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NUR 230 Final Exam Childbearing Child
Caring Family Nursing 2026/2027 Test Bank
with Verified Answers and Comprehensive
Rationales Grade A – Galen
1. A nurse is assessing a client who has fluid overload. Which of the
following findings should the nurse expect? (Select all that apply.)
A) Increased heart rate
B) Increased BP
C) Increased respiratory rate
D) Increased hematocrit
E) Increased temperature
Correct Answer: A) Increased heart rate, B) Increased BP, and C)
Increased respiratory rate
Rationale:
1. Fluid overload increases circulating volume, leading to increased heart rate
(compensatory mechanism).
2. Increased blood volume causes increased blood pressure.
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3. Pulmonary congestion from fluid overload causes increased respiratory rate
(tachypnea).
4. Hematocrit decreases (dilution) in fluid overload, not increases.
2. A client who has a history of myocardial infarction (MI) is prescribed
aspirin 325 mg. The nurse recognizes that the aspirin given is due to
which of the following actions of the medication?
A) Analgesic
B) Anti-inflammatory
C) Anti-platelet aggregate
D) Antipyretic
Correct Answer: C) Anti-platelet aggregate
Rationale:
1. Low-dose aspirin inhibits platelet aggregation by irreversibly blocking
cyclooxygenase-1 (COX-1).
2. This reduces the risk of thrombus formation and prevents secondary MI.
3. The anti-platelet effect, not analgesic or anti-inflammatory, is the reason for
post-MI use.
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3. A nurse is teaching about risk factors for developing a stroke with a
group of older adult clients. Which of the following nonmodifiable risk
factors should the nurse include?
A) History of smoking
B) Obesity
C) History of HTN
D) Genetics
Correct Answer: D) Genetics
Rationale:
1. Nonmodifiable risk factors cannot be changed by the patient.
2. Genetics (family history, race, age, gender) are nonmodifiable.
3. Smoking, obesity, and hypertension are modifiable risk factors.
4. A nurse is assessing a client who had left femoral cardiac angiography.
Identify where the nurse will palpate to assess the most distal pulse on
the affected side.
Correct Answer: Left pedal pulse (dorsalis pedis or posterior tibial)
Rationale:
1. The most distal pulse on the lower extremity is the dorsalis pedis (top of foot)
or posterior tibial (behind medial malleolus).
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2. Assessing distal pulses checks for adequate circulation after femoral artery
catheterization.
3. Absent or diminished pulses may indicate arterial occlusion or hematoma
formation.
5. A nurse on a medical-surgical unit is caring for four clients who are 24
hours post-op. Which of the following surgical procedures places the
client at risk for deep-vein thrombosis?
A) Myringotomy (ear)
B) Laparoscopic appendectomy
C) Hip arthroplasty
D) Cataract extraction (eye)
Correct Answer: C) Hip arthroplasty
Rationale:
1. Hip arthroplasty (joint replacement) carries a high risk of DVT due to
immobility, venous stasis, and surgical trauma.
2. DVT prophylaxis (anticoagulants, compression devices) is standard after
orthopedic surgery.
3. Ear and eye surgeries have minimal DVT risk.
NUR 230 Final Exam Childbearing Child
Caring Family Nursing 2026/2027 Test Bank
with Verified Answers and Comprehensive
Rationales Grade A – Galen
1. A nurse is assessing a client who has fluid overload. Which of the
following findings should the nurse expect? (Select all that apply.)
A) Increased heart rate
B) Increased BP
C) Increased respiratory rate
D) Increased hematocrit
E) Increased temperature
Correct Answer: A) Increased heart rate, B) Increased BP, and C)
Increased respiratory rate
Rationale:
1. Fluid overload increases circulating volume, leading to increased heart rate
(compensatory mechanism).
2. Increased blood volume causes increased blood pressure.
,2|Page
3. Pulmonary congestion from fluid overload causes increased respiratory rate
(tachypnea).
4. Hematocrit decreases (dilution) in fluid overload, not increases.
2. A client who has a history of myocardial infarction (MI) is prescribed
aspirin 325 mg. The nurse recognizes that the aspirin given is due to
which of the following actions of the medication?
A) Analgesic
B) Anti-inflammatory
C) Anti-platelet aggregate
D) Antipyretic
Correct Answer: C) Anti-platelet aggregate
Rationale:
1. Low-dose aspirin inhibits platelet aggregation by irreversibly blocking
cyclooxygenase-1 (COX-1).
2. This reduces the risk of thrombus formation and prevents secondary MI.
3. The anti-platelet effect, not analgesic or anti-inflammatory, is the reason for
post-MI use.
,3|Page
3. A nurse is teaching about risk factors for developing a stroke with a
group of older adult clients. Which of the following nonmodifiable risk
factors should the nurse include?
A) History of smoking
B) Obesity
C) History of HTN
D) Genetics
Correct Answer: D) Genetics
Rationale:
1. Nonmodifiable risk factors cannot be changed by the patient.
2. Genetics (family history, race, age, gender) are nonmodifiable.
3. Smoking, obesity, and hypertension are modifiable risk factors.
4. A nurse is assessing a client who had left femoral cardiac angiography.
Identify where the nurse will palpate to assess the most distal pulse on
the affected side.
Correct Answer: Left pedal pulse (dorsalis pedis or posterior tibial)
Rationale:
1. The most distal pulse on the lower extremity is the dorsalis pedis (top of foot)
or posterior tibial (behind medial malleolus).
, 4|Page
2. Assessing distal pulses checks for adequate circulation after femoral artery
catheterization.
3. Absent or diminished pulses may indicate arterial occlusion or hematoma
formation.
5. A nurse on a medical-surgical unit is caring for four clients who are 24
hours post-op. Which of the following surgical procedures places the
client at risk for deep-vein thrombosis?
A) Myringotomy (ear)
B) Laparoscopic appendectomy
C) Hip arthroplasty
D) Cataract extraction (eye)
Correct Answer: C) Hip arthroplasty
Rationale:
1. Hip arthroplasty (joint replacement) carries a high risk of DVT due to
immobility, venous stasis, and surgical trauma.
2. DVT prophylaxis (anticoagulants, compression devices) is standard after
orthopedic surgery.
3. Ear and eye surgeries have minimal DVT risk.
