NURS 620 ADULT 1 EXAM 2 ACTUAL EXAM 2026/2027 |
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Graded
Course Description: NURS 620 Adult-Gerontology Health Care I covers the care of adults
experiencing acute, chronic and complex health problems of select body systems. This
exam focuses on respiratory, cardiovascular, gastrointestinal, endocrine disorders, and
fluid/electrolyte/acid-base balance, emphasizing current research-based interventions,
primary/secondary/tertiary prevention, and patient/family education .
Unit 1: Respiratory Disorders (20 Questions)
Q1: A 68-year-old male patient presents to the clinic with a 3-day history of increasing
shortness of breath, productive cough with thick yellow-green sputum, and fever of
101.2°F. He has a history of COPD and smoking (40 pack-years). On examination, you
note decreased breath sounds in the right lower lobe and dullness to percussion. Chest
X-ray confirms right lower lobe consolidation. Which nursing intervention should be
prioritized for this patient?
A. Administer antibiotics as prescribed and monitor for adverse reactions
B. Encourage increased fluid intake to 3 liters per day
C. Administer oxygen at 4 L/min via nasal cannula to maintain SpO2 > 90% [CORRECT]
D. Schedule pulmonary function tests for the following week
,Correct Answer: C
Rationale: This patient presents with signs of community-acquired pneumonia
superimposed on COPD (fever, productive cough, consolidation on X-ray, decreased
breath sounds). The priority nursing intervention follows the ABCs (Airway, Breathing,
Circulation). Administering oxygen to maintain SpO2 > 90% addresses immediate gas
exchange impairment. According to Maryville NURS 620 competencies for respiratory
disorders, hypoxemia in pneumonia with COPD requires immediate oxygen therapy
while monitoring for CO2 retention .
Why others are wrong: A is important but antibiotics don't address immediate
oxygenation needs; B is appropriate but secondary to oxygenation; D delays urgent
care—PFTs are not priority during acute infection.
Q2: [Select-All-That-Apply] A 55-year-old female with newly diagnosed asthma is
prescribed an albuterol inhaler for rescue use and fluticasone/salmeterol (Advair) for
maintenance. Which patient education points should the nurse include? (Select all that
apply)
A. Use the albuterol inhaler 15-30 minutes before exercise to prevent exercise-induced
bronchospasm [CORRECT]
B. Rinse mouth with water after using the fluticasone/salmeterol inhaler [CORRECT]
C. Use the fluticasone/salmeterol inhaler for acute asthma attacks
,D. The fluticasone component reduces airway inflammation [CORRECT]
E. Albuterol works by blocking histamine receptors
F. Stop taking fluticasone/salmeterol when symptoms improve
Correct Answer: A, B, D
Rationale: A is correct—prophylactic albuterol before exercise is standard for
exercise-induced bronchospasm. B is correct—rinsing after inhaled corticosteroids
prevents oral candidiasis and hoarseness. D is correct—fluticasone is a corticosteroid
that reduces inflammation. C is wrong—fluticasone/salmeterol is maintenance therapy,
not for acute attacks (LABA alone can increase asthma-related death risk). E is
wrong—albuterol is a beta-2 agonist, not an antihistamine. F is wrong—corticosteroids
must be continued as prescribed; stopping abruptly can cause adrenal insufficiency and
symptom rebound .
Q3: [Priority Order] A nurse is caring for a patient admitted with an acute exacerbation
of COPD. Place the following nursing interventions in the correct order of priority:
A. Obtain arterial blood gas (ABG) results
B. Position patient in high Fowler's position [1st]
C. Administer prescribed bronchodilators [2nd]
, D. Assess breath sounds and respiratory rate [3rd]
E. Teach pursed-lip breathing techniques [4th]
Correct Answer: B, C, D, A, E [CORRECT SEQUENCE]
Rationale: The correct sequence follows nursing process and airway priority: (1) B -
Positioning in high Fowler's immediately improves ventilation and reduces work of
breathing; (2) C - Bronchodilators open airways after positioning; (3) D - Assessment
follows initial interventions to evaluate effectiveness; (4) A - ABG provides objective
data after stabilization; (5) E - Teaching occurs when patient is stable. This prioritization
aligns with Maryville's emphasis on "management of complex symptomatology" and
primary intervention for respiratory distress .
Q4: A patient with pulmonary embolism (PE) is receiving heparin therapy. The nurse
notes the patient's partial thromboplastin time (PTT) is 95 seconds (normal: 25-35
seconds). Which action should the nurse take?
A. Continue current heparin infusion rate—therapeutic range achieved
B. Hold the next dose of heparin and notify the provider [CORRECT]
C. Administer protamine sulfate immediately
D. Increase heparin rate to achieve better anticoagulation
Latest Update | Maryville University | 100% Verified Complete
Solutions with Detailed Rationales | Pass Guaranteed - A+
Graded
Course Description: NURS 620 Adult-Gerontology Health Care I covers the care of adults
experiencing acute, chronic and complex health problems of select body systems. This
exam focuses on respiratory, cardiovascular, gastrointestinal, endocrine disorders, and
fluid/electrolyte/acid-base balance, emphasizing current research-based interventions,
primary/secondary/tertiary prevention, and patient/family education .
Unit 1: Respiratory Disorders (20 Questions)
Q1: A 68-year-old male patient presents to the clinic with a 3-day history of increasing
shortness of breath, productive cough with thick yellow-green sputum, and fever of
101.2°F. He has a history of COPD and smoking (40 pack-years). On examination, you
note decreased breath sounds in the right lower lobe and dullness to percussion. Chest
X-ray confirms right lower lobe consolidation. Which nursing intervention should be
prioritized for this patient?
A. Administer antibiotics as prescribed and monitor for adverse reactions
B. Encourage increased fluid intake to 3 liters per day
C. Administer oxygen at 4 L/min via nasal cannula to maintain SpO2 > 90% [CORRECT]
D. Schedule pulmonary function tests for the following week
,Correct Answer: C
Rationale: This patient presents with signs of community-acquired pneumonia
superimposed on COPD (fever, productive cough, consolidation on X-ray, decreased
breath sounds). The priority nursing intervention follows the ABCs (Airway, Breathing,
Circulation). Administering oxygen to maintain SpO2 > 90% addresses immediate gas
exchange impairment. According to Maryville NURS 620 competencies for respiratory
disorders, hypoxemia in pneumonia with COPD requires immediate oxygen therapy
while monitoring for CO2 retention .
Why others are wrong: A is important but antibiotics don't address immediate
oxygenation needs; B is appropriate but secondary to oxygenation; D delays urgent
care—PFTs are not priority during acute infection.
Q2: [Select-All-That-Apply] A 55-year-old female with newly diagnosed asthma is
prescribed an albuterol inhaler for rescue use and fluticasone/salmeterol (Advair) for
maintenance. Which patient education points should the nurse include? (Select all that
apply)
A. Use the albuterol inhaler 15-30 minutes before exercise to prevent exercise-induced
bronchospasm [CORRECT]
B. Rinse mouth with water after using the fluticasone/salmeterol inhaler [CORRECT]
C. Use the fluticasone/salmeterol inhaler for acute asthma attacks
,D. The fluticasone component reduces airway inflammation [CORRECT]
E. Albuterol works by blocking histamine receptors
F. Stop taking fluticasone/salmeterol when symptoms improve
Correct Answer: A, B, D
Rationale: A is correct—prophylactic albuterol before exercise is standard for
exercise-induced bronchospasm. B is correct—rinsing after inhaled corticosteroids
prevents oral candidiasis and hoarseness. D is correct—fluticasone is a corticosteroid
that reduces inflammation. C is wrong—fluticasone/salmeterol is maintenance therapy,
not for acute attacks (LABA alone can increase asthma-related death risk). E is
wrong—albuterol is a beta-2 agonist, not an antihistamine. F is wrong—corticosteroids
must be continued as prescribed; stopping abruptly can cause adrenal insufficiency and
symptom rebound .
Q3: [Priority Order] A nurse is caring for a patient admitted with an acute exacerbation
of COPD. Place the following nursing interventions in the correct order of priority:
A. Obtain arterial blood gas (ABG) results
B. Position patient in high Fowler's position [1st]
C. Administer prescribed bronchodilators [2nd]
, D. Assess breath sounds and respiratory rate [3rd]
E. Teach pursed-lip breathing techniques [4th]
Correct Answer: B, C, D, A, E [CORRECT SEQUENCE]
Rationale: The correct sequence follows nursing process and airway priority: (1) B -
Positioning in high Fowler's immediately improves ventilation and reduces work of
breathing; (2) C - Bronchodilators open airways after positioning; (3) D - Assessment
follows initial interventions to evaluate effectiveness; (4) A - ABG provides objective
data after stabilization; (5) E - Teaching occurs when patient is stable. This prioritization
aligns with Maryville's emphasis on "management of complex symptomatology" and
primary intervention for respiratory distress .
Q4: A patient with pulmonary embolism (PE) is receiving heparin therapy. The nurse
notes the patient's partial thromboplastin time (PTT) is 95 seconds (normal: 25-35
seconds). Which action should the nurse take?
A. Continue current heparin infusion rate—therapeutic range achieved
B. Hold the next dose of heparin and notify the provider [CORRECT]
C. Administer protamine sulfate immediately
D. Increase heparin rate to achieve better anticoagulation
