Page 1 of 145
NUR 445 EXAM 1 — ARIZONA COLLEGE OF
NURSING QUESTIONS AND DETAILED
SOLUTIONS JUST RELEASED
NUR 445 EXAM 1 — ARIZONA COLLEGE OF NURSING
COVERAGE — MOST TESTED AREAS
1. Critical-care nursing, clinical judgment, prioritization, and interprofessional communication
2. Acute respiratory failure, hypoxemia, hypercapnia, ABGs, and oxygenation
3. Mechanical ventilation, ventilator management, weaning, sedation, and airway emergencies
4. ARDS, pulmonary edema, pulmonary embolism, pneumothorax, and chest-tube management
5. Cardiovascular assessment, dysrhythmias, hemodynamics, and emergency interventions
6. Acute coronary syndromes, STEMI/NSTEMI, cardiac catheterization, CABG, and complications
7. Heart failure, cardiomyopathy, valvular disease, endocarditis, tamponade, aneurysm, and
dissection
8. Endocrine disorders, including diabetes emergencies, thyroid disorders, adrenal disorders, and
hormone regulation
9. High-acuity medications, analgesia, sedation, vasoactive therapies, anticoagulation, and
medication safety
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10. Complex multisystem care, rapid response, patient/family-centered care, ethics, palliative
care, and evidence-based decision-making
Arizona College currently lists NUR 445 as Acute & Chronic Health Disruptions in Adults III, a three-
credit course emphasizing complex adult and older-adult care, clinical judgment, evidence-
based decision-making, and patient-centered interprofessional care. (Arizona College of
Nursing) Current study materials associated with NUR 445 Exam 1 also identify
respiratory/ventilator care, cardiovascular disorders, endocrine disorders, ABGs, critical-care
medications, and prioritization as major preparation areas. (CliffsNotes)
QUESTIONS 1–250
1. Critical-Care Assessment and Clinical Judgment
1. Which assessment finding should the nurse recognize as the highest priority when caring for a
deteriorating adult patient with multiple acute conditions?
A. New confusion with oxygen saturation of 82%
B. Mild chronic back discomfort rated 3/10
C. Decreased appetite during the previous meal
D. Difficulty sleeping during the previous night
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Answer: A
Rationale:
• Severe hypoxemia can rapidly compromise neurologic and cardiac function.
• New confusion may indicate inadequate oxygen delivery to the brain.
• Airway and breathing concerns take priority over stable comfort concerns.
2. What nursing action best demonstrates clinical judgment when several abnormal findings are
identified in a critically ill patient?
A. Document every finding before taking action
B. Address the most immediately life-threatening problem first
C. Ask the family which problem should receive priority
D. Wait until laboratory results are available before intervening
Answer: B
Rationale:
• Clinical judgment requires recognizing threats to airway, breathing, circulation, and neurologic
status.
• Immediate threats should be addressed while additional data are collected.
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3. Why is trending vital signs particularly important when monitoring patients with acute and
chronic health disruptions?
A. It eliminates the need for physical assessment
B. It determines the patient's insurance classification
C. It helps identify clinically significant changes over time
D. It guarantees that complications will not develop
Answer: C
Rationale:
• Trends can reveal deterioration before a single abnormal value becomes dramatic.
• Changes over time provide more clinical meaning than isolated measurements.
4. How should the nurse respond when a patient suddenly becomes difficult to arouse and
develops shallow respirations?
A. Offer oral fluids and reassess in thirty minutes
B. Encourage ambulation to stimulate circulation
C. Place the patient flat and leave the room
D. Immediately assess airway and breathing while calling for assistance
Answer: D
Rationale:
NUR 445 EXAM 1 — ARIZONA COLLEGE OF
NURSING QUESTIONS AND DETAILED
SOLUTIONS JUST RELEASED
NUR 445 EXAM 1 — ARIZONA COLLEGE OF NURSING
COVERAGE — MOST TESTED AREAS
1. Critical-care nursing, clinical judgment, prioritization, and interprofessional communication
2. Acute respiratory failure, hypoxemia, hypercapnia, ABGs, and oxygenation
3. Mechanical ventilation, ventilator management, weaning, sedation, and airway emergencies
4. ARDS, pulmonary edema, pulmonary embolism, pneumothorax, and chest-tube management
5. Cardiovascular assessment, dysrhythmias, hemodynamics, and emergency interventions
6. Acute coronary syndromes, STEMI/NSTEMI, cardiac catheterization, CABG, and complications
7. Heart failure, cardiomyopathy, valvular disease, endocarditis, tamponade, aneurysm, and
dissection
8. Endocrine disorders, including diabetes emergencies, thyroid disorders, adrenal disorders, and
hormone regulation
9. High-acuity medications, analgesia, sedation, vasoactive therapies, anticoagulation, and
medication safety
, Page 2 of 145
10. Complex multisystem care, rapid response, patient/family-centered care, ethics, palliative
care, and evidence-based decision-making
Arizona College currently lists NUR 445 as Acute & Chronic Health Disruptions in Adults III, a three-
credit course emphasizing complex adult and older-adult care, clinical judgment, evidence-
based decision-making, and patient-centered interprofessional care. (Arizona College of
Nursing) Current study materials associated with NUR 445 Exam 1 also identify
respiratory/ventilator care, cardiovascular disorders, endocrine disorders, ABGs, critical-care
medications, and prioritization as major preparation areas. (CliffsNotes)
QUESTIONS 1–250
1. Critical-Care Assessment and Clinical Judgment
1. Which assessment finding should the nurse recognize as the highest priority when caring for a
deteriorating adult patient with multiple acute conditions?
A. New confusion with oxygen saturation of 82%
B. Mild chronic back discomfort rated 3/10
C. Decreased appetite during the previous meal
D. Difficulty sleeping during the previous night
, Page 3 of 145
Answer: A
Rationale:
• Severe hypoxemia can rapidly compromise neurologic and cardiac function.
• New confusion may indicate inadequate oxygen delivery to the brain.
• Airway and breathing concerns take priority over stable comfort concerns.
2. What nursing action best demonstrates clinical judgment when several abnormal findings are
identified in a critically ill patient?
A. Document every finding before taking action
B. Address the most immediately life-threatening problem first
C. Ask the family which problem should receive priority
D. Wait until laboratory results are available before intervening
Answer: B
Rationale:
• Clinical judgment requires recognizing threats to airway, breathing, circulation, and neurologic
status.
• Immediate threats should be addressed while additional data are collected.
, Page 4 of 145
3. Why is trending vital signs particularly important when monitoring patients with acute and
chronic health disruptions?
A. It eliminates the need for physical assessment
B. It determines the patient's insurance classification
C. It helps identify clinically significant changes over time
D. It guarantees that complications will not develop
Answer: C
Rationale:
• Trends can reveal deterioration before a single abnormal value becomes dramatic.
• Changes over time provide more clinical meaning than isolated measurements.
4. How should the nurse respond when a patient suddenly becomes difficult to arouse and
develops shallow respirations?
A. Offer oral fluids and reassess in thirty minutes
B. Encourage ambulation to stimulate circulation
C. Place the patient flat and leave the room
D. Immediately assess airway and breathing while calling for assistance
Answer: D
Rationale:
