NUR 254 EXAM 2 - (50 QUESTIONS) UP-TO-DATE ACTUAL EXAM
QUESTIONS AND 100% ACCURATE SOLUTIONS | VERIFIED
ANSWERS - INSTANT PDF DOWNLOAD
Candidate Name: ____________________________
Candidate ID: ________________________________
Date: _______________________________________
Examination Centre: __________________________
Instructions to Candidates:
This examination consists of approximately 50 multiple-choice questions
designed to assess clinical judgment, pathophysiology understanding, and
safe nursing practice aligned with second-level nursing coursework. You are
required to select the best possible answer for each question. Carefully read
each scenario before responding. Time allocation for this examination is 90
minutes. No external materials are permitted unless specified by the
instructor. Ensure all responses are recorded clearly. Accuracy, critical
thinking, and prioritization are essential to achieving a passing score.
Core Competency Areas:
• Cardiovascular and Respiratory Nursing
• Fluid & Electrolyte Balance
• Gastrointestinal and Renal Disorders
• Pharmacological Principles in Nursing
• Clinical Decision-Making & Patient Safety
• Endocrine and Metabolic Disorders
This simulated examination is designed to reflect the structure and rigor of a
typical NUR 254 Exam 2 assessment. It is intended solely for educational
preparation and does not represent any official or administered examination.
This assessment evaluates the student nurse’s ability to apply theoretical
knowledge to clinical scenarios involving acute and chronic conditions.
, Emphasis is placed on prioritization, interpretation of clinical data, safe
medication administration, and patient-centered care planning. Students must
demonstrate competence in recognizing complications, implementing
interventions, and evaluating outcomes across multiple body systems.
Q1. A patient with heart failure presents with worsening dyspnea, crackles, and
3+ pitting edema. Which intervention should the nurse prioritize?
A. Administer IV furosemide
B. Encourage oral fluid intake
C. Elevate the legs
D. Monitor daily weight
Correct Answer: A. Administer IV furosemide
Explanation: Furosemide is a loop diuretic that reduces fluid overload
quickly, addressing pulmonary congestion and edema. Option B worsens
overload, C is supportive but not priority, and D is important for monitoring but
not immediate intervention.
Q2. A patient’s potassium level is 6.2 mEq/L. Which ECG finding is expected?
A. U waves
B. Flattened T waves
C. Peaked T waves
D. ST depression
Correct Answer: C. Peaked T waves
Explanation: Hyperkalemia causes peaked T waves due to altered cardiac
conduction. U waves and flattened T waves indicate hypokalemia. ST
depression is not specific to potassium imbalance.
,Q3. A nurse is caring for a patient with COPD. Which finding indicates
worsening respiratory status?
A. Respiratory rate of 18
B. Oxygen saturation of 92%
C. Increased confusion
D. Mild wheezing
Correct Answer: C. Increased confusion
Explanation: Confusion signals hypoxia or CO₂ retention, a serious
deterioration. RR 18 is normal, SpO₂ 92% may be acceptable in COPD, and
mild wheezing is expected.
Q4. A patient with diabetes reports shakiness and sweating. Blood glucose is 58
mg/dL. What is the nurse’s first action?
A. Administer insulin
B. Provide 15 g of glucose
C. Call the provider
D. Start IV fluids
Correct Answer: B. Provide 15 g of glucose
Explanation: Hypoglycemia requires immediate glucose replacement.
Insulin worsens condition, provider notification is secondary, and IV fluids are
unnecessary unless severe.
, Q5. A postoperative patient has absent bowel sounds and abdominal distention.
What is the likely condition?
A. Constipation
B. Paralytic ileus
C. Gastroenteritis
D. Peptic ulcer
Correct Answer: B. Paralytic ileus
Explanation: Paralytic ileus presents with absent bowel sounds and
distention. Constipation has bowel sounds, gastroenteritis causes diarrhea, and
ulcers cause pain, not distention.
Q6. A patient with chronic kidney disease has a GFR of 25 mL/min. What stage
is this?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Correct Answer: D. Stage 4
Explanation: Stage 4 CKD is defined by GFR 15–29. Earlier stages have
higher GFR values.
Q7. Which lab value is most concerning in a patient receiving heparin?
A. Hemoglobin 13 g/dL
B. Platelets 80,000/mm³
QUESTIONS AND 100% ACCURATE SOLUTIONS | VERIFIED
ANSWERS - INSTANT PDF DOWNLOAD
Candidate Name: ____________________________
Candidate ID: ________________________________
Date: _______________________________________
Examination Centre: __________________________
Instructions to Candidates:
This examination consists of approximately 50 multiple-choice questions
designed to assess clinical judgment, pathophysiology understanding, and
safe nursing practice aligned with second-level nursing coursework. You are
required to select the best possible answer for each question. Carefully read
each scenario before responding. Time allocation for this examination is 90
minutes. No external materials are permitted unless specified by the
instructor. Ensure all responses are recorded clearly. Accuracy, critical
thinking, and prioritization are essential to achieving a passing score.
Core Competency Areas:
• Cardiovascular and Respiratory Nursing
• Fluid & Electrolyte Balance
• Gastrointestinal and Renal Disorders
• Pharmacological Principles in Nursing
• Clinical Decision-Making & Patient Safety
• Endocrine and Metabolic Disorders
This simulated examination is designed to reflect the structure and rigor of a
typical NUR 254 Exam 2 assessment. It is intended solely for educational
preparation and does not represent any official or administered examination.
This assessment evaluates the student nurse’s ability to apply theoretical
knowledge to clinical scenarios involving acute and chronic conditions.
, Emphasis is placed on prioritization, interpretation of clinical data, safe
medication administration, and patient-centered care planning. Students must
demonstrate competence in recognizing complications, implementing
interventions, and evaluating outcomes across multiple body systems.
Q1. A patient with heart failure presents with worsening dyspnea, crackles, and
3+ pitting edema. Which intervention should the nurse prioritize?
A. Administer IV furosemide
B. Encourage oral fluid intake
C. Elevate the legs
D. Monitor daily weight
Correct Answer: A. Administer IV furosemide
Explanation: Furosemide is a loop diuretic that reduces fluid overload
quickly, addressing pulmonary congestion and edema. Option B worsens
overload, C is supportive but not priority, and D is important for monitoring but
not immediate intervention.
Q2. A patient’s potassium level is 6.2 mEq/L. Which ECG finding is expected?
A. U waves
B. Flattened T waves
C. Peaked T waves
D. ST depression
Correct Answer: C. Peaked T waves
Explanation: Hyperkalemia causes peaked T waves due to altered cardiac
conduction. U waves and flattened T waves indicate hypokalemia. ST
depression is not specific to potassium imbalance.
,Q3. A nurse is caring for a patient with COPD. Which finding indicates
worsening respiratory status?
A. Respiratory rate of 18
B. Oxygen saturation of 92%
C. Increased confusion
D. Mild wheezing
Correct Answer: C. Increased confusion
Explanation: Confusion signals hypoxia or CO₂ retention, a serious
deterioration. RR 18 is normal, SpO₂ 92% may be acceptable in COPD, and
mild wheezing is expected.
Q4. A patient with diabetes reports shakiness and sweating. Blood glucose is 58
mg/dL. What is the nurse’s first action?
A. Administer insulin
B. Provide 15 g of glucose
C. Call the provider
D. Start IV fluids
Correct Answer: B. Provide 15 g of glucose
Explanation: Hypoglycemia requires immediate glucose replacement.
Insulin worsens condition, provider notification is secondary, and IV fluids are
unnecessary unless severe.
, Q5. A postoperative patient has absent bowel sounds and abdominal distention.
What is the likely condition?
A. Constipation
B. Paralytic ileus
C. Gastroenteritis
D. Peptic ulcer
Correct Answer: B. Paralytic ileus
Explanation: Paralytic ileus presents with absent bowel sounds and
distention. Constipation has bowel sounds, gastroenteritis causes diarrhea, and
ulcers cause pain, not distention.
Q6. A patient with chronic kidney disease has a GFR of 25 mL/min. What stage
is this?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
Correct Answer: D. Stage 4
Explanation: Stage 4 CKD is defined by GFR 15–29. Earlier stages have
higher GFR values.
Q7. Which lab value is most concerning in a patient receiving heparin?
A. Hemoglobin 13 g/dL
B. Platelets 80,000/mm³
