NUR 200 ADVANCED NURSING
FUNDAMENTALS EXAM STUDY GUIDE
QUESTIONS AND CORRECT ANSWERS
WITH DETAILED EXPLANATIONS
1. A patient presents with a serum potassium level of 6.8 mEq/L. Which of the following is the
most immediate priority for the nurse?
A. Obtaining a 12-lead electrocardiogram (ECG)
B. Administering a dose of sodium polystyrene sulfonate (Kayexalate)
C. Educating the patient on a low-potassium diet
D. Checking the patient’s urine output for the last 8 hours
Answer: A
Conceptual Explanation: Severe hyperkalemia (above 6.5 mEq/L) can cause life-
threatening cardiac dysrhythmias. An ECG is the priority to assess for peaked T-waves or
widened QRS complexes before initiating treatments like Kayexalate.
2. An arterial blood gas (ABG) report shows: pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Compensated Metabolic Acidosis
B. Uncompensated Metabolic Alkalosis
,C. Partially Compensated Respiratory Acidosis
D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is normal, indicating that the kidneys have not yet compensated.
3. Which pharmacokinetic process is most significantly affected by a patient’s severely
decreased serum albumin levels?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
Answer: B
Conceptual Explanation: Distribution is affected because many drugs bind to albumin.
Low albumin levels lead to more ‘free’ active drug in the bloodstream, increasing the risk of
toxicity.
4. A nurse is caring for a patient who refuses a life-saving blood transfusion due to religious
beliefs. The nurse supports this decision based on which ethical principle?
A. Autonomy
B. Beneficence
, C. Non-maleficence
D. Justice
Answer: A
Conceptual Explanation: Autonomy refers to the right of the patient to make their own
decisions about their medical care, even if the healthcare provider disagrees.
5. Which of the following describes a Stage 3 pressure injury?
A. Non-blanchable erythema of intact skin
B. Partial-thickness loss of dermis presenting as a shallow open ulcer
C. Full-thickness skin loss with visible adipose tissue
D. Full-thickness tissue loss with exposed bone, tendon, or muscle
Answer: C
Conceptual Explanation: Stage 3 involves full-thickness skin loss where subcutaneous fat
(adipose) may be visible, but bone, tendon, or muscle are not exposed.
6. During a blood transfusion, the patient complains of chills and lower back pain. What is the
nurse’s first action?
A. Slow the infusion rate and notify the physician
B. Administer ordered diphenhydramine
C. Stop the transfusion immediately
FUNDAMENTALS EXAM STUDY GUIDE
QUESTIONS AND CORRECT ANSWERS
WITH DETAILED EXPLANATIONS
1. A patient presents with a serum potassium level of 6.8 mEq/L. Which of the following is the
most immediate priority for the nurse?
A. Obtaining a 12-lead electrocardiogram (ECG)
B. Administering a dose of sodium polystyrene sulfonate (Kayexalate)
C. Educating the patient on a low-potassium diet
D. Checking the patient’s urine output for the last 8 hours
Answer: A
Conceptual Explanation: Severe hyperkalemia (above 6.5 mEq/L) can cause life-
threatening cardiac dysrhythmias. An ECG is the priority to assess for peaked T-waves or
widened QRS complexes before initiating treatments like Kayexalate.
2. An arterial blood gas (ABG) report shows: pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Compensated Metabolic Acidosis
B. Uncompensated Metabolic Alkalosis
,C. Partially Compensated Respiratory Acidosis
D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory cause),
and the HCO3 is normal, indicating that the kidneys have not yet compensated.
3. Which pharmacokinetic process is most significantly affected by a patient’s severely
decreased serum albumin levels?
A. Metabolism
B. Distribution
C. Absorption
D. Excretion
Answer: B
Conceptual Explanation: Distribution is affected because many drugs bind to albumin.
Low albumin levels lead to more ‘free’ active drug in the bloodstream, increasing the risk of
toxicity.
4. A nurse is caring for a patient who refuses a life-saving blood transfusion due to religious
beliefs. The nurse supports this decision based on which ethical principle?
A. Autonomy
B. Beneficence
, C. Non-maleficence
D. Justice
Answer: A
Conceptual Explanation: Autonomy refers to the right of the patient to make their own
decisions about their medical care, even if the healthcare provider disagrees.
5. Which of the following describes a Stage 3 pressure injury?
A. Non-blanchable erythema of intact skin
B. Partial-thickness loss of dermis presenting as a shallow open ulcer
C. Full-thickness skin loss with visible adipose tissue
D. Full-thickness tissue loss with exposed bone, tendon, or muscle
Answer: C
Conceptual Explanation: Stage 3 involves full-thickness skin loss where subcutaneous fat
(adipose) may be visible, but bone, tendon, or muscle are not exposed.
6. During a blood transfusion, the patient complains of chills and lower back pain. What is the
nurse’s first action?
A. Slow the infusion rate and notify the physician
B. Administer ordered diphenhydramine
C. Stop the transfusion immediately
