SENECA COLLEGE PNR 300 EXAM SOLUTIONS
LATEST SPRING | PNR300 Verified Answers | Already
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Part One: Health Assessment & Clinical Reasoning
Q1: During morning handoff, you receive report on four patients. Who should you
assess first?
A. Patient A: Stable post-appendectomy day 2, pain 3/10
B. Patient B: COPD exacerbation, O2 sat 94% on 2L NC
C. Patient C: New-onset chest pain, diaphoretic, BP 88/52, HR 118 [CORRECT]
D. Patient D: Type 2 diabetes awaiting discharge, fasting glucose 7.2 mmol/L
Correct Answer: C
Rationale: This patient shows signs of shock (hypotension, tachycardia, diaphoresis)
with chest pain—potential MI or pulmonary embolism requiring immediate
assessment. The COPD patient is stable on oxygen; post-op and discharge patients
are lower priority. ABCs and hemodynamic stability always come first.
Q2: A 78-year-old patient has the following vital signs: T 38.9°C, HR 112, RR 24, BP
92/58, O2 sat 89% on room air. Using the NEWS (National Early Warning Score),
which score range indicates this patient needs urgent review?
A. 0-2 (low risk)
B. 3-4 (medium risk)
C. 5-6 or more (high risk - urgent response needed) [CORRECT]
D. Score cannot be calculated without blood glucose
Correct Answer: C
Rationale: This patient scores at least 3 for O2 sat, 2 for RR, 2 for HR, 2 for systolic
BP, 2 for temperature = 11 points. NEWS ≥5-6 triggers urgent clinical review and
,escalation. Low scores (0-2) need routine monitoring only. Blood glucose is an
additional parameter, not required for core score.
Q3: You are assessing a patient's pain using the PQRST method. The patient
describes sharp, stabbing pain (Quality) in the right lower quadrant (Region) that
started 2 hours ago (Timing) and worsens with movement (Provocation). What does
the "S" in PQRST assess?
A. Social history and family support
B. Severity and any associated Symptoms [CORRECT]
C. Sleep patterns and rest needs
D. Spiritual beliefs about suffering
Correct Answer: B
Rationale: PQRST stands for Provocation/Palliation, Quality, Region/Radiation,
Severity (0-10 scale), and Timing. The "S" specifically assesses Severity and associated
Symptoms (nausea, vomiting, diaphoresis). This systematic approach ensures
comprehensive pain assessment rather than relying on a single number.
Q4: During a focused respiratory assessment, you note decreased breath sounds on
the left side, dullness to percussion, and egophony. Which condition do these
findings suggest?
A. Pneumothorax
B. Pleural effusion or consolidation (pneumonia) [CORRECT]
C. Asthma exacerbation
D. Pulmonary embolism
Correct Answer: B
Rationale: Decreased breath sounds, dull percussion, and egophony (E-to-A
changes) are classic for pleural effusion or lobar consolidation from pneumonia.
Pneumothorax presents with hyperresonance and absent breath sounds. Asthma
, shows wheezing and prolonged expiration. PE typically has clear lungs unless
infarction occurs.
Q5: A patient with heart failure has 2+ pitting edema bilaterally, JVD at 45 degrees,
and reports waking breathless at night. Which assessment finding would you expect
on auscultation?
A. Clear lung fields throughout
B. Crackles in the lung bases and an S3 gallop [CORRECT]
C. Wheezing throughout all lung fields
D. Friction rub at the left sternal border
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion (crackles, especially
bibasilar) and volume overload (S3 gallop from rapid ventricular filling, JVD, edema).
Orthopnea and paroxysmal nocturnal dyspnea are classic symptoms. Wheezing
suggests asthma/COPD; friction rub indicates pericarditis.
Q6: You are performing a neurological assessment on a patient post-stroke. The
patient follows commands, speaks clearly, but has weakness on the left side. Using
the Glasgow Coma Scale, which component would be scored as "localizes to pain"
rather than "obeys commands"?
A. Eye opening
B. Verbal response
C. Motor response [CORRECT]
D. Pupillary response
Correct Answer: C
Rationale: The GCS assesses Eye opening (1-4), Verbal response (1-5), and Motor
response (1-6). "Localizes to pain" (5) and "obeys commands" (6) are motor response
scores. A patient who follows commands scores 6; if they only localizes to pain, they
score 5. Pupillary response is not part of GCS but is assessed separately.
LATEST SPRING | PNR300 Verified Answers | Already
Graded | Pass Guaranteed - A+ Graded
Part One: Health Assessment & Clinical Reasoning
Q1: During morning handoff, you receive report on four patients. Who should you
assess first?
A. Patient A: Stable post-appendectomy day 2, pain 3/10
B. Patient B: COPD exacerbation, O2 sat 94% on 2L NC
C. Patient C: New-onset chest pain, diaphoretic, BP 88/52, HR 118 [CORRECT]
D. Patient D: Type 2 diabetes awaiting discharge, fasting glucose 7.2 mmol/L
Correct Answer: C
Rationale: This patient shows signs of shock (hypotension, tachycardia, diaphoresis)
with chest pain—potential MI or pulmonary embolism requiring immediate
assessment. The COPD patient is stable on oxygen; post-op and discharge patients
are lower priority. ABCs and hemodynamic stability always come first.
Q2: A 78-year-old patient has the following vital signs: T 38.9°C, HR 112, RR 24, BP
92/58, O2 sat 89% on room air. Using the NEWS (National Early Warning Score),
which score range indicates this patient needs urgent review?
A. 0-2 (low risk)
B. 3-4 (medium risk)
C. 5-6 or more (high risk - urgent response needed) [CORRECT]
D. Score cannot be calculated without blood glucose
Correct Answer: C
Rationale: This patient scores at least 3 for O2 sat, 2 for RR, 2 for HR, 2 for systolic
BP, 2 for temperature = 11 points. NEWS ≥5-6 triggers urgent clinical review and
,escalation. Low scores (0-2) need routine monitoring only. Blood glucose is an
additional parameter, not required for core score.
Q3: You are assessing a patient's pain using the PQRST method. The patient
describes sharp, stabbing pain (Quality) in the right lower quadrant (Region) that
started 2 hours ago (Timing) and worsens with movement (Provocation). What does
the "S" in PQRST assess?
A. Social history and family support
B. Severity and any associated Symptoms [CORRECT]
C. Sleep patterns and rest needs
D. Spiritual beliefs about suffering
Correct Answer: B
Rationale: PQRST stands for Provocation/Palliation, Quality, Region/Radiation,
Severity (0-10 scale), and Timing. The "S" specifically assesses Severity and associated
Symptoms (nausea, vomiting, diaphoresis). This systematic approach ensures
comprehensive pain assessment rather than relying on a single number.
Q4: During a focused respiratory assessment, you note decreased breath sounds on
the left side, dullness to percussion, and egophony. Which condition do these
findings suggest?
A. Pneumothorax
B. Pleural effusion or consolidation (pneumonia) [CORRECT]
C. Asthma exacerbation
D. Pulmonary embolism
Correct Answer: B
Rationale: Decreased breath sounds, dull percussion, and egophony (E-to-A
changes) are classic for pleural effusion or lobar consolidation from pneumonia.
Pneumothorax presents with hyperresonance and absent breath sounds. Asthma
, shows wheezing and prolonged expiration. PE typically has clear lungs unless
infarction occurs.
Q5: A patient with heart failure has 2+ pitting edema bilaterally, JVD at 45 degrees,
and reports waking breathless at night. Which assessment finding would you expect
on auscultation?
A. Clear lung fields throughout
B. Crackles in the lung bases and an S3 gallop [CORRECT]
C. Wheezing throughout all lung fields
D. Friction rub at the left sternal border
Correct Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion (crackles, especially
bibasilar) and volume overload (S3 gallop from rapid ventricular filling, JVD, edema).
Orthopnea and paroxysmal nocturnal dyspnea are classic symptoms. Wheezing
suggests asthma/COPD; friction rub indicates pericarditis.
Q6: You are performing a neurological assessment on a patient post-stroke. The
patient follows commands, speaks clearly, but has weakness on the left side. Using
the Glasgow Coma Scale, which component would be scored as "localizes to pain"
rather than "obeys commands"?
A. Eye opening
B. Verbal response
C. Motor response [CORRECT]
D. Pupillary response
Correct Answer: C
Rationale: The GCS assesses Eye opening (1-4), Verbal response (1-5), and Motor
response (1-6). "Localizes to pain" (5) and "obeys commands" (6) are motor response
scores. A patient who follows commands scores 6; if they only localizes to pain, they
score 5. Pupillary response is not part of GCS but is assessed separately.
