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NUR401 | Nursing Practice Exam | 2025 | Clinical Scenario Questions with Answers

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This document provides detailed clinical scenario-based questions and answers for the 2025 NUR401 nursing exam. It covers acute and chronic conditions, prioritization in emergency care, renal failure management, hemodialysis procedures, sickle cell anemia, and patient education. Each answer includes rationale, making it ideal for both practice and review.

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NUR401 practice exam 2025 Questions and Answers with
complete solution

1. When caring for a client who has just been admitted with septic shock, which of these
assessment data will be of greatest concern to the nurse?


a. Arterial oxygen saturation 90%
b. Apical pulse 110 beats/min
c. Blood pressure 88/56 mm Hg
d. Urinary output 15 mL for 2 hours - d. Urinary output 15 mL for 2 hours


2. A client is recovering from a cystoscopy. The nurse would expect to assess
which of the following regarding the client's urine after the procedure?


a. Hematuria
b. Blood clots
c. Pink-tinged
d. Anuria - c. Pink-tinged


Explanation: The bladder and urethra are usually irritated as a result of the procedure. This
causes pink-tinged urine. Large amounts of blood in the urine, anuria, or blood clots are not
expected findings after this procedure.


3. A client with congestive heart failure and pulmonary edema develops early symptoms of acute
renal failure (ARF). The nurse plans care for the client based on the knowledge that collaborative
care of the renal failure will be directed towards which of the following goals?


a. Diluting nephrotoxic substances
b. Replacing fluid volume
c. Promoting diuresis

,d. Maintaining cardiac output - d. Maintaining cardiac output


Rationale: The primary goal of treatment for ARF is to eliminate the cause and provide
supportive care while the kidneys recover. Because this patient's heart failure is causing ARF,
the care will be directed toward treatment of the heart failure. For renal failure caused by
hypertension, hypovolemia, or nephrotoxins, the other responses would be correct.


4. Which of the following is the proper positioning for a client experiencing hypovolemic shock?


a. Trendelenburg
b. Reverse Trendelenburg
c. Supine with head on a pillow
d. Supine with feet elevated - d. Supine with feet elevated - shock position


5. During discharge teaching for the client with sickle cell anemia, which of the following
precipitating factors for sickle cell crisis should the nurse instruct the client to avoid?


a. Exposure to crowds
b. Limiting fluids to 2 L per day
c. Excessive dietary iron intake
d. Caffeine and alcohol intake - a. Exposure to crowds


rationale: Exposure to crowds increases the patient's risk for infection, the most common cause
of sickle cell crisis. There is no restriction on caffeine use. Iron supplementation is generally not
recommended. A high-fluid intake is recommended.


6. A client with chronic lymphocytic leukemia is hospitalized for the treatment of severe
hemolytic anemia. Which of the following is an appropriate nursing intervention for the client?


a. Plan care to alternate periods of rest and activity.
b. Isolate the client from visitors and other clients.

,c. Encourage increased intake of fluid and fibre in the diet.
d. Provide a diet high in vitamin K and folic acid. - a. Plan care to alternate periods of rest and
activity.


Rationale: Nursing care for patients with anemia should alternate periods of rest and activity to
maintain patient mobility without causing undue fatigue. High vitamin K diets might be used for
a patient with a bleeding disorder. There is no indication that the patient is neutropenic, so
isolation is not needed. Increased intake of fluid and fiber will not improve the anemia.


7. A client is scheduled for a fistula creation due to end-stage renal disease. The
nurse would include which of the following in teaching the client about the fistula?


a. A vein and an artery will be attached surgically.
b. The fistula can be used 2 to 4 weeks after the surgery for dialysis treatment.
c. The arm should be immobilized for 4 to 6 weeks.
d. One needle will be inserted for each dialysis treatment. - d. One needle will be inserted for
each dialysis treatment


couldn't find on google, seems right though


8. A 12 years old is admitted to the emergency department after being stung by a
bee. The client's mother tells the nurse that her son has an allergy to bees and he has been stung
before. In what order of priority will the nurse address the complications?


1. Airway swelling
2. Hypotension
3. Tachypnea
4. Tachycardia


a. 2, 4, 1, 3

, b. 1, 2, 3, 4
c. 1, 3 ,2, 4
d. 3, 1, 2, 4 - c. 1, 3 ,2, 4


1. Airway swelling
3. Tachypnea
2. Hypotension
4. Tachycardia


9. A client with multiple trauma is brought to the emergency department. The
nurse initiates two peripheral intravenous (IV) sites and begins fluid resuscitation with which of
the following fluids?


a. Dextran
b. 3.0% saline
c. Dextrose 5% in water in one-half normal saline
d. 0.9% saline - d. 0.9% saline


Fluid resuscitation is accomplished by using normal saline, that is, 0.9% saline.


10. A client asks the nurse what effect dialysis will have on the medications he is
currently taking. What is the nurse's best response?


a. Dangerously low blood pressure may occur if antihypertensives are taken before dialysis
b. Once-daily medications are best taken before dialysis treatments
c. Dialysis treatments remove all medications from the blood.
d. Medications are not removed during dialysis treatments - a. Dangerously low blood pressure
may occur if antihypertensives are taken before dialysis

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