NU 160 Final Spring 2025 Exams | Unlimited Practice | Premium Support | The Prep Site Nurses Trust Most
Nursing Exams
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A nurse is teaching a client who has acute kidney disease about fluid restrictions. Which of the following statements by the client should the nurse identify as understanding of the teaching
I will make a list of my favorite beverages.
I will not add ice cream to the amount of fluid intake.
I will put beverages in large containers to give the appearance of drinking a lot.
I should consume most of the fluid during the evening.
Correct Answer A: I will make a list of my favorite beverages.
Explanation:
Clients with acute kidney injury must strictly monitor fluid intake to avoid volume overload. Making a list of favorite beverages helps patients prioritize which fluids they enjoy most and plan their daily intake wisely. It reflects understanding and participation in self-management.
Why Other Options are Wrong:
B. I will not add ice cream to the amount of fluid intake.
This reflects a misunderstanding. Foods like ice cream, gelatin, and soup must be counted toward total fluid intake because they melt into liquid. Excluding them could lead to unintentional fluid overload.
C. I will put beverages in large containers to give the appearance of drinking a lot.
This strategy can be misleading. The goal is to limit actual intake, not create an illusion. This statement shows the client is trying to trick themselves, which is not appropriate for managing a strict restriction.
D. I should consume most of the fluid during the evening.
This can lead to discomfort, nocturia, and sleep disturbances. Fluids should be spaced evenly throughout the day to avoid complications and ensure better management of fluid balance.
A nurse is caring for a client who has an unrepaired femur fracture of the midshaft. Which of the following techniques should the nurse use when performing an assessment of the client's neurovascular status
Instruct the client to wiggle his toes
Monitor the client’s calf for edema
Measure the circumference of the thigh
Palpate the femoral pulse
Correct Answer A: Instruct the client to wiggle his toes
Explanation:
Assessing neurovascular status involves checking for circulation, movement, and sensation (CMS). Having the client wiggle their toes assesses motor function, which is critical for identifying possible nerve impairment or compartment syndrome following a fracture. It's a key component of the "6 P's" of neurovascular assessment: pain, pallor, pulselessness, paresthesia, paralysis, and poikilothermia.
Why Other Options are Wrong:
B. Monitor the client’s calf for edema
While edema may indicate complications, it is a nonspecific sign and not a direct test of neurovascular integrity.
C. Measure the circumference of the thigh
This may help monitor swelling, but it is not a reliable or essential method for assessing neurovascular status.
D. Palpate the femoral pulse
The femoral pulse is located in the groin, not distal to the fracture site. Neurovascular checks for a femur fracture typically focus on distal pulses (like dorsalis pedis or posterior tibial), movement, and sensation in the foot.
A client with peptic ulcer disease is prescribed sucralfate. What is the primary action of sucralfate in the treatment of ulcers
Sucralfate promotes healing of the ulcer by increasing blood flow to the area
Sucralfate coats the ulcer and protects it from the actions of pepsin and acid.
Sucralfate neutralizes stomach acid.
Sucralfate inhibits the growth of H. pylori bacteria.
Correct Answer B: Sucralfate coats the ulcer and protects it from the actions of pepsin and acid.
Explanation:
B. Sucralfate coats the ulcer and protects it from the actions of pepsin and acid.
Sucralfate is a medication that works by forming a protective barrier over the ulcer. This barrier helps protect the ulcer from the damaging effects of stomach acid and pepsin, promoting healing. It does not directly affect the acid production or the bacteria but instead protects the ulcerated area.
Why the Other Options Are Incorrect:
A. Sucralfate promotes healing of the ulcer by increasing blood flow to the area.
Sucralfate does not increase blood flow to the ulcer. Its primary function is to form a protective barrier over the ulcer, which helps in healing, but it doesn't enhance blood circulation.
C. Sucralfate neutralizes stomach acid.
This is incorrect because sucralfate does not neutralize stomach acid. Medications such as antacids or proton pump inhibitors (PPIs) are used for neutralizing stomach acid. Sucralfate works differently by creating a protective coating on the ulcer.
D. Sucralfate inhibits the growth of H. pylori bacteria.
Sucralfate does not directly inhibit H. pylori growth. While H. pylori infection is a common cause of peptic ulcers, sucralfate does not target the bacteria itself. H. pylori infections are typically treated with antibiotics or proton pump inhibitors.
Which of the following risk factors is associated with a client having a higher risk of experiencing status asthmaticus
Previous intubation due to status asthmaticus episode
Previous stroke
Bronchial pneumonia
Irritants and hypersensitivity to medications
Correct Answer A: Previous intubation due to status asthmaticus episode
Explanation:
Status asthmaticus is a life-threatening condition where an asthma attack does not respond to standard treatment. A history of intubation due to a past status asthmaticus episode strongly indicates severe, uncontrolled asthma and places the client at a significantly higher risk for recurrence. This history reflects a pattern of dangerous exacerbations and poor response to routine interventions.
Why Other Options are Wrong:
B. Previous stroke:
While a stroke affects neurologic and sometimes respiratory function, it is not directly related to the severity or recurrence of asthma or status asthmaticus.
C. Bronchial pneumonia:
Though pneumonia can exacerbate asthma symptoms, it is not a predictive or primary risk factor for status asthmaticus. It's an acute condition rather than a chronic indicator of asthma control.
D. Irritants and hypersensitivity to medications:
While these may trigger asthma episodes, they are not as significant or specific a risk factor for status asthmaticus as a past intubation episode, which clearly reflects prior severe respiratory compromise.
A nurse is caring for a client in a clinic who has foul-smelling urine, a low-grade fever of 37.7°C (100°F), and pain with urination. Which of the following should the nurse expect the health care provider to order
0.9% sodium chloride infusion at 100 mL/hr
Foley catheter placement
Broad-spectrum antibiotic
A clean-catch urinalysis and urine culture
WBC count
Blood cultures x2
Correct Answers
C: Broad-spectrum antibiotic
D: A clean-catch urinalysis and urine culture
E: WBC count
Explanation:
These symptoms are consistent with a urinary tract infection (UTI). Appropriate next steps include:
C. Broad-spectrum antibiotic: Initiate treatment empirically until culture results guide specific therapy.
D. Urinalysis and urine culture: Essential to confirm diagnosis and identify the causative organism.
E. WBC count: Helps assess systemic involvement or inflammation.
Why Other Options are Wrong:
A. 0.9% sodium chloride infusion at 100 mL/hr:
While hydration is important, IV fluids are not routinely needed for mild or outpatient UTIs unless the client is dehydrated or unable to tolerate oral fluids.
B. Foley catheter placement:
Increases risk of introducing or worsening infection. Catheters are avoided unless there's urinary retention or another compelling need.
E. Blood cultures x2:
Reserved for suspected urosepsis or more severe systemic infection (e.g., high fever, hypotension). Not typically required for low-grade fever and mild symptoms.
A nurse is performing an assessment of a female client in the clinic. The client reports foul-smelling urine and pain with urination. The client states, “I bet I have a UTI. Why do I tend to get urinary tract infections?” Which of the following statements should the nurse include in the explanation
If you take too many showers you are more susceptible to getting a UTI because you are washing off the protective bacteria.
As a female, you have a shorter urethra creating an easier way for bacteria to invade your bladder.
As a female, you have more E. coli in your gastrointestinal system that can enter the bladder through your urethra.
At your age, you have more sexual intercourse than older females making you more likely to get a UTI.
Correct Answer B: As a female, you have a shorter urethra creating an easier way for bacteria to invade your bladder.
Explanation:
The short female urethra, along with its proximity to the anus and vagina, makes it easier for bacteria (especially E. coli) to travel to the bladder, increasing the risk of urinary tract infections. This is the most clinically relevant explanation for recurrent UTIs in females.
Why Other Options are Wrong:
A. If you take too many showers you are more susceptible
While hygiene practices can affect flora, routine showering does not significantly increase UTI risk. Overwashing is not a common cause.
C. As a female, you have more E. coli in your gastrointestinal system
The presence of E. coli in the gut is normal for all humans. The difference in UTI risk is due to urethral length and anatomy, not bacterial abundance.
D. At your age, you have more sexual intercourse
This is speculative and inappropriate unless the nurse has relevant data. While sexual activity is a known risk factor, assuming it based on age is not evidence-based or respectful.
A nurse is teaching a client, who is newly diagnosed with type 1 diabetes mellitus, about insulin safety. Which of the following statements by the nurse is appropriate
All insulins can be mixed in the same syringe.
Storing insulin in the freezer will prolong its stability.
Insulin is stable at room temperature for one month.
Clients with type 1 diabetes mellitus should keep backup medication and supplies in their car.
Correct Answer C: Insulin is stable at room temperature for one month.
Explanation:
Most insulins are safe to store at room temperature (below 86°F/30°C) for up to 28–30 days once opened. This makes it easier for clients to carry and use insulin without constantly needing refrigeration, while still maintaining efficacy.
Why Other Options are Wrong:
A. All insulins can be mixed in the same syringe.
Not all types of insulin are compatible for mixing. For example, long-acting insulins like glargine or detemir should not be mixed with other types. Mixing incompatible insulins can alter absorption and effectiveness.
B. Storing insulin in the freezer will prolong its stability.
Freezing insulin destroys its molecular structure, rendering it ineffective and potentially dangerous. Insulin should never be frozen.
D. Clients with type 1 diabetes mellitus should keep backup medication and supplies in their car.
This is unsafe because temperature fluctuations in a car (especially extreme heat or cold) can degrade insulin. Backup supplies should be kept in a temperature-controlled environment.
. A nurse is caring for an older adult client who has osteoporosis. Which of the following should the nurse recognize as the pathophysiology of osteoporosis
Bone loss in the cortical and cancellous bones
Buildup of inflammation in the joints
Increase in calcium levels in the blood
Autoimmune disorder affecting the bones
Correct Answer A: Bone loss in the cortical and cancellous bones
Explanation:
Osteoporosis is a condition characterized by decreased bone density and mass, affecting both cortical (compact) and cancellous (spongy) bone. The result is porous, fragile bones that are prone to fractures. The imbalance between bone resorption and formation leads to a gradual loss of bone tissue.
Why Other Options are Wrong:
B. Buildup of inflammation in the joints:
This describes the pathophysiology of arthritis, particularly rheumatoid arthritis or osteoarthritis—not osteoporosis. Osteoporosis involves loss of bone mass, not joint inflammation.
C. Increase in calcium levels in the blood:
Osteoporosis may slightly affect serum calcium during bone resorption, but the hallmark is low bone density—not hypercalcemia. Calcium levels in the blood often remain normal.
D. Autoimmune disorder affecting the bones:
Osteoporosis is not autoimmune in nature. Autoimmune bone disorders, such as rheumatoid arthritis or lupus, are inflammatory, whereas osteoporosis is a metabolic bone disease.
A nurse is caring for a client in the emergency department with a diagnosis of renal calculi. Which of the following areas of the renal system does most renal calculi begin forming
Ureter
Urethra
Bladder
Renal papilla
Correct Answer D: Renal papilla
Explanation:
Renal calculi (kidney stones) typically form in the renal papilla, the region of the kidney where urine is first collected before entering the calyces and renal pelvis. Here, high concentrations of calcium, oxalate, or uric acid can precipitate, forming crystals that may eventually grow into stones.
Why Other Options are Wrong:
A. Ureter:
Stones may travel through the ureter and cause obstruction and pain, but they do not usually form there.
B. Urethra:
The urethra is the exit point for urine. It is not a site of stone formation but can become obstructed by a stone that has traveled from the upper urinary tract.
C. Bladder:
While stones can sometimes be found in the bladder (especially if urine is retained), primary formation usually starts in the kidney, not the bladder.
A nurse has been notified that a child is being admitted from the emergency department with confirmed active tuberculosis (TB). Which of the following should the nurse implement when caring for this client
Assign the child to a single occupancy room
Designate the child for airborne isolation precautions
Assign the child to a negative pressure room
Utilize an N95 HEPA filter or respirator
Assign staff who have been fit-tested for the respirator mask
Allow the child to use the unit playroom when it is unoccupied
Correct Answers:
A. Assign the child to a single occupancy room
B. Designate the child for airborne isolation precautions
C. Assign the child to a negative pressure room
D. Utilize an N95 HEPA filter or respirator
E. Assign staff who have been fit-tested for the respirator mask
Explanation:
A. Assign the child to a single occupancy room
A child with active TB should be placed in a private room to prevent transmission to other clients.
B. Designate the child for airborne isolation precautions
TB is transmitted via airborne droplets, so airborne precautions are essential, including the use of isolation signage and PPE.
C. Assign the child to a negative pressure room
A negative pressure room prevents airborne particles from leaving the room, minimizing the risk of transmission to others in the facility.
D. Utilize an N95 HEPA filter or respirator
An N95 or HEPA-filtered respirator is necessary to protect staff from inhaling airborne TB bacteria.
E. Assign staff who have been fit-tested for the respirator mask
Proper fit-testing ensures the respirator provides an effective seal for protection against airborne pathogens.
Why the Other Option Is Incorrect:
F. Allow the child to use the unit playroom when it is unoccupied
Even if unoccupied, the child with active TB should not use the unit playroom due to the risk of airborne transmission in shared spaces.
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