FINAL EXAM WITH COMPLETE DETAILED QUESTIONS AND
CORRECT VERIFIED ANSWERS WITH RATIONALES ALREADY A+
GRADED BRAND NEW!!!
A nurse is assessing a client with suspected deep vein
thrombosis (DVT). Which finding is most consistent with
this diagnosis?
A. Unilateral calf swelling, warmth, and tenderness
B. Bilateral pitting edema
C. Diminished peripheral pulses
D. Brownish discoloration of the ankle
Correct Answer: A
Rationale: Unilateral calf swelling, warmth, tenderness,
and erythema are classic signs of DVT. Bilateral edema
suggests systemic causes (e.g., heart failure). Brownish
discoloration occurs in chronic venous insufficiency.
A client with chronic obstructive pulmonary disease
(COPD) has a PaO₂ of 55 mmHg and PaCO₂ of 60 mmHg.
,Which oxygen delivery method should the nurse
anticipate?
A. High-flow oxygen via non-rebreather mask
B. Low-flow oxygen via nasal cannula
C. Mechanical ventilation with 100% FiO₂
D. Oxygen administration only during exercise
Correct Answer: B
Rationale: In COPD with chronic hypercapnia, high-flow
oxygen can worsen hypercapnia by reducing hypoxic
drive. Low-flow oxygen (1-3 L/min) is used to maintain
SpO₂ at 88-92%.
A client with heart failure has crackles in both lung bases,
jugular venous distension, and 3+ pitting edema in the
lower extremities. Which dietary restriction is most
important for the nurse to reinforce?
A. Fluid restriction to 500 mL/day
B. Low-fat, low-cholesterol diet
C. Sodium restriction to 2 grams or less per day
D. High-protein, high-calorie diet
,Correct Answer: C
Rationale: Sodium restriction reduces fluid retention by
decreasing osmotic drive for water retention. This is a
cornerstone of heart failure management to reduce
preload and edema.
A client receiving a blood transfusion develops chills,
fever, and lower back pain 30 minutes after the start.
What is the priority nursing action?
A. Slow the transfusion rate
B. Administer acetaminophen
C. Stop the transfusion immediately
D. Notify the healthcare provider
Correct Answer: C
Rationale: Chills, fever, and back pain suggest an acute
hemolytic or febrile transfusion reaction. The immediate
priority is to stop the transfusion to prevent further
complications.
A client with a new tracheostomy is being suctioned.
Which technique is correct to minimize hypoxia?
, A. Suction for 20-30 seconds each pass
B. Hyperoxygenate with 100% oxygen before and after
suctioning
C. Apply suction while inserting the catheter
D. Use a clean (non-sterile) catheter for each suction pass
Correct Answer: B
Rationale: Hyperoxygenation before and after suctioning
prevents hypoxemia. Suction duration should be limited
to 10-15 seconds; suction is applied during withdrawal,
not insertion.
A client with a chest tube after a thoracotomy has an air
leak that has persisted for 4 days. Which finding indicates
that the air leak may be from the chest tube system
rather than the lung?
A. Continuous bubbling in the water-seal chamber
B. Bubbling that increases with coughing
C. Bubbling that stops when the chest tube is clamped
near the insertion site
D. No tidaling in the water-seal chamber
Correct Answer: C