NURS 4581- Nursing of Adults with complex needs
Exam Questions and Answers
A patient with COPD presents with worsening dyspnea and wheezing. The priority
nursing intervention is:
A. Encourage oral fluids
B. Administer prescribed bronchodilator
C. Teach pursed‑lip breathing
D. Provide high‑calorie snacks
In managing heart failure, which medication reduces preload by promoting diuresis?
A. ACE inhibitor
B. Loop diuretic
C. Beta‑blocker
D. Digoxin
A patient with end‑stage renal disease requires dialysis. The nurse should monitor for:
A. Hypokalemia
B. Hypotension
C. Hyperglycemia
D. Hypertension
Which lab value is most concerning in a patient receiving warfarin?
A. INR of 4.5
B. Platelets 200,000
C. Hemoglobin 13 g/dL
D. WBC 7,000
Answer: A
A patient with cirrhosis develops ascites. The nurse anticipates which order?
A. Increase sodium intake
B. Administer spironolactone
C. Encourage fluid intake
D. Provide iron supplements
Which nursing action prevents ventilator‑associated pneumonia?
A. Elevating head of bed 30–45°
B. Increasing sedation
C. Restricting oral care
D. Limiting suctioning
A patient with diabetes reports polyuria and polydipsia. Lab shows glucose 520 mg/dL.
The priority intervention is:
A. Administer IV insulin
,B. Provide oral fluids
C. Encourage ambulation
D. Offer carbohydrate snack
In palliative care, the nurse’s primary role is to:
A. Cure the disease
B. Provide comfort and symptom relief
C. Extend life expectancy
D. Focus on rehabilitation
Which finding indicates digoxin toxicity?
A. Bradycardia and visual disturbances
B. Hypertension and headache
C. Tachycardia and tremors
D. Hyperglycemia and thirst
A patient with spinal cord injury at T4 develops sudden hypertension, bradycardia, and
flushing. The nurse suspects:
A. Autonomic dysreflexia
B. Neurogenic shock
C. Sepsis
D. Pulmonary embolism
A patient with pneumonia has O2 saturation of 88% on room air. The nurse’s priority is:
A. Encourage coughing and deep breathing
B. Administer supplemental oxygen
C. Provide oral fluids
D. Position supine
Which electrolyte imbalance is most common in chronic kidney disease?
A. Hypocalcemia
B. Hypokalemia
C. Hypernatremia
D. Hypomagnesemia
A patient with atrial fibrillation is prescribed warfarin. The nurse teaches the patient to:
A. Avoid foods high in vitamin K
B. Increase green leafy vegetables
C. Limit fluid intake
D. Avoid potassium supplements
Which symptom indicates worsening left‑sided heart failure?
A. Peripheral edema
B. Jugular vein distension
C. Pulmonary crackles
D. Hepatomegaly
, A patient with type 1 diabetes is found unconscious. The nurse should first:
A. Administer IV insulin
B. Give IV dextrose
C. Provide oral glucose
D. Start IV fluids
Which intervention reduces risk of pressure ulcers in immobile patients?
A. Reposition every 2 hours
B. Increase protein intake
C. Apply heating pads
D. Limit fluid intake
A patient with cirrhosis develops confusion and asterixis. The nurse suspects:
A. Hepatic encephalopathy
B. Hypoglycemia
C. Stroke
D. Sepsis
Which lab value is most concerning in a patient receiving chemotherapy?
A. WBC 1,200
B. Platelets 180,000
C. Hemoglobin 12 g/dL
D. Sodium 140 mmol/L
A patient with acute pancreatitis should avoid:
A. High‑fat meals
B. Carbohydrates
C. Protein supplements
D. Oral fluids
Which nursing action prevents catheter‑associated urinary tract infection?
A. Maintain closed drainage system
B. Irrigate catheter daily
C. Use large‑bore catheter
D. Encourage fluid restriction
A patient with COPD is at risk for respiratory acidosis due to:
A. Hypoventilation
B. Hyperventilation
C. Excess oxygen therapy
D. Metabolic alkalosis
Which medication is contraindicated in asthma?
A. Beta‑blocker
B. Corticosteroid
Exam Questions and Answers
A patient with COPD presents with worsening dyspnea and wheezing. The priority
nursing intervention is:
A. Encourage oral fluids
B. Administer prescribed bronchodilator
C. Teach pursed‑lip breathing
D. Provide high‑calorie snacks
In managing heart failure, which medication reduces preload by promoting diuresis?
A. ACE inhibitor
B. Loop diuretic
C. Beta‑blocker
D. Digoxin
A patient with end‑stage renal disease requires dialysis. The nurse should monitor for:
A. Hypokalemia
B. Hypotension
C. Hyperglycemia
D. Hypertension
Which lab value is most concerning in a patient receiving warfarin?
A. INR of 4.5
B. Platelets 200,000
C. Hemoglobin 13 g/dL
D. WBC 7,000
Answer: A
A patient with cirrhosis develops ascites. The nurse anticipates which order?
A. Increase sodium intake
B. Administer spironolactone
C. Encourage fluid intake
D. Provide iron supplements
Which nursing action prevents ventilator‑associated pneumonia?
A. Elevating head of bed 30–45°
B. Increasing sedation
C. Restricting oral care
D. Limiting suctioning
A patient with diabetes reports polyuria and polydipsia. Lab shows glucose 520 mg/dL.
The priority intervention is:
A. Administer IV insulin
,B. Provide oral fluids
C. Encourage ambulation
D. Offer carbohydrate snack
In palliative care, the nurse’s primary role is to:
A. Cure the disease
B. Provide comfort and symptom relief
C. Extend life expectancy
D. Focus on rehabilitation
Which finding indicates digoxin toxicity?
A. Bradycardia and visual disturbances
B. Hypertension and headache
C. Tachycardia and tremors
D. Hyperglycemia and thirst
A patient with spinal cord injury at T4 develops sudden hypertension, bradycardia, and
flushing. The nurse suspects:
A. Autonomic dysreflexia
B. Neurogenic shock
C. Sepsis
D. Pulmonary embolism
A patient with pneumonia has O2 saturation of 88% on room air. The nurse’s priority is:
A. Encourage coughing and deep breathing
B. Administer supplemental oxygen
C. Provide oral fluids
D. Position supine
Which electrolyte imbalance is most common in chronic kidney disease?
A. Hypocalcemia
B. Hypokalemia
C. Hypernatremia
D. Hypomagnesemia
A patient with atrial fibrillation is prescribed warfarin. The nurse teaches the patient to:
A. Avoid foods high in vitamin K
B. Increase green leafy vegetables
C. Limit fluid intake
D. Avoid potassium supplements
Which symptom indicates worsening left‑sided heart failure?
A. Peripheral edema
B. Jugular vein distension
C. Pulmonary crackles
D. Hepatomegaly
, A patient with type 1 diabetes is found unconscious. The nurse should first:
A. Administer IV insulin
B. Give IV dextrose
C. Provide oral glucose
D. Start IV fluids
Which intervention reduces risk of pressure ulcers in immobile patients?
A. Reposition every 2 hours
B. Increase protein intake
C. Apply heating pads
D. Limit fluid intake
A patient with cirrhosis develops confusion and asterixis. The nurse suspects:
A. Hepatic encephalopathy
B. Hypoglycemia
C. Stroke
D. Sepsis
Which lab value is most concerning in a patient receiving chemotherapy?
A. WBC 1,200
B. Platelets 180,000
C. Hemoglobin 12 g/dL
D. Sodium 140 mmol/L
A patient with acute pancreatitis should avoid:
A. High‑fat meals
B. Carbohydrates
C. Protein supplements
D. Oral fluids
Which nursing action prevents catheter‑associated urinary tract infection?
A. Maintain closed drainage system
B. Irrigate catheter daily
C. Use large‑bore catheter
D. Encourage fluid restriction
A patient with COPD is at risk for respiratory acidosis due to:
A. Hypoventilation
B. Hyperventilation
C. Excess oxygen therapy
D. Metabolic alkalosis
Which medication is contraindicated in asthma?
A. Beta‑blocker
B. Corticosteroid