NR 325 EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED AND WELL DETAILED
ANSWERS) PLUS RATIONALES 2026/2027 Q&A |
INSTANT DOWNLOAD PDF.
Core Domains
• Cardiovascular Disorders and Emergency Management
• Respiratory Disorders and Mechanical Ventilation
• Renal and Urinary System Disorders
• Neurological Disorders and Increased Intracranial Pressure
• Endocrine and Metabolic Disorders
• Gastrointestinal, Hepatic, and Pancreatic Disorders
• Hematologic and Oncologic Disorders
• Fluid, Electrolyte, and Acid-Base Imbalances
• Perioperative and Postoperative Nursing Care
• Emergency, Critical Care, and Multisystem Disorders
Introduction
The NR 325 Adult Health II examination assesses the clinical knowledge and
applied judgment required for safe, evidence-based nursing care of adults with
complex, multisystem health alterations. This comprehensive assessment evaluates
understanding of cardiovascular, respiratory, renal, neurologic, endocrine,
gastrointestinal, hematologic, and critical care disorders. Questions are structured
as multiple-choice and scenario-based items requiring applied clinical decision-
making. Emphasis is placed on real-world application, patient safety,
prioritization, regulatory compliance, ethical practice, and the integration of
professional nursing standards into medical-surgical practice.
Section One: Questions 1–100
,1. A nurse is caring for a client admitted with acute myocardial infarction
(MI). The client suddenly reports severe chest pain unrelieved by
nitroglycerin. Which action should the nurse take first?
A. Administer morphine sulfate as prescribed
B. Obtain a 12-lead ECG
C. Administer oxygen via nasal cannula
D. Notify the healthcare provider
C
RATIONALE: In acute MI, the priority is improving oxygen delivery to
ischemic myocardial tissue. According to ABCs, oxygenation is the first priority.
While ECG and medications are important, oxygen should be administered
immediately to prevent further myocardial damage.
2. A nurse is caring for a client with septic shock. Which finding indicates that
the client is progressing into the late stage of shock?
A. Warm, flushed skin
B. Bounding pulse
C. Hypotension unresponsive to fluids
D. Increased urine output
C
RATIONALE: Late septic shock is characterized by persistent hypotension
despite fluid resuscitation, indicating severe circulatory failure. Early stages show
warm skin and bounding pulse, while late stages reflect poor perfusion and organ
failure.
3. A nurse is assessing a client with increased intracranial pressure (ICP).
Which finding requires immediate intervention?
A. Headache
B. Projectile vomiting
C. Unequal pupils
D. Restlessness
C
, RATIONALE: Unequal pupils indicate possible brain herniation, a life-
threatening complication of increased ICP. Immediate intervention is required to
prevent irreversible brain damage.
4. A nurse is caring for a client with acute respiratory distress syndrome
(ARDS). Which assessment finding is most concerning?
A. Respiratory rate of 24/min
B. Oxygen saturation of 85% despite oxygen therapy
C. Mild anxiety
D. Use of accessory muscles
B
RATIONALE: ARDS involves severe hypoxemia that is often refractory to
oxygen therapy. An SpO₂ of 85% indicates critical oxygenation failure and
requires urgent intervention such as mechanical ventilation.
5. Because of normal changes due to aging, the nurse anticipates that a 75-
year-old client's serum creatinine level might be what amount?
A. 0.3 mg/dL
B. 2.4 mg/dL
C. 4.8 mg/dL
D. 6.4 mg/dL
A
RATIONALE: Serum creatinine level reflects the byproduct of muscle
breakdown, and an older adult with less muscle mass can be expected to have a
lower than normal level such as 0.3 mg/dL. The normal creatinine range for adults
is 0.5–1.5 mg/dL. A higher than normal level would not be expected for an older
patient.
6. During an assessment of a client's cranial nerves, the nurse states, "Please
stick out your tongue." The nurse observes that the tongue deviates markedly
to the right side. What is the patient most likely exhibiting?
A. Sluggish oculomotor response
B. Abnormal hypoglossal nerve response
, C. First cranial nerve (CN I) damage
D. Absence of Homans sign
B
RATIONALE: Cranial nerve XII (Hypoglossal) is tested by having the patient
stick out the tongue. An abnormal finding is that the tongue deviates to either side.
Cranial nerve I is the olfactory nerve; cranial nerve III is the oculomotor nerve.
Homans sign is a check for thrombophlebitis in the calves.
7. During the palpation of a client's chest for expansion, the nurse notices a
decrease in the expansion of the right side. This finding is consistent with what
health problem? Select all that apply.
A. Emphysema
B. Pneumonia
C. Pleural effusion
D. Heart failure
E. Pneumothorax
B, C, E
RATIONALE: Thoracic expansion is decreased on the affected side in
pneumonia, pneumothorax, and pleural effusion. Bilateral chest expansion is
decreased in emphysema. Heart failure would not result in a change in chest
expansion.
8. A client with Cushing's Syndrome is concerned about having a head cold
every few weeks. What should the nurse do to address this client's concern?
A. Review coping strategies
B. Encourage daily weights
C. Plan for frequent rest periods
D. Assess for protein and vitamin intake
D
RATIONALE: The patient with Cushing syndrome is at risk for infection due
to the overproduction of glucocorticoids. The nurse should teach the importance of
increasing intake of protein and vitamins C & A, which are all needed to support
ANSWERS (VERIFIED AND WELL DETAILED
ANSWERS) PLUS RATIONALES 2026/2027 Q&A |
INSTANT DOWNLOAD PDF.
Core Domains
• Cardiovascular Disorders and Emergency Management
• Respiratory Disorders and Mechanical Ventilation
• Renal and Urinary System Disorders
• Neurological Disorders and Increased Intracranial Pressure
• Endocrine and Metabolic Disorders
• Gastrointestinal, Hepatic, and Pancreatic Disorders
• Hematologic and Oncologic Disorders
• Fluid, Electrolyte, and Acid-Base Imbalances
• Perioperative and Postoperative Nursing Care
• Emergency, Critical Care, and Multisystem Disorders
Introduction
The NR 325 Adult Health II examination assesses the clinical knowledge and
applied judgment required for safe, evidence-based nursing care of adults with
complex, multisystem health alterations. This comprehensive assessment evaluates
understanding of cardiovascular, respiratory, renal, neurologic, endocrine,
gastrointestinal, hematologic, and critical care disorders. Questions are structured
as multiple-choice and scenario-based items requiring applied clinical decision-
making. Emphasis is placed on real-world application, patient safety,
prioritization, regulatory compliance, ethical practice, and the integration of
professional nursing standards into medical-surgical practice.
Section One: Questions 1–100
,1. A nurse is caring for a client admitted with acute myocardial infarction
(MI). The client suddenly reports severe chest pain unrelieved by
nitroglycerin. Which action should the nurse take first?
A. Administer morphine sulfate as prescribed
B. Obtain a 12-lead ECG
C. Administer oxygen via nasal cannula
D. Notify the healthcare provider
C
RATIONALE: In acute MI, the priority is improving oxygen delivery to
ischemic myocardial tissue. According to ABCs, oxygenation is the first priority.
While ECG and medications are important, oxygen should be administered
immediately to prevent further myocardial damage.
2. A nurse is caring for a client with septic shock. Which finding indicates that
the client is progressing into the late stage of shock?
A. Warm, flushed skin
B. Bounding pulse
C. Hypotension unresponsive to fluids
D. Increased urine output
C
RATIONALE: Late septic shock is characterized by persistent hypotension
despite fluid resuscitation, indicating severe circulatory failure. Early stages show
warm skin and bounding pulse, while late stages reflect poor perfusion and organ
failure.
3. A nurse is assessing a client with increased intracranial pressure (ICP).
Which finding requires immediate intervention?
A. Headache
B. Projectile vomiting
C. Unequal pupils
D. Restlessness
C
, RATIONALE: Unequal pupils indicate possible brain herniation, a life-
threatening complication of increased ICP. Immediate intervention is required to
prevent irreversible brain damage.
4. A nurse is caring for a client with acute respiratory distress syndrome
(ARDS). Which assessment finding is most concerning?
A. Respiratory rate of 24/min
B. Oxygen saturation of 85% despite oxygen therapy
C. Mild anxiety
D. Use of accessory muscles
B
RATIONALE: ARDS involves severe hypoxemia that is often refractory to
oxygen therapy. An SpO₂ of 85% indicates critical oxygenation failure and
requires urgent intervention such as mechanical ventilation.
5. Because of normal changes due to aging, the nurse anticipates that a 75-
year-old client's serum creatinine level might be what amount?
A. 0.3 mg/dL
B. 2.4 mg/dL
C. 4.8 mg/dL
D. 6.4 mg/dL
A
RATIONALE: Serum creatinine level reflects the byproduct of muscle
breakdown, and an older adult with less muscle mass can be expected to have a
lower than normal level such as 0.3 mg/dL. The normal creatinine range for adults
is 0.5–1.5 mg/dL. A higher than normal level would not be expected for an older
patient.
6. During an assessment of a client's cranial nerves, the nurse states, "Please
stick out your tongue." The nurse observes that the tongue deviates markedly
to the right side. What is the patient most likely exhibiting?
A. Sluggish oculomotor response
B. Abnormal hypoglossal nerve response
, C. First cranial nerve (CN I) damage
D. Absence of Homans sign
B
RATIONALE: Cranial nerve XII (Hypoglossal) is tested by having the patient
stick out the tongue. An abnormal finding is that the tongue deviates to either side.
Cranial nerve I is the olfactory nerve; cranial nerve III is the oculomotor nerve.
Homans sign is a check for thrombophlebitis in the calves.
7. During the palpation of a client's chest for expansion, the nurse notices a
decrease in the expansion of the right side. This finding is consistent with what
health problem? Select all that apply.
A. Emphysema
B. Pneumonia
C. Pleural effusion
D. Heart failure
E. Pneumothorax
B, C, E
RATIONALE: Thoracic expansion is decreased on the affected side in
pneumonia, pneumothorax, and pleural effusion. Bilateral chest expansion is
decreased in emphysema. Heart failure would not result in a change in chest
expansion.
8. A client with Cushing's Syndrome is concerned about having a head cold
every few weeks. What should the nurse do to address this client's concern?
A. Review coping strategies
B. Encourage daily weights
C. Plan for frequent rest periods
D. Assess for protein and vitamin intake
D
RATIONALE: The patient with Cushing syndrome is at risk for infection due
to the overproduction of glucocorticoids. The nurse should teach the importance of
increasing intake of protein and vitamins C & A, which are all needed to support
