NUR 676 Final Exam 2025 | Verified Exam Questions with Correct Answers | Graded A+ | Just Released Updated Version

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NUR 676 Final Exam 2025 | Verified Exam
Questions with Correct Answers | Graded A+
| Just Released Updated Version

1. A patient with type 2 diabetes presents with polyuria and a blood glucose of 350
mg/dL. Which initial intervention is most appropriate?
A. Administer oral metformin
B. Initiate IV insulin therapy
C. Encourage oral fluid intake
D. Order a hemoglobin A1C test
Correct Answer: B
Rationale: A blood glucose of 350 mg/dL with polyuria suggests significant
hyperglycemia, potentially leading to dehydration. IV insulin therapy is the priority to
lower glucose levels and prevent complications like hyperosmolar hyperglycemic state
(HHS). Metformin is for long-term management, fluids are supportive, and A1C is for
chronic control assessment.
2. Which finding in a patient with chronic heart failure indicates worsening condition?
A. Stable weight
B. Bilateral crackles
C. Heart rate of 80 bpm
D. Clear lung fields
Correct Answer: B
Rationale: Bilateral crackles indicate pulmonary edema, a sign of worsening heart failure
due to fluid overload. Stable weight, normal heart rate, and clear lungs suggest stable or
controlled disease.
3. A nurse practitioner is evaluating a client with suspected hypothyroidism. Which
symptom is most specific?
A. Fatigue
B. Cold intolerance
C. Weight loss
D. Anxiety
Correct Answer: B
Rationale: Cold intolerance is highly specific to hypothyroidism due to decreased
metabolic rate. Fatigue and anxiety are nonspecific, and weight loss is associated with
hyperthyroidism.
4. What is the priority action for a patient presenting with chest pain, diaphoresis, and
ST-elevation on ECG?
A. Administer nitroglycerin
B. Prepare for percutaneous coronary intervention (PCI)
C. Start IV heparin
D. Order a chest X-ray

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Correct Answer: B
Rationale: ST-elevation myocardial infarction (STEMI) requires urgent reperfusion, with
PCI being the preferred method. Nitroglycerin and heparin are adjunctive, and a chest X-
ray is not a priority.
5. Which medication is contraindicated for a patient with asthma and hypertension?
A. Metoprolol
B. Amlodipine
C. Losartan
D. Hydrochlorothiazide
Correct Answer: A
Rationale: Metoprolol, a non-selective beta-blocker, can cause bronchoconstriction,
worsening asthma. Amlodipine, losartan, and hydrochlorothiazide are safer options for
hypertension in asthmatics.
6. A client with schizophrenia reports auditory hallucinations. Which medication is
most appropriate?
A. Fluoxetine
B. Olanzapine
C. Lorazepam
D. Lithium
Correct Answer: B
Rationale: Olanzapine, an atypical antipsychotic, is effective for positive symptoms like
hallucinations in schizophrenia. Fluoxetine is for depression, lorazepam for anxiety, and
lithium for bipolar disorder.
7. What is the most concerning finding in a patient receiving IV fluids for
dehydration?
A. Urine output of 40 mL/hr
B. Crackles in lung bases
C. Heart rate of 90 bpm
D. Blood pressure of 130/85 mmHg
Correct Answer: B
Rationale: Crackles suggest fluid overload, a complication of excessive IV fluid
administration. Normal urine output, heart rate, and blood pressure indicate adequate
hydration.
8. A 55-year-old patient with COPD presents with a PaCO2 of 60 mmHg. What is the
most appropriate intervention?
A. Increase oxygen to 6 L/min
B. Initiate non-invasive ventilation
C. Administer albuterol nebulizer
D. Order a chest CT scan
Correct Answer: B
Rationale: Elevated PaCO2 indicates CO2 retention, common in COPD exacerbations.
Non-invasive ventilation (e.g., BiPAP) improves ventilation. High-flow oxygen risks
worsening hypercapnia, albuterol is supportive, and a CT scan is diagnostic but not
urgent.
9. Which laboratory value requires immediate intervention in a patient with chronic
kidney disease?

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A. Potassium of 6.5 mEq/L
B. Creatinine of 2.5 mg/dL
C. Sodium of 135 mEq/L
D. Hemoglobin of 10 g/dL
Correct Answer: A
Rationale: Hyperkalemia (potassium >6 mEq/L) can cause life-threatening arrhythmias,
requiring urgent treatment. Elevated creatinine and low hemoglobin are expected in
CKD, and sodium is normal.
10. A nurse is teaching a client with newly diagnosed hypertension about dietary
changes. Which recommendation is most effective?
A. Follow a DASH diet
B. Increase saturated fat intake
C. Limit protein consumption
D. Avoid all sodium-containing foods
Correct Answer: A
Rationale: The DASH diet, rich in fruits, vegetables, and low-fat dairy, is evidence-
based for lowering blood pressure. Increasing fats or limiting protein is not beneficial,
and total sodium avoidance is unrealistic.
11. What is the priority action for a client with a suspected anaphylactic reaction?
A. Administer IV antihistamines
B. Give intramuscular epinephrine
C. Start high-flow oxygen
D. Insert an IV line
Correct Answer: B
Rationale: Intramuscular epinephrine is the first-line treatment for anaphylaxis to reverse
airway constriction and hypotension. Oxygen and IV access are supportive, and
antihistamines are adjunctive.
12. A patient with a history of atrial fibrillation is prescribed warfarin. Which INR
range is therapeutic?
A. 1.0–1.5
B. 2.0–3.0
C. 3.5–4.5
D. 4.5–5.5
Correct Answer: B
Rationale: An INR of 2.0–3.0 is therapeutic for atrial fibrillation to prevent
thromboembolism while minimizing bleeding risk. Higher ranges increase bleeding risk,
and lower ranges are ineffective.
13. Which finding in a postoperative patient indicates a potential wound infection?
A. Clear serous drainage
B. Erythema and warmth
C. Pain rated 2/10
D. Stable temperature
Correct Answer: B
Rationale: Erythema and warmth at the wound site suggest infection. Serous drainage
and mild pain are normal, and a stable temperature does not rule out early infection.