NUR 231 FINAL EXAM (MODULE 1-10) – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains*
*Fluid and Electrolytes*
*Pharmacological Therapies*
*Acid-Base Balance Regulation*
*Perioperative Nursing Management*
*Infection Control and Safety Protocols*
*Pain Management and Comfort Care*
*Respiratory System Interventions*
*Cardiovascular Health and Disorders*
*Ethics and Legal Nursing Standards*
*Gastrointestinal Care Models*
*Introduction*
*The NUR 231 Final Exam is a comprehensive assessment designed to evaluate a student's*
*mastery of complex nursing concepts across clinical modules. The purpose of this exam*
*is to ensure readiness for professional practice by validating knowledge of core*
*pathophysiological processes and evidence-based interventions. The assessment utilizes*
*a mix of foundational theory and scenario-based questions to measure clinical*
*judgment. Emphasis is placed on real-world application, patient safety, and critical*
*decision-making. Candidates are expected to analyze patient data, prioritize care*
*actions, and demonstrate an understanding of the legal and ethical framework within*
*the modern healthcare environment through a rigorous 200-question structure.*
, SECTION ONE
1. A patient is admitted with a serum sodium level of 128 mEq/L. Which clinical manifestation should the
nurse prioritize?
A. Dry mucous membranes
B. Increased thirst
C. Confusion and lethargy
D. Weight gain
🟢 C. Confusion and lethargy
🔴 Explanation: Hyponatremia (sodium < 135 mEq/L) causes water to shift into brain cells, leading to cerebral
edema. Neurological changes such as confusion, lethargy, and seizures are the highest priority.
2. A nurse is preparing to administer a blood transfusion. What is the only intravenous fluid compatible with
blood products?
A. Lactated Ringer's
B. 0.9% Sodium Chloride
C. 5% Dextrose in Water
D. 0.45% Sodium Chloride
🟢 B. 0.9% Sodium Chloride
🔴 Explanation: Normal saline (0.9% NaCl) is the only isotonic solution compatible with blood; other fluids like
Dextrose cause hemolysis or clotting of the blood cells.
3. Which acid-base imbalance is a patient with chronic obstructive pulmonary disease (COPD) most at risk
for developing?
,A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
🟢 D. Respiratory acidosis
🔴 Explanation: COPD causes hypoventilation and CO2 retention. As carbon dioxide (an acid) builds up in the
blood, the pH drops, resulting in respiratory acidosis.
4. A patient is 12 hours postoperative following abdominal surgery. Which finding requires immediate
notification of the surgeon?
A. Absent bowel sounds in all quadrants
B. Serosanguineous drainage on the dressing
C. Urine output of 20 mL/hr for two consecutive hours
D. Patient report of pain as 7 out of 10
🟢 C. Urine output of 20 mL/hr for two consecutive hours
🔴 Explanation: Urine output below 30 mL/hr indicates poor renal perfusion or potential hypovolemia/shock,
requiring immediate intervention.
5. In the chain of infection, a contaminated stethoscope is an example of which link?
A. Reservoir
B. Portal of entry
C. Fomite (Mode of transmission)
D. Susceptible host
🟢 C. Fomite (Mode of transmission)
, 🔴 Explanation: A fomite is an inanimate object that can carry and transmit infectious agents from one person
to another.
6. Which medication is considered the "gold standard" for the treatment of acute pulmonary edema?
A. Furosemide
B. Atenolol
C. Warfarin
D. Spironolactone
🟢 A. Furosemide
🔴 Explanation: Furosemide is a rapid-acting loop diuretic that reduces preload by promoting diuresis, which is
essential in clearing fluid from the lungs during acute heart failure.
7. A nurse observes a patient’s heart rate increase from 80 to 110 bpm and blood pressure drop from 120/80
to 90/60 mmHg. What is the priority nursing action?
A. Administer a scheduled beta-blocker
B. Lower the head of the bed and increase IV fluids
C. Encourage the patient to ambulate
D. Document the findings as a normal postoperative response
🟢 B. Lower the head of the bed and increase IV fluids
🔴 Explanation: These vital signs suggest hypovolemic shock. Lowering the head of the bed (Trendelenburg or
supine) and increasing fluids helps maintain cerebral and vital organ perfusion.
8. When assessing a patient with hypocalcemia, the nurse taps the facial nerve and observes twitching of
the facial muscles. What is this sign called?
A. Trousseau’s sign
B. Babinski’s sign
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST EXAM UPDATE
*Core Domains*
*Fluid and Electrolytes*
*Pharmacological Therapies*
*Acid-Base Balance Regulation*
*Perioperative Nursing Management*
*Infection Control and Safety Protocols*
*Pain Management and Comfort Care*
*Respiratory System Interventions*
*Cardiovascular Health and Disorders*
*Ethics and Legal Nursing Standards*
*Gastrointestinal Care Models*
*Introduction*
*The NUR 231 Final Exam is a comprehensive assessment designed to evaluate a student's*
*mastery of complex nursing concepts across clinical modules. The purpose of this exam*
*is to ensure readiness for professional practice by validating knowledge of core*
*pathophysiological processes and evidence-based interventions. The assessment utilizes*
*a mix of foundational theory and scenario-based questions to measure clinical*
*judgment. Emphasis is placed on real-world application, patient safety, and critical*
*decision-making. Candidates are expected to analyze patient data, prioritize care*
*actions, and demonstrate an understanding of the legal and ethical framework within*
*the modern healthcare environment through a rigorous 200-question structure.*
, SECTION ONE
1. A patient is admitted with a serum sodium level of 128 mEq/L. Which clinical manifestation should the
nurse prioritize?
A. Dry mucous membranes
B. Increased thirst
C. Confusion and lethargy
D. Weight gain
🟢 C. Confusion and lethargy
🔴 Explanation: Hyponatremia (sodium < 135 mEq/L) causes water to shift into brain cells, leading to cerebral
edema. Neurological changes such as confusion, lethargy, and seizures are the highest priority.
2. A nurse is preparing to administer a blood transfusion. What is the only intravenous fluid compatible with
blood products?
A. Lactated Ringer's
B. 0.9% Sodium Chloride
C. 5% Dextrose in Water
D. 0.45% Sodium Chloride
🟢 B. 0.9% Sodium Chloride
🔴 Explanation: Normal saline (0.9% NaCl) is the only isotonic solution compatible with blood; other fluids like
Dextrose cause hemolysis or clotting of the blood cells.
3. Which acid-base imbalance is a patient with chronic obstructive pulmonary disease (COPD) most at risk
for developing?
,A. Metabolic acidosis
B. Metabolic alkalosis
C. Respiratory alkalosis
D. Respiratory acidosis
🟢 D. Respiratory acidosis
🔴 Explanation: COPD causes hypoventilation and CO2 retention. As carbon dioxide (an acid) builds up in the
blood, the pH drops, resulting in respiratory acidosis.
4. A patient is 12 hours postoperative following abdominal surgery. Which finding requires immediate
notification of the surgeon?
A. Absent bowel sounds in all quadrants
B. Serosanguineous drainage on the dressing
C. Urine output of 20 mL/hr for two consecutive hours
D. Patient report of pain as 7 out of 10
🟢 C. Urine output of 20 mL/hr for two consecutive hours
🔴 Explanation: Urine output below 30 mL/hr indicates poor renal perfusion or potential hypovolemia/shock,
requiring immediate intervention.
5. In the chain of infection, a contaminated stethoscope is an example of which link?
A. Reservoir
B. Portal of entry
C. Fomite (Mode of transmission)
D. Susceptible host
🟢 C. Fomite (Mode of transmission)
, 🔴 Explanation: A fomite is an inanimate object that can carry and transmit infectious agents from one person
to another.
6. Which medication is considered the "gold standard" for the treatment of acute pulmonary edema?
A. Furosemide
B. Atenolol
C. Warfarin
D. Spironolactone
🟢 A. Furosemide
🔴 Explanation: Furosemide is a rapid-acting loop diuretic that reduces preload by promoting diuresis, which is
essential in clearing fluid from the lungs during acute heart failure.
7. A nurse observes a patient’s heart rate increase from 80 to 110 bpm and blood pressure drop from 120/80
to 90/60 mmHg. What is the priority nursing action?
A. Administer a scheduled beta-blocker
B. Lower the head of the bed and increase IV fluids
C. Encourage the patient to ambulate
D. Document the findings as a normal postoperative response
🟢 B. Lower the head of the bed and increase IV fluids
🔴 Explanation: These vital signs suggest hypovolemic shock. Lowering the head of the bed (Trendelenburg or
supine) and increasing fluids helps maintain cerebral and vital organ perfusion.
8. When assessing a patient with hypocalcemia, the nurse taps the facial nerve and observes twitching of
the facial muscles. What is this sign called?
A. Trousseau’s sign
B. Babinski’s sign
