NUR176/NUR 176 Final Exam V1 |
Concepts of Adult Health Nursing for the
Practical Nurse I Q&A with Rationale |
Hondros College of Nursing
1. A nurse is assessing a patient with a fluid volume deficit. Which clinical manifestation
should the nurse expect to find?
A. Decreased skin turgor
B. Bounding pulse
C. Distended neck veins
D. Crackles in the lungs
Correct Answer: A
Rationale: Decreased skin turgor is a classic sign of dehydration or fluid volume deficit
because the skin loses elasticity. Distended neck veins and bounding pulses are typically
associated with fluid volume excess rather than deficit. The nurse should also monitor for
other signs such as dry mucous membranes and concentrated urine.
2. A patient is diagnosed with hypokalemia. Which of the following foods should the nurse
recommend to increase potassium intake?
A. Bananas
B. White bread
,C. Apples
D. Cucumbers
Correct Answer: A
Rationale: Bananas are a high-potassium food frequently recommended for patients with
hypokalemia to help restore normal electrolyte levels. Apples and cucumbers are relatively
low in potassium compared to fruits like bananas or oranges. Maintaining adequate
potassium is vital for proper cardiac and muscle function.
3. A nurse is caring for a patient who has a pH of 7.30, a PaCO2 of 50, and an HCO3 of 24. How
should the nurse interpret these ABG results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: B
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 indicates a
respiratory cause. Since the HCO3 is within the normal range of 22-26, this represents
uncompensated respiratory acidosis. This condition often occurs in patients with
hypoventilation or COPD.
, 4. During the preoperative phase, what is the primary responsibility of the nurse regarding
informed consent?
A. Explaining the risks and benefits of the surgery
B. Performing the surgical procedure
C. Deciding if the patient should undergo the procedure
D. Witnessing the patient’s signature on the consent form
Correct Answer: D
Rationale: The nurse’s role is to witness the patient signing the form and to ensure the
patient appears competent to give consent. It is the surgeon’s responsibility to explain the
risks, benefits, and alternatives of the procedure. If the patient has questions about the
surgery itself, the nurse must notify the surgeon to return and provide further clarification.
5. A patient is 24 hours postoperative following abdominal surgery. The nurse notes that the
patient’s wound has dehisced and organs are protruding. What is the immediate nursing
action?
A. Cover the wound with sterile gauze soaked in normal saline
B. Push the organs back into the abdominal cavity
C. Ask the patient to cough to clear the airway
D. Apply a tight pressure dressing to the site
Correct Answer: A
Concepts of Adult Health Nursing for the
Practical Nurse I Q&A with Rationale |
Hondros College of Nursing
1. A nurse is assessing a patient with a fluid volume deficit. Which clinical manifestation
should the nurse expect to find?
A. Decreased skin turgor
B. Bounding pulse
C. Distended neck veins
D. Crackles in the lungs
Correct Answer: A
Rationale: Decreased skin turgor is a classic sign of dehydration or fluid volume deficit
because the skin loses elasticity. Distended neck veins and bounding pulses are typically
associated with fluid volume excess rather than deficit. The nurse should also monitor for
other signs such as dry mucous membranes and concentrated urine.
2. A patient is diagnosed with hypokalemia. Which of the following foods should the nurse
recommend to increase potassium intake?
A. Bananas
B. White bread
,C. Apples
D. Cucumbers
Correct Answer: A
Rationale: Bananas are a high-potassium food frequently recommended for patients with
hypokalemia to help restore normal electrolyte levels. Apples and cucumbers are relatively
low in potassium compared to fruits like bananas or oranges. Maintaining adequate
potassium is vital for proper cardiac and muscle function.
3. A nurse is caring for a patient who has a pH of 7.30, a PaCO2 of 50, and an HCO3 of 24. How
should the nurse interpret these ABG results?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Correct Answer: B
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 indicates a
respiratory cause. Since the HCO3 is within the normal range of 22-26, this represents
uncompensated respiratory acidosis. This condition often occurs in patients with
hypoventilation or COPD.
, 4. During the preoperative phase, what is the primary responsibility of the nurse regarding
informed consent?
A. Explaining the risks and benefits of the surgery
B. Performing the surgical procedure
C. Deciding if the patient should undergo the procedure
D. Witnessing the patient’s signature on the consent form
Correct Answer: D
Rationale: The nurse’s role is to witness the patient signing the form and to ensure the
patient appears competent to give consent. It is the surgeon’s responsibility to explain the
risks, benefits, and alternatives of the procedure. If the patient has questions about the
surgery itself, the nurse must notify the surgeon to return and provide further clarification.
5. A patient is 24 hours postoperative following abdominal surgery. The nurse notes that the
patient’s wound has dehisced and organs are protruding. What is the immediate nursing
action?
A. Cover the wound with sterile gauze soaked in normal saline
B. Push the organs back into the abdominal cavity
C. Ask the patient to cough to clear the airway
D. Apply a tight pressure dressing to the site
Correct Answer: A
