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NURS 355 Exam 2 Questions with Detailed
Verified Answers
Question: Which information obtained by the nurse in the endocrine
clinic about a patient who has been taking prednisone 40 mg daily for 3
weeks is most important to report to the health care provider?
a. Patient's blood pressure is 148/94 mm Hg.
b. Patient has bilateral 2+ pitting ankle edema.
c. Patient stopped taking the medication 2 days ago.
d. Patient has not been taking the prescribed vitamin D.
Ans✅ ✅: Answer: Patient stopped taking the medication 2 days ago.
Rationale: Sudden cessation of corticosteroids after taking the medication for a week
or more can lead to adrenal insufficiency, with problems such as severe hypotension
and hypoglycemia. The patient will need immediate evaluation by the health care
provider to prevent or treat adrenal insufficiency. The other information will also be
reported but does not require rapid treatment.
Question: Which finding for a patient who has hypothyroidism and
hypertension indicates that the nurse should contact the health care
provider before administering levothyroxine (Synthroid)?
a. Increased thyroxine (T4) level
b. Blood pressure 112/62 mm Hg
c. Distant and difficult to hear heart sounds
d. Elevated thyroid stimulating hormone level
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Ans✅ ✅: Answer: Increased thyroxine (T4) level
Rationale: An increased thyroxine level indicates the levothyroxine dose needs to be
decreased. The other data are consistent with hypothyroidism and the nurse should
administer the levothyroxine.
Question: The nurse teaches a patient about pulmonary spirometry
testing. Which statement by the patient indicates teaching was effective?
a. "I should use my inhaler right before the test."
b. "I won't eat or drink anything 8 hours before the test."
c. "I will inhale deeply and blow out hard during the test."
d. "My blood pressure and pulse will be checked every 15 minutes."
Ans✅ ✅: Answer: "I will inhale deeply and blow out hard during the test."
Rationale: For spirometry, the patient should inhale deeply and exhale as long, hard,
and fast as possible. The other actions are not needed. The administration of inhaled
bronchodilators should be avoided 6 hours before the procedure.
Question: A patient with acute shortness of breath is admitted to the
hospital. Which action should the nurse take during the initial assessment
of the patient?
a. Ask the patient to lie down for complete a full physical assessment.
b. Complete the health history and check for allergies before treatment.
c. Briefly ask specific questions about this episode of respiratory distress.
d. Delay the physical assessment to first complete pulmonary function
tests.
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Ans✅ ✅: Answer: Briefly ask specific questions about this episode of respiratory
distress
Rationale: When a patient has severe respiratory distress, only information pertinent
to the current episode is obtained, and a more thorough assessment is deferred until
later. Obtaining a comprehensive health history or full physical examination is
unnecessary until the acute distress has resolved. Brief questioning and a focused
physical assessment should be done rapidly to help determine the cause of the distress
and suggest treatment. Checking for allergies is important, but it is not appropriate to
complete the entire admission database at this time. The initial respiratory assessment
must be completed before any diagnostic tests or interventions can be ordered.
Question: The nurse prepares a patient who has a left-sided pleural
effusion for a thoracentesis. How should the nurse position the patient?
a. High-Fowler's position with the left arm extended
b. Supine with the head of the bed elevated 30 degrees
c. On the right side with the left arm extended above the head
d. Sitting upright with the arms supported on an over bed table
Ans✅ ✅: Answer: Sitting upright with the arms supported on an over bed table
Rationale: The upright position with the arms supported increases lung expansion,
allows fluid to collect at the lung bases, and expands the intercostal space so that
access to the pleural space is easier. The other positions would increase the work of
breathing for the patient and make it more difficult for the health care provider
performing the thoracentesis.
Question: A patient with diabetes has arterial blood gas (ABG) results
pH 7.28; PaCO2 34 mm Hg; PaO2 85 mm Hg; HCO3?2- 18 mEq/L. The
nurse would expect which finding?
a. Intercostal retractions
b. Kussmaul respirations
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c. Low oxygen saturation (SpO2)
d. Decreased venous O2 pressure
Ans✅ ✅: Answer: Kussmaul respirations
Rationale: Kussmaul (deep and rapid) respirations are a compensatory mechanism for
metabolic acidosis. The low pH and low bicarbonate result indicate metabolic acidosis.
Acidosis does not cause intercostal retractions, a low oxygen saturation rate, and a
decrease in venous O2 pressure.
Question: On auscultation of a patient's lungs, the nurse hears low-
pitched, bubbling sounds during inhalation in the lower third bilaterally.
How should the nurse document this finding?
a. Inspiratory crackles at the bases
b. Expiratory wheezes in both lungs
c. Abnormal lung sounds in the apices of both lungs
d. Pleural friction rub in the right and left lower lobes
Ans✅ ✅: Answer: Inspiratory crackles at the bases
Rationale: Crackles are low-pitched, bubbling sounds usually heard on inspiration.
Wheezes are high-pitched sounds. They can be heard during the expiratory or
inspiratory phase of the respiratory cycle. The lower third of both lungs are the bases,
not apices. Pleural friction rubs are grating sounds that are usually heard during both
inspiration and expiration.
Question: The nurse palpates the posterior chest and notes absent
fremitus while the patient says "99". Which action should the nurse take
next?
a. Palpate the anterior chest and observe for barrel chest.
NURS 355 Exam 2 Questions with Detailed
Verified Answers
Question: Which information obtained by the nurse in the endocrine
clinic about a patient who has been taking prednisone 40 mg daily for 3
weeks is most important to report to the health care provider?
a. Patient's blood pressure is 148/94 mm Hg.
b. Patient has bilateral 2+ pitting ankle edema.
c. Patient stopped taking the medication 2 days ago.
d. Patient has not been taking the prescribed vitamin D.
Ans✅ ✅: Answer: Patient stopped taking the medication 2 days ago.
Rationale: Sudden cessation of corticosteroids after taking the medication for a week
or more can lead to adrenal insufficiency, with problems such as severe hypotension
and hypoglycemia. The patient will need immediate evaluation by the health care
provider to prevent or treat adrenal insufficiency. The other information will also be
reported but does not require rapid treatment.
Question: Which finding for a patient who has hypothyroidism and
hypertension indicates that the nurse should contact the health care
provider before administering levothyroxine (Synthroid)?
a. Increased thyroxine (T4) level
b. Blood pressure 112/62 mm Hg
c. Distant and difficult to hear heart sounds
d. Elevated thyroid stimulating hormone level
, Page | 2
Ans✅ ✅: Answer: Increased thyroxine (T4) level
Rationale: An increased thyroxine level indicates the levothyroxine dose needs to be
decreased. The other data are consistent with hypothyroidism and the nurse should
administer the levothyroxine.
Question: The nurse teaches a patient about pulmonary spirometry
testing. Which statement by the patient indicates teaching was effective?
a. "I should use my inhaler right before the test."
b. "I won't eat or drink anything 8 hours before the test."
c. "I will inhale deeply and blow out hard during the test."
d. "My blood pressure and pulse will be checked every 15 minutes."
Ans✅ ✅: Answer: "I will inhale deeply and blow out hard during the test."
Rationale: For spirometry, the patient should inhale deeply and exhale as long, hard,
and fast as possible. The other actions are not needed. The administration of inhaled
bronchodilators should be avoided 6 hours before the procedure.
Question: A patient with acute shortness of breath is admitted to the
hospital. Which action should the nurse take during the initial assessment
of the patient?
a. Ask the patient to lie down for complete a full physical assessment.
b. Complete the health history and check for allergies before treatment.
c. Briefly ask specific questions about this episode of respiratory distress.
d. Delay the physical assessment to first complete pulmonary function
tests.
, Page | 3
Ans✅ ✅: Answer: Briefly ask specific questions about this episode of respiratory
distress
Rationale: When a patient has severe respiratory distress, only information pertinent
to the current episode is obtained, and a more thorough assessment is deferred until
later. Obtaining a comprehensive health history or full physical examination is
unnecessary until the acute distress has resolved. Brief questioning and a focused
physical assessment should be done rapidly to help determine the cause of the distress
and suggest treatment. Checking for allergies is important, but it is not appropriate to
complete the entire admission database at this time. The initial respiratory assessment
must be completed before any diagnostic tests or interventions can be ordered.
Question: The nurse prepares a patient who has a left-sided pleural
effusion for a thoracentesis. How should the nurse position the patient?
a. High-Fowler's position with the left arm extended
b. Supine with the head of the bed elevated 30 degrees
c. On the right side with the left arm extended above the head
d. Sitting upright with the arms supported on an over bed table
Ans✅ ✅: Answer: Sitting upright with the arms supported on an over bed table
Rationale: The upright position with the arms supported increases lung expansion,
allows fluid to collect at the lung bases, and expands the intercostal space so that
access to the pleural space is easier. The other positions would increase the work of
breathing for the patient and make it more difficult for the health care provider
performing the thoracentesis.
Question: A patient with diabetes has arterial blood gas (ABG) results
pH 7.28; PaCO2 34 mm Hg; PaO2 85 mm Hg; HCO3?2- 18 mEq/L. The
nurse would expect which finding?
a. Intercostal retractions
b. Kussmaul respirations
, Page | 4
c. Low oxygen saturation (SpO2)
d. Decreased venous O2 pressure
Ans✅ ✅: Answer: Kussmaul respirations
Rationale: Kussmaul (deep and rapid) respirations are a compensatory mechanism for
metabolic acidosis. The low pH and low bicarbonate result indicate metabolic acidosis.
Acidosis does not cause intercostal retractions, a low oxygen saturation rate, and a
decrease in venous O2 pressure.
Question: On auscultation of a patient's lungs, the nurse hears low-
pitched, bubbling sounds during inhalation in the lower third bilaterally.
How should the nurse document this finding?
a. Inspiratory crackles at the bases
b. Expiratory wheezes in both lungs
c. Abnormal lung sounds in the apices of both lungs
d. Pleural friction rub in the right and left lower lobes
Ans✅ ✅: Answer: Inspiratory crackles at the bases
Rationale: Crackles are low-pitched, bubbling sounds usually heard on inspiration.
Wheezes are high-pitched sounds. They can be heard during the expiratory or
inspiratory phase of the respiratory cycle. The lower third of both lungs are the bases,
not apices. Pleural friction rubs are grating sounds that are usually heard during both
inspiration and expiration.
Question: The nurse palpates the posterior chest and notes absent
fremitus while the patient says "99". Which action should the nurse take
next?
a. Palpate the anterior chest and observe for barrel chest.
