RNSG 2539 FINAL EXAM QUESTIONS AND ANSWERS WITH RATIONALES

RNSG 2539 FINAL EXAM QUESTIONS AND ANSWERS
WITH RATIONALES



RNSG 2539 Final Exam

1.A patient with congestive heart failure is admitted with
shortness of breath, bilateral crackles, and +3pitting edema.
The nurse notes oxygen saturation is 86% on room air. What is the priority
nursing action?
A.Administer oral fluids
B.Place patient in high Fowler's position and apply oxygen
C.Encourage ambulation
D.Obtain dietary history
Answer:B
Rationale: Airway and breathing take priority; oxygen and positioning improve
ventilation.

2.A postoperative patient suddenly develops chest pain,

tachycardia, and dyspnea. The nurse suspects pulmonary
embolism. What should the nurse do first?
A.Encourage coughing
B.Notify provider and apply oxygen
C.Raise the legs
D.Offer fluids
Answer:B
Rationale:PE is life-threatening; oxygen and immediate escalation are priority.


3. A diabetic patient presents with confusion, diaphoresis,and
shakiness.Blood glucose is 48 mg/dL. What is the priority intervention?
A.Administer insulin
B.Give 15g fast-acting carbohydrate

,C.Restrict fluids
D.Prepare for dialysis
Answer:B
Rationale: The patient is hypoglycemic and needs immediate glucose.

4.A nurse is caring for a patient with pneumonia who has thick secretions

and wweak cough. What intervention is most appropriate?

A. Restrict fluids
B.Encourage incentive spirometry and hydration
C.Limit movement
D.Administer sedatives
Answer:B
Rationale:Hydration and lung expansion help clear secretions.

5.A patient receiving morphine reports decreasedI respiratory rate of 8
breaths per minute. What is the nurse's priority action?
A.Document findings
B.Stop oxygen
C.Administer naloxone
D.Encourage fluids
Answer:C
Rationale:Naloxone reverses opioid-induced respiratory depression.

6.A patient with hypertension is prescribed a new medication.
The nurse teaches about orthostatic hypotension. What
instruction is most important?
A.Increase salt intake
B.Rise slowvly from sitting or lying positions
C.Avoid all fluids
D.Take medication at bedtime only
Answer:B
Rationale:Prevents dizziness and falls.

,7.A postoperative patient has decreased urine output of 20mL/hr.What is
the nurse's priority action?
A.Encourage fluids
B.Notify provider
C.Administer diuretics
D.Restrict protein
Answer:B
Rationale: Low output may indicate renal compromise or hypovolemia.

8. A patient is experiencing an asthma attack with wheezing and difficulty

speaking. What medication should be given first?

A.Oral corticosteroid
B.Short-acting bronchodilator
C.Antibiotic
D.Antihistamine
Answer:B
Rationale: Bronchodilators provide immediate airway relief.

9.A nurse is caring for a patient with hyperkalemia. Which ECG finding is
most concerning?
A.Flat T waves
B.Peaked T waves
C.Normal sinus rhythm
D.ST elevation
Answer:B
Rationale:Peaked T waves indicate dangerous potassium elevation.

10.A patient with a stroke is unable to swallow safely. What is the priority
intervention?
A.Provide thin liquids
B.Keep patient NPO
C.Offer solid food
D.Encourage drinking
Answer:B
Rationale: Prevents aspiration.

, 11.A patient develops sudden severe headache and neck
stiffness.What condition is suspected?
A.Migraine
B.Meningitis
C.Sinus infection
D.Hypertension
Answer:B
Rationale:Neck stiffness and headache suggest meningitis.

12. A nurse is caring for a patient with dehydration. Which finding is
expected?
A.Low heart rate
B. Dry mucous membranes
C.Increased urine output
D.Edema
Answer:B
Rationale: Dehydration causes dry tissues.

13.A patient is receiving IV potassium. What is the most important
nursing action?
A.Administer IV push
B.Monitor cardiac rhythm
C.Increase infusion rate
D.Encourage fluids
Answer:B
Rationale: Potassium affects heart rhythm.

14.A patient has a temperature of 39.5 ° C with chills and
sweating.What is the priority nursing intervention?
A.Apply ice packs and administer antipyretics
B.Restrict fluids
C. Encourage heavy blankets
D.Limit oxygen