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NUR 3226 Adult Health Nursing II Midterm Exam Questions And Correct Answers (Verified Ans, Exams of Nursing

Western Carolina University (WCU)Nursing

NUR 3226 Adult Health Nursing II Midterm Exam Questions And Correct Answers (Verified Answers) Plus Rationales 2025

Typology: Exams

2024/2025

Available from 06/23/2025

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NUR 3226 Adult Health Nursing II Midterm
Exam Questions And Correct Answers
(Verified Answers) Plus Rationales 2025
1. A nurse is caring for a client with heart failure who is experiencing
dyspnea. Which of the following actions should the nurse take first?
Elevate the head of the bed
Elevating the head of the bed promotes lung expansion and
improves oxygenation in clients experiencing difficulty breathing.
2. A client with chronic kidney disease reports muscle cramps and
tingling. Which electrolyte imbalance is most likely?
Hypocalcemia
Low calcium levels are common in CKD and cause neuromuscular
irritability, leading to cramps and tingling.
3. Which lab value is most concerning in a client receiving heparin
therapy?
Platelets 90,000/mm³
Heparin-induced thrombocytopenia is a serious complication;
platelets <150,000 is concerning, <100,000 is critical.
4. A nurse is caring for a client post-thyroidectomy. What is the
priority assessment?
Airway patency
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Download NUR 3226 Adult Health Nursing II Midterm Exam Questions And Correct Answers (Verified Ans and more Exams Nursing in PDF only on Docsity!

NUR 3226 Adult Health Nursing II Midterm

Exam Questions And Correct Answers

(Verified Answers) Plus Rationales 2025

  1. A nurse is caring for a client with heart failure who is experiencing dyspnea. Which of the following actions should the nurse take first? Elevate the head of the bed

Elevating the head of the bed promotes lung expansion and

improves oxygenation in clients experiencing difficulty breathing.

  1. A client with chronic kidney disease reports muscle cramps and tingling. Which electrolyte imbalance is most likely? Hypocalcemia

Low calcium levels are common in CKD and cause neuromuscular

irritability, leading to cramps and tingling.

  1. Which lab value is most concerning in a client receiving heparin therapy? Platelets 90,000/mm³

Heparin-induced thrombocytopenia is a serious complication;

platelets <150,000 is concerning, <100,000 is critical.

  1. A nurse is caring for a client post-thyroidectomy. What is the priority assessment? Airway patency

Swelling or bleeding after thyroid surgery can compromise the

airway, making it the top priority.

  1. A client with COPD is receiving oxygen at 4 L/min via nasal cannula. What is the priority nursing action? Decrease oxygen flow rate

High-flow oxygen can suppress the respiratory drive in COPD clients.

  1. A client is receiving furosemide. Which finding should be reported immediately? Potassium 2.8 mEq/L

Furosemide can cause hypokalemia, increasing the risk for

arrhythmias.

  1. Which dietary choice is best for a client with cirrhosis and ascites? Grilled chicken with steamed vegetables

Clients with cirrhosis need high-protein (if no encephalopathy) and

low-sodium meals.

  1. What is the priority teaching for a client prescribed warfarin? Avoid taking aspirin unless prescribed

Both warfarin and aspirin increase bleeding risk; combined use

should be physician-approved.

  1. What assessment finding indicates worsening heart failure? Weight gain of 3 lbs in 2 days
  1. What is an expected finding in a client with chronic bronchitis? Productive cough for at least 3 months

Chronic bronchitis is defined by a persistent productive cough.

  1. A nurse is caring for a client with pancreatitis. Which lab finding should be monitored? Amylase

Amylase and lipase are elevated in pancreatitis.

  1. What is the priority nursing intervention for a client with an upper GI bleed? Insert a large-bore IV catheter

IV access allows for rapid fluid/blood replacement.

  1. Which is a common side effect of isoniazid? Peripheral neuropathy

Isoniazid can deplete vitamin B6, causing neuropathy.

  1. A nurse reviews ABGs: pH 7.50, PaCO₂ 30, HCO₃ 24. What is the interpretation? Respiratory alkalosis High pH and low CO ₂ indicate respiratory alkalosis.
  2. What should be avoided in a client with liver cirrhosis? Acetaminophen

Acetaminophen is hepatotoxic and should be avoided in liver disease.

  1. A client with a new AV fistula for dialysis needs further teaching if they state:

"I will measure my blood pressure in that arm."

Blood pressure should not be taken on the fistula arm to prevent

damage.

  1. Which finding indicates digoxin toxicity? Visual disturbances

Blurred vision and yellow halos are classic signs of digoxin toxicity.

  1. What is a key symptom of left-sided heart failure? Pulmonary congestion

Left-sided HF backs up into the lungs causing crackles and dyspnea.

  1. Which client is at highest risk for colorectal cancer? A 55-year-old with ulcerative colitis

Ulcerative colitis significantly increases the risk of colon cancer.

  1. What intervention prevents ventilator-associated pneumonia? Oral care every 2 hours

Frequent oral hygiene reduces colonization and risk of pneumonia.

  1. Which medication should be avoided in a client with asthma? Propranolol

Non-selective beta-blockers can cause bronchoconstriction.

  1. A nurse is teaching about nitroglycerin. Which statement indicates understanding? "I will call 911 if chest pain persists after the first dose."

Immediate medical help is needed if the first dose is ineffective.

  1. A client on lithium reports nausea and tremors. What should the nurse assess next? Serum lithium level

These are signs of lithium toxicity; levels should be checked

immediately.

  1. What assessment finding is expected in a client with Cushing's syndrome? Buffalo hump

Excess cortisol causes fat redistribution including the upper back.

  1. Which position is appropriate for a client after liver biopsy? Right side-lying

Lying on the right side applies pressure to the biopsy site, reducing

bleeding risk.

  1. Which condition places a client at risk for metabolic acidosis? Diabetic ketoacidosis

DKA causes a build-up of ketones, leading to metabolic acidosis.

  1. What is a common side effect of chemotherapy? Neutropenia

Bone marrow suppression often leads to low white cell counts.

  1. What is the best method to assess for fluid volume excess? Daily weights

Weight is the most sensitive indicator of fluid balance.

  1. Which lab value is consistent with liver failure? Elevated ammonia

Ammonia accumulates when the liver cannot convert it to urea.

  1. Which interve ntion is appropriate for a client with Raynaud’s disease? Wear warm gloves in cold weather

Raynaud’s is triggered by cold; warmth is preventative.

  1. A client receiving vancomycin develops red flushing. What is the most likely cause? Infusion rate too fast

Red man syndrome occurs when vancomycin is infused rapidly.

  1. What action helps prevent complications in a client with peripheral arterial disease? Inspect feet daily

PAD increases risk for ulcers and gangrene; foot care is essential.

  1. Which is a complication of untreated obstructive sleep apnea? Hypertension

OSA causes hypoxia and sympathetic activation, leading to high BP.

  1. A nurse is reviewing ECG and sees ST elevation. What is the priority action? Notify the provider immediately

ST elevation suggests MI; it is a medical emergency.

  1. A client with ulcerative colitis is experiencing frequent diarrhea. Which intervention is appropriate? Maintain a low-residue diet

A low-residue diet reduces bowel movements and irritation in clients

with ulcerative colitis.

  1. What is the best position for a client experiencing a pulmonary embolism? High Fowler’s

Sitting upright improves ventilation and oxygenation.

  1. A nurse is caring for a client post-laminectomy. What is the priority assessment? Extremity movement and sensation

Assessing for spinal nerve damage is essential following spine surgery.

  1. Which instruction should be included for a client taking prednisone? Do not stop taking the medication abruptly

Abrupt discontinuation can cause adrenal insufficiency.

  1. A client is admitted with a myasthenic crisis. What is the priority action? Assist with mechanical ventilation

Myasthenic crisis involves respiratory muscle weakness requiring

ventilatory support.

  1. Which finding in a client with chronic liver disease indicates hepatic encephalopathy? Asterixis

Asterixis (flapping tremor) is a classic sign of hepatic encephalopathy.

  1. A client with bacterial pneumonia is producing thick yellow sputum. What should the nurse do? Encourage fluid intake

Increased fluids help thin secretions for easier expectoration.

  1. A nurse notes a new systolic murmur in a client with endocarditis. What should be done first? Notify the provider

New murmurs may indicate valve damage and require immediate

attention.

  1. What instruction is important for a client undergoing a stress test? Avoid caffeine the day of the test

Caffeine can interfere with heart rate and blood pressure responses.

  1. A client with a DVT is started on enoxaparin. What lab should the nurse monitor? Platelet count

Enoxaparin can cause thrombocytopenia; platelets must be

monitored.

  1. A client with systemic lupus erythematosus reports joint pain and fatigue. What is the priority intervention?

Encourage use of a walker

Mobility aids help prevent falls and promote safety.

  1. A nurse notes coffee-ground emesis in a client. What does this indicate? Upper gastrointestinal bleeding

Coffee-ground emesis suggests partially digested blood.

  1. What assessment finding is associated with peripheral arterial disease? Pale, cool extremities

Reduced arterial flow causes pallor and coolness.

  1. A client with hypocalcemia may experience which sign? Positive Chvostek's sign

Chvostek’s sign is facial twitching when the cheek is tapped.

  1. A client is prescribed lactulose. What is the therapeutic effect? Decreased serum ammonia

Lactulose traps ammonia in the colon for excretion.

  1. Which lab result suggests a complication of chemotherapy? WBC count of 1,000/mm³

Severe neutropenia increases infection risk.

  1. What assessment finding supports a diagnosis of appendicitis? Rebound tenderness in the RLQ

Rebound tenderness over McBurney's point is classic for appendicitis.

  1. Which lab value confirms a diagnosis of pancreatitis? Lipase 800 U/L

Lipase is more specific than amylase for diagnosing pancreatitis.

  1. A client with cirrhosis has ascites. Which intervention is appropriate? Restrict sodium intake

Sodium restriction helps reduce fluid accumulation in the abdomen.

  1. What should a nurse do before administering metoprolol? Check apical pulse

Beta-blockers can cause bradycardia; pulse should be >60 bpm.

  1. Which finding indicates a complication of diabetes insipidus? Urine specific gravity of 1.

Very dilute urine is expected in diabetes insipidus due to lack of

ADH.

  1. What is an early sign of increased intracranial pressure? Change in level of consciousness

Altered LOC is usually the first sign of rising ICP.

  1. Which is an expected finding in a client with chronic kidney disease? Elevated BUN and creatinine

Impaired kidney function leads to waste product accumulation.

  1. A nurse notes jugular vein distention in a client with heart failure. What does this indicate?

A drop in systolic BP >10 mmHg during inspiration indicates

tamponade.

  1. A client with MS reports blurry vision and fatigue. What should the nurse do? Encourage periods of rest throughout the day

MS symptoms worsen with heat and fatigue.

  1. What is the best method to confirm placement of a nasogastric tube? X-ray of the abdomen

X-ray is the gold standard for confirming NG tube placement.

  1. Which finding is a red flag during a blood transfusion? Back pain and chills

These are signs of a hemolytic reaction, requiring immediate

intervention.

  1. A client is newly diagnosed with hypertension. What should the nurse teach? Limit sodium to 2,300 mg/day or less

Dietary sodium contributes to fluid retention and high blood pressure.

  1. A nurse administers insulin lispro at 8:00 AM. When should the nurse monitor for hypoglycemia? 9:00 AM

Lispro peaks 30-90 minutes after administration.

  1. A client has a serum sodium of 128 mEq/L. What finding is expected? Confusion

Hyponatremia can lead to cerebral edema and altered mental

status.

  1. A client with diverticulitis should avoid which food? Nuts and seeds

These can lodge in diverticula and cause inflammation.

  1. What does a high BNP level indicate in a client with shortness of breath? Heart failure

BNP is released in response to ventricular stretching in HF.

  1. A client with rheumatoid arthritis reports morning stiffness. What is the nurse’s best response? "Try taking a warm shower each morning."

Heat therapy can relieve joint stiffness in RA.

  1. Which lab value indicates therapeutic effect of warfarin? INR of 2.

The target INR for anticoagulation is typically 2.0–3.0.

  1. A nurse is assessing a client for compartment syndrome. What is a concerning finding? Pain unrelieved by medication