NURS 221 – FINAL EXAM | LIBERTY UNIVERSITY ACTUAL EXAM 2026 ||
MOST RECENT EXAM 2026|2027 ACTUAL COMPLETE REAL
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ | GUARANTEED
SUCCESS!! BRAND NEW VERSION! | JUST RELEASED!!
A nurse is assessing a client who reports sudden shortness of breath
and chest discomfort. Which assessment finding requires the nurse's
immediate attention?
A. Respiratory rate of 18/min
B. Oxygen saturation of 96% on room air
C. New-onset cyanosis and severe dyspnea
D. Mild anxiety about hospitalization
Answer: C. New-onset cyanosis and severe dyspnea
Rationale: Cyanosis accompanied by severe dyspnea indicates
significant impairment of oxygenation and may represent acute
respiratory compromise. The nurse should immediately assess airway
and breathing, provide oxygen as indicated, and activate emergency
interventions. The other findings are not immediately life-threatening.
A nurse is caring for a client receiving oxygen through a nasal cannula.
Which intervention is most appropriate?
A. Apply petroleum jelly around the client's nares
B. Assess the client's respiratory status regularly
,C. Increase the oxygen flow rate whenever the client reports anxiety
D. Remove the oxygen during meals
Answer: B. Assess the client's respiratory status regularly
Rationale: Oxygen therapy requires ongoing assessment of respiratory
rate, effort, oxygen saturation, breath sounds, and response to
treatment. Petroleum-based products should be avoided around
oxygen because they increase fire risk. Oxygen should not be increased
without appropriate clinical assessment or an order when required.
A client with heart failure has gained 2.5 kg over several days. Which
interpretation by the nurse is most appropriate?
A. The weight gain is expected with aging
B. The client is likely experiencing fluid retention
C. The client has probably increased muscle mass
D. The finding indicates inadequate nutritional intake
Answer: B. The client is likely experiencing fluid retention
Rationale: Rapid weight gain in a client with heart failure is commonly
associated with fluid accumulation. Daily weights are an important
method of monitoring fluid balance.
A rapid increase is more suggestive of fluid retention than increased
tissue mass.
Which assessment finding is most characteristic of hypoglycemia in a
client receiving insulin?
,A. Warm, dry skin
B. Bradycardia and hypertension
C. Diaphoresis and tremors
D. Fruity breath odor
Answer: C. Diaphoresis and tremors
Rationale: Hypoglycemia activates the sympathetic nervous system,
producing manifestations such as sweating, tremors, palpitations,
hunger, anxiety, and tachycardia. Fruity breath is associated with
ketoacidosis rather than hypoglycemia. Severe hypoglycemia can
progress to confusion, seizures, and loss of consciousness.
A client with diabetes mellitus is awake, oriented, and has a blood
glucose level of 54 mg/dL. What should the nurse do first?
A. Administer rapid-acting insulin
B. Give an appropriate source of fast-acting carbohydrate
C. Encourage the client to exercise
D. Restrict oral intake
Answer: B. Give an appropriate source of fast-acting carbohydrate
Rationale: An alert client with symptomatic or significantly low blood
glucose should receive a rapid source of carbohydrate, such as glucose
tablets or an appropriate carbohydrate-containing beverage. Insulin
would worsen hypoglycemia. Exercise is contraindicated until the
glucose level is corrected.
, A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD). Which intervention is appropriate?
A. Encourage controlled breathing techniques
B. Maintain the client in a completely flat position
C. Encourage prolonged breath-holding
D. Administer oxygen at an unrestricted high flow rate
Answer: A. Encourage controlled breathing techniques
Rationale: Controlled breathing techniques, including pursed-lip
breathing, can help clients with COPD improve ventilation and reduce
air trapping. Positioning that facilitates lung expansion is generally
preferred. Oxygen should be administered carefully according to the
prescribed therapy and the client's clinical condition.
Which finding is most concerning in a client with a suspected
myocardial infarction?
A. Mild fatigue
B. New ST-segment changes on an ECG
C. Slight thirst
D. Decreased appetite
Answer: B. New ST-segment changes on an ECG
Rationale: New ischemic ECG changes may indicate acute myocardial
injury and require immediate evaluation and treatment. A myocardial
infarction can cause life-threatening dysrhythmias and hemodynamic
instability, so rapid recognition is essential.
MOST RECENT EXAM 2026|2027 ACTUAL COMPLETE REAL
EXAM QUESTIONS AND CORRECT ANSWERS (VERIFIED
ANSWERS) ALREADY GRADED A+ | GUARANTEED
SUCCESS!! BRAND NEW VERSION! | JUST RELEASED!!
A nurse is assessing a client who reports sudden shortness of breath
and chest discomfort. Which assessment finding requires the nurse's
immediate attention?
A. Respiratory rate of 18/min
B. Oxygen saturation of 96% on room air
C. New-onset cyanosis and severe dyspnea
D. Mild anxiety about hospitalization
Answer: C. New-onset cyanosis and severe dyspnea
Rationale: Cyanosis accompanied by severe dyspnea indicates
significant impairment of oxygenation and may represent acute
respiratory compromise. The nurse should immediately assess airway
and breathing, provide oxygen as indicated, and activate emergency
interventions. The other findings are not immediately life-threatening.
A nurse is caring for a client receiving oxygen through a nasal cannula.
Which intervention is most appropriate?
A. Apply petroleum jelly around the client's nares
B. Assess the client's respiratory status regularly
,C. Increase the oxygen flow rate whenever the client reports anxiety
D. Remove the oxygen during meals
Answer: B. Assess the client's respiratory status regularly
Rationale: Oxygen therapy requires ongoing assessment of respiratory
rate, effort, oxygen saturation, breath sounds, and response to
treatment. Petroleum-based products should be avoided around
oxygen because they increase fire risk. Oxygen should not be increased
without appropriate clinical assessment or an order when required.
A client with heart failure has gained 2.5 kg over several days. Which
interpretation by the nurse is most appropriate?
A. The weight gain is expected with aging
B. The client is likely experiencing fluid retention
C. The client has probably increased muscle mass
D. The finding indicates inadequate nutritional intake
Answer: B. The client is likely experiencing fluid retention
Rationale: Rapid weight gain in a client with heart failure is commonly
associated with fluid accumulation. Daily weights are an important
method of monitoring fluid balance.
A rapid increase is more suggestive of fluid retention than increased
tissue mass.
Which assessment finding is most characteristic of hypoglycemia in a
client receiving insulin?
,A. Warm, dry skin
B. Bradycardia and hypertension
C. Diaphoresis and tremors
D. Fruity breath odor
Answer: C. Diaphoresis and tremors
Rationale: Hypoglycemia activates the sympathetic nervous system,
producing manifestations such as sweating, tremors, palpitations,
hunger, anxiety, and tachycardia. Fruity breath is associated with
ketoacidosis rather than hypoglycemia. Severe hypoglycemia can
progress to confusion, seizures, and loss of consciousness.
A client with diabetes mellitus is awake, oriented, and has a blood
glucose level of 54 mg/dL. What should the nurse do first?
A. Administer rapid-acting insulin
B. Give an appropriate source of fast-acting carbohydrate
C. Encourage the client to exercise
D. Restrict oral intake
Answer: B. Give an appropriate source of fast-acting carbohydrate
Rationale: An alert client with symptomatic or significantly low blood
glucose should receive a rapid source of carbohydrate, such as glucose
tablets or an appropriate carbohydrate-containing beverage. Insulin
would worsen hypoglycemia. Exercise is contraindicated until the
glucose level is corrected.
, A nurse is caring for a client with chronic obstructive pulmonary
disease (COPD). Which intervention is appropriate?
A. Encourage controlled breathing techniques
B. Maintain the client in a completely flat position
C. Encourage prolonged breath-holding
D. Administer oxygen at an unrestricted high flow rate
Answer: A. Encourage controlled breathing techniques
Rationale: Controlled breathing techniques, including pursed-lip
breathing, can help clients with COPD improve ventilation and reduce
air trapping. Positioning that facilitates lung expansion is generally
preferred. Oxygen should be administered carefully according to the
prescribed therapy and the client's clinical condition.
Which finding is most concerning in a client with a suspected
myocardial infarction?
A. Mild fatigue
B. New ST-segment changes on an ECG
C. Slight thirst
D. Decreased appetite
Answer: B. New ST-segment changes on an ECG
Rationale: New ischemic ECG changes may indicate acute myocardial
injury and require immediate evaluation and treatment. A myocardial
infarction can cause life-threatening dysrhythmias and hemodynamic
instability, so rapid recognition is essential.
