1
NUR 676 Final Exam 2025 | Verified
Exam Questions with Correct Answers
| Graded A+ | Just Released Updated
Version
1. A patient with chronic obstructive pulmonary disease (COPD) presents with
increased dyspnea and a barrel chest. Which assessment finding is most indicative
of advanced disease?
A. Decreased breath sounds
B. Clubbing of fingers
C. Prolonged inspiratory phase
D. Wheezing on inspiration
Correct Answer: B
Rationale: Clubbing of fingers is a hallmark of chronic hypoxemia, often seen in
advanced COPD due to long-term oxygen deprivation. Decreased breath sounds and
wheezing are common but less specific, and a prolonged inspiratory phase is more typical
of restrictive lung diseases.
2. Which medication is contraindicated for a pregnant patient in the third trimester
presenting with hypertension?
A. Labetalol
B. Methyldopa
C. Lisinopril
D. Nifedipine
Correct Answer: C
Rationale: Lisinopril, an ACE inhibitor, is contraindicated in pregnancy due to risks of
fetal renal damage and oligohydramnios. Labetalol, methyldopa, and nifedipine are safer
options for managing hypertension in pregnancy.
3. A nurse practitioner is assessing a client with suspected heart failure. Which
diagnostic test is most specific for confirming left ventricular dysfunction?
A. Chest X-ray
B. Electrocardiogram (ECG)
C. Echocardiogram
D. B-type natriuretic peptide (BNP)
Correct Answer: C
Rationale: An echocardiogram directly visualizes left ventricular function, making it the
most specific test for heart failure. BNP is sensitive but less specific, while chest X-ray
and ECG provide supportive but indirect evidence.
4. A 45-year-old patient with type 2 diabetes mellitus reports blurred vision and
fatigue. What is the priority nursing intervention?
, 2
A. Administer insulin
B. Check blood glucose level
C. Refer to an ophthalmologist
D. Provide dietary counseling
Correct Answer: B
Rationale: Blurred vision and fatigue may indicate hyperglycemia or hypoglycemia.
Checking blood glucose is the priority to guide immediate management. Other
interventions follow based on the result.
5. Which electrolyte imbalance is most likely in a patient with chronic kidney disease
(CKD) presenting with muscle cramps and arrhythmias?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hyperkalemia is common in CKD due to impaired potassium excretion,
leading to muscle cramps and arrhythmias. Hypokalemia and hyponatremia are less
likely, and hypocalcemia may occur but is less directly linked to these symptoms.
6. A patient with bipolar disorder in a manic phase is prescribed lithium. Which
laboratory value should the nurse monitor closely?
A. Serum sodium
B. Serum creatinine
C. Thyroid-stimulating hormone (TSH)
D. Blood urea nitrogen (BUN)
Correct Answer: C
Rationale: Lithium can cause hypothyroidism, necessitating regular TSH monitoring.
While renal function (creatinine, BUN) and sodium levels are also monitored, TSH is
critical due to lithium’s direct effect on thyroid function.
7. What is the primary goal of care for a client with borderline personality disorder
exhibiting impulsive behaviors?
A. Promote medication adherence
B. Enhance emotional regulation
C. Encourage social isolation
D. Reduce cognitive distortions
Correct Answer: B
Rationale: Emotional regulation is the primary goal to manage impulsivity in borderline
personality disorder. Medication may support this, but therapy focusing on emotional
regulation is key. Social isolation is counterproductive, and cognitive distortions are more
relevant to other disorders.
8. A 60-year-old patient presents with chest pain and an elevated troponin level.
Which intervention is the priority?
A. Administer nitroglycerin
B. Obtain a 12-lead ECG
C. Start heparin infusion
D. Order a stress test
Correct Answer: B
, 3
Rationale: Obtaining a 12-lead ECG is the priority to confirm acute coronary syndrome
(ACS) in a patient with chest pain and elevated troponin. Nitroglycerin and heparin
follow based on ECG findings, and stress tests are not appropriate acutely.
9. Which vaccination is recommended for a 65-year-old patient with no prior history
of pneumococcal vaccination?
A. PCV13 only
B. PPSV23 only
C. PCV20 or PCV15 followed by PPSV23
D. No vaccination needed
Correct Answer: C
Rationale: For adults ≥65 years, the CDC recommends PCV20 alone or PCV15 followed
by PPSV23 to protect against pneumococcal disease. PCV13 is no longer routinely
recommended for this age group.
10. A patient with schizophrenia is prescribed risperidone. Which adverse effect should
the nurse prioritize monitoring?
A. Weight gain
B. Hypotension
C. Dry mouth
D. Insomnia
Correct Answer: A
Rationale: Weight gain is a common and significant side effect of risperidone, an
atypical antipsychotic, requiring monitoring to prevent metabolic syndrome. Other effects
like hypotension or dry mouth are less critical but may occur.
11. What is the most appropriate initial management for a patient with suspected
anaphylaxis?
A. Administer diphenhydramine
B. Provide oxygen therapy
C. Give intramuscular epinephrine
D. Start IV corticosteroids
Correct Answer: C
Rationale: Intramuscular epinephrine is the first-line treatment for anaphylaxis to reverse
airway constriction and hypotension. Diphenhydramine, oxygen, and corticosteroids are
adjunctive therapies.
12. A nurse is caring for a client with a new diagnosis of hyperthyroidism. Which
symptom is most likely to be reported?
A. Weight gain
B. Bradycardia
C. Heat intolerance
D. Constipation
Correct Answer: C
Rationale: Heat intolerance is a classic symptom of hyperthyroidism due to increased
metabolic rate. Weight loss, tachycardia, and diarrhea are also common, ruling out the
other options.
13. Which assessment finding in a postoperative hip replacement patient indicates a
potential complication?
A. Pain rated 3/10
NUR 676 Final Exam 2025 | Verified
Exam Questions with Correct Answers
| Graded A+ | Just Released Updated
Version
1. A patient with chronic obstructive pulmonary disease (COPD) presents with
increased dyspnea and a barrel chest. Which assessment finding is most indicative
of advanced disease?
A. Decreased breath sounds
B. Clubbing of fingers
C. Prolonged inspiratory phase
D. Wheezing on inspiration
Correct Answer: B
Rationale: Clubbing of fingers is a hallmark of chronic hypoxemia, often seen in
advanced COPD due to long-term oxygen deprivation. Decreased breath sounds and
wheezing are common but less specific, and a prolonged inspiratory phase is more typical
of restrictive lung diseases.
2. Which medication is contraindicated for a pregnant patient in the third trimester
presenting with hypertension?
A. Labetalol
B. Methyldopa
C. Lisinopril
D. Nifedipine
Correct Answer: C
Rationale: Lisinopril, an ACE inhibitor, is contraindicated in pregnancy due to risks of
fetal renal damage and oligohydramnios. Labetalol, methyldopa, and nifedipine are safer
options for managing hypertension in pregnancy.
3. A nurse practitioner is assessing a client with suspected heart failure. Which
diagnostic test is most specific for confirming left ventricular dysfunction?
A. Chest X-ray
B. Electrocardiogram (ECG)
C. Echocardiogram
D. B-type natriuretic peptide (BNP)
Correct Answer: C
Rationale: An echocardiogram directly visualizes left ventricular function, making it the
most specific test for heart failure. BNP is sensitive but less specific, while chest X-ray
and ECG provide supportive but indirect evidence.
4. A 45-year-old patient with type 2 diabetes mellitus reports blurred vision and
fatigue. What is the priority nursing intervention?
, 2
A. Administer insulin
B. Check blood glucose level
C. Refer to an ophthalmologist
D. Provide dietary counseling
Correct Answer: B
Rationale: Blurred vision and fatigue may indicate hyperglycemia or hypoglycemia.
Checking blood glucose is the priority to guide immediate management. Other
interventions follow based on the result.
5. Which electrolyte imbalance is most likely in a patient with chronic kidney disease
(CKD) presenting with muscle cramps and arrhythmias?
A. Hypokalemia
B. Hyperkalemia
C. Hypocalcemia
D. Hyponatremia
Correct Answer: B
Rationale: Hyperkalemia is common in CKD due to impaired potassium excretion,
leading to muscle cramps and arrhythmias. Hypokalemia and hyponatremia are less
likely, and hypocalcemia may occur but is less directly linked to these symptoms.
6. A patient with bipolar disorder in a manic phase is prescribed lithium. Which
laboratory value should the nurse monitor closely?
A. Serum sodium
B. Serum creatinine
C. Thyroid-stimulating hormone (TSH)
D. Blood urea nitrogen (BUN)
Correct Answer: C
Rationale: Lithium can cause hypothyroidism, necessitating regular TSH monitoring.
While renal function (creatinine, BUN) and sodium levels are also monitored, TSH is
critical due to lithium’s direct effect on thyroid function.
7. What is the primary goal of care for a client with borderline personality disorder
exhibiting impulsive behaviors?
A. Promote medication adherence
B. Enhance emotional regulation
C. Encourage social isolation
D. Reduce cognitive distortions
Correct Answer: B
Rationale: Emotional regulation is the primary goal to manage impulsivity in borderline
personality disorder. Medication may support this, but therapy focusing on emotional
regulation is key. Social isolation is counterproductive, and cognitive distortions are more
relevant to other disorders.
8. A 60-year-old patient presents with chest pain and an elevated troponin level.
Which intervention is the priority?
A. Administer nitroglycerin
B. Obtain a 12-lead ECG
C. Start heparin infusion
D. Order a stress test
Correct Answer: B
, 3
Rationale: Obtaining a 12-lead ECG is the priority to confirm acute coronary syndrome
(ACS) in a patient with chest pain and elevated troponin. Nitroglycerin and heparin
follow based on ECG findings, and stress tests are not appropriate acutely.
9. Which vaccination is recommended for a 65-year-old patient with no prior history
of pneumococcal vaccination?
A. PCV13 only
B. PPSV23 only
C. PCV20 or PCV15 followed by PPSV23
D. No vaccination needed
Correct Answer: C
Rationale: For adults ≥65 years, the CDC recommends PCV20 alone or PCV15 followed
by PPSV23 to protect against pneumococcal disease. PCV13 is no longer routinely
recommended for this age group.
10. A patient with schizophrenia is prescribed risperidone. Which adverse effect should
the nurse prioritize monitoring?
A. Weight gain
B. Hypotension
C. Dry mouth
D. Insomnia
Correct Answer: A
Rationale: Weight gain is a common and significant side effect of risperidone, an
atypical antipsychotic, requiring monitoring to prevent metabolic syndrome. Other effects
like hypotension or dry mouth are less critical but may occur.
11. What is the most appropriate initial management for a patient with suspected
anaphylaxis?
A. Administer diphenhydramine
B. Provide oxygen therapy
C. Give intramuscular epinephrine
D. Start IV corticosteroids
Correct Answer: C
Rationale: Intramuscular epinephrine is the first-line treatment for anaphylaxis to reverse
airway constriction and hypotension. Diphenhydramine, oxygen, and corticosteroids are
adjunctive therapies.
12. A nurse is caring for a client with a new diagnosis of hyperthyroidism. Which
symptom is most likely to be reported?
A. Weight gain
B. Bradycardia
C. Heat intolerance
D. Constipation
Correct Answer: C
Rationale: Heat intolerance is a classic symptom of hyperthyroidism due to increased
metabolic rate. Weight loss, tachycardia, and diarrhea are also common, ruling out the
other options.
13. Which assessment finding in a postoperative hip replacement patient indicates a
potential complication?
A. Pain rated 3/10
