NUR 283 Comp Exam Comprehensive 160 Study
Questions and Answers | 2026 Updated | 100% Correct
1. A nurse is preparing to administer insulin to a patient with type 1 diabetes.
Which action is most critical to prevent medication error?
A. Verifying the insulin type, dose, and time with another licensed nurse
B. Checking the patient's blood glucose after administration
C. Documenting the administration immediately
D. Using a new needle for each injection
Rationale: Independent double-checks for high-alert medications like insulin are a
Joint Commission National Patient Safety Goal to prevent fatal dosing errors.
While all options are important, verification with another nurse is the most critical
safety step specific to insulin administration.
2. When assessing a patient with suspected sepsis, which finding requires
immediate intervention?
A. Temperature of 38.1°C (100.6°F)
B. Heart rate of 92 bpm
C. Lactate level of 4.2 mmol/L
D. Urine output of 40 mL/hr
Rationale: A lactate level >4 mmol/L indicates tissue hypoperfusion and is a key
criterion for septic shock per Surviving Sepsis Campaign guidelines, requiring
immediate fluid resuscitation and source control. Mild fever, tachycardia, and
borderline urine output are concerning but less urgent than elevated lactate.
,3. A postoperative patient reports sudden shortness of breath and chest pain. The
nurse notes tachycardia and oxygen saturation of 88% on room air. What is the
priority action?
A. Administer supplemental oxygen and notify the provider immediately
B. Encourage deep breathing and coughing exercises
C. Reposition the patient to high Fowler's position
D. Obtain a stat chest X-ray
Rationale: These symptoms suggest pulmonary embolism, a life-threatening
emergency. Immediate oxygen administration supports oxygenation while rapid
provider notification activates the emergency response. While positioning and
breathing exercises are supportive, they do not address the critical hypoxemia.
4. Which statement by a patient with heart failure indicates understanding of
daily weight monitoring?
A. "I'll weigh myself after breakfast each day."
B. "I should call my doctor if I gain 1 pound in a week."
C. "I will weigh myself every morning after voiding, wearing similar clothing."
D. "Weight fluctuations of 3-5 pounds are normal and not concerning."
Rationale: Consistent technique (same time, post-void, similar clothing) ensures
accurate trend monitoring. A weight gain of ≥2 lbs in 24 hours or ≥5 lbs in a week
typically warrants provider notification in heart failure management. Weighing
after breakfast introduces variability from food/fluid intake.
5. A nurse is caring for a patient with a new tracheostomy. Which assessment
finding is most urgent?
A. Small amount of thick, yellow secretions
,B. Mild redness at the stoma site
C. Subcutaneous emphysema around the neck
D. Patient reporting mild discomfort
Rationale: Subcutaneous emphysema (crepitus) suggests air leakage into tissues,
potentially indicating tracheostomy tube displacement or tracheal injury—a
medical emergency requiring immediate assessment of tube placement and
airway patency. Secretions, mild redness, and discomfort are expected post-
procedure findings.
6. When teaching a patient about warfarin therapy, which instruction is essential
to prevent complications?
A. "Take your dose with a full glass of milk."
B. "Avoid all green vegetables in your diet."
C. "Maintain consistent vitamin K intake and report unusual bleeding."
D. "Use aspirin for headache relief as needed."
Rationale: Warfarin's anticoagulant effect is influenced by vitamin K; consistency
in dietary intake stabilizes INR. Patients must recognize bleeding signs (e.g.,
bruising, hematuria). Milk doesn't affect warfarin; eliminating green vegetables is
unnecessary and unhealthy; aspirin increases bleeding risk and is contraindicated.
7. A patient with COPD is prescribed oxygen at 2 L/min via nasal cannula. Why is
higher flow rates avoided?
A. It dries out the nasal mucosa excessively
B. It increases the risk of oxygen toxicity
C. It may suppress the hypoxic drive to breathe
, D. It causes bronchospasm in COPD patients
Rationale: Some COPD patients rely on hypoxic drive (low O2) rather than
hypercapnic drive (high CO2) to stimulate breathing. High-flow oxygen can
eliminate this stimulus, leading to respiratory depression. While mucosal drying
occurs, it's not the primary concern; oxygen toxicity requires prolonged high
concentrations; bronchospasm isn't directly caused by oxygen flow.
8. Which action by a nurse demonstrates proper infection control when removing
PPE after caring for a patient on contact precautions?
A. Removing gloves first, then gown, performing hand hygiene
B. Removing gown first, then gloves, performing hand hygiene
C. Removing gloves and gown together, then performing hand hygiene
D. Performing hand hygiene before removing any PPE
Rationale: CDC guidelines recommend removing contaminated PPE in a sequence
that minimizes self-contamination: gloves first (most contaminated), then gown,
followed immediately by hand hygiene. Removing them together risks transferring
pathogens; hand hygiene before removal doesn't address contamination during
doffing.
9. A patient with acute kidney injury has a potassium level of 6.8 mEq/L. Which
ECG change should the nurse anticipate?
A. Prolonged PR interval
B. ST-segment depression
C. Peaked T-waves
D. U-waves
Questions and Answers | 2026 Updated | 100% Correct
1. A nurse is preparing to administer insulin to a patient with type 1 diabetes.
Which action is most critical to prevent medication error?
A. Verifying the insulin type, dose, and time with another licensed nurse
B. Checking the patient's blood glucose after administration
C. Documenting the administration immediately
D. Using a new needle for each injection
Rationale: Independent double-checks for high-alert medications like insulin are a
Joint Commission National Patient Safety Goal to prevent fatal dosing errors.
While all options are important, verification with another nurse is the most critical
safety step specific to insulin administration.
2. When assessing a patient with suspected sepsis, which finding requires
immediate intervention?
A. Temperature of 38.1°C (100.6°F)
B. Heart rate of 92 bpm
C. Lactate level of 4.2 mmol/L
D. Urine output of 40 mL/hr
Rationale: A lactate level >4 mmol/L indicates tissue hypoperfusion and is a key
criterion for septic shock per Surviving Sepsis Campaign guidelines, requiring
immediate fluid resuscitation and source control. Mild fever, tachycardia, and
borderline urine output are concerning but less urgent than elevated lactate.
,3. A postoperative patient reports sudden shortness of breath and chest pain. The
nurse notes tachycardia and oxygen saturation of 88% on room air. What is the
priority action?
A. Administer supplemental oxygen and notify the provider immediately
B. Encourage deep breathing and coughing exercises
C. Reposition the patient to high Fowler's position
D. Obtain a stat chest X-ray
Rationale: These symptoms suggest pulmonary embolism, a life-threatening
emergency. Immediate oxygen administration supports oxygenation while rapid
provider notification activates the emergency response. While positioning and
breathing exercises are supportive, they do not address the critical hypoxemia.
4. Which statement by a patient with heart failure indicates understanding of
daily weight monitoring?
A. "I'll weigh myself after breakfast each day."
B. "I should call my doctor if I gain 1 pound in a week."
C. "I will weigh myself every morning after voiding, wearing similar clothing."
D. "Weight fluctuations of 3-5 pounds are normal and not concerning."
Rationale: Consistent technique (same time, post-void, similar clothing) ensures
accurate trend monitoring. A weight gain of ≥2 lbs in 24 hours or ≥5 lbs in a week
typically warrants provider notification in heart failure management. Weighing
after breakfast introduces variability from food/fluid intake.
5. A nurse is caring for a patient with a new tracheostomy. Which assessment
finding is most urgent?
A. Small amount of thick, yellow secretions
,B. Mild redness at the stoma site
C. Subcutaneous emphysema around the neck
D. Patient reporting mild discomfort
Rationale: Subcutaneous emphysema (crepitus) suggests air leakage into tissues,
potentially indicating tracheostomy tube displacement or tracheal injury—a
medical emergency requiring immediate assessment of tube placement and
airway patency. Secretions, mild redness, and discomfort are expected post-
procedure findings.
6. When teaching a patient about warfarin therapy, which instruction is essential
to prevent complications?
A. "Take your dose with a full glass of milk."
B. "Avoid all green vegetables in your diet."
C. "Maintain consistent vitamin K intake and report unusual bleeding."
D. "Use aspirin for headache relief as needed."
Rationale: Warfarin's anticoagulant effect is influenced by vitamin K; consistency
in dietary intake stabilizes INR. Patients must recognize bleeding signs (e.g.,
bruising, hematuria). Milk doesn't affect warfarin; eliminating green vegetables is
unnecessary and unhealthy; aspirin increases bleeding risk and is contraindicated.
7. A patient with COPD is prescribed oxygen at 2 L/min via nasal cannula. Why is
higher flow rates avoided?
A. It dries out the nasal mucosa excessively
B. It increases the risk of oxygen toxicity
C. It may suppress the hypoxic drive to breathe
, D. It causes bronchospasm in COPD patients
Rationale: Some COPD patients rely on hypoxic drive (low O2) rather than
hypercapnic drive (high CO2) to stimulate breathing. High-flow oxygen can
eliminate this stimulus, leading to respiratory depression. While mucosal drying
occurs, it's not the primary concern; oxygen toxicity requires prolonged high
concentrations; bronchospasm isn't directly caused by oxygen flow.
8. Which action by a nurse demonstrates proper infection control when removing
PPE after caring for a patient on contact precautions?
A. Removing gloves first, then gown, performing hand hygiene
B. Removing gown first, then gloves, performing hand hygiene
C. Removing gloves and gown together, then performing hand hygiene
D. Performing hand hygiene before removing any PPE
Rationale: CDC guidelines recommend removing contaminated PPE in a sequence
that minimizes self-contamination: gloves first (most contaminated), then gown,
followed immediately by hand hygiene. Removing them together risks transferring
pathogens; hand hygiene before removal doesn't address contamination during
doffing.
9. A patient with acute kidney injury has a potassium level of 6.8 mEq/L. Which
ECG change should the nurse anticipate?
A. Prolonged PR interval
B. ST-segment depression
C. Peaked T-waves
D. U-waves
