NR603 Adult Primary Care — Original Latest Version Study Set

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Sample questions from NR603 Adult Primary Care — Original Latest Version Study Set

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.At change of shift on a medical-surgical unit, a 68-year-old client with pneumonia has a new order for IV antibiotics. The client is alert, temperature 38.2 C, HR 104/min, RR 24/min, BP 118/72 mm Hg, and SpO2 93% on 2 L/min by nasal cannula. Which action should the nurse take first?

   • A.Teach the client to use the incentive spirometer every hour.
   • B.Administer the antibiotic immediately to reduce the fever.
   • C.Verify the client's allergies and obtain the prescribed cultures before the first antibiotic dose.
   • D.Ask the unlicensed assistive personnel to recheck the client's temperature.

   Rationale: Verifying allergies and obtaining ordered cultures before the first antimicrobial dose supports safe, timely treatment and preserves culture accuracy. Giving the antibiotic before cultures may reduce diagnostic yield, while incentive spirometry and temperature rechecking do not take priority over safe initiation of the prescribed therapy. The nurse should not delegate the assessment and safety checks required before medication administration.

2. 2.On a medical unit, a 74-year-old client with heart failure is being discharged with a new prescription for furosemide. The client says, "I sometimes cannot afford my medicines." Which action by the nurse best supports a safe discharge?

   • A.Tell the client to take the medication every other day to make it last longer.
   • B.Notify the prescriber and case manager to explore an affordable medication plan before discharge.
   • C.Document the concern and proceed with the existing discharge plan.
   • D.Ask a family member to pay for the medication without discussing options with the client.

   Rationale: The nurse should address the financial barrier with the prescriber and case manager so the client leaves with a feasible, safe treatment plan. Altering the dose without an order risks worsening heart failure, and documenting alone does not resolve the access problem. Involving family without the client's permission disregards autonomy and may not be practical.

3. 3.In an emergency department, a 63-year-old client with atrial fibrillation has sudden right facial droop and arm weakness that began 35 minutes ago. Glucose is 108 mg/dL, BP is 178/96 mm Hg, and the client is alert. Which action should the nurse take first?

   • A.Lower the blood pressure rapidly with an unscheduled medication.
   • B.Give oral aspirin and water immediately.
   • C.Wait to see whether the weakness resolves before notifying the stroke team.
   • D.Activate the stroke response and document the last-known-well time.

   Rationale: New focal neurologic deficits within a short onset window require immediate stroke-team activation and accurate last-known-well documentation. Oral intake is unsafe until swallowing is assessed, and unscheduled rapid blood pressure reduction can impair cerebral perfusion. Waiting can delay time-dependent assessment and treatment.

4. 4.On a rehabilitation unit, a 77-year-old client with a new prescription for warfarin asks whether to take an extra dose after missing yesterday's dose. The client has no bleeding, HR 78/min, and BP 132/76 mm Hg. Which response is best?

   • A.Do not double the dose; contact the anticoagulation prescriber for instructions.
   • B.Stop warfarin permanently because a missed dose makes it unsafe.
   • C.Take an over-the-counter aspirin instead of today's warfarin.
   • D.Take two doses today to make up for the missed dose.

   Answer and rationale are in the full material.

5. 5.In a family practice clinic, a 52-year-old client with type 2 diabetes reports burning and numbness in both feet. Which assessment is most important to include at today's visit?

   • A.Check visual acuity before examining the feet.
   • B.Recommend soaking the feet in hot water each night.
   • C.Ask only whether the client has pain while walking.
   • D.Inspect the feet and assess protective sensation, pulses, and footwear.

   Answer and rationale are in the full material.