N176: Adult Health & Geriatric Nursing Exam 4
Practice Questions
300 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 N176: Adult Health & Geriatric Nursing Exam 4 Practice Questions
,Q1
A client with acute respiratory distress is using accessory muscles and can speak only one or
two words at a time. What is the nurse's priority?
A) Call for urgent assistance and assess airway, breathing, oxygenation CORRECT
B) Offer a full glass of water
C) Complete the admission history first
D) Encourage the client to lie flat
Rationale
** Severe work of breathing and inability to speak full sentences signal possible respiratory failure.
Immediate ABC assessment and escalation take priority.
Q2
A client with pneumonia has an oxygen saturation of 86% on room air and new cyanosis. What
should the nurse do?
A) Initiate urgent assessment and oxygen per protocol/prescription while
CORRECT
escalating care
B) Document the value and recheck at the next routine round
C) Ask the client to walk to improve circulation
D) Encourage breath-holding
Rationale
** Severe hypoxemia with cyanosis is an emergency. Support oxygenation and promptly escalate
according to orders and local protocol.
Q3
Which finding in a client with asthma requires immediate escalation?
A) Mild expiratory wheeze after exercise
B) Ability to speak in full sentences
C) Silent chest with severe respiratory effort CORRECT
D) Occasional dry cough
2
,Rationale
** A silent chest during severe distress may mean minimal air movement and impending respiratory
failure; urgent emergency response is required.
Q4
A client with COPD is receiving oxygen as prescribed and becomes drowsy. What is the nurse's
priority?
A) Remove oxygen without assessment
B) Assess respiratory status, oxygen saturation, and level of consciousness CORRECT
C) Encourage the client to sleep
D) Increase oxygen flow independently to the maximum setting
Rationale
** A change in alertness may indicate worsening ventilation, hypoxemia, or hypercapnia. Assess
promptly and escalate care according to findings and prescribed parameters.
Q5
A nurse is teaching incentive spirometer use after surgery. Which instruction is correct?
A) Blow forcefully into the device
B) Inhale slowly and deeply through the mouthpiece, then briefly hold the breath CORRECT
C) Use it only when short of breath
D) Lie flat and use it once daily
Rationale
** Slow sustained inhalation expands alveoli; a brief breath hold supports lung expansion. Use should
follow the care plan, often while awake.
3
, Q6
A client with pneumonia becomes increasingly confused, restless, and tachypneic. Which action
should the nurse take first?
A) Obtain a complete dietary history
B) Assess oxygen saturation and respiratory effort CORRECT
C) Encourage the client to walk in the hallway
D) Offer oral fluids and reassess in one hour
Rationale
** New confusion and restlessness can be early signs of hypoxemia. Rapid assessment of oxygenation
and work of breathing guides urgent intervention.
---
### Section 2: Cardiovascular System
Q7
A client reports crushing chest pressure, diaphoresis, and nausea. What should the nurse do
first?
A) Ask the client to walk to the nurses' station
B) Activate the emergency response pathway and rapidly assess ABCs CORRECT
C) Give a large meal to reduce nausea
D) Document the report and reassess at the end of the shift
Rationale
** These symptoms may indicate acute coronary syndrome. Immediate assessment and emergency
escalation are needed; follow facility protocol for ECG and prescribed therapies.
Q8
Which assessment finding is most consistent with worsening left-sided heart failure?
A) Increasing crackles and orthopnea CORRECT
B) Dry skin on both hands
C) Improved exercise tolerance
4
Practice Questions
300 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 N176: Adult Health & Geriatric Nursing Exam 4 Practice Questions
,Q1
A client with acute respiratory distress is using accessory muscles and can speak only one or
two words at a time. What is the nurse's priority?
A) Call for urgent assistance and assess airway, breathing, oxygenation CORRECT
B) Offer a full glass of water
C) Complete the admission history first
D) Encourage the client to lie flat
Rationale
** Severe work of breathing and inability to speak full sentences signal possible respiratory failure.
Immediate ABC assessment and escalation take priority.
Q2
A client with pneumonia has an oxygen saturation of 86% on room air and new cyanosis. What
should the nurse do?
A) Initiate urgent assessment and oxygen per protocol/prescription while
CORRECT
escalating care
B) Document the value and recheck at the next routine round
C) Ask the client to walk to improve circulation
D) Encourage breath-holding
Rationale
** Severe hypoxemia with cyanosis is an emergency. Support oxygenation and promptly escalate
according to orders and local protocol.
Q3
Which finding in a client with asthma requires immediate escalation?
A) Mild expiratory wheeze after exercise
B) Ability to speak in full sentences
C) Silent chest with severe respiratory effort CORRECT
D) Occasional dry cough
2
,Rationale
** A silent chest during severe distress may mean minimal air movement and impending respiratory
failure; urgent emergency response is required.
Q4
A client with COPD is receiving oxygen as prescribed and becomes drowsy. What is the nurse's
priority?
A) Remove oxygen without assessment
B) Assess respiratory status, oxygen saturation, and level of consciousness CORRECT
C) Encourage the client to sleep
D) Increase oxygen flow independently to the maximum setting
Rationale
** A change in alertness may indicate worsening ventilation, hypoxemia, or hypercapnia. Assess
promptly and escalate care according to findings and prescribed parameters.
Q5
A nurse is teaching incentive spirometer use after surgery. Which instruction is correct?
A) Blow forcefully into the device
B) Inhale slowly and deeply through the mouthpiece, then briefly hold the breath CORRECT
C) Use it only when short of breath
D) Lie flat and use it once daily
Rationale
** Slow sustained inhalation expands alveoli; a brief breath hold supports lung expansion. Use should
follow the care plan, often while awake.
3
, Q6
A client with pneumonia becomes increasingly confused, restless, and tachypneic. Which action
should the nurse take first?
A) Obtain a complete dietary history
B) Assess oxygen saturation and respiratory effort CORRECT
C) Encourage the client to walk in the hallway
D) Offer oral fluids and reassess in one hour
Rationale
** New confusion and restlessness can be early signs of hypoxemia. Rapid assessment of oxygenation
and work of breathing guides urgent intervention.
---
### Section 2: Cardiovascular System
Q7
A client reports crushing chest pressure, diaphoresis, and nausea. What should the nurse do
first?
A) Ask the client to walk to the nurses' station
B) Activate the emergency response pathway and rapidly assess ABCs CORRECT
C) Give a large meal to reduce nausea
D) Document the report and reassess at the end of the shift
Rationale
** These symptoms may indicate acute coronary syndrome. Immediate assessment and emergency
escalation are needed; follow facility protocol for ECG and prescribed therapies.
Q8
Which assessment finding is most consistent with worsening left-sided heart failure?
A) Increasing crackles and orthopnea CORRECT
B) Dry skin on both hands
C) Improved exercise tolerance
4
