NR 224 Exam 1: The Real Test Results
(Summer 2025- 2026)
Original NR 224 Exam Practice Questions
1. A patient with COPD is experiencing shortness of
breath. Which intervention should the nurse implement
first?
A. Administer high-flow oxygen at 10 L/min
B. Encourage pursed-lip breathing
C. Place the patient in a supine position
D. Begin chest physiotherapy
Answer: B
Explanation: Pursed-lip breathing helps reduce dyspnea and improves gas exchange.
High-flow oxygen could suppress respiratory drive in COPD patients.
2. The nurse is caring for a patient with heart failure.
Which finding indicates fluid overload?
A. Dry mucous membranes
B. Bilateral lower extremity edema
C. Weak, thready pulse
D. Decreased blood pressure
Answer: B
Explanation: Edema is a classic sign of fluid retention in heart failure.
,3. A patient is prescribed furosemide. Which electrolyte
should the nurse monitor closely?
A. Sodium
B. Potassium
C. Magnesium
D. Phosphate
Answer: B
Explanation: Furosemide is a loop diuretic that can cause hypokalemia.
4. The nurse is caring for a patient with type 1 diabetes.
Which insulin should be used for rapid correction of
hyperglycemia?
A. Glargine
B. NPH
C. Lispro
D. Detemir
Answer: C
Explanation: Lispro is rapid-acting insulin, used for postprandial hyperglycemia.
5. A patient presents with sudden chest pain radiating to
the left arm. Which action should the nurse take first?
A. Obtain vital signs
B. Administer aspirin
C. Apply oxygen
D. Notify the healthcare provider
Answer: C
Explanation: Oxygen is given immediately to improve myocardial oxygenation in
suspected MI.
,6. A patient with a new tracheostomy is receiving
mechanical ventilation. Which finding requires immediate
intervention?
A. Moist secretions in the tubing
B. SpO₂ 85%
C. Heart rate 90 bpm
D. Patient alert and oriented
Answer: B
Explanation: SpO₂ of 85% indicates hypoxemia and requires urgent action.
7. The nurse is assessing a patient with dehydration.
Which sign is most indicative of fluid deficit?
A. Bounding pulse
B. Weight gain
C. Tachycardia
D. Peripheral edema
Answer: C
Explanation: Tachycardia is an early compensatory response to decreased circulating
volume.
8. A patient with pneumonia has a fever of 102°F. Which
lab value would the nurse expect to be elevated?
A. Hemoglobin
B. White blood cell count
C. Platelets
D. Sodium
Answer: B
Explanation: Infection stimulates leukocytosis, increasing WBC count.
, 9. Which position is best for a patient with dyspnea?
A. Supine
B. Trendelenburg
C. High Fowler’s
D. Prone
Answer: C
Explanation: High Fowler’s position allows maximum lung expansion and eases
breathing.
10. A patient is prescribed digoxin. Which sign indicates
digoxin toxicity?
A. Bradycardia, nausea, visual disturbances
B. Tachycardia, hypertension
C. Polyuria, polydipsia
D. Edema and weight gain
Answer: A
Explanation: Digoxin toxicity can cause GI symptoms, visual changes, and bradycardia.
11. A patient with COPD is anxious and restless. Which is
the priority nursing intervention?
A. Reassure the patient
B. Assess oxygen saturation
C. Encourage coughing
D. Administer bronchodilator
Answer: B
Explanation: Anxiety may indicate hypoxia; assessing oxygenation is the priority.
(Summer 2025- 2026)
Original NR 224 Exam Practice Questions
1. A patient with COPD is experiencing shortness of
breath. Which intervention should the nurse implement
first?
A. Administer high-flow oxygen at 10 L/min
B. Encourage pursed-lip breathing
C. Place the patient in a supine position
D. Begin chest physiotherapy
Answer: B
Explanation: Pursed-lip breathing helps reduce dyspnea and improves gas exchange.
High-flow oxygen could suppress respiratory drive in COPD patients.
2. The nurse is caring for a patient with heart failure.
Which finding indicates fluid overload?
A. Dry mucous membranes
B. Bilateral lower extremity edema
C. Weak, thready pulse
D. Decreased blood pressure
Answer: B
Explanation: Edema is a classic sign of fluid retention in heart failure.
,3. A patient is prescribed furosemide. Which electrolyte
should the nurse monitor closely?
A. Sodium
B. Potassium
C. Magnesium
D. Phosphate
Answer: B
Explanation: Furosemide is a loop diuretic that can cause hypokalemia.
4. The nurse is caring for a patient with type 1 diabetes.
Which insulin should be used for rapid correction of
hyperglycemia?
A. Glargine
B. NPH
C. Lispro
D. Detemir
Answer: C
Explanation: Lispro is rapid-acting insulin, used for postprandial hyperglycemia.
5. A patient presents with sudden chest pain radiating to
the left arm. Which action should the nurse take first?
A. Obtain vital signs
B. Administer aspirin
C. Apply oxygen
D. Notify the healthcare provider
Answer: C
Explanation: Oxygen is given immediately to improve myocardial oxygenation in
suspected MI.
,6. A patient with a new tracheostomy is receiving
mechanical ventilation. Which finding requires immediate
intervention?
A. Moist secretions in the tubing
B. SpO₂ 85%
C. Heart rate 90 bpm
D. Patient alert and oriented
Answer: B
Explanation: SpO₂ of 85% indicates hypoxemia and requires urgent action.
7. The nurse is assessing a patient with dehydration.
Which sign is most indicative of fluid deficit?
A. Bounding pulse
B. Weight gain
C. Tachycardia
D. Peripheral edema
Answer: C
Explanation: Tachycardia is an early compensatory response to decreased circulating
volume.
8. A patient with pneumonia has a fever of 102°F. Which
lab value would the nurse expect to be elevated?
A. Hemoglobin
B. White blood cell count
C. Platelets
D. Sodium
Answer: B
Explanation: Infection stimulates leukocytosis, increasing WBC count.
, 9. Which position is best for a patient with dyspnea?
A. Supine
B. Trendelenburg
C. High Fowler’s
D. Prone
Answer: C
Explanation: High Fowler’s position allows maximum lung expansion and eases
breathing.
10. A patient is prescribed digoxin. Which sign indicates
digoxin toxicity?
A. Bradycardia, nausea, visual disturbances
B. Tachycardia, hypertension
C. Polyuria, polydipsia
D. Edema and weight gain
Answer: A
Explanation: Digoxin toxicity can cause GI symptoms, visual changes, and bradycardia.
11. A patient with COPD is anxious and restless. Which is
the priority nursing intervention?
A. Reassure the patient
B. Assess oxygen saturation
C. Encourage coughing
D. Administer bronchodilator
Answer: B
Explanation: Anxiety may indicate hypoxia; assessing oxygenation is the priority.
