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NUR 445 FINAL EXAM 1 & 2 (NEWEST 2026-2027) | ARIZONA
COLLEGE OF NURSING | 100% VERIFIED TEST BANK WITH
CORRECT ANSWERS & RATIONALES
Question 1
The nurse is caring for a patient with heart failure who reports shortness of breath
at night and sleeps with two pillows. This symptom is best described as:
A. Dyspnea on exertion
B. Orthopnea
C. Paroxysmal nocturnal dyspnea
D. Tachypnea
Correct Answer: B
Rationale: Orthopnea is difficulty breathing when lying flat, often relieved by
sitting up or using pillows. It is a common symptom of left-sided heart failure and
fluid overload.
Question 2
A patient on warfarin therapy presents with an INR of 5.6. The priority nursing
action is to:
A. Administer the next scheduled dose
B. Hold the medication and notify the provider
C. Encourage the patient to increase vitamin K intake
D. Document as a normal finding
Correct Answer: B
Rationale: An INR of 5.6 indicates a high bleeding risk. The nurse should hold the
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dose and notify the provider. Increasing vitamin K may be part of management, but
not the first step.
Question 3
The nurse identifies which assessment finding as a priority for a patient with
pneumonia?
A. Fever of 101°F (38.3°C)
B. Oxygen saturation of 84% on room air
C. Productive cough with yellow sputum
D. Respiratory rate of 20 breaths per minute
Correct Answer: B
Rationale: Severe hypoxemia (SpO₂ 84%) is life-threatening and requires
immediate oxygen therapy. Fever and productive cough are expected findings and
less urgent.
Question 4
A patient with diabetes presents with diaphoresis, tremors, and irritability. Which
action should the nurse take first?
A. Administer 50% dextrose IV
B. Give a carbohydrate snack
C. Check the patient’s blood glucose level
D. Notify the healthcare provider
Correct Answer: C
Rationale: Hypoglycemia is suspected, but blood glucose must be confirmed
before treatment. If low, the next step depends on whether the patient is alert and
able to swallow.
Question 5
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The nurse prepares to administer digoxin. Which assessment finding requires the
nurse to withhold the medication?
A. Heart rate of 56 bpm
B. Blood pressure of 120/78 mmHg
C. Respiratory rate of 22 breaths/min
D. Oxygen saturation of 96%
Correct Answer: A
Rationale: Digoxin is withheld if the apical pulse is less than 60 bpm because of
the risk of severe bradycardia and toxicity. Other findings are within normal range.
Question 6
Which diet choice by a patient with hypertension demonstrates effective teaching?
A. Canned soup and pickles
B. Baked chicken with steamed vegetables
C. Ham sandwich with potato chips
D. Frozen pizza with soda
Correct Answer: B
Rationale: A low-sodium, heart-healthy diet includes lean protein and fresh
vegetables. The other choices are high in sodium, which worsens hypertension.
Question 7
Which assessment finding in a patient with COPD requires immediate
intervention?
A. Oxygen saturation of 90%
B. Barrel-shaped chest
C. Respiratory rate of 10/min after opioid administration
D. Chronic productive cough
Correct Answer: C
Rationale: A low respiratory rate after opioids indicates respiratory depression,
which is life-threatening in COPD patients. The other findings are expected.
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Question 8
A nurse is reinforcing discharge teaching for a patient with heart failure. Which
statement indicates understanding?
A. “I will weigh myself daily at the same time.”
B. “I can stop taking my diuretic once I feel better.”
C. “If I gain 2 pounds in a week, I don’t need to worry.”
D. “I should avoid resting during the day.”
Correct Answer: A
Rationale: Daily weights help monitor fluid status. Stopping diuretics abruptly or
ignoring weight gain can worsen heart failure. Rest periods are encouraged.
Question 9
Which lab result is most concerning in a patient receiving furosemide?
A. Potassium 2.9 mEq/L
B. Sodium 138 mEq/L
C. BUN 18 mg/dL
D. Creatinine 0.9 mg/dL
Correct Answer: A
Rationale: Hypokalemia (K+ <3.5 mEq/L) is a dangerous complication of loop
diuretics and can cause life-threatening dysrhythmias.
Question 10
A patient with chest pain reports relief after taking nitroglycerin. Which side effect
is expected?
A. Hypertension
B. Bradycardia
C. Headache
D. Seizures
NUR 445 FINAL EXAM 1 & 2 (NEWEST 2026-2027) | ARIZONA
COLLEGE OF NURSING | 100% VERIFIED TEST BANK WITH
CORRECT ANSWERS & RATIONALES
Question 1
The nurse is caring for a patient with heart failure who reports shortness of breath
at night and sleeps with two pillows. This symptom is best described as:
A. Dyspnea on exertion
B. Orthopnea
C. Paroxysmal nocturnal dyspnea
D. Tachypnea
Correct Answer: B
Rationale: Orthopnea is difficulty breathing when lying flat, often relieved by
sitting up or using pillows. It is a common symptom of left-sided heart failure and
fluid overload.
Question 2
A patient on warfarin therapy presents with an INR of 5.6. The priority nursing
action is to:
A. Administer the next scheduled dose
B. Hold the medication and notify the provider
C. Encourage the patient to increase vitamin K intake
D. Document as a normal finding
Correct Answer: B
Rationale: An INR of 5.6 indicates a high bleeding risk. The nurse should hold the
,2 | Page
dose and notify the provider. Increasing vitamin K may be part of management, but
not the first step.
Question 3
The nurse identifies which assessment finding as a priority for a patient with
pneumonia?
A. Fever of 101°F (38.3°C)
B. Oxygen saturation of 84% on room air
C. Productive cough with yellow sputum
D. Respiratory rate of 20 breaths per minute
Correct Answer: B
Rationale: Severe hypoxemia (SpO₂ 84%) is life-threatening and requires
immediate oxygen therapy. Fever and productive cough are expected findings and
less urgent.
Question 4
A patient with diabetes presents with diaphoresis, tremors, and irritability. Which
action should the nurse take first?
A. Administer 50% dextrose IV
B. Give a carbohydrate snack
C. Check the patient’s blood glucose level
D. Notify the healthcare provider
Correct Answer: C
Rationale: Hypoglycemia is suspected, but blood glucose must be confirmed
before treatment. If low, the next step depends on whether the patient is alert and
able to swallow.
Question 5
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The nurse prepares to administer digoxin. Which assessment finding requires the
nurse to withhold the medication?
A. Heart rate of 56 bpm
B. Blood pressure of 120/78 mmHg
C. Respiratory rate of 22 breaths/min
D. Oxygen saturation of 96%
Correct Answer: A
Rationale: Digoxin is withheld if the apical pulse is less than 60 bpm because of
the risk of severe bradycardia and toxicity. Other findings are within normal range.
Question 6
Which diet choice by a patient with hypertension demonstrates effective teaching?
A. Canned soup and pickles
B. Baked chicken with steamed vegetables
C. Ham sandwich with potato chips
D. Frozen pizza with soda
Correct Answer: B
Rationale: A low-sodium, heart-healthy diet includes lean protein and fresh
vegetables. The other choices are high in sodium, which worsens hypertension.
Question 7
Which assessment finding in a patient with COPD requires immediate
intervention?
A. Oxygen saturation of 90%
B. Barrel-shaped chest
C. Respiratory rate of 10/min after opioid administration
D. Chronic productive cough
Correct Answer: C
Rationale: A low respiratory rate after opioids indicates respiratory depression,
which is life-threatening in COPD patients. The other findings are expected.
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Question 8
A nurse is reinforcing discharge teaching for a patient with heart failure. Which
statement indicates understanding?
A. “I will weigh myself daily at the same time.”
B. “I can stop taking my diuretic once I feel better.”
C. “If I gain 2 pounds in a week, I don’t need to worry.”
D. “I should avoid resting during the day.”
Correct Answer: A
Rationale: Daily weights help monitor fluid status. Stopping diuretics abruptly or
ignoring weight gain can worsen heart failure. Rest periods are encouraged.
Question 9
Which lab result is most concerning in a patient receiving furosemide?
A. Potassium 2.9 mEq/L
B. Sodium 138 mEq/L
C. BUN 18 mg/dL
D. Creatinine 0.9 mg/dL
Correct Answer: A
Rationale: Hypokalemia (K+ <3.5 mEq/L) is a dangerous complication of loop
diuretics and can cause life-threatening dysrhythmias.
Question 10
A patient with chest pain reports relief after taking nitroglycerin. Which side effect
is expected?
A. Hypertension
B. Bradycardia
C. Headache
D. Seizures
