question 7
ANSWERS | PLUS RATIONALES |DOWNLOAD AND PASS | LATEST EXAM UPDATE
2026/2027
Core Domains
Cardiovascular Disorders
Respiratory Disorders
Neurological Disorders
Endocrine Disorders
Renal and Urinary Disorders
Gastrointestinal and Hepatobiliary Disorders
Shock, Sepsis, and Critical Care
Fluid, Electrolyte, and Acid-Base Balance
Perioperative and Pain Management
Ethics, Safety, and Professional Standards
Introduction
This comprehensive examination assesses the clinical knowledge and decision-
making skills essential for professional nursing practice in adult health. The
assessment evaluates foundational theory, applied professional knowledge,
regulatory compliance, ethical standards, and real-world clinical judgment across
medical-surgical populations. Multiple-choice and scenario-based questions
emphasize safe prioritization, evidence-based interventions, and patient-centered
care. Candidates must demonstrate the ability to synthesize assessment data, identify
complications, and implement appropriate nursing actions within the scope of
practice.
SECTION ONE: QUESTIONS 1–50
,Question 1
A nurse is assessing a client with suspected systemic inflammatory response
syndrome (SIRS). Which finding meets the criteria for this condition?
A. Temperature of 100.0°F (37.8°C)
B. Heart rate of 78 beats per minute
C. Respiratory rate of 24 breaths per minute
D. White blood cell count of 9,000/mm³
🟢 Correct Answer: C. Respiratory rate of 24 breaths per minute
🔴 Explanation: SIRS criteria include a respiratory rate greater than 20 breaths per
minute, temperature greater than 100.4°F or less than 96.8°F, heart rate greater
than 90 beats per minute, and WBC count greater than 12,000/mm³ or less than
4,000/mm³. Only the respiratory rate meets the threshold.
Question 2
A client with acute decompensated heart failure has gained 2.5 kg since yesterday.
Which nursing action is most appropriate?
A. Restrict all oral fluids immediately
B. Administer the prescribed diuretic and notify the provider
C. Reassess the weight in 4 hours
D. Document the finding as expected
🟢 Correct Answer: B. Administer the prescribed diuretic and notify the provider
🔴 Explanation: A weight gain of 2.5 kg in 24 hours indicates significant fluid
retention requiring prompt intervention. The nurse should administer prescribed
diuretics and notify the provider, as medication adjustments may be needed.
Question 3
,A nurse is caring for a patient with a T6 spinal cord injury who develops a severe
pounding headache, nasal congestion, and blood pressure of 190/110 mm Hg.
What is the priority nursing action?
A. Administer PRN antihypertensive medication
B. Place the patient in a supine position
C. Sit the patient upright and check for bladder distention
D. Obtain a STAT head CT scan
🟢 Correct Answer: C. Sit the patient upright and check for bladder distention
🔴 Explanation: These findings indicate autonomic dysreflexia, a life-threatening
emergency. The priority is to sit the patient upright to reduce blood pressure and
identify the noxious stimulus, most commonly a full bladder.
Question 4
A patient with acute respiratory distress syndrome (ARDS) has an oxygen saturation
of 85% despite receiving 100% oxygen via non-rebreather mask. Which
pathophysiological mechanism explains this finding?
A. Decreased alveolar surface tension
B. Damage to the alveolar-capillary membrane
C. Increased surfactant production
D. Localized bronchial constriction
🟢 Correct Answer: B. Damage to the alveolar-capillary membrane
🔴 Explanation: ARDS is characterized by non-cardiogenic pulmonary edema
resulting from damage to the alveolar-capillary membrane. This leads to severe
hypoxemia that is often refractory to oxygen therapy due to intrapulmonary
shunting.
Question 5
, A nurse is preparing to administer intravenous potassium chloride to a patient with
hypokalemia. Which safety measure is critical?
A. Administer the potassium by rapid IV push
B. Infuse the potassium via a peripheral line at a maximum rate of 10 mEq/hour
C. Mix the potassium in 50 mL of sterile water
D. Verify the patient has adequate urine output prior to administration
🟢 Correct Answer: D. Verify the patient has adequate urine output prior to
administration
🔴 Explanation: Potassium should never be given by IV push. Adequate renal
function must be confirmed before administration to prevent hyperkalemia. The
maximum recommended infusion rate is typically 10 mEq/hour through a
peripheral line, but confirming urine output is the essential safety assessment.
Question 6
A client with cirrhosis and ascites is receiving spironolactone. Which laboratory
finding indicates a need to discontinue the medication?
A. Serum sodium of 132 mEq/L
B. Serum potassium of 5.8 mEq/L
C. Blood urea nitrogen of 20 mg/dL
D. Serum creatinine of 1.2 mg/dL
🟢 Correct Answer: B. Serum potassium of 5.8 mEq/L
🔴 Explanation: Spironolactone is a potassium-sparing diuretic. Hyperkalemia is a
significant adverse effect, and a potassium level of 5.8 mEq/L is dangerously
elevated, requiring discontinuation of the medication.
Question 7
