NR 341/ NR341 COMPLEX ADULT HEALTH EXAM 2 LATEST
VERSION REAL EXAM QUESTIONS AND CORRECT ANSWERS | A
GRADE | BRAND NEW VERSION!! QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF
Core Domains
Cardiovascular Disorders and Hemodynamic Monitoring
Respiratory Failure and Mechanical Ventilation
Neurological Emergencies and Increased Intracranial Pressure
Renal Failure and Fluid-Electrolyte Balance
Endocrine Crises and Metabolic Emergencies
Sepsis, Shock, and Multiple Organ Dysfunction
Critical Care Pharmacology and Medication Safety
Ethics, Legal Issues, and End-of-Life Care in Critical Settings
Introduction
This examination assesses the clinical knowledge and applied
judgment required of nurses caring for complex adult health
patients in acute and critical care settings. It evaluates
understanding of cardiovascular, respiratory, neurological, renal,
and endocrine emergencies; sepsis and shock management; critical
care pharmacology; and ethical and legal responsibilities. Items are
presented as multiple-choice and scenario-based questions
requiring candidates to analyze realistic patient situations and
select the most appropriate, evidence-based nursing action. The
examination emphasizes clinical decision-making, patient safety,
and prioritization of care.
SECTION ONE: QUESTIONS 1–100
1. A patient is admitted with acute decompensated heart failure.
Which assessment finding requires immediate nursing
,intervention?
A. Blood pressure 110/70 mm Hg
B. Heart rate 88 beats per minute
🟢 C. Pink frothy sputum with crackles bilaterally
D. Urine output of 40 mL per hour
🔴 RATIONALE: Pink frothy sputum with bilateral crackles
indicates pulmonary edema, a life-threatening complication
requiring immediate intervention. A blood pressure of 110/70 mm
Hg and heart rate of 88 are within acceptable ranges. Urine
output of 40 mL per hour is adequate.
2. A patient with a pulmonary artery catheter has a pulmonary
artery wedge pressure of 22 mm Hg. Which condition does this
finding most likely indicate?
A. Hypovolemia
B. Right ventricular failure
🟢 C. Left ventricular failure
D. Pulmonary embolism
🔴 RATIONALE: An elevated PAWP (normal 6-12 mm Hg) reflects
increased left ventricular filling pressures, consistent with left
ventricular failure. Hypovolemia would decrease PAWP. Right
ventricular failure and pulmonary embolism typically affect right-
sided pressures.
3. A patient is receiving mechanical ventilation. Which action is
the priority when the high-pressure alarm sounds?
A. Increase the tidal volume
B. Document the alarm
🟢 C. Assess the patient and the ventilator circuit for the cause
D. Silence the alarm and reassess in fifteen minutes
,🔴 RATIONALE: The high-pressure alarm indicates increased
airway resistance or decreased compliance. The priority is to
assess the patient and circuit for causes such as secretions,
kinking, or bronchospasm. Increasing tidal volume, documenting
only, and delaying reassessment are unsafe.
4. A patient with increased intracranial pressure is positioned
with the head of the bed elevated. What is the primary rationale
for this position?
A. To increase cerebral blood flow
B. To prevent aspiration
🟢 C. To promote venous drainage and reduce intracranial
pressure
D. To improve lung expansion
🔴 RATIONALE: Elevating the head of the bed promotes venous
drainage from the head, which helps reduce intracranial pressure.
Increasing cerebral blood flow, preventing aspiration, and
improving lung expansion are not the primary rationale.
5. A patient with acute kidney injury has a serum potassium
level of 6.8 mEq/L. Which intervention is the priority?
A. Administer a potassium supplement
B. Encourage a high-potassium diet
🟢 C. Prepare for administration of calcium gluconate and insulin
with glucose
D. Restrict fluid intake
🔴 RATIONALE: A potassium level of 6.8 mEq/L is dangerously
high and can cause cardiac dysrhythmias. Calcium gluconate
stabilizes the myocardium, and insulin with glucose shifts
potassium into cells. Administering potassium, high-potassium
, diet, and fluid restriction are not immediate treatments for
hyperkalemia.
6. A patient with diabetic ketoacidosis is receiving an insulin
infusion. Which assessment finding indicates the treatment is
effective?
A. Increased serum glucose
B. Decreased serum potassium
🟢 C. Decreasing serum glucose and improving pH
D. Increased urine ketones
🔴 RATIONALE: Effective DKA treatment includes decreasing
serum glucose and improving pH as ketosis resolves. Increased
glucose and increased ketones indicate worsening. Decreasing
potassium may occur but is not the primary indicator of
effectiveness.
7. A patient is in septic shock. Which finding is most consistent
with this condition?
A. Warm, flushed skin with hypertension
B. Bradycardia with hypertension
🟢 C. Hypotension with tachycardia and warm extremities in early
stages
D. Decreased cardiac output with cold extremities in all stages
🔴 RATIONALE: Early septic shock is characterized by
hypotension, tachycardia, and warm extremities due to
vasodilation. Warm flushed skin with hypertension, bradycardia
with hypertension, and cold extremities in all stages are not
characteristic of early septic shock.
8. A patient is receiving heparin therapy. Which laboratory value
should the nurse monitor to evaluate therapeutic effect?
VERSION REAL EXAM QUESTIONS AND CORRECT ANSWERS | A
GRADE | BRAND NEW VERSION!! QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF
Core Domains
Cardiovascular Disorders and Hemodynamic Monitoring
Respiratory Failure and Mechanical Ventilation
Neurological Emergencies and Increased Intracranial Pressure
Renal Failure and Fluid-Electrolyte Balance
Endocrine Crises and Metabolic Emergencies
Sepsis, Shock, and Multiple Organ Dysfunction
Critical Care Pharmacology and Medication Safety
Ethics, Legal Issues, and End-of-Life Care in Critical Settings
Introduction
This examination assesses the clinical knowledge and applied
judgment required of nurses caring for complex adult health
patients in acute and critical care settings. It evaluates
understanding of cardiovascular, respiratory, neurological, renal,
and endocrine emergencies; sepsis and shock management; critical
care pharmacology; and ethical and legal responsibilities. Items are
presented as multiple-choice and scenario-based questions
requiring candidates to analyze realistic patient situations and
select the most appropriate, evidence-based nursing action. The
examination emphasizes clinical decision-making, patient safety,
and prioritization of care.
SECTION ONE: QUESTIONS 1–100
1. A patient is admitted with acute decompensated heart failure.
Which assessment finding requires immediate nursing
,intervention?
A. Blood pressure 110/70 mm Hg
B. Heart rate 88 beats per minute
🟢 C. Pink frothy sputum with crackles bilaterally
D. Urine output of 40 mL per hour
🔴 RATIONALE: Pink frothy sputum with bilateral crackles
indicates pulmonary edema, a life-threatening complication
requiring immediate intervention. A blood pressure of 110/70 mm
Hg and heart rate of 88 are within acceptable ranges. Urine
output of 40 mL per hour is adequate.
2. A patient with a pulmonary artery catheter has a pulmonary
artery wedge pressure of 22 mm Hg. Which condition does this
finding most likely indicate?
A. Hypovolemia
B. Right ventricular failure
🟢 C. Left ventricular failure
D. Pulmonary embolism
🔴 RATIONALE: An elevated PAWP (normal 6-12 mm Hg) reflects
increased left ventricular filling pressures, consistent with left
ventricular failure. Hypovolemia would decrease PAWP. Right
ventricular failure and pulmonary embolism typically affect right-
sided pressures.
3. A patient is receiving mechanical ventilation. Which action is
the priority when the high-pressure alarm sounds?
A. Increase the tidal volume
B. Document the alarm
🟢 C. Assess the patient and the ventilator circuit for the cause
D. Silence the alarm and reassess in fifteen minutes
,🔴 RATIONALE: The high-pressure alarm indicates increased
airway resistance or decreased compliance. The priority is to
assess the patient and circuit for causes such as secretions,
kinking, or bronchospasm. Increasing tidal volume, documenting
only, and delaying reassessment are unsafe.
4. A patient with increased intracranial pressure is positioned
with the head of the bed elevated. What is the primary rationale
for this position?
A. To increase cerebral blood flow
B. To prevent aspiration
🟢 C. To promote venous drainage and reduce intracranial
pressure
D. To improve lung expansion
🔴 RATIONALE: Elevating the head of the bed promotes venous
drainage from the head, which helps reduce intracranial pressure.
Increasing cerebral blood flow, preventing aspiration, and
improving lung expansion are not the primary rationale.
5. A patient with acute kidney injury has a serum potassium
level of 6.8 mEq/L. Which intervention is the priority?
A. Administer a potassium supplement
B. Encourage a high-potassium diet
🟢 C. Prepare for administration of calcium gluconate and insulin
with glucose
D. Restrict fluid intake
🔴 RATIONALE: A potassium level of 6.8 mEq/L is dangerously
high and can cause cardiac dysrhythmias. Calcium gluconate
stabilizes the myocardium, and insulin with glucose shifts
potassium into cells. Administering potassium, high-potassium
, diet, and fluid restriction are not immediate treatments for
hyperkalemia.
6. A patient with diabetic ketoacidosis is receiving an insulin
infusion. Which assessment finding indicates the treatment is
effective?
A. Increased serum glucose
B. Decreased serum potassium
🟢 C. Decreasing serum glucose and improving pH
D. Increased urine ketones
🔴 RATIONALE: Effective DKA treatment includes decreasing
serum glucose and improving pH as ketosis resolves. Increased
glucose and increased ketones indicate worsening. Decreasing
potassium may occur but is not the primary indicator of
effectiveness.
7. A patient is in septic shock. Which finding is most consistent
with this condition?
A. Warm, flushed skin with hypertension
B. Bradycardia with hypertension
🟢 C. Hypotension with tachycardia and warm extremities in early
stages
D. Decreased cardiac output with cold extremities in all stages
🔴 RATIONALE: Early septic shock is characterized by
hypotension, tachycardia, and warm extremities due to
vasodilation. Warm flushed skin with hypertension, bradycardia
with hypertension, and cold extremities in all stages are not
characteristic of early septic shock.
8. A patient is receiving heparin therapy. Which laboratory value
should the nurse monitor to evaluate therapeutic effect?
