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NURS 275 Exam 2 2025 | Questions and
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A nurse in the ED is assessing a client who was in a motor vehicle crash. Findings include absent breath sounds in the left lower lobe with dyspnea, blood pressure 118/68 mm Hg, heart rate 124/min, RR 38/min, temp 38.6 degrees Celsius (101. degrees Farenheit) and SaO2 92% on room air. Which of the following actions should the nurse take first? A. Obtain chest x ray B. Prep for chest tube insertion C. Administer O2 via a high flow mask D. Initiate IV access ---------CORRECT ANSWER-----------------C A nurse is reviewing the health records of five clients. Which of the following clients are at risk for developing acute respiratory distress syndrome? (Select all that apply) A. A client who experienced a near drowning incident B. A client following coronary artery bypass graft surgery C. A client who has a hemoglobin of 15.1 mg/dL D. A client who has dysphagia E. A client who experienced acute drug toxicity ---------CORRECT ANSWER------------ -----A, B, D, E
A nurse is caring for a client who is receiving mechanical ventilation and is on pressure support ventilation (PSV) mode. Which of the following statements by the nurse indicates an understanding of PSV? A. "It keeps the alveoli open and prevents atelectasis" B. "It allows preset pressure delivered during spontaneous ventilation" C. "It guarantees minimal minute ventilator" D. "It delivers a preset ventilatory rate and tidal volume to the client" --------- CORRECT ANSWER-----------------B A nurse is caring for a client who is experiencing respiratory distress. Which of the following early manifestations of hypoxemia should the nurse recognize? (Select all that apply) A. Confusion B. Pale skin C. Bradycardia D. Hypotension E. Elevated blood pressure ---------CORRECT ANSWER-----------------B, E A nurse is caring for a client who is receiving mechanical ventilation via an ET tube. Which of the following actions should the nurse take?
ETake sleeping pills before going to bed. ---------CORRECT ANSWER-----------------A, B, C, D Which statement regarding type I hypersensitivity reactions is/are true? Select all that apply: A. Antihistamines are of minimal benefit because the reactions are mediated by IgE rather than histamine B. The response is characterized by the five cardinal symptoms of inflammation C. Type I responses are usually directed against non self but the response is excessive D. Susceptibility for developing a type I hypersensitivity response follows an X linked recessive pattern of inheritance E. This type of hypersensitivity reaction is most strongly associated with systemic lupus erythematosus F. Responses always occur within minutes of exposure to the allergen G. The second phase of the reaction with accumulation of excess bradykinin is responsible for development of angioedema ---------CORRECT ANSWER--------------- --B, C, G Which action will the nurse perform first for a client in anaphylaxis to prevent harm? A. Apply oxygen by nonrebreather mask B. Administering IV diphenydramine
C. Injecting epinephrine D. Initiating IV access ---------CORRECT ANSWER-----------------C A client in progressive stage of hypovolemic shock has all of the following signs, symptoms or changes. Which signs will the nurse attribute to ongoing compensatory mechanisms? Select all that apply A. Increasing pallor B. Increasing thirst C. Increasing confusion D. Increasing heart rate E. Increasing respiratory rate F. Decreasing systolic blood pressure G. Decreasing blood pH H. Decreasing urine output ---------CORRECT ANSWER-----------------A, B, D, E, H The nurse is reviewing the lab profile of a client with hypovolemic shock. What lab value will the nurse anticipate? A. pH 7. B. PaO2 106 mm Hg C. Paco2 49 mm Hg D. Lactate 0.4 mmol/L ---------CORRECT ANSWER-----------------C
The nurse is caring for a client with hypovolemic shock. Which new assessment finding indicates to the nurse that the interventions are currently effective? A. Oxygen saturation remains unchanged B. Core body temp has increased to 99 degrees F (37.2 degrees celcius) C. The client correctly states the month and year D. Serum lactate and serum potassium levels are declining ---------CORRECT ANSWER-----------------D The nurse is caring for a client in the initial stage of hypovolemic shock. What assessment data will the nurse anticipate? A. HR 118 bpm B. 2+ pedal pulses C. Bilateral fine crackles in lung bases D. BP change from 100/60 to 100/40 mmHg ---------CORRECT ANSWER----------------
- A The nurse is assessing a client with septic shock. What assessment data indicate a progression of shock? Select all that apply A. BP change from 86/50 to 100/64 mm Hg B. HR change from 98 to 76 bpm C. Cool and clammy skin
D. Petechiae along the gum line E. Urine output 45 mL/hr ---------CORRECT ANSWER-----------------A, C, D The patient in hypovolemic shock is prescribed an infusion of lactated ringer's. What is the purpose for infusing this solution in shock? (Select all that apply) A. The solution will help to replace fluid and promote urine output B. The solution will draw water into the cells C. The solution will draw water from cells to blood vessels D. The solution will maintain vascular volume E. The solution is used to provide adequate calories for metabolic needs --------- CORRECT ANSWER-----------------A, D TRUE or FALSE: Ventricular fibrillation (V-fib) is a lethal rhythm that results in the quivering of the ventricles which leads to a rapid fall in cardiac output. A. True B. False ---------CORRECT ANSWER-----------------A The nurse sees Vfib on the ECG. The patient is unresponsive and has no pulse. The nurse calls a code blue and takes what step next? A. Prepare for defibrillation
TRUE or FALSE: Torsades de pointes is known as a type of monomorphic ventricular tachycardia.(Required) A. True B. False ---------CORRECT ANSWER-----------------B Your patient is unresponsive and the cardiac monitor shows Torsades de Pointes as the patient's rhythm. As the code team is attempting to resuscitate the patient, you look through the patient's electronic health record to try to determine a potential cause for this rhythm. What found in the patient's record is a cause of this rhythm? A. Magnesium level 2 mg/dL B. Amiodarone C. Potassium 5 mEq/L D. Glyburide ---------CORRECT ANSWER-----------------B (can cause prolonged QT interval- common cause of Torsades) The patient is experiencing Vtach. You assess the patient and find the patient is having no symptoms and a pulse is present. What type of treatment do you anticipate will be ordered for this patient? A. CPR B. Defibrillation C. Amiodarone IV
D. Digoxin IV ---------CORRECT ANSWER-----------------C The patient is experiencing vtach. The patient is presenting with a blood pressure of 70/42, mental status changes, and is clammy and pale. A pulse is present. The nurse preps the patient for? A. CPR B. Synchronized cardioversion C. Defibrillation D. Atropine IV ---------CORRECT ANSWER-----------------B The patient is experiencing torsades de pointes. The patient is unresponsive and has no pulse. What order below would the nurse ask for clarification if received? A. IV Amiodarone B. IV Magnesium Sulfate C. Defibrillation D. IV epinephrine ---------CORRECT ANSWER-----------------A A patient is experiencing ventricular tachycardia and is unresponsive with no pulse. After activating the emergency response system, the nurse would immediately?
A. Prepare the patient for defibrillation B. Check the H's and T's C. Administer Atropine D. Start CPR ---------CORRECT ANSWER-----------------D What medication can be administered during resuscitation to a patient who is in asystole? A. Amiodarone B. Epinephrine C. Atropine D. Adenosine ---------CORRECT ANSWER-----------------B An attempt by a primary health care provider to intubate a client for mechanical ventilation is unsuccessful after 45 seconds. What is the nurse's priority action? A. Placing a nasotracheal tube B. Assessing for bilateral breath sounds C. Assessing O2 sat by pulse oximetry D. Applying oxygen with a bag valve mask device ---------CORRECT ANSWER---------- -------D
Which actions does the nurse ensure are performed for a client being mechanically ventilated to prevent ventilator associated pneumonia (VAP)? Select all that apply: A. Assessing temp every 4 hours B. Checking the ventilator settings every 4 hours C. Getting the patient out of bed as soon as prescribed D. Keeping the head of bed elevated to 30 degrees or above E. Maintaining the client in prone position F. Providing adequate humidification G. Providing meticulous mouth care every 12 hours H. Suggesting that pneumonia vaccine be prescribed ---------CORRECT ANSWER----- ------------C, D, G A client being mechanically ventilated has all of the following changes. Which changes are most relevant in helping the nurse determine whether suctioning is needed at this time? Select all that apply: A. Decreased SpO B. Elevated temperature C. Crackles auscultated over the trachea D. Crackles auscultated in the lung periphery E. High pressure ventilator alarm sounds F. Presence of fluid within the endotracheal tube
A nurse assesses a client who reports waking up feeling very tired, even after 8 hours of good sleep. Which action should the nurse take first? a.Contact the provider for a prescription for sleep medication. b.Tell the client not to drink beverages with caffeine before bed. c.Educate the client to sleep upright in a reclining chair. d.Ask the client if he or she has ever been evaluated for sleep apnea. --------- CORRECT ANSWER-----------------D The most effective treatments for sleep apnea include all of the following EXCEPT a. weight loss. b. the use of stimulant drugs. c. the use of a continuous positive airway pressure (CPAP) mask. d. surgery for breathing obstructions. ---------CORRECT ANSWER-----------------B Signs and symptoms of sleep apnea include which of the following? a. Loud snoring b. Difficulty falling asleep c. Headache in the evening d. Nighttime sleepiness ---------CORRECT ANSWER-----------------A
What is the rationale for using CPAP to treat sleep apnea? A) positive air pressure holds the airway open B) negative air pressure holds the airway closed C) delivery of oxygen facilitates respiratory effort D) alternating waves of air stimulate breathing ---------CORRECT ANSWER------------ -----A A 32-year-old morbidly obese male complains of excessive fatigue, snoring, and awakening in the middle of the night, which prevents restorative sleep.He is sluggish during the day due to the lack of sleep and feels like he is going "fall asleep at the wheel" when driving to work. Occupation: dishwasher. Medical history includes hypertension and type 2 diabetes. Current medications include ACE inhibitor and metformin. Denies use of alcohol, tobacco, or drugs. On physical examination, the patient is afebrile, pulse 88, resps 20/min, BP 178/95. BMI is 45.These are signs and symptoms of: A. Obstructive sleep apnea B. Primary insomnia C. Heart failure D. All of the above ---------CORRECT ANSWER-----------------A Which problem is associated with obesity, heavy snoring, and shallow breathing?
A patient's partner informs the nurse that the patient wakes up with a startle and gasps for breath several times at night. The nurse understands the patient is experiencing sleep apnea. What are the common risk factors in this patient for sleep apnea? Select all that apply. A Body mass index (BMI) 30 kg/m B Age 44 years C Habit of smoking D.Neck circumference 18 inches E .Occasional consumption of alcohol ---------CORRECT ANSWER-----------------A, C, D A patient with sleep apnea asks the nurse, "What can I do to get better sleep?" What is an appropriate nursing response? A"Taking one to two sleeping pills at night will prevent sleep apneic episodes." B"Keeping your hypertension under control is beneficial for general health." C"Being overweight is a contributing factor; losing weight can often resolve apnea." D"High blood glucose levels contribute to the apnea; monitor your sugar carefully." ---------CORRECT ANSWER-----------------C
The nurse evaluates the effectiveness of dopamine therapy for a patient in shock. Which of the following may indicate treatment is successful? (Select all that apply) A. Improved urine output B. Increased blood pressure C. Slight hypotension D. Intact peripheral pulses ---------CORRECT ANSWER-----------------A, B A patient who is experiencing shock is started on norepinephrine (Levophed) by IV drip. Why must the nurse conduct frequent inspections of the IV insertion site while the patient remains on this drug? A. The patient's BP may rise if the site is occluded B. Extravasation and leakage at the IV site may cause local tissue damage C. Bleeding may occur from the site due to localized drug effects D. The patient's BP may drop precipitously if the IV runs too quickly --------- CORRECT ANSWER-----------------B A patient is starting to receive dobutamine by IV infusion for treatment of shock. This drug is particularly useful for which type of shock? A. Anaphylactic B. Septic
