NUR176/NUR 176 Exam 4 V2 | Concepts of
Adult Health Nursing for the Practical
Nurse I Q&A with Rationale | Hondros
College of Nursing
1. A nurse is providing discharge instructions to a client who had a total hip arthroplasty.
Which statement by the client indicates a need for further teaching?
A. I will use an elevated toilet seat.
B. I will use a pillow between my legs when sleeping.
C. I will avoid bending forward more than 90 degrees.
D. I will cross my legs at the ankles when sitting.
Correct Answer: D
Rationale: Crossing the legs at the ankles or knees is contraindicated because it can lead to
dislocation of the prosthetic joint. The client must maintain abduction to ensure the
stability of the new hip. The nurse must reinforce that hip flexion should remain less than
90 degrees and abduction pillows should be used to prevent adduction.
2. The nurse is collecting data from a client suspected of having a fat embolism syndrome
(FES) following a femur fracture. Which of the following findings is a classic sign of this
condition?
A. Bradycardia and hypertension
,B. Petechiae over the chest and neck
C. Numbness in the distal extremity
D. Increased urinary output
Correct Answer: B
Rationale: Petechiae over the chest, neck, and axilla are a hallmark sign of fat embolism
syndrome due to the occlusion of small dermal capillaries. This condition typically occurs
24 to 72 hours after a long bone fracture and is often accompanied by respiratory distress.
The nurse should immediately report these findings as FES is a life-threatening
complication requiring prompt intervention.
3. A practical nurse is caring for a client with a newly applied plaster cast. Which action
should the nurse take to prevent complications?
A. Keep the extremity in a dependent position.
B. Handle the wet cast with the palms of the hands.
C. Use a hairdryer on the hot setting to dry the cast.
D. Cover the cast with a heavy blanket for warmth.
Correct Answer: B
Rationale: Handling a wet plaster cast with the palms of the hands instead of the fingers
prevents indentations that could create pressure points on the skin. The cast should be left
uncovered to allow for air circulation and drying via evaporation. The extremity should be
,elevated to reduce edema, and heat should never be applied as it can cause burns or
uneven drying.
4. Which of the following assessments is most critical for a nurse to perform on a client with a
chest tube?
A. Check for continuous bubbling in the water seal chamber.
B. Empty the drainage collection chamber every shift.
C. Observe for tidaling in the water seal chamber.
D. Strip the chest tube every two hours to maintain patency.
Correct Answer: C
Rationale: Tidaling, the rise and fall of water with respiration, indicates that the chest tube
is patent and functioning correctly. Continuous bubbling in the water seal chamber may
indicate an air leak in the system, which requires immediate troubleshooting. The nurse
should never strip or milk the tube without a specific order, as it can create dangerous
negative pressure in the pleural space.
5. A nurse is caring for a client with Chronic Obstructive Pulmonary Disease (COPD) who is
receiving oxygen therapy. Which oxygen delivery rate is generally most appropriate for this
client?
A. 15 L/min via non-rebreather mask
B. 6 to 10 L/min via simple mask
C. 1 to 2 L/min via nasal cannula
, D. Oxygen is contraindicated for clients with COPD
Correct Answer: C
Rationale: Clients with COPD often rely on a hypoxic drive to breathe; therefore, high
concentrations of oxygen can potentially suppress their respiratory drive. Low-flow
oxygen, such as 1 to 2 L/min, is typically used to maintain an oxygen saturation between
88% and 92%. The nurse must monitor the client closely for signs of carbon dioxide
narcosis or respiratory depression when oxygen is administered.
6. A client is diagnosed with primary open-angle glaucoma. What information should the
nurse include in the teaching plan?
A. The condition is characterized by a sudden onset of severe eye pain.
B. Surgery is the only treatment available to restore lost vision.
C. The loss of peripheral vision occurs gradually and is often painless.
D. Vision will return to normal once the intraocular pressure is stabilized.
Correct Answer: C
Rationale: Primary open-angle glaucoma is often called the ‘silent thief of sight’ because it
progresses slowly without pain and results in gradual peripheral vision loss. Once vision is
lost due to glaucoma, it cannot be restored, making early detection and lifelong medication
adherence vital. The nurse should emphasize that treatment focuses on preventing further
damage by lowering intraocular pressure.
Adult Health Nursing for the Practical
Nurse I Q&A with Rationale | Hondros
College of Nursing
1. A nurse is providing discharge instructions to a client who had a total hip arthroplasty.
Which statement by the client indicates a need for further teaching?
A. I will use an elevated toilet seat.
B. I will use a pillow between my legs when sleeping.
C. I will avoid bending forward more than 90 degrees.
D. I will cross my legs at the ankles when sitting.
Correct Answer: D
Rationale: Crossing the legs at the ankles or knees is contraindicated because it can lead to
dislocation of the prosthetic joint. The client must maintain abduction to ensure the
stability of the new hip. The nurse must reinforce that hip flexion should remain less than
90 degrees and abduction pillows should be used to prevent adduction.
2. The nurse is collecting data from a client suspected of having a fat embolism syndrome
(FES) following a femur fracture. Which of the following findings is a classic sign of this
condition?
A. Bradycardia and hypertension
,B. Petechiae over the chest and neck
C. Numbness in the distal extremity
D. Increased urinary output
Correct Answer: B
Rationale: Petechiae over the chest, neck, and axilla are a hallmark sign of fat embolism
syndrome due to the occlusion of small dermal capillaries. This condition typically occurs
24 to 72 hours after a long bone fracture and is often accompanied by respiratory distress.
The nurse should immediately report these findings as FES is a life-threatening
complication requiring prompt intervention.
3. A practical nurse is caring for a client with a newly applied plaster cast. Which action
should the nurse take to prevent complications?
A. Keep the extremity in a dependent position.
B. Handle the wet cast with the palms of the hands.
C. Use a hairdryer on the hot setting to dry the cast.
D. Cover the cast with a heavy blanket for warmth.
Correct Answer: B
Rationale: Handling a wet plaster cast with the palms of the hands instead of the fingers
prevents indentations that could create pressure points on the skin. The cast should be left
uncovered to allow for air circulation and drying via evaporation. The extremity should be
,elevated to reduce edema, and heat should never be applied as it can cause burns or
uneven drying.
4. Which of the following assessments is most critical for a nurse to perform on a client with a
chest tube?
A. Check for continuous bubbling in the water seal chamber.
B. Empty the drainage collection chamber every shift.
C. Observe for tidaling in the water seal chamber.
D. Strip the chest tube every two hours to maintain patency.
Correct Answer: C
Rationale: Tidaling, the rise and fall of water with respiration, indicates that the chest tube
is patent and functioning correctly. Continuous bubbling in the water seal chamber may
indicate an air leak in the system, which requires immediate troubleshooting. The nurse
should never strip or milk the tube without a specific order, as it can create dangerous
negative pressure in the pleural space.
5. A nurse is caring for a client with Chronic Obstructive Pulmonary Disease (COPD) who is
receiving oxygen therapy. Which oxygen delivery rate is generally most appropriate for this
client?
A. 15 L/min via non-rebreather mask
B. 6 to 10 L/min via simple mask
C. 1 to 2 L/min via nasal cannula
, D. Oxygen is contraindicated for clients with COPD
Correct Answer: C
Rationale: Clients with COPD often rely on a hypoxic drive to breathe; therefore, high
concentrations of oxygen can potentially suppress their respiratory drive. Low-flow
oxygen, such as 1 to 2 L/min, is typically used to maintain an oxygen saturation between
88% and 92%. The nurse must monitor the client closely for signs of carbon dioxide
narcosis or respiratory depression when oxygen is administered.
6. A client is diagnosed with primary open-angle glaucoma. What information should the
nurse include in the teaching plan?
A. The condition is characterized by a sudden onset of severe eye pain.
B. Surgery is the only treatment available to restore lost vision.
C. The loss of peripheral vision occurs gradually and is often painless.
D. Vision will return to normal once the intraocular pressure is stabilized.
Correct Answer: C
Rationale: Primary open-angle glaucoma is often called the ‘silent thief of sight’ because it
progresses slowly without pain and results in gradual peripheral vision loss. Once vision is
lost due to glaucoma, it cannot be restored, making early detection and lifelong medication
adherence vital. The nurse should emphasize that treatment focuses on preventing further
damage by lowering intraocular pressure.
