1|Page
NUR 254 EXAM 2 2026-2027 BANK QUESTIONS WITH
DETAILED VERIFIED ANSWERS EXAM QUESTIONS WILL
COME FROM HERE (100% CORRECT ANSWERS A+ GRADED
1. A nurse is caring for a patient with a nasogastric tube set to low
intermittent suction. Which electrolyte imbalance is the patient at the
highest risk for developing?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
Explanation: Gastric fluid is rich in potassium, and loss of gastric
contents via suction directly leads to potassium depletion. The kidneys
also attempt to compensate for the loss of hydrochloric acid,
exchanging potassium for hydrogen ions, which further worsens
hypokalemia.
2. The nurse is assessing a patient 24 hours after abdominal surgery.
Which finding requires the most immediate intervention?
A. Absence of bowel sounds in all four quadrants
B. Temperature of 100.4°F (38°C)
,2|Page
C. Incisional pain rated 4 out of 10
D. Firm, distended abdomen with absent flatus
Answer: D. Firm, distended abdomen with absent flatus
Explanation: A firm and distended abdomen with an absence of flatus
suggests a paralytic ileus or a mechanical obstruction, which can lead to
severe complications like bowel ischemia or perforation. While the
absence of bowel sounds alone can be a normal finding
postoperatively, the combination of firmness and distention indicates a
worsening problem needing urgent surgical evaluation. The
temperature is an expected low-grade postoperative finding.
3. A patient with chronic pancreatitis is being discharged. Which
statement by the patient indicates a need for further teaching?
A. "I will make sure to eat small, frequent meals throughout the day."
B. "I can have a glass of wine on special occasions."
C. "I will take my pancrelipase with every meal and snack."
D. "I should choose grilled chicken instead of fried chicken."
Answer: B. "I can have a glass of wine on special occasions."
Explanation: Alcohol is a primary cause of chronic pancreatitis, and
absolute abstinence is the single most critical factor in preventing
disease progression and managing pain. Even small amounts can trigger
acute inflammation.
,3|Page
4. While assessing a patient with fluid volume deficit, the nurse
observes a flat neck vein when the patient is supine. What is the
priority nursing action?
A. Document the normal finding
B. Increase the IV fluid rate
C. Administer an antiemetic
D. Notify the health care provider immediately
Answer: A. Document the normal finding
Explanation: In a healthy individual, neck veins (jugular veins) are flat in
the supine position and distend when the head of the bed is lowered or
when the torso is horizontal. In fluid volume deficit, the veins collapse
even when supine, which is an expected clinical manifestation
consistent with the diagnosis.
5. A patient with cirrhosis is developing ascites. Which
pathophysiological mechanism is primarily responsible for this third-
spacing of fluid?
A. Increased capillary permeability from inflammation
B. Portal hypertension and decreased albumin synthesis
C. Obstruction of the lymphatic ducts
D. Increased cardiac output and hydrostatic pressure
Answer: B. Portal hypertension and decreased albumin synthesis
Explanation: Ascites in cirrhosis results from two main factors: portal
hypertension increases hydrostatic pressure in the splanchnic
circulation, forcing fluid out of the capillaries, and the damaged liver's
, 4|Page
decreased synthesis of albumin lowers plasma oncotic pressure,
reducing the capacity to hold fluid within the vascular space.
6. A nurse is monitoring a patient who has received IV furosemide for
pulmonary edema. Which assessment finding indicates the medication
is having the desired therapeutic effect?
A. Increased urine specific gravity
B. Crackles clearing on auscultation
C. Serum potassium of 4.5 mEq/L
D. Heart rate increasing from 72 to 88 bpm
Answer: B. Crackles clearing on auscultation
Explanation: Furosemide is a loop diuretic used to rapidly mobilize fluid
from the lungs in pulmonary edema. The therapeutic goal is to reduce
pulmonary congestion, which is clinically evidenced by the resolution of
adventitious breath sounds like crackles.
7. A patient is receiving parenteral nutrition (PN) via a central line. The
current bag is empty, and the new bag is not ready. What is the nurse's
priority action?
A. Hang a bag of 10% dextrose in water at the same rate
B. Flush the central line with sterile saline and cap it
C. Hang 0.9% normal saline at a keep-vein-open rate
D. Notify the health care provider about the delay
Answer: A. Hang a bag of 10% dextrose in water at the same rate
NUR 254 EXAM 2 2026-2027 BANK QUESTIONS WITH
DETAILED VERIFIED ANSWERS EXAM QUESTIONS WILL
COME FROM HERE (100% CORRECT ANSWERS A+ GRADED
1. A nurse is caring for a patient with a nasogastric tube set to low
intermittent suction. Which electrolyte imbalance is the patient at the
highest risk for developing?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Answer: B. Hypokalemia
Explanation: Gastric fluid is rich in potassium, and loss of gastric
contents via suction directly leads to potassium depletion. The kidneys
also attempt to compensate for the loss of hydrochloric acid,
exchanging potassium for hydrogen ions, which further worsens
hypokalemia.
2. The nurse is assessing a patient 24 hours after abdominal surgery.
Which finding requires the most immediate intervention?
A. Absence of bowel sounds in all four quadrants
B. Temperature of 100.4°F (38°C)
,2|Page
C. Incisional pain rated 4 out of 10
D. Firm, distended abdomen with absent flatus
Answer: D. Firm, distended abdomen with absent flatus
Explanation: A firm and distended abdomen with an absence of flatus
suggests a paralytic ileus or a mechanical obstruction, which can lead to
severe complications like bowel ischemia or perforation. While the
absence of bowel sounds alone can be a normal finding
postoperatively, the combination of firmness and distention indicates a
worsening problem needing urgent surgical evaluation. The
temperature is an expected low-grade postoperative finding.
3. A patient with chronic pancreatitis is being discharged. Which
statement by the patient indicates a need for further teaching?
A. "I will make sure to eat small, frequent meals throughout the day."
B. "I can have a glass of wine on special occasions."
C. "I will take my pancrelipase with every meal and snack."
D. "I should choose grilled chicken instead of fried chicken."
Answer: B. "I can have a glass of wine on special occasions."
Explanation: Alcohol is a primary cause of chronic pancreatitis, and
absolute abstinence is the single most critical factor in preventing
disease progression and managing pain. Even small amounts can trigger
acute inflammation.
,3|Page
4. While assessing a patient with fluid volume deficit, the nurse
observes a flat neck vein when the patient is supine. What is the
priority nursing action?
A. Document the normal finding
B. Increase the IV fluid rate
C. Administer an antiemetic
D. Notify the health care provider immediately
Answer: A. Document the normal finding
Explanation: In a healthy individual, neck veins (jugular veins) are flat in
the supine position and distend when the head of the bed is lowered or
when the torso is horizontal. In fluid volume deficit, the veins collapse
even when supine, which is an expected clinical manifestation
consistent with the diagnosis.
5. A patient with cirrhosis is developing ascites. Which
pathophysiological mechanism is primarily responsible for this third-
spacing of fluid?
A. Increased capillary permeability from inflammation
B. Portal hypertension and decreased albumin synthesis
C. Obstruction of the lymphatic ducts
D. Increased cardiac output and hydrostatic pressure
Answer: B. Portal hypertension and decreased albumin synthesis
Explanation: Ascites in cirrhosis results from two main factors: portal
hypertension increases hydrostatic pressure in the splanchnic
circulation, forcing fluid out of the capillaries, and the damaged liver's
, 4|Page
decreased synthesis of albumin lowers plasma oncotic pressure,
reducing the capacity to hold fluid within the vascular space.
6. A nurse is monitoring a patient who has received IV furosemide for
pulmonary edema. Which assessment finding indicates the medication
is having the desired therapeutic effect?
A. Increased urine specific gravity
B. Crackles clearing on auscultation
C. Serum potassium of 4.5 mEq/L
D. Heart rate increasing from 72 to 88 bpm
Answer: B. Crackles clearing on auscultation
Explanation: Furosemide is a loop diuretic used to rapidly mobilize fluid
from the lungs in pulmonary edema. The therapeutic goal is to reduce
pulmonary congestion, which is clinically evidenced by the resolution of
adventitious breath sounds like crackles.
7. A patient is receiving parenteral nutrition (PN) via a central line. The
current bag is empty, and the new bag is not ready. What is the nurse's
priority action?
A. Hang a bag of 10% dextrose in water at the same rate
B. Flush the central line with sterile saline and cap it
C. Hang 0.9% normal saline at a keep-vein-open rate
D. Notify the health care provider about the delay
Answer: A. Hang a bag of 10% dextrose in water at the same rate
