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NUR 185 FINAL EXAM QUESTIONS WITH VERIFIED ANSWERS
DETAILED RATIONALES GRADED A+
NUR 185 Final Exam
Questions 1–40: Perioperative Care, Emergency Management &
Fluids/Electrolytes
1. A nurse is caring for a patient in the emergent phase of a major burn injury and
notes a serum potassium level of 6.1 mEq/L, so which finding is most consistent
with this electrolyte imbalance?
A. Muscle weakness and bradycardia
B. Positive Trousseau sign
C. Hyperactive bowel sounds
D. Hyporeflexia
Answer: A. Rationale: Hyperkalemia in the emergent burn phase causes cardiac
dysrhythmias and muscle weakness. Hyperkalemia commonly leads to bradycardia, not
hyperactive reflexes. Positive Trousseau sign is associated with hypocalcemia.
2. A patient with acute decompensated heart failure is receiving IV furosemide, so
which assessment finding best indicates a therapeutic response to the medication?
A. Serum potassium of 3.1 mEq/L
B. Urine output of 90 mL/hr with decreased crackles
C. Weight increase of 0.5 kg over 24 hours
D. Bilateral jugular venous distention of 5 cm
Answer: B. Rationale: Furosemide reduces preload by promoting diuresis; effective
response is reflected by increased urine output and clearing pulmonary crackles.
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Hypokalemia (A) is an adverse effect, weight gain (C) suggests fluid retention, and
persistent JVD (D) indicates ongoing volume overload.
3. A patient with type 1 diabetes is admitted with blood glucose 512 mg/dL, pH
7.22, positive serum ketones, and K+ 5.6 mEq/L, so which prescription should the
nurse implement first?
A. Administer regular insulin IV bolus per protocol
B. Administer sodium bicarbonate IV push
C. Give potassium chloride 20 mEq IV
D. Start subcutaneous insulin glargine
Answer: A. Rationale: Diabetic ketoacidosis requires immediate IV regular insulin to halt
ketogenesis and lower glucose. Bicarbonate is not routine, potassium is already elevated
(C is unsafe), and long-acting insulin (D) is not used for acute DKA management.
4. Which arterial blood gas result is most consistent with an acute exacerbation of
COPD in a patient retaining carbon dioxide?
A. pH 7.48, PaCO2 30 mm Hg, HCO3 22 mEq/L
B. pH 7.30, PaCO2 58 mm Hg, HCO3 26 mEq/L
C. pH 7.50, PaCO2 40 mm Hg, HCO3 30 mEq/L
D. pH 7.36, PaCO2 44 mm Hg, HCO3 24 mEq/L
Answer: B. Rationale: Acute CO2 retention produces respiratory acidosis with an
elevated PaCO2 and low pH; the minimally elevated HCO3 reflects early renal
compensation. Options A and C represent alkalosis, and D reflects normal acid-base
balance.
5. A patient with chronic kidney disease (stage 4) has a hemoglobin of 8.6 g/dL
and is prescribed epoetin alfa, so which laboratory value must the nurse verify
before administration?
A. Serum potassium
B. Serum ferritin and transferrin saturation
C. Serum calcium
D. Serum albumin
Answer: B. Rationale: Erythropoiesis-stimulating agents require adequate iron stores to
be effective; ferritin and transferrin saturation must be assessed before and during
therapy. Potassium, calcium, and albumin do not determine epoetin alfa readiness.
6. During a code blue, epinephrine is administered IV push, so where should the
nurse place the used vial after administration?
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A. Biohazard bag
B. Regular trash
C. Sharps container
D. Medication disposal bin
Answer: C. Rationale: Used vials (glass) are considered sharps and must be disposed of
in a sharps container to prevent injury.
7. Which nutrients are essential to promote tissue healing? (Select all that apply.)
A. Protein (chicken, fish, eggs, lean meat)
B. Vitamin A
C. Vitamin C
D. Vitamin D
Answer: A, B, C. Rationale: Protein, vitamin A, and vitamin C are essential for tissue
healing. Vitamin C promotes collagen production for wound healing.
8. Which interventions are effective for skin cancer prevention? (Select all that
apply.)
A. Use sunscreen liberally with SPF 15 and above, reapply every 2 hours
B. Avoid sunlight from 10 a.m. to 4 p.m.
C. Use tanning beds for vitamin D
D. Check moles regularly
Answer: A, B, D. Rationale: Sunscreen, avoiding peak sun hours, and regular mole
checks are effective prevention strategies. Tanning beds increase skin cancer risk and
should be avoided.
9. An RN is delegating tasks to an LPN, so which task would be within the LPN's
scope of practice?
A. Insert an IV in a 45-year-old patient rating pain 10/10 who is about to go to the Cath
lab
B. Administer IV push medications
C. Perform the initial patient assessment
D. Develop the nursing care plan
Answer: A. Rationale: LPNs can insert IVs in adult patients under supervision. They
cannot administer IV push medications, perform initial assessments, or develop care
plans.
10. A 25-year-old patient is admitted to the ER with O2 saturation of 89%,
respiratory rate of 86, and is unresponsive to stimuli, so the nurse anticipates
administration of which medication?
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A. Epinephrine
B. Atropine
C. Naloxone (Narcan)
D. Amiodarone
Answer: C. Rationale: Unresponsiveness with respiratory depression suggests opioid
overdose, requiring naloxone (Narcan) as the antidote.
11. A patient with a history of heart failure is prescribed sacubitril/valsartan, so
which assessment finding requires the nurse to hold the medication and notify the
provider?
A. Potassium 4.2 mEq/L
B. Blood pressure 82/48 mm Hg
C. Heart rate 88 beats/min
D. Weight loss of 1 kg
Answer: B. Rationale: Sacubitril/valsartan is an ARNI that can cause hypotension; a
systolic BP below 90 mm Hg warrants holding the medication and notifying the
provider.
12. A patient receiving continuous IV heparin for venous thromboembolism has an
aPTT of 98 seconds (therapeutic range 60-80 seconds), so which action should the
nurse take?
A. Increase the heparin infusion rate
B. Continue the current infusion rate
C. Stop the infusion and prepare to administer protamine sulfate
D. Administer vitamin K
Answer: C. Rationale: An aPTT of 98 seconds is supratherapeutic, placing the patient at
risk for bleeding. The infusion should be stopped, and protamine sulfate may be
administered as the antidote.
13. A nurse is assessing a patient with suspected fluid volume deficit, so which
finding is most consistent with this condition?
A. Bounding pulse
B. Crackles in the lungs
C. Poor skin turgor and dry mucous membranes
D. Weight gain
Answer: C. Rationale: Fluid volume deficit presents with poor skin turgor, dry mucous
membranes, tachycardia, and hypotension. Bounding pulse, crackles, and weight gain
indicate fluid overload.
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NUR 185 FINAL EXAM QUESTIONS WITH VERIFIED ANSWERS
DETAILED RATIONALES GRADED A+
NUR 185 Final Exam
Questions 1–40: Perioperative Care, Emergency Management &
Fluids/Electrolytes
1. A nurse is caring for a patient in the emergent phase of a major burn injury and
notes a serum potassium level of 6.1 mEq/L, so which finding is most consistent
with this electrolyte imbalance?
A. Muscle weakness and bradycardia
B. Positive Trousseau sign
C. Hyperactive bowel sounds
D. Hyporeflexia
Answer: A. Rationale: Hyperkalemia in the emergent burn phase causes cardiac
dysrhythmias and muscle weakness. Hyperkalemia commonly leads to bradycardia, not
hyperactive reflexes. Positive Trousseau sign is associated with hypocalcemia.
2. A patient with acute decompensated heart failure is receiving IV furosemide, so
which assessment finding best indicates a therapeutic response to the medication?
A. Serum potassium of 3.1 mEq/L
B. Urine output of 90 mL/hr with decreased crackles
C. Weight increase of 0.5 kg over 24 hours
D. Bilateral jugular venous distention of 5 cm
Answer: B. Rationale: Furosemide reduces preload by promoting diuresis; effective
response is reflected by increased urine output and clearing pulmonary crackles.
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,Page 2 of 49
Hypokalemia (A) is an adverse effect, weight gain (C) suggests fluid retention, and
persistent JVD (D) indicates ongoing volume overload.
3. A patient with type 1 diabetes is admitted with blood glucose 512 mg/dL, pH
7.22, positive serum ketones, and K+ 5.6 mEq/L, so which prescription should the
nurse implement first?
A. Administer regular insulin IV bolus per protocol
B. Administer sodium bicarbonate IV push
C. Give potassium chloride 20 mEq IV
D. Start subcutaneous insulin glargine
Answer: A. Rationale: Diabetic ketoacidosis requires immediate IV regular insulin to halt
ketogenesis and lower glucose. Bicarbonate is not routine, potassium is already elevated
(C is unsafe), and long-acting insulin (D) is not used for acute DKA management.
4. Which arterial blood gas result is most consistent with an acute exacerbation of
COPD in a patient retaining carbon dioxide?
A. pH 7.48, PaCO2 30 mm Hg, HCO3 22 mEq/L
B. pH 7.30, PaCO2 58 mm Hg, HCO3 26 mEq/L
C. pH 7.50, PaCO2 40 mm Hg, HCO3 30 mEq/L
D. pH 7.36, PaCO2 44 mm Hg, HCO3 24 mEq/L
Answer: B. Rationale: Acute CO2 retention produces respiratory acidosis with an
elevated PaCO2 and low pH; the minimally elevated HCO3 reflects early renal
compensation. Options A and C represent alkalosis, and D reflects normal acid-base
balance.
5. A patient with chronic kidney disease (stage 4) has a hemoglobin of 8.6 g/dL
and is prescribed epoetin alfa, so which laboratory value must the nurse verify
before administration?
A. Serum potassium
B. Serum ferritin and transferrin saturation
C. Serum calcium
D. Serum albumin
Answer: B. Rationale: Erythropoiesis-stimulating agents require adequate iron stores to
be effective; ferritin and transferrin saturation must be assessed before and during
therapy. Potassium, calcium, and albumin do not determine epoetin alfa readiness.
6. During a code blue, epinephrine is administered IV push, so where should the
nurse place the used vial after administration?
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,Page 3 of 49
A. Biohazard bag
B. Regular trash
C. Sharps container
D. Medication disposal bin
Answer: C. Rationale: Used vials (glass) are considered sharps and must be disposed of
in a sharps container to prevent injury.
7. Which nutrients are essential to promote tissue healing? (Select all that apply.)
A. Protein (chicken, fish, eggs, lean meat)
B. Vitamin A
C. Vitamin C
D. Vitamin D
Answer: A, B, C. Rationale: Protein, vitamin A, and vitamin C are essential for tissue
healing. Vitamin C promotes collagen production for wound healing.
8. Which interventions are effective for skin cancer prevention? (Select all that
apply.)
A. Use sunscreen liberally with SPF 15 and above, reapply every 2 hours
B. Avoid sunlight from 10 a.m. to 4 p.m.
C. Use tanning beds for vitamin D
D. Check moles regularly
Answer: A, B, D. Rationale: Sunscreen, avoiding peak sun hours, and regular mole
checks are effective prevention strategies. Tanning beds increase skin cancer risk and
should be avoided.
9. An RN is delegating tasks to an LPN, so which task would be within the LPN's
scope of practice?
A. Insert an IV in a 45-year-old patient rating pain 10/10 who is about to go to the Cath
lab
B. Administer IV push medications
C. Perform the initial patient assessment
D. Develop the nursing care plan
Answer: A. Rationale: LPNs can insert IVs in adult patients under supervision. They
cannot administer IV push medications, perform initial assessments, or develop care
plans.
10. A 25-year-old patient is admitted to the ER with O2 saturation of 89%,
respiratory rate of 86, and is unresponsive to stimuli, so the nurse anticipates
administration of which medication?
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, Page 4 of 49
A. Epinephrine
B. Atropine
C. Naloxone (Narcan)
D. Amiodarone
Answer: C. Rationale: Unresponsiveness with respiratory depression suggests opioid
overdose, requiring naloxone (Narcan) as the antidote.
11. A patient with a history of heart failure is prescribed sacubitril/valsartan, so
which assessment finding requires the nurse to hold the medication and notify the
provider?
A. Potassium 4.2 mEq/L
B. Blood pressure 82/48 mm Hg
C. Heart rate 88 beats/min
D. Weight loss of 1 kg
Answer: B. Rationale: Sacubitril/valsartan is an ARNI that can cause hypotension; a
systolic BP below 90 mm Hg warrants holding the medication and notifying the
provider.
12. A patient receiving continuous IV heparin for venous thromboembolism has an
aPTT of 98 seconds (therapeutic range 60-80 seconds), so which action should the
nurse take?
A. Increase the heparin infusion rate
B. Continue the current infusion rate
C. Stop the infusion and prepare to administer protamine sulfate
D. Administer vitamin K
Answer: C. Rationale: An aPTT of 98 seconds is supratherapeutic, placing the patient at
risk for bleeding. The infusion should be stopped, and protamine sulfate may be
administered as the antidote.
13. A nurse is assessing a patient with suspected fluid volume deficit, so which
finding is most consistent with this condition?
A. Bounding pulse
B. Crackles in the lungs
C. Poor skin turgor and dry mucous membranes
D. Weight gain
Answer: C. Rationale: Fluid volume deficit presents with poor skin turgor, dry mucous
membranes, tachycardia, and hypotension. Bounding pulse, crackles, and weight gain
indicate fluid overload.
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