NRSG 220 Midterm Exam Fall 2025. Questions & Answers {100% all correct}.

NRSG 220 Midterm Exam Fall 2025. Questions & Answers (Answer key below) 1. After a change of shift, you are assigned to care for the following patients. Which patient should you assess first? a. A 60-year old patient on a ventilator for whom a sterile sputum specimen must be sent to the lab. b. A 55-year old with COPD and a pulse oximetry reading from the previous shift of 90% saturation. c. A 70-year old with pneumonia who needs to be started on intravenous (IV) antibiotics. d. A 50-year old with asthma who complains of shortness of breath after using a bronchodilator. 2. You are the nurse preparing a patient with iron deficiency anemia for discharge and are about to complete required teaching. What foods should you suggest the patient eat? a. Cereal and milk b. Caesar salad c. Egg with wheat toast and orange juice d. Baked potato with butter 3. Select ALL the signs and symptoms that can present in pernicious anemia: a. Erythema b. Paresthesia of hands and feet c. Racing thoughts d. Extreme hunger e. Unsteady gait f. Shortness of breath with activity 4. A newly admitted client has sickle cell crisis. The nurse is planning care based on assessment of the client. The client is complaining of severe pain in his feet and hands. The pulse oximetry is 89. Which of the following interventions would be implemented first? Assume that there are orders for each intervention. a. Adjust the room temperature b. Give a bolus of IV fluids c. Start O2 d. Administer Morphine 2 mg IV push 5. What will the nurse identify as symptoms of hypovolemic shock in a patient? SATA a. Temperature of 97.6°F (36.4°C) b. Restlessness c. Decrease in blood pressure of 20 mm Hg when the patient sits up d. Capillary refill time greater than 3 seconds e. Sinus bradycardia of 55 beats per minute 6. What type of solution below can be used to treat cerebral edema? a. Isotonic b. Hypertonic c. Hypotonic 7. A client shows the nurse two pictures of the same lesion, taken one month apart. Which assessment finding requires nursing intervention? a. The light pink color of the lesion is the same in both photographs. b. The lesion has almost disappeared by the time of the second photograph. c. The lesion borders have expanded and are shaped differently in the second picture. d. The lesion's well-approximated margins and size look no different in either photograph. 8. The female client admitted for an unrelated diagnosis asks the nurse to check her back because "it itches all the time in that one spot." When the nurse assesses the client's back, the nurse notes an irregular-shaped lesion with some scabbed-over areas surrounding the lesion. Which action should the nurse implement first? a. Notify the HCP to check the lesion on rounds. b. Measure the lesion and note the color. c. Apply lotion to the lesion. d. Instruct the client to make sure the HCP checks the lesion. 9. You provide care for a patient diagnosed with malignant melanoma. Which treatment do you expect? a. Cryotherapy b. Intralesional vinblastine c. Full thickness surgical removal d. Topical application of fluorouracil 10. The nurse performs health screenings on a group of clients. The nurse identifies which individual is at greatest risk for developing skin cancer? a. An adolescent with dark skin who works as a lifeguard at the local pool b. An adult client with light skin who works as a cashier at the local store c. A middle age adult client with dark skin who swims daily at a health club d. An older adult client with light skin who worked as a roofer for 40 years 11. The clinic nurse assesses the skin of a client with a diagnosis of psoriasis. The nurse understands which characteristic is associated with this skin disorder? a. Clear, thin nail beds b. Red-purplish scaly lesions c. Oily skin and no episodes or pruritus d. Silvery-white scaly patches on the scalp, elbows, knees, and sacral regions. 12. A nurse is providing education in a community setting about general measures to avoid excessive sun exposure. Which of the following recommendations is appropriate? a. Wear loosely woven clothing for added ventilation b. Apply sunscreen only after going in the water c. Apply sunscreen with an SPF of 30 or higher before sun exposure d. Avoid peak exposure hours from 9am to 1pm 13. The client received 10 units of Humulin R, a short-acting insulin,at 0700. At 1030 the unlicensed assistive personnel (UAP) tells the nurse the client has a headache and is really acting "funny." Which intervention should the nurse implement first? a. Instruct the UAP to obtain the blood glucose level b. Have the client drink eight (8) ounces of orange juice c. Go to the client's room and assess the client for hypoglycemia d. Prepare to administer one (1) ampule 50% dextrose intravenously 14. The client diagnosed with type 2 diabetes is admitted to the intensive care unit with hyperosmolar hyperglycemic nonketotic syndrome (HHNS) coma. Which assessment data should the nurse expect the client to exhibit? a. Kussmaul's respirations b. Diarrhea and epigastric c. Dry mucous membranes d. Ketone breath odor 15. The elderly client is admitted to the intensive care department diagnosed with severe HHNS. Which collaborative intervention should the nurse include in the plan of care? a. Infuse 0.9% normal saline intravenously. b. Administer intermediate-acting insulin. c. Perform blood glucometer checks daily. d. Monitor arterial blood gas results. 16. A patient with chronic obstructive pulmonary disease (COPD). Which intervention for airway management should you delegate to an experienced nursing assistant? a. Assisting the patient to sit up on the side of the bed b. Instructing the patient to cough effectively. c. Teaching the patient to use incentive spirometry. d. Auscultation of breath sounds every 4 hours. 17. A patient is presenting with chronic obstructive pulmonary disease. The patient has a chronic productive cough with dyspnea on exertion. Arterial blood gasses show a low oxygen level and high carbon dioxide level in the blood. On assessment, the patient has cyanosis in the lips and edema in the abdomen and legs. Based on your nursing knowledge and the patient’s symptoms, you suspect the patient suffers from what type of COPD? a. Emphysema b. Pneumonia c. Chronic bronchitis d. Pneumothorax 18. A patient with asthma is prescribed to take inhaled Salmeterol and Fluticasone for long- term management of asthma. You observe the patient taking these medications. Which option below best describes the correct order in how to take these medications? a. The patient inhales the Salmeterol first and then waits 5 minutes before inhaling the Fluticasone. b. The patient inhales the Fluticasone first and then waits 5 minutes before inhaling the Salmeterol. c. The patient inhales the Salmeterol first and then waits 1 minute before inhaling the Fluticasone. d. The patient inhales the Fluticasone and immediately inhales the Salmeterol. 19. An alarm beeps notifying you that one of your patient’s oxygen saturation is reading 89%. You arrive to the patient’s room, and see the patient comfortably resting in bed watching television. The patient is already on 2 L of oxygen via nasal cannula. The patient is admitted for COPD exacerbation. Your next nursing action would be: a. Continue to monitor the patient b. Increase the patient’s oxygen level to 3 L c. Notify the doctor for further orders d. Turn off the alarm settings 20. The client diagnosed with diverticulitis is complaining of severe pain in the left lower quadrant and has an oral temperature of 100.6 degrees Fahrenheit. Which intervention should the nurse implement first? a. Notify the HCP b. Document the findings in the chart c. Administer an oral antipyretic d. Assess the client's abdomen 21. The nurse is teaching the client diagnosed with diverticulosis. Which instruction should the nurse include in the teaching session? a. Discuss the importance of drinking 1,000mL of water daily b. Instruct the client to avoid exercise c. Teach the client about eating a low-residue diet d. Explain the need to have daily bowel movements 22. The client is admitted to the medical unit with a diagnosis of acute diverticulitis. Which health-care provider's order should the nurse question? a. Insert a nasogastric tube. b. Start IV fluids c. Put the client on a full liquid diet. d. Place the client on bed rest with bathroom privileges. 23. The client is diagnosed with an acute exacerbation of ulcerative colitis. Which intervention should the nurse implement? a. Provide a high fiber diet b. Rest the client's bowels c. Assess vital signs daily d. Administer antacids orally 24. What are the characteristics of Crohn’s Disease? SATA a. Lead Pipe Appearance b. Cobblestone Appearance c. Primarily affects ileum (RLQ), but also impacts whole GI tract d. Primary affects sigmoid colon and rectum e. Steatorrhea f. Bloody Diarrhea g. Surgery is curative h. Surgery is not curative 25. You’re providing education to a group of nursing students about the care of a patient with appendicitis. Which statement by a nursing student requires re-education about your teaching? a. “After an appendectomy the patient may have a nasogastric tube to remove stomach fluids and swallowed air.” b. “Non-pharmacological techniques for a patient with appendicitis include application of heat to the abdomen and the side-lying position.” c. “The nurse should monitor the patient for signs and symptoms of peritonitis which includes increased heart rate, respirations, temperature, abdominal distention, and intense abdominal pain.” d. “It is normal for some patients to have shoulder pain after a laparoscopic appendectomy.” 26. The fluid shift that occurs in peritonitis may result in which of the following? SATA a. Intracellular fluid moving into the peritoneal cavity b. Significant increase in circulatory volume c. Decreased circulatory volume and hypovolemic shock d. Increased bowel motility caused by increased fluid volume