NR 341 – Complex Adult Health Final Exam
2 Questions and Answers with Rationales
2024/2025
1. A client with COPD is experiencing increased shortness of breath. Which
nursing action is most appropriate?
A. Administer high-flow oxygen at 100% via non-rebreather
B. Place the client in supine position
C. Encourage pursed-lip breathing
D. Limit fluid intake to prevent overload
Correct Answer: C. Encourage pursed-lip breathing
Rationale: Pursed-lip breathing promotes CO₂ elimination and improves
oxygenation. High O₂ can reduce respiratory drive in COPD patients.
2. A patient is post-op day 1 from abdominal surgery and complains of sudden
SOB. What should the nurse do first?
A. Administer pain medication
B. Notify the provider
,C. Check oxygen saturation
D. Elevate the legs
Correct Answer: C. Check oxygen saturation
Rationale: The priority is to assess oxygenation before intervening. Sudden SOB
post-op raises concern for PE or atelectasis.
3. A client with heart failure has 3+ pitting edema, crackles, and weight gain.
What is the priority action?
A. Reassess weight in 1 hour
B. Increase IV fluids
C. Administer prescribed diuretic
D. Place in Trendelenburg position
Correct Answer: C. Administer prescribed diuretic
Rationale: These are signs of fluid overload. Diuretics help remove excess fluid and
reduce symptoms.
4. Which finding indicates digoxin toxicity?
A. Bradycardia and yellow vision
B. Hypertension and tremors
C. Tinnitus and hyperkalemia
D. Sweating and dilated pupils
, Correct Answer: A. Bradycardia and yellow vision
Rationale: Classic signs of digoxin toxicity include visual changes (halos/yellow
vision) and bradycardia.
5. The nurse is caring for a patient with DKA. Which intervention takes priority?
A. Administer insulin IV as prescribed
B. Start sodium bicarbonate drip
C. Monitor for bradycardia
D. Limit fluid intake
Correct Answer: A. Administer insulin IV as prescribed
Rationale: Insulin corrects hyperglycemia and acidosis, which are primary
concerns in DKA.
6. A client with a chest tube for pneumothorax has continuous bubbling in the
water seal chamber. What should the nurse do?
A. Clamp the chest tube
B. Notify the provider immediately
C. Check the system for air leaks
D. Increase suction pressure
Correct Answer: C. Check the system for air leaks
Rationale: Continuous bubbling in the water seal suggests an air leak that needs
to be identified and corrected.
2 Questions and Answers with Rationales
2024/2025
1. A client with COPD is experiencing increased shortness of breath. Which
nursing action is most appropriate?
A. Administer high-flow oxygen at 100% via non-rebreather
B. Place the client in supine position
C. Encourage pursed-lip breathing
D. Limit fluid intake to prevent overload
Correct Answer: C. Encourage pursed-lip breathing
Rationale: Pursed-lip breathing promotes CO₂ elimination and improves
oxygenation. High O₂ can reduce respiratory drive in COPD patients.
2. A patient is post-op day 1 from abdominal surgery and complains of sudden
SOB. What should the nurse do first?
A. Administer pain medication
B. Notify the provider
,C. Check oxygen saturation
D. Elevate the legs
Correct Answer: C. Check oxygen saturation
Rationale: The priority is to assess oxygenation before intervening. Sudden SOB
post-op raises concern for PE or atelectasis.
3. A client with heart failure has 3+ pitting edema, crackles, and weight gain.
What is the priority action?
A. Reassess weight in 1 hour
B. Increase IV fluids
C. Administer prescribed diuretic
D. Place in Trendelenburg position
Correct Answer: C. Administer prescribed diuretic
Rationale: These are signs of fluid overload. Diuretics help remove excess fluid and
reduce symptoms.
4. Which finding indicates digoxin toxicity?
A. Bradycardia and yellow vision
B. Hypertension and tremors
C. Tinnitus and hyperkalemia
D. Sweating and dilated pupils
, Correct Answer: A. Bradycardia and yellow vision
Rationale: Classic signs of digoxin toxicity include visual changes (halos/yellow
vision) and bradycardia.
5. The nurse is caring for a patient with DKA. Which intervention takes priority?
A. Administer insulin IV as prescribed
B. Start sodium bicarbonate drip
C. Monitor for bradycardia
D. Limit fluid intake
Correct Answer: A. Administer insulin IV as prescribed
Rationale: Insulin corrects hyperglycemia and acidosis, which are primary
concerns in DKA.
6. A client with a chest tube for pneumothorax has continuous bubbling in the
water seal chamber. What should the nurse do?
A. Clamp the chest tube
B. Notify the provider immediately
C. Check the system for air leaks
D. Increase suction pressure
Correct Answer: C. Check the system for air leaks
Rationale: Continuous bubbling in the water seal suggests an air leak that needs
to be identified and corrected.
