N580 EXAM / LATEST N580 MIDTERM EXAM 2026/2027 PRACTICE QUESTIONS
AND STUDY GUIDE COMPLETE ACCURATE EXAM APPROVED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES (100% CORRECT
VERIFIED SOLUTIONS) CURRENTLY UPDATED VERSION 2026 EDITION
|ALREADY GRADED A+ |FULL REVISED N580 MIDTERM EXAM |INSTANT
DOWNLOAD PDF
1. A 68-year-old patient presents with acute shortness of breath, crackles in bilateral lung
bases, and an S3 gallop. Which intervention should the nurse implement first?
A) Administer IV furosemide
B) Place the patient in high-Fowler’s position
C) Apply supplemental oxygen at 4 L/min via nasal cannula (CORRECT ANSWER)
D) Obtain a stat portable chest x-ray
Rationale: Oxygenation is the priority in acute pulmonary edema to prevent hypoxia;
positioning and diuretics follow but do not address immediate gas exchange.
2. Which laboratory value is most indicative of acute kidney injury (AKI) in a postoperative
patient?
A) BUN 18 mg/ld.
B) Serum creatinine increase from 0.9 to 2.1 mg/ld. within 48 hours (CORRECT
ANSWER)
C) Urine output 350 mL over 8 hours
D) Serum potassium 4.0 me/L
*Rationale: A rapid rise in creatinine (≥0.3 mg/ld. in 48 hours or ≥1.5× baseline) defines
AKI; BUN and output are supportive but less specific.*
3. A nurse is caring for a patient with diabetic ketoacidosis (DKA). Which finding indicates
that insulin therapy is effective?
A) Blood glucose decreased from 650 to 300 mg/ld.
, B) Serum potassium increased from 4.0 to 4.5 me/L
C) PaCO2 increased from 28 to 32 mm Hg
D) Anion gap decreased from 22 to 14 me/L (CORRECT ANSWER)
Rationale: Anion gap closure reflects resolution of ketoacidosis; glucose decline lags
behind correction of acidosis.
4. Which medication is contraindicated in a patient with acute intermittent porphyria?
A) Acetaminophen
B) Phenobarbital (CORRECT ANSWER)
C) Metoprolol
D) Lisinopril
Rationale: Barbiturates induce hepatic ALA synthase, precipitating porphyria attacks;
acetaminophen and others are generally safe.
5. A patient with heart failure has a digoxin level of 2.4 ng/milk Which symptom is most
specific to digoxin toxicity?
A) Nausea and vomiting
B) Bradycardia
C) Visual disturbances (yellow halos) (CORRECT ANSWER)
D) Fatigue
Rationale: Xanthopsia (yellow-green halos) is pathognomonic for digoxin toxicity; GI and
cardiac effects are less specific.
6. Which arterial blood gas (ABG) finding is expected in a patient with salicylate overdose?
A) pH 7.48, PaCO2 48, HCO3 30
B) pH 7.32, PaCO2 28, HCO3 16
C) pH 7.38, PaCO2 22, HCO3 12 (CORRECT ANSWER)
D) pH 7.52, PaCO2 30, HCO3 24
*Rationale: Salicylates cause mixed respiratory alkalosis (early) and high-anion-gap
, metabolic acidosis; a near-normal pH with low PaCO2 and low HCO3 indicates
compensation.*
7. A nurse is assessing a patient with suspected meningitis. Which finding is consistent
with Kerning’s sign?
A) Neck stiffness with passive neck flexion
B) Pain and resistance with knee extension while hip is flexed (CORRECT ANSWER)
C) Involuntary flexion of hips and knees when neck is flexed
D) Nuchal rigidity relieved by hip flexion
Rationale: Kerning’s sign is pain on knee extension after hip flexion; Brzezinski’s sign is
hip/knee flexion with neck flexion.
8. Which electrolyte imbalance is most likely in a patient receiving continuous loop diuretic
infusion?
A) Hypernatremia
B) Hypokalemia (CORRECT ANSWER)
C) Hypercalcemia
D) Hypomagnesemia (also correct but hypokalemia is more common and acute; the
question asks “most likely” – loop diuretics cause both, but hypokalemia is the classic
answer)
*Rationale: Loop diuretics inhibit Na-K-2Cl reabsorption, increasing potassium excretion;
hypokalemia is a frequent adverse effect.*
9. A patient with chronic obstructive pulmonary disease (COPD) has a SpO2 of 88% on
room air. Which intervention is appropriate?
A) Titrate oxygen to maintain SpO2 94–98%
B) Titrate oxygen to maintain SpO2 88–92% (CORRECT ANSWER)
C) Apply non-rebreather mask at 15 L/min
D) Intubate for mechanical ventilation
AND STUDY GUIDE COMPLETE ACCURATE EXAM APPROVED QUESTIONS AND
CORRECT DETAILED ANSWERS WITH RATIONALES (100% CORRECT
VERIFIED SOLUTIONS) CURRENTLY UPDATED VERSION 2026 EDITION
|ALREADY GRADED A+ |FULL REVISED N580 MIDTERM EXAM |INSTANT
DOWNLOAD PDF
1. A 68-year-old patient presents with acute shortness of breath, crackles in bilateral lung
bases, and an S3 gallop. Which intervention should the nurse implement first?
A) Administer IV furosemide
B) Place the patient in high-Fowler’s position
C) Apply supplemental oxygen at 4 L/min via nasal cannula (CORRECT ANSWER)
D) Obtain a stat portable chest x-ray
Rationale: Oxygenation is the priority in acute pulmonary edema to prevent hypoxia;
positioning and diuretics follow but do not address immediate gas exchange.
2. Which laboratory value is most indicative of acute kidney injury (AKI) in a postoperative
patient?
A) BUN 18 mg/ld.
B) Serum creatinine increase from 0.9 to 2.1 mg/ld. within 48 hours (CORRECT
ANSWER)
C) Urine output 350 mL over 8 hours
D) Serum potassium 4.0 me/L
*Rationale: A rapid rise in creatinine (≥0.3 mg/ld. in 48 hours or ≥1.5× baseline) defines
AKI; BUN and output are supportive but less specific.*
3. A nurse is caring for a patient with diabetic ketoacidosis (DKA). Which finding indicates
that insulin therapy is effective?
A) Blood glucose decreased from 650 to 300 mg/ld.
, B) Serum potassium increased from 4.0 to 4.5 me/L
C) PaCO2 increased from 28 to 32 mm Hg
D) Anion gap decreased from 22 to 14 me/L (CORRECT ANSWER)
Rationale: Anion gap closure reflects resolution of ketoacidosis; glucose decline lags
behind correction of acidosis.
4. Which medication is contraindicated in a patient with acute intermittent porphyria?
A) Acetaminophen
B) Phenobarbital (CORRECT ANSWER)
C) Metoprolol
D) Lisinopril
Rationale: Barbiturates induce hepatic ALA synthase, precipitating porphyria attacks;
acetaminophen and others are generally safe.
5. A patient with heart failure has a digoxin level of 2.4 ng/milk Which symptom is most
specific to digoxin toxicity?
A) Nausea and vomiting
B) Bradycardia
C) Visual disturbances (yellow halos) (CORRECT ANSWER)
D) Fatigue
Rationale: Xanthopsia (yellow-green halos) is pathognomonic for digoxin toxicity; GI and
cardiac effects are less specific.
6. Which arterial blood gas (ABG) finding is expected in a patient with salicylate overdose?
A) pH 7.48, PaCO2 48, HCO3 30
B) pH 7.32, PaCO2 28, HCO3 16
C) pH 7.38, PaCO2 22, HCO3 12 (CORRECT ANSWER)
D) pH 7.52, PaCO2 30, HCO3 24
*Rationale: Salicylates cause mixed respiratory alkalosis (early) and high-anion-gap
, metabolic acidosis; a near-normal pH with low PaCO2 and low HCO3 indicates
compensation.*
7. A nurse is assessing a patient with suspected meningitis. Which finding is consistent
with Kerning’s sign?
A) Neck stiffness with passive neck flexion
B) Pain and resistance with knee extension while hip is flexed (CORRECT ANSWER)
C) Involuntary flexion of hips and knees when neck is flexed
D) Nuchal rigidity relieved by hip flexion
Rationale: Kerning’s sign is pain on knee extension after hip flexion; Brzezinski’s sign is
hip/knee flexion with neck flexion.
8. Which electrolyte imbalance is most likely in a patient receiving continuous loop diuretic
infusion?
A) Hypernatremia
B) Hypokalemia (CORRECT ANSWER)
C) Hypercalcemia
D) Hypomagnesemia (also correct but hypokalemia is more common and acute; the
question asks “most likely” – loop diuretics cause both, but hypokalemia is the classic
answer)
*Rationale: Loop diuretics inhibit Na-K-2Cl reabsorption, increasing potassium excretion;
hypokalemia is a frequent adverse effect.*
9. A patient with chronic obstructive pulmonary disease (COPD) has a SpO2 of 88% on
room air. Which intervention is appropriate?
A) Titrate oxygen to maintain SpO2 94–98%
B) Titrate oxygen to maintain SpO2 88–92% (CORRECT ANSWER)
C) Apply non-rebreather mask at 15 L/min
D) Intubate for mechanical ventilation
