Final Exam Study Guide Questions with Answers All Correctly Verified 2024/2025 Updates, Exams of Nursing

Download Final Exam Study Guide Questions with Answers All Correctly Verified 2024/2025 Updates and more Exams Nursing in PDF only on Docsity! Final Exam Study Guide Questions with Answers All Correctly Verified 2024/2025 Updates • Question 1 Which cardiac biomarker is a highly specific for myocardial damage? A. BNP B. CK-MB C. Troponin I D. Total calcium • Question 2 A patient just involved in a motor vehicle accident has sustained blunt chest trauma as part of his injuries. The nurse notes absent breath sounds on the left side. A left-sided pneumothorax is suspected and is further validated when assessment of the trachea reveals what finding? A. A shift to the right B. A shift to the left C. No deviation D. Subcutaneous emphysema • Question 3 The nursing management plan for a patient with angina would include which intervention? A. Immediate administration of antiplatelet therapy. B. Teaching the patient how to perform the Valsalva maneuver C. Assessment and documentation of chest pain episodes D. Administration of prophylactic lidocaine for ventricular ectopy • Question 4 Which mechanisms are responsible for a myocardial infarction (MI)? (Select all that apply.) A. Coronary artery thrombosis B. Plaque rupture C. Coronary artery spasm near the ruptured plaque D. Preinfarction angina E. Hyperlipidemia • Question 5 A patient’s blood pressure is 90/72 mm Hg. What is the patient’s pulse pressure? A. 40 mm Hg B. 18 mm Hg C. 25 mm Hg D. 12 mm Hg • Question 6 A patient is admitted for palliative care for end-stage heart failure. What is the nurse’s primary goal when caring for this patient? A. To reverse heart failure with the use of diuretics B. To increase activity tolerance C. To manage symptoms and relieve pain D. To increase cardiac output related to alteration of contractility • Question 7 On admission, a patient presents with a respiratory rate of 24 breaths/min, pursed-lip breathing, heart rate of 96 beats/min in sinus tachycardia, and a blood pressure of 110/68 mm Hg. The patient’s arterial blood gas (ABG) values on room air are PaO2, 70 mm Hg; pH, 7.38; PaCO2, 52 mm Hg; and HCO3−, 34 mEq/L. Which diagnoses would be most consistent with the above arterial blood gas values? A. Acute pulmonary embolism B. Acute myocardial infarction C. Acute heart failure D. Chronic obstructive pulmonary disease • Question 8 When assessing a patient with PVCs, the nurse knows that the ectopic beat is multifocal because it appears in what way? A. In various shapes in the same lead B. Wider than a normal QRS C. With increasing frequency D. On the T wave • Question 9 Which dysrhythmia is most frequently associated with sudden cardiac death? A. Premature ventricular contractions B. Ventricular tachycardia C. Third-degree heart block D. Asystole • Question 10 A patient with acute lung failure has been mechanically ventilated for 3 days and is being evaluated for a spontaneous breathing trial. The ventilator high-pressure limit alarm keeps alarming. The patient should be evaluated for which problem? A. Leak in the patient’s endotracheal tube cuff B. Kink in the ventilator tubing C. Disconnection from the ventilator D. Repeat chest radiograph • Question 20 A patient with pneumonia is reporting shortness of breath. The nurse suspects the patient is hypoxemic and may need additional oxygen therapy. Which arterial blood gas (ABG) value would validate the nurse’s suspicions? A. PaO2 of 80 mm Hg B. PaCO2 of 35 mm Hg C.HCO3− of 24 mEq D. SaO2 of 87% • Question 21 Which electrocardiographic (ECG) abnormality is most often found in ventricular dysrhythmias – what would you expect that value to be? (If you measure that complex, what would you expect the range to be if it were ABNORMAL? A <0.1 . b. 0.06-0.12 c. 0.04-0.2 d. >0.12 • Question 22 What parameter must be assessed frequently in the patient with an intra-aortic balloon in place? A. Skin turgor in the affected extremity B. Peripheral pulses distal to the insertion site C. Blood pressures in both arms and legs D. Oxygen saturation • Question 23 A patient has been admitted with the diagnosis of acute respiratory distress syndrome (ARDS). Arterial blood gasses (ABGs) revealed an elevated pH and decreased PaCO2. The patient is becoming fatigued, and the practitioner orders a repeat ABG. Which set of results would be indicative of the patient’s current condition? A. Elevated pH and decreased PaCO2 B. Elevated pH and elevated PaCO2 C. Decreased pH and decreased PaCO2 D. Decreased pH and elevated PaCO2 • Question 24 A patient has recently been started on anticoagulation therapy for atrial fibrillation. What would be the target range for the INR? A. 1.0 to 2.0 B. 1.5 to 2.5 C. 1.5 to 3.0 D. 2.0 to 3.0 Question 25 When assessing an intubated patient, the nurse observes normal breath sounds on the right side of the chest and absent breath sounds on the left side of the chest. Which problem should the nurse suspect? A. Right mainstem intubation B. Left pneumothorax C. Right hemothorax D. Gastric intubation • Question 26 Which statement regarding the difference between stable and unstable angina is accurate? A. Stable angina responds predictably well to nitrates. B. Stable angina is not precipitated by activity. C. Stable angina has a low correlation to coronary artery disease (CAD). D. Stable angina is a result of coronary artery spasm. • Question 27 A patient has an implantable cardioverter defibrillator (ICD) for chronic ventricular tachydysrhythmias. What action should the nurse take when the patient’s rhythm deteriorates to ventricular fibrillation? A. Apply an external defibrillator to the patient. B. Call a code and start CPR on the patient. C. Wait for the ICD to defibrillate the patient. D. Turn the ICD off and administer epinephrine. Question 28 A patient was admitted following an aspiration event on the medical-surgical floor. The patient is receiving 40% oxygen via a simple face mask. The patient has become increasingly agitated and confused. The patient’s oxygen saturation has dropped from 92% to 84%. The nurse notifies the practitioner about the change in the patient’s condition. What interventions should the nurse anticipate? A. Intubation and mechanical ventilation B. Change in antibiotics orders C. Suction and reposition the patient D. Orders for a sedative • Question 29 A patient with acute lung failure has been mechanically ventilated for 3 days and is being evaluated for a spontaneous breathing trial. When the nurse enters the room, the ventilator inoperative alarm sounds. Which action should the nurse perform FIRST? A. Troubleshoot the ventilator until the problem is found. B. Take the patient off the ventilator and manually ventilate the patient. C. Call the respiratory therapist for help. D. Silence the ventilator alarms until the problem is resolved. • Question 30 Which major clinical finding is present in a patient with ventricular fibrillation (VF)? A. Hypertension B. Diaphoresis C. Bradycardia D. Pulselessness Question 31 The nurse is questioning the accuracy of the arterial catheter readings. Which two actions should the nurse perform to ensure the accuracy of the transducer? A. Obtain a cuff blood pressure and adjust the monitor to match. B. Level the transducer to the phlebostatic axis and zero the transducer. C. Have the patient lay flat and closing the transducer to air. D. Obtain blood return on the arterial line and closing all the stopcocks. • Question 32 To limit respiratory muscle fatigue, the practitioner would like to augment the patient’s inspiratory effort. The nurse should anticipate the addition of which therapy? A. Positive end-expiratory pressure (PEEP) B. Continuous positive airway pressure (CPAP) C. Pressure control ventilation (PCV) D. Pressure support ventilation (PSV) • Question 33 The patient’s arterial blood gas (ABG) values on room air are PaO2, 40 mm Hg; pH, 7.10; PaCO2, 44 mm Hg; and HCO3, 16 mEq/L. What is the interpretation of the patient’s ABG? a. Uncompensated respiratory acidosis b. Uncompensated metabolic acidosis • Question 39 How does a percutaneous transluminal coronary angioplasty (PTCA) improve blood flow? A. The balloon stretches the vessel wall, fractures the plaque, and enlarges the vessel lumen B. Medication is delivered through the catheter that dissolves the plague and enhances vessel patency. C. The balloon removes blood clots from the vessel improving patency of the vessel. D. The balloon compresses the plaque against the vessel wall enlarging the vessel lumen. • Question 40 The nurse is caring for a patient with left-sided heart failure. The nurse suspects the patient is developing pulmonary edema. Which finding would confirm the nurse’s suspicions? A. Pulmonary crackles B. Peripheral edema C. Pink, frothy sputum D. Elevated central venous pressure Exam 2 Questions • Question 1 The nurse is teaching a nursing student about the importance of assessing the patient’s level of conscious (LOC). Which statement indicates the nursing student understood the information? a. “The LOC is the most prognostic indicator of the patient’s neurologic outcome.” b. “The LOC limited to the Glasgow Coma Scale making it the quickest part of the assessment.” c. “The LOC is the easiest part of the neurologic exam and thus is generally performed first.” d. “In most situations, the LOC deteriorates before any other neurologic changes are observed.” • Question 2 The nurse is caring for a patient with a closed head injury with a Glasgow Coma Scale (GCS) score of 6. What does this score indicate about the patient’s neurologic status? a. Patient is in vegetative state. b. Patient is a paraplegic. c. Patient is in a coma. d. Patient is able to obey commands. • Question 3 While the Glasgow Coma Scale (GCS) is part of the routine neurologic assessment, the nurse knows that it is not a valid measure for certain types of patients. In which patient is the GCS not valid? Patient who is intoxicated • Question 4 The nurse is caring for a patient who has sustained a traumatic head injury. The practitioner has asked the nurse to test the patient’s oculocephalic reflex. What must the nurse verify before performing the test? a. Absence of cervical injury b. Depth and rate of respiration c. Patient’s ability to swallow d. Patient’s ability to follow a verbal command Question 5 The nurse is starting a peripheral intravenous catheter in the right hand of an unconscious patient. During the procedure, the patient reaches over with his left hand and tries to remove the noxious stimuli. How would the nurse document this response? a. Decorticate posturing b. Decerebrate posturing c. Withdrawal d. Localization • • • Question 6 The nurse is caring for a patient with a head injury and observes a rhythmic increase and decrease in the rate and depth of respiration followed by brief periods of apnea. What should the nurse document under breathing pattern? a. Central neurogenic hyperventilation b. Apneustic breathing c. Ataxic respirations d. Cheyne-Stokes respirations • Question 7 The nurse is caring for a severely head injured comatose patient who is dying. The practitioner asks to be notified when the patient starts to exhibit signs of Cushing reflex. The nurse would call the practitioner when the patient starts to show what signs? a. Bradycardia, systolic hypertension, and widening pulse pressure b. Tachycardia, systolic hypotension, and tachypnea c. Headache, nuchal rigidity, and hyperthermia d. Bradycardia, aphasia, and visual field disturbances • Question 8 Which procedure is the diagnostic study of choice for acute head injury? a. MRI b. CT c. Trancranial Doppler d. Electroencephalography Question 9 The patient is ordered a computed tomography (CT) scan with contrast. Which question should the nurse ask the conscious patient before the procedure? a. “Are you allergic to penicillin?” b. “Are you allergic to iodine-based dye?” c. “Are you allergic to latex?” d. “Are you allergic to eggs?” • Question 10 The patient was admitted with a head injury and an intracranial pressure (ICP) monitoring device was placed. The nurse knows to notify the practitioner if what type of wave start to appear on the monitor? a. A waves b. B waves c. C waves d. D waves • Question 11 The nurse is precepting a new graduate nurse. The new graduate asks about testing the oculovestibular reflex. What should the nurse tell the new graduate? a. “The test should not be performed on an unconscious patient because of the risk of aspiration.” b. “An abnormal response is manifested by conjugate, slow, tonic nystagmus, deviating toward the irrigated ear.” c. “This test should be included in the nursing neurologic examination of a patient with a head injury.” d. “This test is performed by the practitioner and one of the final clinical assessments of brainstem function.” • Question 12 The nurse is caring for a patient with an intracranial pressure-monitoring device that provides access to cerebrospinal fluid (CSF) for sampling. What type of device does the patient have? a. Subarachnoid bolt b. Epidural catheter c. Intraventricular catheter d. Fiberoptic catheter • Question 13 According to the 2007 Brain Trauma Foundation guidelines, the recommended CPP range is: 50-70 b. Intravenous pyelography (IVP) c. Renal ultrasonography (ECHO) d. Renal angiography • Question 26 The patient complains of a metallic taste and loss of appetite. The nurse is concerned that the patient has developed what problem? a. Glycosuria b. Proteinuria c. Myoglobin d. Uremia • Question 27 A patient is admitted in acute heart failure secondary to renal insufficiency. The patient reports that over the past few weeks, his urine output has decreased, and he has developed peripheral edema and ascites. A diagnosis of renal failure is made. The nurse would expect to see elevated values in which laboratory results? (Select all that apply.) a. BUN. b. creatinine. c. glucose. d. hemoglobin and hematocrit. e. protein. • Question 28 What causes the presence of myoglobin in the urine? (Select all that apply) a. Injection b. Crush injury c. Acidosis d. Rhabdomyolysis e. Intrarenal acute kidney injury • Question 29 An elderly patient is in a motor vehicle accident and sustains a significant internal hemorrhage. The nurse knows the patient is at risk for developing what type of acute kidney injury a. Intrinsic b. Postrenal c. Prerenal d. Intrarenal (AKI) Question 30 A patient has developed acute kidney injury (AKI) secondary to cardiogenic shock. Which laboratory value would the nurse find helpful in evaluating patient’s renal status? a. Serum sodium b. Serum creatinine c. Serum potassium d. Urine potassium • • • Question 31 One therapeutic measure for treating hyperkalemia is the administration of dextrose and regular insulin. Which statement regarding how this treatment works is accurate? a. Forces potassium out of the serum into the lymphatic space. b. Promotes higher excretion of potassium in the urine. c. Binds with potassium lowering available amounts. d. Forces potassium out of the serum into the cells. • Question 32 To assess whether or not an arteriovenous fistula is functioning, what must the nurse do and why? a. Palpate the quality of the pulse distal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. b. Palpate the quality of the pulse proximal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. c. Palpate gently over the site of the fistula to determine whether a thrill is present; listen with a stethoscope over this site to appreciate a bruit to assess the quality of the blood flow. d. Palpate over the site of the fistula to determine whether a thrill is present; check whether the extremity is pink and warm. Question 33 A patient was admitted with an infection that had to be treated with gentamicin, an aminoglycoside antibiotic. After 3 days of administration, the patient developed oliguria, and an elevated blood urea nitrogen and creatinine levels. The nurse suspects the patient has developed what type of kidney injury? a. Prerenal b. Intrarenal c. Anuric d. Postrenal • Question 34 A patient was admitted with an infection that had to be treated with an aminoglycoside antibiotic. After a few days the patient developed oliguria and elevated blood urea nitrogen and creatinine levels. The patient’s vital signs are stable. The nurse would anticipate the practitioner ordering which dialysis method for this patient? a. Peritoneal dialysis b. Hemodialysis c. Continuous renal replacement therapy d. Intermittent ultrafiltration • Question 35 What is the most common site for short-term vascular access for immediate hemodialysis? a. Subclavian artery b. Subclavian vein c. Femoral artery d. Radial vein • Question 36 A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodialysis (CVVHD). The nurse understands the patient should be closely monitored for what patient-related complications of the therapy? a. Air embolism, access failure, and blood leaks b. Decreased inflow pressure, air bubbles, and power surge c. Infection, hypotension, and electrolyte imbalances d. Catheter dislodgement, decreased outflow pressure, and acid-base imbalances • Question 37 A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodialysis (CVVHD). The nurse knows the hemodialyzer filter used in this type of therapy is permeable to what substance? a. Electrolytes b. Red blood cells c. Protein d. Lipids • Question 3 The nurse is caring for a patient with an upper gastrointestinal bleed. What procedure would the nurse expect the practitioner to order to confirm this diagnosis? Endoscopy • Question 4 The nurse is caring for a patient with acute liver failure. What laboratory value would the nurse expect to decrease in this situation? a. Albumin b. Total bilirubin c. Alkaline phosphatase d. Aspartate aminotransferase Question 5 A patient is admitted with an upper gastrointestinal bleed. Which disorder is the leading cause of upper gastrointestinal (GI) hemorrhage? a. Stress ulcers b. Peptic ulcers c. Nonspecific erosive gastritis d. Esophageal varices • Question 6 A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. The nurse knows that varices are caused by which pathophysiologic mechanism? a. Portal hypertension b. Superficial mucosal erosions c. Breakdown the mucosal resistance d. Inflammation and ulceration • Question 7 A patient is admitted with a severe head injury. The nurse knows that critically ill patients are at risk for gastrointestinal hemorrhage due to stress-related mucosal disease. The nurse would monitor the patient for which signs and symptoms? a. Metabolic acidosis and hypovolemia b. Decreasing hemoglobin and hematocrit c. Hyperkalemia and hypernatremia d. Hematemesis and melena • Question 8 A patient is admitted with a gastrointestinal hemorrhage due to esophagogastric varices. What medication would the nurse expect the practitioner to order for this patient? a. Histamine2 (H2) antagonists b. Vasopressin c. Heparin d. Antacids Question 9 Which nursing intervention is a priority for a patient with gastrointestinal hemorrhage? a. Positioning the patient in a high-Fowler position b. Ensuring the patient has a patent airway c. Irrigating the nasogastric tube with iced saline d. Maintaining venous access so that fluids and blood can be administered • Question 10 A patient was admitted with acute pancreatitis. The nurse understands that pancreatitis occurs as a result of what pathophysiologic mechanism? a. Uncontrolled hypoglycemia caused by an increased release of insulin b. Loss of storage capacity for senescent red blood cells c. Premature activation of inactive digestive enzymes, resulting in autodigestion d. Release of glycogen into the serum, resulting in hyperglycemia • Question 11 A patient with a history of chronic alcoholism was admitted with acute pancreatitis. The nurse is developing a patient education plan. Which topic would the nurse include in the plan? a. Diabetes management b. Alcohol cessation c. Occult blood testing d. Anticoagulation management • Question 12 A Salem sump nasogastric tube has two lumens. The first lumen is for suction and drainage. What is the purpose of the second lumen? a. Allows for administration of tube feeding. b. Allows for testing of gastric secretions. c. Prevents tube from adhering to the gastric wall. d. Prevents the tube from advancing Question 13 The nurse is caring for a patient with acute liver failure. The patient has elevated ammonia levels. Which medication would the nurse expect the practitioner to order for this patient? a. Insulin b. Vitamin K c. Lactulose d. Lorazepam Question 14 A patient was admitted after a Roux-en-Y gastric bypass (RYGBP). A nursing student asks the nurse what type of surgery is a RYGBP. What would be an appropriate response from the nurse? a. “It is an esophagectomy performed using the transthoracic approach.” b. “It is an esophagectomy performed using a transhiatal approach.” c. “It is a combination of restrictive and malabsorption types of bariatric surgery. d. “It is a standard operation for pancreatic cancer.” • Question 15 A patient has been admitted with severe abdominal pain. When examining the patient, the nurse notes hypoactive bowel sounds, abdominal guarding, distention, and a discoloration around the umbilicus. The nurse suspects the patient may have which condition? a. Peptic ulcer disease b. Esophageal varices c. Acute liver failure d. Acute pancreatitis • Question 16 A patient has been admitted with acute liver failure. Which interventions would the nurse expect as part of the interprofessional collaborative management plan? (Select all that apply.) a. Benzodiazepines for agitation b. Pulse oximetry and serial arterial blood gas measurements c. Insulin drip for hyperglycemia and hyperkalemia d. Monitoring electrolyte blood levels e. Assessing for signs of cerebral edema • • • Question 17 A patient is admitted with diabetic ketoacidosis. The nurse requests the practitioner order a glycosylated hemoglobin (HbA1C). What information does this test provide to the health care team? a. It is an indicator of the patient’s average blood glucose level over the previous 3 to 4 months. b. It compares blood glucose levels with serum hemoglobin over the previous 3 to 4 weeks c. It is an indicator of the patient’s highest blood ketone level over the past month. patient may be developing thyroid storm. Which finding would confirm this suspicion? a. Tachycardia b. Hypotension c. Decreased appetite d. Hypothermia • Question 28 The nurse is caring for a patient with type 1 diabetes who was admitted with complaints of increased lethargy. Serum laboratory values validate the diagnosis of diabetic ketoacidosis (DKA). Which statement best describes the rationale for administrating potassium supplements with the patient’s insulin therapy? a. Potassium replaces losses incurred with diuresis. b. The patient has been in a long-term malnourished state. c. IV potassium renders the infused solution isotonic. d. Insulin drives the potassium back into the cells. Question 29 A patient with a history of type 2 diabetes was admitted after aneurysm repair. The patient’s serum glucose levels have been elevated for the past 2 days, and the patient is concerned about becoming dependent on insulin. Which statement is the nurse’s best response to the patient’s concerns? a. “This surgery may have damaged your pancreas. We will have to do more evaluation.” b. “Perhaps your diabetes was more serious from the beginning.” c. “You will need to discuss this with your physician.” d. “The stress on your body has temporarily increased your blood sugar levels.” • Question 30 The nurse knows that during the resuscitation of a patient with diabetic ketoacidosis (DKA), the intravenous (IV) line should be changed to a solution containing glucose when what happens? A. patient becomes more alert. B. IV insulin has been infusing for 4 hours. C. blood glucose drops to 200 mg/dL. D. blood glucose drops to 100 mg/dL. • Question 31 A patient with bronchogenic oat cell carcinoma has a drop in urine output. The laboratory reports a serum sodium level of 120 mEq/L, a serum osmolality level of 220 mOsm/kg, and urine specific gravity of 1.035. The nurse suspects the patient may be developing what problem? a. diuresis. b. DI. c. SIADH. d. hyperaldosteronism. Question 32 The nurse is caring for a patient with myxedema coma. The patient’s temperature is 94° F. Which intervention would the nurse include in the plan of care for this patient? Rewarm slowly with heated blankets Question 33 A patient with severe traumatic brain injury has been admitted to the critical care unit. What is one intervention to minimize secondary brain injury? a. Hyperventilate the patient to keep PCO2 less than 30. b. Restrict fluids to keep central venous pressure less than 6 cm H2O . c. Maintain the patient’s body temperature more than 37.5°C. d. Administer fluids to keep the mean arterial pressure greater than 60 mm Hg. • Question 34 A patient has been admitted with a pulmonary contusion. Which finding will cause a nurse to suspect that the patient’s condition is deteriorating? a. Increased bruising on the chest wall b. Increased need for pain medication c. The development of respiratory alkalosis d. Increased work of breathing • Question 35 Older trauma patients have a higher mortality than younger trauma patients. The nurse understands that this fact is probably related to what physiologic change? a. Deterioration of cerebral and motor skills b. Poor vision and hearing c. Diminished pain perception d. Limited physiologic reserve • Question 36 A patient with multisystem trauma has been in the critical care unit for 2 days. The patient is still intubated and mechanically ventilated and has a chest tube, urinary drainage catheter, nasogastric tube, and two abdominal drains. The nurse understands that immobility places the patient at risk for developing which complication? a. Hypovolemic shock b. Acute kidney injury c. Venous thromboembolism d. Malnutrition • • • Question 37 The nurse understands that certain trauma patients are at risk for developing fat embolism syndrome. Which type of trauma is this complication usually associated with? a. Liver trauma b. Kidney trauma c. Orthopedic trauma d. Spinal cord trauma • Question 38 Which of the following is a top nursing consideration in a patient with an inhalation injury admitted to the Burn Unit? Early Intubation • Question 39 The nurse is caring for a patient in cardiogenic shock. The nurse recognizes that the patient’s signs and symptoms are the result of what problem? a. Inability of the heart to pump blood forward b. Loss of circulating volume and subsequent decreased venous return c. Disruption of the conduction system when reentry phenomenon occurs d. Suppression of the sympathetic nervous system • Question 40 A patient has been admitted with anaphylactic shock due to an unknown allergen. The nurse understands that the decrease in the patient’s cardiac output is the result of which mechanism? a. Peripheral vasodilation b. Increased venous return c. Increased alveolar ventilation d. Decreased myocardial contractility • Question 41 A patient has been admitted with a neurologic disorder. With which disorder should the nurse be the most vigilant for the development of neurogenic shock? a. Ischemic stroke b. Spinal cord injury c. Guillain-Barré syndrome d. Brain tumor