NUR200 Exam 1 Critical Thinking Exam 1 Prep (Nur 200 Hondros)
Questions and Answers | 100% Pass Guaranteed | Graded A+ |
NUR200 Exam 1 Critical Thinking for the RN Exam 1 NUR200
Critical Thinking for the Registered Nurse
1. A nurse is caring for a client who is post-operative and has a nasogastric tube set to low
intermittent suction. The client's most recent blood gas results show a pH of 7.50, PaCO2 of 42
mm Hg, and HCO3- of 32 mEq/L. The nurse interprets these findings as which acid-base
imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: D. Metabolic alkalosis
Rationale: The pH is elevated (alkalotic), and the primary disturbance is in the bicarbonate
(HCO3- > 26 mEq/L), indicating a metabolic cause. Gastric suctioning causes loss of hydrogen
ions, leading to metabolic alkalosis.
2. The charge nurse is observing a newly licensed nurse perform a sterile dressing change. Which
action by the new nurse requires immediate intervention by the charge nurse?
A. Holding the sterile dressing package above waist level while opening it.
B. Pouring sterile solution into a sterile basin from a height of 2 inches.
C. Placing the sterile field on the over-bed table away from the client's feet.
D. Reaching over the sterile field with a non-sterile arm to adjust the IV pump.
Answer: D. Reaching over the sterile field with a non-sterile arm to adjust the IV pump.
Rationale: Reaching over a sterile field contaminates the entire field because microorganisms can
fall from the non-sterile arm onto the field. This breaks the principle of sterility.
3. A client with heart failure is prescribed furosemide 40 mg IV twice daily. Which finding
indicates to the nurse that the medication is effective?
A. A decrease in the client's heart rate from 112 to 98 bpm.
,B. A weight loss of 1.5 kg (3.3 lbs) 24 hours after initiation.
C. An increase in the client's oxygen saturation from 90% to 94% on room air.
D. A decrease in the client's blood pressure from 160/90 mmHg to 110/70 mmHg.
Answer: B. A weight loss of 1.5 kg (3.3 lbs) 24 hours after initiation.
Rationale: Furosemide is a loop diuretic that promotes fluid excretion. The most direct and
objective measure of its effectiveness in a client with heart failure is a reduction in fluid volume,
evidenced by weight loss.
4. During hand-off report, the oncoming nurse is told a client has "sundowning." Which
intervention is most appropriate for the nurse to implement during the night shift?
A. Keep the room dark and quiet to promote deep sleep.
B. Restrain the client loosely if they attempt to get out of bed.
C. Provide orientation and a night light in the room.
D. Administer a sedative-hypnotic medication at bedtime as needed.
Answer: C. Provide orientation and a night light in the room.
Rationale: Sundowning is confusion that worsens in the evening/night. A night light reduces
shadows and confusion, and reorientation promotes safety and reduces anxiety. Restraints and
sedatives can increase confusion and fall risk.
5. A nurse is preparing to administer a unit of packed red blood cells to a client. Which action is
the priority before initiating the transfusion?
A. Prime the IV tubing with 0.9% sodium chloride.
B. Obtain a signed informed consent from the client.
C. Have two licensed nurses verify the blood product and client identification at the bedside.
D. Ensure the client has a patent 20-gauge IV catheter.
Answer: C. Have two licensed nurses verify the blood product and client identification at the
bedside.
Rationale: While all are important, the priority action to prevent a fatal hemolytic transfusion
reaction is the correct identification of the client and the blood product. This is a mandatory
safety step.
,6. A client with a history of alcoholism is admitted with confusion and ataxia. The nurse suspects
Wernicke-Korsakoff syndrome. Which vitamin deficiency is the primary cause of this condition?
A. Vitamin A
B. Vitamin B1 (Thiamine)
C. Vitamin B12
D. Vitamin C
Answer: B. Vitamin B1 (Thiamine)
Rationale: Wernicke-Korsakoff syndrome is a neurological disorder caused by thiamine
deficiency, which is common in individuals with chronic alcoholism.
7. The nurse is teaching a client with Crohn's disease about nutrition. Which food choice by the
client indicates a need for further teaching?
A. White bread toast
B. Poached eggs
C. A large bowl of raw vegetable salad
D. Baked chicken breast
Answer: C. A large bowl of raw vegetable salad
Rationale: Crohn's disease often involves inflammation of the small intestine. A high-fiber, raw
vegetable diet can exacerbate symptoms like diarrhea and abdominal pain. A low-residue diet is
often recommended during flare-ups.
8. A client is receiving a continuous IV infusion of heparin for a deep vein thrombosis (DVT).
Which laboratory value is essential for the nurse to monitor?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Platelet count
Answer: C. Activated Partial Thromboplastin Time (aPTT)
, Rationale: The aPTT is the primary test used to monitor the therapeutic effect of unfractionated
heparin. The therapeutic goal is typically 1.5 to 2.5 times the normal control value.
9. A nurse is caring for a client who is 2 days post-operative from a total abdominal
hysterectomy. The client refuses to use the incentive spirometer, stating, "It hurts too much when
I breathe deep." What is the nurse's best response?
A. "That's okay, we can try again later."
B. "If you don't use it, you are at high risk for getting pneumonia."
C. "I will administer your pain medication, and then we can practice together in 30 minutes."
D. "The doctor's order is mandatory, so you have to try."
Answer: C. "I will administer your pain medication, and then we can practice together in 30
minutes."
Rationale: This response addresses the client's barrier (pain) and provides collaborative support.
It uses therapeutic communication and promotes client autonomy while ensuring an important
health intervention is performed.
10. A client with type 1 diabetes has a blood glucose level of 55 mg/dL. The client is alert and
oriented. What is the nurse's priority action?
A. Administer 1 mg of glucagon IM.
B. Provide 4 oz of fruit juice orally.
C. Notify the healthcare provider immediately.
D. Have the client ambulate to increase blood sugar.
Answer: B. Provide 4 oz of fruit juice orally.
Rationale: For a conscious client with hypoglycemia, the priority is to administer a rapid-acting
carbohydrate orally. Fruit juice is an appropriate choice. Glucagon is reserved for unconscious
clients.
11. During a home visit, the nurse suspects elder abuse based on the client's withdrawn behavior
and the caregiver's hostile responses. What is the nurse's legal responsibility?
A. Confront the caregiver directly about the suspicions.
Questions and Answers | 100% Pass Guaranteed | Graded A+ |
NUR200 Exam 1 Critical Thinking for the RN Exam 1 NUR200
Critical Thinking for the Registered Nurse
1. A nurse is caring for a client who is post-operative and has a nasogastric tube set to low
intermittent suction. The client's most recent blood gas results show a pH of 7.50, PaCO2 of 42
mm Hg, and HCO3- of 32 mEq/L. The nurse interprets these findings as which acid-base
imbalance?
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
Answer: D. Metabolic alkalosis
Rationale: The pH is elevated (alkalotic), and the primary disturbance is in the bicarbonate
(HCO3- > 26 mEq/L), indicating a metabolic cause. Gastric suctioning causes loss of hydrogen
ions, leading to metabolic alkalosis.
2. The charge nurse is observing a newly licensed nurse perform a sterile dressing change. Which
action by the new nurse requires immediate intervention by the charge nurse?
A. Holding the sterile dressing package above waist level while opening it.
B. Pouring sterile solution into a sterile basin from a height of 2 inches.
C. Placing the sterile field on the over-bed table away from the client's feet.
D. Reaching over the sterile field with a non-sterile arm to adjust the IV pump.
Answer: D. Reaching over the sterile field with a non-sterile arm to adjust the IV pump.
Rationale: Reaching over a sterile field contaminates the entire field because microorganisms can
fall from the non-sterile arm onto the field. This breaks the principle of sterility.
3. A client with heart failure is prescribed furosemide 40 mg IV twice daily. Which finding
indicates to the nurse that the medication is effective?
A. A decrease in the client's heart rate from 112 to 98 bpm.
,B. A weight loss of 1.5 kg (3.3 lbs) 24 hours after initiation.
C. An increase in the client's oxygen saturation from 90% to 94% on room air.
D. A decrease in the client's blood pressure from 160/90 mmHg to 110/70 mmHg.
Answer: B. A weight loss of 1.5 kg (3.3 lbs) 24 hours after initiation.
Rationale: Furosemide is a loop diuretic that promotes fluid excretion. The most direct and
objective measure of its effectiveness in a client with heart failure is a reduction in fluid volume,
evidenced by weight loss.
4. During hand-off report, the oncoming nurse is told a client has "sundowning." Which
intervention is most appropriate for the nurse to implement during the night shift?
A. Keep the room dark and quiet to promote deep sleep.
B. Restrain the client loosely if they attempt to get out of bed.
C. Provide orientation and a night light in the room.
D. Administer a sedative-hypnotic medication at bedtime as needed.
Answer: C. Provide orientation and a night light in the room.
Rationale: Sundowning is confusion that worsens in the evening/night. A night light reduces
shadows and confusion, and reorientation promotes safety and reduces anxiety. Restraints and
sedatives can increase confusion and fall risk.
5. A nurse is preparing to administer a unit of packed red blood cells to a client. Which action is
the priority before initiating the transfusion?
A. Prime the IV tubing with 0.9% sodium chloride.
B. Obtain a signed informed consent from the client.
C. Have two licensed nurses verify the blood product and client identification at the bedside.
D. Ensure the client has a patent 20-gauge IV catheter.
Answer: C. Have two licensed nurses verify the blood product and client identification at the
bedside.
Rationale: While all are important, the priority action to prevent a fatal hemolytic transfusion
reaction is the correct identification of the client and the blood product. This is a mandatory
safety step.
,6. A client with a history of alcoholism is admitted with confusion and ataxia. The nurse suspects
Wernicke-Korsakoff syndrome. Which vitamin deficiency is the primary cause of this condition?
A. Vitamin A
B. Vitamin B1 (Thiamine)
C. Vitamin B12
D. Vitamin C
Answer: B. Vitamin B1 (Thiamine)
Rationale: Wernicke-Korsakoff syndrome is a neurological disorder caused by thiamine
deficiency, which is common in individuals with chronic alcoholism.
7. The nurse is teaching a client with Crohn's disease about nutrition. Which food choice by the
client indicates a need for further teaching?
A. White bread toast
B. Poached eggs
C. A large bowl of raw vegetable salad
D. Baked chicken breast
Answer: C. A large bowl of raw vegetable salad
Rationale: Crohn's disease often involves inflammation of the small intestine. A high-fiber, raw
vegetable diet can exacerbate symptoms like diarrhea and abdominal pain. A low-residue diet is
often recommended during flare-ups.
8. A client is receiving a continuous IV infusion of heparin for a deep vein thrombosis (DVT).
Which laboratory value is essential for the nurse to monitor?
A. Prothrombin Time (PT)
B. International Normalized Ratio (INR)
C. Activated Partial Thromboplastin Time (aPTT)
D. Platelet count
Answer: C. Activated Partial Thromboplastin Time (aPTT)
, Rationale: The aPTT is the primary test used to monitor the therapeutic effect of unfractionated
heparin. The therapeutic goal is typically 1.5 to 2.5 times the normal control value.
9. A nurse is caring for a client who is 2 days post-operative from a total abdominal
hysterectomy. The client refuses to use the incentive spirometer, stating, "It hurts too much when
I breathe deep." What is the nurse's best response?
A. "That's okay, we can try again later."
B. "If you don't use it, you are at high risk for getting pneumonia."
C. "I will administer your pain medication, and then we can practice together in 30 minutes."
D. "The doctor's order is mandatory, so you have to try."
Answer: C. "I will administer your pain medication, and then we can practice together in 30
minutes."
Rationale: This response addresses the client's barrier (pain) and provides collaborative support.
It uses therapeutic communication and promotes client autonomy while ensuring an important
health intervention is performed.
10. A client with type 1 diabetes has a blood glucose level of 55 mg/dL. The client is alert and
oriented. What is the nurse's priority action?
A. Administer 1 mg of glucagon IM.
B. Provide 4 oz of fruit juice orally.
C. Notify the healthcare provider immediately.
D. Have the client ambulate to increase blood sugar.
Answer: B. Provide 4 oz of fruit juice orally.
Rationale: For a conscious client with hypoglycemia, the priority is to administer a rapid-acting
carbohydrate orally. Fruit juice is an appropriate choice. Glucagon is reserved for unconscious
clients.
11. During a home visit, the nurse suspects elder abuse based on the client's withdrawn behavior
and the caregiver's hostile responses. What is the nurse's legal responsibility?
A. Confront the caregiver directly about the suspicions.
