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NU372 FINAL EXAM|2025-2026|180QUESTIONS&ANSWERS
WITH RATIONALES|A+GRADE
Which is the primary cause of otitis media in young children? An obstructed eustachian tube Rationale: A blocked eustachian tube impairs drainage and creates negative pressure; when the tube opens, bacteria are pulled into the middle ear. A client is prescribed rifampin after being exposed to active tuberculosis. Which finding would the nurse immediately report to the health care provider? Select all that apply. Small, red, pinpoint areas on the arms A client is being admitted to a medical unit with a diagnosis of pulmonary tuberculosis. Which type of room would the nurse assign this client? Negative-airflow room A client arrives at a health clinic stating, "I am here to have my tuberculin skin test read." The nurse notes that there is a 7-mm indurated area at the injection site. Which statement made by the nurse correctly describes this result? "The result indicates that you are infected with the tuberculosis organism." A client with tuberculosis receives instructions regarding isoniazid (INH) therapy from the assigned nurse. Which client statement indicates a misunderstanding of the content? "I should apply sunscreen and wear sun-protective clothing while going outside."
Rationale: This medication is not a photosensitive medication. All the rest of the statements are accurate. The nurse identifies 12 mm of induration at the site of a client's tuberculin purified protein derivative (PPD) test. Which rational would the nurse use to explain this test? The result indicates a need for further tests and a chest x-ray. Rationale: The test result is positive, not negative; thus further testing is necessary. It is the most accurate skin test for tuberculosis (TB) because of the testing material and the intradermal method used Which clinical manifestations are associated with a diagnosis of tuberculosis? Select all that apply. Hemoptysis Anorexia Night sweats Which client is at an increased risk for hospital-acquired pneumonia? Select all that apply.. Client who was admitted to the hospital 5 days ago for abdominal pain Rationale: Hospital-acquired pneumonia occurs in non-intubated clients and begins 48 hours after admission. A client admitted 5 days ago with abdominal pain would meet the criteria and is at increased risk for hospital-acquired pneumonia. A client admitted the previous day has not been in the hospital at least 48 hours. A client on mechanical ventilation is intubated and does not meet the criteria for hospital- acquired pneumonia. A client who has been on an airplane with other ill individuals would be at risk for community-acquired pneumonia. A client in the emergency department has not been admitted to the hospital.
Rationale: A gown, mask, and gloves when bathing the client prevent contact with feces, sputum, or other body fluids during intimate body care A client is admitted with cellulitis of the left leg and a temperature of 103°F (39.4°C). The primary health care provider prescribes intravenous (IV) antibiotics. Which action is the priority before administering the antibiotics? Determine the client's allergies. Which clinical manifestation is associated with cellulitis? Lymphadenopathy (swelling of the lymph nodes) Which assessment findings would the nurse identify in a client with clinical manifestations of rheumatoid arthritis (RA)? Select all that apply. *Development of antinuclear antibodies *Inflammatory disease pattern *Bilateral involvement of metacarpophalangeal joints When developing the plan of care for a client with rheumatoid arthritis, which client consideration would the nurse include? Comfort A client with rheumatoid arthritis has been taking a corticosteroid medication for the past year. Prolonged use of corticosteroids puts this client at increased risk for which complication? Decreased white blood cells
Which suggestion would the nurse make to a client with rheumatoid arthritis who asks about ways to decrease morning stiffness? Take a hot bath or shower in the morning. Rationale: Moist heat increases circulation and decreases muscle tension, which help relieve chronic stiffness Which factor explains why a client who experiences an acute episode of rheumatoid arthritis has swollen finger joints? Inflammation in the joint's synovial lining Which laboratory test would the nurse review for a client suspected to have rheumatoid arthritis? Antinuclear antibody The nurse is providing counseling to a client with the diagnosis of systemic lupus erythematosus (SLE). Which recommendations are essential for the nurse to include? Select all that apply..
- "Wear a large-brimmed hat."
- "Take your temperature daily."
- "Balance periods of rest and activity." The nurse is interviewing a client who was diagnosed with systemic lupus erythematosus (SLE). Which clinical findings to this disease would the nurse expect the client to exhibit? Select all that apply..
- Butterfly facial rash
- Inflammation of the joints
Rationale: Pneumocystis jiroveci causes pneumonia, which is the most common opportunistic infection in clients infected with the human immunodeficiency virus (HIV). Which clinic manifestations would the nurse expect to find in a client who has acute human immunodeficiency virus (HIV) infection? Select all that apply..
- Malaise
- Swollen lymph glands Rationale: Soon after being infected with HIV, many clients develop a flu-like syndrome called acute HIV infection. Clinical manifestations of this syndrome include malaise, swollen lymph glands, fever, sore throat, headache, nausea, diarrhea, muscle or joint pain, or a diffuse rash Which statement by the nursing student indicates understanding of the precautions needed in the provision of care to a child who is human immunodeficiency virus (HIV) positive? "I'll put on gloves if I'm going to be in contact with body fluids" Which statement by an adolescent during an annual physical examination indicates the need for human immunodeficiency virus (HIV) testing? I have shared needles when using drugs." The nurse is preparing to administer a vaccine to a child. Which conditions, if present, would allow for the safe administration of the vaccine? Select all that apply..
- Current antimicrobial therapy
- Mild to moderate local reactions
- Recent exposure to infectious diseases
A client expresses concern regarding the lack of annual flu vaccines because of a supply and demand problem. Which response by the nurse is best? "There are other things you and your family can do to prevent the flu, such as hand washing." Which causative agent is common to both hyperthermia and hypothermia? Alcohol Which activity places a client at risk for hyperthermia? Performing strenuous activity in high humidity The nurse assesses for which client symptoms that indicate hyperthermia? Select all that apply..
- Vasodilation
- Dry and flushed skin
- Decreased urinary output A client has a history of a persistent cough, hemoptysis, unexplained weight loss, fatigue, night sweats, and fever. Which risk would be assessed? Human immunodeficiency virus (HIV) infection A client reports fever, redness, skin breakdown, and inflammation on the leg. Upon assessment, the nurse finds the area to be tender and edematous with diffused borders. The nurse would anticipate teaching the client about which condition? Cellulitis
Which nursing action will be most helpful in preventing transmission of influenza in crowded communities? Educating about the importance of having annual vaccinations Which information would the nurse include when teaching about why women are more susceptible to urinary tract infections than men? The length of the urethra Which characteristic of urine changes in the presence of a urinary tract infection (UTI)? Clarity Which instruction would the nurse include in a health practices teaching plan for a female client with a history of recurrent urinary tract infections? "Wear cotton underwear or lingerie." A client recovering from deep partial-thickness burns develops chills, fever, flank pain, and malaise. The primary health care provider makes a tentative diagnosis of urinary tract infection. Which diagnostic tests would the nurse expect the primary health care provider to prescribe to confirm this diagnosis? Urinalysis with a urine culture and sensitivity A primary health care provider diagnoses the client's condition as otitis media. Which assessment finding supports that diagnosis? Redness of the eardrum The nurse would include which instruction to the parents of a child being treated with oral ampicillin for otitis media?
Complete the entire course of antibiotic therapy. Which factor would the nurse consider when the parent of a 10-month-old infant expresses frustration that this is the baby's third otitis media in 3 months? The eustachian tube is short and horizontal. The parent of a preterm infant asks the nurse in the neonatal intensive care unit why the baby is in a bed with a radiant warmer. How would the nurse explain the increased risk for hypothermia in preterm infants? Lack the subcutaneous fat that usually provides insulation While performing cardiac surgery, the cardiologist intentionally induces hypothermia in the client. Which rationale explains this intervention by the cardiologist? To prevent tissue ischemia Rationale: surgeons intentionally induce hypothermia to decrease the oxygen requirement of the tissues and ultimately prevent tissue ischemia. Which action would be the nurse's priority of care for a client with hypothermia? Removing the client from the cold environment Rationale: Hypothermia is associated with a decrease in core body temperature, which requires interventions that lead to an increase in the client's internal body temperature. The client should be first removed from the cold environment. Electrolytes should be administered once the client's temperature is controlled Which nursing intervention would prevent septic shock in the hospitalized client? Use aseptic technique during all invasive procedures.
Rationale: With hypovolemic shock, extravascular fluid depletion leads to client feeling of thirst. With hypovolemia, urine output will decrease due to compensatory mechanisms designed to retain volume When a client with hypovolemic shock has a hematocrit value of 25%, which fluid therapy will the nurse prepare to infuse? Packed red blood cells Rationale: Blood replacement is needed to increase the oxygen-carrying capacity of the blood; the expected hematocrit for women is 37% to 47% and for men is 42% to 52%. Which clinical manifestations would the nurse expect when assessing a client who is diagnosed with cardiogenic shock? Select all that apply..
- Tachycardia
- Restlessness
- Bradypnea Which assessment finding will the nurse expect when caring for a client who has cardiogenic shock? Cold, clammy skin Which change in the client's lab results indicates that the client is in septic shock? An increased serum lactate level Which nursing interventions would the nurse provide to an older client with hypertension? Select all that apply..
- Advise the client to limit salt intake
- Teach stress management
- Instruct the client to quit smoking A 78-year-old client who has hypertension is beginning treatment with furosemide. Considering the client's age, which would the nurse teach the client to do? Change positions slowly. Which of these clients seen at a health fair will be most at risk for hypertension 62 - year-old African American man Rationale: African Americans have the highest risk for hypertension; before the age of 45, men are at higher risk than women. When teaching a client with hypertension about a 2-gram sodium diet, which foods would the nurse instruct the client to avoid? Select all that apply.
- canned chili
- Luncheon meat A client with hypertension tells the nurse, "I took the blood pressure pills for a few weeks, but I didn't feel any different, so I decided I'd only take them when I feel sick." Which is the best action for the nurse to take? Ask the client questions to determine the current understanding of high blood pressure When a client with a history of hypertension that is usually successfully treated with medications has a blood pressure of 160/100 mm Hg during a clinic appointment, which action would the nurse take next? Question the client about symptoms such as headache or chest pain.
A client who is receiving atenolol for hypertension frequently reports feeling dizzy. Which effect of atenolol is responsible for this response? Blocking the adrenergic response Rationale: The beta-adrenergic blocking effect of atenolol decreases the heart's rate and contractility; it may result in orthostatic hypotension and decreased cerebral perfusion, causing dizziness Intravenous furosemide has been prescribed for a client with severe edema and hypertension. Which subjective clinical manifestations lead the nurse to suspect that the furosemide is infusing too rapidly? Select all that apply..
- Tinnitus
- Weakness
- Leg cramps Rationale: tinnitus is a CNS side effect of furosemide, weakness and leg cramps result from hypokalemia caused by an overload of furosemide, nausea and anorexia are side effects of dehydration that may occur with overload of furosemide. Dry mouth as well. A health care provider prescribes a diuretic for a client with hypertension. Which mechanism of action explains how diuretics reduce blood pressure? They reduce the circulating blood volume. Metoprolol is prescribed for a client with hypertension. The nurse monitors the client for which adverse effect? Bradycardia
Rationale: The client should be monitored for bradycardia, which can progress to heart failure or cardiac arrest. A client taking multiple medications for hypertension develops a persistent, hacking cough. Which antihypertensive medication class would the nurse identify as the likely cause of the cough? Angiotensin-converting enzyme (ACE) inhibitors Rationale: When ACE is inhibited, the increase of kinins in the lung can cause bronchial irritation, leading to the common adverse effect sometimes referred to as an ACE cough For which complication is a client with gestational hypertension at risk? Abruptio placentae Rationale: due to increased BP, vasospasms of placental vessels occur - > placenta may separate prematurely Which instruction will the home health nurse give when teaching a client with arterial insufficiency of both lower extremities? "Check pulses in the legs regularly." When a client with peripheral arterial disease returns to the nursing unit after a femoral angiogram, which action will the nurse take first? Assess the client's affected leg. When caring for a client with peripheral arterial insufficiency, how would the nurse position the client's feet and legs?
Frequent ambulation A client develops a deep vein thrombophlebitis in her leg 3 weeks after giving birth and is admitted for anticoagulant therapy. The nurse would anticipate developing a teaching plan for which anticoagulant? Heparin After giving a patient the initial dose of oral labetalol (Normodyne) for treatment of hypertension, which action should the nurse take? Ask the patient to request assistance when getting out of bed. A patient has just been diagnosed with hypertension and has a new prescription for captopril (Capoten). Which information is important to include when teaching the patient? Change position slowly to help prevent dizziness and falls The nurse in the emergency department received change-of-shift report on four patients with hypertension. Which patient should the nurse assess first? 43 - year-old with a BP of 190/102 who is complaining of chest pain A client is diagnosed with gestational hypertension and is receiving magnesium sulfate. Which finding would the nurse interpret as indicating a therapeutic level of medication? Deep tendons reflexes 2+ Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia? Calcium gluconate
A woman with gestational hypertension experiences a seizure. Which of the following would be the priority? Oxygenation When administering furosemide (Lasix) to a client who does not like bananas or orange juice, the nurse recommends that the client try which intervention to maintain potassium levels? Consume melons and baked potatoes. Which are risk factors that are known to contribute to atherosclerosis-related diseases? (Select all that apply.)
- Low-density lipoprotein cholesterol (LDL-C) of 160 mg/dL
- Smoking
- Type 2 diabetes You're developing a plan of care for a patient who is at risk for the development of a deep vein thrombosis after surgery. What nursing intervention below would the nurse NOT include in the patient's plan of care to prevent DVT formation? The nurse will apply sequential compression devices (SCDs) per physician's order to the patient's lower extremities every night at bedtime Rationale: Yes, the nurse would apply SCDs per MD order to help prevent DVTs, BUT they are to be applied and worn by the patient anytime they are in bed or sitting. The nurse is assessing a patient, who has many risk factors for the development of a DVT, for signs and symptoms of a deep vein thrombosis. What signs and symptoms below would possibly indicate a deep vein thrombosis is present?
