NR-325 Final Exam Guide: Clinical Decision-
Making and Patient Safety Excellence latest
update 2026-2027
1. A nurse is caring for a patient with left-sided heart failure.
Which finding is most expected?
A. Pulmonary crackles
B. Peripheral edema
C. Jugular vein distention
D. Ascites
Rationale: Left-sided heart failure leads to pulmonary
congestion, resulting in crackles and dyspnea.
2. Which lab value is most important to monitor in a patient
receiving furosemide?
A. Sodium
B. Potassium
C. Calcium
D. Glucose
Rationale: Furosemide is a loop diuretic that can cause
hypokalemia.
3. A patient with COPD is receiving oxygen at 4 L/min via nasal
cannula. What is the priority concern?
A. Oxygen toxicity
B. Dry nasal mucosa
C. Suppression of respiratory drive
D. Carbon monoxide retention
, Rationale: COPD patients may rely on hypoxic drive; high
oxygen levels can suppress respirations.
4. Which symptom is an early sign of hypoglycemia?
A. Diaphoresis
B. Polyuria
C. Fruity breath
D. Kussmaul respirations
Rationale: Sweating, shakiness, and tachycardia are early signs
of low blood glucose.
5. A patient reports chest pain radiating to the left arm. What is
the nurse’s first action?
A. Administer nitroglycerin
B. Obtain a full history
C. Assess vital signs
D. Call the provider
Rationale: Assessment is always the first step to determine
patient stability.
6. Which position is best for a patient experiencing dyspnea?
A. Supine
B. Prone
C. High Fowler’s
D. Trendelenburg
Rationale: High Fowler’s maximizes lung expansion and
oxygenation.
7. A nurse is caring for a patient with chronic kidney disease.
Which lab result is expected?
, A. Low creatinine
B. Elevated BUN
C. Low potassium
D. Decreased phosphate
Rationale: Reduced kidney function causes waste products like
BUN to accumulate.
8. Which intervention helps prevent deep vein thrombosis?
A. Bed rest
B. Limiting fluids
C. Early ambulation
D. Applying heat
Rationale: Movement promotes venous return and reduces clot
formation.
9. A patient with pneumonia should be encouraged to do which
activity?
A. Restrict fluids
B. Use an incentive spirometer
C. Remain on bed rest
D. Avoid coughing
Rationale: Incentive spirometry improves lung expansion and
prevents atelectasis.
10. Which assessment finding suggests fluid volume
overload?
A. Dry mucous membranes
B. Decreased blood pressure
C. Crackles in lungs
D. Concentrated urine
Making and Patient Safety Excellence latest
update 2026-2027
1. A nurse is caring for a patient with left-sided heart failure.
Which finding is most expected?
A. Pulmonary crackles
B. Peripheral edema
C. Jugular vein distention
D. Ascites
Rationale: Left-sided heart failure leads to pulmonary
congestion, resulting in crackles and dyspnea.
2. Which lab value is most important to monitor in a patient
receiving furosemide?
A. Sodium
B. Potassium
C. Calcium
D. Glucose
Rationale: Furosemide is a loop diuretic that can cause
hypokalemia.
3. A patient with COPD is receiving oxygen at 4 L/min via nasal
cannula. What is the priority concern?
A. Oxygen toxicity
B. Dry nasal mucosa
C. Suppression of respiratory drive
D. Carbon monoxide retention
, Rationale: COPD patients may rely on hypoxic drive; high
oxygen levels can suppress respirations.
4. Which symptom is an early sign of hypoglycemia?
A. Diaphoresis
B. Polyuria
C. Fruity breath
D. Kussmaul respirations
Rationale: Sweating, shakiness, and tachycardia are early signs
of low blood glucose.
5. A patient reports chest pain radiating to the left arm. What is
the nurse’s first action?
A. Administer nitroglycerin
B. Obtain a full history
C. Assess vital signs
D. Call the provider
Rationale: Assessment is always the first step to determine
patient stability.
6. Which position is best for a patient experiencing dyspnea?
A. Supine
B. Prone
C. High Fowler’s
D. Trendelenburg
Rationale: High Fowler’s maximizes lung expansion and
oxygenation.
7. A nurse is caring for a patient with chronic kidney disease.
Which lab result is expected?
, A. Low creatinine
B. Elevated BUN
C. Low potassium
D. Decreased phosphate
Rationale: Reduced kidney function causes waste products like
BUN to accumulate.
8. Which intervention helps prevent deep vein thrombosis?
A. Bed rest
B. Limiting fluids
C. Early ambulation
D. Applying heat
Rationale: Movement promotes venous return and reduces clot
formation.
9. A patient with pneumonia should be encouraged to do which
activity?
A. Restrict fluids
B. Use an incentive spirometer
C. Remain on bed rest
D. Avoid coughing
Rationale: Incentive spirometry improves lung expansion and
prevents atelectasis.
10. Which assessment finding suggests fluid volume
overload?
A. Dry mucous membranes
B. Decreased blood pressure
C. Crackles in lungs
D. Concentrated urine
