SENECA COLLEGE PNR 300 (PNR300)
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF
1. A 68-year-old patient with COPD has increasing dyspnea
and wheezes. The nurse’s priority initial action is to:
A. Administer a bronchodilator as ordered
B. Assess respiratory rate, effort, and oxygen saturation
C. Encourage deep breathing and coughing exercises
D. Obtain a chest x-ray
Rationale: Initial assessment guides urgent interventions
and determines severity before treatments.
2. Which lab result most directly indicates acute kidney
injury?
A. Low hemoglobin
B. Elevated ALT
C. Rising serum creatinine
D. Low albumin
Rationale: Serum creatinine is a primary marker of renal
filtration function and acute changes.
3. A postoperative patient develops sudden chest pain and
shortness of breath on day 3. The nurse suspects
, pulmonary embolism. Immediate action:
A. Give IV morphine for pain
B. Assess vital signs and call the rapid response team
C. Obtain a 12-lead ECG next hour
D. Encourage ambulation
Rationale: Sudden deterioration requires immediate
assessment and escalation to stabilize and diagnose.
4. For a patient on warfarin (coumadin), which lab is most
important to monitor?
A. Serum potassium
B. INR (international normalized ratio)
C. Platelet count
D. aPTT
Rationale: INR monitors warfarin anticoagulation and
guides dosing.
5. A nurse instructs a patient taking metformin about signs of
lactic acidosis. Which symptom should the nurse include?
A. Dry mouth
B. Unusual muscle pain and rapid breathing
C. Constipation
D. Weight gain
Rationale: Lactic acidosis presents with muscle pain,
hyperventilation, and malaise; it’s rare but serious with
metformin.
,6. Best nursing intervention to prevent pressure ulcers in an
immobile patient:
A. Use of massage cream every 12 hours
B. Apply adhesive tape to sacrum
C. Reposition at least every 2 hours and use pressure-
relieving surfaces
D. Keep patient on low-protein diet
Rationale: Frequent repositioning and pressure
redistribution are evidence-based for prevention.
7. A patient demonstrates confusion, visual hallucinations,
and fluctuating consciousness — most consistent with:
A. Major depressive disorder
B. Delirium
C. Schizophrenia
D. Dementia
Rationale: Delirium has acute onset, fluctuating course,
and disturbed attention/awareness.
8. Which medication classification is first-line for acute
asthma exacerbation?
A. Inhaled corticosteroids
B. Short-acting beta2-agonists (e.g., albuterol)
C. Leukotriene modifiers
D. Long-acting beta2-agonists
, Rationale: Short-acting beta2-agonists provide rapid
bronchodilation for acute symptoms.
9. A nurse administering IV potassium should:
A. Push rapidly as a bolus for hypokalemia
B. Infuse diluted and monitor cardiac rhythm
C. Give with insulin to increase serum level
D. Mix with magnesium and push IVP
Rationale: IV potassium must be diluted and infused
slowly with cardiac monitoring to avoid arrhythmias.
10. Which sign is most indicative of increased intracranial
pressure (ICP)?
A. Hypothermia
B. Bradypnea
C. Decreased level of consciousness and pupillary changes
D. Hyperactive bowel sounds
Rationale: Changes in LOC and pupil response are key
early indicators of rising ICP.
11. When performing handoff using SBAR, the "A" stands
for:
A. Assessment
B. Action
C. Assessment (sometimes “Background” in variants) —
standardized as Situation, Background, Assessment,
Recommendation
QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES 2026
Q&A | INSTANT DOWNLOAD PDF
1. A 68-year-old patient with COPD has increasing dyspnea
and wheezes. The nurse’s priority initial action is to:
A. Administer a bronchodilator as ordered
B. Assess respiratory rate, effort, and oxygen saturation
C. Encourage deep breathing and coughing exercises
D. Obtain a chest x-ray
Rationale: Initial assessment guides urgent interventions
and determines severity before treatments.
2. Which lab result most directly indicates acute kidney
injury?
A. Low hemoglobin
B. Elevated ALT
C. Rising serum creatinine
D. Low albumin
Rationale: Serum creatinine is a primary marker of renal
filtration function and acute changes.
3. A postoperative patient develops sudden chest pain and
shortness of breath on day 3. The nurse suspects
, pulmonary embolism. Immediate action:
A. Give IV morphine for pain
B. Assess vital signs and call the rapid response team
C. Obtain a 12-lead ECG next hour
D. Encourage ambulation
Rationale: Sudden deterioration requires immediate
assessment and escalation to stabilize and diagnose.
4. For a patient on warfarin (coumadin), which lab is most
important to monitor?
A. Serum potassium
B. INR (international normalized ratio)
C. Platelet count
D. aPTT
Rationale: INR monitors warfarin anticoagulation and
guides dosing.
5. A nurse instructs a patient taking metformin about signs of
lactic acidosis. Which symptom should the nurse include?
A. Dry mouth
B. Unusual muscle pain and rapid breathing
C. Constipation
D. Weight gain
Rationale: Lactic acidosis presents with muscle pain,
hyperventilation, and malaise; it’s rare but serious with
metformin.
,6. Best nursing intervention to prevent pressure ulcers in an
immobile patient:
A. Use of massage cream every 12 hours
B. Apply adhesive tape to sacrum
C. Reposition at least every 2 hours and use pressure-
relieving surfaces
D. Keep patient on low-protein diet
Rationale: Frequent repositioning and pressure
redistribution are evidence-based for prevention.
7. A patient demonstrates confusion, visual hallucinations,
and fluctuating consciousness — most consistent with:
A. Major depressive disorder
B. Delirium
C. Schizophrenia
D. Dementia
Rationale: Delirium has acute onset, fluctuating course,
and disturbed attention/awareness.
8. Which medication classification is first-line for acute
asthma exacerbation?
A. Inhaled corticosteroids
B. Short-acting beta2-agonists (e.g., albuterol)
C. Leukotriene modifiers
D. Long-acting beta2-agonists
, Rationale: Short-acting beta2-agonists provide rapid
bronchodilation for acute symptoms.
9. A nurse administering IV potassium should:
A. Push rapidly as a bolus for hypokalemia
B. Infuse diluted and monitor cardiac rhythm
C. Give with insulin to increase serum level
D. Mix with magnesium and push IVP
Rationale: IV potassium must be diluted and infused
slowly with cardiac monitoring to avoid arrhythmias.
10. Which sign is most indicative of increased intracranial
pressure (ICP)?
A. Hypothermia
B. Bradypnea
C. Decreased level of consciousness and pupillary changes
D. Hyperactive bowel sounds
Rationale: Changes in LOC and pupil response are key
early indicators of rising ICP.
11. When performing handoff using SBAR, the "A" stands
for:
A. Assessment
B. Action
C. Assessment (sometimes “Background” in variants) —
standardized as Situation, Background, Assessment,
Recommendation
