Chamberlain NR 324 Final Exam (pdf) | 2026/2027 | Adult Health I |
Med-Surg Nursing
1. A nurse is caring for a client with a nasogastric tube attached to low
suction. The nurse should monitor the client for which of the following acid-
base imbalances?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: Metabolic alkalosis
Rationale: Nasogastric suctioning removes hydrochloric acid from the
stomach, leading to a loss of hydrogen ions and an increase in serum
bicarbonate, resulting in metabolic alkalosis. This is a classic complication of
prolonged NG suctioning or vomiting.
2. A nurse is assessing a client who has a serum potassium level of 6.8
mEq/L. Which of the following electrocardiogram (ECG) changes should the
nurse expect?
A) Flattened T-waves
B) Tall, peaked T-waves
C) ST-segment depression
D) Prolonged PR interval
Correct Answer: Tall, peaked T-waves
Rationale: Hyperkalemia (serum potassium > 5.0 mEq/L) is characterized by
tall, peaked T-waves on the ECG. Flattened T-waves and ST-segment
depression are associated with hypokalemia.
,3. A client with chronic obstructive pulmonary disease (COPD) presents with
a barrel chest and pursed-lip breathing. Which of the following is the primary
rationale for teaching pursed-lip breathing?
A) To increase the respiratory rate
B) To increase oxygen intake
C) To keep the airways open longer by preventing airway collapse
D) To reduce the work of breathing
Correct Answer: To keep the airways open longer by preventing airway
collapse
Rationale: In COPD, the airways tend to collapse during exhalation due to
loss of elastic recoil. Pursed-lip breathing creates backpressure in the
airways, helping to keep them open longer, facilitating more complete
exhalation and preventing air trapping.
4. A nurse is preparing to administer a blood transfusion to a client. Which of
the following is the most important action to prevent a transfusion reaction?
A) Warm the blood product before administration
B) Administer the blood product rapidly over 15 minutes
C) Verify the client's identity and blood product with another licensed
professional
D) Premedicate the client with an antihistamine
Correct Answer: Verify the client's identity and blood product with another
licensed professional
Rationale: The most critical step in preventing a transfusion reaction is to
verify the correct client and blood product with another licensed professional.
,This two-person verification prevents ABO incompatibility, the most serious
cause of transfusion reactions.
5. A nurse is reviewing a client's arterial blood gas (ABG) results: pH 7.30,
PaCO₂ 50 mmHg, HCO₃ 24 mEq/L. The nurse should interpret this as which of
the following acid-base imbalances?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: Respiratory acidosis
Rationale: The pH is low (7.30), indicating acidosis. The PaCO₂ is elevated (50
mmHg), indicating a respiratory cause due to hypoventilation. The HCO₃ is
normal, suggesting an acute, uncompensated respiratory acidosis.
6. A client with heart failure is prescribed furosemide. The nurse should
monitor the client for which of the following adverse effects?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
Correct Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the loop of Henle, also leading to increased potassium
excretion. This can result in hypokalemia. Monitoring serum potassium levels
is essential.
, 7. A nurse is assessing a client with a pulmonary embolism (PE). Which of the
following findings is most consistent with this condition?
A) Gradual onset of a productive cough
B) Painless hematuria and flank pain
C) Sudden onset of pleuritic chest pain and dyspnea
D) Bradycardia and hypotension
Correct Answer: Sudden onset of pleuritic chest pain and dyspnea
Rationale: A pulmonary embolism (PE) typically presents with a sudden onset
of pleuritic chest pain, dyspnea, tachycardia, and tachypnea. Hemoptysis
may also occur. Hypotension may occur in a massive PE but is not a classic
presenting sign.
8. A nurse is providing discharge teaching to a client with heart failure who is
prescribed digoxin. Which of the following signs of digoxin toxicity should the
nurse include?
A) Tachycardia
B) Yellow-green halos around lights
C) Hypertension
D) Dry cough
Correct Answer: Yellow-green halos around lights
Rationale: Digoxin has a narrow therapeutic range, and toxicity can cause
visual disturbances, including yellow-green halos around lights. Other signs
include nausea, vomiting, confusion, and cardiac arrhythmias.
Med-Surg Nursing
1. A nurse is caring for a client with a nasogastric tube attached to low
suction. The nurse should monitor the client for which of the following acid-
base imbalances?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: Metabolic alkalosis
Rationale: Nasogastric suctioning removes hydrochloric acid from the
stomach, leading to a loss of hydrogen ions and an increase in serum
bicarbonate, resulting in metabolic alkalosis. This is a classic complication of
prolonged NG suctioning or vomiting.
2. A nurse is assessing a client who has a serum potassium level of 6.8
mEq/L. Which of the following electrocardiogram (ECG) changes should the
nurse expect?
A) Flattened T-waves
B) Tall, peaked T-waves
C) ST-segment depression
D) Prolonged PR interval
Correct Answer: Tall, peaked T-waves
Rationale: Hyperkalemia (serum potassium > 5.0 mEq/L) is characterized by
tall, peaked T-waves on the ECG. Flattened T-waves and ST-segment
depression are associated with hypokalemia.
,3. A client with chronic obstructive pulmonary disease (COPD) presents with
a barrel chest and pursed-lip breathing. Which of the following is the primary
rationale for teaching pursed-lip breathing?
A) To increase the respiratory rate
B) To increase oxygen intake
C) To keep the airways open longer by preventing airway collapse
D) To reduce the work of breathing
Correct Answer: To keep the airways open longer by preventing airway
collapse
Rationale: In COPD, the airways tend to collapse during exhalation due to
loss of elastic recoil. Pursed-lip breathing creates backpressure in the
airways, helping to keep them open longer, facilitating more complete
exhalation and preventing air trapping.
4. A nurse is preparing to administer a blood transfusion to a client. Which of
the following is the most important action to prevent a transfusion reaction?
A) Warm the blood product before administration
B) Administer the blood product rapidly over 15 minutes
C) Verify the client's identity and blood product with another licensed
professional
D) Premedicate the client with an antihistamine
Correct Answer: Verify the client's identity and blood product with another
licensed professional
Rationale: The most critical step in preventing a transfusion reaction is to
verify the correct client and blood product with another licensed professional.
,This two-person verification prevents ABO incompatibility, the most serious
cause of transfusion reactions.
5. A nurse is reviewing a client's arterial blood gas (ABG) results: pH 7.30,
PaCO₂ 50 mmHg, HCO₃ 24 mEq/L. The nurse should interpret this as which of
the following acid-base imbalances?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: Respiratory acidosis
Rationale: The pH is low (7.30), indicating acidosis. The PaCO₂ is elevated (50
mmHg), indicating a respiratory cause due to hypoventilation. The HCO₃ is
normal, suggesting an acute, uncompensated respiratory acidosis.
6. A client with heart failure is prescribed furosemide. The nurse should
monitor the client for which of the following adverse effects?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypermagnesemia
Correct Answer: Hypokalemia
Rationale: Furosemide is a loop diuretic that inhibits sodium and chloride
reabsorption in the loop of Henle, also leading to increased potassium
excretion. This can result in hypokalemia. Monitoring serum potassium levels
is essential.
, 7. A nurse is assessing a client with a pulmonary embolism (PE). Which of the
following findings is most consistent with this condition?
A) Gradual onset of a productive cough
B) Painless hematuria and flank pain
C) Sudden onset of pleuritic chest pain and dyspnea
D) Bradycardia and hypotension
Correct Answer: Sudden onset of pleuritic chest pain and dyspnea
Rationale: A pulmonary embolism (PE) typically presents with a sudden onset
of pleuritic chest pain, dyspnea, tachycardia, and tachypnea. Hemoptysis
may also occur. Hypotension may occur in a massive PE but is not a classic
presenting sign.
8. A nurse is providing discharge teaching to a client with heart failure who is
prescribed digoxin. Which of the following signs of digoxin toxicity should the
nurse include?
A) Tachycardia
B) Yellow-green halos around lights
C) Hypertension
D) Dry cough
Correct Answer: Yellow-green halos around lights
Rationale: Digoxin has a narrow therapeutic range, and toxicity can cause
visual disturbances, including yellow-green halos around lights. Other signs
include nausea, vomiting, confusion, and cardiac arrhythmias.
