NU 136 EXAM 3: ADVANCED NURSING
CONCEPTS AND PHARMACOLOGY
QUESTIONS WITH CORRECT ANSWERS
2026/2027
1. A patient presents with a pH of 7.32, PaCO2 of 52 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range (22-26), it is
uncompensated respiratory acidosis.
2. A nurse is caring for a client with a potassium level of 6.2 mEq/L. Which ECG change should
the nurse monitor for most closely?
A. Prominent U waves
B. ST-segment depression
,C. Widened QT interval
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves. U waves
and ST depression are associated with hypokalemia.
3. Which of the following interventions is the highest priority for a patient receiving Total
Parenteral Nutrition (TPN)?
A. Changing the IV tubing every 72 hours
B. Monitoring fingerstick glucose every 6 hours
C. Massaging the insertion site to improve flow
D. Encouraging oral intake of clear liquids
Answer: B
Conceptual Explanation: TPN contains high concentrations of glucose, placing the patient
at risk for hyperglycemia; therefore, blood glucose monitoring is essential. Tubing should
be changed every 24 hours to prevent infection.
4. A nurse is preparing to administer Digoxin to a client with heart failure. Which assessment
finding requires the nurse to withhold the medication?
A. Apical pulse of 52 beats per minute
B. Blood pressure of 110/70 mmHg
, C. Respiratory rate of 18 breaths per minute
D. Serum potassium level of 4.5 mEq/L
Answer: A
Conceptual Explanation: Digoxin is a negative chronotrope and should be withheld if the
apical pulse is less than 60 bpm in adults to prevent bradycardia.
5. The nurse is teaching a client about a new prescription for Warfarin. Which statement by
the client indicates a need for further teaching?
A. I should eat a large salad every day to stay healthy.
B. I will use a soft-bristled toothbrush.
C. I will need to have my blood tested frequently.
D. I will report any dark, tarry stools to my doctor.
Answer: A
Conceptual Explanation: Warfarin’s effectiveness is affected by Vitamin K. While patients
don’t need to avoid green leafy vegetables, they must maintain a consistent intake rather
than suddenly increasing it.
6. A client is scheduled for an IV pyelogram (IVP). What is the priority nursing assessment
before the procedure?
A. Determine the client’s ability to remain NPO
B. Measure the client’s baseline height and weight
CONCEPTS AND PHARMACOLOGY
QUESTIONS WITH CORRECT ANSWERS
2026/2027
1. A patient presents with a pH of 7.32, PaCO2 of 52 mmHg, and HCO3 of 26 mEq/L. Which
acid-base imbalance is the patient experiencing?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Conceptual Explanation: A pH below 7.35 indicates acidosis. A PaCO2 above 45 mmHg
indicates a respiratory cause. Since the HCO3 is within the normal range (22-26), it is
uncompensated respiratory acidosis.
2. A nurse is caring for a client with a potassium level of 6.2 mEq/L. Which ECG change should
the nurse monitor for most closely?
A. Prominent U waves
B. ST-segment depression
,C. Widened QT interval
D. Tall, peaked T waves
Answer: D
Conceptual Explanation: Hyperkalemia (K+ > 5.0) causes tall, peaked T waves. U waves
and ST depression are associated with hypokalemia.
3. Which of the following interventions is the highest priority for a patient receiving Total
Parenteral Nutrition (TPN)?
A. Changing the IV tubing every 72 hours
B. Monitoring fingerstick glucose every 6 hours
C. Massaging the insertion site to improve flow
D. Encouraging oral intake of clear liquids
Answer: B
Conceptual Explanation: TPN contains high concentrations of glucose, placing the patient
at risk for hyperglycemia; therefore, blood glucose monitoring is essential. Tubing should
be changed every 24 hours to prevent infection.
4. A nurse is preparing to administer Digoxin to a client with heart failure. Which assessment
finding requires the nurse to withhold the medication?
A. Apical pulse of 52 beats per minute
B. Blood pressure of 110/70 mmHg
, C. Respiratory rate of 18 breaths per minute
D. Serum potassium level of 4.5 mEq/L
Answer: A
Conceptual Explanation: Digoxin is a negative chronotrope and should be withheld if the
apical pulse is less than 60 bpm in adults to prevent bradycardia.
5. The nurse is teaching a client about a new prescription for Warfarin. Which statement by
the client indicates a need for further teaching?
A. I should eat a large salad every day to stay healthy.
B. I will use a soft-bristled toothbrush.
C. I will need to have my blood tested frequently.
D. I will report any dark, tarry stools to my doctor.
Answer: A
Conceptual Explanation: Warfarin’s effectiveness is affected by Vitamin K. While patients
don’t need to avoid green leafy vegetables, they must maintain a consistent intake rather
than suddenly increasing it.
6. A client is scheduled for an IV pyelogram (IVP). What is the priority nursing assessment
before the procedure?
A. Determine the client’s ability to remain NPO
B. Measure the client’s baseline height and weight
