NUR 283 Comp Exam Comprehensive 160 Study
Questions and Answers | 2026 Updated | 100% Correct
1. A nurse is assessing a patient with suspected hypovolemic shock. Which
finding would the nurse expect to observe?
a) Tachycardia and decreased blood pressure
Rationale: Hypovolemic shock leads to decreased circulating volume,
causing compensatory tachycardia and eventual hypotension as
compensatory mechanisms fail.
2. A patient with heart failure presents with dyspnea, crackles in lung bases,
and jugular venous distension. Which medication does the nurse anticipate
administering first?
c) Furosemide
Rationale: Furosemide is a loop diuretic that reduces preload by promoting
fluid excretion, relieving pulmonary congestion and symptoms of fluid
overload.
3. Which laboratory value is most critical to monitor in a patient receiving
intravenous heparin therapy?
b) aPTT
Rationale: Activated partial thromboplastin time (aPTT) measures heparin’s
therapeutic effect; therapeutic range is typically 1.5–2.5 times the control
value.
4. A nurse is caring for a patient with acute kidney injury (AKI) in the oliguric
phase. Which finding requires immediate provider notification?
, d) Serum potassium of 6.2 mEq/L
Rationale: Hyperkalemia (K+ >5.5) in AKI can cause fatal cardiac
dysrhythmias; this level requires immediate intervention such as insulin,
dextrose, or dialysis.
5. A patient with chronic obstructive pulmonary disease (COPD) has an
oxygen saturation of 88% on room air. Which oxygen delivery device is
most appropriate?
c) Nasal cannula at 2 L/min
Rationale: Low-flow oxygen via nasal cannula prevents suppression of
hypoxic drive while improving saturation to 88–92% target range for COPD.
6. Which acid-base imbalance is most common in a patient with salicylate
overdose?
b) Mixed respiratory alkalosis and metabolic acidosis
Rationale: Salicylates directly stimulate respiratory center causing
respiratory alkalosis early, then uncouple oxidative phosphorylation leading
to metabolic acidosis.
7. A nurse is teaching a patient with type 2 diabetes about metformin. Which
adverse effect should the patient be instructed to report immediately?
d) Unexplained muscle pain or weakness
Rationale: Muscle pain can indicate lactic acidosis, a rare but serious
metformin complication, especially in renal impairment or hypoperfusion
states.
, 8. A patient post-myocardial infarction develops crackles in bilateral lung
bases and an S3 heart sound. The nurse recognizes these findings as
indicative of which condition?
c) Left-sided heart failure
Rationale: S3 gallop and pulmonary crackles are classic signs of left
ventricular failure with resulting pulmonary congestion.
9. Which dietary instruction is most important for a patient with hyperkalemia
secondary to chronic kidney disease?
b) Avoid oranges, bananas, and potatoes
Rationale: Oranges, bananas, and potatoes are high-potassium foods;
restriction helps prevent life-threatening hyperkalemia in CKD.
10. A nurse assesses a patient with pancreatitis who reports severe
abdominal pain radiating to the back. Which position typically provides the
most relief?
a) Leaning forward while sitting
Rationale: Leaning forward reduces tension on the pancreatic capsule and
may relieve pain in acute pancreatitis.
11. Which finding in a patient with cirrhosis is most suggestive of
progression to hepatic encephalopathy?
d) Asterixis (liver flap)
Rationale: Asterixis is a flapping tremor of the hands when wrists are
extended, indicating increased serum ammonia and encephalopathy.
Questions and Answers | 2026 Updated | 100% Correct
1. A nurse is assessing a patient with suspected hypovolemic shock. Which
finding would the nurse expect to observe?
a) Tachycardia and decreased blood pressure
Rationale: Hypovolemic shock leads to decreased circulating volume,
causing compensatory tachycardia and eventual hypotension as
compensatory mechanisms fail.
2. A patient with heart failure presents with dyspnea, crackles in lung bases,
and jugular venous distension. Which medication does the nurse anticipate
administering first?
c) Furosemide
Rationale: Furosemide is a loop diuretic that reduces preload by promoting
fluid excretion, relieving pulmonary congestion and symptoms of fluid
overload.
3. Which laboratory value is most critical to monitor in a patient receiving
intravenous heparin therapy?
b) aPTT
Rationale: Activated partial thromboplastin time (aPTT) measures heparin’s
therapeutic effect; therapeutic range is typically 1.5–2.5 times the control
value.
4. A nurse is caring for a patient with acute kidney injury (AKI) in the oliguric
phase. Which finding requires immediate provider notification?
, d) Serum potassium of 6.2 mEq/L
Rationale: Hyperkalemia (K+ >5.5) in AKI can cause fatal cardiac
dysrhythmias; this level requires immediate intervention such as insulin,
dextrose, or dialysis.
5. A patient with chronic obstructive pulmonary disease (COPD) has an
oxygen saturation of 88% on room air. Which oxygen delivery device is
most appropriate?
c) Nasal cannula at 2 L/min
Rationale: Low-flow oxygen via nasal cannula prevents suppression of
hypoxic drive while improving saturation to 88–92% target range for COPD.
6. Which acid-base imbalance is most common in a patient with salicylate
overdose?
b) Mixed respiratory alkalosis and metabolic acidosis
Rationale: Salicylates directly stimulate respiratory center causing
respiratory alkalosis early, then uncouple oxidative phosphorylation leading
to metabolic acidosis.
7. A nurse is teaching a patient with type 2 diabetes about metformin. Which
adverse effect should the patient be instructed to report immediately?
d) Unexplained muscle pain or weakness
Rationale: Muscle pain can indicate lactic acidosis, a rare but serious
metformin complication, especially in renal impairment or hypoperfusion
states.
, 8. A patient post-myocardial infarction develops crackles in bilateral lung
bases and an S3 heart sound. The nurse recognizes these findings as
indicative of which condition?
c) Left-sided heart failure
Rationale: S3 gallop and pulmonary crackles are classic signs of left
ventricular failure with resulting pulmonary congestion.
9. Which dietary instruction is most important for a patient with hyperkalemia
secondary to chronic kidney disease?
b) Avoid oranges, bananas, and potatoes
Rationale: Oranges, bananas, and potatoes are high-potassium foods;
restriction helps prevent life-threatening hyperkalemia in CKD.
10. A nurse assesses a patient with pancreatitis who reports severe
abdominal pain radiating to the back. Which position typically provides the
most relief?
a) Leaning forward while sitting
Rationale: Leaning forward reduces tension on the pancreatic capsule and
may relieve pain in acute pancreatitis.
11. Which finding in a patient with cirrhosis is most suggestive of
progression to hepatic encephalopathy?
d) Asterixis (liver flap)
Rationale: Asterixis is a flapping tremor of the hands when wrists are
extended, indicating increased serum ammonia and encephalopathy.
