UR 202/ NUR202 Exam 1 –
N
Maternal-Newborn Nursing Review
ACTUAL EXAM 2026/2027 |
Maternal-Newborn Nursing Review |
Verified Q&A | Pass Guaranteed - A+
Graded
=======================================================================
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========
ISCLAIMER: This is a practice study resource based on standard undergraduate
D
medical-surgical nursing curriculum, evidence-based clinical guidelines (AHA, ADA,
GOLD, GINA, CDC), and the NCLEX-RN test plan. It is designed for learning and
self-assessment purposes only. It does not represent actual exam content.
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========
PART A – MULTIPLE CHOICE (Q1–60)
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========
* *Q1 (Respiratory – COPD oxygen therapy):**
A 68-year-old patient with severe COPD presents with acute exacerbation.
SpO₂ is 84% on room air. Which oxygen saturation target is most appropriate
for this patient per GOLD guidelines?
. 94–98% to ensure adequate tissue oxygenation
A
B. 88–92% to avoid CO₂ retention and respiratory acidosis
C. 85–88% to minimize oxygen toxicity
D. 92–96% as the standard target for all respiratory patients
* *[CORRECT]** B
*Rationale: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2026
,r ecommends a target SpO₂ of 88–92% in patients with COPD at risk of hypercapnic
respiratory failure; higher oxygen levels can suppress the hypoxic drive and worsen
CO₂ retention. Option A represents the standard target for patients without COPD and
would be dangerous in this population. Option C is too low and could lead to
significant hypoxemia. Option D fails to account for the unique pathophysiology of
COPD. Clinical pearl: Always verify baseline CO₂ levels and use controlled low-flow
oxygen in COPD patients.*
---
* *Q2 (Respiratory – COPD pharmacology):**
A patient with COPD is prescribed tiotropium (Spiriva). The nurse understands
this medication belongs to which drug class?
. Short-acting beta-2 agonist (SABA)
A
B. Long-acting muscarinic antagonist (LAMA)
C. Inhaled corticosteroid (ICS)
D. Methylxanthine bronchodilator
* *[CORRECT]** B
*Rationale: Tiotropium is a long-acting muscarinic antagonist (LAMA) that provides
24-hour bronchodilation by blocking acetylcholine at muscarinic receptors; it is a
cornerstone of maintenance therapy in COPD per GOLD guidelines. Option A describes
albuterol, used for acute rescue. Option C describes medications like fluticasone.
Option D describes theophylline, which is rarely used today due to toxicity.
Clinical pearl: LAMAs improve lung function, reduce exacerbations, and enhance
quality of life in COPD patients.*
---
* *Q3 (Respiratory – Asthma action plan):**
A 22-year-old with moderate persistent asthma uses a peak flow meter. The nurse
knows that a peak flow reading in the "yellow zone" (60–80% of personal best)
indicates which action?
. Continue current medications; no changes needed
A
B. Add quick-relief medication and contact healthcare provider
C. Seek emergency medical attention immediately
D. Discontinue controller medications and use rescue inhaler only
* *[CORRECT]** B
*Rationale: The yellow zone (60–80% of personal best) signals caution—airways are
narrowing and the patient should add quick-relief medication (SABA) and notify the
provider per GINA guidelines. Option A describes the green zone (>80%). Option C
, escribes the red zone (<60%). Option D is dangerous and contradicts asthma
d
management principles. Clinical pearl: Teach patients to check peak flow at the
same time daily and record results to identify patterns.*
---
* *Q4 (Respiratory – Pneumonia assessment):**
A 55-year-old is admitted with community-acquired pneumonia. Which assessment
finding is the earliest indicator of hypoxemia?
. Cyanosis of the lips and nail beds
A
B. Restlessness and confusion
C. Tachypnea and use of accessory muscles
D. Bradycardia and hypotension
* *[CORRECT]** C
*Rationale: Tachypnea (respiratory rate >20) and use of accessory muscles are
among the earliest compensatory responses to hypoxemia as the body attempts to
increase oxygen intake; these occur before visible cyanosis or mental status changes.
Option A appears late when SpO₂ is <85%. Option B indicates cerebral hypoxia, a
later sign. Option D represents decompensation and shock. Clinical pearl: In
pneumonia, monitor respiratory rate closely—it is often the first vital sign to
change and the most sensitive indicator of deterioration.*
---
* *Q5 (Respiratory – Pneumonia CURB-65):**
A patient with pneumonia has the following: Confusion (new onset), BUN 22 mg/dL,
Respiratory rate 28, Blood pressure 118/72, Age 62. What is the CURB-65 score
and recommended disposition?
. Score 2; outpatient treatment with oral antibiotics
A
B. Score 3; consider hospital admission
C. Score 4; ICU admission recommended
D. Score 1; home observation only
* *[CORRECT]** B
*Rationale: CURB-65 scoring: Confusion (+1), Urea >20 (+1), RR ≥30 (+1—this patient
has RR 28, so no point), BP <90 systolic or ≤60 diastolic (0), Age ≥65 (0). Total
score = 2 (Confusion + Urea). However, RR 28 is close to threshold; some scoring
systems use RR >30. With score 2, consider short hospitalization or close outpatient
follow-up; score 3+ warrants hospital admission. The patient has confusion and
elevated BUN (2 points), indicating moderate risk. Clinical pearl: CURB-65 helps
standardize pneumonia severity assessment; always combine with clinical judgment
, and oxygenation status.*
---
* *Q6 (Respiratory – Pulmonary embolism diagnostics):**
A patient presents with sudden-onset dyspnea, pleuritic chest pain, and
tachycardia. Wells score is intermediate. What is the next best diagnostic step?
. Immediate CT pulmonary angiography (CTPA) without D-dimer
A
B. D-dimer testing to rule out PE if negative
C. Ventilation-perfusion (V/Q) scan as first-line
D. Pulmonary angiography as the gold standard initial test
* *[CORRECT]** B
*Rationale: For intermediate Wells score, D-dimer testing is appropriate; if negative,
PE is effectively ruled out and invasive testing can be avoided per ACCP guidelines.
Option A is reserved for high probability or when D-dimer would be falsely positive.
Option C is used when CTPA is contraindicated (e.g., renal impairment). Option D is
invasive and reserved for equivocal cases. Clinical pearl: D-dimer is sensitive but
not specific—elevated in pregnancy, infection, surgery, and malignancy.*
---
* *Q7 (Respiratory – PE anticoagulation):**
A patient with confirmed PE and no contraindications is started on anticoagulation.
Which statement about direct oral anticoagulants (DOACs) is correct?
. DOACs require routine INR monitoring like warfarin
A
B. Rivaroxaban and apixaban are preferred over warfarin for most patients
C. DOACs are contraindicated in all patients with renal impairment
D. Protamine sulfate reverses all DOACs effectively
* *[CORRECT]** B
*Rationale: DOACs (rivaroxaban, apixaban, dabigatran, edoxaban) are preferred over
warfarin for most patients with PE due to fixed dosing, fewer drug interactions,
and no routine monitoring per CHEST guidelines. Option A is incorrect—DOACs do not
require INR monitoring. Option C is too absolute—reduced doses are used in mild-moderate
renal impairment. Option D is incorrect—protamine reverses heparin, not DOACs;
andexanet alfa or idarucizumab are specific reversal agents. Clinical pearl: Always
assess creatinine clearance before prescribing DOACs and adjust dosing accordingly.*
---
**Q8 (Respiratory – ARDS management):**
N
Maternal-Newborn Nursing Review
ACTUAL EXAM 2026/2027 |
Maternal-Newborn Nursing Review |
Verified Q&A | Pass Guaranteed - A+
Graded
=======================================================================
=
========
ISCLAIMER: This is a practice study resource based on standard undergraduate
D
medical-surgical nursing curriculum, evidence-based clinical guidelines (AHA, ADA,
GOLD, GINA, CDC), and the NCLEX-RN test plan. It is designed for learning and
self-assessment purposes only. It does not represent actual exam content.
=======================================================================
=
========
PART A – MULTIPLE CHOICE (Q1–60)
========================================================================
========
* *Q1 (Respiratory – COPD oxygen therapy):**
A 68-year-old patient with severe COPD presents with acute exacerbation.
SpO₂ is 84% on room air. Which oxygen saturation target is most appropriate
for this patient per GOLD guidelines?
. 94–98% to ensure adequate tissue oxygenation
A
B. 88–92% to avoid CO₂ retention and respiratory acidosis
C. 85–88% to minimize oxygen toxicity
D. 92–96% as the standard target for all respiratory patients
* *[CORRECT]** B
*Rationale: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2026
,r ecommends a target SpO₂ of 88–92% in patients with COPD at risk of hypercapnic
respiratory failure; higher oxygen levels can suppress the hypoxic drive and worsen
CO₂ retention. Option A represents the standard target for patients without COPD and
would be dangerous in this population. Option C is too low and could lead to
significant hypoxemia. Option D fails to account for the unique pathophysiology of
COPD. Clinical pearl: Always verify baseline CO₂ levels and use controlled low-flow
oxygen in COPD patients.*
---
* *Q2 (Respiratory – COPD pharmacology):**
A patient with COPD is prescribed tiotropium (Spiriva). The nurse understands
this medication belongs to which drug class?
. Short-acting beta-2 agonist (SABA)
A
B. Long-acting muscarinic antagonist (LAMA)
C. Inhaled corticosteroid (ICS)
D. Methylxanthine bronchodilator
* *[CORRECT]** B
*Rationale: Tiotropium is a long-acting muscarinic antagonist (LAMA) that provides
24-hour bronchodilation by blocking acetylcholine at muscarinic receptors; it is a
cornerstone of maintenance therapy in COPD per GOLD guidelines. Option A describes
albuterol, used for acute rescue. Option C describes medications like fluticasone.
Option D describes theophylline, which is rarely used today due to toxicity.
Clinical pearl: LAMAs improve lung function, reduce exacerbations, and enhance
quality of life in COPD patients.*
---
* *Q3 (Respiratory – Asthma action plan):**
A 22-year-old with moderate persistent asthma uses a peak flow meter. The nurse
knows that a peak flow reading in the "yellow zone" (60–80% of personal best)
indicates which action?
. Continue current medications; no changes needed
A
B. Add quick-relief medication and contact healthcare provider
C. Seek emergency medical attention immediately
D. Discontinue controller medications and use rescue inhaler only
* *[CORRECT]** B
*Rationale: The yellow zone (60–80% of personal best) signals caution—airways are
narrowing and the patient should add quick-relief medication (SABA) and notify the
provider per GINA guidelines. Option A describes the green zone (>80%). Option C
, escribes the red zone (<60%). Option D is dangerous and contradicts asthma
d
management principles. Clinical pearl: Teach patients to check peak flow at the
same time daily and record results to identify patterns.*
---
* *Q4 (Respiratory – Pneumonia assessment):**
A 55-year-old is admitted with community-acquired pneumonia. Which assessment
finding is the earliest indicator of hypoxemia?
. Cyanosis of the lips and nail beds
A
B. Restlessness and confusion
C. Tachypnea and use of accessory muscles
D. Bradycardia and hypotension
* *[CORRECT]** C
*Rationale: Tachypnea (respiratory rate >20) and use of accessory muscles are
among the earliest compensatory responses to hypoxemia as the body attempts to
increase oxygen intake; these occur before visible cyanosis or mental status changes.
Option A appears late when SpO₂ is <85%. Option B indicates cerebral hypoxia, a
later sign. Option D represents decompensation and shock. Clinical pearl: In
pneumonia, monitor respiratory rate closely—it is often the first vital sign to
change and the most sensitive indicator of deterioration.*
---
* *Q5 (Respiratory – Pneumonia CURB-65):**
A patient with pneumonia has the following: Confusion (new onset), BUN 22 mg/dL,
Respiratory rate 28, Blood pressure 118/72, Age 62. What is the CURB-65 score
and recommended disposition?
. Score 2; outpatient treatment with oral antibiotics
A
B. Score 3; consider hospital admission
C. Score 4; ICU admission recommended
D. Score 1; home observation only
* *[CORRECT]** B
*Rationale: CURB-65 scoring: Confusion (+1), Urea >20 (+1), RR ≥30 (+1—this patient
has RR 28, so no point), BP <90 systolic or ≤60 diastolic (0), Age ≥65 (0). Total
score = 2 (Confusion + Urea). However, RR 28 is close to threshold; some scoring
systems use RR >30. With score 2, consider short hospitalization or close outpatient
follow-up; score 3+ warrants hospital admission. The patient has confusion and
elevated BUN (2 points), indicating moderate risk. Clinical pearl: CURB-65 helps
standardize pneumonia severity assessment; always combine with clinical judgment
, and oxygenation status.*
---
* *Q6 (Respiratory – Pulmonary embolism diagnostics):**
A patient presents with sudden-onset dyspnea, pleuritic chest pain, and
tachycardia. Wells score is intermediate. What is the next best diagnostic step?
. Immediate CT pulmonary angiography (CTPA) without D-dimer
A
B. D-dimer testing to rule out PE if negative
C. Ventilation-perfusion (V/Q) scan as first-line
D. Pulmonary angiography as the gold standard initial test
* *[CORRECT]** B
*Rationale: For intermediate Wells score, D-dimer testing is appropriate; if negative,
PE is effectively ruled out and invasive testing can be avoided per ACCP guidelines.
Option A is reserved for high probability or when D-dimer would be falsely positive.
Option C is used when CTPA is contraindicated (e.g., renal impairment). Option D is
invasive and reserved for equivocal cases. Clinical pearl: D-dimer is sensitive but
not specific—elevated in pregnancy, infection, surgery, and malignancy.*
---
* *Q7 (Respiratory – PE anticoagulation):**
A patient with confirmed PE and no contraindications is started on anticoagulation.
Which statement about direct oral anticoagulants (DOACs) is correct?
. DOACs require routine INR monitoring like warfarin
A
B. Rivaroxaban and apixaban are preferred over warfarin for most patients
C. DOACs are contraindicated in all patients with renal impairment
D. Protamine sulfate reverses all DOACs effectively
* *[CORRECT]** B
*Rationale: DOACs (rivaroxaban, apixaban, dabigatran, edoxaban) are preferred over
warfarin for most patients with PE due to fixed dosing, fewer drug interactions,
and no routine monitoring per CHEST guidelines. Option A is incorrect—DOACs do not
require INR monitoring. Option C is too absolute—reduced doses are used in mild-moderate
renal impairment. Option D is incorrect—protamine reverses heparin, not DOACs;
andexanet alfa or idarucizumab are specific reversal agents. Clinical pearl: Always
assess creatinine clearance before prescribing DOACs and adjust dosing accordingly.*
---
**Q8 (Respiratory – ARDS management):**
