NR 329: Exam Questions With COMPLETE
sOLUTIONS
Course
NR 329
1. Question:
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy at 4 L/min via nasal cannula. The nurse monitors the client closely, knowing
that the client is at risk for which condition?
A. Atelectasis
B. Oxygen toxicity
C. Hypercapnia
D. Pulmonary embolism
Answer: C. Hypercapnia
Rationale: Clients with COPD are at risk for hypercapnia (CO₂ retention) when given high-
flow oxygen, as it can suppress their hypoxic drive, leading to decreased respiratory rate and
CO₂ retention.
2. Question:
The nurse is caring for a client with type 1 diabetes who received regular insulin at 7:30
AM. The nurse should monitor the client for signs of hypoglycemia at which time?
A. 8:30 AM
B. 9:30 AM
C. 11:30 AM
D. 12:30 PM
Answer: C. 11:30 AM
Rationale: Regular insulin has an onset of 30 minutes, peaks around 2-4 hours, and has a
duration of 5-8 hours. Thus, hypoglycemia is most likely to occur at the peak time, around
11:30 AM.
3. Question:
Which assessment finding would indicate to the nurse that a client with heart failure is
not responding adequately to treatment?
A. Clear lung sounds
, B. Jugular vein distention
C. Pulse oximetry of 95%
D. Decreased peripheral edema
Answer: B. Jugular vein distention
Rationale: Jugular vein distention is a sign of fluid overload and right-sided heart failure,
indicating that the heart is not adequately managing the fluid volume and thus is not
responding well to treatment.
4. Question:
A nurse is teaching a client newly diagnosed with hypertension about dietary changes.
Which instruction is appropriate?
A. Increase intake of red meat for protein
B. Increase intake of foods high in sodium
C. Increase intake of potassium-rich foods
D. Increase intake of dairy products
Answer: C. Increase intake of potassium-rich foods
Rationale: Potassium-rich foods help lower blood pressure by counteracting the effects of
sodium and helping to relax blood vessel walls.
5. Question:
A client with a history of chronic kidney disease is scheduled for a CT scan with
contrast. What should the nurse anticipate before the procedure?
A. Increasing fluid intake before the test
B. Administration of insulin to lower glucose levels
C. Administration of a beta-blocker
D. Withholding all medications
Answer: A. Increasing fluid intake before the test
Rationale: Hydration helps prevent contrast-induced nephropathy, which is particularly
important for clients with renal impairment. The nurse may anticipate IV fluids to support
kidney function.
6. Question:
,The nurse is caring for a client receiving heparin therapy. Which laboratory value
would the nurse monitor to assess the effectiveness of the therapy?
A. Platelet count
B. Prothrombin time (PT)
C. Partial thromboplastin time (PTT)
D. Hematocrit
Answer: C. Partial thromboplastin time (PTT)
Rationale: Heparin therapy is monitored by PTT values, which should be prolonged within a
therapeutic range to prevent clotting without causing excessive bleeding.
7. Question:
A nurse is assessing a client with a suspected deep vein thrombosis (DVT). Which sign
would be a clinical indication of this condition?
A. Pallor in the affected limb
B. Warmth and tenderness over the affected area
C. Decreased pedal pulse
D. Coldness in the affected leg
Answer: B. Warmth and tenderness over the affected area
Rationale: DVT commonly presents with warmth, tenderness, and swelling over the affected
area due to inflammation and venous congestion.
8. Question:
The nurse is providing discharge instructions for a client who has been prescribed
warfarin (Coumadin). Which food should the client avoid?
A. Bananas
B. Spinach
C. Carrots
D. Apples
Answer: B. Spinach
Rationale: Spinach is high in vitamin K, which can interfere with the effectiveness of
warfarin. Clients are instructed to maintain a consistent intake of vitamin K to avoid
fluctuations in INR.
, 9. Question:
The nurse is assessing a client with left-sided heart failure. Which symptom would the
nurse expect to find?
A. Peripheral edema
B. Crackles in the lungs
C. Jugular vein distention
D. Hepatomegaly
Answer: B. Crackles in the lungs
Rationale: Left-sided heart failure leads to pulmonary congestion due to a backlog of blood
into the lungs, often resulting in crackles upon auscultation.
10. Question:
A client with hypothyroidism is receiving levothyroxine (Synthroid). Which finding
indicates the medication is effective?
A. Weight gain
B. Improved energy levels
C. Increased sensitivity to cold
D. Bradycardia
Answer: B. Improved energy levels
Rationale: An increase in energy levels suggests the thyroid hormone levels are returning to
normal, which is a sign of effective treatment for hypothyroidism.
11. Question:
The nurse is preparing to administer digoxin (Lanoxin) to a client with heart failure.
Before administration, the nurse should check which of the following?
A. Respiratory rate
B. Blood pressure
C. Apical pulse
D. Temperature
Answer: C. Apical pulse
Rationale: Digoxin can cause bradycardia, so the nurse should check the apical pulse before
administration. If the pulse is below 60 bpm, the medication should be held and the
healthcare provider notified.
sOLUTIONS
Course
NR 329
1. Question:
A client with chronic obstructive pulmonary disease (COPD) is receiving oxygen
therapy at 4 L/min via nasal cannula. The nurse monitors the client closely, knowing
that the client is at risk for which condition?
A. Atelectasis
B. Oxygen toxicity
C. Hypercapnia
D. Pulmonary embolism
Answer: C. Hypercapnia
Rationale: Clients with COPD are at risk for hypercapnia (CO₂ retention) when given high-
flow oxygen, as it can suppress their hypoxic drive, leading to decreased respiratory rate and
CO₂ retention.
2. Question:
The nurse is caring for a client with type 1 diabetes who received regular insulin at 7:30
AM. The nurse should monitor the client for signs of hypoglycemia at which time?
A. 8:30 AM
B. 9:30 AM
C. 11:30 AM
D. 12:30 PM
Answer: C. 11:30 AM
Rationale: Regular insulin has an onset of 30 minutes, peaks around 2-4 hours, and has a
duration of 5-8 hours. Thus, hypoglycemia is most likely to occur at the peak time, around
11:30 AM.
3. Question:
Which assessment finding would indicate to the nurse that a client with heart failure is
not responding adequately to treatment?
A. Clear lung sounds
, B. Jugular vein distention
C. Pulse oximetry of 95%
D. Decreased peripheral edema
Answer: B. Jugular vein distention
Rationale: Jugular vein distention is a sign of fluid overload and right-sided heart failure,
indicating that the heart is not adequately managing the fluid volume and thus is not
responding well to treatment.
4. Question:
A nurse is teaching a client newly diagnosed with hypertension about dietary changes.
Which instruction is appropriate?
A. Increase intake of red meat for protein
B. Increase intake of foods high in sodium
C. Increase intake of potassium-rich foods
D. Increase intake of dairy products
Answer: C. Increase intake of potassium-rich foods
Rationale: Potassium-rich foods help lower blood pressure by counteracting the effects of
sodium and helping to relax blood vessel walls.
5. Question:
A client with a history of chronic kidney disease is scheduled for a CT scan with
contrast. What should the nurse anticipate before the procedure?
A. Increasing fluid intake before the test
B. Administration of insulin to lower glucose levels
C. Administration of a beta-blocker
D. Withholding all medications
Answer: A. Increasing fluid intake before the test
Rationale: Hydration helps prevent contrast-induced nephropathy, which is particularly
important for clients with renal impairment. The nurse may anticipate IV fluids to support
kidney function.
6. Question:
,The nurse is caring for a client receiving heparin therapy. Which laboratory value
would the nurse monitor to assess the effectiveness of the therapy?
A. Platelet count
B. Prothrombin time (PT)
C. Partial thromboplastin time (PTT)
D. Hematocrit
Answer: C. Partial thromboplastin time (PTT)
Rationale: Heparin therapy is monitored by PTT values, which should be prolonged within a
therapeutic range to prevent clotting without causing excessive bleeding.
7. Question:
A nurse is assessing a client with a suspected deep vein thrombosis (DVT). Which sign
would be a clinical indication of this condition?
A. Pallor in the affected limb
B. Warmth and tenderness over the affected area
C. Decreased pedal pulse
D. Coldness in the affected leg
Answer: B. Warmth and tenderness over the affected area
Rationale: DVT commonly presents with warmth, tenderness, and swelling over the affected
area due to inflammation and venous congestion.
8. Question:
The nurse is providing discharge instructions for a client who has been prescribed
warfarin (Coumadin). Which food should the client avoid?
A. Bananas
B. Spinach
C. Carrots
D. Apples
Answer: B. Spinach
Rationale: Spinach is high in vitamin K, which can interfere with the effectiveness of
warfarin. Clients are instructed to maintain a consistent intake of vitamin K to avoid
fluctuations in INR.
, 9. Question:
The nurse is assessing a client with left-sided heart failure. Which symptom would the
nurse expect to find?
A. Peripheral edema
B. Crackles in the lungs
C. Jugular vein distention
D. Hepatomegaly
Answer: B. Crackles in the lungs
Rationale: Left-sided heart failure leads to pulmonary congestion due to a backlog of blood
into the lungs, often resulting in crackles upon auscultation.
10. Question:
A client with hypothyroidism is receiving levothyroxine (Synthroid). Which finding
indicates the medication is effective?
A. Weight gain
B. Improved energy levels
C. Increased sensitivity to cold
D. Bradycardia
Answer: B. Improved energy levels
Rationale: An increase in energy levels suggests the thyroid hormone levels are returning to
normal, which is a sign of effective treatment for hypothyroidism.
11. Question:
The nurse is preparing to administer digoxin (Lanoxin) to a client with heart failure.
Before administration, the nurse should check which of the following?
A. Respiratory rate
B. Blood pressure
C. Apical pulse
D. Temperature
Answer: C. Apical pulse
Rationale: Digoxin can cause bradycardia, so the nurse should check the apical pulse before
administration. If the pulse is below 60 bpm, the medication should be held and the
healthcare provider notified.
