NUR 290 Final

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Sample questions from NUR 290 Final

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

1. 1.A 72-year-old client is admitted to a medical unit with pneumonia. The client is newly confused, has an oxygen saturation of 86% on room air, a respiratory rate of 30/min, and a temperature of 38.6 C (101.5 F). Which action should the nurse take first?

   • A.Apply oxygen and reassess respiratory status
   • B.Obtain a urine specimen for culture
   • C.Reorient the client to the date and location
   • D.Administer the prescribed antipyretic

   Rationale: Hypoxemia and tachypnea indicate an immediate breathing problem, so the nurse should support oxygenation first. A urine culture and antipyretic may be appropriate later but do not address the urgent threat. Reorientation alone will not correct confusion caused or worsened by hypoxemia; use the ABC priority framework.

2. 2.A 34-year-old client with type 1 diabetes is in the emergency department with vomiting, abdominal pain, and deep rapid respirations. Glucose is 486 mg/dL, potassium is 5.6 mEq/L, and arterial pH is 7.18. Which prescription should the nurse implement first?

   • A.Begin an isotonic IV fluid bolus
   • B.Administer IV potassium chloride
   • C.Give subcutaneous long-acting insulin
   • D.Restrict oral and IV fluids

   Rationale: The client has diabetic ketoacidosis with likely severe volume depletion, making isotonic fluid replacement the first intervention. Potassium is elevated, so potassium replacement is not appropriate initially; insulin is given after fluid therapy and potassium assessment according to protocol. Fluid restriction would worsen dehydration, and the takeaway is to restore circulation before correcting glucose.

3. 3.A 68-year-old client with heart failure is receiving IV furosemide on a telemetry unit. The client reports new palpitations; the monitor shows frequent premature ventricular contractions, and potassium is 2.9 mEq/L. Which action is most appropriate?

   • A.Notify the provider and anticipate potassium replacement
   • B.Administer the next furosemide dose early
   • C.Encourage the client to ambulate in the hallway
   • D.Document the rhythm as an expected medication effect

   Rationale: Hypokalemia can trigger dangerous ventricular dysrhythmias, so the nurse should promptly report the findings and anticipate replacement. An additional diuretic dose may worsen potassium loss, while ambulation does not address the rhythm risk. Documenting without intervention is unsafe; monitor the ECG and potassium during correction.

4. 4.A 79-year-old client with a urinary tract infection is admitted from home. The client is febrile at 39.1 C (102.4 F), has a blood pressure of 82/46 mm Hg, a heart rate of 126/min, and a lactate of 4.1 mmol/L. Which action should the nurse prioritize?

   • A.Activate the facility sepsis response and begin prescribed fluid resuscitation
   • B.Give an oral antipyretic and recheck the temperature in one hour
   • C.Obtain a detailed home medication history before intervening
   • D.Encourage oral fluids and assist the client to the bathroom

   Answer and rationale are in the full material.

5. 5.A 58-year-old client arrives at the emergency department 40 minutes after sudden right-sided weakness and difficulty speaking began. Blood glucose is 112 mg/dL and blood pressure is 178/96 mm Hg. Which action should the nurse take first?

   • A.Activate the stroke response and prepare for rapid brain imaging
   • B.Give aspirin before obtaining imaging
   • C.Lower the blood pressure rapidly with an IV medication
   • D.Offer water to assess swallowing

   Answer and rationale are in the full material.