NR 326 FINAL EXAM QUESTIONS AND CORRECT
ANSWERS (VERIFIED ASWERS) PLUS RATIONALES Q
&A 2026 |INSTANT DOWNLOAD PDF
1. A patient with chronic heart failure is prescribed
furosemide. Which assessment is most important before
administering the medication?
A. Heart rate
B. Blood pressure
C. Potassium level
D. Respiratory rate
Answer: C. Potassium level
Rationale: Furosemide is a loop diuretic that can cause
hypokalemia, which may lead to arrhythmias. Monitoring
potassium is crucial.
2. Which clinical manifestation is most indicative of left-
sided heart failure?
A. Peripheral edema
B. Jugular vein distention
C. Pulmonary congestion
D. Hepatomegaly
Answer: C. Pulmonary congestion
Rationale: Left-sided heart failure causes fluid backup into
the lungs, leading to dyspnea and pulmonary edema.
,3. A patient with chronic obstructive pulmonary disease
(COPD) presents with increased dyspnea and purulent
sputum. Which intervention has the highest priority?
A. Administering oxygen
B. Encouraging fluid intake
C. Administering antibiotics
D. Positioning in high Fowler’s
Answer: C. Administering antibiotics
Rationale: The acute change in sputum and dyspnea
suggests infection (exacerbation), which requires
immediate antibiotic therapy.
4. Which symptom best indicates hypoglycemia in a patient
with type 1 diabetes?
A. Polyuria
B. Polydipsia
C. Tremors and diaphoresis
D. Blurred vision
Answer: C. Tremors and diaphoresis
Rationale: Hypoglycemia triggers adrenergic symptoms
like shaking, sweating, and tachycardia.
5. Which nursing action is most appropriate for a patient
with a nasogastric tube (NGT) connected to suction?
A. Irrigate the tube every 2 hours
B. Measure the stomach residual volume every 4–6 hours
C. Keep the suction continuous at high pressure
D. Flush the tube with water before medications only
, Answer: B. Measure the stomach residual volume every 4–
6 hours
Rationale: Monitoring residual volume helps prevent
aspiration and ensures proper gastric emptying.
6. Which electrolyte imbalance is most likely in a patient
receiving total parenteral nutrition (TPN)?
A. Hyperkalemia
B. Hypomagnesemia
C. Hypercalcemia
D. Hyponatremia
Answer: B. Hypomagnesemia
Rationale: TPN can lead to deficiencies in magnesium and
other electrolytes if not carefully monitored.
7. A patient with cirrhosis develops ascites. Which nursing
intervention is most appropriate?
A. Encourage a high-protein diet
B. Restrict sodium intake
C. Administer IV potassium
D. Promote ambulation
Answer: B. Restrict sodium intake
Rationale: Sodium restriction helps reduce fluid retention
and manage ascites.
8. Which clinical manifestation is most specific for
hyperthyroidism?
A. Weight gain
B. Bradycardia
, C. Heat intolerance
D. Constipation
Answer: C. Heat intolerance
Rationale: Hyperthyroidism increases metabolism, leading
to heat intolerance and weight loss.
9. A patient with acute kidney injury (AKI) shows rising
creatinine and decreased urine output. Which nursing
action is priority?
A. Administer loop diuretics
B. Monitor intake and output
C. Prepare for dialysis
D. Encourage oral fluids
Answer: B. Monitor intake and output
Rationale: Tracking fluid balance is essential for AKI
management; interventions like dialysis are based on
trends.
10. Which symptom indicates a patient may be
experiencing metabolic acidosis?
A. Slow, shallow respirations
B. Confusion and hypotension
C. Hypoventilation
D. Bradycardia
Answer: B. Confusion and hypotension
Rationale: Metabolic acidosis leads to CNS changes and
cardiovascular instability due to low pH.
ANSWERS (VERIFIED ASWERS) PLUS RATIONALES Q
&A 2026 |INSTANT DOWNLOAD PDF
1. A patient with chronic heart failure is prescribed
furosemide. Which assessment is most important before
administering the medication?
A. Heart rate
B. Blood pressure
C. Potassium level
D. Respiratory rate
Answer: C. Potassium level
Rationale: Furosemide is a loop diuretic that can cause
hypokalemia, which may lead to arrhythmias. Monitoring
potassium is crucial.
2. Which clinical manifestation is most indicative of left-
sided heart failure?
A. Peripheral edema
B. Jugular vein distention
C. Pulmonary congestion
D. Hepatomegaly
Answer: C. Pulmonary congestion
Rationale: Left-sided heart failure causes fluid backup into
the lungs, leading to dyspnea and pulmonary edema.
,3. A patient with chronic obstructive pulmonary disease
(COPD) presents with increased dyspnea and purulent
sputum. Which intervention has the highest priority?
A. Administering oxygen
B. Encouraging fluid intake
C. Administering antibiotics
D. Positioning in high Fowler’s
Answer: C. Administering antibiotics
Rationale: The acute change in sputum and dyspnea
suggests infection (exacerbation), which requires
immediate antibiotic therapy.
4. Which symptom best indicates hypoglycemia in a patient
with type 1 diabetes?
A. Polyuria
B. Polydipsia
C. Tremors and diaphoresis
D. Blurred vision
Answer: C. Tremors and diaphoresis
Rationale: Hypoglycemia triggers adrenergic symptoms
like shaking, sweating, and tachycardia.
5. Which nursing action is most appropriate for a patient
with a nasogastric tube (NGT) connected to suction?
A. Irrigate the tube every 2 hours
B. Measure the stomach residual volume every 4–6 hours
C. Keep the suction continuous at high pressure
D. Flush the tube with water before medications only
, Answer: B. Measure the stomach residual volume every 4–
6 hours
Rationale: Monitoring residual volume helps prevent
aspiration and ensures proper gastric emptying.
6. Which electrolyte imbalance is most likely in a patient
receiving total parenteral nutrition (TPN)?
A. Hyperkalemia
B. Hypomagnesemia
C. Hypercalcemia
D. Hyponatremia
Answer: B. Hypomagnesemia
Rationale: TPN can lead to deficiencies in magnesium and
other electrolytes if not carefully monitored.
7. A patient with cirrhosis develops ascites. Which nursing
intervention is most appropriate?
A. Encourage a high-protein diet
B. Restrict sodium intake
C. Administer IV potassium
D. Promote ambulation
Answer: B. Restrict sodium intake
Rationale: Sodium restriction helps reduce fluid retention
and manage ascites.
8. Which clinical manifestation is most specific for
hyperthyroidism?
A. Weight gain
B. Bradycardia
, C. Heat intolerance
D. Constipation
Answer: C. Heat intolerance
Rationale: Hyperthyroidism increases metabolism, leading
to heat intolerance and weight loss.
9. A patient with acute kidney injury (AKI) shows rising
creatinine and decreased urine output. Which nursing
action is priority?
A. Administer loop diuretics
B. Monitor intake and output
C. Prepare for dialysis
D. Encourage oral fluids
Answer: B. Monitor intake and output
Rationale: Tracking fluid balance is essential for AKI
management; interventions like dialysis are based on
trends.
10. Which symptom indicates a patient may be
experiencing metabolic acidosis?
A. Slow, shallow respirations
B. Confusion and hypotension
C. Hypoventilation
D. Bradycardia
Answer: B. Confusion and hypotension
Rationale: Metabolic acidosis leads to CNS changes and
cardiovascular instability due to low pH.
