NUR176/NUR 176 Final Exam V3 |
Concepts of Adult Health Nursing for the
Practical Nurse I Q&A with Rationale |
Hondros College of Nursing
1. A nurse is caring for a patient with a serum potassium level of 6.2 mEq/L. Which cardiac
change should the nurse monitor for on the EKG?
A. Tall, peaked T waves
B. Presence of U waves
C. ST-segment depression
D. Prominent P waves
Correct Answer: A
Rationale: Hyperkalemia is defined as a serum potassium level greater than 5.0 mEq/L.
This elevation in potassium affects cardiac electrical conduction and can lead to life-
threatening arrhythmias. Tall, peaked T waves are a classic early sign of hyperkalemia on
an EKG strip.
2. The nurse is providing education to a patient newly diagnosed with Type 2 Diabetes
Mellitus. Which statement by the patient indicates a need for further teaching regarding foot
care?
A. I will check my feet every day for redness or sores.
,B. I will soak my feet in warm water daily to keep them soft.
C. I will wear well-fitting shoes at all times.
D. I will notify my doctor if I notice any new calluses.
Correct Answer: B
Rationale: Patients with diabetes should avoid soaking their feet because it can lead to
skin maceration and increase the risk of infection. Instead, feet should be washed and dried
thoroughly, especially between the toes. This prevention strategy is vital due to the high
risk of peripheral neuropathy and poor wound healing.
3. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula. What is the standard recommended oxygen flow rate to prevent respiratory
depression in this population?
A. 6 to 8 L/min
B. 1 to 2 L/min
C. 10 to 12 L/min
D. 4 to 5 L/min
Correct Answer: B
Rationale: Patients with COPD often rely on a hypoxic drive to breathe due to chronic CO2
retention. Administering high concentrations of oxygen can decrease their stimulus to
, breathe, leading to respiratory arrest. Therefore, low-flow oxygen, typically 1 to 2 L/min, is
used to maintain adequate saturation without suppressing the respiratory drive.
4. Which clinical manifestation should the nurse expect to find in a patient diagnosed with
Left-Sided Heart Failure?
A. Jugular venous distention
B. Peripheral edema in the lower extremities
C. Hepatosplenomegaly
D. Crackles in the lung bases
Correct Answer: D
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
leading to pulmonary congestion. The nurse would anticipate hearing crackles during lung
auscultation and observing dyspnea. Other options like JVD and peripheral edema are
primary indicators of right-sided heart failure.
5. A patient presents with a serum sodium level of 120 mEq/L. Which safety intervention is
the highest priority for the nurse to implement?
A. Encouraging increased fluid intake
B. Administering a prescribed diuretic
C. Implementing seizure precautions
D. Placing the patient on a low-sodium diet
Concepts of Adult Health Nursing for the
Practical Nurse I Q&A with Rationale |
Hondros College of Nursing
1. A nurse is caring for a patient with a serum potassium level of 6.2 mEq/L. Which cardiac
change should the nurse monitor for on the EKG?
A. Tall, peaked T waves
B. Presence of U waves
C. ST-segment depression
D. Prominent P waves
Correct Answer: A
Rationale: Hyperkalemia is defined as a serum potassium level greater than 5.0 mEq/L.
This elevation in potassium affects cardiac electrical conduction and can lead to life-
threatening arrhythmias. Tall, peaked T waves are a classic early sign of hyperkalemia on
an EKG strip.
2. The nurse is providing education to a patient newly diagnosed with Type 2 Diabetes
Mellitus. Which statement by the patient indicates a need for further teaching regarding foot
care?
A. I will check my feet every day for redness or sores.
,B. I will soak my feet in warm water daily to keep them soft.
C. I will wear well-fitting shoes at all times.
D. I will notify my doctor if I notice any new calluses.
Correct Answer: B
Rationale: Patients with diabetes should avoid soaking their feet because it can lead to
skin maceration and increase the risk of infection. Instead, feet should be washed and dried
thoroughly, especially between the toes. This prevention strategy is vital due to the high
risk of peripheral neuropathy and poor wound healing.
3. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula. What is the standard recommended oxygen flow rate to prevent respiratory
depression in this population?
A. 6 to 8 L/min
B. 1 to 2 L/min
C. 10 to 12 L/min
D. 4 to 5 L/min
Correct Answer: B
Rationale: Patients with COPD often rely on a hypoxic drive to breathe due to chronic CO2
retention. Administering high concentrations of oxygen can decrease their stimulus to
, breathe, leading to respiratory arrest. Therefore, low-flow oxygen, typically 1 to 2 L/min, is
used to maintain adequate saturation without suppressing the respiratory drive.
4. Which clinical manifestation should the nurse expect to find in a patient diagnosed with
Left-Sided Heart Failure?
A. Jugular venous distention
B. Peripheral edema in the lower extremities
C. Hepatosplenomegaly
D. Crackles in the lung bases
Correct Answer: D
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
leading to pulmonary congestion. The nurse would anticipate hearing crackles during lung
auscultation and observing dyspnea. Other options like JVD and peripheral edema are
primary indicators of right-sided heart failure.
5. A patient presents with a serum sodium level of 120 mEq/L. Which safety intervention is
the highest priority for the nurse to implement?
A. Encouraging increased fluid intake
B. Administering a prescribed diuretic
C. Implementing seizure precautions
D. Placing the patient on a low-sodium diet
