NUR 201 ADULT HEALTH I EXAM GUIDE WITH QUESTIONS AND
CORRECT ANSWERS 2026/27
1. A 68-year-old patient with chronic heart failure presents with
sudden onset of dyspnea, orthopnea, and crackles bilaterally. The
nurse notes jugular vein distention and 3+ pitting edema. Which
medication should the nurse anticipate administering first?
A. Furosemide IV
B. Digoxin IV
C. Metoprolol oral
D. Warfarin oral
Correct Answer: A
Explanation: Furosemide (loop diuretic) is the first-line treatment
for acute decompensated heart failure with pulmonary edema as
it rapidly reduces fluid overload. Digoxin improves contractility but
acts slower. Metoprolol is contraindicated in acute
decompensation. Warfarin is for anticoagulation, not acute
symptom relief .
2. A patient with COPD has an arterial blood gas showing pH 7.32,
PaCO2 58 mmHg, PaO2 62 mmHg, and HCO3 28 mEq/L. How
should the nurse interpret these results?
A. Uncompensated respiratory alkalosis
B. Partially compensated respiratory acidosis
C. Fully compensated metabolic acidosis
D. Uncompensated metabolic alkalosis
Correct Answer: B
Explanation: The low pH (<7.35) and elevated PaCO2 (>45)
, indicate respiratory acidosis. The elevated HCO3 (>26) shows renal
compensation has begun but isn't complete since pH remains
abnormal. This is characteristic of chronic COPD with acute
exacerbation .
3. Which assessment finding in a patient with acute myocardial
infarction requires immediate intervention?
A. ST-segment elevation on ECG
B. Blood pressure 90/58 mmHg
C. Heart rate 110 bpm
D. Chest pain rating 7/10
Correct Answer: B
Explanation: Hypotension (BP 90/58) in MI suggests cardiogenic
shock or right ventricular infarction, requiring immediate fluid
resuscitation or vasopressors. ST elevation confirms MI but isn't
immediately life-threatening. Tachycardia and pain are expected
but less critical than hypotension .
4. A patient with type 2 diabetes is prescribed metformin. Which
taught instruction is most important for the nurse to provide?
A. Take with meals to reduce GI upset
B. Stop the medication if you develop a cough
C. Increase potassium-rich foods
D. Take on an empty stomach for better absorption
Correct Answer: A
Explanation: Metformin commonly causes gastrointestinal side
effects (nausea, diarrhea), which are minimized when taken with
, meals. Cough is associated with ACE inhibitors, not metformin.
Metformin doesn't affect potassium. Taking with food is preferred,
not empty stomach .
5. Which finding indicates effective treatment of diabetic
ketoacidosis (DKA)?
A. Blood glucose 250 mg/dL with clear mental status
B. Serum potassium 3.2 mEq/L
C. pH 7.28 with positive ketones
D. Bicarbonate 15 mEq/L
Correct Answer: A
Explanation: Effective DKA treatment shows glucose trending
down (250 is acceptable), improved mental status, and resolution
of acidosis. Potassium 3.2 is low (requires replacement). pH 7.28
and bicarbonate 15 indicate persistent acidosis. Positive ketones
mean DKA isn't resolved .
6. A patient with pneumonia has a oxygen saturation of 88% on
room air. Which intervention should the nurse implement first?
A. Administer oxygen via nasal cannula
B. Obtain a chest X-ray
C. Suction the airway
D. Administer IV antibiotics
Correct Answer: A
Explanation: Hypoxemia (SpO2 88%) requires immediate oxygen
administration to prevent tissue hypoxia. Chest X-ray and
antibiotics are important but secondary to restoring oxygenation.
, Suctioning is only needed if there's evidence of airway obstruction
.
7. Which laboratory value requires immediate notification of the
provider in a patient receiving heparin therapy?
A. PTT 68 seconds
B. Platelet count 85,000/mm³
C. INR 2.5
D. Hemoglobin 12 g/dL
Correct Answer: B
Explanation: Platelet count 85,000 suggests heparin-induced
thrombocytopenia (HIT), a serious complication requiring
immediate heparin discontinuation. PTT 68 is therapeutic (60-80).
INR 2.5 is for warfarin, not heparin. Hemoglobin 12 is normal .
8. A patient with chronic kidney disease has a serum potassium of
6.2 mEq/L. Which medication should the nurse anticipate
administering?
A. Calcium gluconate IV
B. Insulin and dextrose IV
C. Sodium polystyrene sulfonate oral
D. All of the above
Correct Answer: D
Explanation: Severe hyperkalemia (K+ 6.2) requires multimodal
treatment: calcium gluconate stabilizes cardiac membrane,
insulin/dextrose shifts potassium intracellularly, and sodium
CORRECT ANSWERS 2026/27
1. A 68-year-old patient with chronic heart failure presents with
sudden onset of dyspnea, orthopnea, and crackles bilaterally. The
nurse notes jugular vein distention and 3+ pitting edema. Which
medication should the nurse anticipate administering first?
A. Furosemide IV
B. Digoxin IV
C. Metoprolol oral
D. Warfarin oral
Correct Answer: A
Explanation: Furosemide (loop diuretic) is the first-line treatment
for acute decompensated heart failure with pulmonary edema as
it rapidly reduces fluid overload. Digoxin improves contractility but
acts slower. Metoprolol is contraindicated in acute
decompensation. Warfarin is for anticoagulation, not acute
symptom relief .
2. A patient with COPD has an arterial blood gas showing pH 7.32,
PaCO2 58 mmHg, PaO2 62 mmHg, and HCO3 28 mEq/L. How
should the nurse interpret these results?
A. Uncompensated respiratory alkalosis
B. Partially compensated respiratory acidosis
C. Fully compensated metabolic acidosis
D. Uncompensated metabolic alkalosis
Correct Answer: B
Explanation: The low pH (<7.35) and elevated PaCO2 (>45)
, indicate respiratory acidosis. The elevated HCO3 (>26) shows renal
compensation has begun but isn't complete since pH remains
abnormal. This is characteristic of chronic COPD with acute
exacerbation .
3. Which assessment finding in a patient with acute myocardial
infarction requires immediate intervention?
A. ST-segment elevation on ECG
B. Blood pressure 90/58 mmHg
C. Heart rate 110 bpm
D. Chest pain rating 7/10
Correct Answer: B
Explanation: Hypotension (BP 90/58) in MI suggests cardiogenic
shock or right ventricular infarction, requiring immediate fluid
resuscitation or vasopressors. ST elevation confirms MI but isn't
immediately life-threatening. Tachycardia and pain are expected
but less critical than hypotension .
4. A patient with type 2 diabetes is prescribed metformin. Which
taught instruction is most important for the nurse to provide?
A. Take with meals to reduce GI upset
B. Stop the medication if you develop a cough
C. Increase potassium-rich foods
D. Take on an empty stomach for better absorption
Correct Answer: A
Explanation: Metformin commonly causes gastrointestinal side
effects (nausea, diarrhea), which are minimized when taken with
, meals. Cough is associated with ACE inhibitors, not metformin.
Metformin doesn't affect potassium. Taking with food is preferred,
not empty stomach .
5. Which finding indicates effective treatment of diabetic
ketoacidosis (DKA)?
A. Blood glucose 250 mg/dL with clear mental status
B. Serum potassium 3.2 mEq/L
C. pH 7.28 with positive ketones
D. Bicarbonate 15 mEq/L
Correct Answer: A
Explanation: Effective DKA treatment shows glucose trending
down (250 is acceptable), improved mental status, and resolution
of acidosis. Potassium 3.2 is low (requires replacement). pH 7.28
and bicarbonate 15 indicate persistent acidosis. Positive ketones
mean DKA isn't resolved .
6. A patient with pneumonia has a oxygen saturation of 88% on
room air. Which intervention should the nurse implement first?
A. Administer oxygen via nasal cannula
B. Obtain a chest X-ray
C. Suction the airway
D. Administer IV antibiotics
Correct Answer: A
Explanation: Hypoxemia (SpO2 88%) requires immediate oxygen
administration to prevent tissue hypoxia. Chest X-ray and
antibiotics are important but secondary to restoring oxygenation.
, Suctioning is only needed if there's evidence of airway obstruction
.
7. Which laboratory value requires immediate notification of the
provider in a patient receiving heparin therapy?
A. PTT 68 seconds
B. Platelet count 85,000/mm³
C. INR 2.5
D. Hemoglobin 12 g/dL
Correct Answer: B
Explanation: Platelet count 85,000 suggests heparin-induced
thrombocytopenia (HIT), a serious complication requiring
immediate heparin discontinuation. PTT 68 is therapeutic (60-80).
INR 2.5 is for warfarin, not heparin. Hemoglobin 12 is normal .
8. A patient with chronic kidney disease has a serum potassium of
6.2 mEq/L. Which medication should the nurse anticipate
administering?
A. Calcium gluconate IV
B. Insulin and dextrose IV
C. Sodium polystyrene sulfonate oral
D. All of the above
Correct Answer: D
Explanation: Severe hyperkalemia (K+ 6.2) requires multimodal
treatment: calcium gluconate stabilizes cardiac membrane,
insulin/dextrose shifts potassium intracellularly, and sodium
