NUR176/NUR 176 Exam 2 V3 | Concepts of
Adult Health Nursing for the Practical
Nurse I Q&A with Rationale | Hondros
College of Nursing
1. A patient with chronic obstructive pulmonary disease (COPD) is being coached on pursed-
lip breathing. What is the primary physiological purpose of this technique?
A. To strengthen the intercostal muscles used for inspiration.
B. To increase the rate of respirations to clear carbon dioxide.
C. To prevent airway collapse and promote the removal of trapped air.
D. To decrease the amount of oxygen required by the body.
Correct Answer: C
Rationale: Pursed-lip breathing creates back-pressure in the airways, which helps keep
the bronchioles open during exhalation. This process allows for more effective removal of
carbon dioxide and prevents the air trapping commonly seen in emphysema. The technique
also helps the patient gain control over their breathing pattern during episodes of dyspnea.
2. Which clinical manifestation should the nurse prioritize when assessing a patient for
suspected left-sided heart failure?
A. Crackles in the lungs and shortness of breath.
B. Hepatomegaly and abdominal girth increase.
,C. Jugular venous distention (JVD) and peripheral edema.
D. Sacral edema and weight gain.
Correct Answer: A
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
leading to pulmonary congestion. Symptoms include dyspnea, orthopnea, and adventitious
breath sounds such as crackles. Right-sided heart failure is characterized by systemic
congestion like JVD and peripheral edema.
3. A nurse is caring for a patient on the second postoperative day. Which assessment finding
is most indicative of a pulmonary embolism?
A. Productive cough with yellow sputum.
B. Sudden onset of chest pain and dyspnea.
C. Pain and redness in the left calf.
D. Bilateral crackles at the lung bases.
Correct Answer: B
Rationale: Pulmonary embolism (PE) is a life-threatening complication often caused by a
detached deep vein thrombus. The hallmark signs are sudden, sharp chest pain and acute
respiratory distress. Immediate intervention is required because PE can quickly lead to
cardiovascular collapse.
, 4. When performing a preoperative assessment, the nurse notes the patient is taking
Warfarin (Coumadin). Why is this information critical for the surgical team?
A. It increases the risk of intraoperative and postoperative hemorrhage.
B. It may cause an adverse reaction to general anesthesia.
C. It increases the risk of postoperative wound infection.
D. It helps prevent deep vein thrombosis during the surgery.
Correct Answer: A
Rationale: Warfarin is an anticoagulant that prolongs clotting time, significantly increasing
the risk of bleeding during and after surgery. Surgeons typically require these medications
to be held several days prior to an elective procedure. The nurse must verify the patient’s
international normalized ratio (INR) before the procedure begins.
5. A patient with a history of hypertension is prescribed a low-sodium DASH diet. Which food
choice indicates the patient understands the teaching?
A. Canned vegetable soup with crackers.
B. Fresh roasted chicken and steamed broccoli.
C. Ham and cheese sandwich on rye bread.
D. Pickled beets and a side of potato salad.
Correct Answer: B
Adult Health Nursing for the Practical
Nurse I Q&A with Rationale | Hondros
College of Nursing
1. A patient with chronic obstructive pulmonary disease (COPD) is being coached on pursed-
lip breathing. What is the primary physiological purpose of this technique?
A. To strengthen the intercostal muscles used for inspiration.
B. To increase the rate of respirations to clear carbon dioxide.
C. To prevent airway collapse and promote the removal of trapped air.
D. To decrease the amount of oxygen required by the body.
Correct Answer: C
Rationale: Pursed-lip breathing creates back-pressure in the airways, which helps keep
the bronchioles open during exhalation. This process allows for more effective removal of
carbon dioxide and prevents the air trapping commonly seen in emphysema. The technique
also helps the patient gain control over their breathing pattern during episodes of dyspnea.
2. Which clinical manifestation should the nurse prioritize when assessing a patient for
suspected left-sided heart failure?
A. Crackles in the lungs and shortness of breath.
B. Hepatomegaly and abdominal girth increase.
,C. Jugular venous distention (JVD) and peripheral edema.
D. Sacral edema and weight gain.
Correct Answer: A
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
leading to pulmonary congestion. Symptoms include dyspnea, orthopnea, and adventitious
breath sounds such as crackles. Right-sided heart failure is characterized by systemic
congestion like JVD and peripheral edema.
3. A nurse is caring for a patient on the second postoperative day. Which assessment finding
is most indicative of a pulmonary embolism?
A. Productive cough with yellow sputum.
B. Sudden onset of chest pain and dyspnea.
C. Pain and redness in the left calf.
D. Bilateral crackles at the lung bases.
Correct Answer: B
Rationale: Pulmonary embolism (PE) is a life-threatening complication often caused by a
detached deep vein thrombus. The hallmark signs are sudden, sharp chest pain and acute
respiratory distress. Immediate intervention is required because PE can quickly lead to
cardiovascular collapse.
, 4. When performing a preoperative assessment, the nurse notes the patient is taking
Warfarin (Coumadin). Why is this information critical for the surgical team?
A. It increases the risk of intraoperative and postoperative hemorrhage.
B. It may cause an adverse reaction to general anesthesia.
C. It increases the risk of postoperative wound infection.
D. It helps prevent deep vein thrombosis during the surgery.
Correct Answer: A
Rationale: Warfarin is an anticoagulant that prolongs clotting time, significantly increasing
the risk of bleeding during and after surgery. Surgeons typically require these medications
to be held several days prior to an elective procedure. The nurse must verify the patient’s
international normalized ratio (INR) before the procedure begins.
5. A patient with a history of hypertension is prescribed a low-sodium DASH diet. Which food
choice indicates the patient understands the teaching?
A. Canned vegetable soup with crackers.
B. Fresh roasted chicken and steamed broccoli.
C. Ham and cheese sandwich on rye bread.
D. Pickled beets and a side of potato salad.
Correct Answer: B
