NUR 170 Exam 4 2026-2027 BANK QUESTIONS WITH
DETAILED VERIFIED ANSWERS EXAM QUESTIONS
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1. A patient with a history of chronic obstructive pulmonary disease
(COPD) presents with worsening dyspnea and a productive cough.
Which arterial blood gas (ABG) finding is most consistent with an acute
exacerbation of COPD?
A) pH 7.38, PaCO2 48 mm Hg, HCO3 24 mEq/L
B) pH 7.32, PaCO2 55 mm Hg, HCO3 26 mEq/L
C) pH 7.42, PaCO2 38 mm Hg, HCO3 22 mEq/L
D) pH 7.25, PaCO2 60 mm Hg, HCO3 28 mEq/L
Answer: D) pH 7.25, PaCO2 60 mm Hg, HCO3 28 mEq/L
Explanation: An acute exacerbation of COPD often leads to respiratory
acidosis due to alveolar hypoventilation and carbon dioxide retention.
Choice D demonstrates a low pH with an elevated PaCO2, indicating
respiratory acidosis, with a compensatory slight elevation in
bicarbonate, suggesting a chronic process with an acute component.
Choice A is within normal limits. Choice B has a lower pH but the
bicarbonate is not elevated enough to suggest significant chronic
compensation. Choice C is normal or slightly alkalotic.
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2. A patient is prescribed digoxin for heart failure. Which finding is most
indicative of digoxin toxicity?
A) Heart rate of 100 beats per minute
B) Yellow-green halos around visual fields
C) Serum potassium level of 4.0 mEq/L
D) Blood pressure of 140/88 mm Hg
Answer: B) Yellow-green halos around visual fields
Explanation: Digoxin toxicity manifests with various signs, including
gastrointestinal disturbances, cardiac dysrhythmias, and
neurologic/visual changes. The classic visual disturbance is the
perception of yellow-green halos around lights. A heart rate of 100 is
not specific to toxicity; bradycardia is more common. Normal potassium
is 3.5-5.0 mEq/L, and while hypokalemia increases the risk of toxicity, a
level of 4.0 is not indicative of toxicity itself.
3. Which is a primary nursing intervention for a patient experiencing an
acute asthma attack?
A) Administer oral corticosteroids
B) Position the patient in a supine position
C) Administer a nebulized beta-2 agonist
D) Encourage deep breathing and coughing
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Answer: C) Administer a nebulized beta-2 agonist
Explanation: The priority intervention in an acute asthma attack is to
rapidly reverse bronchospasm. Nebulized beta-2 agonists (e.g.,
albuterol) are the first-line treatment. Oral corticosteroids take longer
to take effect. The supine position can worsen dyspnea; high Fowler's is
preferred. Deep breathing and coughing are not effective during an
acute attack because the airways are constricted and the patient
cannot move air effectively.
4. A patient is receiving heparin therapy for a deep vein thrombosis.
The nurse should monitor for which adverse effect?
A) Hyperkalemia
B) Heparin-induced thrombocytopenia
C) Hypertension
D) Hyperglycemia
Answer: B) Heparin-induced thrombocytopenia
Explanation: Heparin-induced thrombocytopenia (HIT) is a serious,
immune-mediated adverse reaction to heparin. It causes a drop in
platelet count and can lead to paradoxical thrombosis. Hyperkalemia,
hypertension, and hyperglycemia are not typical adverse effects of
heparin.
5. The nurse is caring for a patient with syndrome of inappropriate
antidiuretic hormone (SIADH). Which laboratory value is expected?
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A) Serum sodium 130 mEq/L
B) Serum sodium 150 mEq/L
C) Serum potassium 5.5 mEq/L
D) Serum osmolarity 310 mOsm/kg
Answer: A) Serum sodium 130 mEq/L
Explanation: SIADH is characterized by excessive release of antidiuretic
hormone (ADH), leading to water retention and dilutional
hyponatremia. A serum sodium of 130 mEq/L is low (normal 135-145).
Choice B indicates hypernatremia. Choice C indicates hyperkalemia.
Choice D indicates hyperosmolarity, which is not consistent with SIADH,
as the serum osmolarity is typically low.
6. A patient with diabetes mellitus type 2 is prescribed metformin.
Which statement indicates the patient understands the teaching?
A) I will take this medication only when my blood sugar is high.
B) I can stop taking this medication if I start a low-carbohydrate diet.
C) I should take this medication with meals to reduce gastrointestinal
upset.
D) I will take this medication at bedtime.
Answer: C) I should take this medication with meals to reduce
gastrointestinal upset.
Explanation: Metformin is commonly associated with gastrointestinal
side effects such as nausea, diarrhea, and abdominal discomfort. Taking