NUR185/NUR 185 Final Exam V1 |
Concepts of Adult Health Nursing for the
Practical Nurse II Q&A with Rationale |
Hondros College of Nursing
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD) who is
receiving oxygen therapy. Which of the following is the most appropriate flow rate for this
patient?
A. 10 to 15 liters per minute via non-rebreather mask
B. 6 to 8 liters per minute via simple face mask
C. 1 to 2 liters per minute via nasal cannula
D. Oxygen should be withheld entirely to prevent respiratory arrest
Correct Answer: C
Rationale: Patients with COPD often rely on a hypoxic drive to breathe due to chronic
carbon dioxide retention. Administering high levels of oxygen can suppress this drive,
leading to hypoventilation or apnea. Therefore, low-flow oxygen, typically 1-2 L/min, is
recommended to maintain safe saturation levels without compromising the respiratory
drive.
2. Which clinical manifestation should a nurse expect to find in a patient diagnosed with
right-sided heart failure?
A. Crackles in the lungs
,B. Orthopnea
C. Frothy pink sputum
D. Peripheral edema
Correct Answer: D
Rationale: Right-sided heart failure results in the inability of the right ventricle to pump
blood effectively into the pulmonary circulation, causing systemic venous congestion. This
leads to symptoms such as peripheral edema, jugular venous distention, and hepatomegaly.
Conversely, lung-related symptoms like crackles and frothy sputum are characteristic of
left-sided heart failure.
3. A patient is prescribed Digoxin 0.125 mg daily. The nurse identifies which of the following
as an early sign of Digoxin toxicity?
A. Increased appetite
B. Bradycardia
C. Anorexia and nausea
D. Yellow-green halos around lights
Correct Answer: C
Rationale: Gastrointestinal symptoms such as anorexia, nausea, and vomiting are often the
earliest indicators of Digoxin toxicity. While visual changes like yellow-green halos and
bradycardia are also signs, they typically manifest after the gastrointestinal onset. The
, nurse must monitor serum digoxin levels and electrolyte balances, especially potassium, to
mitigate these risks.
4. What is the primary purpose of pursed-lip breathing for a patient with emphysema?
A. To strengthen the diaphragm muscles
B. To increase the rate of respirations
C. To reduce the amount of oxygen required
D. To promote carbon dioxide elimination by preventing airway collapse
Correct Answer: D
Rationale: Pursed-lip breathing creates positive end-expiratory pressure in the airways,
which helps keep the small bronchioles open during exhalation. This technique allows for a
more complete emptying of the lungs and reduces the trapping of carbon dioxide. It is a
vital intervention for patients with obstructive diseases like emphysema to manage
dyspnea.
5. A nurse is teaching a patient with Type 1 Diabetes Mellitus about the ‘Rule of 15’ for
managing hypoglycemia. Which action is correct?
A. Administer 15 grams of protein and wait 15 minutes
B. Give 15 units of regular insulin if the glucose is low
C. Give 15 grams of simple carbohydrates and recheck blood glucose in 15 minutes
D. Wait 15 minutes to see if symptoms resolve before treating
Concepts of Adult Health Nursing for the
Practical Nurse II Q&A with Rationale |
Hondros College of Nursing
1. A nurse is caring for a patient with Chronic Obstructive Pulmonary Disease (COPD) who is
receiving oxygen therapy. Which of the following is the most appropriate flow rate for this
patient?
A. 10 to 15 liters per minute via non-rebreather mask
B. 6 to 8 liters per minute via simple face mask
C. 1 to 2 liters per minute via nasal cannula
D. Oxygen should be withheld entirely to prevent respiratory arrest
Correct Answer: C
Rationale: Patients with COPD often rely on a hypoxic drive to breathe due to chronic
carbon dioxide retention. Administering high levels of oxygen can suppress this drive,
leading to hypoventilation or apnea. Therefore, low-flow oxygen, typically 1-2 L/min, is
recommended to maintain safe saturation levels without compromising the respiratory
drive.
2. Which clinical manifestation should a nurse expect to find in a patient diagnosed with
right-sided heart failure?
A. Crackles in the lungs
,B. Orthopnea
C. Frothy pink sputum
D. Peripheral edema
Correct Answer: D
Rationale: Right-sided heart failure results in the inability of the right ventricle to pump
blood effectively into the pulmonary circulation, causing systemic venous congestion. This
leads to symptoms such as peripheral edema, jugular venous distention, and hepatomegaly.
Conversely, lung-related symptoms like crackles and frothy sputum are characteristic of
left-sided heart failure.
3. A patient is prescribed Digoxin 0.125 mg daily. The nurse identifies which of the following
as an early sign of Digoxin toxicity?
A. Increased appetite
B. Bradycardia
C. Anorexia and nausea
D. Yellow-green halos around lights
Correct Answer: C
Rationale: Gastrointestinal symptoms such as anorexia, nausea, and vomiting are often the
earliest indicators of Digoxin toxicity. While visual changes like yellow-green halos and
bradycardia are also signs, they typically manifest after the gastrointestinal onset. The
, nurse must monitor serum digoxin levels and electrolyte balances, especially potassium, to
mitigate these risks.
4. What is the primary purpose of pursed-lip breathing for a patient with emphysema?
A. To strengthen the diaphragm muscles
B. To increase the rate of respirations
C. To reduce the amount of oxygen required
D. To promote carbon dioxide elimination by preventing airway collapse
Correct Answer: D
Rationale: Pursed-lip breathing creates positive end-expiratory pressure in the airways,
which helps keep the small bronchioles open during exhalation. This technique allows for a
more complete emptying of the lungs and reduces the trapping of carbon dioxide. It is a
vital intervention for patients with obstructive diseases like emphysema to manage
dyspnea.
5. A nurse is teaching a patient with Type 1 Diabetes Mellitus about the ‘Rule of 15’ for
managing hypoglycemia. Which action is correct?
A. Administer 15 grams of protein and wait 15 minutes
B. Give 15 units of regular insulin if the glucose is low
C. Give 15 grams of simple carbohydrates and recheck blood glucose in 15 minutes
D. Wait 15 minutes to see if symptoms resolve before treating
