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NRSG 2350 MODULE 4 COMPREHENSIVE PRACTICE EXAMINATION
CLINICAL ASSESSMENT & NURSING JUDGMENT
NRSG 2350 Module 4 Comprehensive Practice Examination
Questions 1–25
Question 1. A nurse is assessing a patient who reports sudden onset of severe chest pressure
accompanied by diaphoresis and nausea. What is the nurse's priority action?
A. Obtain a detailed dietary history
B. Assess vital signs and initiate cardiac monitoring
C. Encourage the patient to ambulate
D. Administer an antacid
Correct Answer: B
Rationale: Sudden chest pressure with autonomic symptoms may indicate acute coronary
syndrome, requiring immediate cardiovascular assessment and monitoring. Dietary history and
antacid administration delay evaluation of a potentially life-threatening condition.
Question 2. Which finding requires the most immediate nursing intervention?
A. Temperature of 37.4°C (99.3°F)
B. Heart rate of 88/min
C. Respiratory rate of 8/min
D. Blood pressure of 128/76 mm Hg
Correct Answer: C
Rationale: Bradypnea can indicate respiratory depression and impaired ventilation. The other
findings are within commonly accepted adult ranges and do not represent the same immediate
threat to airway and breathing.
Question 3. A patient becomes confused and restless several hours after surgery. Which
assessment should the nurse perform first?
,A. Assess oxygen saturation
B. Review the patient's dietary intake
C. Ask about sleep habits
D. Determine the patient's usual activity level
Correct Answer: A
Rationale: Acute confusion and restlessness may be early manifestations of hypoxemia.
Oxygenation should therefore be assessed promptly before less urgent causes are investigated.
Question 4. Which assessment finding most strongly suggests impaired peripheral tissue
perfusion?
A. Warm skin with brisk capillary refill
B. Pale, cool extremity with delayed capillary refill
C. Symmetric peripheral pulses
D. Pink nail beds
Correct Answer: B
Rationale: Coolness, pallor, and delayed capillary refill indicate reduced peripheral blood flow.
The other findings generally indicate adequate circulation.
Question 5. A nurse is evaluating a patient's pain. Which question provides the most useful
information for developing an individualized pain-management plan?
A. “Do you have pain?”
B. “Is your pain severe?”
C. “What does your pain feel like, where is it located, and what makes it better or worse?”
D. “Would you like pain medication?”
Correct Answer: C
Rationale: Comprehensive pain assessment includes location, quality, intensity, timing, and
aggravating or relieving factors. A yes/no question provides insufficient information for
individualized treatment.
Question 6. A patient has a new onset of unilateral weakness and difficulty speaking. What
should the nurse do first?
A. Offer oral fluids
B. Determine the time the symptoms began
,C. Encourage the patient to rest
D. Place the patient in Trendelenburg position
Correct Answer: B
Rationale: Determining the last-known-well time is critical when stroke is suspected because
eligibility for time-sensitive interventions depends on symptom onset. Oral intake may also be
unsafe because dysphagia is common after stroke.
Question 7. Which finding is most concerning in a patient receiving opioid analgesia?
A. Pain rating of 4/10
B. Respiratory rate of 7/min
C. Mild nausea
D. Drowsiness while resting
Correct Answer: B
Rationale: Significant respiratory depression is a potentially life-threatening adverse effect of
opioids. Mild nausea and expected drowsiness may occur, but profound bradypnea requires
immediate intervention.
Question 8. A nurse obtains a blood pressure of 184/112 mm Hg in a patient who reports severe
headache and blurred vision. What is the priority?
A. Recheck the blood pressure after the next scheduled meal
B. Assess for evidence of acute target-organ involvement
C. Encourage increased oral sodium intake
D. Document the finding as expected hypertension
Correct Answer: B
Rationale: Severe hypertension accompanied by neurologic symptoms may represent
hypertensive emergency and requires assessment for target-organ injury. Delaying evaluation
could allow potentially irreversible complications to develop.
Question 9. Which patient should the nurse assess first?
A. Patient requesting assistance with bathing
B. Patient reporting new-onset shortness of breath
C. Patient requesting a television remote
D. Patient with chronic arthritis reporting mild pain
, Correct Answer: B
Rationale: New respiratory difficulty can indicate an acute threat to oxygenation and requires
immediate assessment. The other needs are lower priority.
Question 10. A nurse is assessing a patient with suspected dehydration. Which finding supports
this conclusion?
A. Moist mucous membranes
B. Bounding pulse
C. Orthostatic hypotension
D. Increased urine output
Correct Answer: C
Rationale: Orthostatic hypotension can result from reduced circulating volume. Moist mucous
membranes, bounding pulses, and increased urine output do not typically indicate significant
dehydration.
Question 11. Which nursing action best demonstrates clinical judgment?
A. Following every intervention exactly as previously performed
B. Identifying changing patient cues and adjusting care accordingly
C. Waiting for the provider to identify every clinical concern
D. Treating all patients with the same intervention
Correct Answer: B
Rationale: Clinical judgment involves recognizing relevant cues, interpreting their significance,
and adapting interventions to changing conditions. Standardized procedures do not replace
individualized assessment.
Question 12. A patient suddenly becomes pale, diaphoretic, and hypotensive. Which additional
finding would most strongly support shock?
A. Warm extremities with normal urine output
B. Decreased urine output and altered mental status
C. Increased appetite
D. Bradycardia with hypertension
Correct Answer: B