Page 1 of 47
NR 341 Complex Adult Health Exam 1 (W1-W3)
STUDY GUIDE EXAM LATEST 2026-2027 QUESTIONS
AND CORRECT VERIFIED ANSWERS LATEST UPDATE
JUST RELEASED THIS YEAR
The nurse notes premature ventricular contractions (PVCs) on the monitor while suctioning a
patient's endotracheal tube. Which action would the nurse take?
Ventilate the patient with 100% oxygen.
Which assessment finding for a patient receiving mechanical ventilation indicates the need for
suctioning?
The patient's respiratory rate is 32 breaths/min.
The nurse notes thick, white secretions in the endotracheal tube (ET) of a patient who is
receiving mechanical ventilation. Which intervention will most directly treat this finding?
Add additional water to the patient's enteral feedings.
Four hours after mechanical ventilation is initiated, a patient's arterial blood gas (ABG) results
include a pH of 7.51, PaO₂ of 82 mm Hg, PaCO₂ of 26 mm Hg, and HCO₃- of 23 mEq/L (23
mmol/L). What change should the nurse anticipate to the ventilator settings?
Decrease the respiratory rate.
1
SUCCESS!
,Page 2 of 47
The nurse is weaning a patient who has chronic obstructive pulmonary disease (COPD) and
weighs 68-kg from mechanical ventilation. Which finding indicates that theweaning protocol
should be stopped?
The patient respiratory rate is 32 breaths/min.
The nurse responding to a ventilator alarm finds the patient lying in bed, gasping, and the
endotracheal tube on the floor. Which action would the nurse take next?
Manually ventilate the patient with 100% oxygen.
The nurse notes that a patient's endotracheal tube (ET), which was at the 22-cm mark, is now
at the 25-cm mark, and the patient is anxious and restless. Which action would the nurse take
next?
Listen to the patient's breath sounds.
The charge nurse is evaluating the care that a new registered nurse (RN) provides to a patient
receiving mechanical ventilation. Which action by the new RN indicates the need for more
education?
The RN positions the patient with the head of bed at 10 degrees.
A patient who is orally intubated and receiving mechanical ventilation is anxious and is
"fighting" the ventilator. Which action would the nurse take first?
Verbally coach the patient to breathe with the ventilator.
2
SUCCESS!
,Page 3 of 47
A patient is receiving mechanical ventilation with 15 cm H₂O of peak end-expiratory pressure
(PEEP). Which action by the nurse promotes patient safety?
Using a closed-suction technique when suctioning is needed.
Which finding by the nurse should result in postponing the spontaneous breathing trial for a
patient receiving positive pressure ventilation?
New dysrhythmias are observed on the cardiac monitor.
After change-of-shift report, which patient would the nurse assess first?
Patient who was successfully weaned and extubated 4 hours ago and has no urine output for
the last 6 hours
A patient on a positive pressure ventilator is receiving a neuromuscular blocking agent
(NMBA) to prevent asynchronous breathing. Which situation requires action by the nurse?
No sedative is ordered for the patient.
The nurse has just auscultated coarse crackles bilaterally on a patient with a tracheostomy
tube in place. If the patient is unsuccessful in coughing up secretions, which action would the
nurse take?
Put on sterile gloves and use a sterile catheter to suction.
A patient with a tracheostomy has a new order for a fenestrated tracheostomy tube. Which
action would the nurse include in the plan of care in collaboration with the speech therapist?
3
SUCCESS!
, Page 4 of 47
Assess the ability to swallow before using the fenestrated tube.
The nurse is caring for a mechanically ventilated patient who has a cuffed tracheostomy tube.
Which action by the nurse would determine if the cuff has been properly inflated?
Use a hand-held manometer to measure cuff pressure.
After a laryngectomy, a patient coughs violently during suctioning and dislodges the
tracheostomy tube. Which action would the nurse take first?
Attempt to reinsert the tracheostomy tube with the obturator in place.
Which nursing action could the registered nurse (RN) delegate to an experienced licensed
practical/vocational nurse (LPN/LVN) caring for a patient with a permanent tracheostomy?
Suction the tracheostomy when directed.
What should the nurse measure to determine whether there is a delay in impulse conduction
through the patient's ventricles?
QRS complex
The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm.
Which method will be fastest to use?
Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS
complexes.
4
SUCCESS!
NR 341 Complex Adult Health Exam 1 (W1-W3)
STUDY GUIDE EXAM LATEST 2026-2027 QUESTIONS
AND CORRECT VERIFIED ANSWERS LATEST UPDATE
JUST RELEASED THIS YEAR
The nurse notes premature ventricular contractions (PVCs) on the monitor while suctioning a
patient's endotracheal tube. Which action would the nurse take?
Ventilate the patient with 100% oxygen.
Which assessment finding for a patient receiving mechanical ventilation indicates the need for
suctioning?
The patient's respiratory rate is 32 breaths/min.
The nurse notes thick, white secretions in the endotracheal tube (ET) of a patient who is
receiving mechanical ventilation. Which intervention will most directly treat this finding?
Add additional water to the patient's enteral feedings.
Four hours after mechanical ventilation is initiated, a patient's arterial blood gas (ABG) results
include a pH of 7.51, PaO₂ of 82 mm Hg, PaCO₂ of 26 mm Hg, and HCO₃- of 23 mEq/L (23
mmol/L). What change should the nurse anticipate to the ventilator settings?
Decrease the respiratory rate.
1
SUCCESS!
,Page 2 of 47
The nurse is weaning a patient who has chronic obstructive pulmonary disease (COPD) and
weighs 68-kg from mechanical ventilation. Which finding indicates that theweaning protocol
should be stopped?
The patient respiratory rate is 32 breaths/min.
The nurse responding to a ventilator alarm finds the patient lying in bed, gasping, and the
endotracheal tube on the floor. Which action would the nurse take next?
Manually ventilate the patient with 100% oxygen.
The nurse notes that a patient's endotracheal tube (ET), which was at the 22-cm mark, is now
at the 25-cm mark, and the patient is anxious and restless. Which action would the nurse take
next?
Listen to the patient's breath sounds.
The charge nurse is evaluating the care that a new registered nurse (RN) provides to a patient
receiving mechanical ventilation. Which action by the new RN indicates the need for more
education?
The RN positions the patient with the head of bed at 10 degrees.
A patient who is orally intubated and receiving mechanical ventilation is anxious and is
"fighting" the ventilator. Which action would the nurse take first?
Verbally coach the patient to breathe with the ventilator.
2
SUCCESS!
,Page 3 of 47
A patient is receiving mechanical ventilation with 15 cm H₂O of peak end-expiratory pressure
(PEEP). Which action by the nurse promotes patient safety?
Using a closed-suction technique when suctioning is needed.
Which finding by the nurse should result in postponing the spontaneous breathing trial for a
patient receiving positive pressure ventilation?
New dysrhythmias are observed on the cardiac monitor.
After change-of-shift report, which patient would the nurse assess first?
Patient who was successfully weaned and extubated 4 hours ago and has no urine output for
the last 6 hours
A patient on a positive pressure ventilator is receiving a neuromuscular blocking agent
(NMBA) to prevent asynchronous breathing. Which situation requires action by the nurse?
No sedative is ordered for the patient.
The nurse has just auscultated coarse crackles bilaterally on a patient with a tracheostomy
tube in place. If the patient is unsuccessful in coughing up secretions, which action would the
nurse take?
Put on sterile gloves and use a sterile catheter to suction.
A patient with a tracheostomy has a new order for a fenestrated tracheostomy tube. Which
action would the nurse include in the plan of care in collaboration with the speech therapist?
3
SUCCESS!
, Page 4 of 47
Assess the ability to swallow before using the fenestrated tube.
The nurse is caring for a mechanically ventilated patient who has a cuffed tracheostomy tube.
Which action by the nurse would determine if the cuff has been properly inflated?
Use a hand-held manometer to measure cuff pressure.
After a laryngectomy, a patient coughs violently during suctioning and dislodges the
tracheostomy tube. Which action would the nurse take first?
Attempt to reinsert the tracheostomy tube with the obturator in place.
Which nursing action could the registered nurse (RN) delegate to an experienced licensed
practical/vocational nurse (LPN/LVN) caring for a patient with a permanent tracheostomy?
Suction the tracheostomy when directed.
What should the nurse measure to determine whether there is a delay in impulse conduction
through the patient's ventricles?
QRS complex
The nurse needs to quickly estimate the heart rate for a patient with a regular heart rhythm.
Which method will be fastest to use?
Print a 1-minute electrocardiogram (ECG) strip and count the number of QRS
complexes.
4
SUCCESS!
