Nada Study Guide

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Sample questions from Nada Study Guide

This material has 20 questions with answers and rationales. Here are the first 5.

1. 1.A patient with left-sided heart failure develops shortness of breath and bilateral lung crackles. Which physiologic change best explains these findings?

   • A.Reduced plasma glucose causes fluid to move into the alveoli.
   • B.Increased pulmonary capillary pressure causes fluid to accumulate in lung tissue.
   • C.Reduced systemic venous pressure causes blood to collect in the lungs.
   • D.Increased airway smooth muscle contraction causes pulmonary fluid retention.

   Rationale: Left-sided heart failure increases pressure in the pulmonary circulation, promoting fluid movement into lung tissue and causing dyspnea and crackles. Low glucose does not explain pulmonary congestion. Reduced systemic venous pressure is not the mechanism. Airway smooth muscle contraction causes bronchoconstriction, not the fluid accumulation characteristic of heart failure.

2. 2.An older adult reports dizziness when standing and recently started a prescribed diuretic. Which focused assessment is most appropriate to investigate the symptom?

   • A.Measure blood pressure and pulse after lying down and again after standing with assistance.
   • B.Compare pupil size before and after exposure to light.
   • C.Measure oxygen saturation before and after incentive spirometry.
   • D.Assess abdominal sounds before and after eating.

   Rationale: Position-related dizziness may indicate orthostatic hypotension, especially with diuretic-associated volume loss. Measuring blood pressure and pulse supine and standing helps identify this problem; assistance reduces fall risk. Pupil responses assess neurologic function but do not directly evaluate this pattern. Oxygen response to spirometry and bowel sounds do not assess postural blood pressure changes.

3. 3.A patient receiving furosemide for fluid overload has new muscle weakness. Which laboratory result requires prompt follow-up before the nurse administers the next scheduled dose?

   • A.Serum sodium of 138 mEq/L
   • B.Serum creatinine of 0.9 mg/dL
   • C.Serum potassium of 2.9 mEq/L
   • D.Serum calcium of 9.4 mg/dL

   Rationale: Potassium of 2.9 mEq/L indicates hypokalemia, which can cause weakness and dangerous dysrhythmias. Furosemide increases urinary potassium loss, so the nurse should promptly contact the prescriber and clarify treatment before the next dose. Sodium of 138 mEq/L, creatinine of 0.9 mg/dL, and calcium of 9.4 mg/dL are generally within adult reference ranges and do not explain this concern.

4. 4.An adult with diabetes is awake, can swallow safely, and reports shakiness and sweating. The blood glucose level is 58 mg/dL. Which action should the nurse take first?

   • A.Administer the prescribed rapid-acting correction insulin.
   • B.Give 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes.
   • C.Provide a high-fat snack and recheck glucose in 1 hour.
   • D.Give intramuscular glucagon despite the patient's ability to swallow.

   Answer and rationale are in the full material.

5. 5.A patient with heart failure is preparing for discharge and prefers health information in a language the nurse does not speak. Which approach best evaluates readiness for home self-management?

   • A.Give written instructions in English and ask whether the patient understands.
   • B.Ask an adult family member to interpret the discharge instructions instead of arranging a qualified interpreter.
   • C.Use a qualified medical interpreter and ask the patient to explain the daily weight routine and when to contact the care team.
   • D.Read the translated discharge instructions aloud without asking the patient to describe the plan.

   Answer and rationale are in the full material.