Updated for 2026-2027
NUR 417 EXAM 2026-2027 CARE OF ADULT II PRACTICE QUESTIONS
& VERIFIED ANSWERS (230),100% CORRECT ALREADY GRADED A+
1.
A 58-year-old male with a history of hypertension and type 2 diabetes is admitted
with acute shortness of breath, orthopnea, and bilateral crackles on lung
auscultation. His oxygen saturation is 86% on room air, and BNP levels are
elevated. What is the nurse’s priority intervention?
A. Administer prescribed diuretics and place the patient in high Fowler’s position
B. Start IV fluids to improve cardiac output
C. Encourage the patient to ambulate to improve oxygenation
D. Administer beta blockers to reduce heart rate
Correct Answer: A — Administer prescribed diuretics and place the patient in
high Fowler’s position.
Rationale: This patient shows signs of acute decompensated heart failure with
pulmonary edema. Positioning improves ventilation, and diuretics reduce fluid
overload quickly, improving oxygenation.
2.
A nurse is caring for a 72-year-old patient admitted for COPD exacerbation. The
patient is receiving oxygen via nasal cannula at 4 L/min and suddenly becomes
confused and drowsy. ABG results show pH 7.28, PaCO₂ 60 mmHg, PaO₂ 75
mmHg. What should the nurse do first?
A. Decrease oxygen flow rate and assess respiratory effort
B. Increase oxygen to 6 L/min
C. Prepare the patient for immediate intubation
D. Administer a bronchodilator and continue current O₂
Correct Answer: A — Decrease oxygen flow rate and assess respiratory effort.
Rationale: COPD patients can retain CO₂ when given excessive oxygen, leading
,Updated for 2026-2027
to CO₂ narcosis. Lowering oxygen and assessing ventilation can help restore their
hypoxic drive and prevent further respiratory depression.
3.
A patient with a history of deep vein thrombosis suddenly complains of chest pain,
shortness of breath, and hemoptysis. Vital signs show tachycardia, hypotension,
and SpO₂ of 84%. Which action should the nurse take first?
A. Apply oxygen and elevate the head of the bed
B. Start chest compressions immediately
C. Prepare the patient for emergency surgery
D. Administer aspirin and monitor
Correct Answer: A — Apply oxygen and elevate the head of the bed.
Rationale: This presentation is consistent with pulmonary embolism, a life-
threatening emergency. Supporting oxygenation is the priority, followed by
notifying the provider for anticoagulation or thrombolytic therapy.
4.
A nurse is reviewing lab values for a patient with chronic kidney disease. The
results show K⁺ 6.2 mEq/L, BUN 85 mg/dL, and creatinine 4.0 mg/dL. The patient
reports muscle weakness. What intervention should the nurse anticipate?
A. Administration of IV insulin and glucose
B. Giving potassium supplements to restore balance
C. Encouraging oral fluids to flush excess potassium
D. Administering loop diuretics and increasing protein intake
Correct Answer: A — Administration of IV insulin and glucose.
Rationale: Hyperkalemia is dangerous and can cause arrhythmias. IV insulin
with glucose drives potassium into cells quickly, temporarily lowering serum K⁺
while definitive treatments (e.g., dialysis) are arranged.
5.
,Updated for 2026-2027
A 65-year-old woman post–abdominal surgery suddenly develops shortness of
breath, anxiety, and mild cyanosis. Lung sounds are diminished in the right lower
lobe. Which is the most likely cause?
A. Atelectasis due to shallow breathing
B. Acute respiratory distress syndrome
C. Pulmonary embolism
D. Pleural effusion from surgery
Correct Answer: A — Atelectasis due to shallow breathing.
Rationale: Atelectasis commonly develops postoperatively due to pain and
inadequate lung expansion. Incentive spirometry, ambulation, and deep breathing
exercises help re-expand alveoli and improve oxygenation.
6.
A patient receiving a blood transfusion begins to complain of chills, headache, and
lower back pain within 15 minutes of starting the infusion. The nurse notices dark
urine in the Foley bag. What is the priority nursing action?
A. Stop the transfusion immediately and keep the IV line open with normal saline
B. Administer acetaminophen and continue the transfusion
C. Slow the transfusion and observe the patient closely
D. Document findings and notify the blood bank after completion
Correct Answer: A — Stop the transfusion immediately and keep the IV line
open with normal saline.
Rationale: These are signs of an acute hemolytic reaction, a medical emergency.
Stopping the transfusion and maintaining IV access is crucial to prevent further
hemolysis and renal damage.
7.
A 48-year-old male with cirrhosis is admitted for worsening ascites. On
assessment, he has a distended abdomen, mild dyspnea, and 2+ pedal edema.
Which nursing intervention should be prioritized?
A. Measure abdominal girth and daily weights
, Updated for 2026-2027
B. Increase protein intake to improve nutrition
C. Restrict fluids and sodium as ordered
D. Encourage ambulation to improve circulation
Correct Answer: C — Restrict fluids and sodium as ordered.
Rationale: Fluid and sodium restriction are key management steps for ascites to
reduce fluid retention. Daily weights and girth measurements help monitor
progress but do not directly treat the underlying issue.
8.
A patient with type 1 diabetes is found diaphoretic, shaky, and confused. Blood
glucose reads 45 mg/dL. What is the best initial action by the nurse?
A. Give 15 g of fast-acting carbohydrates such as juice
B. Call the provider immediately
C. Administer long-acting insulin
D. Start an IV line for fluids
Correct Answer: A — Give 15 g of fast-acting carbohydrates such as juice.
Rationale: Hypoglycemia must be corrected quickly to prevent seizures or coma.
The “15-15 rule” (give 15 g carbs, recheck in 15 minutes) is the immediate
intervention for conscious patients.
9.
A nurse is caring for a patient with a nasogastric tube set to continuous suction.
The patient’s latest labs show K⁺ 2.8 mEq/L and metabolic alkalosis. What is the
most likely cause of these findings?
A. Loss of gastric acid and potassium through suction
B. Excess potassium intake
C. Renal failure causing retention of bicarbonate
D. Hyperventilation leading to acid loss
Correct Answer: A — Loss of gastric acid and potassium through suction.
Rationale: Gastric suction removes hydrochloric acid and electrolytes, leading to
NUR 417 EXAM 2026-2027 CARE OF ADULT II PRACTICE QUESTIONS
& VERIFIED ANSWERS (230),100% CORRECT ALREADY GRADED A+
1.
A 58-year-old male with a history of hypertension and type 2 diabetes is admitted
with acute shortness of breath, orthopnea, and bilateral crackles on lung
auscultation. His oxygen saturation is 86% on room air, and BNP levels are
elevated. What is the nurse’s priority intervention?
A. Administer prescribed diuretics and place the patient in high Fowler’s position
B. Start IV fluids to improve cardiac output
C. Encourage the patient to ambulate to improve oxygenation
D. Administer beta blockers to reduce heart rate
Correct Answer: A — Administer prescribed diuretics and place the patient in
high Fowler’s position.
Rationale: This patient shows signs of acute decompensated heart failure with
pulmonary edema. Positioning improves ventilation, and diuretics reduce fluid
overload quickly, improving oxygenation.
2.
A nurse is caring for a 72-year-old patient admitted for COPD exacerbation. The
patient is receiving oxygen via nasal cannula at 4 L/min and suddenly becomes
confused and drowsy. ABG results show pH 7.28, PaCO₂ 60 mmHg, PaO₂ 75
mmHg. What should the nurse do first?
A. Decrease oxygen flow rate and assess respiratory effort
B. Increase oxygen to 6 L/min
C. Prepare the patient for immediate intubation
D. Administer a bronchodilator and continue current O₂
Correct Answer: A — Decrease oxygen flow rate and assess respiratory effort.
Rationale: COPD patients can retain CO₂ when given excessive oxygen, leading
,Updated for 2026-2027
to CO₂ narcosis. Lowering oxygen and assessing ventilation can help restore their
hypoxic drive and prevent further respiratory depression.
3.
A patient with a history of deep vein thrombosis suddenly complains of chest pain,
shortness of breath, and hemoptysis. Vital signs show tachycardia, hypotension,
and SpO₂ of 84%. Which action should the nurse take first?
A. Apply oxygen and elevate the head of the bed
B. Start chest compressions immediately
C. Prepare the patient for emergency surgery
D. Administer aspirin and monitor
Correct Answer: A — Apply oxygen and elevate the head of the bed.
Rationale: This presentation is consistent with pulmonary embolism, a life-
threatening emergency. Supporting oxygenation is the priority, followed by
notifying the provider for anticoagulation or thrombolytic therapy.
4.
A nurse is reviewing lab values for a patient with chronic kidney disease. The
results show K⁺ 6.2 mEq/L, BUN 85 mg/dL, and creatinine 4.0 mg/dL. The patient
reports muscle weakness. What intervention should the nurse anticipate?
A. Administration of IV insulin and glucose
B. Giving potassium supplements to restore balance
C. Encouraging oral fluids to flush excess potassium
D. Administering loop diuretics and increasing protein intake
Correct Answer: A — Administration of IV insulin and glucose.
Rationale: Hyperkalemia is dangerous and can cause arrhythmias. IV insulin
with glucose drives potassium into cells quickly, temporarily lowering serum K⁺
while definitive treatments (e.g., dialysis) are arranged.
5.
,Updated for 2026-2027
A 65-year-old woman post–abdominal surgery suddenly develops shortness of
breath, anxiety, and mild cyanosis. Lung sounds are diminished in the right lower
lobe. Which is the most likely cause?
A. Atelectasis due to shallow breathing
B. Acute respiratory distress syndrome
C. Pulmonary embolism
D. Pleural effusion from surgery
Correct Answer: A — Atelectasis due to shallow breathing.
Rationale: Atelectasis commonly develops postoperatively due to pain and
inadequate lung expansion. Incentive spirometry, ambulation, and deep breathing
exercises help re-expand alveoli and improve oxygenation.
6.
A patient receiving a blood transfusion begins to complain of chills, headache, and
lower back pain within 15 minutes of starting the infusion. The nurse notices dark
urine in the Foley bag. What is the priority nursing action?
A. Stop the transfusion immediately and keep the IV line open with normal saline
B. Administer acetaminophen and continue the transfusion
C. Slow the transfusion and observe the patient closely
D. Document findings and notify the blood bank after completion
Correct Answer: A — Stop the transfusion immediately and keep the IV line
open with normal saline.
Rationale: These are signs of an acute hemolytic reaction, a medical emergency.
Stopping the transfusion and maintaining IV access is crucial to prevent further
hemolysis and renal damage.
7.
A 48-year-old male with cirrhosis is admitted for worsening ascites. On
assessment, he has a distended abdomen, mild dyspnea, and 2+ pedal edema.
Which nursing intervention should be prioritized?
A. Measure abdominal girth and daily weights
, Updated for 2026-2027
B. Increase protein intake to improve nutrition
C. Restrict fluids and sodium as ordered
D. Encourage ambulation to improve circulation
Correct Answer: C — Restrict fluids and sodium as ordered.
Rationale: Fluid and sodium restriction are key management steps for ascites to
reduce fluid retention. Daily weights and girth measurements help monitor
progress but do not directly treat the underlying issue.
8.
A patient with type 1 diabetes is found diaphoretic, shaky, and confused. Blood
glucose reads 45 mg/dL. What is the best initial action by the nurse?
A. Give 15 g of fast-acting carbohydrates such as juice
B. Call the provider immediately
C. Administer long-acting insulin
D. Start an IV line for fluids
Correct Answer: A — Give 15 g of fast-acting carbohydrates such as juice.
Rationale: Hypoglycemia must be corrected quickly to prevent seizures or coma.
The “15-15 rule” (give 15 g carbs, recheck in 15 minutes) is the immediate
intervention for conscious patients.
9.
A nurse is caring for a patient with a nasogastric tube set to continuous suction.
The patient’s latest labs show K⁺ 2.8 mEq/L and metabolic alkalosis. What is the
most likely cause of these findings?
A. Loss of gastric acid and potassium through suction
B. Excess potassium intake
C. Renal failure causing retention of bicarbonate
D. Hyperventilation leading to acid loss
Correct Answer: A — Loss of gastric acid and potassium through suction.
Rationale: Gastric suction removes hydrochloric acid and electrolytes, leading to
