NR 324 Adult Health I Exam 1 Prep Document | 2026/2027
Edition | 200 Verified Questions
NR 324 Adult Health I Exam 1 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest AACN & QSEN Guidelines | Graded A+
This comprehensive exam preparation resource provides 200 verified, exam-style questions for NR 324
Adult Health I Exam 1. Each question is mapped to current nursing standards and includes detailed
rationales to reinforce clinical reasoning. Designed to simulate the actual exam experience, this
document ensures readiness for topics such as cardiovascular, respiratory, and gastrointestinal
disorders. Trusted by nursing students for high-stakes success, this guide is your pathway to an A+
grade.
Abstract:
This document presents a curated collection of 200 exam-style questions for NR 324 Adult Health I Exam 1,
reflecting the most current nursing education standards and the 2026/2027 academic year. Content is aligned with
the AACN Essentials and QSEN competencies, covering key areas of adult health nursing including assessment,
pathophysiology, nursing interventions, and patient education. Each question is accompanied by a detailed
rationale explaining the correct answer and common misconceptions, fostering deep understanding rather than
rote memorization. The questions are organized by body system and clinical theme, allowing for targeted review.
Additionally, the document incorporates practice scenarios that require clinical judgment and prioritization skills.
This resource has been thoroughly reviewed for accuracy and is designed to build confidence and competence for
exam success. Students will benefit from the structured approach that mirrors the actual exam blueprint and
difficulty level.
Content Area Overview:
Content Area Questions Key Topics Weight
Cardiovascular Disorders 1-45 Heart failure, hypertension, coronary artery 22.5%
disease, arrhythmias, cardiac assessment
Respiratory Disorders 46-90 COPD, asthma, pneumonia, pulmonary 22.5%
embolism, oxygen therapy
Gastrointestinal Disorders 91-130 Bowel obstruction, pancreatitis, peptic ulcer, 20%
liver disease, nutritional support
Fluid & Electrolyte Balance 131-155 Dehydration, fluid overload, electrolyte 12.5%
imbalances, acid-base disorders
Perioperative Nursing Care 156-175 Pre-op assessment, intra-op complications, 10%
post-op recovery, wound care
Pain Management 176-200 Pain assessment, pharmacologic and 12.5%
non-pharmacologic interventions, opioid
safety
Page 1
,Q1. A patient with a documented history of malignant hyperthermia is scheduled for surgery under
general anesthesia. Which anesthetic agent is contraindicated for this patient?
A. Propofol
B. Sevoflurane
C. Ketamine
D. Etomidate
Correct Answer: B. Sevoflurane
Rationale: Sevoflurane is a volatile inhalation anesthetic that can trigger malignant hyperthermia in
susceptible individuals. Propofol, ketamine, and etomidate are intravenous agents considered safe and do
not trigger this condition. The mechanisms involve dysregulation of calcium release in skeletal muscle.
Why Wrong:
A - Propofol is an intravenous induction agent not associated with malignant hyperthermia.
C - Ketamine is a dissociative anesthetic that does not trigger malignant hyperthermia.
D - Etomidate is an intravenous agent safe for use in patients with malignant hyperthermia
susceptibility.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 14: Malignant
Hyperthermia.
Q2. A patient receiving intravenous furosemide for acute heart failure develops muscle cramps and
weakness. Which laboratory value should the nurse prioritize for assessment?
A. Serum sodium level of 135 mEq/L
B. Serum potassium level of 3.0 mEq/L
C. Serum calcium level of 9.0 mg/dL
D. Serum magnesium level of 2.0 mg/dL
Correct Answer: B. Serum potassium level of 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that promotes potassium excretion, leading to hypokalemia.
Symptoms include muscle cramps, weakness, and arrhythmias. Sodium levels are less affected, and
calcium and magnesium are not primarily wasted by loop diuretics at this dosage.
Why Wrong:
A - Sodium may be mildly reduced but does not typically cause muscle cramps and weakness.
C - Loop diuretics can cause hypocalcemia but it is rare and less directly linked to muscle cramps.
D - Magnesium levels can decrease but hypomagnesemia is less common with furosemide alone.
Reference: Ignatavicius, D.D. & Workman, M.L. (2026). Medical-Surgical Nursing, 10th Ed., Ch. 12:
Fluid and Electrolyte Balance.
Page 2
,Q3. A patient on long-term high-dose morphine for chronic cancer pain reports new-onset
widespread pain that is not relieved by increasing morphine doses. The nurse suspects
opioid-induced hyperalgesia. Which intervention is most appropriate?
A. Increase morphine dose by 25%
B. Add a nonsteroidal anti-inflammatory drug (NSAID)
C. Rotate to a different opioid, such as hydromorphone
D. Administer naloxone to reverse opioid effects
Correct Answer: C. Rotate to a different opioid, such as hydromorphone
Rationale: Opioid-induced hyperalgesia is treated by opioid rotation to a different mu-opioid receptor
agonist, reducing the dose of the offending opioid. Increasing the dose worsens hyperalgesia. NSAIDs
may be adjunctive but do not address the primary cause. Naloxone is for overdose reversal, not
hyperalgesia.
Why Wrong:
A - Increasing dose exacerbates hyperalgesia.
B - NSAIDs provide limited benefit and do not resolve opioid-induced hyperalgesia.
D - Naloxone would precipitate withdrawal and is not indicated.
Reference: Pasero, C. & McCaffery, M. (2026). Pain Assessment and Management, 5th Ed., Ch. 11:
Opioid-Induced Hyperalgesia.
Q4. A patient with a stage 3 pressure ulcer on the sacrum has 50% yellow slough and 50% red
granulation tissue. The wound edges are rolled. Which debridement method is most appropriate at
this time?
A. Surgical sharp debridement
B. Autolytic debridement with transparent film dressing
C. Enzymatic debridement with collagenase
D. Mechanical debridement with wet-to-dry gauze
Correct Answer: C. Enzymatic debridement with collagenase
Rationale: Enzymatic debridement with collagenase effectively dissolves slough while preserving
granulation tissue, making it ideal for mixed wounds with viable granulation. Surgical debridement is too
aggressive when granulation is present. Autolytic debridement works slowly and may not handle thick
slough. Mechanical debridement is non-selective and damages granulation.
Why Wrong:
A - Surgical debridement is too aggressive and would remove healthy granulation.
B - Autolytic debridement requires a moist environment but is slow for thick slough.
D - Wet-to-dry gauze is non-selective and damages new granulation tissue.
Reference: National Pressure Injury Advisory Panel (2026). Prevention and Treatment of Pressure
Ulcers, 3rd Ed., Section 6.3.
Page 3
, Q5. A patient in septic shock has received 30 mL/kg of intravenous crystalloid over 3 hours. Mean
arterial pressure remains 58 mm Hg, and central venous pressure is 14 mm Hg. What is the next
priority intervention?
A. Administer a second fluid bolus of 500 mL
B. Start a norepinephrine infusion
C. Begin intravenous hydrocortisone
D. Obtain a bedside echocardiogram
Correct Answer: B. Start a norepinephrine infusion
Rationale: After adequate fluid resuscitation (CVP 14 indicates possibly fluid-overloaded), persistent
hypotension requires vasopressor support. Norepinephrine is first-line for septic shock per surviving
sepsis guidelines. Additional fluid may cause pulmonary edema. Corticosteroids are reserved for
vasopressor-refractory shock. Echo may be useful but is not the next priority.
Why Wrong:
A - CVP 14 suggests adequate or excess volume; more fluid risks pulmonary edema.
C - Corticosteroids are indicated only if hypotension persists despite vasopressors.
D - Echocardiogram is diagnostic but does not address immediate hypotension.
Reference: Surviving Sepsis Campaign (2026). International Guidelines for Management of Sepsis and
Septic Shock, Section 3.1.
Q6. A patient with chronic obstructive pulmonary disease (COPD) and baseline SpO of 88% on
room air presents with confusion and an SpO of 78%. Arterial blood gas shows pH 7.28, PaCO 68
mm Hg, PaO 42 mm Hg. Which oxygen delivery device should the nurse prepare?
A. Non-rebreather mask at 15 L/min
B. Venturi mask at 24% FiO
C. Nasal cannula at 2 L/min
D. Simple face mask at 8 L/min
Correct Answer: B. Venturi mask at 24% FiO
Rationale: This patient has acute-on-chronic hypercapnic respiratory failure. High FiO ‚
(non-rebreather) may worsen CO retention by blunting hypoxic drive, but recent evidence values
controlled oxygen. Venturi mask at 24% delivers precise low FiO, gradually raising PaO to 55-60 mm Hg
while avoiding hyperoxia. Nasal cannula is less precise. Simple mask may still provide too much oxygen.
Why Wrong:
A - Non-rebreather delivers high FiO, risking CO retention and respiratory depression.
C - Nasal cannula at 2 L provides ~28% FiO, which may be adequate but less precise than Venturi.
D - Simple mask at 8 L delivers about 50% FiO, too high for initial management.
Reference: Global Initiative for Chronic Obstructive Lung Disease (2026). GOLD Report, Chapter 5:
Management of Exacerbations.
Page 4
Edition | 200 Verified Questions
NR 324 Adult Health I Exam 1 2026-2027 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100% Verified
Solutions | Updated Per Latest AACN & QSEN Guidelines | Graded A+
This comprehensive exam preparation resource provides 200 verified, exam-style questions for NR 324
Adult Health I Exam 1. Each question is mapped to current nursing standards and includes detailed
rationales to reinforce clinical reasoning. Designed to simulate the actual exam experience, this
document ensures readiness for topics such as cardiovascular, respiratory, and gastrointestinal
disorders. Trusted by nursing students for high-stakes success, this guide is your pathway to an A+
grade.
Abstract:
This document presents a curated collection of 200 exam-style questions for NR 324 Adult Health I Exam 1,
reflecting the most current nursing education standards and the 2026/2027 academic year. Content is aligned with
the AACN Essentials and QSEN competencies, covering key areas of adult health nursing including assessment,
pathophysiology, nursing interventions, and patient education. Each question is accompanied by a detailed
rationale explaining the correct answer and common misconceptions, fostering deep understanding rather than
rote memorization. The questions are organized by body system and clinical theme, allowing for targeted review.
Additionally, the document incorporates practice scenarios that require clinical judgment and prioritization skills.
This resource has been thoroughly reviewed for accuracy and is designed to build confidence and competence for
exam success. Students will benefit from the structured approach that mirrors the actual exam blueprint and
difficulty level.
Content Area Overview:
Content Area Questions Key Topics Weight
Cardiovascular Disorders 1-45 Heart failure, hypertension, coronary artery 22.5%
disease, arrhythmias, cardiac assessment
Respiratory Disorders 46-90 COPD, asthma, pneumonia, pulmonary 22.5%
embolism, oxygen therapy
Gastrointestinal Disorders 91-130 Bowel obstruction, pancreatitis, peptic ulcer, 20%
liver disease, nutritional support
Fluid & Electrolyte Balance 131-155 Dehydration, fluid overload, electrolyte 12.5%
imbalances, acid-base disorders
Perioperative Nursing Care 156-175 Pre-op assessment, intra-op complications, 10%
post-op recovery, wound care
Pain Management 176-200 Pain assessment, pharmacologic and 12.5%
non-pharmacologic interventions, opioid
safety
Page 1
,Q1. A patient with a documented history of malignant hyperthermia is scheduled for surgery under
general anesthesia. Which anesthetic agent is contraindicated for this patient?
A. Propofol
B. Sevoflurane
C. Ketamine
D. Etomidate
Correct Answer: B. Sevoflurane
Rationale: Sevoflurane is a volatile inhalation anesthetic that can trigger malignant hyperthermia in
susceptible individuals. Propofol, ketamine, and etomidate are intravenous agents considered safe and do
not trigger this condition. The mechanisms involve dysregulation of calcium release in skeletal muscle.
Why Wrong:
A - Propofol is an intravenous induction agent not associated with malignant hyperthermia.
C - Ketamine is a dissociative anesthetic that does not trigger malignant hyperthermia.
D - Etomidate is an intravenous agent safe for use in patients with malignant hyperthermia
susceptibility.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 14: Malignant
Hyperthermia.
Q2. A patient receiving intravenous furosemide for acute heart failure develops muscle cramps and
weakness. Which laboratory value should the nurse prioritize for assessment?
A. Serum sodium level of 135 mEq/L
B. Serum potassium level of 3.0 mEq/L
C. Serum calcium level of 9.0 mg/dL
D. Serum magnesium level of 2.0 mg/dL
Correct Answer: B. Serum potassium level of 3.0 mEq/L
Rationale: Furosemide is a loop diuretic that promotes potassium excretion, leading to hypokalemia.
Symptoms include muscle cramps, weakness, and arrhythmias. Sodium levels are less affected, and
calcium and magnesium are not primarily wasted by loop diuretics at this dosage.
Why Wrong:
A - Sodium may be mildly reduced but does not typically cause muscle cramps and weakness.
C - Loop diuretics can cause hypocalcemia but it is rare and less directly linked to muscle cramps.
D - Magnesium levels can decrease but hypomagnesemia is less common with furosemide alone.
Reference: Ignatavicius, D.D. & Workman, M.L. (2026). Medical-Surgical Nursing, 10th Ed., Ch. 12:
Fluid and Electrolyte Balance.
Page 2
,Q3. A patient on long-term high-dose morphine for chronic cancer pain reports new-onset
widespread pain that is not relieved by increasing morphine doses. The nurse suspects
opioid-induced hyperalgesia. Which intervention is most appropriate?
A. Increase morphine dose by 25%
B. Add a nonsteroidal anti-inflammatory drug (NSAID)
C. Rotate to a different opioid, such as hydromorphone
D. Administer naloxone to reverse opioid effects
Correct Answer: C. Rotate to a different opioid, such as hydromorphone
Rationale: Opioid-induced hyperalgesia is treated by opioid rotation to a different mu-opioid receptor
agonist, reducing the dose of the offending opioid. Increasing the dose worsens hyperalgesia. NSAIDs
may be adjunctive but do not address the primary cause. Naloxone is for overdose reversal, not
hyperalgesia.
Why Wrong:
A - Increasing dose exacerbates hyperalgesia.
B - NSAIDs provide limited benefit and do not resolve opioid-induced hyperalgesia.
D - Naloxone would precipitate withdrawal and is not indicated.
Reference: Pasero, C. & McCaffery, M. (2026). Pain Assessment and Management, 5th Ed., Ch. 11:
Opioid-Induced Hyperalgesia.
Q4. A patient with a stage 3 pressure ulcer on the sacrum has 50% yellow slough and 50% red
granulation tissue. The wound edges are rolled. Which debridement method is most appropriate at
this time?
A. Surgical sharp debridement
B. Autolytic debridement with transparent film dressing
C. Enzymatic debridement with collagenase
D. Mechanical debridement with wet-to-dry gauze
Correct Answer: C. Enzymatic debridement with collagenase
Rationale: Enzymatic debridement with collagenase effectively dissolves slough while preserving
granulation tissue, making it ideal for mixed wounds with viable granulation. Surgical debridement is too
aggressive when granulation is present. Autolytic debridement works slowly and may not handle thick
slough. Mechanical debridement is non-selective and damages granulation.
Why Wrong:
A - Surgical debridement is too aggressive and would remove healthy granulation.
B - Autolytic debridement requires a moist environment but is slow for thick slough.
D - Wet-to-dry gauze is non-selective and damages new granulation tissue.
Reference: National Pressure Injury Advisory Panel (2026). Prevention and Treatment of Pressure
Ulcers, 3rd Ed., Section 6.3.
Page 3
, Q5. A patient in septic shock has received 30 mL/kg of intravenous crystalloid over 3 hours. Mean
arterial pressure remains 58 mm Hg, and central venous pressure is 14 mm Hg. What is the next
priority intervention?
A. Administer a second fluid bolus of 500 mL
B. Start a norepinephrine infusion
C. Begin intravenous hydrocortisone
D. Obtain a bedside echocardiogram
Correct Answer: B. Start a norepinephrine infusion
Rationale: After adequate fluid resuscitation (CVP 14 indicates possibly fluid-overloaded), persistent
hypotension requires vasopressor support. Norepinephrine is first-line for septic shock per surviving
sepsis guidelines. Additional fluid may cause pulmonary edema. Corticosteroids are reserved for
vasopressor-refractory shock. Echo may be useful but is not the next priority.
Why Wrong:
A - CVP 14 suggests adequate or excess volume; more fluid risks pulmonary edema.
C - Corticosteroids are indicated only if hypotension persists despite vasopressors.
D - Echocardiogram is diagnostic but does not address immediate hypotension.
Reference: Surviving Sepsis Campaign (2026). International Guidelines for Management of Sepsis and
Septic Shock, Section 3.1.
Q6. A patient with chronic obstructive pulmonary disease (COPD) and baseline SpO of 88% on
room air presents with confusion and an SpO of 78%. Arterial blood gas shows pH 7.28, PaCO 68
mm Hg, PaO 42 mm Hg. Which oxygen delivery device should the nurse prepare?
A. Non-rebreather mask at 15 L/min
B. Venturi mask at 24% FiO
C. Nasal cannula at 2 L/min
D. Simple face mask at 8 L/min
Correct Answer: B. Venturi mask at 24% FiO
Rationale: This patient has acute-on-chronic hypercapnic respiratory failure. High FiO ‚
(non-rebreather) may worsen CO retention by blunting hypoxic drive, but recent evidence values
controlled oxygen. Venturi mask at 24% delivers precise low FiO, gradually raising PaO to 55-60 mm Hg
while avoiding hyperoxia. Nasal cannula is less precise. Simple mask may still provide too much oxygen.
Why Wrong:
A - Non-rebreather delivers high FiO, risking CO retention and respiratory depression.
C - Nasal cannula at 2 L provides ~28% FiO, which may be adequate but less precise than Venturi.
D - Simple mask at 8 L delivers about 50% FiO, too high for initial management.
Reference: Global Initiative for Chronic Obstructive Lung Disease (2026). GOLD Report, Chapter 5:
Management of Exacerbations.
Page 4
