NU 578 UNIT 1 EXAM | ADVANCED NURSING /
ACTUAL EXAM QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES GRADED A+ LATEST
UNIVERSITY OF SOUTH ALABAMA
1. A 65-year-old patient with chronic obstructive pulmonary disease (COPD)
presents with increasing shortness of breath and a productive cough. Which
assessment finding most strongly suggests an acute exacerbation?
A. Mild wheezing on exertion
B. Clear lung sounds
C. Increased sputum production with purulence
D. Occasional dry cough
Answer: C
Rationale: Acute exacerbations of COPD often present with increased sputum
volume and purulence, along with worsening dyspnea. Wheezing alone or a dry
cough is less specific.
2. A patient reports a sudden onset of severe, stabbing chest pain radiating to the
back, accompanied by shortness of breath. Which condition should the nurse
suspect?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pneumothorax
Answer: C
Rationale: Sudden, severe, tearing chest pain radiating to the back is classic for
aortic dissection. While MI and PE can cause chest pain, the radiating pattern and
abrupt onset are more consistent with dissection.
,3. Which nursing intervention is most appropriate for a patient with heart failure
who presents with pulmonary edema?
A. Encourage fluid intake of at least 3 liters per day
B. Place the patient in a high Fowler’s position
C. Administer intravenous fluids rapidly
D. Restrict oxygen therapy unless hypoxemic
Answer: B
Rationale: High Fowler’s position improves respiratory effort and oxygenation in
pulmonary edema. Fluid restriction, cautious diuresis, and supplemental oxygen
are typically indicated; rapid IV fluids worsen edema.
4. A patient is admitted with diabetic ketoacidosis (DKA). Which laboratory
finding is most consistent with DKA?
A. Hypoglycemia with pH > 7.4
B. Hyperglycemia with metabolic acidosis
C. Normoglycemia with respiratory alkalosis
D. Hyperglycemia with metabolic alkalosis
Answer: B
Rationale: DKA presents with hyperglycemia, ketonemia, and metabolic acidosis.
Hypoglycemia and alkalosis are not characteristic of DKA.
5. A patient with chronic kidney disease (CKD) is at highest risk for which
electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: A
Rationale: CKD often impairs potassium excretion, increasing the risk of
hyperkalemia. Hypocalcemia may also occur, but hyperkalemia is more acutely
life-threatening.
,6. A nurse is assessing a patient on warfarin therapy. Which laboratory test is most
important for monitoring therapeutic effect?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Platelet count
D. Prothrombin time (PT) only
Answer: B
Rationale: INR standardizes PT results to monitor warfarin therapy. aPTT is used
for heparin monitoring.
7. Which symptom is most indicative of increased intracranial pressure (ICP) in an
adult patient?
A. Bradycardia and widened pulse pressure
B. Tachycardia and hypotension
C. Fever and chills
D. Nausea without vomiting
Answer: A
Rationale: Cushing’s triad (bradycardia, hypertension with widened pulse
pressure, irregular respirations) is a classic sign of increased ICP.
8. A patient with sepsis is started on broad-spectrum antibiotics. Which early
intervention is most important to prevent progression to septic shock?
A. Initiate vasopressors immediately
B. Obtain blood cultures before antibiotic administration
C. Restrict fluids to avoid overload
D. Delay antibiotic therapy until cultures confirm infection
Answer: B
Rationale: Blood cultures should be obtained prior to antibiotics without delaying
therapy. Early fluid resuscitation and timely antibiotics are crucial in sepsis
management.
, 9. Which of the following findings is most concerning in a patient receiving total
parenteral nutrition (TPN)?
A. Blood glucose of 140 mg/dL
B. Mild nausea
C. Fever and chills
D. Slight electrolyte imbalance
Answer: C
Rationale: Fever and chills in a TPN patient may indicate catheter-related
bloodstream infection, which is potentially life-threatening.
10. A 58-year-old patient presents with severe abdominal pain, nausea, and
vomiting. Laboratory results show elevated serum amylase and lipase. Which
condition is most likely?
A. Appendicitis
B. Cholecystitis
C. Pancreatitis
D. Hepatitis
Answer: C
Rationale: Elevated amylase and lipase, along with severe abdominal pain, are
indicative of pancreatitis.
11. In a patient with chronic hypertension, which lifestyle modification is most
effective for long-term blood pressure control?
A. Restricting physical activity
B. Reducing dietary sodium intake
C. Increasing sugar intake for energy
D. Eliminating potassium-rich foods
Answer: B
Rationale: Sodium reduction lowers blood pressure. Regular physical activity and
potassium-rich foods also help, whereas sugar intake does not aid control.
ACTUAL EXAM QUESTIONS AND 100% VERIFIED
ANSWERS WITH RATIONALES GRADED A+ LATEST
UNIVERSITY OF SOUTH ALABAMA
1. A 65-year-old patient with chronic obstructive pulmonary disease (COPD)
presents with increasing shortness of breath and a productive cough. Which
assessment finding most strongly suggests an acute exacerbation?
A. Mild wheezing on exertion
B. Clear lung sounds
C. Increased sputum production with purulence
D. Occasional dry cough
Answer: C
Rationale: Acute exacerbations of COPD often present with increased sputum
volume and purulence, along with worsening dyspnea. Wheezing alone or a dry
cough is less specific.
2. A patient reports a sudden onset of severe, stabbing chest pain radiating to the
back, accompanied by shortness of breath. Which condition should the nurse
suspect?
A. Myocardial infarction
B. Pulmonary embolism
C. Aortic dissection
D. Pneumothorax
Answer: C
Rationale: Sudden, severe, tearing chest pain radiating to the back is classic for
aortic dissection. While MI and PE can cause chest pain, the radiating pattern and
abrupt onset are more consistent with dissection.
,3. Which nursing intervention is most appropriate for a patient with heart failure
who presents with pulmonary edema?
A. Encourage fluid intake of at least 3 liters per day
B. Place the patient in a high Fowler’s position
C. Administer intravenous fluids rapidly
D. Restrict oxygen therapy unless hypoxemic
Answer: B
Rationale: High Fowler’s position improves respiratory effort and oxygenation in
pulmonary edema. Fluid restriction, cautious diuresis, and supplemental oxygen
are typically indicated; rapid IV fluids worsen edema.
4. A patient is admitted with diabetic ketoacidosis (DKA). Which laboratory
finding is most consistent with DKA?
A. Hypoglycemia with pH > 7.4
B. Hyperglycemia with metabolic acidosis
C. Normoglycemia with respiratory alkalosis
D. Hyperglycemia with metabolic alkalosis
Answer: B
Rationale: DKA presents with hyperglycemia, ketonemia, and metabolic acidosis.
Hypoglycemia and alkalosis are not characteristic of DKA.
5. A patient with chronic kidney disease (CKD) is at highest risk for which
electrolyte imbalance?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: A
Rationale: CKD often impairs potassium excretion, increasing the risk of
hyperkalemia. Hypocalcemia may also occur, but hyperkalemia is more acutely
life-threatening.
,6. A nurse is assessing a patient on warfarin therapy. Which laboratory test is most
important for monitoring therapeutic effect?
A. Activated partial thromboplastin time (aPTT)
B. International normalized ratio (INR)
C. Platelet count
D. Prothrombin time (PT) only
Answer: B
Rationale: INR standardizes PT results to monitor warfarin therapy. aPTT is used
for heparin monitoring.
7. Which symptom is most indicative of increased intracranial pressure (ICP) in an
adult patient?
A. Bradycardia and widened pulse pressure
B. Tachycardia and hypotension
C. Fever and chills
D. Nausea without vomiting
Answer: A
Rationale: Cushing’s triad (bradycardia, hypertension with widened pulse
pressure, irregular respirations) is a classic sign of increased ICP.
8. A patient with sepsis is started on broad-spectrum antibiotics. Which early
intervention is most important to prevent progression to septic shock?
A. Initiate vasopressors immediately
B. Obtain blood cultures before antibiotic administration
C. Restrict fluids to avoid overload
D. Delay antibiotic therapy until cultures confirm infection
Answer: B
Rationale: Blood cultures should be obtained prior to antibiotics without delaying
therapy. Early fluid resuscitation and timely antibiotics are crucial in sepsis
management.
, 9. Which of the following findings is most concerning in a patient receiving total
parenteral nutrition (TPN)?
A. Blood glucose of 140 mg/dL
B. Mild nausea
C. Fever and chills
D. Slight electrolyte imbalance
Answer: C
Rationale: Fever and chills in a TPN patient may indicate catheter-related
bloodstream infection, which is potentially life-threatening.
10. A 58-year-old patient presents with severe abdominal pain, nausea, and
vomiting. Laboratory results show elevated serum amylase and lipase. Which
condition is most likely?
A. Appendicitis
B. Cholecystitis
C. Pancreatitis
D. Hepatitis
Answer: C
Rationale: Elevated amylase and lipase, along with severe abdominal pain, are
indicative of pancreatitis.
11. In a patient with chronic hypertension, which lifestyle modification is most
effective for long-term blood pressure control?
A. Restricting physical activity
B. Reducing dietary sodium intake
C. Increasing sugar intake for energy
D. Eliminating potassium-rich foods
Answer: B
Rationale: Sodium reduction lowers blood pressure. Regular physical activity and
potassium-rich foods also help, whereas sugar intake does not aid control.
