NR 324 ADULT HEALTH I EXAM QUESTIONS AND
ANSWERS
100% VERIFIED SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
1. A patient with heart failure is prescribed furosemide. Which
laboratory value requires the most immediate nursing intervention?
A. Serum sodium of 135 mEq/L
B. Serum potassium of 2.8 mEq/L
C. Serum calcium of 9.5 mg/dL
D. Serum magnesium of 2.0 mEq/L
Answer: B. Serum potassium of 2.8 mEq/L
RATIONALE: Furosemide is a loop diuretic that causes potassium
wasting. A serum potassium of 2.8 mEq/L indicates severe hypokalemia,
which can lead to cardiac arrhythmias, especially in patients with heart
failure who may also be taking digoxin. This value requires immediate
intervention with potassium replacement and cardiac monitoring. The
other values are within normal limits.
2. A patient with status asthmaticus is not responding to standard
bronchodilator therapy. The nurse anticipates which medication will
be prescribed?
,A. Oral prednisone
B. Intravenous magnesium sulfate
C. Inhaled ipratropium
D. Oral montelukast
Answer: B. Intravenous magnesium sulfate
RATIONALE: In severe asthma exacerbations not responding to
bronchodilators, IV magnesium sulfate is administered as a
bronchodilator and to reduce inflammation. It works by relaxing smooth
muscle and inhibiting calcium influx into cells. Oral prednisone takes
hours to take effect. Ipratropium and montelukast are not first-line
agents for acute severe exacerbations.
3. A patient with end-stage renal disease is scheduled for
hemodialysis. Which assessment finding should the nurse report to
the provider before the procedure?
A. Blood pressure of 148/90 mmHg
B. Temperature of 99.2°F
C. Potassium level of 5.8 mEq/L
D. Presence of an AV fistula with a palpable thrill
Answer: C. Potassium level of 5.8 mEq/L
RATIONALE: While a potassium level of 5.8 mEq/L is elevated and
requires dialysis, the question asks for a finding to report before the
procedure. Actually, all findings should be reported, but a potassium of
5.8 indicates the patient needs dialysis. The AV fistula with thrill is a
normal finding indicating patency. The blood pressure and temperature
are slightly elevated but not immediately threatening.
,4. The nurse is caring for a patient with diabetic ketoacidosis (DKA).
Which IV fluid should the nurse anticipate administering first?
A. 0.9% normal saline
B. 0.45% normal saline
C. D5W
D. 3% normal saline
Answer: A. 0.9% normal saline
RATIONALE: The initial fluid of choice for DKA is 0.9% normal saline to
rapidly restore intravascular volume and correct dehydration. Isotonic
saline is preferred because patients with DKA are severely dehydrated
and may be in hypovolemic shock. After initial resuscitation, fluid may
be changed to 0.45% normal saline once hemodynamic stability is
achieved.
5. A patient is receiving heparin therapy for a deep vein thrombosis.
Which laboratory test should the nurse monitor to evaluate
therapeutic effectiveness?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Answer: B. Activated partial thromboplastin time (aPTT)
RATIONALE: Heparin therapy is monitored using the aPTT, with a
therapeutic goal typically 1.5-2.5 times the control value. PT and INR
, are used to monitor warfarin therapy. Platelet count is monitored to
detect heparin-induced thrombocytopenia but does not evaluate
therapeutic effectiveness of anticoagulation.
6. A patient with COPD has arterial blood gas results: pH 7.30, PaCO2
58 mmHg, HCO3 28 mEq/L, PaO2 70 mmHg. The nurse interprets these
results as:
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Uncompensated metabolic alkalosis
D. Fully compensated respiratory acidosis
Answer: B. Partially compensated respiratory acidosis
RATIONALE: The pH is acidic (7.30), PaCO2 is elevated (58 mmHg)
indicating respiratory acidosis, and HCO3 is elevated (28 mEq/L)
indicating renal compensation. Since the pH is still abnormal,
compensation is partial. Full compensation would have a normal pH.
The PaO2 is low but within acceptable range for a COPD patient.
7. A patient is admitted with acute pancreatitis. Which laboratory
finding is most specific for this diagnosis?
A. Elevated serum amylase
B. Elevated serum lipase
C. Elevated white blood cell count
D. Elevated blood glucose
Answer: B. Elevated serum lipase
ANSWERS
100% VERIFIED SOLUTIONS | UPDATED PER LATEST
GUIDELINES | GRADED A+
1. A patient with heart failure is prescribed furosemide. Which
laboratory value requires the most immediate nursing intervention?
A. Serum sodium of 135 mEq/L
B. Serum potassium of 2.8 mEq/L
C. Serum calcium of 9.5 mg/dL
D. Serum magnesium of 2.0 mEq/L
Answer: B. Serum potassium of 2.8 mEq/L
RATIONALE: Furosemide is a loop diuretic that causes potassium
wasting. A serum potassium of 2.8 mEq/L indicates severe hypokalemia,
which can lead to cardiac arrhythmias, especially in patients with heart
failure who may also be taking digoxin. This value requires immediate
intervention with potassium replacement and cardiac monitoring. The
other values are within normal limits.
2. A patient with status asthmaticus is not responding to standard
bronchodilator therapy. The nurse anticipates which medication will
be prescribed?
,A. Oral prednisone
B. Intravenous magnesium sulfate
C. Inhaled ipratropium
D. Oral montelukast
Answer: B. Intravenous magnesium sulfate
RATIONALE: In severe asthma exacerbations not responding to
bronchodilators, IV magnesium sulfate is administered as a
bronchodilator and to reduce inflammation. It works by relaxing smooth
muscle and inhibiting calcium influx into cells. Oral prednisone takes
hours to take effect. Ipratropium and montelukast are not first-line
agents for acute severe exacerbations.
3. A patient with end-stage renal disease is scheduled for
hemodialysis. Which assessment finding should the nurse report to
the provider before the procedure?
A. Blood pressure of 148/90 mmHg
B. Temperature of 99.2°F
C. Potassium level of 5.8 mEq/L
D. Presence of an AV fistula with a palpable thrill
Answer: C. Potassium level of 5.8 mEq/L
RATIONALE: While a potassium level of 5.8 mEq/L is elevated and
requires dialysis, the question asks for a finding to report before the
procedure. Actually, all findings should be reported, but a potassium of
5.8 indicates the patient needs dialysis. The AV fistula with thrill is a
normal finding indicating patency. The blood pressure and temperature
are slightly elevated but not immediately threatening.
,4. The nurse is caring for a patient with diabetic ketoacidosis (DKA).
Which IV fluid should the nurse anticipate administering first?
A. 0.9% normal saline
B. 0.45% normal saline
C. D5W
D. 3% normal saline
Answer: A. 0.9% normal saline
RATIONALE: The initial fluid of choice for DKA is 0.9% normal saline to
rapidly restore intravascular volume and correct dehydration. Isotonic
saline is preferred because patients with DKA are severely dehydrated
and may be in hypovolemic shock. After initial resuscitation, fluid may
be changed to 0.45% normal saline once hemodynamic stability is
achieved.
5. A patient is receiving heparin therapy for a deep vein thrombosis.
Which laboratory test should the nurse monitor to evaluate
therapeutic effectiveness?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Answer: B. Activated partial thromboplastin time (aPTT)
RATIONALE: Heparin therapy is monitored using the aPTT, with a
therapeutic goal typically 1.5-2.5 times the control value. PT and INR
, are used to monitor warfarin therapy. Platelet count is monitored to
detect heparin-induced thrombocytopenia but does not evaluate
therapeutic effectiveness of anticoagulation.
6. A patient with COPD has arterial blood gas results: pH 7.30, PaCO2
58 mmHg, HCO3 28 mEq/L, PaO2 70 mmHg. The nurse interprets these
results as:
A. Uncompensated respiratory acidosis
B. Partially compensated respiratory acidosis
C. Uncompensated metabolic alkalosis
D. Fully compensated respiratory acidosis
Answer: B. Partially compensated respiratory acidosis
RATIONALE: The pH is acidic (7.30), PaCO2 is elevated (58 mmHg)
indicating respiratory acidosis, and HCO3 is elevated (28 mEq/L)
indicating renal compensation. Since the pH is still abnormal,
compensation is partial. Full compensation would have a normal pH.
The PaO2 is low but within acceptable range for a COPD patient.
7. A patient is admitted with acute pancreatitis. Which laboratory
finding is most specific for this diagnosis?
A. Elevated serum amylase
B. Elevated serum lipase
C. Elevated white blood cell count
D. Elevated blood glucose
Answer: B. Elevated serum lipase
