NUR 355 Exam 2: Acute & Chronic Health Disruptions In
Adults I V3 - Arizona College Updated and Latest Questions
and Correct Answers with Rationale
1. A patient with left-sided heart failure reports increased shortness of breath and has crackles upon
auscultation. Which physiological mechanism primarily causes these symptoms?
A. Reduced blood flow to the kidneys and liver
B. Fluid accumulation in the abdominal cavity
C. Backflow of blood into the pulmonary circulation
D. Decreased pressure in the left atrium
Ans: C
Explanation: Left-sided heart failure occurs when the left ventricle fails to pump efficiently. This
inefficiency causes blood to back up into the pulmonary veins and capillaries. The increased pressure
forces fluid into the alveoli, resulting in crackles and dyspnea. Managing fluid volume is a critical nursing
priority for these patients. Diuretics are commonly prescribed to reduce this pulmonary congestion and
improve gas exchange.
2. A nurse is caring for a patient who is experiencing an acute exacerbation of COPD. Which oxygen delivery
method is most appropriate to maintain a target SpO2 of 88-92%?
A. Simple face mask at 10 L/min
B. Non-rebreather mask at 15 L/min
C. Venturi mask at a precise low flow rate
D. High-flow nasal cannula at 40 L/min
Ans: C
,Explanation: The Venturi mask provides a precise concentration of oxygen which is vital for COPD
patients. High levels of oxygen can suppress the hypoxic drive in individuals with chronic carbon dioxide
retention. Maintaining the target saturation of 88 to 92 percent prevents oxygen toxicity and respiratory
depression. The nurse must monitor the patient closely for changes in mental status or respiratory effort.
Using the correct delivery device ensures safety while treating hypoxemia.
3. A patient with Type 1 Diabetes Mellitus is admitted with a blood glucose of 550 mg/dL and positive
ketones in the urine. Which acid-base imbalance is likely present?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Ans: D
Explanation: Diabetic Ketoacidosis leads to an accumulation of ketone bodies which are acidic. This
process results in a decrease in serum bicarbonate and a drop in pH level. The body compensates for this
metabolic acidosis through Kussmaul respirations to blow off carbon dioxide. Fluid resuscitation and
insulin therapy are the primary treatments for this condition. Electrolyte monitoring is essential as
potassium levels shift during treatment.
4. A patient is diagnosed with Chronic Kidney Disease (CKD) Stage 4. Which dietary restriction should the
nurse prioritize in the teaching plan?
A. High intake of lean protein sources
B. Increased consumption of leafy green vegetables
C. High intake of dairy products and nuts
, D. Restriction of potassium and phosphorus
Ans: D
Explanation: As kidney function declines, the ability to excrete potassium and phosphorus is severely
impaired. High levels of potassium can lead to life-threatening cardiac dysrhythmias. Phosphorus
restriction is necessary to prevent secondary hyperparathyroidism and bone disease. Patients should
avoid high-potassium foods like bananas and oranges. Nursing education focuses on helping the patient
choose low-mineral alternatives to maintain stability.
5. Which clinical manifestation is a hallmark sign of Right-Sided Heart Failure?
A. Jugular Venous Distention (JVD)
B. Pulmonary edema and frothy sputum
C. Dry, non-productive nocturnal cough
D. Decreased peripheral pulses in lower extremities
Ans: A
Explanation: Right-sided heart failure causes blood to back up into the systemic venous system. This
systemic congestion results in visible jugular venous distention and peripheral edema. Other symptoms
include hepatomegaly and ascites due to venous engorgement of the organs. It often occurs as a result of
left-sided failure or pulmonary disease. Nurses must assess daily weights to monitor fluid retention
status accurately.
6. A patient with a peptic ulcer reports sudden, severe abdominal pain that radiates to the shoulder. The
abdomen is rigid and board-like. What is the priority nursing action?
A. Administer the prescribed PRN antacid
B. Increase the IV fluid infusion rate
Adults I V3 - Arizona College Updated and Latest Questions
and Correct Answers with Rationale
1. A patient with left-sided heart failure reports increased shortness of breath and has crackles upon
auscultation. Which physiological mechanism primarily causes these symptoms?
A. Reduced blood flow to the kidneys and liver
B. Fluid accumulation in the abdominal cavity
C. Backflow of blood into the pulmonary circulation
D. Decreased pressure in the left atrium
Ans: C
Explanation: Left-sided heart failure occurs when the left ventricle fails to pump efficiently. This
inefficiency causes blood to back up into the pulmonary veins and capillaries. The increased pressure
forces fluid into the alveoli, resulting in crackles and dyspnea. Managing fluid volume is a critical nursing
priority for these patients. Diuretics are commonly prescribed to reduce this pulmonary congestion and
improve gas exchange.
2. A nurse is caring for a patient who is experiencing an acute exacerbation of COPD. Which oxygen delivery
method is most appropriate to maintain a target SpO2 of 88-92%?
A. Simple face mask at 10 L/min
B. Non-rebreather mask at 15 L/min
C. Venturi mask at a precise low flow rate
D. High-flow nasal cannula at 40 L/min
Ans: C
,Explanation: The Venturi mask provides a precise concentration of oxygen which is vital for COPD
patients. High levels of oxygen can suppress the hypoxic drive in individuals with chronic carbon dioxide
retention. Maintaining the target saturation of 88 to 92 percent prevents oxygen toxicity and respiratory
depression. The nurse must monitor the patient closely for changes in mental status or respiratory effort.
Using the correct delivery device ensures safety while treating hypoxemia.
3. A patient with Type 1 Diabetes Mellitus is admitted with a blood glucose of 550 mg/dL and positive
ketones in the urine. Which acid-base imbalance is likely present?
A. Respiratory alkalosis
B. Metabolic alkalosis
C. Respiratory acidosis
D. Metabolic acidosis
Ans: D
Explanation: Diabetic Ketoacidosis leads to an accumulation of ketone bodies which are acidic. This
process results in a decrease in serum bicarbonate and a drop in pH level. The body compensates for this
metabolic acidosis through Kussmaul respirations to blow off carbon dioxide. Fluid resuscitation and
insulin therapy are the primary treatments for this condition. Electrolyte monitoring is essential as
potassium levels shift during treatment.
4. A patient is diagnosed with Chronic Kidney Disease (CKD) Stage 4. Which dietary restriction should the
nurse prioritize in the teaching plan?
A. High intake of lean protein sources
B. Increased consumption of leafy green vegetables
C. High intake of dairy products and nuts
, D. Restriction of potassium and phosphorus
Ans: D
Explanation: As kidney function declines, the ability to excrete potassium and phosphorus is severely
impaired. High levels of potassium can lead to life-threatening cardiac dysrhythmias. Phosphorus
restriction is necessary to prevent secondary hyperparathyroidism and bone disease. Patients should
avoid high-potassium foods like bananas and oranges. Nursing education focuses on helping the patient
choose low-mineral alternatives to maintain stability.
5. Which clinical manifestation is a hallmark sign of Right-Sided Heart Failure?
A. Jugular Venous Distention (JVD)
B. Pulmonary edema and frothy sputum
C. Dry, non-productive nocturnal cough
D. Decreased peripheral pulses in lower extremities
Ans: A
Explanation: Right-sided heart failure causes blood to back up into the systemic venous system. This
systemic congestion results in visible jugular venous distention and peripheral edema. Other symptoms
include hepatomegaly and ascites due to venous engorgement of the organs. It often occurs as a result of
left-sided failure or pulmonary disease. Nurses must assess daily weights to monitor fluid retention
status accurately.
6. A patient with a peptic ulcer reports sudden, severe abdominal pain that radiates to the shoulder. The
abdomen is rigid and board-like. What is the priority nursing action?
A. Administer the prescribed PRN antacid
B. Increase the IV fluid infusion rate
